Mental Health

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  • Mental Health
    • History of mental health
      • 1500 BC
        • Ancient Egyptian records recognised depression
        • Trephination (drilling holes in head to release evil spirits)
        • Other treatments included temple attendance and exorcism to drive demons out
      • Hippocrates
        • Madness as a result of an imbalance of the four humours
          • Depression a result of an imbalance of black bile
            • Believed certain diets would cure this
      • 1300's-1400's
        • Burning of witches common. Hysteria and epilepsy confused as witchcraft. More prevalent in women so more women burnt as witches. Faded in 1500's due to greater understanding.
      • 1800's
        • Mental asylums
          • Housing and confining mentally ill
          • Lived in filth, chained and exhibited to public
          • Treatments included purges, bleedings and emetics (medicine to make you throw up. Gyrating chair aimed to shake up the blood and tissues to restore equilibrium.
      • 1900's
        • Mental asylums viewed as poor treatment
        • Psychiatry recognised
        • Mental illness accepted as biological and unconscious conflicts of Freud's theory recognised
        • Talking therapies brought forward
      • Today
        • Biological
          • Chemical and medical techniques used
    • Definitions of Mental Health
      • Statistical infrequency
        • A person's trait, thinking or behavior is classified as abnormal if it is rare or statistically unusual
        • Normal distribution curve
          • Extremes (5%) are seen as abnormal
      • Failure to function adequately
        • Considered abnormal if they cannot live life adequately
          • Hold down a job, look after themselves, etc.
        • Maladaptiveness
        • Global Assessment of Functioning Scale ( GAF)
      • Deviance from social norms
        • Societies have social norms maintained through laws, guidelines and societal pressure. People who do not abide by this may be considered abnormal.
      • Ideal Mental Health
        • Jahoda
          • Positive attitude towards the self (self esteem)
          • Self-actualisation (becoming the best you you can be)
          • Autonomy (independence and self-reliance)
          • Environmental mastery (can adapt to all new situations)
          • Accurate perception of reality (should have a perspective that is similar to how others see the world)
          • Resistance to stress (should not feel under stress and should be able to handle stressful situations competently.)
    • Categorising mental health
      • DSM (Diagnostic Statistical Manual of Mental Disorders)
        • Updated/reviewed at regular intervals
        • Mental Illnesses only
        • Mainly used in America
        • Evaluate the patient in five axes
        • Holistic
          • Uses all the features of the way a person behaves to build an accurate diagnosis
      • ICD-10 (International Classification of Diseases and Related Health Problems)
        • By the  World Health Organisation (WHO)
        • Revised every 10 years
        • Includes all diseases and disorders, not just mental disorders
          • Only chapter V is relevant for mental disorders
        • Symptom-based
        • 10 Groups of disorders
    • Evaluation of defining and categorising mental health
      • Strengths
        • Reliable way to categorise and diagnose behaviours.
        • Helps to direct appropriate treatment.
        • Helps individual come to terms and understand why they are different
      • Weaknesses
        • Subjective- can change from one health professional to the next.
        • Requires self report from people who may not see behaviour as abnormal. May lie due to social desirability.
        • Ethnocentrism- different cultures perceive behaviour differently.
        • Overlap- e.g. loss of pleasure factor in depression and schizophrenia.
        • Ignores biological symptoms only focuses on behavioural.
    • The medical model
      • Biochemical Explanation (depression)
        • SSRI'S
          • Selective serotonin reuptake inhibitors
            • Stop the serotonin from being reuptaken so there is a build up of serotonin in the synaptic gap.
        • MAOI's
          • Inhibit monoamine oxidase so that the monoamines are not broken down leading to a build up of monoamines in the synaptic gap.
        • Neurotransmitters are called monoamines
          • Serotonin, noradrenaline and dopamine
            • Dopamine responsible for mood. Serotonin controls activity of noradrenaline and dopamine.
              • In depressed people serotonin levels are low which decreases levels of dopamine resulting in low moods.
      • Enzymes
        • High levels of the enzyme that breaks down monoamines resulting in disrupted brain messages impacting mood.
        • The enzymes which breaks these monamines down is monoamine oxidase.
      • Brain abnormality
        • Studies shown the frontal lobe (the region of the brain responsible for thinking, emotions etc) is smaller in depressed patients.
      • Genetic explanation
        • 2 short alleles of the 5-HTT gene can lead to a predisposition to depression.
        • Adoption Studies
        • Twin Studies
          • Concordance rate of 87% between MZ twins and 72% between DZ twins
          • Gottesman (1991) did a Meta-analysis of 40 twin studies in schizophrenia and found a concordance rate of 48% for identical twins and 17% for non-identical twins.
          • Identical twins (also called monozygotic twins) share 100% identical genes.
            • Expected 100% concordance rate in MZ twins.
          • Non-identical twins (also called dizygotic twins) share 50% identical genes.
          • Concordance rate=the likelihood of one twin showing the characteristic of the other twin.
        • Family Studies
    • Behaviourist explanation of depression
      • Operant conditioning- People learn behaviours through reinforcement
        • Operant conditioning states depression is caused by removal of positive reinforcement
          • Eg. losing a job can remove positive reinforcement. This can result in social isolation so even less reinforcement
      • Classical conditioning- Proposes depression is learned through associating certain things with negative states
        • For example going to work may be associated with depressive moods. By avoiding going to work they are further isolated causing more depression.
      • Social Learning theory- Children may see role models reacting to challenges in life in an unhealthy way.
        • Therefore imitate this so become helpless frustrated and depressed.
      • Flooding
        • Stimuli presented directly eg someone scared of spiders given spider.They realise nothing bad will happen. Associate with calm. Difficult to apply to depression
      • Aversion therapy
        • Unpleasant association with symptoms. E.g. electric shocks.
      • Positive reinforcement
        • Only reward when non- depressive symptoms shown
    • Cognitive explanation of depression
      • Errors in cognitive processes explain mental health.
      • Irrational cognition involved in depression. The way the individual perceives the situation is the problem not the situation.
      • Beck's cognitive triad
        • Negative thoughts about the self, the world and the future
        • Interacts with negative schemas and cognitive biases to produce depressive thinking
      • Ellis's ABC model
        • Ellis believes that it is not the activating event (A) that causes depression (C), but rather that a person interpret these events unrealistically and therefore has an irrational belief system (B) that helps cause the consequences (C) of depressive behaviour.
      • Errors in logic
        • Overgeneralisation: When we draw a faulty conclusion about something based on just one example
        • Magnification: If they have a problem they make it appear bigger than it is
        • Personalisation: Negative events are interpreted as their fault.
        • Negative Bias: The tendency to notice and dwell on negative information while neglecting positive information.
      • Negative shcema's
        • Acquired in childhood as a result of a traumatic event
        • in depression dormant negative schemas that have been formed in childhood become activated by a life events or ongoing stressors
    • Rosenhan (1973)
      • Aim: To investigate whether the same can be reliably and accurately distinguished from the insane
      • 8 Pseudopatients  above age of 20 with a variety of professions - 3 female and 5 male.
      • 12 Different hospitals used and length of time stayed was 7 - 52 days.
      • Concluded that Psychiatrists are unable to reliably identify sane pseudopatients (Type 1 error)
      • Psychiatrists also fail to reliably detect insanity (Type 2 error)
      • Within an 'insane' environment of a psychiatric hospital, individuals behaviour is perceived in a distorted manner which can maintain a diagnostic label
    • Gottesman et al (2010
      • Aim: To examine how vulnerable the children of two parents with mental illness are to developing a mental illness themselves.
      • 2.7 Million danish people born before 1997
        • 196 couples who both had schizophrenia and their 270 children
        • 83 couples who both had bipolar disorder and their 146 children
      • In offspring with both parents diagnosed of having schizophrenia - 27.3% developed schizophrenia by age 52 - 67.5% developed a mental illness of some sort
      • In offspring with both parents diagnosed of having bipolar disorder - 24.95% developed bipolar by age 52 - 44.2% having mental illness of some sort
      • Having both parents with a serious mental illness is associated with significantly increased risk
      • Having 1 parent with serious mental illness carries a lower risk
    • Szasz (2011)
      • Revisits his book "The myth of mental illness" (1960,61) and writes about things have changed since.
      • Medicalisation and Politicisation have led to a dehumanised model of care.
        • Politicians have defined mental illness in the same way as physical illness - Szasz rejects this
        • Alternative therapies to the medical model now have reduced credibility. Medical terms such as diagnosis and treatment are used in relation to mental illness.
      • The term Mental illness is a 'metaphor'., used by parts of society to label other for their socially unacceptable behaviour.
      • Szasz rejects the moral legitimacy of Psychiatry as a violation of human liberty.
  • Predictive validity-The extent to which the categories predict course or outcome of treatment.
  • Descriptive validity- The extent to which people diagnosed with the same disorder are similar.
  • Synapses
    • 2. Vesicles containing the neurotransmitters fuse with the walls of the membrane of the pre-synapse to release the neurotransmitters into the synaptic gap.
    • 1. An action potential arrives at the pre-synapse
    • 3. The neurotransmitters bind to receptor sites on the post synapse and widen them to all ions to pass through to continue the action potential if  enough ions pass through (the more neurotransmitters that bind to the receptor the wider the gates open).
    • 4. The neurotransmitters can be re-uptaken into the synapse to be reused. Or an enzyme breaks them down into their chemical parts.
    • 5. The process then continues.

Comments

hlevisap

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cheers bro

hlevisap

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good comment friend

hlevisap

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cheers mate, just feel a bit lonely sometimes

hlevisap

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oh really? i also feel lonely sometimes. Fancy meeting up?

hlevisap

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sorry, need to revise for psychology but you seem like a nice little lamb

hlevisap

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bye

hlevisap

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see yah

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