Issues in mental health: Topic One

Question 1

What is topic one?

Answer 1

The historical context of mental health

Question 2

What are the 3 historical views of mental illness?

Answer 2

Animism, humourism and animalism

Question 3

What is the general belief of animism?

Answer 3

That everyone and everything has a soul and mental illness was as a result of evil spirits taking possession of an individual and controlling their behaviour

Question 4

Some skulls of Paleolithic cave dwellers have been found with what?

Answer 4

Characteristic holes (trephines/trepanes) which were chipped out by stone instruments

Question 5

What was the purpose of trepanning?

Answer 5

To provide an exit for the evil spirit

Question 6

Who came up with the theory of humourism?

Answer 6

Hippocrates

Question 7

What did Hippocrates identify mental illness as?

Answer 7

A scientific phenomenon

Question 8

What did Hippocrates believe in terms of mental illness?

Answer 8

That ‘madness’ resulted from an imbalance of the four humours and could therefore be balanced to cure the person

Question 9

What were the 4 humours?

Answer 9

Blood, phlegm, yellow bile and black bile

Question 10

What did Hippocrates believe that depression (melancholia) was a result of?

Answer 10

Too much black bile

Question 11

What were some treatments used to rebalance the four humours?

Answer 11

Bloodletting, blistering and laxatives

Question 12

What was the main principle of animalism?

Answer 12

The idea to treat the mentally ill like animals

Question 13

What was the main reasoning for treating the ‘insane’ like animals?

Answer 13

Because they believed that madness caused a lack of capacity of ‘reason’ which they felt distinguished humans from beasts

Question 14

As a result of disordered and wild behaviour, what was the first part of treatment? (animalism)

Answer 14

To restore reason by keeping patients locked up, chained and possibly whipped

Question 15

Why were the mentally ill treated via bleeding, blistering and vomiting? (animalism)

Answer 15

As it was believed patients didn’t have sensitivities, like animals

Question 16

Who suggested the 4 ways of defining abnormality?

Answer 16

Rosenhan and Seligman

Question 17

What are the 4 ways to define abnormality?

Answer 17

Statistical infrequency, failure to function adequately, deviation from social norms and deviation from ideal mental health

Question 18

What is the general idea of statistical infrequency?

Answer 18

The idea that if something is outside the statistical ‘norm’ then it would be termed abnormal

Question 19

Give an example of statistical infrequency

Answer 19

Schizophrenia - only affects 3.5% of the population and is therefore statistically rare/abnormal

Question 20

What is failure to function adequately?

Answer 20

Whereby someone is unable to meet typical obligations and cannot live a ‘normal’ life they are seen as not functioning adequately

Question 21

Give some examples of things that would be considered a failure to function adequately

Answer 21

Not going to work, not maintaining relationships or not looking after one’s health

Question 22

What are social norms and therefore what can be abnormal behaviour be seen as?

Answer 22

Social norms are expected or approved ways of behaving so abnormal behaviour may be seen as that which deviates from social norms

Question 23

What is ‘ideal mental health’?

Answer 23

Being positive about yourself
Able to cope independently
Accurate perception of reality and being able to cope with demands
Positive social interactions

Question 24

What is deviation from ideal mental health?

Answer 24

When a person does multiple ‘abnormal’ things in terms of mental health

Question 25

Give some examples of behaviour which would show deviation from ideal mental health

Answer 25

Suffering, maladaptiveness, unconventional behaviour, irrationality, unpredictability and violation of moral standards

Question 26

How do we categorise mental disorders?

Answer 26

Using the DSM-5

Question 27

Who produces the DSM?

Answer 27

The American Psychiatric association

Question 28

What does DSM stand for?

Answer 28

Diagnostic and statistical manual of mental disorders

Question 29

Where else are mental disorders categorised other than the DSM?

Answer 29

The international classification of disease (ICD-10)

Question 30

How many categories of mental disorder are in DSM-5 and give some examples

Answer 30

22 categories including, depressive, anxiety, feeding and eating, sleep-wake disorders and sexual dysfunction disorder

Question 31

How does the DSM cluster disorders?

Answer 31

Into internalising disorders and externalising disorders

Question 32

Give an example of an internalising disorder

Answer 32

Depression

Question 33

Give an example of an externalising disorder

Answer 33

Impulsive disorder

Question 34

What other things does the DSM include information on?

Answer 34

Gender and culture related diagnostic issues, comorbidity (when disorders occur together), prevalence (frequency of issue within age groups) and diagnostic criteria

Question 35

What is the key research for topic 1?

Answer 35

Rosenhan - on being sane in insane places

Question 36

What was study 1 of Rosenhan's research?

Answer 36

Can psychiatric hospitals detect sanity?

Question 37

How many sane people phoned up for an appointment at how many different mental hospitals?

Answer 37

8 people called 12 different hospitals

Question 38

When the pseudopatients arrived at admissions what did they all report?

Answer 38

The same symptoms of hearing an unfamiliar voice of the same sex saying 'empty', 'hollow', 'thud'

Question 39

Once the pseudopatients were admitted what did they stop doing?

Answer 39

They stopped simulating any symptoms and took part in regular ward activities

Question 40

What diagnoses were the pseudopatients given?

Answer 40

11 were given a diagnosis of schizophrenia and 1 manic-depressive psychosis

Question 41

How long, on average did the pseudopatients remain in hospital?

Answer 41

19 days

Question 42

Upon discharge, what diagnosis were the pseudopatients given?

Answer 42

Schizophrenia 'in remission'

Question 43

How many patients at the hospital had suspicions about the pseudopatients?

Answer 43

35 out of 118

Question 44

Give some qualitative data from the patients about the pseudopatients?

Answer 44

'You're not crazy', 'You're a journalist or professor', 'You're checking up on the hospital'

Question 45

Outline which normal behaviours were seen as a symptom of their disorder

Answer 45

Note-taking and queuing up for lunch was described as displaying oral acquisitive behaviour that might be expected of someone with schizophrenia

Question 46

Who had access to patients records?

Answer 46

Anyone

Question 47

What was the total time a patient spent with psychologists, psychiatrists etc in a day?

Answer 47

6.8 minutes

Question 48

Describe the experiment in study 1

Answer 48

The pseudopatients would approach a member of staff with a simple polite request asking when they would be presented at the staff meeting

Question 49

What did pseudopatients record from the experiment in study 1?

Answer 49

They recorded how staff responded to the request (i.e. if they moved on with head averted, made eye contact, paused and chatted or stopped and talked)

Question 50

At how many of the hospitals did the pseudopatients conduct the experiment?

Answer 50

4

Question 51

What was Rosenhan's second study?

Answer 51

Can psychiatric hospitals detect insanity?

Question 52

What were the psychiatric hospital told in the second study?

Answer 52

They were informed that during the next three months, one or more pseudopatients would attempt to be admitted to the hospital

Question 53

In reality, how many pseudopatients did Rosenhan send to the hospital?

Answer 53

0

Question 54

How many patients were confidently judged as pseudopatients by one psychiatrist and one other staff member?

Answer 54

19 out of 193

Question 55

Summarise Rosenhan's conclusions

Answer 55

Mental hospitals made inaccurate and unreliable diagnoses in the 1970s and treated patients with profound language/disrespect

Question 56

What is an affective disorder?

Answer 56

A disorder that affects mood

Question 57

Give an example of an affective disorder

Answer 57

Depression

Question 58

What does the DSM-5 say about the diagnosis of depression?

Answer 58

That 5 or more symptoms must be present during the same 2 week period including either symptom 1 or 2 for a diagnosis of depression to be given

Question 59

What is symptom 1 of depression?

Answer 59

Depressed mood most of the day, nearly every day

Question 60

What is symptom 2 of depression?

Answer 60

Diminished interest or pleasure in all or most activities most of the day, nearly every day

Question 61

Give 3 other symptoms of depression

Answer 61

Insomnia or excessive sleep (hypersonic) nearly every day, Fatigue or loss of energy, Recurrent thoughts of death or suicide

Question 62

What is a psychotic disorder?

Answer 62

A disorder which causes someone to lose touch with reality (e.g. through hallucinations or delusions)

Question 63

Give an example of a psychotic disorder

Answer 63

Schizophrenia

Question 64

What are symptoms of psychotic disorders said to be?

Answer 64

Either positive or negative

Question 65

What does a diagnosis of schizophrenia require?

Answer 65

Major symptoms need to be persistent with at least 2 positive symptoms for at least one month

Question 66

Give some examples of positive symptoms of schizophrenia

Answer 66

Hallucinations (perceptual disturbances e.g. voices), Delusions (false beliefs)/Paranoid delusions/delusions of grandeur (believing you're famous) or disordered thinking (unable to concentrate and sort thoughts)

Question 67

Give some examples of negative symptoms of schizophrenia

Answer 67

Affective problems (reduction in range and intensity of emotion e.g. laughing at an inappropriate time), Poverty of speech (reduction in speech fluency) and reduced motivation

Question 68

Give an example of an anxiety disorder

Answer 68

Phobias

Question 69

What is a phobia?

Answer 69

An extreme or excessive fear or something with a physiological response

Question 70

What are the 3 types of phobia?

Answer 70

Agoraphobia, specific phobia or social phobia

Question 71

Describe agoraphobia

Answer 71

Fear of open spaces - typically the fear of not being able to escape. In extreme cases, agoraphobics become 'prisoners' in their own homes

Question 72

Describe social phobia

Answer 72

Intense and excessive fear of being in a situation in which one is exposed to possible scrutiny by others. Also, a fear of embarrassing oneself

Question 73

Describe specific phobia

Answer 73

A fear of a specific thing or situation (e.g. spiders)

Question 74

What are the strengths of the process of diagnosis?

Answer 74

DSM has a comprehensive list of symptoms and disorders, so can easily diagnose with the help of this

Question 75

What is a weakness of the process of diagnosis?

Answer 75

Reliant on a patient being honest about their issues and they could therefore exaggerate as they rely on self report