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what is the definition of abnormality
behaviour, thoughts or traits the deviates from the norms of society
what are the 4 types of abnormality
statistical infrequency/deviation
deviation from social norms
failure to function adequately
deviation from ideal mental health
what is the definition of abnormality in the context of statistical infrequency/deviation
when a person’s trait, thinking or behaviour is classified as abnormal if it is rare or statistically unusual
evaluating statistical infrequency/deviation as an explanation for abnormality
strength: real life application - almost always used for clinically diagnosing mental disorders as a comparison with a baseline/normal value
limitation: just because a characteristic is unusual doesn’t make it undesirable eg. having a higher IQ isn’t undesirable
what is the definition of abnormality in the context of failure to function adequately
if a person’s current mental state is preventing them from leading a ‘normal’ life alongside the associated normal levels of motivation and obedience to social norms
evaluating failure to function adequately as an explanation for abnormality
strength: final diagnosis takes the person’s perspective into account (the patients account of symptoms and the psychologists objective opinions are both considered) = more accurate diagnosis’ as they aren’t constrained by statistical limits
limitation: may lead to embarrassing labels such as ‘crazy’ or ‘strange’ and because each person has such a different diagnosis (some hugely minor and other more severe) their quality of life could be ruined by these labels from employers or friends
what is the definition of abnormality in the context of deviation from social norms
the straying away from social norms specific to a certain culture and the behaviour a person portrays is violating the unwritten rules of social groups
evaluating deviation from social norms as an explanation for abnormality
strength: participant characteristics - a person may be mislabelled as not normal but simply disagree with or wish to break the social norms
limitation: no universal agreement over social norms = the line between normal in different cultures changes (eg. hallucinations are normal in Zulu culture) and norms change overtime (eg. drink driving used to be acceptable)
what is the definition of abnormality in the context of deviation from ideal mental health
when a person does not meet a set of criteria for good mental health - such as an inability to self-actualise and having an accurate perception of ourselves
who proposed the failure to function adequately form of abnormality
Rosenhan and Seligman 1989
who proposed the deviation from ideal mental health form of abnormality
Marie Jahoda 1958
what did Jahoda say were the 8 ideal mental health criteria
positive attitude towards one’s self
self-actualisation (fulfilling ones potential)
integration (ability to balance aspects of personality and life experiences)
autonomy (ability to make important decisions and to take control of one’s life)
accurate perception of reality
environmental mastery
positive relationships with others
a sense of purpose in life
evaluating deviation ideal mental health as an explanation for abnormality
strength: real world application - most people with concerning mental health issues, will have some form of diagnosis
limitation: Jahoda may have had an unrealistic expectation of ideal mental health with the vast majority unable to acquire - making it that almost the whole population would be considered not normal = limited method of diagnosing mental health disorders
limitation: cultural bias - this criteria is not inclusive of all cultures but mainly focuses on western culture
what is a phobia
a group of mental health disorders characterised by high levels of anxiety that interferes with normal living, in response to a particular stimulus or group of stimuli
what are behavioural characteristics towards phobias
how we act
what are emotional characteristics towards phobias
how we feel
what are cognitive characteristics towards phobias
how we think
what are some examples of behavioural characteristics towards phobias
avoidance
freezing or fainting (panic)
endurance
what are some examples of emotional characteristics towards phobias
feelings of panic or anxiety
persistent or excessive fear
(all emotions cued by a stimulus or anticipation of stimuli)
what are some examples of cognitive characteristics towards phobias
cognitive distortions - irrational nature of a person’s thinking
irrational beliefs - resisting logical and rational arguments
aware of their unreasonableness
selective attention - the patients focus on the phobic stimuli even when it causes them anxiety (causes irrational beliefs or cognitive distortions)
what is endurance as a behavioural characteristic towards phobias
when a person is exposed to a phobic stimuli for an extended period of time and experiences heightened levels of anxiety throughout this time
what is depression
a mood disorder when people have a low mood for an extended period of time (weeks or months) and that affects daily life
usual symptoms of depression (7)
feeling sad
lacking interest in normal activities
irrational or negative thoughts
lowered activity levels
lowered concentration levels
not eating properly
insomnia
what are some behavioural characteristics of depression (4)
reduced/increased activity levels
tiredness and lack of energy (inability to get up and out of bed in the morning)
agitation and aggression
changes in sleep or eating patterns
what are some emotional characteristics of depression (5)
feeling sad
loss of interest in everyday activities
lowered self-esteem
constant poor mood (lasting up to months)
high anger levels both internal and external (lack of control)
what are some cognitive characteristics of depression (3)
absolutist thinking leading to irrational thoughts (eg. thinking your an absolute failure)
selective attention towards negative events (glass half empty)
poor concentration
what is OCD
an anxiety disorder when anxiety arises from obsessions and compulsions (a response to these obsessions as the individual believes the compulsions will reduce the anxiety)
what are obsessions
persistent and intrusive thoughts - the person is obsessed with this thinking
what are compulsions
the behaviours that are repeated over and over again as the person believes it will help the reduce the anxiety they feel from an obsession
what are some behavioural characteristics of OCD
compulsive behaviours (eg. continuous cleaning)
mental acts
repeated behaviours - not realistically related to the individual beliefs as to what it will prevent
avoidance
what are some emotional characteristics of OCD
anxiety and distress (scale of how intense)
awareness of their excessive behaviours
feelings of disgust and guilt
feeling fear about something that could happen (mostly irrational situations)
what are some cognitive characteristics of OCD
reoccurring, intrusive thoughts and impulses
embarrassment or frightened
acknowledgement of irrational actions and knowning the thoughts are all in their mind
the OCD cycle
→obsessive thought →
→anxiety →
→compulsive behaviour →
→temporary relief →
what is the two-process model for phobias
an explanation for the onset and persistence of disorders that create anxiety, such as phobias.
what are the two processes in the two - process model
classical conditioning for onset
operant conditioning for persistence
who proposed the two - process model
Orval Hobart Mowrer 1960
how do psychologists explain behavioural characteristics of phobias
panic
avoidance
endurance
Who conducted the Little Albert study to see about phobias
John Watson and Rosalie Rayner
what is the Little Albert study
classical conditioning:
exposed Albert to a white rat (NS), producing no response, then paired the white rat with a loud bang (UCS) producing fear (UCR) and through repetition Albert made the association between the rat (CS) and fear (CR)
operant conditioning:
conditioned response occurs in other objects (eg. white fluffy things - rabbits), operant conditioning takes place when a behaviour is rewarded or punished. Once a CR is established towards a CS, people often avoid the stimulus (negative reinforcement) making them more likely to repeat the behaviour, Little Albert avoided the white rats (negative reinforcement) to avoid the fear associated with them
evaluating the behaviourist explanation of phobias
strength: real-world application - led to exposure therapies (eg. systematic desensitisation)
strength: explains the link between acquisition and maintenance of phobias - Little Albert proved how the phobia was acquired and why is was maintained
C/A: not all phobias are acquired through bad experiences and not all bad experiences acquire phobias
limitation: alternate explanation for th acquisition of phobias (Seligman) = alternative theories can explain why some phobias are more frequent that others
Seligman
we are more likely to develop phobias towards ‘prepared stimulus’ = stimulus that have posed a threat to ancestors (eg. fire or deep water) and therefore phobias can be acquired from things that present danger in our evolutionary past
what is systematic desensitisation
a behaviour therapy designed to reduce an unwanted response (eg. anxiety)
involves drawing up a hierarchy of anxiety - provoking situations related to a person’s phobic stimulus
teaches the person to relax then slowly exposes them to more stressful phobic situations (up the hierarchy) while maintaining relaxation
what is flooding
a behavioural therapy in which a person is exposed to an extreme of their phobic stimuli to reduce the anxiety triggered by the stimulus
what is counterconditioning
a learning response used in systematic desensitisation
the person is taught to associate the phobic stimulus with relaxations instead of anxiety (through classical conditioning)
what are the 3 processes of systematic desensitisation
anxiety hierarchy
relaxation
exposure
how does flooding stop the CS producing the CR as fear
avoidance behaviour becomes extinct
a learned response is extinguished when the CS/phobic stimulus is encountered without the UCS/phobia
basically reverses classical conditioning and the effect of it
overall summary of systematic desensitisation
lots of shorter sessions (longer time to complete)
client is gradually exposed to increasingly anxiety-provoking situations
effective but not as much as flooding
overall summary of flooding
1-3 longer sessions (up to 2 or 3 hours)
client is immediately exposed to very high anxiety - proving situations
more traumatic but also more effective if completed (but clients have the choice to withdraw at any point)
evaluating systematic desensitisation
strength: research support - Gilroy et al 2003
strength: can be used to help people with learning disabilities - anxiety disorders are normally accompanied with learning disabilities, and these people are unable to give full cognitive commitment with cognitive behavioural therapy, but they can with behavioural therapy
limitation: more expensive than flooding - more sessions
limitation: people have the right to withdraw consent at any point meaning it can be a very long process if the client is unwilling to cooperate and face their phobias
Gilroy et al 2003
42 people underwent systematic desensitisation for a spider phobia over three 45mins sessions, at 3 months and 33 months the group showed a significant reduce in their sympitns compared to the control group
evaluating the use of VR for exposure therapy
strength: provides exposure while avoiding real dangers (eg. heights)
strength: cost effective - no money spent on sessions and overcoming some fears can be costly (eg. flying)
limitation: may be less effective as it lacks the social and realistic element of life
evaluating flooding
strength: cost -effective - less sessions means less money spent (frequently as little as 1 session can overcome a phobia) meaning they can continue their normal lives soon after
limitation: ethical issues - can be traumatic for the client
limitation: symptom substitution - deals with the anxiety response but doesn’t change the root of he phobia
what are the main cognitive explanations of depression
the disorder is the result of disturbance of thinking
focus of an individuals irrational beliefs, negative thoughts and misinterpretation of events
is it about how you see/ think about a problem that causes depression (not the problem itself)
people can overcome mental disorders by learning to use cognitions that are more appropriate
what did Aaron Beck suggest
there’s a cognitive explanation as to why some people are more vulnerable to depression than others - 3 parts to this cognitive vunerablitity
what are Aaron becks 3 cognitive vulnerability points
faulty information processing - only focusing on negative outcomes of a situation and disregarding positive ones (blowing things out of proportion, thinking in black and white)
negative self schemas - a belief of knowledge (interpreting information about themselves from the world in a negative light, lowering their self confidence) - Weissman and Beck 1978
negative triad - patient suffers from having negative thoughts about the self, the future and the world
Weissman and Beck 1978
aim: investigate the process of depressed people to establish if they were made up of negative self schemas
method: measured by using a dysfunctional attitude scale - asking participants to agree/disagree with statement
results: depressed participants made more negative assessments and concluded that depression does involve negative self schemas
evaluating Beck’s theory
strength: research evidence - weissman and Beck 1978
strength: practical application - forms the basis of cognitive behavioural therapy (CBT) and they can all be challenged in CBT
limitation: doesn’t explain all aspects of depression - only explains the basic symptoms of depression, but its a complex disorder with a range of symptoms not all of which can be explained
Albert Ellis
believed good mental health is a results of rational thinking
argued that people with depression have based their lives off common irrational beliefs that underlie depression
what was Ellis’ ABC theory
A - an activating event triggers
B- an individual’s irrational beliefs
C - a consequence
each steps leads to the next
evaluating Ellis’ ABC model
strength: practical application - led to a successful therapy (REBT - rational emotive behavioural therapy) in which irrational beliefs are challenged to reduce depression symptoms (so irrational beliefs must play a role in depression)
limitation: only offers a partial information - aside from those that have a clear activating event (eg. reactive depression), many suffer from depression without an apparent cause and feel frustrated their concerns/experineces aren’t reflected in this theory
limitation: can’t explain all aspects of depression - only explains the basic symptoms of depression, but its a complex disorder with a range of symptoms not all of which can be explained (eg. hallucinations and delusions)
(limitation: may blame the depressed person for their symptoms)
what is Beck’s cognitive behavioural therapy
a therapy to challenge the negative triad (beliefs) of a client
first they will be assessed to discover the severity of their condition (depression)
the therapist will then establish a baseline/starting point prior to treatment - to monitor the improvement
the therapist makes the client aware of the relationships between thought and emotion (eg. I am stupid → this makes me feel sad → I feel sad so I’m not enjoying myself)
the client is asked to provide information about how they perceive themselves, the future and the world
the therapist challenges the triad by focusing on successions and achievements from the client
clients become aware of their negative views and replace their irrational beliefs with more optimistic and rational ones
Ellis’ Rational Emotive Behavioural therapy (1962)
Ellis extends his model to the ABCDE model
D - dispute (challenges the negative thoughts)
E - effect (see a more beneficial effect on thought and behaviour
central technique for REBT is to identify and dispute the patient’s irrational thoughts
Ellis argues irrational thoughts are the main cause of all types of emotional distress and behaviour disorders, and these irrational thoughts make impossible demands of the individual = anxiety, failure and psychological difficulty
REBT challenges the client to prove these statements (and when this isn’t possible) they are replaced with more reasonable and realistic statements
Newark et al 1973
aim: discover if people with psychological problems have irrational attitudes
method: 2 groups (one with anxiety and a control group) of participants were asked whether they agreed with statements that Ellis identified as irrational
results: 65% of anxious participants agreed with the first statement while 2% agreed from the control group
80% anxious participants agreed with the second statement compared to 25% from the control group
conclusion: people with emotional problems this in irrational ways
evaluating the cognitive approaches (Beck and Ellis’ to treating depression)
strength: research support - John March = CBT is effective
limitation: not effective for all people - some people with severe depression can’t be treated using CBT as they are unable to attend regular sessions due to low mood etc… (only those that are willing to help will be treated successfully with CBT)
limitation: CBT focuses on present life and present challenges, while some depression cases are related to past events (eg. childhood trauma or past deaths of loved ones) and since CBT tells people not to dwell on the past, it isn’t useful for everyone
John March
aim: test the effectiveness of CBT
method: 327 adolescents in 3 groups (one treated with Cat, one with drugs and one with both CBT and drugs)
results: after 36 weeks:
81% of CBT group improved
81% od drugs improved
86% both treatments improved
what are genetic explanations
genes that make up chromosomes which code for our physical (eye colour, hair colour) and psychological (mental disorder, IQ) features
genes are transmitted from parents to offspring
what are neutral explanations
the view that physical and psychological features are determined by the behaviour of the nervous system (mostly the brain - as well as other neurons)
chromosomes and DNA determine behaviour
Aubrey Lewis 1936
observed his OCD patients:
37% had parents with OCD
21% had siblings with OCD
suggests that the vulnerability of having OCD runs in families
what is the diathesis - stress model
a model that suggest that certain genes leave some people more likely to develop a mental disorder (but no for certain), and an environmental stress/experinece is required to trigger the condition
what are candidate genes
genes that researchers have identified as creating vulnerability for OCD
some of these are involved in regulating the development of serotonin
what does the belief in OCD being polygenic mean
OCD is caused by a combination of genetic variations that together cause vulnerability
Steven Taylor 2013
found that 230 different genes may be involved in OCD - some of which relate to dopamine and serotonin
what is dopamine
a neurotransmitter involved in making people happy
what is serotonin
a neurotransmitter involved in making people sad
what does aetiologically heterogeneous mean
origins may vary from one person to another (eg. one set of genetic material may cause the disorder in one person and a different material will cause it for another person)
what are the neural explanations of OCD
the genes associated with OCD are likely to affect the levels of neurotransmitters and the structures of the brain
low levels of serotonin disrupt normal transmission of mood-related information between neurons
what part of the brain is associated with decision-making (ab)normalities
lateral frontal lobes
what part of the brain is associated with processing unpleasant emotions and functions abnormally for people with OCD
left parahippocampal lobes
evaluating genetic explanations of OCD
strength: research support - Nestadt et al 2010 and Marini and Stebnicki 2012
limitation: environmental risk factors - OCD isn’t entirely genetic in origin and environmental risk factors contribute to OCD (Kiara Cromer et al 2007 proves genetic vulnerability only provides a partial explanation for OCD)
limitation: ani
Mal studies - some of our evidence to support genetic causes for repetitive behaviour is based off animals (eg. mice) and although they share some of the same genes, human brain is much more complex
Nestadt et al 2010
reviewed twin studies
found 68% identical twins shared OCD
31% of non-identical twins shared OCD
Marini and Stebnicki 2012
discovered a family member diagnosed with OCD is 4 times more likely to develop it compared to a family without the diagnosis
Kiara Cromer et al 2007
found that half of OCD clients had experienced a past traumatic event and they had the least severe cases of OCD
evaluating neural explanations
strength: research support - drugs that target serotonin levels are effective in reducing OCD symptoms meaning there has to be a link between OCD and serotonin levels
limitation: no unique neural system - the serotonin and OCD link may not be unique to just OCD as most people with OCD also have depression (co-morbidity)and depression is also linked to serotonin levels meaning that serotonin leads to depression which leads to OCD instead of serotonin levels leading to OCD
co-morbidity
when a person has 2 illnesses at the same time - and sometimes one can be a consequence of another (eg. depression and OCD)
what is drug therapy
treatment involving drugs - normally for treating psychological disorders, it affects the nurotransmitters levels
how long does it take SSRI’s to change a person’s behaviour and affect their neurotransmitter levels
3-4 months
what does SSRI stand for
selective serotonin re-uptake inhibitor
what is the standard treatment for OCD
antidepressant drug therapy - SSRI’s
explain the journey serotonin takes in the brain
released by the presynaptic neuron and travels across the synapse to the postsynaptic neutron
it conveys the message from the pre to the postsynaptic neuron
it is then reabsorbed by the presynaptic neuron
how does SSRI’s change the journey of serotonin in the brain
prevents the reabsorbtion/re-uptake by the presynaptic neuron
this means there is a higher level of serotonin in the synapse
meaning the serotonin can continue to affect the postsynaptic neuron
is the dosage of serontonin the same in every SSRI
the dosage of serotonin depends on the SSRI but a typical dose of Prozac (fluoxetine) is 20mg (available as a capsule or liquid)
can drug treatment and oral treatment work alongside each other when treating OCD
yes, SSRI’s and CBT are often used together as drugs reduce the emotional symptoms meaning the person can engage in CBT more successfully
but some people refer to use just one or the other with treatment - but depends on the person
is there alternative drugs to SSRI and if so, why?
yes because SSRI’s can take up to 3 or 4 months to work, so it can be paired with other drugs
Tricyclics (eg. cholmipramine) - acts of the serotonin system but has more severe side effects so its normally a last resort alternative for people who dont have any response to SSRI’s
SNRI’s (serotonin - noradrenaline re-uptake) - increase the levels of serotonin and the levels of the neurotransmitter noradrenaline and is also a second resort for people who don’t suit SSRI’s
evaluating drug therapy
strength: evidence of effectiveness - clear evidence that SSRI’s reduce symptom severity and improve quality of life for people with OCD (Mustafa Soomro et al 2009)
C/A: drug treatments might not be the most effective treatment - Petros Sapkinakis et al 2016
strength: cost-effective and non-disruptive - drugs are easier as they dont intrude in everyday life and routines and are provided for free by the NHS
limitation: serious side effects - SSRi’s can have bad side effects like blurred vision, loss of sex drive and can be distressing (and those taking tricyclic clomipromine have a higher chance of side effects and these can be bad - weight gain, heart-related problems and aggressive behaviour)
limitation: biased research - some believe that evidence for drug effectiveness is biased because some researchers are sponsered by drug companies and may selectively publish positive outcomes, there is a lack of independent studies on drug effectiveness
Petros Sapkinakis et al 2016
concluded that cognitive and behavioural therapies were more effective than SSRI’s
Mustafa Soomro et al 2009
reviewed 17 studies of SSRI' effectiveness compared to a placebo group
found that all SSRI people had better improvement than the placebo group
70% taking SSRI people had reduced symptoms
the remaining 30% could be helped by a combination of drugs or psychological therapies