Theories of causation of Mental illness

1. Theories of causation of Mental illness Dr Joanna Bennett

2. Psychodynamic theories • Explain the development of mental or emotional processes and their effects on behaviour and relationships. • Helped form the basis for interpersonal intervention including therapeutic relationships, transference and empathy.

3. Psychodynamic models Psychoanalytic (Freud) • individual psychoanalysis • Concept of ego, unconscious mental processes Neo-Freudian Development of other forms of psychoanalysis

4. Humanistic theories • Focus is on the individual ability to learn about and accept themselves • Therapy involves exploration of personal capabilities and self-worth • Rogers client-centred therapy • Gestalt • Maslow hierarchy of needs

5. Cognitive-Behavioural theories • Focus is how people think and act, not on explaining mental disorders • Some theorists: • Pavlov, Watson, Skinner, Beck, Bandura • Intervention based on behavioural theories is widespread in psychiatry • Patient education • Coping skills training • In-patient – privilege system/token economy

6. Developmental theories • Explain normal human growth and development • Theories are presented in terms of stages • Used to understand childhood and adolescent experiences and their manifestation in adult problems • Most of these theories assume development is linear • Not tested, nor consider gender or culture, so limited applicability • Erickson – adolescence and identity • Jean Piaget

7. Social Theories • Social and socio-cultural theories important in assessment of individuals and families. • Intervention maybe based on family and cultural norms • Informs group interventions Some theories: • Familiy dynamics • Social support • Role theories • Sociocultural perspectives – transcultural care

8. Biological theories (Medical Model) Genectics • Family studies – relatives of an individual with a mental disorder are more likely to develop the disorder • Twin studies – monozygotic (identical) – more likely that if one twin develops a mental disorder the other twin is more likely to also develop the disorder

9. Brain Neurochemistry Abnormality of the neurotransmitter system • Too much or too little of a specific neurotransmitter • Problems related to inadequate synthesis or reuptake • Psychiatric drugs alter synaptic levels of neurotransmitters

10. Structural and functional brain abnormalities • Advances in brain imaging techniques, such as magnetic resonance imaging (MRI) and positron emission tomography (PET), have enabled scientists to study the role of brain structure in mental illness. • Some studies have revealed structural brain abnormalities in certain mental illnesses. For example, some people with schizophrenia have enlarged brain ventricles • However, this may be a result of schizophrenia rather than a cause, and not all people with schizophrenia show this abnormality

11. Stress-vulnerability model • “Vulnerability” refers to our basic susceptibility to mental health problems. • This is determined by our genetic makeup and our early life experiences. • It is affected by our use of medications, and our likelihood of using alcohol or drugs. • “Stress” refers to the challenges faced in our lives. • Stress is affected by our coping skills, social support, and involvement in meaningful activities

13. Some Nursing Theories • Interpersonal relations models • Peplau – First systematic theory in mental health nursing –1952 • Orlando – nurse-patient relationship Existential and humanistic theories • Jean Watson – transpersonal caring – caring is the foundation of nursing Systems models King, Neuman, Orem