The Science of Mental Illness
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National Institute of Mental Health

The Science of Mental Illness

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Teacher's Guide

Lesson 3—Explain/Elaborate

Mental Illness: Could It Happen to Me? (Page 2 of 2)

Procedure

Activity 1: What Are the Risks? (continued)

  1. After the teams have finished their analysis, reconvene the class and display the transparency of Master 3.3, Mental Illness—More Likely or Less Likely?, that you partially completed earlier (Step 5). Ask teams to decide whether the risks they identified for depression are also risks for ADHD and schizophrenia. Complete the table accordingly.

Before teams report their findings about risk factors, ask them to give a brief overview of ADHD or schizophrenia to the class so that the students will have some background about the other disease. Students will have different responses for each of the diseases.

For some of the factors that are important for depression, no information is given for the other diseases. Ask students to consider whether this means the information is unknown or whether those factors just aren’t important for ADHD or schizophrenia. For example, the influence of family or social factors is not addressed in the information about schizophrenia. As currently understood, these factors do not play a large part in increasing someone’s risk for schizophrenia—a person’s genes are a much more predictive risk factor. A goal of continuing scientific research is to learn more about how genetic and nongenetic factors influence a person’s risk of getting a mental illness. It is important for students to understand the distinction between a factor not changing a person’s risk level and a factor about which scientists do not know the answer.

Students also might raise questions about factors such as food allergies (related to the reading about ADHD) or viral infections (related to the reading about schizophrenia) being risk factors for depression. Questions such as these suggest that students are really trying to synthesize the information. You can tell students that it is unlikely that food allergies or viral infections change a person’s risk for depression. The risk factors included in the modeling activity are not the only ones that influence a person’s risk for getting depression, but they are generally agreed upon by scientists as important ones.

A sample version of the completed Master 3.3 follows. Asking students to share their information will help them understand the similarities and differences among the diseases with respect to the types of factors that influence their occurrence.

Mental Illness—More Likely or Less Likely?
Category Is this a risk factor for depression? Why? Is this a risk factor for ADHD? Why? Is this a risk factor for schizophrenia? Why?
Gender Yes—depression is more common in females. Yes—ADHD is more common in males. No—schizophrenia occurs in males and females equally.
Age No—depression can occur at any age. Yes—a criterion for diagnosing ADHD is that symptoms appear before age 7. Yes—schizophrenia begins most commonly when a person is in their late teens or twenties. It is very rare in children.
Family relationships Yes—an individual who has a good family relationship is less likely to become depressed. No information is given. No information is given.
Occurrence of disease in family Yes—a person’s risk for depression increases if a family member has depression (or a history of depression). Yes—a person is much more likely to have ADHD if a family member also has it. Yes—a person is much more likely to have schizophrenia if a family member also has it.
Smoking Yes—smoking cigarettes increases a person’s risk for depression. No information is given. No information is given.
Attitude Yes—a person who has a negative attitude is more likely to have depression. No information is given. No information is given.
Ending a relationship Yes—stressful events such as a romantic breakup can make depression more likely. No information is given. No information is given.
Death of a family member or friend Yes—the stress of losing a close relative or friend can make a person more susceptible to depression. No information is given. No information is given.
Experiencing abuse or violence Yes—a person who has experienced abuse or violence is more likely to become depressed. No information is given. No information is given.
National Science Education Standards icon
Content Standard A:
Communicate scientific procedure and explanations.

Content Standard F:
Important personal and social decisions are made based on perceptions of benefits and risks.
  1. Conclude the activity with a class discussion that focuses on the overall role of risk factors in mental illness. Guide the discussion with questions such as

Students should understand that the three diseases modeled have similar types of factors that determine a person’s risk. You might wish to display the completed transparency of Master 3.3, Mental Illness—More Likely or Less Likely?, to remind students about these factors, which among others, can include:

It is important for students to realize that everyone has risk factors for mental illness (just as everyone has risk factors for other diseases).

Students should recognize that they cannot infer that someone will or will not get a mental illness. A person does not develop a mental illness because of a single risk factor; the likelihood that a person will develop a mental illness is influenced by the presence of a combination of risk factors and protective factors (factors that decrease the risk for a mental illness). An example of a protective factor for depression would be a good relationship within the family or with a trusted, supportive adult with whom the person can talk.

assessment icon
Assessment:
If you wish, ask students to write their answers to these final questions in Step 10 before holding a class discussion. This gives students an opportunity to think through their answers before the discussion, and you can read each student’s responses to assess his or her understanding.

The idea that mental illness is influenced by a combination of factors is particularly important for middle school students to understand. Some students probably will have relatives with a mental illness, or they might feel that something in their environment places them at risk. These feelings could cause them to feel that they are at high risk overall, when actually they cannot determine their true risk from this activity. The purpose of this activity is not to induce a fear or a feeling of inevitability, but rather to have students acknowledge that mental illness is something that could affect anyone.

During the course of analyzing risk factors, students should realize that there are some risk factors over which a person has control. For example, a person can choose not to smoke cigarettes, which would lower his or her risk for depression. Students should also realize the importance of having a trusted and supportive adult to talk to when they are feeling sad or anxious about things. Talking with someone and getting help early are two ways of changing the potential influence of social and environmental stressors (risk factors) on developing depression. On the other hand, an individual cannot control other factors, such as his or her genetic makeup.

Scientists continue to search for the causes of mental illnesses. If scientists can find out what factors are common among people with a specific mental illness, those commonalities can help scientists make informed decisions about what to investigate to learn more about a particular mental illness. If almost everyone who has a specific mental illness has the same trait or life situation, that might give scientists a clue about what part of the brain to investigate.

Also, doctors and other mental health professionals are interested to know what the risk factors are for a specific mental illness for a different reason. Knowing the risk factors can help them identify people who are most likely to develop a mental illness before the mental illness actually begins. This way, individuals can get help early—before they experience severe problems in their lives. In addition, if people know that something increases their risk for mental illness, perhaps they can change their behaviors or improve their life situation to reduce the risk. For example, if a person and his or her physician know that going through a stressful period increases the risk for depression, they can work together to find ways to deal with the stress and thereby reduce the individual’s risk. A person doesn’t have control over all the risk factors (such as genetics) that can contribute to a mental illness, but it can be beneficial to reduce risk in the areas in which a person does have some control.

Lesson Wrap-Up

assessment icon
Assessment:
Students summarize the big ideas from this lesson.

Ask students to write a few sentences in their journals to summarize what they believe are the big ideas that are important to remember from this lesson. As with the previous summaries students have written, this information will help them when they do the Evaluate lesson (Lesson 6) at the end of this module.

Lesson 3 Organizer
Activity 1: What Are the Risks?
What the Teacher Does Procedure Reference

Begin the activity by asking students to consider why some individuals get a mental illness and others do not.

Step 1

Introduce the terms risk and risk factor to students.

Step 2

Explain to students that they will use a model to learn about risk factors for depression and how those risk factors influence whether a person is more likely or less likely to get depression. Hold up Masters 3.1 and 3.2 and explain how the activity works

master iconStep 3

Organize the class into teams of three students. Give each team one copy of Master 3.1, The Roll of the Die for Depression, and one copy of Master 3.2, The Risk Meter. Ask teams to complete the die rolls and worksheets.

master iconStep 4

Display a transparency of Master 3.3, Mental Illness—More Likely or Less Likely? Ask teams to share their findings to fill in the first two columns of the chart.

transparency iconStep 5

Hold a class discussion to interpret the model. Guide the discussion with questions such as these:

  • Did you move the arrow on the risk meter the same distance for each roll of the die? Why did you move the amount you did? Why did you decide not to move the arrow?
  • Do you think that some factors are more important than others for determining a person’s chance of getting depression? Why?
  • Did you move the mark in different directions?
  • What does moving in different directions mean about an individual’s chances for getting depression?
  • Do you think some factors really can increase a person’s chance of getting depression and other factors can decrease it?
  • Compare the final position of the marker with the starting position. If this model reflects what happens in real life, what does it say about the number of factors that can influence a person’s overall chance for getting depression?
  • Did the fictitious individual modeled in the activity actually get depression? Can you be sure the individual did or did not get depression?
  • If this model reflects real life, does having risk factors that increase the chances for depression mean that a person will actually get depression?
  • If having risk factors, even some that seem to increase a person’s chances of getting depression by a great amount, doesn’t mean the individual has depression, can you say that a risk factor causes depression?
Step 6

Ask students to think about whether the risk factors they identified for depression might also be risk factors for other mental illnesses. Explain that they will now look at other mental illnesses to find out what risk factors might be important for those illnesses.

Step 7

Have students continue to work in their teams. Give each student in half the teams one copy of Master 3.4, ADHD: What Are the Chances? Give students in the other teams one copy of Master 3.5, Schizophrenia: What Are the Chances? You may need to help students initially with difficult words such as schizophrenia and hyperactivity.

Step 8

Reconvene the class and discuss the findings about risk factors for ADHD and schizophrenia. Display the partially completed transparency of Master 3.3, Mental Illness—More Likely or Less Likely?, and complete the remaining columns.

Step 9

Conclude the activity with a class discussion that focuses on the overall role of risk factors in mental illness. Guide the discussion with questions such as these:

  • Do different mental illnesses have similar types of risk factors? What are they?
  • Does everyone have risk factors for becoming mentally ill?
  • If a person has some risk factors that increase the chances of getting a mental illness, will they definitely get the illness?
  • Can you control or change your risk level for mental illness?
  • This lesson began by asking you to think about why some people get a mental illness and others do not. Then, as you read about ADHD and schizophrenia, you noticed that there wasn’t any information given for some of the factors that were important to think about for depression. Why do you think doctors and scientists want to know if something increases or decreases a person’s risk for mental illness?
Step 10
Lesson Wrap-Up
What the Teacher Does Procedure Reference

Ask students to summarize the main ideas of this lesson by writing a few sentences in their journal.

Wrap-Up
master icon= Involves copying a master.
transparency icon= Involves making a transparency.

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