Psychology - Psychopathology PMT

Paper 1

Statistical Infrequency

Implies that a disorder is abnormal if its frequency is more than two standard deviations away from the mean incidence rates represented on a normally-distributed bell curve.

Evaluation of statistical infrequency

Strength: Statistical infrequency is useful in clinical diagnosis as it provides an objective measure to assess how severe a disorder is compared to the general population.

Limitation: It wrongly assumes all rare behaviours are undesirable, ignoring positive uncommon traits like high intelligence or empathy.

Failure to Function Adequately

Rosenhan and Seligman’s (1989) failure to function adequately definition of abnormality states that a person may be considered abnormal if their mental state prevents them from living a normal life, following social norms, or functioning safely—especially if their behaviour is distressing, noncompliant with social rules, or poses danger to themselves or others.

Evaluation of Failure to Function Adequately 

Strength: Considers the patient’s perspective alongside clinical assessment, allowing for more accurate, individualized diagnoses than purely statistical methods. 

Limitation: Risks labelling individuals as “abnormal,” which can reinforce negative stereotypes and lead to discrimination, even if their condition doesn’t significantly impact their life or others.

Deviation from social norms

Deviation from social norms defines abnormality, with behaviour considered abnormal if it violates general or culture-specific norms. For example, aggression toward strangers or experiencing certain hallucinations may be seen as abnormal across many cultures, though some behaviours may be acceptable in specific cultural contexts.

Evaluation of deviation from social norms

Limitation: Social norms-based diagnoses have been used historically to discriminate and control, reflecting societal biases (e.g., “nymphomania” used to oppress women and enforce class divisions).

Limitation: Cultural relativism means what’s considered abnormal in one culture may be valued in another (e.g., hallucinations seen as spiritual in some African and Asian cultures), leading to inconsistent diagnoses across cultures.

Deviation from Ideal Mental Health

Jahoda’s (1958) deviation from ideal mental health defines abnormality by comparing individuals to criteria for optimal mental health, such as self-actualisation, accurate self-perception, absence of distress, and the ability to maintain effective functioning.

Evaluation of Deviation from Ideal Mental Health

Limitation: Jahoda’s criteria for ideal mental health are unrealistic, meaning most people could be classed as abnormal even for minor shortcomings, limiting its usefulness for diagnosing disorders.

Limitation: Cultural relativism affects this definition; concepts like self-actualisation may be valued in individualist cultures but seen as selfish in collectivist cultures, making the definition culturally biased.

what are the behavioural characteristics of phobias

panic, avoidance and endurance

Panic

the patient suffers from heightened physiological arousal upon exposure to the phobic stimulus

Avoidance

avoidance behaviour is negatively reinforced (in classical conditioning terms) because it is carried out to avoid the unpleasant consequence of exposure to the phobic stimulus. Therefore, avoidance severely impacts the patient’s ability to continue with their day to day lives.

Endurance

this occurs when the patient remains exposed to the phobic stimulus for an extended period of time, but also experiences heightened levels of anxiety during this time.

what are the emotional characteristics of phobias?

anxiety, fear and emotional response is unreasonable

Anxiety

phobias are classed as anxiety disorders. By definition then they involve an emotional response of anxiety, an unpleasant state of high arousal. This prevents a person relaxing and makes it very difficult to experience any positive emotion. Anxiety can be long term.

Fear

Fear is the immediate and extremely unpleasant response we experience when we encounter or think about a phobic stimulus. It is usually more intense but experienced for shorter periods than anxiety. 

Emotional response is unreasonable

The anxiety or fear is much greater than is ‘normal’ and disproportionate to any threat posed.

What are the cognitive characteristics of phobias?

selective attention, irrational beliefs and cognitive distortions

Selective Attention

this means that the patient remains focused on the phobic stimulus, even when it is causing them severe anxiety. This may be the result of irrational beliefs or cognitive distortions.

Irrational Beliefs

this may be the cause of unreasonable responses of anxiety towards the phobic stimulus, due to the patient’s incorrect perception as to what the danger posed actually is.

Cognitive Distortions

the patient does not perceive the phobic stimulus accurately. Therefore, it may often appear grossly distorted or irrational e.g. mycophobia (a phobia of mushrooms) and rectaphobia (a phobia of bottoms).

What are the behavioural characteristics of depression?

activity levels, disruption to sleep and eating behaviour and aggression and self-harm

Activity Levels

Typically people with depression have reduced levels of energy, making them lethargic. This has a knock-on effect, with people tneding to withdraw from work, education and social life. In extreme cases this can be so severe that the person cannot get out of bed. 

In some cases depression can lead to the opposite effect - known as psychomotor agitation. Agitated individuals struggle to relax and may end up pacing up and down a room.

Disruption to sleep and eating behaviours

Depression is associated with changes to sleeping behaviour. A person may experience reduced sleep (insomnia), particularly premature waking, or an increased need for sleep (hypersomnia). Similarly, appetite and eating may increase or decrease, leading to weight gain or loss. 

Agression and Self-Harm

People with depression are often irritable, and in some cases they can become verbally or physically aggressive. This can have serious knock-on effects on a number of aspects of their life. For example, someone experiencing depression might display aggression by ending a relationship 

Depression may also lead to phsyical aggression directed against the self. This includes slef-harm, often in the form of cutting.

What are the emotional characteristics of depression? 

Lowered mood, anger and lowered self-esteem

Lowered mood

Lowered mood is more pronounced than in the daily kind of experience of feeling lethargic and sad. People with depression often describe themselves as ‘worthless’ and ‘empty’.

Anger

People with depression frequently experience anger, sometimes extreme anger. This can be directed at the self or others. On occasion such emotions lead to aggressive behaviour.

Lowered self-esteem

Self-esteem is the emotional experience of how much we like ourselves. People with depression tend to report reduced self-esteem, in other words they like themselves less than usual.

What are the cognitive characteristics of depression?

poor concentration, attending to and dwelling on the negative and absolutist thinking

Poor concentration

Depression is associated with poor levels of concetration. The person may find themselves unable to stick to a task as they usually would, or they might find it hard to make decisions that they would normally find straightforward.

Attending to and dwelling on the negative

When experiencing a depressive episode people are inclined to pay more attention to negative aspects of a situation and ignore the positives.

Absolutist thinking

Most situations are not all-good or all-bad, but when a person is depressed they tend to think in these terms. This is sometimes referred to as ‘black-and-white thinking’. This means that when a situation is unfortunate they tend to see it as an absolute disaster.

What are the behavioural characteristics of OCD?

Compulsions are repetitive, compulsions reduce anxiety and avoidance

Compulsions are repetitive

Typically people with OCD feel compelled to repeat a behaviour. A common example is handwashing.

Compulsions reduce anxiety

Around 10% of people with OCD show compulsive behaviour alone - they have no obsessions, just a general sense of irrational anxiety. However, for the vast majority, compulsive behaviours are performed in an attempt to manage the anxiety produced by obsessions. For example, compulsive handwashing is carried out as a response to an obsessive fear of germs.

Avoidance

The behaviour of people with OCD may also be characterised by their avoidance as they attempt to reduce anxiety by keeping away from situations that rigger it. For example, people who wash compusively may avoid coming into contact with germs.

What are the emotional characteristics of OCD?

Anxiety and distress, accompanying depression and guilt and disgust

Anxiety and distress

OCD is regarded as a particularly unpleasant emotional experience because of the powerful anxiety that accompanies both obsessions and compulsions. Obsessive thoughts are unpleasant and frightening, and the anxiety that goes with these can be overwhelming.

Accompanying depression

OCD is often accompanied by depression, so anxiety can be accompanied by low mood and lack of enjoyment in activities.

Guilt and disgust

OCD is also accompanied with emotions such as irrational guilt, for example over minor moral issues, or disgust, which may directed against something external, e.g. dirt, or at the self.

What are the cognitive characteristics of OCD?

Obsessive thoughts, cognitive coping strategies and insight into excessive anxiety

Obsessive thoughts

For around 90% of people with OCD the major cognitive feature of their condition is obsessive thoughts, i.e. thoughts that recur over and over again. These vary considerably from person to person but are always unpleasant.

Cognitive coping strategies

Obsessions are the major cognitive aspect of OCD, but people also responded by adopting cognitive coping strategies to deal with the obessions. For example a religious person tormented by obsessive guilt may respond by praying.

Insight into excessive anxiety

People with OCD are aware that their obsessions and compulsions are not rational, in fact this is necessary for a diagnosis of OCD. If someone really believed their obsessive thought were based on reality that would be a symptom of a different disorder. 

The behavioural approach to explaining phobias

Mowrer’s two-process model explains that phobias are acquired through classical conditioning and maintained through operant conditioning. Watson and Rayner’s Little Albert study showed fear can be learned when a neutral stimulus (white rat) is paired with an unconditioned stimulus (loud noise), leading to a conditioned fear response that generalised to similar objects. The phobia is then maintained by negative reinforcement, as avoiding the feared object reduces anxiety, making avoidance more likely to continue.

Evaluation of the behavioural explanation of phobias

Strength: Mowrer’s two-process model has strong explanatory power, explaining both how phobias are learned and maintained. It also underpins effective treatments like systematic desensitisation and flooding, which work by preventing avoidance and breaking negative reinforcement.

Limitation: Alternative explanation (Buck): Avoidance may be motivated by seeking safety rather than simply avoiding anxiety (e.g., social phobics go out with a trusted friend).

Limitation: Alternative explanation (Seligman): Evolutionary theory suggests we are biologically predisposed to fear certain “prepared” stimuli (e.g., fire, water) that once threatened survival, meaning Mowrer’s model cannot fully explain all phobias.

The behvioural approach to treating phobias - systematic desensitisation

Systematic desensitisation is a behavioural therapy that reduces phobic anxiety through gradual exposure and counterconditioning, teaching relaxation instead of fear. Based on reciprocal inhibition (you can’t be anxious and relaxed simultaneously), the process involves creating an anxiety hierarchy, learning relaxation techniques, and gradually facing fears until the patient remains calm even at the highest anxiety level, indicating the phobia has been overcome.

Evaluation of systematic desensitisation

Supporting evidence: Gilroy et al. found that patients treated with systematic desensitisation for spider phobia showed lasting improvement (up to 33 months later) compared to a relaxation-only control group, supporting its effectiveness.

Strength: Suitable for a wide range of patients, including those with learning difficulties who may struggle with cognitively demanding therapies like CBT.

Strength: More acceptable and less distressing for patients, leading to low dropout and refusal rates—making it both effective and cost-efficient.

The behvioural approach to treating phobias - flooding

Flooding is a behavioural therapy that treats phobias through immediate, intense exposure to the feared stimulus in a safe environment, preventing avoidance behaviour and breaking its reinforcement. Since high anxiety cannot be sustained indefinitely, the patient eventually realises the phobic stimulus is harmless, leading to a reduction in fear.

Evaluation of flooding

Strength: Flooding is cost-effective, often curing phobias in a single session, saving time and resources compared to cognitive therapies.

Limitation: It is less effective for complex phobias (e.g., social phobia), which involve negative thought patterns as well as anxiety—issues better addressed through cognitive therapies.

The cognitive approach to explaining depression - Becks negative triad

Beck’s cognitive theory suggests people develop depression due to cognitive vulnerability, including faulty information processing, negative self-schemas, and the cognitive triad. Depressed individuals focus on negatives, think in black-and-white terms, view themselves negatively, and have automatic negative thoughts about the self, the world, and the future, reinforcing low mood and hopelessness.

Evaluation of Beck’s negative triad

Supporting evidence: Grazioli and Terry found that women with higher cognitive vulnerability were more likely to develop postnatal depression, supporting Beck’s claim that faulty thinking contributes to depression.

Strength: Beck’s theory has practical applications—by identifying and challenging negative thoughts (the cognitive triad), therapists can effectively treat depression through CBT, supporting the theory’s real-world validity.

The cognitive approach to explaining depression - Ellis’ ABC model

Ellis’s ABC model explains depression as resulting from an activating event (A) that triggers an irrational belief (B), leading to an emotional consequence (C) such as depression. The model emphasises that it’s not the event itself, but how it’s interpreted, that determines whether someone becomes depressed.

Evaluation of Ellis’ ABC model

Limitation: The ABC model only explains reactive depression (triggered by clear events) and fails to account for depression without an identifiable cause, making it incomplete.

Strength: Like Beck’s theory, it has strong practical applications—its success in CBT supports the idea that challenging irrational beliefs helps treat depression.

Limitation: Both Ellis’s and Beck’s theories overlook other symptoms of depression (e.g., anger, hallucinations, Cotard Syndrome), limiting their ability to explain all forms of the disorder.

The cognitive approach to treating depression

CBT treats depression by identifying and challenging irrational thoughts and promoting more adaptive behaviours.

• Beck’s CBT: Targets the cognitive triad (negative thoughts about self, future, world), faulty information processing, and negative self-schemas. Patients test the reality of their beliefs (e.g., keeping a journal to disprove negative assumptions), acting as a “patient as scientist.”

• Ellis’s REBT: Challenges irrational beliefs through logical or empirical arguments and uses behavioural activation to engage patients in enjoyable activities, breaking the link between negative events and depression.

Evaluation of the cognitive approach to treating depression

Supporting evidence: March et al. found that CBT, antidepressants, and their combination significantly improved depression in adolescents, supporting CBT’s effectiveness.

Limitation: CBT may be unsuitable for severe depression, as patients may lack motivation to attend sessions or feel hopeless, making combined treatment more effective.

Limitation: CBT focuses on present challenges, potentially neglecting important past events that contribute to depression, which may frustrate patients seeking to address these issues.

The biological approach to explaining OCD

The genetic explanation, using the diathesis-stress model, proposes that some individuals have a genetic vulnerability to OCD. Evidence shows higher prevalence among relatives (Lewis et al.: 37% of patients had parents with OCD, 21% had siblings). OCD is polygenic (up to 230 genes involved) and linked to neurotransmitters like serotonin and dopamine. Specific candidate genes (e.g., 5HT1-D beta) affect serotonin function. OCD is aetiologically heterogeneous, with different genetic factors contributing to subtypes, such as hoarding disorder.

Evaluation of the biological explanation of OCD

Supporting evidence: Twin studies (Nestadt et al.) show higher concordance of OCD in identical twins (68%) than non-identical twins (31%), supporting a genetic basis, but the diathesis-stress model emphasises that genes interact with environmental stressors.

Limitation: Too many candidate genes (over 230) make it difficult to determine which are most influential, limiting predictive value and practical application for treatments.

Limitation: Genetic explanations may underestimate environmental factors; Cromer et al. found trauma increases both the likelihood and severity of OCD, showing environmental contributions are important.

The biological approach to treating OCD

Drug treatments for OCD:

• SSRIs: Prevent serotonin reuptake and breakdown, increasing its concentration in the synapse and stimulating the post-synaptic neuron.

• Tricyclics: Similar effect to SSRIs, used when SSRIs are ineffective.

• SNRIs: Increase noradrenaline levels in the brain to help regulate mood and anxiety.

Evaluation of the biological treatment of OCD

Limitation: Drug therapies can cause serious side effects (e.g., Clomipramine can cause erection problems, weight gain, tremors, increased heart rate, aggressiveness), affecting daily life.

Strength: Effective drug treatments, alongside cognitive therapies, can reduce sick leave, improve workforce productivity, and help public health services (e.g., NHS) save money.

Strength: Drug treatments are cost-effective and non-disruptive, being cheaper than psychological therapies and allowing patients to manage symptoms while maintaining a relatively normal lifestyle.