Psychopathology

Discuss deviation from social norms and failure to function adequately

Deviation from social norms suggests human behaviour is abnormal if it breaks the unwritten rules in society. For example not wearing clothes in public would be seen as abnormal as wearing clothes is a societal expectation in most cultures.

Failure to function adequately suggests behaviour is abnormal if it prevents the individual from coping in daily life. There are 7 criteria proposed by Rosenham and Seligman: maladaptiveness, observer discomfort, suffering, violates social norms, unpredictability, irrationality, unconventionality. Maladaptiveness is when an individuals behaviours prevents them from completing their daily routine. Observer discomfort is when the behaviour makes witnesses feel uncomfortable. Showing many areas of this criteria suggests the behaviour is likely to be abnormal.

One problem with deviation from social norms is that it is culturally relative; normal behaviour in some cultures may not be normal in other cultures. For example, kissing someone you don’t know as a greeting would be seen as abnormal in the US but in France it is normal. This means that when defining someones behaviour as abnormal it must be relative to the culture. For this reason, this definition often risks mislabelling culturally appropriate behaviour as abnormal making it a less reliable definition for abnormality. So this is a weakness for deviation from social norms.

One strength of failure to function adequately is that is observable. Failure to function adequately can be seen by others around the individual because they may not get out of bed on a morning, or be able to hold a job down. This means that problems can be picked up by others and if the individual is incapable of making a decision or helping themselves others can intervene. So a strength of failure to function adequately is that it allows others to detect people who are struggling and push for them to seek help.

One weakness of failure to function adequately is individual differences. Some people with certain mental health conditions learn ways of coping most of the time. For example, people with anxiety can learn relaxation techniques to manage their distress. However, just because they have learnt ways to manage does not mean their behaviour is normal. This causes problems as it means that some people’s abnormal behaviour goes untreated because its not seen as abnormal. So a weakness of failure to function adequately is that is does not take into account those who are struggling but find ways of hiding/coping.

Discuss deviation from ideal mental health and statistical infrequency

Deviation from ideal mental health suggests human behaviour is abnormal if it deviates from a set of ideal characteristics. Six criteria were developed by Jahoda: self-actualisation, mastery of environment, autonomy, resistance to stress, perception of reality, self-esteem. Self-actualisation is the idea that an individual should be aware and striving for their full potential. Autonomy is the idea that an individual should have the ability to govern their own life independently.

Statistical infrequency suggests that behaviour is abnormal if it is uncommon, or statistically infrequent. For example, people with very high IQ (130+) would be seen as abnormal because their behaviour is rare. Statistical infrequency can be seen on a normal distribution bell curve where the outliers at the ends of the curve are statistically infrequent and would be seen as abnormal.

One weakness of deviation from ideal mental health is that it is highly unrealistic and highly subjective. The idea of reaching ‘self-actualisation’ where an individual knows their full potential is incredibly unlikely in most people, not just those with abnormal behaviour. Furthermore, the criteria is very subjective; the criteria of mastering your environment is subjective because who decides what ‘mastery’ is? For this reason, this definition wrongfully define many people’s behaviour as abnormal because they don’t meet a set of impossible criteria. So this is a weakness of deviation from ideal mental health.

One strength of statistical infrequency is that it is the only objective definition of abnormality. For example, statistical infrequency does not rely on social norms or opinions, and instead says that any thoughts or behaviours are abnormal if they are uncommon when compared against statistics. This makes it more reliable as a definition because by simply comparing measurable data it makes it void of any opinion-related biases like those which can be seen in deviation from ideal mental health. This also makes it a useful tool in clinical settings such as diagnosing an intellectual disability by noticing lower IQ scores (below 70) suggesting abnormality. So a strength of statistical infrequency is that it is objective making it more reliable and lending itself to clinical diagnosis.

However, a weakness of statistical infrequency is that not all abnormal behaviour is undesirable. For example, while High IQ (130+) is statistically rare is actually a very desired trait; yet it would be considered abnormal under this definition. This means that, while this definition is objective it fails to distinguish the difference between harmful and beneficial rare behaviours. As a result, it may lead to misleading classifications of abnormality and overlook the context or inherent value of certain traits. So, a weakness of statistical infrequency is that it can misrepresent desired rare behaviour.

Discuss the behavioural approach to explaining phobias

The behavioural approach suggests that phobias are learned in the environment. Mowrer’s two-process model suggests that phobias are learned through association (classical conditioning) and maintained through avoidance of the phobic stimulus (operant conditioning). Classical conditioning in developing a phobia of spiders would go like this: the unconditioned stimulus of being bitten and the unconditioned response of fear becomes associated with the neutral stimulus of the spider. The spider becomes the conditioned stimulus which presents the now conditioned response of fear upon every interaction.

Operant conditioning maintains the phobia through negative reinforcement. In the example of the spider the discomfort of interacting with the spider leads to the individual actively avoiding any spiders. The avoidance of the phobic stimulus creates the reward of not being scared. Mowrer suggested the reward from avoidance reinforces avoidance of spiders which at the same time maintains the phobia.

A strength of the behavioural approach is research support from Di Gallo which supports classical conditioning as an explanation for phobia development. The study found that around 20% of people who experienced car crashes went on to develop a phobia of cars. This suggests that they formed an association between the car (a neutral stimulus) and the fear experienced during the crash (an unconditioned stimulus), leading to a conditioned fear response. This supports the idea that phobias can be learned through classical conditioning when a neutral object becomes linked with a traumatic event.

However, a weakness of the explanation is that there are individual differences. Many people have frightening experiences and don’t develop fears of phobias. For example, the research previously mentioned by Di Gallo fails to explain how 80% of the people involved in car crashes didn’t gain phobias. This is because of individual differences in areas like personality, resilience and cognitive processing. Therefore, classical conditioning alone is an oversimplification of phobia formation and does not take into account individual differences making it weaker as an explanation.

Another strength of the behavioural approach in explaining phobias comes from the development of effective treatments. Systematic desensitisation was developed as a behavioural treatment and it is very effective. Mcgrath found that 75% of people who had specific phobias improved with the use of SD. If the treatment is so effective it suggests that the explanation which the treatment was developed off of must be valid. Therefore, the effectiveness of SD suggests that the behavioural approach must be valid to some extent. So this is a strength for the behavioural approach.

Discuss the behavioural approach to treating phobias

The behaviourist approach to treating phobias suggests that as phobias are learned and maintained through classical and operant conditioning they must be able to be unlearned. The two main treatments are systematic desensitisation and flooding. Systematic desensitisation is done with a therapist over a period of weeks and follows a structured plan. The client will begin by learning relaxation techniques eg. deep breathing/ meditation. They will then construct a fear hierarchy with the therapist starting with low stress phobic stimuluses like a photo of a spider and working up to high stress phobic stimuluses like holding a spider. Finally the client will confront each of the stages while in a deep state of relaxation. This technique is counter conditioning where the aim is to slowly show that the fear is irrational. The fear usually never becomes fully extinct but the patient learns to cope around the stimulus.

Flooding, however, is an immediate exposure to the phobia, like immediately throwing spiders onto an individual who has a phobia of spiders. The aim of flooding is to show the patient quickly that there is no basis for their fear. The immediate exposure should lead to extinction of the fear if effective.

One strength of systematic desensitisation as a behaviourist treatment for phobias is research support from McGrath. McGrath found that 75% of people with specific phobias who used systematic desensitisation improved. This shows that systematic desensitisation is effective as a large proportion of those who used it saw improvements. Therefore this is a strength for SD as a treatment of phobias.

One strength of flooding is that it is cost effective and time efficient. As flooding requires immediate exposure to the phobia and should lead to extinction of the phobia very rapidly it does not require much time or money to undergo. This is a strength over SD which can be very expensive and can take long times. This is because privately SD requires many sessions with expensive therapists and waiting times on the NHS are extremely high. Therefore, not only is flooding more cost and time effective is also can be more accessible for people who can not afford systematic desensitisation. This is therefore a strength as it means more people can access treatment for their phobias.

However, one weakness of flooding is that it has ethical issues. This is because the intense exposure to the phobia can be very traumatic for individuals. This can actually lead to the problem getting worse where extinction doesn’t occur and the patient actually becomes more scared of the phobia than they were before flooding. Therefore, steps need to be taken before flooding to ensure that the patient is the right fit for flooding and has fully informed consent to the treatment. This is a weakness of the technique because it means it may not be appropriate or safe for everyone which limits its general applicability.

Discuss the cognitive approach for to explaining depression

The cognitive approach suggests that depression is caused by faulty /irrational thought processes/cognitions. There are two main models that have been developed explaining faulty thinking and its link to depression. They are Ellis’s ABC model and Beck’s Cognitive triad. Ellis’s ABC model has 3 stages. The first stage is the activating event: an individual experiences trauma in their life eg. being fired from work. This leads to faulty beliefs: eg. “they fired me because i’m useless”. It is these beliefs which cause consequences of faulty/unhealthy emotions: eg. anxiety or low mood which are symptoms of depression

Beck cognitive triad also has 3 steps. It begins with negative beliefs of the self eg. ‘nobody loves me’. Then this leads to negative beliefs of of the world eg. ‘the world is unfair’ and this leads to negative beliefs of the future eg'. ‘I’m always going to be a failure’. Beck suggested that this depressive loop was a self fulfilling prophecy which led to negative emotions and low mood - symptoms seen in depression. He also suggested people who had negative self schemas - unhealthy mental frameworks about the world developed in early life - were more likely to process information as negative and fail to see the brighter side - further leading to the self-fulfilling prophecy of depressive tendencies (cognitive biases).

One strength for the cognitive approach in explaining depression is that it has led to the development of an effective treatment which suggests the approach itself must be valid. The development of cognitive behavioural therapy is very effective. A study from March found that 80% of people who underwent CBT improved showing it as a highly effective treatment. As the treatment is highly effective is suggests that the approach must also be highly effective. Therefore a strength of the cognitive approach is that it is directly supported in its validity by treatment which was created based off of the approach.

Another strength of the cognitive approach for depression comes from Boury et al. Boury et al found that those who had depression were more likely to see information as negative leading to beliefs of hopelessness of the future. This is directly supports cognitive biases and their role in the cognitive approach and also Beck’s cognitive triad in the faulty thoughts of the future. Therefore a strength of the cognitive approach comes from research support from Boury et al which supports cognitive biases and Beck’s triad.

One weakness of the cognitive approach is that is fails to explain where the faulty thoughts actually originate. Most of the research which is done on cognitions is correlational research. This is because cognitions are not objectively observable and this therefore makes it difficult to establish cause of faulty thinking in relation to depression. As the cause of the cognitions can not be identified it brings into question whether other factors may be at play. For example biological factors including genetic predispositions which may lead to abnormal hormone levels creating faulty thoughts. So therefore, this is a weakness of the cognitive approach for explaining depression because it fails to easily identify cause and brings into question the role of other factors.

Discuss the cognitive approach for treating depression

The cognitive approach for treating depression is cognitive behavioural therapy. Cognitive behavioural therapy aims to change the way a client thinks by challenging faulty thought processes. Cognitive behavioural therapy has 3 steps. First step a therapist will assess a client and identify the patients problem. Then they will set goals and create a plan to work through the faulty thoughts. Then after identifying the faulty thoughts they will begin to dispute them.

Disputing is a technique which aims to falsify irrational thoughts which may lead to anxiety, low mood etc (symptoms of depression). There are 3 types of disputing. Logical disputing: “Does that thought make any sense?”. Empirical disputing: “Is there any evidence that those thoughts are true?.”. Pragmatic disputing: “Are those thoughts helping you?”. By working through these it aims to reduce the negative thoughts and thus reduce the negative symptoms.

One strength of the cognitive approach for treating depression is research support for cognitive behavioural therapy. March found that 81% of people with depression who began using CBT improved. This shows that CBT is a very effective treatment for supporting the cognitive approach’s focus on challenging negative thoughts. The success of CBT when applied to real life makes the cognitive approach a strong approach for treating depression.

However, a consideration of the cognitive approach also comes March who found that 86% improved when CBT was paired with drug therapy such as anti-depressants. So while CBT is incredibly effective it is also important to consider that individual differences may be at play. For example, some people struggle to engage with the tasks in CBT and thus they don’t find it as effective. For some people taking drugs is an easier method of treating the symptoms. So another weakness/consideration of the cognitive approach is that it may not be right for everyone and other treatments (mostly drug therapy) may be more appropriate for some individuals.

Another weakness of the cognitive approach for treating depression is that it can be expensive and takes a long time for most people. Cognitive behavioural therapy requires many focused sessions with a therapist and due to long NHS waiting times going private is usually the only way to get treatment. However, going private is very expensive and many people, especially those struggling with depression, dont have the finances to afford CBT. Furthermore, the improvements in CBT can take time and some people may quit early when they dont see improvements. Both of these issues lead to patients not receiving treatment. So, a weakness of the cognitive approach is that CBT

Discuss the biological approach for explaining OCD.

The biological approach suggests that OCD is caused by neural and genetic factors. In terms of genetics it is suggested that OCD is inherited from relatives. However, OCD is polygenic, meaning many genes play a role. Taylor found that there are 230 genes which are implicated in the development of OCD. Furthermore, abnormalities in the COMT and SERT gene have been linked to OCD. The COMT gene leads to higher levels of dopamine which triggers positive symptoms such as anxiety in OCD. The SERT gene has been linked to lower levels of seretonin which can cause negative symptoms like low mood in OCD.

Neural explanations suggest that abnormal levels of neurotransmitters cause OCD. The two main neurotransmitters involved are dopamine and seretonin. Lower levels of seretonin and higher levels of dopamine are linked to OCD as previously mentioned. Brain structure also suggests that overactivity in the orbitofrontal cortex - the area of the brain responsible for personality can cause symptoms of OCD such as anxiety.

A strength of the biological approach is research support for genetic explanations. For example, research on MZ twins from Grootheest et al found that concordance of genetic influence on OCD ranged from 45% to 65%. The significant influence means that genetic explanations clearly do play an important role in the development of OCD. So this is a strength of the genetic explanation as a component of the biological approach for explaining OCD.

Furthermore, Piggot et al found that SSRI’s were effective at treating OCD. This suggests that seretonin must play a role in the symptoms of OCD. This is because if SSRI’s prevent reuptake of seretonin and they also improve the symptoms then the low levels of seretonin are likely to be the cause of the symptoms. So this is a strength of the neural explanation making the biological approach as a whole stronger.

However, a weakness of the biological approach also comes from Grootheest. As the twin study didn’t find a 100% concordance between MZ twins it suggests that other factors must also play a role in the development of OCD. An alternative explanation for explaining OCD is a behaviourist approach through the two process model. This suggests, that association of germs with anxiety leads to irrational thought symptoms of OCD like obsessions (Classical conditioning). It suggests that it is then maintained through avoidance of the germs which is negatively reinforcing (operant conditioning). This alternative suggests that while the biological approach clearly does play a role in OCD development there are other factors which must be considered. So this is a weakness of the biological approach.

Another issue with the biological approach is that it is biologically reductionist. The biological approach oversimplifies complex human behaviour down to one gene eg. the COMT gene. This is an issue because it does not consider complex cognitions and emotions which are linked to OCD. By ignoring these factors the approach may offer an incomplete explanation of the cause for OCD and limit the effectiveness of treatment options which address more than just biological-related symptoms. So, this is a weakness of the biological approach for explaining OCD.

Discuss the biological approach for treating OCD.

The biological approach for treating OCD assumes that OCD is caused by neurochemical imbalances in the brain. Anti-depressants and anti-anxiety drugs are common treatments for OCD. The antidepressant selective seretonin reuptake inhibitor works by preventing the reuptake of seretonin from the post synaptic neuron allowing it to remain in stimulation with the post synaptic neuron longer reducing OCD related symptoms like low mood and anxiety.

The anti-anxiety drug benzodiazepine increases the action of GABA. GABA is a neurotransmitter which has an inhibitory effect - slowing down the brain by preventing neurons with from firing. This slows down the nervous system reducing the symptoms of OCD such as anxiety.

One strength of the biological approach for treating OCD is research support for SSRI’s. Soomro found that SSRI’s were more effective than placebo across 17 trials at treating OCD. This suggests that OCD has a biological basis as medications targeting neurotransmitter levels such as seretonin can successfully reduce symptoms. So, this is a strength of the biological approach for treating OCD as it has research supporting its effectiveness.

However, a weakness of the biological approach for treating OCD is that the drugs used often have harsh side effects. Some patients taking SSRI’s experience indegestion, hallucinations, erections problems and increased blood pressure. Benzodiazepines are renowned for being highly addictive and can cause aggression and long term memory impairments. This is obviously an issue because it means that treatment can have implications. This may put off patients from getting treatment to begin with which prevents treatment altogether. So this is a weakness of the biological approach for treating OCD

Another weakness is that the biological approach for treating OCD is a nomothetic approach and therefore ignores individual differences. This approach offers the same treatment for all individuals; SSRI’s or benzodiazepines. However, some psychologists suggest that some patients would benefit from cognitive based treatments such as CBT, targeting the irrational thoughts such as obsessions rather than the neurochemical imbalances. So, this is a weakness as this approach does not consider how different individuals may need different treatments.