,The historical context of mental health
Historical views of mental illness:
Bethlem becomes a
Hippocrates - four
First recorded Madhouse Act psychiatric teaching
humours (blood, phlegm,
treatment - inspection of hospital under new
yellow bile, black bile)
of 6 ‘insane’ patients madhouses NHS
Ancient Greece 1403 1774 1948
1247 1634 1815 1960's
Bethlem priory Medical regime - Reforms - no 'Care in the
founded bleeding, purging, more public community’
cold bathing viewing model
Defining abnormality: Categorising mental disorders:
! Very controversial !
DSM:
• first published in 1952
Statistical Infrequency - behaviour rarely • 5th edition
seen in the general population. E.g. • 157 disorders
Intelligence - outside the normal
distribution of scores. Category examples
• Not sufficient - could be happy and
well-functioning. Neurodevelopmental disorders
• Severe intellectual disability (IQ below
Deviation from social norms - behaviour 70)
that deviates from what one society/
culture defines as acceptable. Eating disorders
• Huge discrepancies between • Pica (non-food substances)
definitions of normal.
Impulse control and conduct disorders
Maladaptiveness - when someone's • Pyromania (deliberately setting
thinking, emotional responses, or fire)
behaviour is dangerous or prevents Substance use and addictive disorders
normal functioning. • Gambling disorder
• Broader but allows for individual
differences. Mental retardation = intellectual disability
4 separate disorders = autism
spectrum disorder
, Key Research - Rosenhan (1973)
Aim - to investigate whether the sane can be reliably and accurately
distinguished from the insane.
Study I
Sample
• 8 pseudopatients
• Painter, housewife,
psychiatrists, etc.
• Rosenhan first
patient
• 12 hospitals - 5
states - old and
new
Design and procedure Results
• Field experiment/ • Admitted successfully to all 12 hospitals - no staff
Participant observation detection!
• ‘When am I likely to be • Labeled with schizophrenia / in remission (Private)
discharged? • Real patients -'you're not crazy'
• Pps hearing voices - • Pacing = nervous
‘empty, hollow, thud' • Canteen queue = oral-acquisitive behavior
• On ward - normal - no • Physical abuse
symptoms • Inadequate privacy - no toilet doors
• Pretend to take • 2100 pills given to pseudopatients - flushed in toilet
medication • Depersonalisation - staff fear patients but also want
to help
• Hierarchical structure - average 6.8 minutes with
doctor.
• Rosenhan - places ‘in which the meaning of
behaviour can be easily misunderstood'
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