Unit 3 Issues in Mental Health Topic 1: The Historical Context of Mental Health

Question 1

What are the three historical views of mental health?

Answer 1

Animism, Humorism, Animalism.

Question 2

What is Animism?

Answer 2

SUPERNATURAL EXPLANATION. People have souls which evil spirits can take control of. This can cause madness. Trepanning.

Question 3

What is Humorism?

Answer 3

SOMATOGENIC EXPLANATION. Four humours need to be balanced in order to have good wellbeing.

Question 4

What is Animalism?

Answer 4

BASED ON SOMATOGENIC EXPLANATION. Mental health caused by inability to reason. Restore reason through fear (treated like animals at Bedlam) such as whipping, making them bleed and locking them up.

Question 5

Who was it that “defined abnormalities”?

Answer 5

Rosenhan and Seligman

Question 6

What are the four different ways of defining abnormality?

Answer 6

Statistical infrequency
Failure to function adequately
Deviation from social norm
Deviation from idealistic mental health

Question 7

Regarding Rosenhan and Seligman’s defining abnormality, what was statistical infrequency?

Why was this a bad way of defining abnormality?

Answer 7

Rare behaviours are abnormal.

However bad because more rare and less rare behaviour are put in the same box.

Question 8

Regarding Rosenhan and Seligman’s defining abnormality, what was failure to function adequately?

Why was this a bad way of defining abnormality?

Answer 8

(i.e.) hold down a job, maintain a relational, and interact effectively in society.

However, bad as this may be due to other factors.

Question 9

Regarding Rosenhan and Seligman’s defining abnormality, what was deviation from social norms?

Why was this a bad way of defining abnormality?

Answer 9

Doesn’t follow social norms.

Bad because just because you don’t follow social norms doesn’t mean you have a psychological disorder.

Question 10

Regarding Rosenhan and Seligman’s defining abnormality, what was deviation from ideal mental health?

Why was this a bad way of defining abnormality?

Answer 10

Feeling positive about yourself, positive interactions and self discipline.

Bad because its hard to operationalise, and we ALL go phases like this.

Question 11

How are mental health issues catagorised?

Answer 11

DSM-5 in USA, ICD-10 in Europe.

22 different categories put in lifespan order.

Question 12

What is a downside to the way mental health issues are categorised?

Answer 12

While it may be a starting point, it does not offer EXPLANATION or TREATMENTS for disorders.

May cause harm by labelling a mental health issues something that it isn’t. Corporal pressure to diagnose patients in order for pharmaceutical companies to provide treatments and gain profit.

Question 13

What research was conducted which suggests the way we categorise disorders can be harmful to patients?

Answer 13

Krimsky and Cosgrove found 69% of those who worked on the DSM-5 also had links to the pharmaceutical industry which may have biased the diagnoses (they would want more diagnoses so the pharmacy can gain more money from treatments).

Question 14

What was the aim of Rosenhan’s study?

Answer 14

To investigate if USA hospitals in early 1970s could detect sane from insane.

Question 15

In Rosenhan’s first study, how did the pseudopatients get into the mental hospital?

Answer 15

8 sane people called up hearing voice say ‘hollow’. One diagnosed with manic depression and the others schizophrenia.

Question 16

In Rosenhan’s first study, what was the pseudopatients experience inside of the mental hospital? How did they act? What did they witness?

Answer 16

Stopped displaying symptoms once in hospital. Normal behaviour were misinterpreted such as their note taking.

Staff were brutal to patients when no one else was around.

Only spent an average of 6.8 minutes with psychiatrist per day. In there of an average of 19 days.

Question 17

In Rosenhan’s first study, what did the pseudopatients ask to investigate the treatment of patients in mental hospitals?

Answer 17

In 4 hospitals, pseudopatients asked ‘Pardon me, Mr/Mrs/Dr, could you tell me when I will be present at the staff meeting?’

Comparison done by young female in both Stanford University (‘Pardon me, could you direct me to Endica Hall?’) and University Medical Centre (‘I’m looking for a psychiatrist’).

Question 18

What were the results of Rosenhan’s first study?

Answer 18

0.5% stopped and talked out of 1283, but at Stanford University 100% stopped and talked to her.

Question 19

What was Rosenhan’s second study?

Answer 19

Hospital aware of first study were informed one or more pseudopatient would be admitted over the next three months, but none were sent.

Each member of staff had to rate on a 10-point scale the likelihood that someone was a pseudopatient.

41 patients confidently judged as pseudopatient by at least one member of staff.

Question 20

What conclusions can be made by Rosenhan’s studies into sanity and insanity?

Answer 20

Mental hospitals in 1970’s US are not good at making valid diagnosis, as they failed to detect sanity and insanity.

There were not very good at making reliable diagnoses either, as 1/12 was diagnosed with manic depressive disorder as opposed to schizophrenia.

Mental hospitals viewed all behaviour are reflecting diagnoses- ‘stickiness’ of psychodiagnostic labels.
Patients disrespected.

Question 21

What are the characteristics of an affective disorder?

Answer 21

Depression:
5/9 symptoms for at least 2 weeks, and must include either (i) depressed mood most of the day nearly every day or (ii) loss of pleasure in activities.

Question 22

What are the characteristics of a psychotic disorder?

Answer 22

Schizophrenia
A person must experience 2/5 of the following symptoms in one month, and one must be (1), (2), or (3).
Delusions
Hallucinations
Disorganised speech
Disorganized/catatonic behaviour
Negative symptoms (i.e.) diminished emotional expression.

Question 23

What are the characteristics of an anxiety disorder?

Answer 23

Phobia.
Lasts 6+ months. Extreme fear of a specific object or situation, which provokes immediate fear/anxiety. Not better explained by symptoms or another mental disorder.