psychopathology - phobias + abnormality

state types of abnormality

- statistical deviation/infrequency

- deviation from social norms

- failure to function adequately

- deviation from ideal mental health

Outline statistical infrequency

when a person's trait, thinking, behaviour is found to be numerically or statistically rare or uncommon it would be considered an indication of abnormality

what is an example of an abnormality diagnosed through statistical deviation?

intellectual disability disorder

(deviation of IQ)

how is IQ measured?

- psychometric intelligence tests

- tests give you a mental age and this is compared to you actual age expected IQ

- shown as a normal distribution curve - 100 is the norm

how is intellectual disability disorder diagnosed?

- between 70 and 130 is norm

- below 70 is abnormal

what percentage of the population have intellectual disability disorder?

2.1%

what are strengths of statistical infrequency?

P: real life application

E: helps thinking about what is normal and abnormal and this helps in the diagnosis of disorders such as intellectual disability disorder

E: therefore useful part of clinical assessment P

what are limitations of statistical deviation?

P: unusual characteristics can be positive

E: just because it is statistically abnormal doesn't mean it is undesirable and so needs treatment - IQ over 130 is statistically abnormal but means super intelligence

E: so definition can't be used alone to diagnose

P: not everyone unusual benefits from a label

E: statistical deviation labels the individual as abnormal and this may have a negative impact on the way the individual views themselves and how they are viewed by others. This does not benefit an individual who otherwise was living a happy fulfilled life without distress to themselves or others. Such a label can instead lead to a poor self image and a self fulfilling prophecy. It may become an invitation for discrimination.

E: This means that being labelled as statistically infrequent could cause the person more harm than the condition itself.

Outline deviation from social norms as a definition of abnormality

- abnormal behaviour is that which goes agains the accepted standards if behaviour in a given society or culture.

- they do not conform to our moral or social standards

Give an example of a deviation from social norms

- antisocial personality disorder: do not conform to out social/moral standards

State limitations of deviation from the social norm

- not a sole explanation

- culture relativism

- can lead to human right abuses

- incomplete explanation

Outline Limitations of 'Deviation from Social Norms' as a definition of abnormality.

P: not a sole explanation

E: anti social personality disorder - May be considered abnormal not only because it deviates from social norm but also because of the stress caused to other people because of that behaviour

E: would better be explained by failure to function adequately

P: culture relativism - social norms vary over time from one generation to another and also vary over cultures. So behaviour that is defined as abnormal can vary.

E: homosexuality - in many countries is still illegal and considered abnormal. /kids out of wedlock

E: no global standard for defining behaviour as abnormal and so abnormality is not standardised

P: can lead to human right abuses

E: drapetomania - running away - targeted slaves, nymphomania - sexual attraction to working class men - women targeted

E: diagnosis can be used to maintain control over minority ethnic groups and women

Outline a strength of deviation from social norms

P: includes issue of desirability of a behaviour

E: a genius is statistically abnormal but we would not include it in out definition of abnormal behaviour

E: might be more useful definition of abnormality than statistical infrequency

Outline failure to function adequately as a definition of abnormality

- refers to abnormality when a person is unable to cope with ordinary demands of day to day life. And live independently in society

- signs: not conforming to standard interpersonal rules (eye contact), experiencing severe personal distress, irrational or dangerous behaviour to themselves or others

Give an example of an abnormal behaviour diagnosed with failure to function adequately

- intellectual disability disorder

- diagnosed by statistical infrequency but in order to give the diagnosis individual must also be failing to function adequately

Outline limitations of failure to function adequately

P: behaviours might be explained by other factors

E: failure to keep a job may be due to recession

E: doesn't always explain abnormality

P: context dependant

E: not eating may be considered as failing to function adequately but prisoners on hunger strike making a protest can be seen in a different light

E: reduces usefulness

P: not differentiating between eccentric and abnormal behaviour

E: not meeting nutrition standards

E: we risk limiting personal freedom and discriminate against minority groups

Outline a strength of failure to function adequately

P: considers the subjective personal experiences of the patient

E: personal distress - considers the thoughts and feelings pf the person experiencing the issue an does not make a judgement without taking the personal viewpoint of the sufferer in to consideration

E: useful definition in assessing abnormality

Outline deviation from ideal mental health as a definition of abnormality

There are prescribed criteria that a person should be able to meet to be classed as mentally healthy. If they cannot meet these, they may be able to be classed as abnormal

- no symptoms of distress

- rational

- can self actualise

- can cope with stress

- good self esteem

- independent

- can successfully work, love and enjoy our leisure

Outline strengths of deviation from ideal mental health

P: covers a broad range of criteria for mental health for which a person might seek help from mental health services or be referred for help

E: holistic and comprehensive explanation - concentrates on positive and desirable behaviours rather than considering just negative and undesirable behaviours

E: considers the whole person taking in the multitude of factors that can affect their health and wellbeing

Outline limitations of deviation from ideal mental health

P: culture relativism

E: concept of personal achievement is a trait typical of individualist cultures but would be considered self indulgent in collectivistic cultures that emphasise on family and community

E: represents a very western view of ideal mental health, specific to European and north american cultures

P: criteria is demanding and subjective

E: unlikely that many people would be able to meet all the criteria all the time

E: many people would be classified as abnormal

What are types of characteristics of phobias?

- behavioural

- emotional

- cognitive

What are the behavioural characteristics of phobias?

- Panic: crying/screaming/running

- avoidance

- endurance: remains in presence of stimulus but experiences high levels of anxiety

What are emotional characteristics of phobias

- fear and anxiety

- fear is excessive

What are cognitive characteristics of phobias

- Selective attention: towards phobic stimulus

- Irrational beliefs: relation to phobic stimuli e.g social anxiety (must always sound smart/all spiders are deadly)

- cognitive distortions: distorted perceptions of phobic stimuli (as ugly/disgusting)

What are the types of phobias?

- agoraphobia

- social phobia

- specific phobia

What is agoraphobia and how many people suffer from it?

- fear of open spaces

- 2-3% of population, mostly women

What is social phobia and how many people suffer from it?

- fear of being judged by others and/or intense feelings of embarrassment about performing in front of people

- eg: fear of criticism/blushing/fear of making mistakes

- more common in families where parents and relatives use shame as a way of controlling the adolescents behaviour

- women(15%), men(11%)

What are specific phobias and how many people suffer from it?

- strong fear and avoidance of a particular object or situation

- when exposed to stimulus, will experience great anxiety sometimes even when just anticipating the object

- 10% of population

- mostly women

State a behaviourist explanation of phobias

- Mowrer's two factor theory

Outline Mowrer's two factor theory

- phobias are learned through bad experience with a feared object in the past through association - classical conditioning

- if a previously neutral stimulus is associated with a frightening unconditioned response of fear it can become a conditioned stimulus and produce a conditioned response of fear. People can therefore learn to fear a previous neutral stimulus

- phobia is maintained through negative reinforcement by operant conditioning

- when stimulus is avoided, the fear is reduced and this is negative reinforcing

State supporting evidence for Mowrer's two factor explanation of acquiring phobias

- Watson and Rayner: little albert

Outline supporting evidence for acquiring a phobia through classical conditioning

- Watson and Rayner conditioned a baby (little Albert) to fear white rats.

- For several weeks Albert played with a white rat with no fear. (Neutral stimulus)

- while he played, the experimenters struck a steel bar (unconditioned stimulus) with a hammer close to little Albert's head. Albert was frightened by the noise(unconditioned response).

- repeated each time he reached for the rat

- Albert then associated the rat with the loud noise and became scared (conditioned response) of white rats(conditioned stimulus)

Outline methodological limitations of little Albert

P: unrepresentative sample

E: baby boy

E: can't generalise to girls or adults

P: lab experiment

E: very short time to acquire fear

E: low ecological validity

Outline ethical issues of little Albert

P: protection from harm

E: caused phobia to develop - more harm than in everyday life

E: could have de conditioned

P: Right to withdraw

E: mother had responsibility but she didn't

E: caused harm

P: informed consent

E: none as Albert was a baby

E: harm caused

Outline evidence too support that phobias are maintained through operant conditioning

- DiGallo et al

- found 20% of people who had been in bad traffic accidents debeloped phobias of travelling, not wanting to go into cars and choosing to stay at home instead of travelling

- shows that people avoid travelling to reduce gear and increasing the behaviour of staying at home and increases strength of fear so they continue to stay at home

Outline lab experiment as a weakness of the behavioural explanation of phobias

P: lab experiment

E: real life fears develop more gradually + demand characteristics

E: reduces ecological validity of research into theory

outline weakness of behaviourist explanation of phobias as being an incomplete explanation

P: incomplete explanation

E: we easily acquire fears for snakes or the dark rather than a fear of cars and guns that are more dangerous for us today. May be because we are biologically prepared (innate tendency) to acquire certain fears

E: shows that there is more to acquiring phobias than conditioning - ie evolution

outline weakness of explanation of phobias as being an reductionist

P: may be alternative explanations

E: role of biology and genetic transmission of some disorders/ social learning theory where phobias may have been learned through observation and limitation of a role model E:environmental determinism - suggests no freewill

P: ignores cognitive aspects of the disorder

E: sufferers of claustrophobia might think "I'm going to be trapped I this lift and suffocate" - irrational thought and not considered in this explanation

Outline weakness of research against explanation of phobias

E: DiNardo et al found that only 50% of those with severe fear of dogs reported a previous traumatic experience so not all phobias are triggered by a traumatic experience where the initial association b/w object and fear is formed

E: suggests that alternative explanations are needed. Also this explanation doesn't explain why people with no traumatic experience develop phobias - reduces credibility of explanation

state ways to treat phobias?

- systematic desensitisation

- flooding

outline systematic desensitisation

- it is effective in the treatment of specific phobias

- clients are taught relaxation techniques (breathing/meditation) which they can use whenever they feel tension and anxiety. based on the assumption that 2 competing emotions can't exist at the same time so anxiety and relaxation can't.

- with the help of a therapist, clients construct a hierarchy of fear - a list of feared objects/situations ranked from the least to the most feared. eg) talking about spiders/picture/real/someone else holding/ holding

- in presence of therapist, the client is gradually exposed to each item in the hierarchy while they are in a state of deep relaxation. They start with the least feared item and move on once they feel relaxed and unafraid in its presence. Can be real or imagined. The process continues until they reach the top of the hierarchy and feel relaxed in the presence of all the time.

- if this works, clients have been counter conditioned - no longer associate object with fear but relaxation, but must be maintained not avoided.

State strengths of systematic desensitisation

- research support

- more ethical than flooding

- cheaper and more convenient alternatives available

outline strength of systematic desensitisation of research support

E: aim to investigate if systematic desensitisation is an effective treatment. People with a phobia of snakes were divided into 2 groups. Group1 received SD therapy for their phobia. Grp2 received no therapy. 1 showed less fear of snakes after receiving therapy than 2. same people were followed after 6 months and those in 1 still showed less fear.

E: Supports SD as effective and is generally considered better than other therapies and shows much greater recovery than with no therapy

outline flooding as a treatment for phobias

- immediately exposes clients to the objects/situations that are feared (without option of avoidance)

- to show them that there is no basis for fear

- leads to the extinction of fear

- rationale is that no-one can stay in a state of high anxiety for too long so by facing their fear they will unlearn the association between fear and the phobic stimuli

State weaknesses of flooding

- ethically dubious

- less effective for some phobias

Outline weakness that flooding is ethically dubious

P: very extreme form of therapy so ethically dubious

E: clients find it very frightening and discomforting. So it is important for patients give informed consent. Sometimes time and money might be wasted because patients may not complete treatment.

outline weakness of therapy not being effective for all phobias

P: less effective for social phobias because in those sufferers don't just experience anxiety but also have cognitive aspects such as unpleasant thoughts which flooding does not target

E: cognitive therapy would be more beneficial in these cases since its targets irrational thinking

State strengths of flooding

- more time and cost effective

Outline strength that flooding is more cost effective

E: people with specific phobias can lose their fear after only 3 sessions of flooding

E: so it is quicker and more cost effective compared to alternatives such as cognitive therapy/systematic desensitisation

outline strength of systematic desensitisation being ethical

P: doesn't cause the same degree of trauma as flooding

E: gradual exposure with relaxation techniques

E: leads to lower refusal rates for treatment and lower attrition rates than flooding

outline strength of systematic desensitisation having more convenient and cheaper alternatives

E: modern version of systematic desensitisation is virtual exposure therapy where exposure takes place in a virtual reality world rather than real life

E: has a similar level of success but is often cheaper and more convenient

state weaknesses of systematic desensitisation

- not effective for all phobias

- only effective with real life exposure

- under controlled conditions

- not suited for all patients

outline weakness that systematic desensitisation is not effective for all phobias

E: less effective for social and agoraphobia, as they can only be used when there is a specific feared situation for the patient to be exposed to

outline weakness that systematic desensitisation is only effective with real life exposure

E: less effective when imagined and the longer the exposure the more effective because some people cannot create a vivid image and thus SD is not effective

outline weakness that systematic desensitisation is under controlled conditions

E: doesn't always generalise to real life. When a person returns to everyday life, the phobia can resume.

outline weakness that systematic desensitisation is not suited for all patients

E: not suited for patients with learning difficulties or young children. As these sufferers may not understand what is happening during flooding or be able to engage in cognitive therapies.