historical context

• historical views - prehistoric view

  • behaviour due to presence of demonic possession
  • treatment - trepanning, holes were drilled into patients heads with hopes to remove the demon
  • precursor to lobotomies
• historical views - greek view

  • body contains 4 humours: black bile, yellow bile, blood and phlegm. Excess amounts of one is said to cause behaviour
  • eg excess black bile = melancholia
  • treatment = laxatives, blood letting and purging
• similarities between historical views

  • both deem use removal of excess substance in the body as premise for treatment
  • both unfalsifiable as can just claim it didn't work bc they didn't drill enough holes or didn't purge enough
• differences between historical views

  • greek view based off biological imbalance, prehistoric view based off religion
  • treatments for the greek view are less severe (diet and exercise)
• definition of abnormality 1 - abnormality is behaviour that deviates away from the statistical norm when using a bell curve. Anyone above or below 2SDs is abnormal
• strengths of behaviour that deviates away from the statistical norm

  • scientific as collected objective quantitative data
  • can be useful for clinical diagnosis as evidence present
• weaknesses of behaviour that deviates away from the statistical norm

  • cannot distinguish between desirable and non
  • not fully useful as subjective criteria
  • does allow for individual differences
• defintion 2 - abnormality as behaviour which deviates from social norm. Standards of acceptable behaviour that are expected to be adhered to. Provides a framework that can be used to make judegments about people and their behaviour.
• strengths deviating from social norm

  • can distinguish between desirable and non
  • holistic approach as considers cultural and societal norms, therefore more accurate
• weakness deviates from social norms

  • social norms are subject to culture therefore different interpretations of the same behaviour
  • societal norms are constantly changing therefore not definitive
• defintion 3 - Abnormality  as failure to function adequately. People who cannot look after themselves or who are perceived to be irrational or out of control as viewed at dysfunctional. Focuses on the individual and distress to themselves and others
• weakness failure to function adequately

  • not enough to diagnose someone, symptoms must be analysed further
  • standards of one culture are used to measure people from another which leads to incorrect diagnosis
  • cultural bias
• strengths failure to function adequately

  • very good indication
  • holistic approach, increases accuracy
  • can be measured objectively using a self-report
• definition 4 - deviation from ideal metal health. the absence of good signs of mental health, those who deviate are abnormal
• strengths deviation from ideal mental health

  • a somewhat holistic approach, emotional and cognitive factors
• weaknesses deviate from ideal mental health

  • unrealistic definition, difficult to achieve all characteristics at any one moment
  • very ill defined and not well operationalised
  • highly cultural bound , based on individualist culture
• DSM - 5

  • aim - help clinicians make more accurate and consistent diagnoses and to help researcher better study how disorders are related to each other, leading to better patient care
  • 3 sections - introduction, diagnostic categories and acknowledgement of weaknesses
• introduction of DSM-5

  • states the DSM should be used as a guideline along with critical judement
• diagnostic categories DSM-5

  • symptoms that must be present for each mental illness and the minimum time required
  • the symptoms that must be rejected in order to meet the criteria
  • 20 categories
  • arranged in life span order
• ICD-11

  • produced by the WHO
  • 24 chapters covering physical and mental diseases
  • specific codes are used to denotes specific disorders
  • disorders are categorised into blocks and have at least one characteristic in common
• validity issues with DSM and ICD

  • cheniaux - tow psychiatrists independently diagnosed 100 pz using DSM and ICD, massive inconsisentices found between the ICD and DSM and the psychiatrists. Poor concurrent validity
• reliability issues with DSM and ICD

  • First found that DSM claims to have a delusional disorder symptoms must be present for a minimum of 1 month but ICD claims symptoms but be present for 3 months
• issues relating to categorising disorders

  • cultural bias - black people more likely to be detained under mental health act than white people
  • ethnocentrism - ICD and DSM are base on western culture
  • ethics - stickiness of labels
• background rosenhan

  • reliability and validity issues with the DSM and the ICD
• study 1 rosenhan

  • aim - to test if psychiatrists can reliability tell the difference between those who are sane and insane
  • participant observation and field experiment
  • 8 pseudopatients
  • procedure - ps told nurses that they were hearing voices
  • results - stickiness of labels, distortion of behaviour, lack of normal interaction and attitude to medication
• mini experiment during experiment 1

  • aim - do staff behave differently towards pz compared with an individual in a non-clinal setting
  • procedure - pz asked simple questions and noted the response, comparison were made with students who asked similar questions at Stamford university
  • results - 4% of pz received an answer, 100% students received and answer
• conclusions study 1

  • doctors cannot reliably tell the differences between the sane and insane, may be because of the consequences of failing to identify illness could be more serious than classifying a healthy person as sick.
  • all behaviour was interpreted in terms of their label, this explained the stickiness of labels, suggesting social sensitivity
• study 2

  aim - if once aware of being in a study would the doctors be more cautious when diagnosing pz. would they make a type 2 error

  psychiatric hospitals were told some pseudopatients would be sent and staff were asked to rate each pz on the likelihood of them being pseudo

  results - 19/193 were believed to be pseudo by one psychiatrist and another staff member
• anxiety disorder - phobia

  • when the aversion to something is excessive and unreasonable
  • behavioural symptoms - deliberately avoiding or enduring with strong fear
  • emotional symptoms - stimulus evokes immediate fear
  • cognitive symptoms - if the stimulus if in disproportion to the fear caused
• psychotic disorder - schizophrenia

  • characterised by abnormal perception and thinking
  • positive symptoms - where behaviour is an exaggeration of normal; hallucinations or delusions
  • negative symptoms - where the pz lacks normal behaviour; reduced motivation or reduced quality of speech
  • cognitive deficits - when a persons mental processes are affected; disorganised thoughts or speech
• affective disorder - depression

  • behavioural symptoms - angry outbursts or avoidance of social events
  • emotional symptoms - low self esteem and guilt
  • cognitive symptoms - impaired learning and memory