Psychopathology

Psychopathology

Study of psychological disorder

What is an definition of abnormality

How we decide whether behaviour or psychological state is sufficiently unusual ( could be when there is….)

What are the 4 definitions of abnormality

Statistical infrequency

Deviation from social norms

Failure to function adequately

Deviation from ideal mental health

Statistical infrequency

That someone is considered mentally abnormal when their mental state or characteristics are very rare in the population

• the rarity of behaviour is judged objectively using statistics which compare behaviour with the rest of the population

How can we show the populations average spread of specific characteristics

Using a normal distribution curve

Example of statistical infrequency and distribution curve in real life

IQ: average IQ is 100 , range is 85-115

• only 2% of people have IQ lower than 20 so classed as ‘abnormal’ and liable to receive diagnosis of ‘ intellectual disability disorder’

Strength of statistical infrequency

Those who are assessed are evaluated objectively

• E.g use of normal distribution curve

• A- makes it valid

Limitation of statistical infrequency

Unusual characteristics can also be positive

E- IQ of over 130 is good , but also infrequent. Wouldn’t be classed as abnormal

A- can help form part of diagnosis but not sufficient as the sole basis for defining abnormality

Deviation from social norms

Concerns behaviour that is different from accepted standards of behaviour in a community or society

What do we need to consider about social norms?

Norms are specific to the culture we live in

• for example ,homosexuality illegal in other places

• Varies; what’s abnormal somewhere may be normal somewhere else

Strengths of deviations from social norms as a definition of abnormality

• recognises cultural differences

• Useful in the real word

How does deviation from social norms( as a definition of abnormality) recognise cultural differences?

It doesn’t impose a western view of abnormality or non-western cultures as views very

How is deviation from social norms ( as a definition of abnormality) useful in the real world

It is used in clinical practice, for example being crucial in defining antisocial personality disorder

Limitations of deviations from social norms as a definition of abnormality

It varies; this means we can’t necessarily apply it/define people as abnormal who have moved from one culture to another as they have different norms(abnormal or just different norms?)

Evidence to support that in different cultures, there’s different norms

For example, hearing voices is normal in some cultures

-Africa Caribbean who have moved to the UK are seven times more likely to be diagnosed with schizophrenia

-this is compared to Afro-Caribbeans living in Afro-Caribbean nations(west indies doctors less likely to diagnose )and also Afro- Caribbeans that were born and living in the UK( not their norm )

Failure to function adequately

When individual is defined as abnormal as they are unable to cope with the demands of everyday life

Who outlines the features of failing to function adequate?

Rosenhan and seligman

When is someone failing to function adequately?

They may experience personal distress or discomfort

They may display maladaptive behaviour( Unhelpful harmful behaviour to well-being)

They may be irrational, unpredictable

They may display unconventionality(Doesn’t match what it is typically expected)

What is a strength of failure to function adequately as a definition of abnormality?

It represents a threshold for help

Why is it significant that the failure to function adequately criteria represent a threshold for help?

Everyone will display symptoms of mental illness at times so the failure to function outlines when this is serious and when professional help is needed

A-This means treatment and services can be targeted to those who needs the most

What are some limitations of failure function adequately as a definition of abnormality?

It’s subjective( who decides what is classed as irrational or unpredictable etc? This means judgement can be biased)

Failure to function or lifestyle choice?(some people intentionally choose to do certain things e.g high risk activities=maladaptive, still failure to function ?)

Deviation from ideal mental health

When someone does not meet the set of criteria for good mental health

Who proposed the criteria for good mental health?

Jahoda in 1958

Jahodas criteria

• Environmental mastery(the ability to adapt and thrive in new situations)

• Self actualisation(the strive to reach our potential through growth)

• Autonomy(ability to trust in one’s own ability / act independently)

• Positive attitude towards oneself

• Resistance to stress

• Accurate perception of reality(seeing the world as it truly is)

strengths of deviation for my mental health as a definition of abnormality

It is a comprehensive definition

How is deviation from ideal mental health a comprehensive definition?

It takes A holistic approach and considers all factors/reasons we might seek help

Limitations of deviation from ideal mental health as a definition of abnormality

It is subjective

Maybe culture bound

How is Deviation from ideal mental health Culture bound

Different elements are not equally applicable across a range of cultures, western focus.

-for example, the concept of self actualisation may be seen as self indulgent in some cultures

-Collectivist cultures may not place high value on autonomy

Phobia

Phobia is an irrational fear of an object or situation

DSM-5 categories of phobia

Specific phobia- phobia of object(animal) or situation e.g flying

Social anxiety-phobia of a social situation, e.g. public speaking

Agoraphobia-phobia of being outside during public

Behavioural characteristics or phobias

Panic

Avoidance

Endurance

Emotional characteristics of phobias

Anxiety and fear

Cognitive characteristics of phobias

Selective attention

Irrational beliefs

Cognitive distortions

behaviourist approach to explaining phobias

It focuses on explaining behavioural aspects (what we can see) rather than the cognitive and emotional aspects

Who proposed the ‘two-process model’

Mowrer in 1960

Two process model

States that phobias are acquired by classical conditioning(association) and maintained by operant conditioning(consequences)

Classical conditioning role in two process model

A neutral stimulus paired with UCS (already produces fear response) = associated and becomes a CS that produces CR

Operant conditioning role in two process model

Negative reinforcement: avoids unpleasant situation , desirable outcome so behaviour is repeated

Positive reinforcement: when we successfully escape from the phobic stimulus (causes fear and anxiety) we feel relief , which is a positive feeling so behaviour reinforced .

What are some strengths of the behaviourist explanation of phobias

There is evidence to show the link between a bad experience and a phobia

Real world application

Limitations of the behaviourist explanation to phobias

-evidence that there is not always a bad experience that causes a phobia

-does not account for cognitive aspects

How does the behaviourist explanation of phobias have real world application

Exposure therapies e.g flooding, systematic desensitisation

What evidence is there to show effective classical conditioning and link between a bad experience

Little Albert case study

• conditioned to fear rats( when paired with loud noise) and generalised to similar things

How does behaviourist explanation not account for cognitive aspects

Phobias not just behavioural aspects , just focuses on conditioning

Who’s research suggest thats there is not always a bad experience associated with phobias

Mendes and Clark’s

Mendes Clarks study

Found only 2% of children with phobias could recall a bad experience

• shows it’s not always linked and association not as strong

• Incomplete explanation

Behaviourist approach to treating phobias

assume phobias are learnt associations and so treatments attempt to replace fear association with relaxation(because of reciprocal inhibition)

-includes systematic desentisisation and flooding

Systematic desentisisation

designed to gradually reduce phobia anxiety (by exposing the person to the feared object or situation in a controlled way, while teaching relaxation techniques. )

Process of systematic desenstisation

• patient creates an anxiety hieracy with therapist (what would be most minor to most extreme interaction with phobic stimulus)

• taught relaxation techniques(to replace fear-reciprocal inhibiton)

• The patient is gradually exposed to the phobic stimulus, starting with the least anxiety-provoking situation and moving to more fearful scenarios as they learn to manage their anxiety (with the relaxation techniques)

• reduced fear response

Strengths of systematic desensitisation

-evidence to support its effectiveness

-inclusuive, works for everyone/those with disabilities

Flooding

a way of treating phobias that exposes the patient to the most intense situation with phobic stimulus (without gradual build up unlike s.d)

How does flooding treat phobias

-the extreme exposure creates fear

-fear takes alot of energy to display, screaming etc

-patient may become exhausted of own behaviour and relax, they may also relax once they realise the stimulus is harmless

Reciprocal Inhibition

The idea that opposite emotions cannot occur at the same time as one inhibits another

• hence why in phobia extinction techniques we aim to relax paitents as they then cannot feel fearful

Strength of flooding

more cost effective and time efficent

Limitation of flooding

can be a traumatic, unpleasant experience so may pose conflict regarding how ethical and humane

How is systematic desensitisation inclusive

For example, can be used for those with learning disabilities who otherwise may struggle with cognitive therapies that require high level of rational thoughts

Who did research that supports the effectiveness of systematic desensitisation

Gilroy in 2009

What was gilroys research

-followed up with 42 people who had SD for a spider phobias(had 3 , 45 minute sessions)

-at both three months & 33 months later, participants reported significantly less fear of spiders compared to a control group who had no exposure.

How is flooding cost effective

can be done in one session opposed to like 10 in SD -It minimises therapy time, reducing overall costs for both therapists and clients.

Evidence that can be used to show that flooding more stressful/traumatic

schumacher found participants rated flooding significantly more stressful than SD (ethical issues-knows it causes harm/stress)

Depression

a mental disorder characterised by low mood and low energy levels

DSM-5 categories of depression

The DSM-5 classifies depression into several categories, including Major Depressive Disorder, Persistent Depressive Disorder (Dysthymia), Disruptive Mood Dysregulation Disorder and Premenstrual Dysphoric Disorder

Emotional characteristics of depression

-lowered mood

-anger

-lowered self esteem

-guilt/helplessness

Behavioural characteristics of depression

-sleep disruption

-eating disruption

-aggression or harm

-activity levels(low)

Cognitive characteristics of depression

-poor concentration

-absolutist thinking

-negative schemas

General weakness of behaviourists treatments to phobias

-really only for specific phobias?

Major depressive disorder

Severe but often short term

Disruptive mood dysregulation disorder

Childhood temper tantrums

Cognitive approach to explaining depression

due to irrational thoughts which are a result of maladaptive internal mental processes

What are the two variations of cognitive explanation for depression

Becks negative triad and Ellis’ abc model

Becks negative triad

focuses on the cognitions that create vulnerabilities to depression

-faulty information processing / cognitive biases that maintain negative triad

-negative self schema

-negative triad

Negative triad

Refers to negative views of self, the world and the future

Ellis’s ABC model

explains depression in terms of how the irrational thoughts affect our emotional state & behaviour

Ellis’ ABC model (outlined)

A-activating event, triggers irrational thoughts

B-beliefs, irrational beliefs about A

C-consequences, the emotional and behavioural characteristics

Strength of Ellis abc model

Real world application

How does Ellis abc model have practical application

REBT- effective in treating depression

Strengths of becks negative triad

Research support; Clark and beck

Real world application (CBT)

What did Clark and beck find

Found solid support for cognitive vulnerabilities causing depression

-found tat faulty information processing and negative schema were more common in depressed people and hat they also often proceeded depression

Counter to Clark and becks research

Correlations not causal!

Why might activity levels be high during depression

instead of low activity levels those who are depressed may have have psychomotor agitation-a state of intense restlessness and anxiety that manifests as excessive and purposeless motor activity

Cognitive approach to treating depression

attempts to change negative schemas and challenge irrational thoughts through cognitive restructuring

What are the two cognitive treatments of depression

Beck’s CBT and Ellis’ REBT

Beck’s CBT

Identify thoughts,challenge and then replace

CBT -identifiying thought

may consist with first session to assess the client's thoughts and feelings, establishing a foundation for treatment. (identify problems and thought catching)

-patient will them often be tasked to keep a diary, this is to track triggering situations and recognise negative thought patterns

CBT-challenge

refers to the behavioural activation

-may be set tasks that are feared or avoided by patient in orsder to challenge and test the beliefs

CBT-replace

the process of CBT should ultimately lead to replacing negative thoughts and cognitive distortions with more positive and realistic ones, promoting healthier thinking patterns.

Ellis’ REBT

challenges irrational thoughts via dispute and effect

What are the three ways Ellis’ REBT may dispute/ challenge irrational thoughts

1. Logical Disputation 2. Empirical Disputation 3. Practical Disputation

Logical dispute

therapist questions and encourages patient to question the logic of thoughts

Empirical dispute

therapist encourages use of evidence to counter irrational thoughts (examines real life experience and facts)

-patient may be set homework to find contradicting evidence

How does Ellis’ REBT expand on the abc model

it become ABCDE model, where D represents Disputation of irrational beliefs and E represents Effects (irrational thoughts are replaced) of changing beliefs.

Similarities of REBT

• both aim change irrational beliefs and promote rational thinking

• uses behavioural activation, homework e.g shame attacking exercises

Main difference between Ellis’ REBT and Beck’s CBT

With CBT ,clients are helped to identify themselves while with REBT the therapist explains/challenges thoughts directly (more involved and leading)

Strength for the cognitive treatments of depression

There is evidence for its effectiveness (of cbt)

Who did research supporting CBT(showed its effective)

march (2007)

March 2007 study

Studied hundreds with depression

-found cbt alone was just effective as antidepressants alone (81%)

Limitations of cognitive treatments of depression

-can it fix those with severe depression-no motivation

-focus on present and future but doesn’t get to root cause(past)

-more expensive and time consuming

CBT as time consuming and expensive

could be between 16 and 20 session

BUT:cost benefit analysis?

OCD

A condition characterised by obsessions and/or compulsive behaviour