PSYCHOPATHOLOGY

What are the definitions of abnormality?

• Statistical Infrequency

• Deviation from Social Norms

• Faliure to Function Adequately

• Deviation from Ideal Mental Health

What is Statistical Infrequency as a definition of abnormality?

someone is mentally abnormal if their mental condition is very rare in the population / the rarity of behaviour is judged objectively using statistics, comparing the individual’s behaviour to the rest of the population

What is an example of statistical infrequency as a definition of abnormality?

IQ - the average IQ is set to 100. In a normal distribution, most people have a score in the range on 85 - 115. Only 2% have a score below 70, meaning they are abnormal and are liable to receive a diagnosis of Intellectual Disability Disorder

What are strengths of Statististical Infrequency as a definition of abnormality?

appropriate for many mental illnesses and disorders where statistical criteria is available

What are some limitations of Statistical Infrequency as a definition of abnormality?

• Unusual characteristics can be positive (high IQ)

• subjectively determined cut-off point

• sometimes appropriate (depression experienced by 10% of population so normal?)

What is deviation from social norms as a definition of abnormality?

each society has unwritten rules (norms) for what is acceptable behaviour, and any behaviour that varies from these norms is deemed abnormal

What are some examples of deviations of social norms as an explanation of abnormality?

• homosexuality (illegal in UK until 1967)

• psychopathy (absence of prosocial internal behaviours)

What is a strength of using deviation from social norms as an explanation of abnormality?

distinguishes between desirable and undesirable behaviours

What are some limitations of using deviation from social norms as an explanation of abnormality?

• susceptible to abuse (homosexuality in DSM)

• cultural relativism (afro-carribean people in UK 7x more likely to be diagnosed with schizophrenia)

• deviance related to context and degree (what is normal in one place is not in another)

What is faliure to function adequately?

a person is considered abnormal when they can no longer cope with the demands of everyday life, such as ability to interact with the world and meet their challenges

What are the major features of faliure to function adequately?

• personal distress

• maladaptive behaviour

• irrationality and incomprehensibility

• unpredictability and loss of control

• observer discomfort

• violation of moral standards

What is personal distress?

the person is upset or depressed

What is maladaptive behaviour?

behaviour that prevents an individual from achieving major life goals

What is irrationality and incomprehensibility?

there appears to be no good reason why the personal should choose to behave that way

What is unpredictability and loss of control?

behaviour is often highly unpredictable and inappropriate for the situation

What is observer discomfort?

behaviour that makes other people feel uncomfortable

What is violation of moral standards?

breaking laws, taboos, unwritten social rules, etc.

What is an example of Faliure to Funcion Adequately?

Schizophrenia (person has disturbing hallucinations which may lead to bizarre behaviour / individuals experience personal distress and can be unpredictable around others)

What are some strengths of faliure to function adequately as a definition of abnormality?

• recognises subjective experience

• easy to judge objectively

• represents a threshold for help

What are some limitatinos of faliure to function adequately as a definition of abnormality?

• the behaviour may be functional

• judgement depends on who makes the decision

What is deviation from ideal mental health?

Jahoda(1958) identified 6 criteria necessary for ideal mental health. If a person lacks these, they may be considered abnormal

What are the 6 criteria for ideal mental health?

• positive attitudes towards the self

• self-actualisation of one’s potential

• resistance to stress

• personal autonomy

• accurate perception of reality

• adapting to the environment

What is positive attitude towards the self?

an individual should have high self-esteem and a strong sense of identity

What is self-actualisation of one’s potential?

a person should be focused on the future and their self growth and improvement

What is resitance to stress?

individuals should have effective coping strategies for dealing with life’s stresses

What is personal autonomy?

individuals should be independent and self reliant

What is an accurate perception of reality?

individuals should have a truthful and realistic view of the world

What is adapting to the environment?

this includes the ability to love, solve problems, adjust to new situations, and function at work and interpersonal relationships

What is a strength of deviation from ideal mental health as a definition of abnormality?

it is a positive approach - focus on what is desirable rather than what is undesirable

What are some limitation of deviation of ideal mental health as a definition of abnormality?

• equates physical and mental health

• unrealistic criteria

• cultural relativism

What are three types of phobias?

specific, social, agoraphobia

What is a specific phobia?

phobia of a specific object or situation

What is a social phobia?

phobia of a social situation

What is agoraphobia?

phobia of situations you cannot easily leave

What is an example of a specific phobia?

arachnophobia

What is an example of a social phobia?

fear of public speaking

What is an example of agoraphobia?

crowds, public transport

What are the emotional characteristics of phobias?

anxiety, uncontrollable emotional responses

What is anxiety (as a characteristic of phobia)?

uncomfortably high and persistant state of being aroused, making it difficult to relax

What are the cognitive characteristics of phobias?

irrational beliefs, selective attention

What are irrational beliefs (with regard to phobia)?

irrational beliefs about phobic object which cannot be explained and have no basis in reality

What is selective attention(with regard to phobia)?

selective attention to phobic object, hard to tear attention away from

What are the behavioural characteristics of phobias?

panic, avoidance, endurance

What is panic (with regard to phobias)?

uncontrollable physical response (crying, freezing, screaming)

What is avoidance (with regard to phobias)?

physically adapting normal behaviour to avoid phobic object

What was the aim of the ‘Little Albert’ study by Watson and Rayner?

condition a baby to fear something which previously had a neutral response

What was the procedure for Watson and Rayner’s 1920 ‘Little Albert’ study?

1. white rat gave no response

2. repeatedly present rat and loud noise that scares baby

3. present rat without noise (hoping to scare baby)

What were the results of Watson and Rayner’s 1920 ‘Little Albert’ study?

phobia created in rat and other furry white objects but disappeared without maintenance

What is the two-process model with regard to phobia?

phobias are created through classical conditioning and maintained through operant conditioning

What is positive reinforcement?

reward for behaviour increases likelihood of behaviour

What is negative reinforcement?

rewards for avoidance (reduction in fear) increases likelihood

What are the strengths of the two-processes model as an explanation of phobias?

• real world application in treatment (SD)

• links bad experiences and phobias (De Jongh, 2006 - 71% dentistry)

What is a limitation of the two-process model as an explanation of phobias?

• cannot explain cognitive aspects

What behavioural treatments are available for phobias?

• Systematic Desensitisation / SD

• Flooding

What is systematic desensitisation?

designed to gradually reduce phobic anxiety through counterconditioning (new response of relaxation is learnt)

What are the three processes in systematic desensitisation?

1. anxiety heirarchy

2. exposure

3. relaxation

What is the anxiety heirarchy?

a list of behaviours put together by client and therapist that provoke anxiety arranged in order from least to most frightening

What is exposure in systematic desensitisation?

client exposed to phobic stimulus across several sessions moving up the heirarchy

When is systematic desensitisation considered successful?

when client can stay relaxed in situations high on the heirarchy

What is relaxation in systematic desensitisation?

therapist teaches client to relax as deeply as possible through breathing exercises. due to reciprical inhibition the relaxation response is learnt

What is reciprocal inhibition?

it is impossible to both feel fear and be relaxed at the same time

What are the strengths of systematic desensitisation?

• research support

  • Gilroy (2019) found that at both 3 and 33 months, 42 SD patients were less fearful than a control group

• useful for people with learning disabilities

  • flooding may leave them confused and distressed; shown to struggle with therapies that require complex thought

What are the limitations of SD as a method of treating phobias?

not appropriate for all phobias - Ohman suggests it is inappropriate for phobias with a evolutionary basis (fear or dark, heights, dangerous animals)

What is flooding?

counterconditioning a phobia by immediate and full exposure to the maximum level of phobic stimulus. stops phobic responses quickly as without the option of avoidance, the client quickly learns the phobic stimulus is harmless

What is a strength of flooding?

cost effective - can work in one session, compared with multiple SD sessions

What are the limitations of flooding?

• highly traumatic - more stressful than SD, higher attrition rates, ethical issue - therapist knowingly causing harm to client?

• inappropriate for those with learning disabilities

What are the emotional characteristics of depression?

• anger (towards others or self)

• sadness (persistant, very low mood)

• guilt (helplessness and feelings of no value compared to others)

• loss of interest/pleasure in usual hobbies or activities

What are the behavioural characteristics of depression?

• shift in activity levels (lethargy, insomnia or hypersomnia)

• change in eating behaviour

• increase in aggression (shown towards self through self harm)

What are the cognitive characteristics of depression?

• negative irrational thoughts

• negative view of the world

• absolutist thinking

What are the two cognitive explanations of depression?

• Ellis’ ABC Model

• Beck’s Negative Triad

What is the cognitive explanation of depression?

abnormality is the fault of faulty, irrational cognition, therefore mental disorders can be overcome by learning to use more appropriate ways of thinking

What is Beck’s negative triad?

• negative view of the self

• negative view of the world

• negative view of the future

How does Beck’s negative triad lead to depression?

pessimistic view becomes self fulfilling prophecy and leads to cognitive bias

What are some strengths of Beck’s negative triad?

• research support - Cohen found cognitive vulnerability predicted later depression

• real world application - applications in screening (Cohen) and treatment (CBT) of depression

What is a limitation of Beck’s negative triad?

cannot explain biological factors - success of drug therapies suggests it is not just cognitive but also biological

What does Ellis’ ABC Model (1962) state is the cause of depression?

irrational beliefs

What are the three elements of the ABC Model of depression?

A - activating events

B - beliefs

C - consequences

What are irrational beliefs?

thoughts that do not allow people to be happy and free from pain

What causes irrational beliefs?

musturbatory thinking

What are the three main elements of musturbatory thinking?

• i MUST do well

• i MUST be approved of by people i find important

• the world MUST give me happiness

What is a strength of Ellis’ ABC Model?

real world application - REBT (rational emotive behavioural therapy), supported by David (2018)

What are some limitations of Ellis’ ABC Model?

• irrational beliefs may be realistic - depressed people gave more accurate predictions about disaster likelihood than ‘normal’ control group

• cannot explain endogenous depression - only focuses on reactive depression, if depression not triggered by an external event, cannot explain

• suggests patient is at fault

What are the main aims of CBT?

• therapist and client identify problems and goals

• maladaptive thoughts disputed by therapist

What are the three types of disputing in CBT?

logical, empirical, pragmatic

What does CBT involve?

• clients asked to do homework to test thoughts

• clients taught to monitor automatic maladaptive thoughts and examine evidence supporting in everyday life

• behavioural activation in pursuing pleasurable activities

• therapist provides unconditional positive regard

What are the strengths of CBT?

• as effective in reducing symptoms and preventing relapse as antidepressants (March, 2007)

• Keller (2000) - found that recovery rates for CBT and antidepressants combined was 85% compared to 55% just drugs

What are the limitations of CBT?

• unsuitable for diverse clients - ineffective for severe cases and learning disabilities

• some clients want to explore their past - CBT focuses os the ‘here and now’ which can cause frustration on those that want to explore their past

What are the behavioural characteristic of OCD?

• compulsions

• avoidance - take or resist actions to avoid objects/situations that trigger obsessions

What is a compulsion?

behaviour performed repeatedly to reduce anxiety (anxiety reduction is temporary)

What are the emotional charcteristics of OCD?

• anxiety - resulting from obsession, constant worst-case scenario thinking that defines OCD

• depression - result of inability to control anxiety- causing thought and OCD symptoms to take over sufferer’s life

What are the cognitive characteristics of OCD?

• obsessions

• hypervigilance - permanent state of alertness where sufferer is looking for the source of their intrusive thoughts

• selective attention - the individual with OCD is so focused on the objects connected to the obsession they cannot focus on things in the environment

What is an obsession?

intrusive, irrational and recurrent thoughts that seem to be unpleasant, catastrophic thoughts about potential dangers

What candidate genes are there for the cause of OCD?

• COMT

• SERT

• 5HTI-D

How does COMT explain OCD?

form of gene found to be more common in OCD sufferers which causes higher levels of dopamine

How does SERT explain OCD?

faulty gene can lead to lower levels of serotonin

How many different possible genes are involved in OCD?

230

What is a strength of the genetic explanation of OCD?

supported by Nestadt (2010) - MZ 68% DZ 31%, those with a family member with OCD are 4x more likely to develop (Marini, 2012)

What are some limitations of the genetic explanation of OCD?

• not entirely genetic - Cromer (2007) found that over half OCD sample suffered a traumatic event and that OCD more severe in those who had experienced a trauma

• alternative explanation - 2 process model, learnt when neutral stimulus associated with anxiety and maintained through avoidance of anxiety provoking stimulus. supported by success of ERP (similar to SD) (60% - 90% adults improved symptoms

What is the neural explanation of OCD?

abnormal brain circuits, abnormal neurotransmitters

What structures on the brain are involved in OCD?

• worry circuit - OFC, basal ganglia, thamalus

• parahippocampal gyrus