psychopathology

Definitions of abnormality

AO1

Statistical infrequency→ how rare a behaviour is, the more common the more ‘normal’ it is.
Behaviours are compared to a normal distribution and how far this behaviour deviated from the average…
Ex→ IQ and intellectual disability disorder, average IQ=100 normal IQ is from 100-130 an IQ below 70 would be considered abnormal and person w/ this would receive a psychological diagnosis of having an intellectual disability disorder

AO3

P: SI is objective as it is based on numerical facts

E: SI has clear guidelines w/ numerical data that mental health workers must follow and review before diagnosis.

E: Behaviour will be the same as it is standardised so it leaves no room for bias and feelings.

P: Defines positive attributes/ characteristics as abnormal

E: Having an incredibly high IQ is beneficial but is defined as abnormal according to the definition. Ex Albert Einstein→ has a high IQ above 130 but no treatment needed for having an exceptional intellect

L: Limited definition as it defines healthy people as abnormal.

P: Misses/excludes some disorders

E: Some mental health disorders are common but according to SI are not abnormal so would be ignored. In the UK depression rates were around 10% (1 in 10) during covid rates increased to around 20%

E: The SI would label depression as frequent and ppl w/depression → overlooked when they need treatment

L: Caution when using definition, shouldn’t be used alone but in conjunction w/ others

AO1

Deviation from social norms

How well a person behaves in a socially acceptable way
Ex wearing beach clothes(sunglasses, hat, slippers) to work would not be accepted based on work dress code→ boss be concerned
Those who break ‘norms’ → social deviants
Explicit→ rules written usually by government
Implicit→ unwritten but accepted ex skip the queue

AO3

P: Definition is flexible as it adapts to different culture(unlike SI)

E: high IQ wouldn’t be considered by most societies as abnormal

E: More useful as a definition of abnormality than SI

CP: loses objectivity as its based on peoples opinions and interpretation

P: Differs from culture

E:Fernando→ people from Afro-Carribean background are 7x likely to be diagnosed as Schizophrenic

E:→”Category failure” i.e hallucination,hearing voices and having religious experiences→ category of white culture applied onto others, one culture may label another culture as abnormal due to ethnocentrism Immigrants moving from ethnic backgrounds to the Uk are more likely to be diagnosed w/ mental health disorders→ social exclusion and negatively impact their mental health

L:Limited as can cause problems

AO1

Failure to function adequately

Unable to cope and meet the demands everyday life
Rosenhan & Seligman

Personal distress(how they respond to
Irrationality→dangerous to themselves or others(hoarder: unhygienic)
Conform to standard rules

AO3

P: Takes into account subjective experiences

E: acknowledges personal experiences, unlike SI focusing on numerical info.

E: Although it can negatively affect the assessment of distress(exaggeration) not like SI where an individual is viewed as a number

P: Some abnormalities don’t affect day-to-day lives

E: criminals ex: Ted Bundy, Jefferey Dahmer abnormal but under this definition aren’t

E: their abnormality wouldn't get recognised according to this definition and would be overlooked and not seek the treatment they need

AO1

Deviation from Mental health

Lack of healthy characteristics

Jahoda

Accurate perception objective and realistic view of the world
Self acctualisation→ personal growth and meet full potential
Positive attitude to oneself
Environmental
Autonomy
Resisting stress

AO3

P: Unrealistically high standard

E: Even those w/o mental health issues fail to maintain this standard some may experience no personal growth but feel content according to self-actualisation but no mental illness

P: ethnocentric

E: Culture used as a standard to use on other cultures and judged based on it. Collectivist(Asia) focuses on group identity vs Individualistic(Europe) focuses on individual

E: So Jahoda’s principle-based on ndividualistic cultures
L: Best to use in culture principle is developed in

Behavioural approach to explaining phobias

The behavioural approach to explaining and treating phobias: the two-process model, including classical and operant conditioning; systematic desensitisation, including relaxation and use of hierarchy; flooding.

The two-process model

Classical conditioning

Association
Little Albert 9 month old
Rat(neutral stimulus) → no response
Loud bang( unconditioned stimulus) → unconditioned response (fear)
Rat + loud bang(US+NS) → Unconditioned response (fear)
Rat(conditioned stimulus) → fear(conditioned response
Shown furry objects→ displayed distress

Maintenance operant conditioning

reinforcement(reward) ,punishment
Negative and positive reinforcement
Negative→ frequency of behaviour increases to avoid unpleasant outcome
Avoidance of phobic stimulus leads to pleasant/ desirable outcome

AO3

P: Real life application of exposure therapy such as systematic desensitisation

E: Two-process model suggests phobia is maintained by avoidance of phobia, when avoidance is prevented→ reduces anxiety and is reinforced

E: Explains why ppl benefit from being exposed to phobic stimulus because avoidance is reinforced

L: Therefore the value of the two-process model is increased

P: Incomplete explanation

E: (Nardo et al) not all ppl bitten by dogs have a phobia of dogs

E: according to the two-process model being bitten should result in an unconditioned response because of classical conditioning but this doesn't always occur. Diathesis-stress model is a better explanation as it is due to genetic vulnerability and environmental stress that can lead to having a phobia.

L: The model should not be used on its own to explain phobia symptoms.

P: It is a behaviour approach so important Cognitive factors are not taken into account

E: The two-process model is a behavioural explanation and key behaviour is avoidance

E: However cognitive factors such as irrational beliefs (belief that all spiders are dangerous: arachnophobia).

L: incomplete

Behavioural approach to treating phobias

AO1

Using counter conditioning to cure→ relaxed in the presence of a phobic stimulus

Systematic desensitisation

Anxiety hierarchy→ client and therapist work together to form a hierarchy from low to high ( arachnophobia→ low = small spider high =tarantula)
Relaxation→ Practise relaxation techniques such as breathing exercises, and mental imagery → take drug called Valium can't be relaxed and scared at the same time this is called reciprocal inhibition
Exposure- in the relaxed state work their way up the anxiety hierarchy after sessions

Flooding

No gradual build-up of the anxiety hierarchy
Patient placed in the presence of phobic stimulus (spider crawl on them)
Extinction in terms of classical conditioning
Relaxation due to exhaustion
Extinction person learns phobic stimulus is harmless, extinguished when conditioned stimulus is encountered without the unconditioned stimulus

Ethical safeguards

Not ethical per se but distressful (make sure all patients give their informed consent)

AO3

P: evidence for effectiveness

E: Gilroy et al found follow-up with 42 ppt who undertook SD. Follow-up of 3 and 33 months more relaxed than control who just had relaxation and no exposure. A psychologist concludes that SD is suitable for specific, social and agoraphobia phobias

E: shows SD is effective to many not just specific phobias

P: Helpful for those with learning disabilities

E: Some ppl with phobias may also have learning disabilities

E: an alternative would be cognitive treatment which could be confusing and consequently distressing for those with learning disabilities. So SD is more suitable and accomadating

L: Therefore SD is a better alternative for all including those with learning disabilities

P: Flooding can be more cost-effective

E: cost is a very important factor in healthcare industries such as NHS which receives funding to nurture many people

E: 1 session of flooding can be equally as effective as 10 sessions of SD

L: More people can be treated in a short period for less money this can ensure many have a good quality of life while putting less stress on the economy.

P: Flooding can be very traumatic

E: A psychologist found that therapists and ppts rated flooding as significantly more stressful than SD.

E: tremendous anxiety leads to attrition (drop out) and fewer ppl receiving treatment.Raises ethical concerns but due to informed consent ethical issues can be ruled out. individual differences make it not as effective for all and can have negative effects

L: not suitable for all so limits flooding effectiveness

Cognitive approach to explaining depression

Becks negative triad

Faulty info process

Look and focus on negative aspects e.g win 1 millionlotto but last week someone one 100 million (black and white thinking)

Negative self-schema

Schema→ package of ideas and info developed through experiences, mental framework of interpretation of outr self if person has→ negative schema → poor view of themself

Negative triad

Negative view of them self ‘I am undesirable and plain’
Negative view of the future ‘I will never get a boyfriend i’ll always be alone’
Negative view of the world ‘Noone will ever like me, even my boyfriend left me’’

Ellis’s ABC model

Depression and anxiety due to irrational thoughts and having rational thoughts leads to good mental health

A Activating event

negative event must take place which leads to irrational beliefs→ depression

B Beliefs

Range of irrational beliefs , believe you must always succeed or achieve perfection ‘musturbation’.Utopianism→ belief that life is always meant to be fair

C Consequences

Emotional and behavioural consequences, if a person believes they must succeed at everything then fails this could lead to depression

AO3

P: Research support

E: Cohen et al→ 473 adolescents assessed and those with cognitive vulnerabilities later on had depression.

E:cognitive vulnerabilities are the way a person thinks that predisposes them to getting depression such as faulty info processing, negative self schemas and the negative triad

L: association to cv and d

P: Real world application

E: CBT, assessing cognitive vulnerability can allow psychologists to screen young people and identify those at risk then monitor them. Apply understanding of cognitive vulnerabilities to CBT → REBT can both change and alleviate symptoms of depreession

E: alter the kinds of cognitions that make people vulnerable to depression and make them resilient to negative events vigorous arguing between person and therapist that can alter irrational beliefss

L: has application to help improve ppl quality of life

P:Only explains reactive depressions and not endogenous depression (not due to an event)

E: reactive→ developed due to life events ‘activating events

E: many cases not traceable to life events and not obvious what leads to a persons depression at that current time.

L: ABC model less useful for explaining endogenous depression therfore a partial explanation

Cognitive approach to treating Depression

AO1

Cognitive element→ client and therapist work together to discuss problems and create goals

Behavioural element→ change negative thoughts to more effective behaviours

Beck’s cognitive therapy

Based on Beck→ clients negative view of themselves, world and the futurenegative triad) are challenged → central component of the therapy
Given homework where client collects evidence of when someone was nice to them ‘Client as scientist’ they investigate their reality as a scientist would
Therapist uses these evidence to challenge the clients beliefs e.g ‘Everyone hates me’ a therapist would use evidence of a stranger smiling at them as conflictinge evidence

Ellis’s REBT

Rational emotive behavioural therapy
Extends Ellis’s ABC model to ABCDEF D- dispute, E- effect and F-feeling
Stems from the idea that depressed ppl have irrational thoughts and the therapist Empirical arguement→ beliefs not consistent with reality
Logical arguement → beliefs do not follow logically from evidence

Behavioural activation

depressed ppl avoid difficult situations and become isolated which worsens symptoms. So therapists encourage participation and engagement in activities such as exercise and socialising.

AO3

P: Research support

E: March et al → study CBT, drugs or boths-> 81% CBT ,86% both, significant improvements

E: CBT very effective as there is little difference between on own vs with drugs. Since sessions are brief it is cost-effective and useful in national health services

P: Not very suitable for diverse clients w/ severe cases or learning disabilities

E: those w/ learning disabilities may struggle to understand and can be confused and end up distressed,

severe cases lack motivation → attrition, cant pay attention,also if depression caused by realistic strssors ,Individual differences

E: not suitable for helping all

CP: if CBT applied correctly can be helpful just with adaptations for those w/ LD and CBT with drugs for severe cases

P: evidence supporting behavioural activation

E: over 100 ppts with major depressive disorder

participate in 4 month course of anaerobic exercise, one with drugs and another with both randomly assigned. Less rates of relapse for anaerobic

E: behavioural changes help decrease depression

Biological approach to explaining OCD

AO1

OCD→ obsessions: internal cognitive process, compulsions external behaiour to relieve obsessions (cope)

10% have only obsessions

OCD better explained through biological aspects specifically genetic explanation.
Genes associated with neurotransmitters are affected.
Lewis’ study found out of the ppl with OCD 37% of parents had it and 21% of siblings
Shows OCD is passed down but not it as a whole but as genetic vulnerability.
Diathesis stress model→ environment can affect the development of getting disorder based on vulnerability to it.

Candidate genes

Some genes shown to link to OCD and regulation of seretonin, SERT genes→ 5HT1-D beta
Involved in transport of serotonin

Polygenic genes

Taylor→ 230 genes involved in OCD and associated in neurotransmitter(dopamine)
OCD not caused by one gene but different gene variations that together increas genetic vulnerability

Different types

Aetiologically heterogenous → origins of OCD vary from one person to the other
different types of OCD the result of genetic variations

Neural explanations

Regulates mood (seretonin)
Neurotransmitters responsible for relaying info from one neuron to other
Low serotonin→ normal transmission would balance but OCD will have low mood
Abnormally high levels of dopamine
Antidepressants that increase serotonin reduce symptoms
Frontal lobe important for logical thinking
Parahippocampal gyrus

AO3

P: Strong evidence base for genetic explantion

E: Nestadt→ 68% identical twins (MZ)both had OCD and 31% of non-identical twins(DZ) had OCD, if family member diagnosed with OCD → 4X more likely to develop OCD

P: environmental factors

E: Psychologist found over 50% of clients with OCD had experienced traumatic event, is experience more than one trauma → severe OCD

L: incomplete explanation

P: Research support

E:Treatments for OCD such as antidepressents that work by increasing serotonin levels are effective. Parkinsons disease a degenerative disease w/ symptoms→ muscle tremors and paralysis produces OCD symptoms

E: serotonin mainly affect, Parkinsons → biological in origin

P: cannot be certain seretonin levels are the root cause of OCD

E: Most OCD patients haves sion alongside→ Co-morbidity ,depression low mood→ low seretonin

E: OCD affected by seretonin becaus ethey have depression aswell

The biological approach to treating OCD
→ seretonin levels affect symptoms

Drug therapy

Antidepressant→ SSRI→ selective serotonin reuptake inhibitor→ serotonin transported from presynaptic nerve across synapse to post synaptic nerve carried in synaptiv vesicles → exocytosed then diffuse across vesicle
SSRI blocks reabsorption so more serotonin left in synapse stimulating post synaptic nerve where Serotonin is broken down and reused
Fluoxetine typical dosage of 0mg cna be increased is symptoms dont improve after - 3-4 months

*With other treatments(only mention in marker)

Alongside CBT help patient relax for example fluoxetine

Alternatives

Trycyclics same effect as SSRIs → Clomipramine causes more severe side effects, work well form some, used when SSRIs
SSNRIs serotonin noradrenaline reuptake inhibitor → blocks seretonin and noradrenaline reuptake neurotransmitters)second line of defence

AO3

P:evidence for effectiveness

E: Soomra et al reviewed 17 studies on SSRIs compared to placebo → all 17 significantly better than placebo 70% reduced symptoms 30% could be helped w/ alt drugs

CP: behavioural and cognitive therapies more effective

P: Cost-effective and non-disruptive

E: 1000 of liquid or tablet doses can be manufactured during time to conduct 1 session of psychological therapy→ suitable and good value for health systems such as NHS with limited funds

E: can take drugs until symptoms decline

P: serious side effects

E: SSRI can cause indigestion, blurred vision and low sex drive. Tricylics clomipramine→1/10 erection problems 1/100 agression

E: affects quality of life