Mental Health Stigmas

      Mental Health Stigma can be defined in 2 different ways: as the Social Stigma and the perceived stigma or self-stigma. The Social Stigma is an extreme disapproval or discontent with a person or a group of people on a social level and distinguish them from others in a society because of the “psychiatric label” that they have received. The Self Stigma is the way that the sufferers feel about themselves because of the mental label. This usually leads to a feeling of shame in the person.

                   Studies about Social Stigma have come up with surprising results (Wang & Lai 2008, Realey & Jorm 2011). Through means of a survey with over 1700 adults in the UK, the researchers found that most commonly, people believed that other people with mental health problems (Like schizophrenia, alcoholism and drug dependence) were dangerous and not to be trusted. The next most common belief was that mental health problems like eating disorders were harming themselves, and the third most common was that people with mental health disorders were hard to talk to. Despite the responder’s age, knowledge they had of mental health, and whether they knew someone with a mental health problem, they all can back with relatively negative beliefs.

Many people hold stigmatizing beliefs about mental health problems. Everyone from people who know someone with a mental health problem, have a family member or even have relatively good knowledge about them, have stigmatizing beliefs. This was found by Moses (2010) who discovered that adolescents with mental health problems were mostly stigmatized by peers, teachers, and even family members.

Through history the stigmatization of mental health problems have been prevalent. They are almost always treated differently, excluded and sometimes brutalized. There are many misguided views that people have shared about people with mental health problems contributing to these beliefs. Early people believed that mental health problems were caused by demonic and spiritual possessions. These believes automatically made people cautious discriminate and fearful of people with mental health problems. Even in medical models could be a cause of the discrimination. They put mental health problems on the same level as physical problems and therefore people see them as different. Also, because there is a diagnosis involved, they could be considered as having undesirable attributions.

Another factor in the discrimination of mental health problems is the media and popular press. Cinematic depictions of diseases like schizophrenia are often very stereotypical and include misinformation about the intensity of symptoms, causes and treatments. Owen (2012) discovered that most cinematic depictions of schizophrenics were violent, one-third were involved in homicidal behavior and one-quarter committed suicide. These are all very negative depictions of people with mental health problems, reinforcing these beliefs that people with mental health problems are always dangerous.

Stigma matters because of its judgmental and discriminating attitudes to people with mental health problems. They end up with negative social effects like exclusion, poor to no social support, worse quality of life, and a low self-esteem brought on by comments and general beliefs about them.

Validity and Reliability of Diagnosis

Validity and Reliability of a Diagnosis is vital to understanding a patient and making sure that they are properly cared for. Being able to realize the importance of each aspect it and what affects an invalid or unreliable diagnosis can produce.

            Firstly, how and what is a Diagnosis? In the range of abnormal psychology, it is categorizing and detecting abnormal behavior by means of observing the patient, having clinical tests run, self reports from the patient, and gaining information from others such as relatives. When diagnosing a patient, Clinicians use diagnostic manuals, such as the DSM-IV. These list 300 different “mental disorders” and describe the symptoms but doesn’t explain the cause of it.

            Because of these manuals and means of observations, different clinicians should be able to diagnosis patients similarly, or in other words, with Inter-judge reliability. Also using inter rater reliability, assesses the degree to which several different observers (or “raters”) can give similar estimates to the same idea, can help increase the reliability. In the case of time, using Test- retest reliably assesses the ability of a consistent measure over a period of time.

            In 1973, Rosenhahn created a study that that challenged the psychiatric diagnosis problems by having 8 fake patients and each of them where claimed to have severe psychological disorders even though they were all imposters. A similar study was done by Cooper et al. (1972) just one year earlier named The US-UK Diagnostic Project to examine the reliability of diagnoses made by Clinicians for depression and Schizophrenia. Their method was to have western psychiatrists watch a videotaped interview and provide a diagnosis for the patient. The British psychiatrist diagnosed the patients twice as often and the American Psychiatrists diagnoses the same people with schizophrenia twice as often. Because the diagnoses were not the same, it’s apparent there are problems with reliability.

            The “Validity of Diagnosis” is also extremely important to understanding diagnoses and the patients. The term refers to the correct diagnosis of a patient. The DSM-IV manual doesn’t include causes of disease so it can be hard to make a valid diagnosis.

            In Mitchel et al. (2009), a meta-analysis of validity of diagnosis of depression, used 41 clinical trials with semi-structured interviews to assess depression. The General Practitioners were able to mange 80% reliability to identify healthy patients and 50% reliability in diagnosing depression. They were more likely to make false positive signs of depression during the first meeting with the patient. The study said that GP’s should see patients twice before diagnosing because the accuracy was improved over that time. 

Another study relating to the Validity of diagnosis is Rosenhahn (1973) on being sane in insane places.  5 men and 3 women were to present themselves to 12 different psychiatric hospitals in the US. They all acted normally but all but one was diagnosed with schizophrenia. The other one was diagnosed with manic depression. All though they acted normally through out their stay, the doctors interpreted them taking notes as symptoms of their diagnosis. It took between 7 to 52 days for the 8 pseudo-patients to be released. A follow up was done after this and the study told the doctors that there would be imposters that would present themselves at a hospital. Of the 193 patients who presented themselves, 41 were identified as imposters, 23 were suspected imposters, and one doctor or a staff member suspected 19. None of the identified or suspected patients were imposters. There were none.

Validity and Reliability of a Diagnosis is extremely important because, as in the case of the last study, people who were in fact sick, were thought to be faking. Being able to get a better and more reliable diagnosis will allow psychiatrists to help more people with proper treatments.

Factors Influencing Conformity; Abu Ghraib Prison

     Abu Ghraib Prison; a horrific place that people don't seem to believe can still have a place in todays modern world. Unfortunely in late 2003 to early 2004, during the Iraq War, torture and humiliation of prisons was being performed in the Abu Ghraib Prison.

A Prisoner standing on a box for hours
 and told that he would be executed
if he moved.

After taking over a prison in Iraq, volunteer American Troops were sent to look after the prisoners. These troops physically, sexually and mentally abused the prisoners; including prolonged sleep deprivation, religious humiliation, and and prolonged painful postures were only a few of the techniques they used to "soften" them up for interrogation. 

     Why did these troops do this? Was there a reason? Phsycologist believe it was because of Conformity. Conformity is the act of matching attitudes, beliefs, and behaviors to group norms. Deviations of Conformity may have more specific relevance. The first being informational influence, meaning that we want to be right and believe others have that info we might be lacking so we modify our attitudes to fit theirs. This could have happened with the troops around the them. If one of them decided to do this and the others believed them to have that information that they were lacking, they would conform. Similarly, Normative influence is that we want to be liked by others so we changed to what they expect us to be like, even if its not right. Because they were troops, they might have had a bias for them to all be rough and tough and so for other to like them, they might have conformed to be what they thought others expected them to be. The last influence is Referent Inofrmational Influence, meanignt hat we are more likley to conform to our in group and having a sense of belongingness to maintain their desired social identities. This one is very likely because what if someone protested the torutre. They would no longer be part of the in group and all of a sudden be left in the out group. They wanted to stay together as the American Troops so everyone conformed to stay in the "in-group", even if what they were doing was completely unethical on every level.

     Still, the Troops should have punishments and even though they were exposed to Conformity, there is no excuse for their actions.  

The Stanford Prison Experiment: Ethics and Issues

    The Stanford Prison experiment was not your everyday average experiment. This was a realistic, intensive experiment done in the basement of a university. Basicly what the psychologist and  psychology professor Philip Zimbardo was trying to find out was the psychological effects of becoming a prisoner or prison guard were. Little did he know that he was about to violate

and expose his volunteers to harsh punishments, crossing the line of many boundaries that psychologists deemed inappropriate to put them through. 

   Zimbardos procedure to make this a reality was to first arrest, realistically, each of them. They then striped them and replaced their clothing with tattered uniforms. They were to stay there for 2 weeks but because of the unethical conditions, was short. 

   Observers said that the prison had "dangerous and psychologically damaging situations". The volunteers got so engrossed with their roles that they went over board; abusing the "prisoners" to the point where 5 dropped out early, pleading and crying to get out. They hardly realized that they were just college students, involved in an experiment. Some, protesting the situation, started "to act crazy, to scream, to curse, to go into a rage that seemed out of control" said Zimbardo. They felt that they needed to stick with their fellow prisoners and guards, taking sides and ganging up on one another. Eventually, an outside physiologist saw the situation and convinced Zimbardo that it was completely unethical and stopped the operation. 

   Other issues involved after the experiment. Will the guards and prisoners have hatred toward each other, even though they know it was just an experiment? These students have to shared the same school, will it cause conflicts? Also, what are the lasting affects? No one knows how serious the lasting affects could be but its sure that they all were exposed to physiologically damaging situations during the experiment. 

Why Punishment Doesn't Work.

  Punishment is a form of imposition that people have used for thousands of years and the question has surfaced: Is it even helpful? The answer is no. When parents punishes their children, the parents seem to think it works because right in that moment the child DOES stop, but its not a lasting affect. They may have learned not to do it around THEM but do it the rest of the time. 
   Reasons for punishment are many but one of the main reasons is that the child resents and hates the punishers. The relationship between them gets destroyed and eventually all you know them as is the person who punishes you and the one to avoid. No one actually wants this. They just wanted to stop the undesirable behavior but ends up stopping the respect. 
   Not only do people not respond to it, but they end up repeating these behaviors. Similarly to the Bobo Doll Experiment ( Bandura 1961), when a model demonstrates the behavior then the child learnt o do it too. They will usually end up becoming abusive people and beat their children and spouses similar to the punishment they were given. 
   Being exposed to punishment over a long time also doesn't work because the punishee becomes acclimated to it. Eventually there is so much resentment and pattern, that eventually they stop responding to it. 
Punishment almost never works in the long run because of these reasons and many others. Even though it many seem like the perfect temporary fix, its not useful for the future and the persons overall life. 
   
  

Applications of Social Learning Theory Now

Applications of Social Learning Theory

In Criminology 
- used to explain the emergence and maintenance of deviant behavior, especially aggression
- criminal behavior is learned in both social and nonsocial situations through combinations of direct reinforcement, vicarious reinforcement, explicit instruction, and observation

In Management 
- rewards aren't the sole force behind creating motivation 
- Thoughts, beliefs, morals, and feedback all help to motivate us
- Modeling, or the scenario in which we see someone's behaviors and adopt them as our own, aide the learning process as well as mental states and the cognitive process.

The Influence of Television on Behavior

    Television is a controversial topic on its educational and entertainment sides. There are some great educational programs out there for kids; counting, spellings, general knowledge. But most of what see is entertainment with characters we can relate to and nothing of real educational purposes. Kids end up watching these and because they can connect with the characters and see themselves as THEM, they end uo wanting to do whatever the character is doing. Even if its aggressive.

If the kid is watching  relatively aggressive program with fighting and gore, they are more likely to gain aggressive traits such as using force to get their ideas across especially if they are the same sex as the character. In the 15 year longitudinal study of 557 done by Psychologist L. Rowell Huesmann, Ph.D, showed just this. The first step was identifying what TV shows they watched and how violent they where. 15 years later they talked to the same people, now in their 20s, and measured how violent they are. They found that the kids who had watched more violent shows had more violent traits or convicted of a crime. Watchign these shows had increased their aggressive behaviors and changed them in a negative way. Similarly, a study conducted by Kimball and Zabrack (1986), found that after only 2 years of television being introduced into a Canadian town, that the children became significantly more aggressive.