“But what about real mental illnesses?” Alternatives to the disease model approach to ‘schizophrenia’

The old dichotomy between ‘neurosis’ and ‘psychosis’ appears to be alive and well in the debate about psychiatric diagnosis. It is often suggested that while diagnostic alternatives may be appropriate for the relatively common forms of distress with which we can all identify such as anxiety and depression, psychiatric diagnoses remain vital for experiences such as hearing voices, holding beliefs that others find strange, or appearing out of touch with reality–experiences that are traditionally thought of as symptoms of psychosis. Such experiences are often assumed to be symptoms of underlying brain pathology or ‘real mental illnesses’ that need to be diagnosed or ‘excluded’ (in the medical sense of ruling out particular explanations of problems) before deciding on the appropriate intervention. This paper argues that this belief is misguided, and that far from being essential, psychiatric diagnosis has the potential to be particularly damaging when applied to such experiences. It describes an alternative perspective outlined in a recent consensus report by the British Psychological Society Division of Clinical Psychology (Understanding Psychosis and Schizophrenia [Cooke, 2014]) which has attracted significant attention in the UK and internationally. The report argues that even the most severe distress and the most puzzling behavior can often be understood psychologically, and that psychological approaches to helping can be very effective. It exhorts professionals not to insist that people accept any one particular framework of understanding, for example that their experiences are symptoms of an illness. This paper outlines that report’s main findings, together with their implications for how professionals can best help

F**k business: Brexit and the deep freeze between business and politics in populist nationalism

Business has been f**ked! F**k government! The relationship between business and politics is broken - can it be fixed? This contribution, by Daniel Kinderman (University of Delaware), part book review and part blog post, reflects on the tense and sometimes openly conflictual relationship between business and politics in populist nationalism

Mind your language

A guide to language about mental health and psychological wellbeing in the media and creative art

Stigma: a linguistic analysis of the UK red-top tabloids press’s representation of ‘schizophrenia’

Aims. Media representations of mental health problems may influence readers’ understanding of, and attitude towards, people who have received psychiatric diagnoses. Negative beliefs and attitudes may then lead to discriminatory behaviour, which is understood as stigma. This study explored the language used in popular national newspapers when writing about schizophrenia and considered how this may have contributed to the processes of stigmatisation towards people with this diagnosis. Methods. Using corpus linguistic methods, a sample of newspaper articles over a 24 month period that mentioned the word ‘schizophrenia’ was compared with a similar sample of articles about diabetes. This enabled a theory-driven exploration of linguistic characteristics to explore stigmatising messages, whilst supported by statistical tests (Log-Likelihood) to compare the data sets and identify words with a high relative frequency. Results. Analysis of the ‘schizophrenia’ data set identified that overtly stigmatising language (e.g. “schizo”) was relatively infrequent, but that there was frequent use of linguistic signatures of violence. Articles frequently used graphic language referring to: acts of violence, descriptions of violent acts, implements used in violence, identity labels and exemplars of well-known individuals who had committed violent acts. The word ‘schizophrenic’ was used with a high frequency (n=108) and most commonly to name individuals who had committed acts of violence. Discussion. The study suggests that whilst the press have largely avoided the use of words that press guidance has steered them away from (e.g. “schizo” and “psycho”) that they still use a range of graphic language to present people with a diagnosis of schizophrenia as frighteningly ‘other’ and as prone to violence. This repetition of negative stereotypical messages may well contribute to the processes of stigmatisation many people who experience psychosis have to contend

Depressed people are not less motivated by personal goals but are more pessimistic about attaining them

This is a postprint of an article published in Journal of Abnormal Psychology © 2011 copyright American Psychological Association. 'This article may not exactly replicate the final version published in the APA journal. It is not the copy of record.' Journal of Abnormal Psychology is available online at: http://www.apa.org/pubs/journals/abn/index.aspxDespite its theoretical importance, personal goal motivation has rarely been examined in clinical depression. Here we investigate whether clinically depressed persons (n = 23) differ from never-depressed persons (n = 26) on number of freely generated approach and avoidance goals, appraisals of these goals, and reasons why these goals would and would not be achieved. Participants listed approach and avoidance goals separately and generated explanations for why they would (pro) and would not (con) achieve their most important approach and avoidance goals, before rating the importance, likelihood, and perceived control of goal outcomes. Counter to hypothesis, depressed persons did not differ from never-depressed controls on number of approach or avoidance goals, or on the perceived importance of these goals. However, compared to never-depressed controls, depressed individuals gave lower likelihood judgments for desirable approach goal outcomes, tended to give higher likelihood judgments for undesirable to-be-avoided goal outcomes, and gave lower ratings of their control over goal outcomes. Furthermore, although controls generated significantly more pro than con reasons for goal achievement, depressed participants did not. These results suggest that depressed persons do not lack valued goals but are more pessimistic about their likelihood, controllability, and reasons for successful goal attainment