Psychological Problems

• Jahoda's ideal mental health

  High self-esteem, personal growth and actualisation, integration, autonomy, an accurate perception of reality
• Mental health continuum 


  Scale from healthy, reacting, injured, to ill.

  Healthy and reacting can be treated through social support, injured and ill need professional support
• Prevalence and incidence of mental health problems

  1 in 4 British adults diagnosed with a mental health disorder

  1 in 10 children each year diagnosed with a mental health disorder

  More women are diagnosed than men

  LGBT+ people more likely to be diagnosed

  Incidence seems to be increasing
• Issues with measuring incidence of mental health problems

  1. not all are diagnosed or recorded
  2. diagnoses change over time
  3. relies on self-report surveys
• Changes in classification

  The ICD is on its 11th edition, anorexia nervosa is now a disorder, homosexuality is no longer a disorder
• Changes in attitudes towards mental health

  Using "mental illness" to decrease stigma

  Mental Health Act (1959) - use of "mental disorder", treatment of psychiatric problems made more similar to physical problems, responsibility for care in the community given to councils

  The charity Mind campaigned for the rights of those with mental health problems, e.g. using "mental distress"

  World Mental Health Day (1992)
• Effects of stigma and discrimination

  Stigma: cognitive, a negative belief or perception about a person or group

  Discrimination: treating people differently based on a perceived problem

  Stigma and discrimination occur before diagnosis due to abnormal or socially unacceptable behaviour, and after due to negative stereotypes
• Effects of mental health problems on society

  Puts strain on health and social care services, which is minimised through care in the community

  Society passes laws to reduce discrimination, e.g. Equality Act 2010

  Attitudes can improve or worsen due to higher rates of interaction with people with mental health problems
• Schizophrenia symptoms

  Thought disturbances, delusions, hallucinations, disorganised speech, catatonic behaviour, negative symptoms
• Schizophrenia statistics

  Prevalence: 1% of population

  Recovery rates: 25% fully recover, 25% greatly improve, 25% need support, 15% are hospitalised, 10% die (mainly through suicide)

  Age: adult disorder, usually diagnosed before 40

  Ethnicity: Caribbean or African descent more likely, Asian less likely

  Sex: equal, women diagnosed later, in 30s, versus men earlier, in 20s
• Social drift theory

  Attempts to explain why working class are 5 times more likely to be diagnosed with schizophrenia.

  When people develop schizophrenia, they begin to lose touch with reality, causing them to disengage with society. This causes rejection by society which makes them disengage more, leading to a downwards spiral into poverty and loss of status.
• Social drift theory: criticisms

  1. problems establishing cause and effect
  2. physical factors associated with low social classes may cause schizophrenia
  3. bias in diagnosis
  4. focuses too much on role of society, rather than family
  5. ignores biological factors
• Biological theory of schizophrenia

  Dopamine is responsible for mood, perception, and attention

  Dopamine hypothesis: dopaminergic neurons fire too much or too easily, too many D2 receptors in the post-synaptic neuron

  Faulty brain structure: lower blood flow to and smaller volume of frontal cortex, defective prefrontal cortex, temporal lobes smaller in volume due to less grey matter, hippocampus lower in volume
• Biological theory of schizophrenia: criticisms

  1. focuses on nature; ignores nurture
  2. problems establishing cause and effect
  3. too deterministic
  4. too reductionist
  5. schizophrenia is too broad as a label
• Daniel et al: procedure

  Design: laboratory experiment, repeated measures

  IV: given amphetamine or placebo

  DV: performance on BAR task and WCST, SPECT scan findings

  Sample: 10 in-patients, mostly white, from a hospital in Washington, USA

  Procedure: participants were stabilised for six weeks on antipsychotic (haloperidol), then given either placebo or amphetamine and tested

  Counterbalancing done
• Daniel et al: results and conclusions

  Results: Amphetamine had minimal effect on cerebral blood flow on both tasks, significant differences in blood flow during WCST, small but positive effect on 2 participants during WCST, none with placebo, 3 participants clinically improved, 1 significantly deteriorated

  Conclusions: amphetamine increased prefrontal cortex blood flow, some problems associated with schizophrenia can be reversed with drugs
• Daniel et al: criticisms

  1. sample size too small
  2. culture bias
  3. lacks temporal validity
  4. ethics of using scans without knowing long-term consequences
  5. haloperidol may have been an extraneous variable
• Depression symptoms

  lowered mood, energy, activity, capacity for enjoyment, appetite, self-esteem, self-confidence, interest, pleasurable feelings, libido.

  disturbed sleep, tiredness, waking early, weight loss.
• Depression statistics

  4-10% experience depression in their lives, Asians more likely to be diagnosed than black people, 33% of women diagnosed with a mental health problems compared to 19% of males, more likely in those with lower income, 0.9% of young people and children suffer from severe depression, NHS recovery rates vary from 7-63%
• ABC model of depression

  A - activating event, a situation which triggers a potentially irrational thought

  B - belief, the interpretation of the activating event, can be rational or irrational

  C - consequence, if irrational can cause depression

  REBT (a type of CBT) used to treat depression based on this model
• ABC model of depression: criticisms

  1. negative rational assessments can lead to depression
  2. too reductionist
  3. could be explained by biology when depression seems random
  4. difficulty establishing cause and effect
  5. blames individual for illness
• Social rank theory

  Losing at something causes depression so that the individual can come to terms with the fact they have lost, and the consequences, preventing them from aspiring to achieve a higher status, and stops competition.

  Accepting a lower rank reduces the risk of further injury by the winner, reduces social conflict, and allows the loser to maintain a place in society therefore has continued protection of the group
• Social rank theory: criticisms

  1. too reductionist, ignores individual differences
  2. evidence does not support that depression is limited to "losers" and those with low social status
  3. ignores instances of depression not caused by losing
  4. fails to take into account other biological factors like unbalanced neurotransmitters
• Tandoc et al: procedure

  Design: self-report online survey

  IV: Facebook usage

  DV: levels of envy and depression

  Sample: 736 university students from the Midwest of the USA, average age 19

  Method: participants asked:

  1. average hours per day of Facebook usage
  2. Facebook usage including surveillance using a 5-point scale
  3. envy using a 5-point Likert scale
  4. CES-D for depression
• Tandoc et al: results and conclusions

  Results: heavy Facebook users had higher envy, size of friends network did not impact envy, Facebook envy predicted depression, Facebook surveillance increases envy which increases depression

  Conclusions: Facebook use does not directly lead to depression, but can lead to Facebook envy which leads to depression. Facebook surveillance lowers depression if it does not cause envy
• Tandoc et al: criticisms

  1. cultural bias
  2. age bias
  3. self-report so social desirability
  4. lacks construct validity
• Application: treatment via drugs

  Antipsychotics: block dopamine receptors

  Conventional (first licenced for use in 1950s, treat positive symptoms), or atypical (less neuro-muscular side effects, but can cause weight gain, firs licensed for use in 1990s, treat all symptoms)

  Antidepressants: increase neurotransmitters like serotonin and noradrenaline, by preventing reabsorption, so it builds up in the synapse
• Application: treatment via therapy, and testing

  Psychotherapy: talking therapies originated with Freud, CBT originated with Ellis (ABC model), where she added D and E - Disrupting irrational beliefs, and Effect

  Neuropsychological tests: WCST, Beck Depression Inventory, PET scans (radioactive tracer to show neurotransmitters)