historical context to mental health-Topic 1

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Give one historical view of mental health
Medieval beliefs that the supernatural caused mental illness: possesion by evil spirits, displeasure of the gods as a punishment
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Statistical infrequency
Behaviour that is rarely seen in the general population can be considered abnormal, based on measurable characteristics such as IQ. However people can have a high or low IQ and function well in society
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Deviation from social norms
Behaviour that can be seen as a departure from what one society or culture defines as acceptable. Over time, or in different groups, there are huge discrepancies as to what is considered 'normal' and culture and history play a big part.
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Maladaptiveness
When a person's way of thinking, emotional responses or actual behaviour is dangerous or prevents them from functioning well in society. OCD is an example as a person may be consistently late for work.
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A way mental illnesses can be categorised
The DSM
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Rosenhan- 1973
On being sane in insane places
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Rosenhan- Aim
To investigate whether the sane can be reliably and accurately distinguished from the insane
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Rosenhan- Sample
8 pseudopatients, 12 hospitals, 5 states in the US. All using pseudonyms and occupations
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Rosenhan- RM, IV & DV
RM-Field experiment and observation. IV- the 12 different hospitals. DV- the admissions of pp's, the diagnosis they recieved and the observations they took
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Rosenhan- Procedure
Pseudopatients arrive hearing voices say 'empty, hollow, thud' implying a crisis of existance. Once admitted, pp's were told to act normally, attempting to engage in conversation. They obeyed rules, pretended to take medication and took notes
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Rosenhan- Results
7 were diagnosed with schizophrenia, 1 with BPD and were discharged with 'schizo in remission'- a label of mental illness beyond hospitals. Pp's observed that genuine patients suspected they were fake. Behaviour was interpreted in light of diagnosis
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Rosenhan- Examples of 'stickiness of labels'
Pacing the corridor out of boredom- seen as nervous. Taking observations- engaging in writing behaviour. Waiting in line in the cafeteria- demonstrating the 'oral-acquisitive' nature of their condition
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Rosenhan- What type of error was the first study?
Type 1 error- diagnosed sane patients as insane. False positive
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Rosenhan- Study 2
Staff at one hospital were briefed on the results of the 1st study and were told in the next 3 months, pseudopatients would attempt to gain access and had to rate the likelihood of falseness on a 10point scale.
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Rosenhan- Study 2 results
41 patients within the 3 month period were rated with high confidence to be pseudopatients however no pseudopatients were actually sent. This therefore presents a type 2 error- identifying mentally ill patients as healthy. False negative
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Rosenhan- Conclusions
Psychiatrists are unable to reliably identify and diagnose mentally ill patients. Also that individuals maintain a diagnostic label after being admitted to a hospice.
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Affective disorder
An illness affecting mood ranging from mild to severe. E.G. depression
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Side effects of depression
Loss of concentration or ability to think. Depressed mood all day or most days. Daily fatigue or lack of energy
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Psychotic disorder
Involves a person losing contact with reality and withdrawing from the outside world. E.G. schizophrenia
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Side effects of schizophrenia
Positive- hallucinations, auditory or visual. delusions of grandure. Negative- reduced expression of emotion
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Anxiety disorder
Involve feelings and behaviours characterised by excessive and persistant fear or anxiety.E.G. phobias
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Side effects of a phobia
Phobic stimulus provokes immediate fear and anxiety. Phobic stimulus is deliberately avoided. Fear and anxiety caused by the phobic stimulus is irrational to the actual threat it poses.
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Usefulness
Rosenhan's findings raise concerns about the validity and reliability of diagnostics. This has clear implications for the profession, and creates suggestions on how to improve conditions; focusing on educating preofessionals in diagnosing mental ill
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Nature vs Nurture
The belief that certain illnesses are caused by evil spirits is said to be more 'supernatural' than nature or nurture. However, ways of defining abnormality look more towards nurture (deviation from social norms) due to cultural perspectives
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Freewill vs Determinism
Rosenhan recognised determinism in the treatment of of patients, once a patient was diagnosed, they were forever labelled with that diagnosis. Patients have no freewill to leave hospice as that was determined by staff
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Methodological issues
Field experiment lacks control, but has high ecological validity. The DSM is not a valid way to diagnose but can be useful due to consistency
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Reductionism vs Holism
Statistical infrequency is reductionist as it's one-dimensional; the single factor determining abnormality is frequency. Deviation from social norms and maladaptiveness are more hollistic. The DSM is a hollistic process of diagnosis
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Psychology as a science
definitions of abnormality range from highly scientific (statistical infrequency) to subjective (social norms). Attempts to diagnose come from the DSM which can be subjective through interpretations of symptoms,
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Statistical infrequency

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Behaviour that is rarely seen in the general population can be considered abnormal, based on measurable characteristics such as IQ. However people can have a high or low IQ and function well in society

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Deviation from social norms

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Maladaptiveness

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A way mental illnesses can be categorised

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