Component 3 — Issues in Mental Health

4 Definitions of Abnormality

1. Deviation from Social Norms 2. Failure to Function Adequately 3. Statistical Infrequency 4. Deviation from Ideal Mental Health (Jahoda).

DSM-5 and ICD-11

Diagnostic manuals used to categorize mental disorders. DSM-5 (American Psychiatric Assoc); ICD-11 (WHO - covers mental and physical conditions globally).

Reliability of Diagnosis

Consistency of diagnosis between different clinicians (Inter-rater) or over time (Test-retest). Improved by standardized diagnostic criteria (DSM/ICD).

Validity of Diagnosis

Accuracy of diagnosis—ensuring the diagnostic criteria actually identify a distinct disorder with unique symptoms and responses to treatment (Construct/Criterion validity).

Szasz (1961/2011) - The Myth of Mental Illness

Aim: Re-evaluate mental illness concept. Argument: Mental illness is a metaphor, not a physical medical disease. 'Disturbances' are 'problems in living'. Medicalization takes away moral responsibility and leads to medical control.

Gottesman et al. (2010) - Biological Genetics

Aim: Calculate risk of offspring developing severe mental disorder if parents have bipolar/schizophrenia. Sample: Danish population register (2.7 million people). Findings: Risk of Schizophrenia with 2 affected parents = 27.3% (vs 1.12% population baseline). Risk with 2 parents with Bipolar = 24.9%. Conclusion: Strong genetic transmission of severe psychiatric disorders.

Medical Model Explanations

Disorders caused by biological dysfunctions: Genetics (inherited vulnerability), Biochemical imbalances (Dopamine hypothesis for Schizophrenia, Monoamine hypothesis for Depression), or Brain structure abnormalities.

Biological Treatments - Antipsychotics

First-generation (Typical - e.g., Chlorpromazine) block D2 dopamine receptors; Second-generation (Atypical - e.g., Clozapine) block Dopamine and Serotonin receptors to reduce positive/negative schizophrenia symptoms.

Biological Treatments - Electroconvulsive Therapy (ECT)

Passing electrical currents through the brain under anesthesia to induce a brief seizure. Used for severe, treatment-resistant depression.

Psychological Treatments - CBT

Cognitive Behavioral Therapy: Identifies and restructures dysfunctional core beliefs, cognitive distortions (catastrophizing), and replaces mal-adaptive coping strategies with healthy behavioral activation.

Psychological Treatments - Systemic / Family Therapy

Focuses on changing communication patterns and reducing High Expressed Emotion (criticism, hostility) within families of patients recovering from severe disorders to prevent relapse.