Issues & Debates: Historical context of MH (Topic 1) Flashcards
(7 cards)
Nature/Nurture
Historically mental illness been attributed to range of causes internal and external to individual.
Belief certain disorders caused by possession by evil spirits could be considered ‘supernatural’ rather than result of nature or nurture.
Several ways of defining abnormality: Those involving cultural perspectives i.e deviation from social norms & maladaptiveness argue for strong role in environment in determining what is abnormal.
Some cultures perceive behaviour as normal, may be abnormal in another.
Rosenhan research examined way in which environment (way we are nurtured) affects our mental health & treatment we receive from others. Found once labelled mentally ill, difficult to have one’s behaviour perceived as anything other than abnormal. Interpreted writing as ‘obsessive’ and way which patients were ignored when speaking to hospital staff.
Conducting socially sensitive research
Diagnosis of mental illness is socially sensitive topic in itself- a diagnosis can have profound consequences on individual, family & wider community.
Using social norms definition of abnormality may been some eccentric individuals defined as abnormal just because lifestyle differs to other members of same society. Socially sensitive as subgroups judged and treated different- negative consequences for these groups.
Many nurses complained Rosenhan’s research made their profession look bad- overall benefit to society has been enormous, study raised awareness of flaws in psychiatric diagnosis and subsequent treatment. Diagnostic systems became more strict as consequence.
Free will/ Determinism
Many historical viewpoints of mental illness considered determinist; attribute mental illness to particular biological cause i.e brain structure/function. (Biological determinism)
‘Failure to function adequately’ definition of abnormality suggests element of free will- person free to adjust/ control aspects of life- things that are not predetermined, can be changed i.e activities.
Reductionism/ Holism
Applies to definitions of abnormality: Statistical infrequency is very one dimensional- single factor determining normal from abnormal is frequency in which particular symptom/trait is experienced by general population.
Deviation from social norms is limited picture of abnormality: relies on specific values of culture part of.
Judging abnormality as behaviour or thinking that is maladaptive is more holistic; considers diff aspects of functioning, what is relevant to individuals social, cognitive and emotional needs in context.
DSM classification system offers range of criteria for clinicians to make diagnosis- system can be argued to be reductionist as is simply trying to capture nature of mental illness using list of criteria & cannot offer complete picture of each disorder.
Individual/ situational explanations for behaviour
Some historical viewpoints of mental illness focus on individual as source of mental illness- bodily humors, genes, unconscious; may be source of mental illness (individual).
Deviation from ideal (definition of abnormality) also focuses on individual- suggesting they lack factors that would give them ideal mental health e.g self attitudes.
Rosenhan evidence for situational- labelling & interpretation of mental illness; behaviour of pseudo-patient interpreted according to given label and normal behaviours seen as symptoms of their illness diagnosed.
Deviation from social norms (abnormality definition) = situational argument, suggests behaviour considered abnormal is only defined because of situation behaviour appears in.
Psych as a science
Older historical viewpoints of mental illness not very scientific e.g demonic possession is not falsifiable concept.
Hippocrates theory of 4 humors was first main theory to take physiological abnormalities as explanation for mental illness- can be seen as scientific as is based on objective & measurable physiological phenomena.
Statistical infrequency definition of abnormality= most scientific as uses objectively measurable, quantitative concept.
Failure to function adequately can be judged as scientific- clinicians can objectively list behaviours identifiable as ‘abnormal’.
Deviation from ideal mental health= subjective as concepts hard to operationalise (e.g self actualisation).
Usefulness of research
Rosenhan’s findings question validity & reliability of psychiatric diagnosis as well as raising concerns of treatment received by patients in mental health institutions.
Clear implications for the profession in terms of reviewing diagnostic processes and bringing issues concerning patient experience forward.
Rosenhan’s explanations for experiences of patients and his suggestion to improve conditions; focus on educating staff & changing fundamental methods of practice involved in diagnosis and treatment of ‘insane’.
