OCR Psychology A Level Book 2 sample

Linking it together Alternatives to the medical model Topic 3 It is now time to take a critical look at the background spreads and key research you have studied so far. In the exam, you are likely to be asked to make links between what you have studied related to topic 3. You need to be able to: • Link the key research to the background spreads you studied. • Link methodological issues to the key research and background spreads you studied. • Link debates to the background spreads you studied, topic area and to the key research. Sampling bias Watson and Rayner’s (1920) study of Little Albert used only one young boy to support the behaviourist explanation of phobias . Freud’s study of Little Hans was also of just one boy from a European home in the 20th century—a very specific cultural background. It may be wrong to assume that we can generalise from such restricted and unique samples . In the case of Little Albert it might be that earlier experiences made it more likely that he could be conditioned so easily (or less easily) or it might be that he was more (or less) able to be conditioned compared with most people. Freud’s study of Little Hans was conducted well over one hundred years ago. People at the time had quite different attitudes to sexual relationships compared with people today and therefore the explanation of phobia as derived from this study may not now apply. Ethnocentrism The medical model assumes the universality of mental illness, due to its biological roots. However, the alternative explanations are more culture-specific. For example, Szasz (2011) talks about the politicalisation of mental illness in the USA which means that the view of mental illness is affected by the assumptions of the dominant political groups. Suman Fernando (2014) explains how even the language referring to mental illness is very Western. Non-Western countries are more likely to refer to healing, which can apply to healthy people as well as those with health (including mental health) problems. Links with methodological issues Validity As Szasz’s essay was not a typical study it is difficult to assess its validity . The essay is based on his own opinion and attitudes. He admits that his essay is not based on empirical research, nor is it intended to be. This could reduce the validity of his essay because it is making assumptions based on his own opinions rather than objectively gathered data. On the other hand much research that supports the explanations of mental illness has high validity. For example, the meta-analysis by Ekers et al. (2008) of behavioural explanations for depression recruited studies that had used the Beck Depression Inventory (BDI). Concurrent validity has been demonstrated for the BDI (Kliem et al. 2014) which enhances the validity of the research. It could be argued that Freud’s study of Little Hans had high ecological validity because it is based on a large amount of qualitative data that represented the richness of Hans’ experiences. The case study described Hans’ everyday behaviours and thus provided a real reflection of his reality. Reliability The use of a standardised test such as the BDI also enhances the reliability of the study by Ekers et al . (2008) as it has been shown to have a high test-retest reliability of +.84 (Kliem et al. 2014). fMRI scans were used in studies of brain function such as Kuperberg’s (2007) study of the temporal-prefrontal neural circuit in schizophrenia and Anand et al.’s (2005) research on the neural circuits of depressed patients. One review by Craig Bennett and Michael Miller (2010) concluded that the reliability of fMRI scans is very variable, depending on the type of mental illness being studied, the tasks that are being undertaken and the time frames over which the participant is being retested. This review found the test-retest results from fMRI scans showed inconsistencies, with as low as 33% overlap in results of two scans taken only one hour apart. This reliability reduced further when there was a longer gap between scans. This demonstrates that reliability of fMRI scans as a brain imaging technique can be an issue. A ‘talking’ therapy is one where the patient talks to a trained therapist. They talk about current problems, past events or issues, and anxieties about the future. This allows the patient to understand the thoughts and feelings they are having. Talking therapies are sometimes referred to as counselling or psychotherapy, but there are many different types including Cognitive Behaviour Therapy (CBT) and psychoanalysis. Sometimes such therapies are used in conjunction with medications. How the key research explains the alternatives to the medical model The background concept here is ‘alternative explanations to the medical model’. So the question is, how does Szasz’s (2011) study illustrate this? Explaining mental illness Szasz’s key research attacks the medical model. He claims that if a disorder has a physical basis then it should be diagnosed as a physical illness rather than a mental illness. This would fit with cognitive neuroscience explanations which identify faulty neural circuits. Alternatively, Szasz argues that disturbed or disturbing behaviours should be explained psychologically because they are psychological symptoms. The behaviourist , cognitive , humanistic and psychodynamic perspectives take this approach. Treating mental illness Szasz identifies two types of treatment for mental illness— undertaking some form of talking therapy that the patient consents to or controlling patients against their will, which may involve medication. Many of the alternative explanations, such as cognitive, humanistic and psychodynamic explanations, also advocate the use of ‘talking’ therapies. Evaluation of research on alternatives to the medical model Chapter 1: Issues in mental health 46