Psychology: Issues in Mental Health - The Medical Model

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  • Created by: Madisonxo
  • Created on: 17-04-19 15:14
What are the assumptions of the medical model?
Abnormal behaviour is caused by changes in either the structure or function of the brain, psychological disorders are physical illnesses with physical causes. Biochemical/Genetic/Brain abnormality
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Advantages of the medical model?
Easier + unified approach to treatment, mental illness is taken seriously, stigma is reduced, improves the scientific status of psychology.
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Disadvantages of the medical model?
Not personalised treatment, side effects of treatment, cause of problem not actually dealt with, relies on patient taking medication, labelling, reductionist.
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Biochemical explanation for depression
Reduction in levels of serotonin, SSRIs = effective
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Biochemical explanation for schizophrenia
Excess of dopamine levels, drugs to reduce dopamine levels reduce +ve schizophrenia symptoms, increased dopamine increases psychotic symptoms.
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Biochemical explanation for OCD
Reduced serotonin levels, SSRIs help.
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Kety et al (1994)
Adoptees w/chronic schizophrenia + found that the prevalence of the disorder was 10x higher in the biological relatives of the schizophrenic adoptees than the biological relatives of control group.
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Gottesman (1991)
Compared 40 studies and found that 2 classes of relatives have esp high risk of developing schizophrenia, the offspring of 2 schizophrenic parents and an MZ twin of a schizophrenic.
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Gottseman + Shields (1976 and 1982)
Found that in MZ twins there was a concordance rate of 35-58% compared to DZ twin rates of 9-26%.
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Harrington et al (1993)
20% of close relatives of people with depression also suffer depression compared to 10% of the general population.
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McGuffin et al (1996)
Concordance rate for depression was 46% in MZ twins and about 20% for DZ twins suggesting that genes are a factor in depression.
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Heston (1966)
47 adopted children whose mothers had schizophrenia were studied. Control group = 50 adopted children. Of the experimental group, 5/47 became schizophrenic compared to 0 in control group. Another 4/47 of the experiment group were classed asBorderline
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Gottseman (1991)
meta analysis of 40 twin studies. Found that having an identical twin w/schizophrenia gave you a 48% chance of developing the condition. This reduced to 17% in non-identical twins.
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Heston (1970)
People who had an identical twin with schizophrenia, 90% reported some form of mental health disorder. (holistic)
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Orlovska (2000)
Study on all Danes born between 1977-2000 (1.4 mill). Of those with head injuries, 65% more likely to be diagnosed w/schizophrenia, 59% more likely to develop depression, 28% more likely to be diagnosed with bipolar.
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Brown et al (2004)
Found that pregnant mothers who were exposed to the flu virus during the first few months of pregnancy were more likely to have a child that later develops schizophrenia than those who didn't get the flu (socially sensitive for mothers)
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Crow et al
Conducted MRI and CT studies suggesting that left ventricular enlargement means that normal structure asymmetry is absent in the brains of schizophrenic patients.
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Gur et al
Reported a 16% increase in ventricular volume in 33 never treated patients compared to 65 affected controls.
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McCreadie et al
Reported 20% increase in ventricular volume in 42 patients compared to 31 unaffected controls.
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Strengths of medical model
Does not blame people for their abnormal behaviour, scientific status increased, objective, treatments have helped relieve conditions.
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Limitations of medical model
Drugs can cause addiction, medical treatments may suppress symptoms rather than provide a cure, labelling theory, diagnosis may be unreliable (overlap of symptoms), reductionist, nature not nurture.
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Leucht (2003)
Meta analysis: Half of ppts given new antipsychotic drugs, half given a placebo antipsychotic drug. Patients who had taken the new drugs had a signif lower rate of relapse than those who took the placebo. New drugs = effective relapse treatment.
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Gottesman: Aims
Build on prev research
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Gottseman: Research method
National register based cohort study conducted in Denmark
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Gottseman: Sample
2.6 million people with a link to their biological parents, all info about psychiatric admissions established from two Danish registers. Aged 10+ before Jan 2007. Born later than 1968.
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Gottseman: Registers
1) The Danish Civil Registration System (all people born in Denmark assigned a unique identification number) 2) Danish Psychiatric Central Register. LINKAGE.
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Gottseman: Procedure
Cumulative incidences of schizophrenia and bipolar disorder in offspring of parents (one with/both with/none with)
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Gottseman: Results - schizophrenia
Offspring of 196 parent couples BOTH admitted with schizophrenia 27.3% (increased to 39.2% when schizophrenia-related disorders included) compared with 7% w/one parent admitted and 0.86% neither parent admitted.
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Gottseman: Results - Bipolar
Offspring of 83 parent couples BOTH admitted with bipolar 24.9% (increase to 36% when unipolar depression incl) compared to 4.4% ONE parent admitted and 0.48% neither parent admitted.
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Gottseman: Results - Schizophrenia + Bipolar
Risk of schizophrenia: one parent bipolar, one schizophrenia - 15.6%. Risk of bipolar: one parent bipolar, one schizophrenia - 11.7%
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Gottseman: Conclusions
Offspring of dual matings diagnosed w/psychosis have a higher risk. Genetic explanation of mental illness supported. May be genetic overlap for different disorders.
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Psychosurgery
Moniz developed this surgery, destroys or separates parts of the brain to reduce aggression. Last resort treatment, irreversible.
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ECT to treat depression
Electroconvulsive therapy -Electric shock passed through a person's brain, seizure lasts 15-60s, usually given bilaterally. Sometimes leads to broken bones + burns to the brain + heart problems + memory loss.
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TMS as a treatment for depression
Transcranial Magnetic Stimulation - Magnetic field is created causing a far weaker electrical signal to be sent through the prefrontal cortex, created a magnetic pulse, stimulates nerve cells in the area of the brain involved in mood regulation.
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Drug treatments for OCD
OCD has been linked to low levels of serotonin + increased dopamine.
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Jenike et al (1997)
Placebo-controlled trial of fluoxetine (SSRI). 10 week trial, 64 patients randomly assigned to receive placebo. Fluoxetine patients improved signif more than placebo group (suggests serotonin is involved)
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Drug treatements for depression
SSRI's: Selective Serotonin Reuptake Inhibitors - blocks the mechanism that reabsorbs the serotonin leaving more in the synapses.
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Fisher and Greenberg (1995)
Meta analyses - more than 60% relapse rate among those who responded +vely to the drugs + who later ceased to take them (suggests drug was effective)
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Strengths of drug treatments
Most are effective in reliving symptoms, only require patient to remember to take drugs (not a lifestyle change).
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Disadvantages of drug treatments
Don't work for everyone, unlikely to provide a long-term cure. Brown (2003) 81% of studies reporting signif findings published compared to 68% of studies w/non signif findings (publication bias, drugs may be perceived as more effective than they are)
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Card 2

Front

Advantages of the medical model?

Back

Easier + unified approach to treatment, mental illness is taken seriously, stigma is reduced, improves the scientific status of psychology.

Card 3

Front

Disadvantages of the medical model?

Back

Preview of the front of card 3

Card 4

Front

Biochemical explanation for depression

Back

Preview of the front of card 4

Card 5

Front

Biochemical explanation for schizophrenia

Back

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