Psychological Problems

• Prevalence of mental health problems:

  • one in four British adults report having been diagnosed with a mental health disorder
  • the number of mental health problems tends to decline with age
  • women tend to be diagnosed with mental health problems more than men
  • people who identify as lesbian, gay, bisexual or transgender are particularly at risk of experiencing mental health problems
• stigma - a strong feeling of disapproval about something discrimination - treating an individual or group differently from others

  incidence - a measure of the number of new cases of a particular disorder over a given time period

  prevalence - a measure of the proportion of the population that experience a particular disorder at any one point in time
• since the 1959 Mental Health Act, there have been steady changes in society's attitudes towards mental health problems

  the Act itself removed some of the stigma around people seen as 'lunatics' or 'insane' by using the term 'mental disorder'

  it also aimed to make sure that patients were treated with the same respect and rights as patients with physical illnesses as well as initiating the idea of community care

  recent surveys show that the public have a better understanding of mental health problems, and are more tolerant and less judgemental about people who experience them
• Key statistics of schizophrenia:

  • prevalent in approximately 1 per cent in the population
  • only diagnosed in adults; men, normally in their 20s; women, normally in their 30s
  • diagnosed equally in females and males
  • diagnosed more in people of Caribbean or African origin compared to people who are white
  • leads to hospitalisation in about 15 per cent of cases, while 25 per cent of patients fully recover from the disorder
• Clinical characteristics of schizophrenia:

  • thought disturbances
  • delusions of control
  • hallucinatory voices
  • persistent delusions
  • persistent hallucinations
  • disorganised speech
  • catatonic behaviour
  • negative symptoms
• delusions - false beliefs

  hallucinations - experiences in which you see, hear, feel, taste or smell something that does not exist

  catatonic behaviour - behaviour ranging from repetitive, frenzied actions to statue-like stupor

  negative symptoms - symptoms that include loss of normal function, such as social withdrawal, apathy or lack of emotion

  neurological - relating to the brain
• Biological explanation of schizophrenia: Dopamine Hypothesis

  • people with schizophrenia have an overactive dopamine system which causes high dopamine levels
  • dopamine is a neurotransmitter associated with mood, perception and movement
  • brain scans have shown that people with schizophrenia have dopaminergic neurons that fire too easily or too frequently causing excess dopamine travelling across synapses
  • they also have an excess of dopamine receptors which results in more dopamine binding
• Biological explanation: Faulty brain structures

  • blames schizophrenia on brain dysfunction
  • neurological damage happens as a result of either defective genes or problems during pregnancy when the foetus's brain is developing
  • as the individual matures, the damage causes the symptoms of schizophrenia to develop
• neurological research on people with schizophrenia include the following findings:

  • volume of their brain is around 5 per cent lower than the average brain
  • the frontal lobes are less active due to decreased blood flow
  • the temporal lobes lack grey matter
  • the hippocampus is smaller than average
• grey matter - the darker tissue of the brain; contains 'thinking' cells

  hippocampus - part of the brain mainly associated with the formation of memories and the emotions that go with them
• Biological explanations of schizophrenia: Criticisms

  • focuses too much on nature and ignores the role of nurture. even if biology is responsible for the symptoms, how society responds to them also has an effect
  • problems establishing cause and effect. is brain dysfunction the cause of schizophrenia or just another symptom of it?
  • too reductionist as schizophrenia refers to a set of highly complex behaviours and it seems too simple to explain this in terms of parts of the brain just not working properly
• Psychological explanation: Social Drift Theory

  • suggests that once people have schizophrenia they begin to drift or move down the social scale so that they end up at the bottom of society
  • individuals disengage with society once they have schizophrenia because the things that are most important to people become less important to someone who is experiencing lots of terrible symptoms
  • individuals are rejected by society meaning they may lose jobs or not find it easy to get a job
  • society may also reject them as their behaviour is not normal so they become socially excluded
• Psychological explanation of schizophrenia: Criticisms

  • problems with establishing cause and effect even though schizophrenia and social class are linked. rather than the disorder effecting social class, it may be that being in a lower class leads to schizophrenia
  • people of a lower class may be more likely to be diagnosed with schizophrenia than more affluent people. this is because of a bias in diagnosis among middle class psychiatrists
  • focuses too much on wider society and ignores the role that family environment may have in the development of schizophrenia
• Daniel's study:

  • aim - to investigate the activity in the prefrontal cortices of people with schizophrenia
  • sample - ten in-patients from mental health research wards in USA
  • IV - whether participants had been given amphetamine or not
  • DV - how they performed on a cognitive task
  • repeated measures design
• Daniel's study: results

  • significant differences between the two conditions when participants where doing the cognitive task but not when they were doing the sensori-motor task
  • amphetamine significantly increased prefrontal cortex activity during performance of the cognitive task despite it reducing blood flow in the brain
  • supported the idea that dopamine plays a part in modulating an enhancing cortical activity - as amphetamine stimulates dopamine activity
• Daniel's study: criticisms

  • sample size was too small to be representative
  • the task that the participants did was too artificial to relate to real life
  • the drug used to stabilise symptoms may have been an extraneous variable
  • findings can be seen as outdated as schizophrenia is being diagnosed differently nowadays
  • ethical concerns about using scanning equipment for research purposes alone as it is potentially dangerous
• Key statistics of clinical depression:

  • prevalent in approximately 25 per cent of the population each year
  • most common amongst 18-30 year olds and least common in under 18s
  • approximately twice as many females are diagnosed compared to males
  • people of Indian and Pakistani/Bangladeshi origins report experiencing depression more than people of the Caribbean and African origin
  • although the vast majority of people recover, about 50 per cent will go on to have a second episode, and about 80 per cent of those will have a third
• Clinical characteristics of clinical depression:

  • depressed mood
  • disturbed sleep
  • diminished appetite
  • reduced energy
  • reduced concentration/attention
  • reduced self-esteem
  • loss of interest and enjoyment
  • bleak and pessimistic views of the future
  • ideas of guilt and unworthiness
  • ideas or acts of self-harm
• Biological explanation: Social Rank Theory

  • evolutionary theory state that all adaptive behaviours have a survival value
  • social rank theory relates to this idea by stating that depression has an evolutionary function
  • if we experience loss then a natural reaction is to feel depressed, less motivated and more self-contained
  • by not fighting back, an individual is accepting they are of a lower rank
  • it allows them to keep their place in a social group, community or society
  • being part of a group and having people around us is important for survival
• Biological explanation of clinical depression: criticisms

  • too reductionist as it takes something as complex as clinical depression and tries to simplify it down to an instinctive reaction to losing something. other psychologists take a more holistic approach
  • depression is not limited to people of lower social ranks. there are many successful people who have experienced clinical depression
  • severe depression can lead to suicide attempts and suicide itself which clearly goes against the idea that depression is a mechanism for survival
• Psychological explanation: ABC Model

  • depression begins with irrational beliefs
  • A = activating event - situation which can trigger an individual to have an irrational thought
  • B = beliefs - can be rational or irrational
  • C = consequence
  • if beliefs are irrational then the person is more likely to feel hopeless and down, leading to symptoms of depression
• Psychological explanation of clinical depression:

  • the model assumes that people have control over their beliefs as it believes in the idea of free will. other psychologists suggests that this makes the theory over-optimistic
  • doesn't really explain the type of depression that seems to 'come out of nowhere' without any obvious activating event. this kind of depression may be more biologically driven
  • problems with cause and effect. do irrational beliefs actually cause depression or are they symptoms of it instead?
• Tandoc's study:

  • aim - to see whether depression was linked to Facebook usage, and whether using Facebook led to feelings of envy
  • method was a questionnaire conducted online
  • sample - 736 students from an American university (average age - 19)
  • self-selecting sample

  Hypotheses:

  • Facebook users would report higher levels of envy
  • the higher the network of friends, the greater the feeling of envy
  • higher levels of envy would be associated with more symptoms of depression
• Tandoc's study: results

  • heavy FB users did report higher levels of envy than light users
  • size of the network was not related to levels of envy
  • FB envy was a significant predictor of depression
  • no relationship between how frequently FB was used and how depressed people felt
  • FB surveillance did not predict depression either
  • overall conclusion - FB usage does directly relate to depression but is indirectly linked by causing envy
• Tandoc's study: criticisms

  • culturally biased as they were all from USA and journalism students
  • survey was online - may bias the findings
  • may have been socially desirable bias where participants underplayed their use of social media, level of envy and their experience of depression, giving invalid results
  • may lack construct validity as complex behaviours were reduced to numbers and this may not give a true representation of people's experiences
  • difficulties establishing cause and effect. where there were relationships between variables, we cannot be sure of the cause.
• Use of anti-psychotics to treat schizophrenia:

  • anti-psychotics are a type of drug treatment
  • they improve mental health mainly by reducing symptoms
  • the chemicals in anti-psychotic drugs block some of the receptors in the brain
  • when a neuron send too much dopamine across a synapse, the blocking means that not all of it is received by the next neuron
  • this reduces the number of messages being sent through the brain
• Use of anti-depressants to treat clinical depression:

  • anti-depressants are a type of drug treatment
  • they improve mental health by raising people's mood
  • the chemicals in anti-depressants increases the amount of serotonin and noradrenaline in the brain
  • for example, one type of anti-depressant prevents serotonin being reabsorbed by blocking the neurons that released it
  • this means more serotonin remains in the synapses and this lifts the mood
• Use of psychotherapy:

  • psychotherapy focuses on the psychological explanations for neutral health rather than looking at biological factors
  • all types of psychotherapy involve talking to the individual with a mental health problem and aim to improve mental health by changing the way that people think and behave
• Psychotherapy for schizophrenia:

  • example - psychoanalysis
  • involve the uncovering of childhood traumas that may have led to schizophrenia developing in childhood
  • these traumas are often based on conflicts with parents that have not been resolved and so end up buried in the unconscious part of the mind
  • psychoanalysis aims to improve mental health by discovering these conflicts and resolving them in therapy
  • past conflicts can be discovered through techniques such as analysing dreams and hypnosis
• Psychotherapy for clinical depression:

  • example - counselling
  • involves the clients recognising their own problems and deciding how to address them themselves
  • counsellors do not direct their clients' thinking and do not give advice
  • the idea is that those who are suffering from depression know themselves best, and they will come up with their own solutions for improving their mental health
  • often involves clients improving their self-esteem by having a better view of themselves and being realistic about their expectations
• Neuropsychological tests:

  • standardised tests that give scores that show how well a brain is functioning
  • the scores of people with mental health problems can be compared to the scores of people without, whose brain is functioning

  Examples:

  • Wisconsin Card Sorting test - cognitive ability test that checks the function of the frontal lobe in people with schizophrenia
  • Beck Depression Inventory - measures the severity of depressive symptoms through multiple-choice questions
• Brain imaging techniques:

  • brain scans allow neuropsychologists to produce images of the brain so that brain structure and function can be seen
  • the brains of people with mental health problems can be compared with those without
  • Examples:
  • PET scans have been used to show that the brains of people with schizophrenia have larger ventricles than normal
  • fMRI scans have been used to measure the strength of connections between neural circuits in the brain to show there are different types of depression
• PET scans: position emission tomography scan - radioactive glucose is injected into the bloodstream and then traced by scanning the brain to show where neurons are firing

  fMRI scans: functional magnetic resonance imaging scan - magnetic resonance is used to detect changes in blood flow in the brain