You are not currently logged in. Please create an account or log in to view the full course.
The Medical Model
- About
- Transcript
- Cite
Psychopathology – Models of Mental Health
In this course, Professor Nick Maguire (University of Southampton) explores models of mental health. In the first lecture, we think about the medical model of mental health and some supporting research. In the second lecture, we think about the mechanisms of pharmacological treatments for psychological illness. In the third lecture, we think about some psychological models of, and treatment for, mental health problems. Next, we think about psychosocial treatments, which incorporate situation and circumstance into methods to tackle mental illness. In the fifth and final lecture, we think about how pharmacological and psychological forms of treatment can complement each other.
The Medical Model
In this lecture, we think about the medical model of mental health, focusing in particular on: (i) Gottesman and colleagues’ 2010 paper investigating the prevalence of mental health problems in children born to psychiatrically ill parents; (ii) Gottesman’s findings, that individuals born to two psychiatrically ill parents had a higher prevalence of mental illness than those born to one, who themselves had a higher prevalence than those born to two parents with no psychiatric illness; (iii) a criticism of Gottesman’s paper being a lack of consideration for the environment within which the children were raised; (iv) the function of twin studies, using monozygotic (identical: 100% shared genes) and dizygotic (non-identical: 50% shared genes) either living in the same or different family environments, to separate genetic factors from environmental ones; (v) the concordance rate discrepancy, indicating inconclusive assessment of the heritability of mental health problems; (vi) the biological view of individual differences explaining mental health problem prevalence, that these differences are rooted in brain structure and neurotransmitter levels/sensitivity.
So my name is Nick Maguire.
00:00:06I'm an associate professor in clinical
00:00:08psychology at the University of Southampton.
00:00:10My research interests and my clinical
00:00:12interests are around particularly excluded populations.
00:00:15So people who are homeless
00:00:18and people who are excluded from other forms of mental health care
00:00:20first lecture we're going to talk about is the medical model of mental illness.
00:00:24So thinking about something that a lot of medics, not the doctors,
00:00:28will call the disease model of mental illness
00:00:32and a useful paper that explains this is by Gottesman.
00:00:36What Gottesman was hypothesising is that he was a big data set,
00:00:40was looking at the prevalence of mental health problems for
00:00:46Children who were born to people with mental health problems.
00:00:50And they looked at the prevalence rate of people
00:00:54born two with one parent who had mental health problems
00:00:56and also the prevalence rates for people who
00:01:00had to parents who had mental health problems.
00:01:02And what he noted is that those for those who had two parents mental health problems.
00:01:05The prevalence rate was much higher than one parent,
00:01:08which again was much higher than having no parents.
00:01:11Now,
00:01:14one of the things you might surmise from this is that having parents there's a gin.
00:01:15It means there's a genetic link between mental health problems and, um,
00:01:19of the parents and then the mental health problems with the Children.
00:01:25So there is a genetic predisposition.
00:01:28In other words, it might be fed down through through parents,
00:01:31and therefore that might back up the kind of the disease model.
00:01:34Now there are other, better designs,
00:01:37because what that does that paper doesn't do is to control for the environment.
00:01:39So one of the criticisms is that it's the environment and being brought up
00:01:46in an environment where you have parents
00:01:50who have mental health problems might itself,
00:01:53because the mental health problems and the Children
00:01:55now there are other studies, which they called the twin studies,
00:01:58and what they do is they take to monitor exotic twins or die psychotic twins.
00:02:02And they look at the where one of the twins has been removed from the family
00:02:08and one of the twins has been brought up
00:02:12within the family of people with mental health problems.
00:02:13And they look at the prevalence rates, and it seems that for those
00:02:16with uh for minors, psychotic twins that have been separated at birth.
00:02:20There is still still that the child who has separated and taken out of the family.
00:02:27Still,
00:02:32there's a higher prevalence rate for mental health problems
00:02:32that would be the the non clinical population.
00:02:35In other words,
00:02:38they're trying to control for the environment so
00:02:39that the twin who was removed still suffered.
00:02:41So that's a better design because it attempt to control for the environment.
00:02:44But those studies are themselves criticised in that there's a guy
00:02:47called Richard Ben Tall and he criticises it for the methodology.
00:02:52In other words, there are very few of these twin studies, Um,
00:02:55very few of these examples where, as you might imagine,
00:02:58where my nose I got twins had been separated and one
00:03:01has been removed in the family and the other one stayed,
00:03:05and so he would criticise the methodology.
00:03:07Now the the concordance rate in other words, the rate at which, um,
00:03:10the the prevalence rates where you get both
00:03:16Twins express both suffering mental health problems.
00:03:20They quote as 46%. They call that the concordance rate
00:03:24now.
00:03:28Actually,
00:03:28when Richard Mentor example that he wrote it was more like 27% which is much lower.
00:03:28So although there seems to be quite a lot of evidence that there's
00:03:33a genetic predisposition predisposition to mental
00:03:37health from parents to their Children,
00:03:40those studies are criticised.
00:03:43Um, so what? That's called something called heritability,
00:03:45and we could talk about heritability index.
00:03:49In other words, how heritable is a mental health problem from your parents?
00:03:52And it's one of the things which is used to
00:03:56back up this idea that mental health is a disease,
00:03:59which is there's at least a partial genetic cause to those diseases
00:04:02Other biological psychiatrist will often talk
00:04:08about some of the biological differences
00:04:10in brains between those suffering mental health problems and those who don't.
00:04:13And they note difference is in a number of factors,
00:04:17including chemicals like serotonin, which is a neurotransmitter,
00:04:21and what they notice that people who suffer depression and who are diagnosed with
00:04:25depression have lower levels of serotonin than
00:04:30those who perhaps don't suffer depression.
00:04:33And that's so that biological marker is then
00:04:36cited as an explanation for the disease model. And it's called a disease.
00:04:39So there are brain abnormalities, and there are There's the heritability index,
00:04:46which are often used to justify this idea as a disease.
00:04:52Now we're going to talk about treatment in a minute, which is also used.
00:04:56But just starting to think about some of the other biological differences, um,
00:05:00that are noted, Um,
00:05:05there are some differences in ventricle size that have been noted.
00:05:06There are differences in fatty acids prevalence, which had been noted,
00:05:11and the has been.
00:05:15These have been noted that seem to correlate with
00:05:16dizzy with what psychiatrists call a disease like schizophrenia.
00:05:20Now the interesting thing is that schizophrenia
00:05:25is wouldn't really achieve a disease status.
00:05:28We would call it a syndrome
00:05:31rather than a disease, because
00:05:33there are all sorts of different ways of
00:05:36being diagnosed with the same thing with schizophrenia,
00:05:37and psychologists will tend to call schizophrenia.
00:05:40They wouldn't refer to schizophrenia. They would call it psychosis.
00:05:42And so we would refer to psychosis rather than schizophrenia,
00:05:45because we don't think schizophrenia is.
00:05:48It's particularly disease. But in psychiatry it is a diagnosable disease, as is
00:05:50other things like bipolar disorder, very distinct diseases, disease models and
00:05:55personality disorder,
00:06:00as well as anxiety and depression and
00:06:02those other things post traumatic stress disorder.
00:06:04So what we get to with the biological model is a distinct set of disease processes,
00:06:07um, with distinct diagnoses.
00:06:14So depression is would be diagnosed with lack of energy or lack of
00:06:16appetite and all those other things that go along with low mood.
00:06:25Whereas anxiety would be a heightened state
00:06:28of arousal associated with particular situations.
00:06:29And so each of the disease diseases is categorised.
00:06:33And so we call diagnosis categorical model in that
00:06:37it seeks to categorise diseases into separate labels,
00:06:41um, which enables a particular pharmacological or or medicine to be prescribed.
00:06:46So, uh, that categorical model is something that is critiqued,
00:06:54which we'll talk about later, but it allows a simplification of human experience.
00:06:59It allows a simplification which enables a particular
00:07:04drug to be applied, so you diagnose and then you treat.
00:07:07
Cite this Lecture
APA style
Maguire, N. (2022, June 06). Psychopathology – Models of Mental Health - The Medical Model [Video]. MASSOLIT. https://massolit.io/courses/psychopathology-models-of-mental-health
MLA style
Maguire, N. "Psychopathology – Models of Mental Health – The Medical Model." MASSOLIT, uploaded by MASSOLIT, 06 Jun 2022, https://massolit.io/courses/psychopathology-models-of-mental-health