OCR Psychology A Level Book 2 sample

Links with debates Free will /determinism Many historical viewpoints of mental illness are considered determinist , because they attribute mental illness to a particular biological cause, such as bodily fluids in Hippocrates’ four humours theory or brain structure and function in the more recent somatogenic theories. This demonstrates biological determinism . The failure to function adequately definition of abnormality also suggests an element of free will . A person is free to adjust or control aspects of their life (possibly with some help)—they are things that are not predetermined, and can be changed, such as eating regularly, washing clothes and getting up to go out to a job or other activity. Individual /situational explanations Some of the historical viewpoints of mental illness focus on the individual as the source of mental illness. An individual’s bodily humours or their genes or their unconscious may be the source of the mental illness—but all of these are individual explanations of mental illness. The deviation from ideal mental health definition of abnormality also focuses on the individual, suggesting they lack factors that would give them ideal mental health such as self- attitudes and autonomy. These are factors within the individual. Rosenhan’s study provides strong evidence for the situation in the labelling and interpretation of mental illness. He demonstrated that the behaviour of a person (the pseudo-patient) is interpreted according to the label they have been given. Then ‘normal’ behaviours become seen as symptoms of the illness, and therefore confirm the original diagnosis. The deviation from social norms definition of abnormality also provides a situational argument, because it suggests that behaviour which is considered abnormal is only defined as such because of the situation that the behaviour appears in—for example, crying a lot is absolutely normal during a sad film, but not considered normal when standing in a queue at a supermarket. Ethical considerations In Rosenhan’s study it might seem unethical to make the pseudo- patients spend time in a psychiatric hospital—but they were not participants, they were part of the research team. In terms of the real participants—the staff and patients at the hospital—many guidelines were broken. For example, the psychiatrists were deceived , they were told the pseudo-patients were hearing voices and that they were real patients. The staff on the wards were deceived about the pseudo-patients’ true mental status and were not aware they were being observed by the pseudo- patients. The staff at the hospital in the second study were also deceived—they were told pseudo-patients would be sent and in fact none were. In Rosenhan’s study none of the medical staff were able to provide informed consent nor did they have the right to withdraw from the study or to withdraw their data. No physical harm was caused by Rosenhan’s research, but the anger and embarrassment ( psychological harm ) of the nursing and psychiatric community was widely documented following the publication of the research. Conducting socially sensitive research The diagnosis of disorders can have profound consequences on the individual, their family and the wider community. This makes diagnosis a socially sensitive subject. Following Rosenhan’s first study many nurses complained that his study made their profession look bad. However, although individual groups were upset by the research, overall the benefit to society has been enormous. The study raised awareness of the flaws in the psychiatric diagnosis and treatment at the time, and supported the anti-psychiatry movement. As a consequence diagnostic systems became more stringent, for example DSM-III required one positive symptom for over a week to diagnose schizophrenia , but DSM-5 requires at least two positive symptoms for over one month (Phillips 2011). The research appears to have had an important positive effect on the care with which a diagnosis is made. Using the social norms definition of abnormality might mean that some eccentric individuals or groups are labelled as abnormal just because their lifestyle is not the same as other members of society. This is socially sensitive because it could lead to subgroups being judged and treated differently, having negative consequences for those groups. Psychology as a science The older historical viewpoints of mental illness were not very scientific—for example, demonic possession is not a falsifiable concept. Hippocrates’ theory of the four humours was the first main theory to take physiological abnormalities as the explanation for mental illness. This could therefore be considered more scientific because it is based on objective and measurable physiological phenomena. The statistical infrequency definition of abnormality is the most scientific as it uses objectively measurable, quantitative concepts. The failure to function adequately definition can also be judged to be scientific because clinicians can objectively list behaviours that are identifiable as ‘abnormal’. However, the deviation from ideal mental health definition of abnormality is subjective because the concepts, such as self-actualisation , are difficult to operationalise and therefore the approach lacks scientific rigour. Structure a debate in class, where half of you argue that Rosenhan’s study should not have taken place and the other half argue that it was justified. Prepare several arguments in advance and be prepared to counter-argue what your classmates say. Remember you must back up your points with evidence. If you knew that a friend of yours had a serious mental illness, might that affect your perception of their ‘normal’ behaviours? We have only covered five of the eight debates here, and we have not made every possible link to the background and key research. This is because the aim is not to rote learn these links but to be able, in the exam, to think on your feet and construct your own. So use this information as a template—you can start by considering the three debates we have not covered. check your understanding 1. Discuss the extent to which one historical view of mental illness could be seen as determinist. [5] 2. Discuss how defining abnormality could be considered socially sensitive. [5] 3. Outline what Rosenhan’s study tells us about categorising mental illness. [6] 4. With reference to the key research by Rosenhan, discuss the individual and situational debate. [10] 19 Linking it together: Evaluation of research on the historical context of mental health