Psychopathology

Statistical Infrequency

• Deviating from the statistical norm or average

• Many individual human characteristics can be measured and plotted on a normal distribution

• Those behaviours at either end of the distribution (2 SD above and below the mean) can be considered abnormal

• E.g. IQ (lower or higher than ‘average’ range), mood (higher or lower than ‘average’ range), height (lower or higher than ‘average’ range), weight (lower or higher than ‘average’ range)

Evaluation of Statistical Infrequency

• Does not recognise many known disorders - e.g. Schizophrenia - where behaviours and symptoms are noticable, but not measurable

• The ‘cut off’ point is subjective - sometimes symptoms of disorders (e.g. depression) are difficult to measure and assign a ‘statistical’ cut off point to show where help is needed (e.g. sleeplessness, low mood)

• Cultural Relativism

Deviation from Social Norms

• Society sets norms and value (both written and unwritten)

• Any behaviour that deviates from these norms is considered abnormal

• E.g. cannibalism

Evaluation of Deviation from Social Norms

• Usefulness - the defintion can be used in clinical practice e.g. to define characteristics of antisocial personality disorder (e.g. failing to conform to culturally normal ethical behaviour e.g. recklessness, deceitfulness), depression, anxiety, eating disorders, OCD, schizotypal personality disorders, tourettes, etc.

• Deviance is related to context - e.g. wearing a bikini on the beach vs in the classroom

• Cultural Relativism

Failure to Function Adequately

• Unable to live a ‘norma'l’ day-to-day life

• Do not possess a ‘normal’ range of physical abilities, emotions or behaviours

• Behaviours which disrupt a person’s ability to work & form/maintain relationships

• E.g. disabilities, mood disorders, OCD/ADHD/phobias/eating disorders, etc.

Rosenhan & Seligman’s Characteristics of Dysfunction

1. Personal distress

2. Maladaptive behaviour (stops you achieving goals)

3. Unpredictable behaviour (doesn’t suit circumstances)

4. Irrational behaviour (unexplainable)

5. Cause observer discomfort

6. Deviation from social norms and values

Evaluation of Failure to Function Adequately

• Abnormality isn’t always accompanied by dysfunction: psychopaths can lead seemingly ‘functional’ lives (family, friends, jobs, outward behaviours) e.g. Harold Shipman/Fred & Rose West

• Functional dysfunction, e.g. attention seeking behaviours that gain (wanted) attention

• Cultural Relativism

Deviation from Ideal Mental Health

• Jahoda defines ‘normal’ mental health characteristics

• Abnormality is seen as anything which deviates from these characteristics

• E.g. depression, hallucinations, anxiety

Jahoda’s Characteristics of Ideal Mental Health

1. No symptoms of distress

2. Rational and accurate perception of the self

3. Can sel actualise

4. Can cope with stress

5. Realistic view of the world

6. Good self-esteem

7. Independent of other people

8. Can successfully work, love and enjoy leisure

Evaluation of Deviation from Ideal Mental Health

• Over-demanding (unrealistic) criteria - most people can’t meet the demands of Jahoda’s checklist (therefore if you can, are you abnormal?) - plus it’s Jahoda’s subjective criteria

• Changes over time (temporal validity) - seeing spirits = hallucinations now, but ‘godliness’ before; homosexualisty 50 years ago was a mental illness

• Cultural Relativism

Definition of Phobias

An overwhelming and debilitating fear of an object, place, situation, feeling or animal

Animal Phobias

Spiders, dogs, snakes, birds, or rodents

Envrionmental Phobias

Heights, deep water or germs

Situational Phobias

Public speaking, flying, or visiting the dentist

Bodily Phobias

Blood, vomit, or having injections

Behavioural Characteristics of Phobias

• Panic - Fight, flight, freeze/faint reaction

• Avoidance - the avoidance must interfere with the person’s life significantly to be considered clinically diagnosable

Emotional Characteristics of Phobias

• Anxiety - unable to relax or feel positive emotions (long term), extrement and unreasonable feeling in relation to the situation

• Fear - immediate response when presented by the phobic stimulus

Cognitive Characteristics of Phobias

• Irrational Beliefs - resistant to rational arguments, e.g. a person with arachnophobia may still feel that all spiders are dangerous, despite being aware that no spiders in the UK are dangerous

• Selective Attention - if a person with a phobia is presented with an object or situation they fear, they will find it difficult to direct their attention elsewhere

Two-Process Model

Phobias are learned/initiated and then maintained by two different processes - learned via classical conditioning and maintained by operant conditioning

Classical Conditioning

• NS - Neutral Stimulus - an event that doesn’t produce a response (e.g. rat)

• UCS - Unconditioned Stimulus - an event that produces an innate, unlearned reflex response (e.g. loud noise)

• UCR - Unconditioned Response - an innate, unlearned reflex behaviour that is produced when exposed to an UCS (e.g. fear response)

• CS - Conditioned Stimulus - and event that produces a learned response (e.g. rat)

• CR - Conditioned Response - a learned behaviour that is produced when exposed to a conditioned stimulus (e.g. fear response)

Stimulus Generalisation

Once an animal has been conditioned, they will also respond to other stimulus that are similar, e.g. Little Albert was scared of white fluffy things

Extinction

This association is not permanent, over time it will deteriorate and eventually become extinct

Operant Conditioning

• Prevents the extinction of a phobia

• Avoidance of the feared stimulus is rewarding (reduces fear) and therefore reinforces the behaviour

• An individual learns that avoiding their feared object is completely rewarding, so continues to do so, and therefore they would prevent extinction of the fear

Negative Reinforcement

Removing an unwanted negative state (e.g. removal of being ignored, removal of fear) - leads to maintenance or increase of behaviour, e.g. switching off a loud noise, avoiding walking past a dog on the street

Issue/Debate of Behavioural Approach to Explaining Phobias

Reductionist - sees behaviour as purely a result fo conditioning, reducing the explanation to simple terms; could be a lot more complex than this

Principles of ‘Unlearning’

Maladaptive (mis-learned) behaviour can be corrected by replacing it with a new and appropriate conditioned (learned) behaviour = this is called Counter-Conditioning

Systematic Desensitisation

Where a patient is trained to substitute a relaxation response for the fear response in the gradual presence of the phobic stimulus

Three steps of Systematic Desensitisation

1. Relaxation techniques - training the patient to relax (on demand), e.g. breathing techniques/mindfulness

2. Establishing an anxiety hierarchy of the feared stimulus (identify steps; from a picture, to interaction with the stimulus)

3. Counterconditioning a relaxation response (instead of a fear response) to the feared stimulus at each step of the hierarchy

Evaluation of Systematic Desensitisation

• Effective therapy - had a 75% success rate at curing phobias by 1990

• Good for people who lack insight, as no ‘insight’ is required

• However, relaxation has been found to be an unnecessary part of the therapy - exposure to the feared stimulus alone works just as effectively

Flooding

Patients taught to relax muscles totally - one long immediate exposure to the worst case of the feared stimulus

Steps of Flooding

• Immediately exposing a client to a stimulus that causes an undesirable response to show that the stimulus isn’t dangerous

• Prevents avoidance of the feared stimulus - after the initial f/f response has exhausted itself, the phobia will run into extinction