Mental Health: Alternatives to the Medical Model Flashcards
Made from summary table
Biological approach (medical model)
Type of disorder?
Psychotic disorder.
-> A mental state often described as involving a “loss of contact with reality”).
Example:
-> Schizophrenia
-> Bipolar / unipolar disorder
Biological approach (medical model)
DSM-V symptoms
Example: Schizophrenia.
Two or more of the following, each present for a significant portion of time during a one-month period:
1- Characteristic symptoms:
* Delusions
* Hallucinations
* Disorganised speech
* Grossly disorganised or catatonic behaviour.
* Negative symptoms.
2- Plus:
* Social occupational dysfunction: For a significant portion of time since the onset of the disturbance one or more major area of functioning.
* Duration: continuous symptoms for 6 months, and within this 6-month period – 1 month of active phase symptom.
* The disturbance is not due to a medical problem or drug abuse.
Biological approach (medical model)
Studies to support the approach?
Key study:
* Gottesman et al (2010) -> Investigates the importance of genetic influence on offspring where both parents have been admitted with a severe psychiatric disorder.
- Used secondary research (medical records / office for national statistics).
- Sample: Population of Denmark.
- Diagnosed using ICD-8 & 10 (concurrent validity).
- Mental disorders studied: schizophrenia, bipolar / unipolar disorder.
- Found that there was a higher probability of offspring developing the same mental disorder as their parents if both their parents had previously been diagnosed (27.3%). (As opposed to one (7%) / none (0.85%)).
Other studies:
* Gottesman and Shields (1976) -> Twin study.
Showed that when looking at the development of schizophrenia, twin studies consistently find higher concordance rates in monozygotic twins than dizygotic twins. This suggests evidence of a genetic predisposition. cause of schizophrenia (but not 100% so must be partly due to environment).
- Brown et al. -> Brain abnormality.
Biological approach (medical model)
How does it explain mental illness?
That mental illness is due to 3 main factors:
1) Genetics
Offspring inherit genes from parents which means they develop the same mental disorder.
2) Biochemical
Due to neurotransmitters e.g., dopamine, serotonin, and noradrenaline.
3) Brain abnormality
Biological approach (medical model)
Treatments?
Assumes mental illness is due to biochemical explanation:
1) Drugs (chemotherapy)
E.g., schizophrenia = antipsychotics.
2) ECT (Electro-Convulsive Therapy)
3) Psychosurgery (brain surgery)
Behaviourist approach
Type of disorder?
Anxiety disorder.
-> A continuous feeling of fear and anxiety, which may be triggered by something that may seem trivial / irrational to others.
->Can be experienced on several levels: emotionally, cognitively, physiologically, and behaviourally.
E.g., phobia.
Behaviourist approach
DSM-V Symptoms?
E.g., phobia:
- Marked an persistent fear that is excessive or unreasonable.
- Exposure to phobic stimulus provokes immediate anxiety response.
- The person recognises the fear as excessive.
- The phobic situation is avoided.
- The fear is out of proportion to the actual danger posed by the specific object or situation.
- The phobia disrupts the person’s normal life.
- The phobia has lasted more than 6 months in people under 18 years of age.
Behaviourist approach
Studies to support the approach?
Key study:
* Watson & Raynor (1920) Conditioned emotional reactions (Little Albert). -> Classical conditioning.
- Aim:
To see if it is possible to induce fear of a previously un-feared object through classical conditioning and to see if the fear will be transferred to other, similar objects. - Method:
Case study conducted under controlled laboratory conditions. - Ps: Little Albert.
- Procedure:
Little Albert was shown items which he should not fear e.g., white rat, mask, rabbit etc. Then, once he was given them again there would be a loud noise. This association with the e.g., white rate with the loud noise made Little Albert fear the white rat (developed a phobia of rats). - Learning through association.
Other studies:
-
Bandura
-> Social learning theory.
Where aggression was learnt through the behaviour of models. This links to mental illness because e.g., if a parent displayed symptoms for a mental disorder, their child could learn their behaviour and develop it as well. -
Chaney
-> Classical and operant conditioning. -
Ivan Pavlov (1849 – 1936)
= dogs -> Classical conditioning.
Shows that animals can learn to associate a conditioned stimulus with an unconditioned stimulus (rang a bell before the dog was fed). -
Skinner (rats)
-> Operant conditioning. - Rats given positive reinforcement (behaviour had no consequence. If lever pressed the rat gets food).
- Rats given negative reinforcement (floor is electrified and lever turns off the current).
- Rats given punishment (instead of given treat for pushing lever, given an electric shock).
Behaviourist approach
How is mental illness explained?
That mental illness is due to our environment / experiences.
- Tabala Rasa: “We are born blank slates”.
- This means we can ‘unlearn’ mental disorders e.g., phobia (anxiety disorder).
Can unlearn mental disorder e.g., phobia using:
1) Operant conditioning (Positive / negative reinforcement / punishment).
2) Classical conditioning -> e.g., desensitisation (exposure to e.g., phobia to unlearn fear / behaviour).
3) Social learning theory -> learn through observing behaviour of (role) models. Means we can unlearn / relearn behaviour through observing ‘positive’ models (e.g., people without mental disorder / ‘normal’ / desired behaviour).
Cognitive approach
Type of disorder?
Affective disorder.
-> Marked by a disturbance of mood or emotions, which prevents the individual from leading a ‘normal’ life.
E.g., depression.
Cognitive approach
DSM-V symptoms?
E.g., major depressive disorder.
Five or more of the following symptoms during the same 2-week period.
- Depressed mood most of the day (e.g.,
sad, empty or hopeless). - Markedly diminished interest in most
activities. - Significant weight loss.
- Insomnia most nights.
- Fidgeting or lethargy.
- Tiredness.
- Feeling of worthlessness or guilt.
- Diminished ability to concentrate.
- Recurrent thoughts of death.
- These symptoms are not caused by medication, or situations they are enough to hinder the person from important day-to-day activities / life.
Cognitive approach
Studies to support the approach?
Key study:
* Aaron Beck
- ABC cognitive model of depression:
A = Activating event
B = Belief
C = Consequence.
-
Negative cognitive triad:
1) Defective / inadequate.
2) All experiences result in defeats /
failures.
3) Future is hopeless. - Beck et al (1974)
-
Aim: To understand cognitive
distortions in patients with depression. - Interviews with patients undergoing
therapy for depression. - Self-report.
-
Findings: Depressed patients
showed e.g., low self-esteem, self-
blame, desire to escape etc. - Conclusion: Even in mild depression, patients have cognitive distortions that deviate from realistic and logical thinking. Distortions only related to depression and not other areas.
Other studies:
-
Loftus & Palmer
-> eyewitness testimony. - Looked at how the critical verb affects estimated speed. (+ leading questions – saw glass / not).
- Links to mental health: perception and memory can be altered depending on people / their phrasing.
- **Grant et al. **
-> context dependent memory - Memory is better when in the same environment as learnt the information trying to remember.
- Links to mental health: shows that people’s perceptions can be affected by context.
-
Morray (1962)
-> auditory attention. -
Simon & Chabris (1999)
-> visual attention.
Cognitive approach
How is mental illness explained?
**That mental illness is due to the way people think. **
(Faulty thinking pattern)
E.g., depression -> negative interpretation / processing of situation / comments.
- “Our brains are like a computer”.
- They ‘input’, ‘process’, and ‘output’.
-
Cognitive-Behavioural Therapy (CBT).
-> a type of talk therapy that has been shown to be effective in treating depression. - CBT helps people learn how to identify negative patterns in their thoughts and behaviours that contribute to their depression.
- The therapist works with the individual to challenge and change these negative patterns and develop more positive ways of thinking and behaving.
- Cognitive Therapy (CT)
- Similar to CBT, but it primarily focusses on thoughts without incorporating behavioural interventions etc.
- It specifically emphasises identifying and challenging negative or distorted thoughts that contribute to emotion distress.
- It targets specific cognitive processes and aims to replace negative thinking patterns with more balanced and realistic thoughts.
Humanistic approach
Type of disorder?
Anxiety (e.g., phobia) and affective disorders (e.g., depression).
Humanistic approach
DSM-V symptoms?
**Anxiety disorder: **
E.g., phobia:
* Marked an persistent fear that is excessive or unreasonable.
* Exposure to phobic stimulus provokes immediate anxiety response.
* The person recognises the fear as excessive.
* The phobic situation is avoided.
* The fear is out of proportion to the actual danger posed by the specific object or situation.
* The phobia disrupts the person’s normal life.
The phobia has lasted more than 6 months in people under 18 years of age.
Affective disorder:
E.g., major depressive disorder.
Five or more of the following symptoms during the same 2-week period:
* Depressed mood most of the day (e.g., sad, empty or hopeless).
* Markedly diminished interest in most activities.
* Significant weight loss.
* Insomnia most nights.
* Fidgeting or lethargy.
* Tiredness.
* Feeling of worthlessness or guilt.
* Diminished ability to concentrate.
* Recurrent thoughts of death.
These symptoms are not caused by medication, or situations they are enough to hinder the person from important day-to-day activities / life.
