Psychological Disorders: Crash Course Psychology #28

Summary

This script recounts the history and evolution of mental health treatment and diagnosis, from Nellie Bly's undercover expose in 1887 to David Rosenhan's 'On Being Sane in Insane Places' experiment in 1975. It discusses the medical model, the biopsychological approach, and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), highlighting the complexities and challenges in defining and treating psychological disorders.

Takeaways

• 🕵️ Nellie Bly's undercover investigation in 1887 exposed the deplorable conditions in US asylums, leading to mental health reform.
• 📜 David Rosenhan's 1975 experiment 'On Being Sane in Insane Places' revealed the ease of being admitted to a mental institution and the difficulty of being recognized as mentally healthy.
• 💊 Rosenhan's participants were forced to take psychotropic medication and were discharged with a diagnosis of paranoid schizophrenia in remission, highlighting flaws in the diagnostic system.
• 🤔 Rosenhan's experiment raised questions about the definition, diagnosis, and classification of mental disorders, and the impact of diagnostic labeling.
• 🌐 The World Health Organization reported in 2010 that 450 million people worldwide suffer from mental or behavioral disorders, emphasizing the global reach of these conditions.
• 🏥 Psychological disorders are viewed as deviant, distressful, and dysfunctional patterns of thoughts, feelings, or behaviors within a cultural context.
• 🧬 The Biopsychological Approach considers a holistic view of mental health, incorporating psychological, biological, and social-cultural factors.
• 📚 The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is a work in progress, evolving with new research and understanding of mental health.
• 🔄 Changes in the DSM reflect societal and scientific advancements, such as the removal of homosexuality as a pathology and the renaming of Childhood Bipolar Disorder.
• 🚫 Critics argue that the DSM may inadvertently promote over- or mis-diagnosis and treatment of certain behaviors, and reinforce stigmatizing labels.
• 🌟 The script emphasizes the importance of understanding the definitions and perspectives on mental illness, as well as the ongoing evolution of diagnostic tools like the DSM.

Q & A

Who was Nellie Bly and what did she do to expose the conditions in psychiatric hospitals?

Nellie Bly was the alias of journalist Elizabeth Cochran. She feigned mental illness to infiltrate and report on the deplorable conditions inside psychiatric hospitals, known as asylums, in the US. Her exposé 'Ten Days in a Mad House' detailed rotten food, cold showers, rats, abusive nurses, and patients being tied down, which contributed to mental health reform.

What was the significance of David Rosenhan's experiment 'On Being Sane in Insane Places'?

David Rosenhan's experiment aimed to test the validity of psychiatric diagnoses by sending pseudopatients—mentally sound individuals—to psychiatric institutions. Once admitted, they behaved normally, but it was difficult for them to be recognized as healthy and discharged, highlighting flaws in the system and the ease of misdiagnosis.

What was the average duration of stay for Rosenhan's pseudopatients in the psychiatric institutions?

The pseudopatients were kept in the institutions for an average of 19 days, with one participant staying for as long as 52 days.

How did Rosenhan's experiment challenge the psychiatric system's view of mental illness?

Rosenhan's experiment criticized the system for viewing mental illness as an irreversible condition akin to a personality trait rather than a curable illness. It also questioned the validity of diagnostic labels and the impact of situational factors on diagnoses.

What is the Biopsychological Approach to understanding mental health?

The Biopsychological Approach is a comprehensive perspective that considers psychological, biological, and social-cultural factors to understand mental health. It acknowledges that mental disorders can have physiological causes and can be influenced by stress, trauma, genetics, brain chemistry, and cultural norms.

What is the DSM-5 and why is it significant in the field of psychology?

The DSM-5, or the Diagnostic and Statistical Manual of Mental Disorders, is a manual published by the American Psychiatric Association. It is significant because it provides standardized criteria for the diagnosis of mental disorders and is used by clinicians, insurance companies, policymakers, and the legal system.

How has the DSM evolved over time to reflect changing attitudes and understanding of mental health?

The DSM has evolved with each edition to incorporate new research and societal attitudes. For example, homosexuality was classified as a pathology in earlier editions but was removed in the 1973 edition, reflecting a growing understanding and acceptance of sexual orientation.

What are some criticisms of the DSM and its use in diagnosing mental disorders?

Critics argue that the DSM may inadvertently promote over-diagnosis or mis-diagnosis of certain behaviors. There are also concerns that diagnostic labels can lead to stigmatization and preconceived judgments about individuals, affecting how they are perceived and treated.

What is the definition of psychological disorders according to mental health clinicians?

Psychological disorders are defined as deviant, distressful, and dysfunctional patterns of thoughts, feelings, or behaviors that differ from the cultural norm, cause subjective distress, and impair a person's ability to function in their daily life.

How did the concept of mental health and psychological disorders evolve in the Western world?

The concept evolved from viewing mental health issues as a sickness of the mind during the 18th and 19th centuries to the Medical Model of Psychological Disorder, which suggests physiological causes for mental disorders. This was further expanded by the Biopsychological Approach, which considers a holistic view of influences on mental health.

What is the impact of cultural context on the perception and treatment of psychological disorders?

Cultural context plays a significant role in defining what is considered deviant behavior and how it is perceived. What might be acceptable or expected in one culture could be seen as abnormal or distressing in another, affecting diagnosis and treatment approaches.