AQA GCSE Psychology – Psychological Problems
Chapter 8: Psychological Problems
- An introduction to mental health
- Characteristics of mental health, e.g. positive engagement with society, effective coping with challenges
- Cultural variations in beliefs about mental health problems
- Increased challenges of modern living, e.g. isolation
- Increased recognition of the nature of mental health problems and lessening of social stigma.
- Effects of significant mental health problems on individuals and society
- Individual effects, e.g. damage to relationships, difficulties coping with day to day life, negative impact on physical wellbeing.
- Social effects, e.g. need for more social care, increased crime rates, implications for the economy.
- Characteristics of clinical depression
- Differences between unipolar depression, bipolar depression and sadness.
- The use of international classification of diseases in diagnosing unipolar depression: number and severity of symptoms including low mood, reduced energy levels, changes in sleep patterns and appetite levels, decrease in self-confidence.
- Theories of depression
- Biological explanation (influence of nature): imbalance of neurotransmitters, e.g. serotonin in the brain
- Psychological explanation (influence of nurture): negative schemas and attributions.
- Interventions or therapies for depression
- Use of antidepressant medications.
- Cognitive behaviour therapy (CBT).
- How these improve mental health, reductionist and holistic perspectives. Wiles’ study of the effectiveness of CBT
Chapter 1: Memory
- Processes of memory
- Different types of memory
- Episodic memory
- Semantic memory
- Procedural memory
- How memories are encoded and stored
- Different types of memory
- Structures of memory
- The multi-store memory model
- Sensory memory store
- Short-term memory store
- Long-term memory store
- The features of each store
- The multi-store memory model
- Primacy and recency effects
- The effects of serial position
- Murdock’s serial position curve study
- Memory as an active process
- The Theory of Reconstructive Memory, including the concept of ‘effort after meaning’
- Bartlett’s War of the Ghosts study
- Factors affecting the accuracy of memory, including interference, context and false memories
Chapter 2: Perception
- Sensation and perception
- Visual cues and constancies
- Monocular depth cues: height in plane, relative size, occlusion and linear perspective
- Binocular depth cues: retinal disparity, convergence
- Gibson’s direct theory of perception and the influence of nature
- Role of motion parallax in everyday perception
- Evaluating Gibson’s direct theory of perception and the influence of nature
- Visual illusions
- Explanations for visual illusions: ambiguity, misinterpreted depth cues, fiction, size constancy.
- Examples of visual illusions: the Ponzo, the Müller-Lyer, Rubin’s vase, the Ames Room, the Kanizsa triangle and the Necker cube
- Gregory’s constructivist theory of perception and the influence of nature
- Evaluating Gregory’s theory of perception
- Factors affecting perception
- Perceptual set and the effects of the following factors affecting perception: culture, motivation, emotion, expectation
- The Gilchrist and Nesberg study of motivation and the Bruner and Minturn study of perceptual set
Chapter 3: Development
- Early brain development
- A basic knowledge of brain development, from simple neural structures in the womb, of the brain stem, thalamus, cerebellum and cortex, reflecting the development of autonomic functions, sensory processing, movement and cognition
- The roles of nature and nurture
- Piaget’s stage theory and the development of intelligence
- Piaget’s Theory of Cognitive Development including concepts of assimilation and accommodation
- The role of Piaget’s theory in education
- The four stages of development: sensorimotor, pre-operational, concrete operational and formal operational. Application of these stages in education. Reduction of egocentricity, development of conservation
- McGarrigle and Donaldson’s ‘naughty teddy study’; Hughes’ ‘policeman doll study’
Chapter 4: Research Methods
- Formulation of testable hypotheses
- Types of variable
- Sampling methods
- Designing research
- Research procedures
- Planning and conducting research
- Ethical considerations
- Quantitative and qualitative data
- Primary and secondary data
- Descriptive statistics
- Interpretation and display of quantitative data
- Normal distributions
Chapter 5: Social Influence
- Prosocial behaviour
- Crowd and collective behaviour
Chapter 6: Language, Thought and Communication
- The possible relationship between language and thought
- The effect of language and thought on our view of the world
- Differences between human and animal communication
- Non-verbal communication
- Explanations of non-verbal behaviour
Chapter 7: Brain and Neuropsychology
- Structure and function of the nervous system
- Neuron structure and function
- Structure and function of the brain
- An introduction to neuropsychology
Characteristics of good mental health
Good mental health is more than simply not having a mental health problem. A person with good mental health will display some (not necessarily all) of these characteristics:
- Not being overcome by difficult feelings
- Able to have good relationships with other people
- Able to deal with disappointments and problems they face
- Able to cope with the stresses and demands of everyday life
- Being able to make decisions
- Being able to cope effectively with difficulties or challanges
- Positive engagement with society
- Functioning as part of society
When people suffer from mental health problems, these affect the way they think, feel and behave. There are many different types of mental health problems with some more common than others, such as depression and anxiety. Other mental health problems such as Schizophrenia and bipolar disorder occur less often.
Mental health problems are diagnosed using two recognised ways: The World Health Organization’s (WHO) International Classification of Diseases (ICD-10) and the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Symptoms Of Mental Health Problems
Cultural variations in beliefs about mental health problems
All throughout history, mental health problems have often previously been attributed to supernatural or spiritual causes. These have ranged from possession by evil spirits, being cursed or being a witch. Throughout Europe and North America, during the fourteenth to seventeenth centuries, many women were accused and tried for being witches. It is now believed that mental health problems have resulted in some of the behaviours displayed by those accused.
In many cultures, having mental health issues is seen negatively. For example, in Asian cultures, mental health problems are stigmatised and seen as a form of personal weakness. The stigma attached to mental health problems can cause people to further experience further problems including economic, social and legal discrimination. In other cultures, a person’s behaviour can be seen to reflect on the whole family and it is common for people with mental health problems to be kept away from other people and cared for by the family.
Cultural beliefs about the cause of mental health problems can also influence how people with such issues are treated. In cultures where such problems are seen as having a biological cause, medication is often used. In other cultures, where they are attributed to spiritual causes, treatments may range from prayers to exorcisms. Self-help groups and therapy are more popular in cultures where sharing openly about yourself, your problems and emotions are valued. In cultures where mental health problems are seen as shameful, people may be kept isolated and be unable to talk to others about what they are going through.
Research suggests that more people than ever are being diagnosed with mental health problems globally. Some disorders such as schizophrenia occur at a consistent rate, however, others such as depression have a growing rate of diagnosis. This may not necessarily be down to more people having mental health problems but changes in the classification of disorders which results in more people meeting the criteria for diagnosis. There are also more people seeking medical and psychiatric treatment across cultures as they come to be less reliant on traditional methods of addressing mental health problems.
Challenges of modern living and its effects on mental health
Research suggests that living in more populated (modern) areas can increase stress levels. Brain scans have shown that people who live in cities also have more active amygdala compared to people living in less populated areas. One of the roles of the amygdala is responding to threats, which suggests a link to increased stress levels.
Other factors such as loneliness and isolation can also contribute to mental health problems such as depression an anxiety. A survey for the Mental Health Foundation found that one in ten people in the UK report feeling lonely and this is increasing amongst young people. Changes in the way people live may be a possible cause for increasing levels of loneliness. More people may also be living on their own away from family and friends due to the demands of work, family breakdown or simply people living longer. The advancements of technology and social media
Increased recognition of the nature of mental health problems
Although mental health problems have been recognised throughout history, they have been viewed as having various different causes. For example, the current western understanding of biological and psychological causes began to develop during the nineteenth century when classification systems were first developed and psychiatry became a specific area within medicine. The twentieth century saw the development of psychoanalysis and while the mid-twentieth saw drugs being increasingly common as a way of treating mental health problems.
The traditional explanations of mental health problems has focused on the supernatural and spiritual causes. Today, biological and psychological causes are more accepted however myths and misconceptions are still widespread, particularly in rural areas within developing countries. As the biological and psychological nature of mental health problems become more recognised, this is likely to lead to increases in worldwide diagnosis rates as the subsequently seek medical and psychiatric treatment.
Reducing Social Stigma with Mental Health
The term “mental health” was first coined in the early twentieth century in an attempt to reduce the stigma associated with it by focusing on health, rather than illness. Despite almost a hundreds years later, being diagnosed with a mental health problem can still be hugely stigmatising.
Recent findings in the National Attitudes to Mental Illness survey show that opinions are in the UK are changing. This could be attributed to various reasons including campaigns such as “Time to Change” as well as celebrities also speaking about their own personal experiences.
The World Health Organisation (WHO) views stigma and discrimination towards those suffering with mental health issues as one of the worlds most important health issues. A possible explanation for increasing levels of diagnosis may be due to the lessening of social stigma attached to it thus people feel more confident in seeking treatment to address their issues.
The effects of mental health problems on individuals
Mental health problems can result in people coping with everyday life. This may manifest itself through trouble sleeping, low energy levels and even poor concentration which can make work or education difficult. If an individual develops a mental health problem earlier in life, this can stop them from finishing their education or training. People diagnosed with a mental health problem in the UK are four times more likely to also be out of work. Unemployment and low income can increase stress and anxiety levels and may well make the mental health problems worse.
Poor mental health can also have a detrimental effect on physical wellbeing. For example, due to their mental health problem, they may find it difficult to follow treatment programmes. Individuals may feel anxious about the side effects of their medication, feel too depressed to attend appointments or also forget to take their medication due to concentration difficulties. The changes in appetite or side effects from medication can result in weight gain or weight loss, low energy and mood can also reduce exercise levels. Individuals with mental health problems also have higher rates of drug and alcohol abuse although it is difficult to fully establish cause and effect for this.
People with mental health problems can also see their relationships become damaged. Research suggests that around 50 per cent of family members with someone with mental health problems also develop a disorder too. This may be because family members end up as carers which increases stress levels and leads to conflict. The effect on the household income can also increase stress levels. Children may also subsequently be affected as they are not cared for adequately by parents who have mental health problems. For example, some children may end up in the care system or become carers for their parents which places a huge amount of stress and anxiety on them. People with mental health problems may also become isolated due to the stigma of having a mental health problem and thus struggling to talk about their problems. This may lead to them withdrawing into themselves even further.
The effects of mental health problems on society
One of the main society effects of mental health problems is the implication this has for the economy. A study by WHO (World Health Organisation) found that in the UK, 15% of the cost of all health economic issues can be attributed to mental health problems. According to the Sainsbury Centre for mental health, over £15 billion pounds are lost every year due to decreased work productivity.
Although most individuals with mental health problems do not commit violent crimes, a significant portion of prisoners are found to suffer from mental health problems. A Ministry of Justice study found that 49% of females and 23% of males in prison were suffering from anxiety and depression. This is significantly higher when compared to the general population where 19% of females and 12% of males suffer from mental health issues. These findings suggest a link between mental health problems and crime or at least, a link between imprisonment and mental health problems.
The impact of mental health problems on society feeds through in increased social care costs. A person with mental health issues may require a variety of different needs being met to function. In a welfare state such as the UK, this can result in increased spending in areas such as the health system social housing and benefit payments to sufferers. This would then translate into high levels of tax for workers and businesses.
The clinical characteristics of depression
Before we try and look at the characteristics of depression, it is best to try understand exactly what depression is. Depression is
The differences between unipolar depression, bipolar depression and sadness
Depression is often linked with the main symptoms of sadness or general low mood which makes it difficult for people to distinguish the difference between them. Sadness is a normal emotional reaction to certain situations or events, while depression occurs without any obvious trigger. Sadness may seem like it goes on for a long time however it is not a continous feeling that lasts for weeks or months. Depression on the other hand, affects every part of our daily lives and often does not get better without medical or therapeutic intervention.
Unipolar depression is also known as clinical depression or just depression. People suffering from unipolar depression have a continuous low mood and loss of enjoyment and energy. The word “uni” is derived from Latin and means “one”. This is used to define unipolar depression because someone experiencing this changes their mood only in one direction.
The medical term for bipolar depression is bipolar affective disorder and is also known as manic depression. The term “Bi” comes from Latin also and means “two”. It is described as such because someone with bipolar depression experiences two types of mood changes. For example, although they may display depressive type symptoms involving low moods, they will also experience high moods known as mania. During these manic episodes. they may experience increased energy, feelings of extreme excitement and struggle to sleep, talk excessively or engage in risky or extreme behaviours.
Diagnosing unipolar depression
In order for a doctor to diagnose depression, they ask a number of standardised questions based around the diagnostic criteria set out in the ICD-10 or DSM-5. As some medical conditions have very similar symptoms to depression, a doctor may also do a physical examination as well as blood tests and urine tests.
The ICD-10 gives a number of possible symptoms for depression. The number and severity of symptoms an individual experiences determines whether a depressive episode is considered mild, moderate or severe. Symptoms would usually need to be continuously present for at least two weeks for a diagnosis of depression to be made.
The ICD-10 outlines the symptoms for a depressive episode as:
- Low Mood
- Reduced energy and activity levels
- Changes in sleep pattern
- Changes to appetite levels
- Decreased self-confidence
- Lack of interest and enjoyment
- Reduced concentration and focus
- Feelings of guilt and worthlessness
- Negative thoughts about the future
- Suicidal thoughts
What causes depression?
Research into the explanations of depression suggest that a mixture of biological, psychological and social causes can be attributed to its onset. Each of these factors and the relationship between them is complex which is why it makes it difficult to determine a definitive cause for depression.
The influence of nature: A biological explanation for depression
When we refer to “nature” we are talking about inherited biology and genetics. One explanation for depression suggests it is nature (the genetics and biology of a person) which pre-determines whether a person may be likely to suffer from depression. One biological explanation suggests an imbalance of neurotransmitters (chemicals) may be the cause. The brain uses neurotransmitters to communicate within itself and with the nervous system and body. These chemical messages are received and sent by the brain’s nerve cells (neurons). Neurons are communicating constantly with one another using neurotransmitters and this is very important for the brain to function properly. The two main neurotransmitters linked with depression are serotonin and norepinephrine.
Serotonin helps control a persons biological functions such as sleep patterns, aggression levels, appetite and mood. Researchers have used PET scans to study the link between serotonin and depression, comparing people suffering with depression with those who are not. The levels of a serotonin receptor found in the hippocampus is measured. The hippocampus is part of the temporal lobe and is involved in the storing of memories and connecting them to our emotions. MRI scans have also found that people who are depressed also have a smaller hippocampus.
Norepinephrine is released during the fight and flight response and gets the body and brain ready for action. Autopsy studies conducted on people with depressive episodes have found they have fewer neurons that release norepinephrine. Other research has found that in some people, low levels of serotonin may cause lower levels of norepinephrine.
Research seems to suggest a link between neurotransmitters and depression however it is difficult to measure the actual levels within the brain. The brain is complex with many chemical reactions affecting mood and it is therefore unlikely an imbalance of one neurotransmitter can explain why depression occurs.
The influence of nurture: A psychological explanation for depression
When we refer to “nurture”, this refers to the life experiences and environment a person experiences which can affect them as they grow up. One psychological explanation for depression is the cognitive explanation (cognitive theory). Cognitive theory is a psychological approach that proposes our thought processes determine our behaviour. Cognitive theory proposes our behaviours and emotions are influenced by the way people explain the things that happen to them and the views they have about the world and themselves. The theory is based on the idea of Schemas, which were first introduced by Piaget.
Schemas are based on our previous experiences and are developed and changed to fit new experiences and information. Having negative schemas have been linked to the development of depression. For example, traumatic events in childhood may contribute to the development of negative schemas which affect the way people view themselves and the world.
People who have developed negative schemas are thought to perceive situations negatively to an exaggerated degree. For example, if something bad happens in their life, they may exaggerate how bad things are or will get when presented with such situations. The cumulative effects of this negative type of thinking and perception is applied to all aspects of their life and world. This is then believed to contribute to the onset of depression.
How attributions influence depression
Attributions have also been linked to depression. Attributions are the way in which people explain the causes of behaviours and situations. Two dimensions of attributions are internal-external and stable-unstable.
With an internal attribution, people explain situations or behaviours as being caused by dispositional factors such as personality or ability. People with external attribution tendencies would explain situations or behaviours as being caused by situational factors, such as the weather or the economy.
People who make a stable attribution would explain situations or behaviours as being caused by factors that do not change i.e. gender. When people make an unstable attribution, they explain the behaviour or situation as being caused by factors are are temporary i.e. tiredness.
So a working example would be: Someone who fails an exam and believes they are not clever enough to pass or do anything about this would explain the failed exam as internal and stable. However, someone who fails the exam and believes it is because they did insufficient revision or illness, would explain the failed exam as external and unstable.
Linking this back to depression, research has found that people who are more likely to be depressed have attributions that are internal and stable. People who have attributions that are external and unstable will see negative things as being caused by factors beyond their control and only temporary and thus less likely to be depressed.
Treatments for depression: Antidepressants
Antidepressants are drugs which are used to treat depression. Antidepressants work by increasing the levels of the neurotransmitters such as serotonin and noradrenaline. There are over approximately 30 different types of antidepressants with the most commonly prescribed for the UK as being Serotonin Reuptake Inhibitors, also known as SSRIs. SSRIs stop the reuptake of serotonin. After a neaurotransmitter has communicated its message to the neuron, the message needs to be prevented from being constantly communicated. To achieve this, the neuron reabsorbs the neurotransmitter it released. This process is called reuptake. Stopping this reuptake process increases the levels of serotonin which contributes to the reduced affects of depression.
Antidepressants first became available in the 1950s and their usage as increased since then. Between 2000 and 2010, statistics show that the use of antidepressants as increased each year by 20 percent. The UK has the forth highest level of antidepressant use in Europe with more than 50 million prescriptions written every year.
Despite the high number of people being prescriped antidepressants, there are questions into exactly how affective they are. People generally report some improvement due to taking antidepressants and this is more apprent in cases of severe depression. However research suggests antidepressants are not as effective for people suffering from mild depression.
The Royal College of Psychiatrists say 50-65% of people with depression who take antidepressants will show improvement. However, 25-30% of people will also report improvements when taking a placebo (fake pill). Research into the effectiveness of treating depressed children and adolescents with antidepressants concluded that almost all antidepressants show a similar effect to what is seen when a placebo is taken.
Antidepressants also have a number of side effects. These include weight gain, insomnia, dry mouth or increased aggression and suicidal thoughts.
Treatments for depression: Cognitive behaviour therapy
Cognitive behaviour therapy (CBT) is based on cognitive theory and the assumption that our thought processes affect our behaviour and emotions. CBT is a “talking therapy” that looks to help people change their thinking patterns, such as negative schemas which may have developed. CBT tackles depression by getting people to focus on the “here and now” problems rather than those from the past or imagined ones. CBT sessions will attempt to get sufferers to identify their thought patterns and challenge them on how rational, logical or pragmatic (helpful) they are. CBT can be run by a therapist in one-to-one sessions or it can be run in groups. Research by Wile’s showed positive results for the use of CBT in treating depression.