psychopathology

statistical infrequency

someone is regarded as abnormal if a specific characteristic/behaviour of theirs isn’t near the average statistic.

average IQ is 100, and majority have an IQ +-15 of this. this is the normal distribution. only 2% have an IQ below 70, which is considered abnormal. they are liable to receive a diagnosis of intellectual disability disorder.

statistical infrequency eval

practical application - statistical infrequency lets us know when people are liable for a diagnosis. it is usually involved in diagnosing people with mental health issues within the clinical assessment. real-life application.

abnormal doesn’t always need to be bad - IQ scores over 130 are just as abnormal as a score of 70, however, this doesn’t need treatment and is considered to make people super intelligent. this is why we cannot rely on statistics infrequency alone to make a diagnosis.

being labelled as abnormal may be negative - if someone abnormality doesn’t affect them in their everyday life or prevent them from functioning, there may not be a need for a label. if they were to be labelled, it could interfere with their self-esteem.

deviation from social norms

when a person behaves in a way that is considered unusual compared to the social norms.

this is culturally specific - some cultures have different social norms. for example, homosexuality is illegal in some countries, and is still considered abnormal.

antisocial personality disorder (psychopathy) as an example - person with psychopathy is impulsive and aggressive. according to the DSM-5, this is abnormal as it doesn’t fit with our moral standards. this is the case in many cultures.

what is the dsm-5

a manual used by psychologists to diagnose mental disorders

deviation from social norms eval

cultural relativism - abnormality varies from culture to culture. for example, in some countries hearing voices would be socially acceptable in some countries, but in the UK it would be abnormal. this could lead to many false diagnostics.

not a sole explanation - has real life application, e.g. diagnoses antisocial personality disorder. however, there are other factors to consider. APD also causes others around the person to become distressed (failure to function normally). this means deviation isn’t the only reason for abnormality.

can lead to human right abuses - looking at historical examples, we can see some deviations from social norms which abuse human rights, e.g. homosexuality. some psychologists go as far as to saying some modern deviations from social norms still abuse human rights.

failure to function adequately

rosenhan and seligman. not maintaining basic hygiene, failure to keep relationships, etc.

main 3:

can’t conform to interpersonal standard rules.

experiences severe distress.

behaviour becoming irrational or dangerous to themselves or others.

failure to function adequately eval

takes in account patients subjective experiences - difficult to assess stress but does acknowledge patient’s experiences are important. somewhat specific to each patient. makes this a useful criterion.

difficult to establish if someone is actually failing to function or if they’re just deviating from social norms - some people may choose to not have a job, not because they can’t. those who practice extreme sports may be accused of behaving in a maladaptive way, and religion can be seen as irrational. risk of limiting freedom and individuality.

subjective judgements - while there are objective ways to assess abnormality (dms-5), it is up to the psychiatrist at the end of the day. this means opinions of failing to function will change from psychiatrist, leading to inaccurate diagonistics.

deviation from ideal mental health

jahoda’s idea of ideal mental health:

we self actualise, no symptoms or distress, we are rational and perceive ourselves correctly, we’re independent, we can work love and enjoy our leisure, cope with stress, realistic view of the world.

deviation from ideal mental health eval

comprehensive - covers all the reasons why someone may seek help for their mental health. this makes it a good tool to use when assessing mental health.

cultural relativism - in individualistic cultures, self-actualisation is a good thing. in collectivist cultures, it can be seen as self-indulgent as it doesn’t consider others. this means some of jahoda’s criteria is culture-bound.

unrealistically high standard - it is unlikely anyone meets all of jahoda’s standards. this can be good or bad. good because it shows us what we can do to improve our mental health, bad because there is no value in thinking who might benefit from treatment against their will.

behavioural characteristics of phobias

endurance, panic (crying, screaming), avoidance

emotional characteristics of phobias

anxiety, unreasonable emotional responses

cognitive characteristics of phobias

cognitive distortions, selective attention, irrational beliefs

behavioural characteristics of depression

activity levels either low or too high (psychomotor agitation), aggression and self-harm, disruption to sleep and eating patterns.

emotional characteristics of depression

lowered mood, low self-esteem, anger

cognitive characteristics of depression

poor concentration, absolutist (black and white) thinking, paying attention to only the negative.

behavioural characteristics of ocd

repetitive compulsions to reduce anxiety, avoidance.

emotional characteristics of ocd

anxiety and distress, accompanied by depression, guilt and disgust.

cognitive characteristics of ocd

aware they’re irrational, obsessive thoughts, use cognitive strategies to cope (meditation).

behavioural approach to explaining phobias

two-process model applied by mowrer.

classical: rayner and watson’s little albert (9 month old) experiment. rat - neutral stimulus. when the rat was present, an iron bar was banged (unconditioned stimulus), creating an unconditioned response of fear. the rat becomes associated with fear. the rat turns into the conditioned stimulus, and fear is the conditioned response. this is generalised to other similar objects they also tested on little albert.

operant: negative reinforcement is avoiding what causes fear. punishment is the fear felt. this causes the phobia to be maintained.

behavioural approach to explaining phobias eval

good explanatory power - goes further than just rayner and watson’s classical conditioning as it tells us how phobias are maintained through operant conditioning.

alternate explanation for avoidance - avoidance isn’t just to reduce anxiety, but also because avoidance gave a positive feeling of safety. e.g. in agoraphobia, they may stay home for safety, thats why some people with agoraphobia can go out with another person.

incomplete explanation - doesnt consider biological preparedness and why we are scared of some things for evolutionary reasons, e.g. snakes.

systematic desensitisation simple desc (no steps)

a behavioural therapy which reduces anxiety using classical conditioning. allows the patient to relax in the presence of the phobic stimuli, this is counterconditioning. this works because you can’t feel anxious and relaxed at the same time (reciprocal inhibition).

steps of systematic desensitisation

1. anxiety hierarchy where the psychologist and patient make a hierarchy of what triggers their anxiety the most due to their phobia.

2. relaxation techniques are learnt to the patient.

3. exposure of the stimuli when the patient is in a relaxed state. this will happen over many sessions until the patient no longer feels anxious, and instead relaxed.

systematic desensitisation eval

effective - 42 patients of 3 sessions of systematic desensitisation were compared to a control group 3 months and 33 months after their treatment. in all cases, the patients were less fearful than the control group.

accessible to a diverse range - patients with learning disorders may not understand what is happening during flooding or may not be able to engage with cognitive therapists who need to know what you’re thinking. systematic desensitisation is more appropriate.

people prefer systematic desensitisation - gives the patient less trauma than flooding. this is proved by the low refusal rates and low attrition rates.

flooding

immediate exposure to their phobia. this causes their phobia to become extinct, as in classical conditioning, the conditioned stimulus will no longer bring about the unconditioned stimulus, and the conditioned response. in some cases, the participant will start to relax as they become tired on their own fear.

informed consent must be given as flooding is very traumatic (not necessarily unethical).

flooding eval

cost effective - it is a quick treatment, and doesn’t take as many sessions as systematic desensitisation would. this means the patient doesn’t have to pay as much money as there are less sessions.

less effective for some phobias - some phobias which have cognitive aspects like irrational thoughts (e.g. social phobias) are harder to cure with flooding. people may benefit from cognitive therapists instead.

traumatic - not unethical, but traumatic. there is a possibility patients may not follow the treatment out to the end. this causes it to be a waste of their money and time spent preparing the patient.

becks faulty information processing

focusing on the negatives instead of the positive. thinking in ‘black and white’ terms. blowing small problems out of proportion.

beck’s negative self-schema

schema is a package of ideas developed through experience. negative self-schemes make us think about ourselves in a negative way.

beck’s negative triad

negative view of the world - suggests there is no hope anywhere

negative view of the future - reduces hopefulness

negative view of ourselves - confirms negative self-esteem

beck’s cognitive theory of depression eval

supporting research - study was done on 65 pregnant women. assessed cognitive vulnerability and depression before and after birth. more cognitively vulnerable meant more likely to suffer pre-natal depression. (UNLINKED) cognitions can be seen before depression develops, suggests beck was right when they said cognitions cause depression.

practical application in cbt - allows the negative triad to be challenged. translates well into therapy. knows which areas to target.

limited explanation - doesn’t explain cotard syndrome (where patients think they’re zombies) or cases where patients feel extreme emotions like anger.

ellis’ abc model

a - activating event. what caused their depression.

b - beliefs (musturbation, i-cant-stand-it-itis, utopianism)

c - consequences. emotional and behavioural.

ellis abc model eval

partial explanation - only explains reactive depression as theres an activating event.

practical application in cbt - allows irrational thoughts to be challenged.

doesn’t explain all aspects - doesn’t explain extreme anger or hallucinations/distortions.

cognitive behaviour therapy simple steps

the therapist and the patient will clarify the patients problems. they will then set out goals and how they will achieve them. they then identify any irrational thoughts to challenge. most use both beck and ellis’ ideas.

cognitive therapy - beck

they will identify their thoughts towards the negative triad and challenge these. they will ask the patient to record all the times someone has been nice to them or they enjoyed something. this will be used by the therapist as counter-evidence if the patient says everyone is mean to them, etc.

cognitive therapy - ellis REBT

ABCDE model. D - dispute. E - effect. will identify any irrational beliefs and try to challenge these. there will be a vigorous argument to break the link between negative life events and depression.

empirical argument - disputing whether there is evidence to support a negative belief

logical argument - disputing whether the negative thoughts follow logically from the facts

behavioural activation

therapists encouraging patients to be more active and engage in enjoyable activity. provides more evidence for the irrational nature of beliefs.

cbt eval

as effective as medication - study was done on 300 depressed ppts. group one did cbt, group two had antidepressants, group three had both. after 36 weeks, there was an 81% improvement in group one and two, and 86% in group 3. suggests there is good case for making CBT the first choice of treatment.

cbt may not work in severe cases - patients might be unmotivated to engage with the hard work of cbt. may not pay attention during therapy. in these cases, antidepressants can be given first, then cbt once patients are more motivated. limitation because cbt can’t be the sole treatment.

success because of therapist-patient relationships - little difference between cbt and systematic desensitisation as they build therapist-patient relationships. suggests it doesn’t matter what treatment is used. comparative reviews were done which found small differences, supporting the view that having someone to listen matters the most.