mental health Flashcards
(29 cards)
the historical context of mental health topic 1 topics
Rosenhan - being sane in insane places
-historical views of mental illness
-categorising mental illness
-defining abnormality
four historical views of mental illness
demonic possession - arise from evil spirits taking control of individual
could be the spirits of animals, gods, heroes
treatment was creating holes in the skull to let evil spirit out
humourism by Hippocrates - blood, phlegm, yellow bile and black bile need to be balanced
treatments consist of diets purgatives bleeding and sexual abstinence
animalism - insane should be treated like animals e.g Bedlam chained to walls and bled to a point of unconsciousness
moral treatment - Pinel petitioned to remove chains and exercise patients in the open air, proved to be effective
defining abnormality 3 problems
statistical infrequency - any behaviour shown less than the normal amount can be regarded as abnormal just due to the fact it is not the statistical norm, many behaviour skills may be rare but not abnormal e.g high IQ
failure to function adequately - defining abnormality can centre on an inability to live a normal life adequately such as holding down a job, may not want job/relationship
deviation from social norms - if they go against behaviours that are deemed by society to be acceptable, these social norms change across time so what is normal? e.g gender identity
categorising mental health disorders DSM and ICD
ICD currently on version 10, developed by World Health Organisation
DSM is currently on version 5, used mainly in USA
DSM tries to place the disorders in chronological lifespan order, in accordance with when within a persons life it is most likely to occur
disorders organised into 22 categories e.g obsessive-compulsive, eating disorders
for each disorder there is detail on diagnostic criteria, gender-related diagnostic issues and culture related diagnostic issues
Rosenhan study 1 aim
can psychiatric hospitals detect sanity?
Rosenhan study 1 sample
8 sane people phoning for appointment at 12 different hospitals
Rosenhan study 1 procedure
all reported same symptoms of hearing unfamiliar voice of same sex saying empty, hollow and thud
once admitted they stopped and wrote notes about ward staff and patients
all patients other than 1 admitted with schizophrenia
remained there for 7-52 days
35/118 patients said your not crazy
group of patients queuing up early for lunch said to be a symptom
ward orderlies brutal to patients
6.8 mins a day of patient to psychologist time
Rosenhan study 1 experiment
in 4 of the hospitals the patients approached a staff member with a simple request e.g could you tell me when i will be presented at the staff meeting?
they recorded how staff responded to this request e.g made eye contact, paused and chatted or stopped and talked
comparison study done at Stanford University with a young female approaching a staff member who looked busy and asking them 6 questions e.g Could you direct me here?
another study done an University Medical Centre with a young female saying amongst 6 questions she had to ask I’m looking for a psychiatrist
Rosenhan study 1 results
in psychiatric hospitals most psychiatrists and nurses moved on with head averted e.g 88 nurses, whereas in uni and medical centre 0 did this
100% of university staff and uni medical centre stopped and talked when asked for an internist
Rosenhan study 2 procedure
a teaching and research hospital that was aware of 1st study was informed that in the next 3 months one or more pseudopatients would attempt to be admitted to the hospital
each member of staff rated patients on 10 point scale of their likelihood to be a pseudopatient
in practice, no pseudopatients attempted to be admitted during this period
Rosenhan study 2 findings
41/193 confidently judged as pseudopatients by at least one staff member
19/193 for psychiatrist and staff member
strengths and weaknesses of diagnosing disorders
-clear criteria of symptoms should lead to a more accurate diagnosis
-DSM more scientific
-diagnostic criteria take into account other causes of symptoms
-issues in terms of how doctor assesses patient e.g observing or relying on self report which may be bias
-may not show all symptoms or haven’t shown them for long enough to recieve treatment
-may show symptoms of more than one illness
the medical model topic 2 topics
Gottesman et al
biochemical explanation
genetic explanation
brain abnormality
biochemical explanation of mental illness
depression - low levels of serotonin as it is reabsorbed into presynaptic neurone, so stimulus received cannot generate the appropriate response
drugs called SSRIS inhibit serotonin reabsorption so that it will all be absorbed by post synaptic neurone
schizophrenia - high levels of dopamine
anti-psychotic drugs bind to dopamine receptors preventing an overload of dopamine reaching post synaptic cell
symptoms of schizophrenia similar to cocaine users from excessive dopamine
genetic explanation of mental illness
twins who have identical genetic make-up with dizygotic twins helps us to understand impact of genes and environment
Gottesman and Shield: 58% concordance rate for monozygotic twins
12% dizygotic twins
evolutionary theory by Darwin states genetic traits are passed on via evolution if advantageous
Ohman demonstrated this by showing participants face houses and snakes with mild electric shock, stress measured by sweat showed snake shock easily conditioned the people to be scared
embryo manipulation can reduce inheritance of genetic disorders by using genetic material from three parents
brain abnormality as an explanation of mental illness
with age, sex and year of birth controlled for, brains of patients with schizophrenia were 6% lighter and had enlarged lateral
Weinberger used MRI scans of identical twins but only 1 had schizophrenia, finding differences in prefrontal cortex and hippocampus volume
patients with depression show a smaller hippocampus volume than normal people
stress releases cortisol which destroys hippocampal cells so they cannot respond to serotonin
Sheline et al found elderly woman with depression in remission had smaller hippocampus than woman of same age
drug therapy and surgery used as treatment
Gottesman et al aim
to investigate in a diverse sample the probability of a child being diagnosed with a mental disorder if either or both of their parents had this disorder
Gottesman et al sample
anyone in Denmark between 10-52 years and with a clear link to their biological parents
almost 2.7 million people
Gottesman et al procedure
Gottesman et al identified 4 groups of people:
-both parents admitted to psychiatric hospital with diagnoses of schizophrenia, bipolar or depression
-one parent admitted
-neither parent admitted with a diagnosis of a disorder
-the general public
Gottesman et al findings
27.3% people with 2 parents admitted had schizophrenia, compared to 0.86% with neither parent
genetic overlap with schizophrenia and bipolar, 10.8% had bipolar if parents were schizophrenic, 4.8% had schizophrenia if parents were bipolar
at age 52 very few people received fresh diagnosis of schizophrenia but bipolar disorder diagnosis were still being made
2 applications of medical model (topic 2)
SSRIS block reuptake of serotonin by presynaptic neurone, so there is a greater amount of serotonin in synapse, increasing likelihood of sufficient serotonin reaching post synaptic receptor sites and triggering an electrical impulse. can be used to treat depression and anxiety
electro convulsive therapy (ECT) is where a patient has electrodes placed on their temples to pass an electric shock to their brain, aiming to trigger an epileptic seizure in an attempt to jump start the brain and relieve symptoms of mental disorder
application for historical context of mental health (topic 1)
depression characteristics:
-depressed mood nearly everyday
-diminished interest or pleasure in activities
-fatigue or loss of energy
-feelings of worthlessness
-recurrent thoughts of suicide
schizophrenia characteristics:
-delusions
-hallucinations
-disorganised speech
-disorganised behaviour
phobia characteristics:
-extreme fear of object/situation
-fear of open spaces
-majority people that experience are female
-intense fear of scrutiny of other people
alternatives to the medical model (topic 3) topics
-behaviourist explanation of mental illness
-cognitive explanation of mental illness
-psychodynamic explanation of mental illness
-Szasz, the myth of mental illness
behaviourist explanation of mental illness
Watson and Raynor outlined the case of Little Albert was made phobic of rats, despite previously
having no fear of them, done by repeated pairings of a loud noise with a white rat and this was generalised to other
white things like rabbits (classical conditioning)
signs of anxiety when see a large dog, and the comfort/attention from parent is then taken as a reward
someone with a lift phobia gets towards the lift
doors and experiences anxiety, if they walk away this removes the feelings of anxiety, and so encourages them to take the stairs next time (operant conditioning)
if a child sees a significant adult with a phobia of a particular animal, they might imitate this behaviour (SLT)
