Abnormal psychology

The four Ds Bennett 2005 for abnormality

Deviance from the norm

Distress

Dysfunctional

Dangerous

Psychological disorder

set of symptoms of thoughts, feelings and behaviour that are ‘out of ordeR

Psychological dysfunction.

an individual cannot complete typical daily tasks, cannot socialise or maintain relationships, or is unable to work effectively for psychological reasons

Psychological deviance

People acting in contrary to what is considered societally normal

It may cause them no stress at all to deviate

Psychological distress

experience of psychological disorder or dysfunction, which may be brief or transient, or may become chronic, depending on what is being experienced

Two major guides to diagnosing mental illnesses and disorders in children and adults

The International Classification of Diseases – Version Eleven (ICD-11).

– The Diagnostic and Statistical Manual of Mental Disorders – Version Five (DSM-V).

Diagnostic methods

Clinical interviews are part of any diagnostic assessment

Self report is a form of clinical observation, but it is where the individual monitors their own thoughts, feelings and behaviours.

Psychometric tests and measurements are tools that can be used to gather information about a person’s mental functioning.

Positives and negatives of diagnosis

Formulation

a piece of writing, a diagram, a letter or some other kind of document that provides the story of an individual’s journey to their current mental health state

Butler 1998 list of features of a good formulation

– Grounded in an appropriate level and breadth of assessment.

– Culturally sensitive.

– Expressed in accessible language.

– Considers the possible role of trauma and abuse.

– Considers the possible role of services in compounding problems.

– Includes the impact and meaning of medical and healthcare interventions.

The superego

the part of our personality that contains all the rules we have been taught or that are followed by the culture and society we inhabit.

• The Superego can clash with the Id, and the Ego has to act as the judge and mediator between the two.

The attachment/developmental model

Developmental psychology is truly biopsychosocial, drawing on genetics, neurobiology, family and peer relationships, environmental influences and many other factors.

• Attachment theory seeks to explain how most individuals tend to have a consistent way of forming and maintaining relationships.

• explore an individual’s early life relationships and see how these relate to current behaviours and thoughts about other people.

Sociocultural approaches and Ideas

Help a therapist to remember to consider wider factors

Used with community to to assess individuals environment to see where sources of stress may be maintaining

The power threat meaning (PTM) framework (2018)

attempt to outline a conceptual alternative to psychiatric diagnosis, starting from first principles in order to identify non-medical patterns in distress and troubled or troubling behaviour.

• The PTM framework requires psychologists conducting assessments to consider the following questions in assessment:

– Impact of POWER: ‘what has happened to you?’

– Impact of a sense of THREAT: ‘how has this affected you?’ and ‘what did you do to get through it?’

generalised anxiety disorder GAD

people feel anxious across a whole range of daily experiences and relationships

They can be constantly looking out for danger or something going wrong, and they might avoid doing things they believe will turn out badly.

• Physical symptoms include sweating, shaking, raised heart rate, breathing quickly and tensing or clenching up – this can lead to severe fatigue

Has a strong genetic component

Schizophrenia

experiences that are perceived as unusual by others in society, these are often referred to by mental health professionals as symptoms.

• ‘Positive’ symptoms are unusual and bizarre experiences in relation to thinking, feeling, talking, memory and behaviour:

Schizophrenia characteristics

Delusions are unusual beliefs that would seem bizarre and outside of reality to others.

– Hallucinations are sounds, sights and other sensory events that are not experienced by others.

• disorganised thinking and speech

• Inappropriate emotion display

• Avolition is a lack of energy or interest in goals or life

• Withdrawal from external interests entirely to thier own issues

• Catonia - stops responding to their environment, remaining motionless and silent for prolonged periods

Schizophrenia approaches

• The dopamine hypothesis model suggests that the disorder is due to an excess of the neurotransmitter dopamine and antipsychotic medication is used to manage this

• The diathesis stress model suggests that although there may be a biological underpinning for schizophrenia, it needs external environmental stressors for the symptoms to be triggered (Holmes, 2010).

• Psychological approaches emphasise the impact of trauma, abuse and deprivation on an individual’s thinking, feeling and behaviour (BPS, 2017), and may advocate psychological treatments to manage the distress associated with having these stressful experiences

Bulimia nervosa

episodes of binge eating that occur at least once a week for at least three months, and then attempts to purge themselves to avoid gaining weight

• In a psychodynamic model, BN might be thought to be the result of an individual not developing a sense of their own hunger cues at an early age, possibly as a result of inconsistent or neglectful parenting around eating

• Fairburn’s Transdiagnostic Model (Fairburn, Cooper & Shafran, 2003) sees The thoughts, feelings and behaviours of a person with BN are focused on in four areas: mood intolerance, perfectionism, interpersonal problems, and low self- esteem.