PSYC203: Abnormal Psychology

Zoanthropy

Where someone believes and behaves like they’re turning into an animal

Clinical Lycanthropy

When a person believes and behaves like they’re turning into a werewolf

History of lycanthropy

People assumed others were being possessed by an animal spirit. People with too much hair were believed to be turning into werewolves

1500s History of Mental Illness

When people started giving ideas explanations that are recognisable ones about how mental illness was viewed

Black Bile

Thought to be associated with melancholia which is a distinct quality we see in patients with depression

Melancholia

A person’s lost of interest or pleasure

What is disorder: Statistical Rarity

Something that is unlikely to occur and presents low on a normal distribution

What is disorder: Statistical Rarity criticism

There are two ends to a distribution so if we have something that is very high and is it a disorder because it’s rare both ways?

What is disorder: Lesion

An injury or wound of some sort.

What is disorder: Lesion Criticism

When talking about mental illness people say there is no lesion as nothing is physically wrong so mental illness is a myth

What is disorder: Harm

The idea at face value is that someone is experiencing harm and therefore they have a disorder arising from what is occurring

What is disorder: Harm Criticism

Not all harm is disorder

What is disorder: What professionals treat

The idea is that people come in, we treat them and they have a disorder by virtue of them receiving treatment

What is disorder: What professional treat Criticism

Any one going to a professional for any reason is by definition disordered because a clinician is treating them

What is disorder: Biological Disadvantage

Disorder is anything that brings about a reduction in fitness in the environment or reproduction this is rooted in notion about fitness and reproduction in an evolutionary framework

What is disorder: Biological Disadvantage Criticism

Gaps in the evidence of the productivity associated with different types of psychopathology. Just because someone isn’t reproductive doesn’t mean they have a disorder

What is disorder: Unexpectable Distress

DSM defines a disorder as unexpectable distress

What is disorder: Unexpectable Distress Criticism

Inconsistency between whats at the front of the book and what occurs in the middle with the criteria. E.g. PTS isn’t unexpectable distress because if someone experiences a stressor they can gain PTSD

What is disorder: Wakefield 1992, 2007

Disorder is any situation where there is a combination of value and something that isn’t objective. Value= harm, objective= departure from intended function of a person

Wakefield 1992, 2007

Idea that if you have value and something that isn’t objective is when a disorder occurs. If the harm or dysfunction has a mental component then it can be classified as mental disorder

Challenges when defining mental disorder: Is a unified definition even possible?

A definition will cover all the instances of disorder that we see, objective is to find a definition that will cover everything

Challenges when defining mental disorder: Can we find a universal definition?

We need a definition that will be understand everywhere outside of WEIRD cultures and that’s an increased challenge as we may all think different about mental disorders

Challenges when defining mental disorder: Scientific Method

Can only deal with things that can be observed. In psych we hardly observe anything directly and there is a tendency in science to disregard what can’t be measured or quantified but so much of how we function is not directly observable by people

Challenges when defining mental disorder: Political Functions

A criticism of disorder is that it is a myth

Challenges when defining mental disorder: Political Functions example

Drapetomania: A mania involving escaping from slavery. A disorder used to control in a political and social way the way people within that society operate and behave

Levels of description

These range from social environment at the top to brain operation in the middle right down to the gross level of genetics. Start at the individual level and work our way down

Reductionism

We reduce the thing we’re trying to understand and explain it at a lower level, reducing it down to something that’s occurring differently and it’s causal of the things we see

Levels of Explanation

We can think about a behaviour and turn to a lower level to explain the behaviour

Fetishistic Disorder

A form of sexual desire where gratification is limited to particular non-sexual objects or limited parts of people’s bodies

Another term for fetishistic disorder

Paraphelia: a nature of relationship that is aside

‘Normal’

A value term about how we believe or think about a specific behaviour or function, emotion or thought

‘Normative’

About statistics but statistics generates something that reflects the local environment or the culture from which the participants in a study come

Aberrant

Departing from an accepted standard

Five kinds of paraphilia

Voyeurism, Frotteurism, Exhibitionism, Sadism, Masochism

Each form of paraphilia involves some sort of…. and some sort of…

deviation; harm

Voyeurism

Observing others to become sexually aroused

Frotteurism

Can’t get sexually aroused unless they rub up against other people

Exhibitionsim

There is a dependence on exposing oneself to unsuspecting members of the public to get aroused

Deviation occuring through courtship

Voyeurism, frotteurism, exhibitionsim.

What is the harm in deviation through courtship

It’s either towards other people and to themselves

Deviation occuring through pain

Sadism, masochism

Sadism

Getting sexual gratification from inflicting pain, suffering or humiliation on others

Masochism

Sexual gratification from ones own pain or humiliation

Deviation occurring through anomalous targets

Pedophilia, fetishism, transvestic disorder

Transvestic disorder

Where someone must crossdress in order to become sexually aroused

Aberrant behaviour and learning

There isn’t a problem with learning, there is normal brain function but the behaviour that’s been learned is the thing that is deviant

Psychopathology in relation to behavioural theory

There isn’t a problem with learning but the product of learning is problematic

Classical Conditioning

US paired with a CS produces a UR. Overtime the CS with generate a CR

Fetishism and Classical Conditioning: Malcolm Example

Stimulation of penis through feet of friend (US). Orgasm (UR). Overtime we see the emergence of him engaging in looking at boys feet, masturbating and then orgasm.

Operant Conditioning

We have a pleasant and an adverse outcome and we can supply or remove it through reinforcement or punishment. Sexual arousal can involve both positive and negative reinforcement

Discriminative Stimuli

Things that us that a negative reinforcement is available in the environment

Operant Conditioning: Malcolm and Discriminative Stimuli

Tends to happen when he’s bored and alone and this signals that there is an opportunity for engaging in the behaviour that will be rewarding

Classical Conditioning: How to help Malcolm

Pairing the arousal (US) with something really unpleasant. e.g. feet paired with nausea inducing agent to make him feel sick when he sees feet, removes arousing element

Operant Conditioning: How to help Malcolm

Masturbation is a key part of the problem and Malcolm stops after he’s orgasmed so therefore you have to have him masturbate long after orgasm (maybe even an hour) so there is no longer a reward associated with the behaviour

Problems with Treatment for Malcolm

• Most patients with fetishes have more than one. Can remove the one for feet but can’t remove others if he has several

• Won’t give him the skills he needs to enter into a healthy relationship

Psychologist more concerned with completing his accomplishment of being in a relationship rather than just getting rid of the fetish

Ideas for Self Help

Behavioural approaches- effective for a number of problems

A functional analysis of behaviour when thinking from an operant POV

Functional Analysis of Behaviour

What function does this behaviour serve and is that the reason why I engage in it? Need to think about the behaviour and cast your mind back to when it occurred and then forwards to what were the discriminative stimuli and the consequences

Why Malcolm doesn’t meet criteria for pedophilia

• When looking at DSM5 Criteria: he doesn’t act on his urges jus has fantasies about them

• Isn’t sexually attracted to young boys but their feet so under DSM5 he meets second criteria as this disorder causes him stress

Features of Depression

• changes in affect

• changes in motivation (core feature)

• a desire to escape

• low self esteem, pessimism, suicidal thinking

• inactive or agitated behaviour

• sleep disturbance, appetite, weight, fatigue

DSM5 says need to meet at least two of the criteria to be diagnosed

Freud’s Theory

Superego, ID, Ego

Superego

The embodiment of moral values bestowed by parents or society

ID

An embodiment of desire, wishing for and receiving pleasure

Ego

An arbitrator between these two things, keeps the ID and superego inside

Problems with Freud’s Theory: Purpose given to symptoms

His argument was that the symptoms served specific functions for the individual

Problems with Freud’s Theory: Defy Validation

His argument is that the ID and Superego are unobservable and therefore can only be inferred from behaviour indirectly

Problems with Freud’s Theory: Not disorder specific

The issues he attributed a particular pathology to could’ve been the reason for different pathologies

Problems with Freud’s Theory: Limited account of phenotype

Could look at someone’s symptoms who has depression and freudian perspective might account for some but not all of that

• A reaction from this was emergence of Behavioural Theory

• Another reaction was desire for psychiatry to become meaningful in other medical fields

Aaron Beck

Rather than looking at people objectively we should take it at face value what they say and how they feel. Then see if there’s any utility in looking at the content of thought

Aaron Beck Study

Invited patients with depression to talk to him about the way they were thinking

Results of Aaron Beck Study

We should think about depression cognitively

Beck’s Negative Cognitive Triad of Depression

Consists of the self, the world and the future

Beck: Logical Thinking Errors

People would overgeneralise the negative things in their lives as well as dichotomous thinking where things were either all good, or all bad, no in between

Beck’s Cognitive Idea: Schema

There are underlying schemas that hold the normative script that is a set of dysfunctional assumptions

Beck and Utterances

The content of people’s utterances tends to be negative and they say things that come to mind automatically

Beck’s Diathesis

The cognitive schemas develop early in life and when a sufficient amount of stress activates it

Beck’s Diathesis Model

Schemas in development + Stressor= Negative cognitive triad and Automatic activation of negative thoughts

Beck’s Diathesis Model Consequences

The emergence of depressive symptoms which feed through into the schema and we end up with a bit of a cycle

Overview of Lucy a client experiencing depressive symptoms

• in childhood parents spoke to her about getting good grades

• exams didn’t go well and motivation diminished

• felt unworthy and thought her good grades would fix her parents marriage

• doesn’t go out because she think she’ll bring the mood down

• forecasting she will so fail so she has no motivation

Lucy’s Core Beliefs (Bedrock of the schema)

“I don’t deserve…”; “I’m not worthy…”

Limitation of Beck’s Theory

Doesn’t explain the differences people display with depression. Doesn’t allow us to understand why it happens and doesn’t explain all symptoms and individual differences

Limitation of Beck’s Theory

Doesn't explain how overtime patients become sensitised to stressors and how those schemas can get activated later

Limitation of Beck’s Theory

Argues that cognition comes before affect, before the change in mood. Cognition could lead to change in mood or the other way round

Limitation of Beck’s Theory

Disparity of how he conceives psychopathology and how we think cognitive science works

Limitation of Beck’s Theory

Theory doesn’t explain how you get the patient to change their beliefs. Lucy thinks she’s unworthy so if we make her believe she’s worthy of everything it creates a new problem

Limitation of Beck’s Theory

No clarity on how to identify invariant truths of people

Advantages of Beck’s Thoery

Does highlight the problem of investing our value and worth in our circumstances and experiences

Advantages of Beck’s Theory

Suggests value should not change by circumstance

ABCs

Antecedents, Beliefs/Behaviour, Consequences

Beck and ABCs

Argued that change in mood is a consequence of a belief so you look at the antecedents to figure it out

Why are psychometrics helpful?

Because many constructs in psychology are unable to be measured directly

Psychometrics

Any measure that focuses on indirectly quantifying a construct

Reliability

The repeatability of scores

Validity

The meaning of scores

Projective tests

Tests that project an individual’s psyche onto a particular stimulus

Criterion- keyed tests

When you know that a certain response type is associated with a certain type of pathology

DSM

Is a psychometric construct

Reliability: Item Content

Behaviour sampled by items, domains of behaviour (High variability)

Reliability: Assessment episode

If the construct is not exposed to change, you would not expect high variability

Reliability: Raters and Interviewers

Constant errors, biases (errors introduced by the interviewer/ observer)