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96 Cards in this Set
- Front
- Back
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What are the two definitions of abnormality? |
Deviation from statistical norms. Deviation from social norms. |
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Describe the deviation from statistical norms definition. |
A persons trait, thinking or behaviour is considered to be abnormal if it is rare or statistically infrequent. A population is represented by a normal distribution (bell curve). If a person is two standard deviations away from the mean then the behaviour is considered abnormal. 95.6% are considered normal. 4.4% are considered abnormal. |
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Strengths of the deviation of statistical norms definition of abnormality. |
It gives a quantitative measure which is objective and more likely to be reliable because scores come from tests/studies that can be repeated. It is a scientific measure to determine if a person is entitled to assistance, support and funding. |
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Weaknesses of the deviation of statistical norms definition of abnormality. |
What is considered abnormal may not be undesirable. It is hard to justify labels with a single cut off point e.g 69 IQ = abnormal 70 IQ = normal. Abnormal behaviour itself is not rare so results may not be valid. |
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Describe the deviation from social norms definition of abnormality. |
Behaviour that is considered to be socially abnormal is considered to be abnormal. To be normal a behaviour must conform to social norms. A number of influences have to be taken into account: culture, context and situation, historical context, age and gender. |
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Strengths of the deviation from social norms definition of abnormality. |
What this definition states as abnormal matches with the views of society. It helps explain why different cultures have different ideas about what is normal and what is abnormal. |
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Weaknesses of the deviation from social norms definition of abnormality. |
It is hard to get a reliable idea of abnormal due to the amount of influences that need to be taken into account. Some abnormal people e.g mentally ill people may not be breaking social norms so may not be considered abnormal. Criminals break social norms but aren't considered abnormal. |
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What are the two main classification systems? |
DSM - UK ICD - USA |
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What is the DSM? |
The diagnostical statistical manual. It works using a five axis system. Axis 1- clinical syndromes Axis 2- personality Axis 3- mental conditions Axis 4- psychosocial stressors Axis 5- GAF (global assessment of functioning) |
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Strengths of DSM? |
It is in wide use and commonly agreed upon. Allows for common and universal diagnoses. |
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Weaknesses of the DSM |
It suggests that sufferers of mental illnesses are 'sufferers' that need treatment. Whereas, some people may say that living with a mental illness is a way of life. |
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Is the DSM a reliable tool? |
It has inter rater reliability. Unreliable as it doesn't take different cultures into account. It is unreliable as it keeps changing. ✖️beck et al (1962) ✖️cooper et al (1972) ✖️rosenhan (1973) ✖️ di nardo (1993) ✔️stinchfield (2003) ✖️ Nicholls et al (2000) ✔️ brown et al (2001) ✖️ kirk and kutchins (1992) |
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Is the DSM-IV-TR-2000 valid? |
Construct validity - no - operationalising of disorders causing some understanding to be lost. Concurrent validity - yes - if more than one person reached the same diagnosis. Predictive validity - yes - comparisons made over two time periods. Convergent validity - no - could have if a correlation test was carried out. |
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What are some studies regarding the validity of the DSM? |
Kim Cohen et al (2005) Hoffman (2002) Lee (2000) |
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Should we use DSM around the world? |
Disorders are scientific and are not affected by culture. Some symptoms of mental illnesses in western cultures are not considered symptoms on eastern cultures. Some mental disorders are only recognised in some cultures. |
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Outline the 7 properties that count towards deciding whether a person is abnormal. |
Suffering. Maladaptiveness. Irrationality and incomprehensibility. Unpredictability and loss of control. Vividness and unconventionality. Observer discomfort. Violation of moral and ideal standards. |
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What are culture bound syndromes? |
Illnesses that are only associated with one culture. E.g koro (China) genitals are going to shrink or disappear into their body. Dhat (India) ejaculation is associated with extreme fatigue or exhaustion. |
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Rosenhan (1973) what was the aim? |
To illustrate the problems determining normality and abnormality, in particular, the poor reliability of the diagnostic system for mental disorders at that time. As well as the negative consequences of being diagnosed as abnormal and the effects of institutionalisation. |
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Rosenhan (1973) what was the procedure of study one? |
8 pseudopatients were assessed and all they said was that they could hear a voice saying empty, hollow or thud. All other behaviour was not changed. All pseudopatients were admitted with schizophrenia. Once they were admitted all abnormal behaviour stopped. They were tasked to seek release and record their experience. |
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Rosenhan (1973) results of study one? |
The pseudopatients stayed from 7-52 days. The average stay was 19 days. 35 out of 118 patients suspected the sanity of the pseudopatients. None of the staff did. All aspects of pseudopatients behaviour, normal, was seen as a symptom. When the pseudopatients asked the staff questions they were barely acknowledged, most staff continued walking with eyes averted. Noted: powerlessness and depersonalisation. |
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Rosenhan (1973) what was the procedure of study two? |
Rosenhan informed one hospital, one that was aware of his research, that more pseudopatients would try to be admitted. He asked the staff to rate patients on a scale of 1-10 whether they were pseudopatients over a 3 month period. |
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Rosenhan (1973) what were the results of study two? |
193 patients were admitted. 41 were suspected of being pseudopatients. None were actually pseudopatients. |
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Rosenhan (1973) conclusions? |
The study demonstrates that psychiatrists cannot reliably tell the same from the insane. The studies demonstrated both failure to detect insanity. It also found that psychiatric labels tend to stick. |
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Rosenhan (1973) strengths |
Pseudopatients could observe the institution from a patients point of view whilst maintaining objectivity. It was a field experiment so it had ecological validity whilst still controlling the pseudopatients behaviour. A range of hospitals were used which allows the findings to be generalised. |
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Rosenhan (1973) weaknesses |
Staff were deceived making the study unethical. Pseudopatients experience may have been different from a real patients experience. Rosenhan may have been too hard on the hospitals as insanity is safer to diagnose than sanity. Type two errors are more likely. |
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Define primary data |
Data you or your colleagues collect for the purpose of answering a research question. |
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Define secondary data |
Existing data collected for another purpose that you employ to answer your research question. |
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Advantages of primary data |
It is unbiased, controlled and up to date. |
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Advantages of secondary data |
It is cheap, quick and completely ethical. |
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Disadvantages of secondary data |
It can be subjective. It is unknown how bias or truthful the data is. Cannot be replicated. |
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Define schizophrenia |
A medical illness when a person cannot tell what is real and what isn't. |
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What are positive symptoms? |
Things that are added to a person that shouldn't be there. E.g hallucinations |
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What are negative symptoms? |
Something that is taken away from the person e.g lack of energy. |
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What are some positive symptoms of schizophrenia? |
Hallucinations Delusions Thoughts disorders |
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Describe thought disorders |
Unusual or dysfunctional ways of thinking. Thought insertion - feel like someone is putting thoughts into your head. Thought broadcasting - everyone can hear your thoughts. |
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Define features |
Statistics about a disorder, aspects of it, such as how the illness develops or how other factors link. |
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Define symptoms |
These are what categorise the illness with regard to how the person thinks, feels or behaves. |
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What are some features and symptoms are schizophrenia? |
Features - mental illness - first or second rank symptoms - positive or negative symptoms
Symptoms- thought withdrawal, insertion, interception. - thought broadcasting - delusional perception - feel like being controlled - flattened emotions |
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Goldstein (1988) what were the aims? |
To see if there were gender differences with regard to the rehospitalisation of people with schizophrenia and the length of their stays. Also, to look at social factors before diagnosis. |
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Describe the dopamine hypothesis |
Dopamine is a neurotransmitter. It is thought that excess dopamine receptors at the synapse cause schizophrenia. Then excess dopamine in the Mesolimbic pathway causes positive symptoms. Excess dopamine in the mesocortical pathway leads to negative symptoms. Sensitivity to dopamine can arise in a number of ways: from genetic inheritance to brain lesioning. |
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Evidence for the dopamine hypothesis. |
Amphetamines cause excess dopamine which results in symptoms of psychosis. Phenothiazines block dopamine receptors and alleviate the symptoms of schizophrenia. When a person with schizophrenia is given amphetamines more dopamine is released than in a normal person. Levodopa increases dopamine production which leads to symptoms of schizophrenia. People with schizophrenia tend to have genes that increase sensitivity to dopamine. Scanning shows that the are brain differences in people with schizophrenia and people without. |
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Evidence against the dopamine hypothesis |
People who had schizophrenia for 10 years did not benefit from taking drugs that block dopamine receptors. Drugs block the dopamine receptors immediately but it takes a few days for symptoms to alleviate. Amphetamines only cause positive symptoms. Different dopamine receptors in different parts of the brain cause different results. Excess glutamate also causes psychotic symptoms but leads to sensitivity of dopamine. Social and environmental factors may be involved. |
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Describe the environmental breeder hypothesis. |
There is evidence that people in the lower social classes have a higher incidence of schizophrenia than others in the UK. So this may be a factor that links the the development of schizophrenia. Lower classes experience different treatments of schizophrenia. Social drift, people with schizophrenia become lower class. Social adversity, people in inner city areas have a higher incidence of schizophrenia than people in rural areas. |
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Strengths of the environmental breeder hypothesis |
It is possible that environmental triggers cause with a certain biology to develop schizophrenia. The two explanations can be useful. It helps explain why more lower class people have schizophrenia. |
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Goldstein (1988) what was the procedure? |
Participants were ages 18 to 45 and were diagnosed using the DSM-II as being in the early stages of schizophrenia. Participants were then re-diagnosed using the DSM-III. 199 met the criteria for DSM-II but only 169 met the DSM-III criteria. Four males and four females were re-diagnosed by experts. There was a 0.80 agreement. Only one disagreement. |
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Goldstein (1988) how and what information was gathered? |
Trained interviewers rated symptoms to give an idea of the characteristics of schizophrenia. Questionnaires were given to measure premorbid functioning. The course of the illness was operationalised using the number of re-hospitalisations and length of stay. Obtained over a 10-year period ending in 1983. |
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Goldstein (1988) what were the results? |
Over both the 5 year period and the 10 year period men experienced double the amount of re-hospitalisations and double the length of stay than women.
Re-hospitalisations. 0-5 men - 1.40 0-5 women - 0.59 0-10 men - 2.24 0-10 women - 1.12
Length of stay 0-5 men - 267.41 0-5 women - 129.97 0-10 men - 417.83 0-10 women - 206.81 |
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Goldstein (1988) what were the conclusions? |
Gender differences are strong even when the DSM-III was used. Premorbid functioning accounted for 50% of the outcome after 1 year of observation. But only 1.9% after 10 years. Men had poorer premorbid histories than women. |
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Goldstein (1988) what were the strengths? |
A German study (angermeyer et al 1987) produced the same findings with a larger sample. Evidence suggests that it is valid to say that there are gender differences in the course of schizophrenia. This study is evidence for the reliability of the DSM-III. |
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Goldstein (1988) weaknesses |
The age limit of 45 may have affected findings as women appear to develop schizophrenia later than men. The sample was small and all participants were from New York with simile cultural backgrounds. |
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What are the different treatments for mental health disorders? |
Biological - drug treatment Cognitive - cognitive behavioural therapy. Psychodynamic - dream analysis Learning - token economy programs and systematic desensitisation. |
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What are the different types of schizophrenia? |
Paranoid - when a person is suspicious with hallucinations and delusions of grandeur. Disorganised - hard to follow speech and inappropriate moods. Catatonic - very withdrawn and isolated with very little movement. Residual - low level positive symptoms and some psychotic symptoms. Undifferentiated - doesn't fit in the other categories. |
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Disadvantages of primary data |
They are expensive compared to secondary data as data has to be gathered from the start. Limited to a time, place and number of participants. Secondary data offers more of a range. |
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Describe Twin studies. |
A way of studying issues with nature vs nurture. Both MZ (identical) and DZ (unidentical) twins are used. Then the concordance rate is analysed to see whether a characteristic is genetic or due to environmental influences. |
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Strengths of twin studies. |
no other way to study genetic influences so clearly. Both MZ and DZ twins share the same environment so there is a natural control. |
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MZ twins share DNA but even in the womb they have different environments which may cause them to develop differently. MZ twins are usually treated more alike than DZ twins because they look alike and are always of the same sex so environments may be as controlled as first thought. |
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Describe interviews. |
Can take the form of questionnaire (structured), semi-structured or unstructured. Interviews gather personal data and qualitative data. |
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Strengths of interviews. |
unstructured interviews are useful for obtaining qualitative data because questions can be explored and explained. Data tends to be valid in unstructured interviews as the respondent can use their own words and issues can be explored. |
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Weaknesses of interviews. |
There is a chance of interviewer bias where the interviewer may affect the findings. Data may be analysed subjectively causing findings to lose validity. |
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Describe drug treatment. |
In many cases allows for normal functioning. Drugs are used to reduce the effects of a disease or illness. There are typical drugs that are widely used and accepted. Atypical ones are newer and less used. Mental disorders are treated with a variety of drugs and each person responds to them differently. |
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how do anti-psychotic drugs work? |
They work by interfering with the functioning or neurotransmitters. They work to suppress hallucinations and delusions. This can cause side effects such as tiredness, shaking, muscle spasms, low blood pressure, problems with sex drive and weight gain. |
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Strengths of drug therapy for schizophrenia. |
Drugs are seen as more ethical and effective than former (pre-50's) treatments. Drugs are based on biological evidence with underpinning theory. |
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weaknesses of drug therapy for schizophrenia. |
Only 50% of schizophrenics continue to take their medication as they forget or the side effects make them too uncomfortable. Drugs can be seen as a way of controlling people in society and this can be seen as unethical. Drugs can have serious side effects that need medication themselves. Drugs do not take social or environmental factors into account. |
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Describe a psychosocial treatment for schizophrenia. |
Assertive community therapy is used to help schizophrenics with frequent relapses and bouts of hospitalisation. Patients are kept in a community where 24 hour help is available. Carers are provided to encourage independence and recovery. Holistic treatment is offered as a team of care workers offer the required help to an individual. It is said to be effective as it engaged clients, prevented rehospitalisations, increased housing stability and improved quality of life. |
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strengths of assertive community therapy. |
It is seen to be very effective as it helps people improve their communications and interactions. It helps people function is society. Bond (2002) found that ACT was extremely effective in most mental health disorders across age, gender and culture. |
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Weaknesses of assertive community therapy. |
Although this therapy appears to prevent relapses is does not have an effect on actual functioning. Large amounts of trained staff are required. The client is given little choice and gives up all responsibility of making decisions and taking care of themselves. |
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symptoms of unipolar depression? |
extreme lethargy. disturbed sleep. permanent anxiety. irritability. feelings of despair and hopelessness. lack of concentration. loss of interest or pleasure in usual activities. lack of sex drive. irrational fears and suicidal thoughts. |
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features of unipolar depression. |
depression usually occurs between 30-40 and is at its peak between 40-50. Some people only suffer once whereas some are permanent sufferers. People with depression don't tend to live as long as people without depression. It is though that 30 million people are sufferers in the USA and 3.5 million people are sufferers in the UK. |
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Describe the biological explanation of depression. |
The monoamine hypothesis. Monoamines are a group of neurotransmitters including serotonin, norepinephrine and dopamine. Serotonin regulates other neurotransmitters and without regulation irrational thinking patterns occur. Low levels of serotonin can cause low levels of norepinephrine which leads to lack of alertness, lack of energy and anxiety. Drugs work by working to increase the level of the neurotrnsmitter that is lacking, causing the symptoms. It is thought the biological make-up of a person can predispose a person to develop depression whereas a person in the same situation will not. |
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strengths of the monoamine hypothesis. |
The explanation is supported by the drug treatment as if drugs that replace monoamines work then it is evidence for the hypothesis. The different monoamines link to the different symptoms and treatments reflect those differences, supporting the hypothesis. |
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weaknesses of the monoamine hypothesis. |
There are drugs that effect depression but their action is not related to monoamines putting the hypothesis in doubt. Experiments where monoamines are depleted do not cause depression. Scans have noticed some brain differences in those with depression than those without which may be the cause of depression rather than monoamines. A different biological explanation suggests parts of the nervous system are involved in depression rather than monoamines. |
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describe the cognitive model of depression. |
It is thought that an individuals way of coping or their thinking patterns may be the cause of the disorder. Beck developed the cognitive model - the cognitive triad, negative view of self, the world and the future. - cognitive errors, faulty thinking, negative and unrealistic ideas. - schemata, patterns of maladaptive thoughts and beliefs. Seligman put forward the theory of learned helplessness where people learn to give up trying to put things right because they have only experienced failure. |
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Strengths of the cognitive model of depression. |
There is a lot of evidence that supports this theory, evidence from self report data and other measures. Some studies have taken place that shoe different modes of thinking can lead to depression, Alloy and Abramson (1999). This model takes early experiences and learning into account which can lead to certain thinking patterns and core beliefs which may predispose someone to depression. |
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Weaknesses of the cognitive model of depression. |
It is hard to find evidence that negative thinking causes depression rather than simply being present int hose with depression. Negative thinking stops when depression stops so it may be a result rather than a cause. It is almost impossible to test what causes depression and what is caused by depression such as thinking patterns and brain chemistry, |
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Describe the biological treatment for depression. |
Drug therapy. They work on the principle that low levels of serotonin cause depression. Even though serotonin levels increase almost immediately after started the drugs symptoms may not be alleviated for several weeks. All antidepressants have side effects as neurotransmitters have many functions. |
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What are some side-effects of antidepressants? |
Nausea, insomnia, anxiety, dizziness, weight change, headaches, fatigue, blurred vision. Withdrawal symptoms may also occur such as: crying spells, dizziness, insomnia, fatigue, muscle spasms and aches and pains. |
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Strengths of drug treatment for depression. |
Drugs can be used to boost mood to make an individual feel well enough to make a change in their thinking. More drugs are being developed with less side-effects. There is a lot of theoretical evidence that backs up the use of antidepressants. Particularly the newer ones that consider more neurotransmitters than serotonin. |
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Weaknesses of drug treatment for depression. |
A study has shown that less than 50% of people who take antidepressants become symptom free. Drugs ease symptoms of depression but are not seen as a cure. Therapy is considered to work just as well and is even more likely to prevent relapse. |
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Describe cognitive behavioural therapy as a treatment for depression. |
It works on the principle that depression is caused through negative automatic thoughts that arise from schemata that are built from early experiences. CBT helps the individual focus on negative thoughts then consider new ways of thinking. The practitioner offers a number of different tools to cope with negative automatic thoughts. Some ways of thinking in those who are depressed include: all or nothing thinking - one thing goes wrong then everything goes wrong. emotional reasoning - a job like cleaning up the house seems overwhelming and hopeless. Personalisation - when someone blames themselves for things that are out of their control. |
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How does cognitive behavioural therapy work? |
One session lasts around 50 minutes. There are usually six sessions. The practitioner helps the individual uncover their own core beliefs and thinking patterns. Once their beliefs and thinking patterns are uncovered alternative ways of thinking are offered. |
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Strengths of CBT as a therapy for depression. |
This therapy is evidence based suggesting it is an effective treatment. It is backed by government funding in the UK which suggests it is fairly quick to show results and is relatively cheap to provide. |
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Weaknesses of CBT as a therapy to treat depression. |
It works on the idea that negative automatic thoughts cause depression where they may actually be caused by depression. Much data from CBT is from self report data which may be unreliable as the client may say what they feel like they should say and not what is true. |
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Describe dream analysis as a therapy. |
Freud stated that dreams are 'the royal road to the unconscious,. By analysing the manifest content of dreams the latent content can be discovered. This brings unconscious desires forward. It has been suggested that mental illness is caused by suppressed unconscious desires and bringing them forward cures the illness. |
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How does dream analysis work? |
Dream work involves: Condensation - when two or more ideas get joined into one. Displacement - when someone or something that is giving concern is placed on to someone or something else. Secondary elaboration - when the unconscious puts things together so they seem logical when analysed. |
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strengths of dream analysis. |
Freud's ideas question whether rational scientific approaches to understanding people are necessary. Theerfore, his ideas cannot be criticised because they cannot be tested scientifically as this therapy appears to be effective. Freud's ideas have led to the development of other theories and therapies that may not have been reached without Freuds work. E.g humanistic therapies and CBT. |
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weaknesses of dream analysis. |
This therapy does not offer a quick cure, the patient has to offer a lot of their time and money to this and they have to be motivated enough to continue with it. Freud used case studies to support his ideas and case studies are not generalisable. A lot of analysis is involved which is likely to be subjective. This therapy causes a power difference between the analyst and the analysand which entails ethical issues. |
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Describe token economy programmes as a therapy. |
This is a form of behaviour modification where tokens are offered for desired behaviours (positive reinforcement). This therapy works on operant conditioning principles. If the required behaviour is not shown immediately then shaping can take place where tokens are rewarded for behaviour that gradually moves nearer to the required behaviour. |
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What are the eight steps of the programme? |
Behaviours that will be rewarded are identified. The nature of the tokens are decided. The rewards that are brought with the tokens are chosen. Achievable goals are set. The programme is explained to the individuals involved. Individuals are given feedback on their progress and tokens are withheld or removed for undesired behaviours. Decisions are made on how and when rewards are brought. The programme is then reviewed at regular intervals to review goals and tokens. |
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Strengths of token economy programmes. |
They appear to be effective to an extent for long term schizophrenics. This programme rests on clear behaviour management principles underpinned by a well researched theory. |
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weaknesses of token economy programmes. |
There needs to be a strong team using the programme as rewards must be consistent and clear. This requires a high level of management and commitment from staff. There is a power issue as have the power to reward behaviours and have the power to demand certain behaviours. This is an ethical concern. There are problems with transferring the programmes outside the institution as rewards may be associated with the staff and the setting. |
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Brown et al (1986) background? |
Depression is measured using a life event score. It is claimed that life events with severe long term threats or entail difficulties that last two years or more can bring about depression. Only some people, however, in the same situation develop depression suggesting other factors need to be studied. It is suggested that factors such as self esteem and types of relationships play a part in depression. |
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Brown et al (1986) procedure? |
The study took place in North London, Islington. The age range was between 18 and 50. All participants were women with a child under 18 living at home, had a husband in a manual occupation or were single mothers. 395 women were involved in the first part of the study. The first part had two phases. Firstly self esteem and personal ties were measured and psychiatric history was collected. 12 months later data about any psychiatric disorders were collected and measures of life event stress and social support were taken. Experienced interviewers were used and a reliability was studied. Satisfactory inter-rater reliability was found. |
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Brown et al (1986) results? |
353 women agreed to the follow up interview after 12 months. 50 of these women were depressed at first contact so were excluded. 303 women were interviewed and analysed. 150 of them had a severe life event or a major difficulty in the 12 month period and 32 had the onset of depression. 91% of these 32 women had experienced a severe event in the 6 months before the onset of depression compared to 23% of those who weren't depressed. 33% of those with the onset of depression had a negative evaluation of themselves. 92% of the women who sought crisis support found it helpful. |
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Brown et al (1986) conclusions? |
It was decided that those who were married or had a close tie had a lower chance of the onset of depression. It is thought that support offered at one time but not another increases the chances of depression. Also, it is suggested that people with low self esteem are more likely to develop depression. |
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Brown et al (1986) strengths. |
Interviews gave in-depth and detailed data that was required for the analysis of such concepts. There was inter-rater reliability. Data is likely to be valid as semi-structured interviews were used and trained interviewers were used. Sampling was carefully carried out by contacting eligible women then carrying out random sampling. |
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Brown et al (1986) weaknesses. |
Hard to separate out different concepts that involved in the onset of depression. It is hard to generalise findings as only working class women with one child still at home were studied. |
