Exhaustive Revision Guide to Psychopathology: A-Level Psychology Study Notes
Evaluation of Definitions of Abnormality
Deviation from Social Norms - Definition: Social norms represent unwritten behavioral expectations that fluctuate based on culture, time, and specific contexts. - Abnormality: Individuals classified as "social deviants" are those who violate these societal norms and are consequently regarded as abnormal. - Examples of High Cultural Specificity: - Tolerance toward homosexuality. - Nature of religious experiences. - Social acceptability of public displays of emotion. - Evaluations: - Non-Ethnocentricity: It is argued that using social norms allows diagnosis without imposing a Western perspective on non-Western cultures, suggesting it is not inherently ethnocentric. - Inappropriate Labeling: It can be inappropriate to define individuals moving to new cultures as abnormal based on the new culture's norms. - Instance: People from Afro-Caribbean backgrounds living in the UK are $7\,\text{times}$ more likely to be diagnosed with schizophrenia compared to other groups.
Failure to Function Adequately - Definition: Abnormality is defined by an individual's inability to cope with the challenges of daily life, such as maintaining personal hygiene. - Rosenhan and Seligman's Features: Indicators of maladaptive behavior include: - Irrational and unpredictable actions that work against long-term best interests. - Manifestation of personal anguish. - Causing discomfort to observers in their presence. - Evaluations: - Individual Respect: Unlike statistical infrequency, this definition respects the individual's personal experience. - Scope Limitation: It only accounts for those who cannot cope. Many individuals, such as psychopaths, can function effectively in society to benefit themselves personally. - Example: Low empathy can lead to success in high-pressure fields like business and politics.
Statistical Infrequency - Definition: A mental condition is considered abnormal if it is statistically rare within the population. - Measurement: Behavior is judged objectively by comparing an individual's data against a normal distribution curve showing the population's average spread. - Numerical Threshold: One diagnostic element for Intellectual Disability Disorder in the DSM-5 is having an IQ of $70\,\text{points}$ or fewer, which applies to just over $2\,\%$ of the population. - Evaluations: - Objectivity: Assessments are based on clinical data rather than the subjective opinion of a practitioner. - Desirable Rare Traits: Not all rare traits are negative; an IQ of $130\,\text{points}$ is as statistically rare as an IQ of $70\,\text{points}$ but is viewed positively. - Common Disorders: Some mental health conditions are common. The NHS found $17\,\%$ of surveyed individuals met the criteria for a common mental health disorder, suggesting frequency does not negate the need for diagnosis.
Deviation from Ideal Mental Health - Definition: A humanistic definition proposed by Jahoda that identifies features of "ideal" mental health; deviation from these implies abnormality. - The Six Features of Ideal Mental Health: 1. Environmental mastery. 2. Autonomy. 3. Resisting stress. 4. Self-actualization. 5. A positive attitude toward oneself. 6. An accurate perception of reality. - Evaluations: - Holistic and Positive: Focuses on multiple factors and suggests methods for personal development rather than just identifying pathology. - Strict Criteria: The requirements are so challenging that most people would be defined as abnormal at any given time.
Characteristics of Phobias, Depression, and OCD
Phobias - Behavioral Characteristics: - Avoidance: Physically adapting normal behavior to stay away from the phobic object. - Panic: Uncontrollable physical responses, such as screaming or running away. - Failure to Function: Significant difficulty engaging in normal daily activities. - Emotional Characteristics: - Anxiety: An uncomfortably high, persistent state of arousal. - Fear: Intense emotional sensation of unpleasant alertness that only subsides once the phobic object is removed. - Cognitive Characteristics: - Irrational Thoughts: Exaggerated beliefs regarding the harm a phobic object could cause. - Reduced Cognitive Capacity: Focus is entirely consumed by the presence of the phobic object.
Depression - Behavioral Characteristics: - Activity Reduction: Includes lethargy and a lack of energy for everyday tasks. - Eating Changes: Significant weight loss or weight gain. - Aggression: Directed at others or manifested as self-harm. - Emotional Characteristics: - Sadness: A persistent low mood. - Guilt: Linked to helplessness and feelings of having no value compared to others. - Cognitive Characteristics: - Poor Concentration: Inability to focus on specific tasks. - Negative Schemas: Automatic negative biases regarding the self, the world, and the future.
OCD (Obsessive-Compulsive Disorder) - Behavioral Characteristics: - Compulsions: Repetitive behaviors (e.g., cleaning, checking) performed to reduce anxiety. - Avoidance: Taking specific actions to avoid triggers for obsessions. - Emotional Characteristics: - Anxiety: Persistent high arousal making relaxation difficult. - Depression: Sadness resulting from the inability to control intrusive thoughts. - Cognitive Characteristics: - Obsessions: Intrusive, irrational, and recurrent unpleasant/catastrophic thoughts. - Hypervigilance: A permanent state of alertness for potential sources of obsessive thoughts.
The Behavioral Approach to Phobias: Explaining and Treating
Explaining Phobias: The Two-Process Model - Acquisition (Classical Conditioning): A phobic object changes from a neutral stimulus to a conditioned stimulus ($CS$) by being paired with an unconditioned stimulus ($UCS$) that naturally produces a fear response. - Example: The pain of a sting ($UCS$) paired with a bee ($NS$) results in the bee becoming a $CS$. - Maintenance (Operant Conditioning): Avoidance behavior leads to a reduction in anxiety (negative reinforcement). This reward of felt calm strengthens the phobic response. - Generalization: Fear responses can be triggered by stimuli similar to the original conditioned stimulus (e.g., fear of bees spreading to all small flying insects). - Evaluations: - Watson and Rayner (Little Albert): Demonstrated that pairing a white rat with a loud noise created a phobic association in a child. - Counter-evidence (DiNardo): Found that while $56\,\%$ of people with dog phobias had experienced a conditioning event (dog bite), $66\,\%$ of people with no dog phobia had also been bitten, suggesting conditioning is not the only factor. - Evolutionary Theory: Phobias of snakes and spiders are common despite lack of daily contact, while objects that cause modern pain (knives, cars) rarely become phobic. This suggests biological preparedness.
Treating Phobias: Behavioral Therapies - Core Principle: Counter-conditioning involves replacing fear with relaxation. This relies on Reciprocal Inhibition: the idea that fear and relaxation cannot coexist. - Systematic Desensitization (SD): - Process: Therapist teaches relaxation techniques (e.g., breathing). The client and therapist create an anxiety hierarchy. The client gradually progresses through the hierarchy while remaining relaxed. - Outcome: Extinction of the fear association and formation of a new relaxation association. - Flooding: - Process: Immediate and full exposure to the maximum level of phobic stimulus. The client experiences intense panic until temporary exhaustion occurs. - Outcome: The panic stops because it cannot be sustained biologically, leading the client to remain calm in the presence of the object. - Evaluations: - Client Control: SD is generally more pleasurable as the client controls the pace, whereas flooding can be highly distressing and unsuitable for older people. - Phobia Type: Both are more effective for specific phobias than social phobias, which are hard to simulate in a clinic. - Garcia-Palacios: Found $83\,\%$ improvement in spider phobia using VR exposure compared to $0\,\%$ in a control group.
The Cognitive Approach to Depression: Explaining and Treating
Explaining Depression - Beck's Negative Triad: Depression stems from persistent negative schemas regarding: 1. The Self: Feeling unworthy. 2. The World: Perceiving people as hostile. 3. The Future: Expecting constant failure. - These lead to cognitive distortions like overgeneralization. - Ellis's ABC Model: - A (Activating Event): Any external event. - B (Belief): Irrational interpretation of the event. - C (Consequence): Negative emotions resulting from the irrational belief. - Musturbatory Thinking: The belief that the world "must" be a certain way, leading to inevitable disappointment. - Evaluations: - Support (Grazioli and Terry): Found that of $65\,\text{women}$ assessed before and after birth, those with negative thinking styles were the most likely to develop postpartum depression. - Limitation (Bipolar): Beck's theory struggles to explain the manic phases of bipolar disorder, where individuals feel over-excited and confident.
Treating Depression - CBT (Cognitive Behavioral Therapy): - Patient as Scientist: Patients test hypotheses about their irrational thoughts. If thoughts don't match reality, the schemas are discarded. - Thought Catching: Identifying the triad of negative schemas. - Homework: Keeping diaries to track negative thoughts. - REBT (Rational Emotive Behavior Therapy): - Extends the ABC model to include D (Dispute) and E (Effect). - Disputing Arguments: - Empirical: Challenging the client for evidence. - Logical: Showing the belief doesn't make sense. - Evaluations: - Effectiveness (March et al.): After $36\,\text{weeks}$, CBT and drug therapy both had an $81\,\%$ success rate ($86\,\%$ when combined). CBT showed a more significant reduction in suicidal events. - Requirements: CBT requires high motivation; severely depressed patients may struggle with homework and attendance.
The Biological Approach to OCD: Explaining and Treating
Explaining OCD - Genetic Explanations: OCD is inherited. Analysis shows it is polygenic, involving up to $230\,\text{separate candidate genes}$. - Specific Genes: SERT gene (serotonin re-uptake), COMT gene, 5-HT1-D beta gene. - Twin Studies: Monozygotic (MZ) twins show a $68\,\%$ concordance rate; Dizygotic (DZ) twins show $31\,\%$. - Neural Explanations: - Serotonin: Low levels due to rapid removal from the synapse. - Worry Circuit: Overactivity between the Orbitofrontal Cortex (rational decisions), Basal Ganglia (specifically the caudate nucleus), and Thalamus. - Evaluation: - Diathesis-Stress: Genetics only provide vulnerability. Cromer found $54\,\%$ of $256\,\text{patients}$ reported at least one traumatic life event, implying environment triggers the disorder.
Treating OCD - SSRIs (Selective Serotonin Reuptake Inhibitors): e.g., Fluoxetine (Prozac). They slow the re-uptake process, keeping serotonin in the synaptic cleft longer to stimulate the postsynaptic neuron. This normalizes the worry circuit. - Other Drugs: - Benzodiazepines (BZs): Enhance GABA to slow the central nervous system. - Tricyclics and SNRIs: Non-selective; used when SSRIs fail but have more intense side effects. - Evaluations: - Soomro Meta-analysis: Combining $17\,\text{studies}$ showed SSRIs were significantly more effective than placebos from $6$ to $17\,\text{weeks}$ post-treatment. - Bias (Goldacre): Argues research is often biased by the pharmaceutical companies that fund the studies. - Side Effects: Common issues include nausea, headache, and insomnia.