Paper 3

• which model is today the dominant explanation of mental illness

  the medical model
• describe the historical views of mental illness before modern medicine

  - indication of witchcraft arising from intense religious experiences

  - the result of internal imbalances within the body

  - Hippocrates - occurred as a result of an imbalance of different fluids or humours in the body (blood, phlegm, yellow bile
• who was credited with developing one of the first systems of classifying mental illness

  Hippocrates in Ancient Greece
• what is trepanning and what is it used for

  - surgical procedure involving the piercing of the skull to create a hole from which evil spirits were supposedly released

  - it was used for the treatment of seizure, migraines and mental disorders
• where did most people suffering from mental illness end up in the past

  - in workhouses, prisons or private madhouses

  - these were generally highly unsuitable settings as they were run for profit rather than for the therapeutic benefit of residents
• which modern psychiatric treatments were offered in the past

  - insulin treatment for schizophrenic patients

  - electroconvulsive therapy (ECT)

  - lobotomies
• what was one of the most significant advances in mental health treatment

  - the introduction of medication for the asylum patients, such as chlorpromazine
• what was the first anti-psychotic drug

  chlorpromazine
• what were the changes in vocabulary in terms of how mental illness was viewed

  - mental health and service user reduced the stigma associated with the terms mental illness and patient
• what are the definitions for abnormality

  - statistical infrequency

  - deviations from social norms

  - maladaptiveness
• why is defining abnormality one of the most controversial areas of psychology

  mainly because diagnosing an individual as abnormal or mentally ill has serious implications for their subsequent treatment
• describe statistical infrequency

  - behaviour that is rarely seen in the general population might be considered abnormal

  - based on the idea that in measurable characteristics such as anxiety or intelligence, most peoples scores will group around a central average and the number of people attaining scores much lower or higher than the average will be fewer
• why is measuring statistical infrequency not a sufficient measure for diagnosing abnormality

  - e.g. for IQ, it is not helpful to those individuals with the lowest or highest scores to be labelled abnormal as they might be perfectly happy and function well in society
• what is deviation from social norms

  this denotes behaviour that can be seen as a departure from what society or culture defines as acceptable
• what is a problem with using deviation from social norms as a definition for abnormality

  - it involves a judgment based on the context in which the behaviour occurs

  - while there are behaviours that might be universally considered morally unacceptable, much of what we consider socially acceptable has a strong cultural and historical context

  - that is to say over time or within different groups, there are huge discrepancies between what each would consider normal
• what is maladaptiveness

  - refers to when a persons way of thinking, emotional responses or actual behaviour is dangerous or prevents them from functioning well

  - this might be because they are deliberately self harming or less directly their behaviour might be impeding the success of their relationships or ability to hold down a job
• why is maladaptiveness a broader definition than the other two

  allows for individual differences

  - in some cases a persons behaviour might appear abnormal but does not cause them any great difficulty or risk

  - individuals may be described as eccentric or outspoken in such cases but dont warrant a psychiatric diagnosis
• describe reliability in terms of a diagnostic test

  - refers to how consistent a test or tool is

  - a diagnostic test is considered reliable if it can produce similar results when used again in similar circumstances
• describe validity in terms of diagnostic criteria

  - the extent to which a test measures what it is intended to measure

  - the extent to which the diagnostic criteria can be used to accurately diagnose someone experiencing a mental illness
• describe Rosenhans criticism of the medical model of mental illness as what is part of the anti-psychiatry movement

  - they accept that metal suffering an deviant behaviour do exist, they question whether the most useful way of understanding such behaviour is through a rigid system of classification

  - criticism of psychiatry is that it actually increases the suffering of those who receive a mental health diagnosis

  - this is because it removes control from the patient, who can then be manipulated for political or social purposes

  - also concerned about the reliability and validity of diagnosis: to what extent can the sane be consistently and accurately distinguished from the insane
• which type of disorder is depression

  affective disorder
• what do affective disorder include

  - a broad group of illnesses affecting mood which can range from mild to severe
• what are the symptoms of affective disorders

  individuals may experience marked feelings of sadness, emptiness or irritability and in other cases mania, euphoria or rage are also prevalent
• what is the experience of a person in a major depressive episode

  - one of sadness and hopelessness

  - they may deny their feelings

  - atypical angry or tearful outbursts, or in social withdrawal

  - may loser appetite or eat excessively

  - difficulty sleeping or sleep to excess

  - psychomotor agitation can occur

  - delay to psychomotor responses

  - suicidal ideation
• what is psychomotor agitation

  an inability to relax or keep still e.g. pacing or handwringing
• give examples of delay to psychomotor responses

  excessive pauses before speaking or slowed body movement
• what are the main symptoms (present in past two weeks) of major depressive disorder

  - depressed mood for most or all of the day, nearly every day and/or

  - loss of interest or pleasure in all or more activities
• what are the other possible symptoms of major depressive disorder

  - significant weight/appetite loss or gain

  - frequent insomnia or hypersomnia

  - inability to relax or sit still or excessive lethargy

  - daily fatigue or loss of energy

  - excessive feelings of worthlessness or guilt

  - loss of concentration or ability to think

  - recurrent thoughts of death, suicidal ideation, suicide attempt or plan
• how often do symptoms of major depressive disorder need to be present for a diagnosis

  every day or nearly everyday over the course of at least two consecutive weeks
• what causes recurrence to decrease for major depressive disorder

  more time spent in remission (period of recovery without symptoms)
• briefly describe schizophrenia

  - a long-term mental health condition that affects peoples thoughts, emotions and behaviour
• what type of disorder is schizophrenia

  a psychotic disorder
• describe psychotic disorders

  - refers to the experience of the disorder as a loss of contact with reality

  - those with the diagnosis come to perceive things around them very differently from others
• what are the two types of symptoms in schizophrenia

  positive and negative symptoms
• what do positive symptoms refer to

  the addition of new behaviours such as the onset of hallucinations or delusions
• what are negative symptoms

  - include the removal or loss of normal function, such as a lack of outward emotion or a reduction in speech
• what are hallucinations

  hearing, seeing or feeling things that dont exist
• what are delusions

  refer to beliefs people may have that are not based on reality

  - e.g. a paranoid belief that family, friends or healthcare professionals are out to get the person who is ill, when they are actually trying to help
• why are the symptoms of schizophrenia often not immediately recognisable

  - changes may begin slowly, in the form of social withdrawal or in the appearance of apathy, which may be mistaken for a normal phase of adolescent behaviour

  - these periods can then become acute, meaning the person experiences severe positive symptoms which may lead to diagnosis and psychiatric interventions
• when should a diagnosis for schizophrenia only be given

  only given if symptoms are not better explained by underlying medical issues or substance use

  - they must also have a negative effect on the normal functioning of a person

  - e.g. someone who claims to hear voices but who exhibits no other symptoms and shows a good level of functioning in society would not fit the criteria