Psychopathology - P1

definitions of abnormality - part 1 - AO1

• statistical infrequency - descriptive statistics - mean, median, mode - used to describe the typical value in data sets. Behaviours that are rare are considered abnormal.

• Deviation from social norms - behaviour that goes against the societal norms and values. Some can be against the law - change over time - homosexuality.

Definitions of abnormality - part 1 - AO3.

Statistical infrequency:

1. Some abnormal behaviours are desirable. Very few people have an IQ over 150, but this behaviour is desirable not undesirable. Depression is very common, but it is undesirable. Using statistical infrequency to define abnormality means we cannot distinguish between desirable and undesirable behaviours.

2. The cut-off point for what is normal and abnormal is subjective. For example, one symptom of depression is difficulty sleeping, however, some may think abnormal sleep is less than 6 hrs and some may think the cut off should be 5 hrs. These disagreements make it harder to define abnormality.

Deviation from social norms:

1. What was socially acceptable now may not have been in the past. For example, homosexuality is acceptable in most countries in the world, but it was against the law 50 yrs ago. If we define abnormality in terms of deviation from social norms, there is a danger of creating definitions based on prevailing morals and attitudes.

2. Another limitation is that the judgements on deviance are related to context. For example, someone wearing a bikini on the beach is regarded as normal, but doing the same thing in a classroom would be abnormal and deviant. Social deviance cannot offer a complete definition because it has to relate to both context and degree.

Definitions of abnormality - part 2 - AO1

• failure to function adequately - unable to cope in day-to-day life, like working, laundry cooking etc. can cause distress for individual and others. Some people are content not working but this behaviour is seen as abnormal to the outside world.

• Deviation from ideal mental health - Jahoda - characteristics that enable someone to be happy:

  • self-attitudes - high self esteem

  • Personal growth - self actualisation

  • Integration - coping in stressful situations.

  • Autonomy - independence

  • Accurate perception of reality

  • Mastery of the environment - ability to love and function at work.

• Absence of these leads to abnormality and unhappiness.

Definitions of abnormality - part 2 - AO3

Failure to function adequately:

1. The judgement is subjective. Some people may understand that their behaviour is undesirable and gain help. Some people might be quite content with their situation, even though it is causing distress to others. The judge to depends on who is making the decision.

2. The behaviour that seems dysfunctional may actually be functional for the individual. For example, someone wearing people with eating disorders gain attention and enjoy that and so the behaviour is desirable to them. This means that the definition incomplete as there is a failure to distinguish between functional and dysfunctional behaviours.

Deviation from ideal mental health:

1. The criteria is unrealistic. According to this criteria, a majority of us would be considered abnormal. We have to ask how many need to be lacking for us to be considered abnormal. The criteria is also quite difficult to measure. This means that the approach may be interesting but not very usable when it comes to defining abnormality.

2. The definition equates mental health to physical health. Physical illnesses tend to have physical causes or symptoms. This makes them easier to diagnose. Most mental disorders don’t have these, which makes it unlikely that we can diagnose mental abnormalities like we do physical ones.

Mental disorders - AO1

phobias:

• group of mental starters characterised by high levels of anxiety when in presence of particular stimulus.

  • emotional - anxiety, fear

  • Behavioural - avoidance, freeze/faint

  • Cognitive - irrational thoughts, excessive fear

Depression:

• mood disorder

  • emotional - sadness, loss of interest

  • Behavioural - reduced activity, lack of sleep

  • Cognitive - negative thoughts, negative view of world

OCD:

• anxiety disorder - obsessions and compulsions

  • emotional - anxiety, stress

  • Behavioural - compulsions

  • Cognitive - obsessions

Behavioural approach to explaining phobias - AO1

• Mowrer - 2-process model:

  • classical conditioning - phobia acquired through association - neutral stimulus, white rat, loud noise gives new stimulus response.

  • Operant conditioning - avoidance from the stimulus reduces fear and is rewarding.

Behavioural approach to explaining phobias - AO3

1. The explanation is incomplete - if a neutral stimulus becomes associated with a fearful experience, the result should be a phobia, but this doesn’t always happen. Research has found that not everyone who is bitten by a dog develops a phobia. This can be explained by the diathesis-stress model, where we have inherited a genetic vulnerability for developing mental disorders. However, the disorder will only manifest if triggered by a life event, like being bitten by a dog. The behavioural explanation is incomplete on its own.

2. The fact that phobias don’t always develop after a traumatic incident could be explained in terms of biological preparedness. Seligman found that all animals including humans are genetically programmed to learn an association between potentially life-threatening stimuli and fear. These are referred to as ancient stimuli that may her been dangerous in our evolutionary past, like snakes, heights etc. this would explain why we are less likely to be scared of modern day objects like cars when they are more dangerous. This suggests that the behavioural explanation cannot explain all phobias.

3. The behavioural explanation ignores cognitive aspects to phobias. The alternative would be that phobias are a cause of irrational thinking, which cause extreme anxiety. This leads to therapies like CBT which might be more successful than behaviourist treatments.

Behavioural approach to treating phobias - AO1

systematic desensitisation:

• counterconditioning - new association, new response, replace fear with relaxation.

• Relaxation - focusing on breathing - muscle relaxation.

• Desensitisation hierarchy - gradual introduction to feared situation - less overwhelming.

Flooding:

• person is immersed in one long session experiencing phobia at its worst.

• Can be in real life or virtual reality.

• Adrenaline response has a time limit - new stimulus link can be formed - non-anxious.

Behavioural approach to treating phobias - AO3

systematic desensitisation:

1. McGrath - 75% of people with phobias respond to SD. Real life techniques are more effective than images. Range of different exposure techniques.

Flooding:

1. Flooding is not for every patient as it can be overly traumatic and people can quit during the treatment, meaning they don’t get the full effect. Individual differences limit effectiveness of the therapy.

Overall:

1. Behavioural therapies are faster and cheaper and require less effort from the patient. CBT requires people to think deeply about mental problems, but these therapies help people who cannot think insightfully, like people with learning difficulties. It can be self-administered.

Cognitive approach to explaining depression - AO1

Ellis ABC model:

• Activating event

• Belief - rational or irrational

• Consequences - rational beliefs, rational emotions - irrational beliefs, irrational emotions.

• Musturbatory thinking - thinking that certian ideas must be true for someone to be happy

  • i must be approved by people.

  • I must do well

  • I must be happy

Becks negative triad:

• Negative schema - negative view of the world - overgeneralise self-worth.

• Negative triad

  • the world

  • The self

  • The future

Cognitive approach to explaining depression - AO3

1. This explanation blames the client rather than situations factors. This emphasis on the client is effective because it places the recovery in their hands. This can end to clients overlooking situational factors like family life. The strength of this explanation lies in the focus on the clients mind but other aspects of their environment need to be considered.

2. There are alternative explanations like the biological approach, which claims that low levels of the neurotransmitter serotonin is responsible for depression. The success of drug therapies in treating depression suggests that NT play an important role. Cannot explain depression by the cognitive explanation alone.

Cognitive approach to treating depression - AO1

CBT

• Ellis extended ABC model:

  • Disputing irrational thoughts.

  • Effects of disputing.

  • Feeling acquired through this.

• Types of disputing:

  • Logical - does this thinking make sense?

  • Empirical - is this belief accurate?

  • Pragmatic - will this belief help me?

• Homework - testing irrational beliefs in real life and independently.

• Behavioural activation - encourage activeness.

• Unconditional positive regard - increasing self-worth.

Cognitive approach to treating depression suggest- AO3

1. There is research support. Ellis claimed a 90% success rate for REBT, with an average of 27 sessions needed to complete the therapy. Researchers found that CBT is superior to no treatment at all. Some people didn’t put their revised beliefs into action, therefore reducing the effectiveness of the treatment.

2. CBT is more suitable for some than others. It is less effective for those whose beliefs are rigid and not easily changed. Not effective in situations where the stresses reflect real life that therapy cannot resolve. Some people don want the direct advice that CBT offers. Individual differences hinder the effectiveness.

3. Drug therapies like SSRIs are examples of alternative treatments that are also successful. They require less effort from the client. Can be used in line with CBT. CBT is especially effective if used with drug therapies.

Biological approach to explaining OCD - AO1.

genetic explanation:

• COMT gene - regulates production of dopamine - a form of this gene is more common in people with OCD. Low activity in COMT gene and higher levels of dopamine.

• SERT gene - affect’s transport of serotonin - lower levels in OCD.

• Diathesis-stress - genetic vulnerability for OCD with stressors, external factors that determine whether the disorder develops.

Neural explanations:

• dopamine - very high.

• Serotonin - very low.

• Caudate nucleus damaged - doesn’t suppress minor worries - thalamus alerted - sends back to orbito frontal cortex - worry circuit.

Biological approach to explaining OCD - AO3

1. 2-process model can be used to explain - obsessions and compulsions formed due to link to stimulus and fear/anxiety response. OCD can have psychological causes as well as biological explanations.

Biological treatment of OCD - AO1

• SSRIs - drugs increase levels of serotonin - serotonin released on synapse from one nerve, targets receptors on receiving neurone, re-absorbed by initial neurone sending the message. Re-absorption is inhibited.

• Anti-anxiety drugs - benzodiazepine - slow down NT GABA - quietening effect on many areas of the brain. Chloride ions make it hard for the NT to be stimulated - slows down activity.

Biological treatment of OCD - AO3

1. Drug therapy is cost-effective and widely available

   • Drugs are cheaper and more readily available than other psychological treatments such as CBT

   • The impact on the economy is lessened

     • This is good in terms of health service budgets

     • If more people are treated, they may return to work quicker which positively impacts the economy

2. There is good research support for the efficacy of drug therapy

   • Researchers (Greist et al., 1995) conducted a meta-analysis where they reviewed placebo-controlled trials

     • They found that drugs in each study were significantly more effective than the placebo at reducing the symptoms of OCD

Limitations

• Drug therapies can come with potentially serious side effects

  • SSRIs may cause blurred vision, loss of libido, irritability, indigestion, and sleep disturbances

  • BZs may cause drowsiness, light-headedness, confusion, dizziness and slurred speech

    • This limits the usefulness of these drugs in the treatment of OCD

• Positive results of drug trials are more likely to be published than trials in which the outcome of the drug was less successful (known as publication bias)

  • Goldacre (2013) found that drug companies selectively publish positive outcomes for the drugs their sponsors are selling

  • As well as being unethical, the above practice lessens the validity of drug therapies

    • If only positive results are published, is the drug truly effective in treating OCD?