What are the 3 problems with statistical labelling?
- We don’t treat both ends of the distribution equally (ex: IQ)
- It’s hard to plot abnormal behavior
- What you’re plotting matters ex: Plotting Depression by age: the mean is meaningless because it is a bimodal distribution (has 2 peaks)
What are the 5 models of abnormality?
PASCL
- Possession Model: Possession by evil spirits + demons causes mental illness
- Animal Model: To be mentally ill is not human: mentally ill treated like animals
- Simple Illness (Disease) Model: Mental illness is an illness like any other illness
- Complex Medical Model: Looking at symptoms is not enough, diseases vary in degree
- Labelling Model: Categorizing abnormal behavior based on symptoms
Who gets hospitalized for mental disorders? 5 classes
What do they have in common?
- Suicidal Depressives (31 d)
- Angry Psychotics (57 d)
- Angry Geriatrics (56 d)
- Antisocial Addicts (27 d)
- Social Isolates (63 d)
They pose a threat to themselves or others
Success rate is not good
What are the 6 advantages to high risk research?
- The contemporaneous recording of events
- Allows the study of escape from high risk
- Allows for the study of Heterogeneity of abnormal outcomes (disorders on a spectrum, environmental factors shape symptom characteristics
- Subdivision in terms of age of onset
- We can measure changes over time (factors controlling relapse)
- Can sometimes explain feedback mechanisms: circular process and chain of events important in causation
Reasons for Comorbidity
- One disorder causes the other
- Both disorders caused by something else
- Reciprocal Causality
- Symptoms overlap
5/ We don’t have separate disorders
Why Label? 3 reasons
- Comfort and Convenience
- Scientific reasons
- Validity (hopefully, different disorders would be treated differently)
Complex Medical Model: 4 Characteristics
- Same symptoms can have different eitologies (Anemia example)
- Diseases vary in degree (normal distribution Arthritis example)
- It takes psychological factors to induce the actual disorder (ex stress decreases functioning of immune system)
- Views illness as an interaction between predisposition and environmental factors (Vodka example)
What is the current Zeitgeist?
Abnormal behavior is viewed as a brain disease, biological
Simple illness model
What are it’s Characteristics?
4 cons?
- mental illness is an illness like any other
- discontinuous with normal behavior, sick or healthy, two non overlapping distributions
Cons: - Problem is with the individual, does not look at other factors like environment (ex Purcell’s Asthma study)
- Implies a need for physical intervention (ex: Lobotomies)
- The nature of the model + the nature of the institutions: pure simple medical model = treat people in institutions which is not always best
- Absolves responsibility
When you drill a hole in a person’s skull what is it called? Why?
Trephination
To let evil spirits out
Why should the mean age of 30 be ignored for depression?
The bimodal distribution distorts the mean
What is a “contemporaneous recording of events” give an example
It’s like a longitudinal study
Your follow high risk individuals over time to see which factors promote the disorder
ex: following men with a family history of alcoholism
What percentage of the population is diagnosable at any given time? What percentage aren’t treated?
1/3 of population diagnosable
2/3 of those people are not treated
What predicts violence mental illness
- Positive symptoms (delusions, hallucinations)
- History of Violence
- Substance/drug abuse
Why has there been an increase in Autism?
- Change in definition
- Increased social focus
- Comorbidity + diagnosis substitution
What 2 rules should we follow to clinically label
- Must be high reliability (should be .9 is actually .4-.5) -> Multiple diagnosticians looking at the same patient would give same label -> testing +retesting
- Advantages of labeling must exceed disadvantages
Why shouldn’t we take the DSM as a bible? Why shouldn’t we take it literally?
Allen Francis quote
- one reason supporting it
- one reason against it
For: We need labels for scientific reasons
Against: Low reliability + validity. Problems with disorder inflation, labelling and equating words with reality
List the 4 assumptions of experimentation
DOPE
Determinism
Physicalism
Operationalism
Empiricism
What is Determinism?
Everything has a reason for occurring and it’s the function of certain necessary conditions
What is Physicalism?
Study things that can be measured because they exist in time and space
What is Operationalism?
Measure things with Operational definitions ex: measuring anxiety -> results will depend on 1) nature of the test 2) how anxiety is defined 3) how you measure
Define Empiricism
use of experimentation
observable, repeatable
IV and DV
NOT deductive reasoning
Give an example of hypothesis myopia
Ignaz Semmelweis
Obstetrician who recommended hand washing in charity wards: death rate dropped to 1.2%
Run out of medicine because his ideas were too radical and others refused to accept them
What issues are there in measuring the prevalence of mental disorders?
No Gold Standard
We’re not good at judging ourselves
professional judgements are not reliable (biases)
