psychopathology

what are social norms and how does it link to abnormality

• unwritten behavioural expectations that vary on culture, time and context

• social deviants are seen as abnormal as they dont abide by social norms

• e.g. antisocial personality disorder means someone can’t conform to lawful behaviour

AO3 for deviation from social norms as an explanation for abnormality

✅ real world application - used to diagnose antisocial personality disorder as they deviate from ethical standards

❌cultural differences - e.g. inappropriate to diagnose Afro-Caribbean people as abnormal as they are 7x more likely to be diagnosed w/ schizophrenia

what is FTFA

failure to function adequately means someone cant cope with everyday life, e.g. they cant shower or get out of bed

AO3 for FTFA

✅takes into account individual lived experiences - using GAF scale 1 (normal) to 6 (FTFA), uses holistic view as it considers overall function and acknowledges struggles in all aspects of life

❌only takes those who cant function into account - e.g. psychopaths are abnormal but can still function → reductionist

what is statistical infrequency

behaviours we see frequently are normal, behaviours we see infrequently are abnormal

uses normal distribution (bell curve), normal behaviour is in the middle and abnormal behaviour is shown on the left and right

AO3 for statistical infrequency

✅objective , uses quantitative data (e.g. standard deviation from mean) → data isn’t influenced by personal opinion or subjectivity

❌abnormal behaviour ≠ negative , for example high IQ , so being labelled as abnormal has ethical implications

what is deviation from ideal mental health

(Jahoda) individual is abnormal if they deviate from having:

1. Positive perception of self

2. Autonomy

3. Resistance to stress

4. Mastery of environment

5. Accurate perception of reality

6. Self actualisation

AO3 for DfIMH

✅holistic, takes into account emotional, cognitive & behavioural functioning, reflecting complexity of mental health + suggests personal development

❌too strict, many people would be seen as abnormal

what is a phobia

irrational fear of an object or situation

characteristics of phobias

• behavioural → Panic, Endurance, Avoidance

• emotional → Anxiety, Fear, Unreasonable emotional response

• cognitive → Selective attention to phobic stimulus, Irrational beliefs, Cognitive distortions

characteristics of depression

• behavioural → Reduced energy levels, A change in eating behaviour, Aggression

• emotional → Sadness, Guilt

• cognitive → Negative schema, Poor concentration

characteristics of ocd

• behavioural → Compulsions, Avoidance

• emotional → Anxiety, Depression

• cognitive → Obsessive thoughts, Hypervigilance (a state of high alert)

AO1 behaviourist explanation of phobias

• Mowrer - two process model

• acquired through classical conditioning - the phobic stimulus (NS) is paired with UCS that naturally causes a fear response & becomes CS

• then generalised to other stimuli

• e.g. Little Albert

• maintained via operant conditioning - negative reinforcement when fear is removed from avoiding situation, (individual produces behaviour that removes something unpleasant)

  positive reinforcement when relief is added

AO3 for behaviourist explanation for phobias

✅real world application - exposure therapies → phobias are maintained by avoidance so removal of avoidance means phobia isn’t reinforced by reduction of anxiety

❌two process model doesn’t take cognitive aspects into account → e.g. SIC

✅shows link between bad experiences and phobias (Little Albert)

❌not all phobias are due to bad experiences e.g. people who have never seen snakes can have snake phobias

AO1 behaviourist approach to treating phobias

Systematic desensitisation → (gradual exposure) 1. anxiety hierarchy, 2. relaxation techniques, e.g. breathing exercise, 3. exposure due to reciprocal inhibition

Flooding → immediate and full exposure to phobic stimulus, temporary panic leads to extinction as person learns phobic stimulus is harmless due to exhaustion from fear response

AO3 for behaviourist approach to treating phobias

SD → ✅effective (42 people with spider phobia were compared to control group with no SD and were less fearful) - but not effective for social phobias (anxiety hierarchy)

✅acceptable to patients

✅benefits those with learning disabilities

Flooding → ✅cost effective (2-3 hrs)

❌traumatic → causes attrition, reducing effectiveness and could increase relapse rates, also ethical concerns w/ deliberately causing stress

❌doesnt work with all phobias (e.g. social)

AO1 cognitive explanation depression

• Beck - depression is due to irrational thoughts from maladaptive internal mental processes

  negative self schema + faulty informational processing (viewing negative aspects of a situation) = negative triad (negative view of self, world and future)

• Ellis’ ABC model - bad mental health stems from irrational thoughts which interfere with happiness and being free from pain

  A - activating thoughts

  B - irrational beliefs

  C - consequence

what is mustabatory thinking

thinking the world should be a certain way and that we must always succeed ultimately leads to dissappointment

AO3 depression

✅research support for negative triad - Cohen(2019) found assessing early cognitive vulnerability in 473 adolescents (e.g. faulty info processing) can help predict later depression, shows association between cognitive vulnerability and depression

✅real world application for negative triad - young people who show negative triad are monitored for treatment (CBT), making them more resilient to life events

❌Ellis’ ABC model only explains reactive depression, not endogenous like genes, environmentally reductionist + interactionist approach may be needed → not complete explanation

❌unethical as it blames depressed people for their thought process → e.g. blames people for their irrational thoughts that cause depression while ignoring external factors like their life events, reductionist and can worsen guilt & sadness + socially sensitive

AO1 for cognitive approach to treat depression

• Beck’s CBT and Ellis’ REBT change negative schemas and challenge irrational thoughts

• Beck’s CBT - patient acts as a scientist by creating and testing hypotheses on validity of their irrational thoughts, and when they see its not valid, negative schema and irrational thoughts are discarded

  thought checking - irrational thoughts are identified from negative schema by setting hw tasks like a diary

• Ellis’ REBT - ABCDE model (dispute and effect added)

  dispute - vigorously argue with client using empirical and logical arguments to challenge irrational beliefs

  empirical → asking for evidence

  logical → show that beliefs dont make sense as they don’t follow from facts

• behavioural activation → gradually decrease depressed people’s avoidance and isolation and increase engagement in activities that are shown to improve mood

AO3 for cognitive approach to treating depression

✅effective → (March et al. compared CBT to group with drugs in 327 depressed adolescents and both had 86% improvement after 36 weeks) → strong case for making CBT first choice of treatment in healthcare systems like NHS

✅cost effective (6-12 sessions) → more accessible within NHS, ↑ practical usefulness + economically efficient

❌doesn’t work with those who have learning difficulties or severe depression → requires cognitive understanding so individuals may not be motivated to pay attention / ✅ Taylor et al. (2008) found CBT can be effective for those w/ learning difficulties, so it has wider application than thought

❌CBT has high relapse rate (42% within 6 months) → need to be repeated, doesn’t address underlying cause of depression, economically inefficient

AO1 for biological approach to explaining OCD

• genetic → OCD is inherited, caused by up to 230 candidate genes (e.g. serotonin or dopamine genes) which increase vulnerability for OCD so its polygenic as its caused by a combination of genetic variations that increase vulnerability for OCD

  diathesis stress model also explains OCD → genetic predisposition of OCD and a traumatic event

• neural → malfunctioning neurotransmitters - low serotonin causes OCD when its removed too quickly from synapses before it transmits signals, causing low moods and obsessive thoughts

  frontal lobe is responsible for decision making and can become dysfunctional which can lead to OCD (e.g. hoarding)

  Para hippocampal gyrus → processing unpleasant emotions → can become faulty and cause OCD, resulting in anxiety and depression

AO3 for biological explanation of OCD

✅research support - twin studies (genetic) → Nestadt et al. found 68% of MZ twins share OCD, & having family member with OCD is 4x more likely to develop than someone without, showing genetically similar people are more likely to have OCD / ❌ only 68% of MZ share OCD, may be other factors affecting

❌biologically determinist - ignores environmental factors that may influence OCD e.g. traumatic event → supports diathesis stress model so genetic vulnerability is a partial explanation + interactionist approach better

✅research support (neural) - SSRIs help OCD so serotonin must be involved, increase construct validity

✅real world application - SSRIs treatment → social impacts → increase QoL

how do SSRIs work

1. presynaptic nerve releases serotonin to postsynaptic nerve

2. in OCD patients, serotonin is quickly reabsorbed by presynaptic nerve before it transmits signals

3. SSRIs inhibit uptake of serotonin so it stays in synapses longer

4. this reduces anxiety and elevates mood

AO1 for treatment of OCD

• drug therapies - SSRIs are given to patients where they take 20mg of fluoxetine for 3-4 months daily

• drug therapy can be combined with CBT so person can engage more effectively as drug reduces emotional symptoms

• Alternatives to SSRIs → tricyclics and SNRIs (when SSRIs fail, have more side effects)

AO3 for treatment of OCD

✅effective → Soomro et al. reviewed 70 studies for OCD treatment & found symptoms reduced for 70% of people taking SSRIs compared to placebo / ❌ although drug treatment is more effective than placebos, CBT or exposure therapy may be more effective - drugs not optimum treatment

✅cost effective + non disruptive→ economic implications which benefit NHS, don’t need expensive specialised therapists + drugs more convenient than therapy

❌side effects - nausea, headaches from SSRIs + taking clomipramine has risk of more side effects→ decreases quality of life and effectiveness of treatment

❌patients prefer CBT - drug therapy only supresses symptoms while CBT addresses underlying cause → however, minorities are more likely to be given drug therapy rather than CBT, showing cultural bias and unequal access to effective treatment