Psychopathology

• Statistical infrequency

  Occurs when an individual has a less common characteristic, for example being more depressed or less intelligent than most of the population.
• Deviation from social norms

  Concerns behaviour that is different from the accepted standards of behaviour in a community or society.
• Strength of statistical infrequency

  It‘s useful. It is used in clinical practice, both for formal diagnosis & a way to assess the severity of an individual's symptoms. For example a diagnosis of intellectual disability disorder requires an IQ of below 70 (bottom 2%). An example of statistical infrequency used in an assessment tool is the Beck depression inventory (BDI). A score of 30+ (top 5% of respondents) is widely interpreted as indicating severe depression. This shows that the value of the statistical infrequency criterion is useful in diagnostic and assessment processes.
• Limitation of statistical infrequency

  Infrequent characteristics can be positive & negative. For every person with an IQ below 70 there is another with an IQ above 130, but we would not think of someone as abnormal for having a high IQ. These examples show that being unusual or at one end of a psychological spectrum does not necessarily make someone abnormal. This means that, although statistical infrequency can form part of assessment and diagnostic procedures, it is never sufficient as the sole basis for defining abnormality.
• Strength of deviation from social norms

  It is useful. It is used in clinical practice. E.g., the key defining characteristic of antisocial personality disorder is the failure to conform to culturally acceptable ethical behaviour i.e. recklessness. These signs of the disorder are all deviations from social norms. Such norms also play a part in the diagnosis of schizotypal personality disorder, where the term 'strange' is used to characterise the thinking, behaviour and appearance of people with the disorder. This shows that the deviation from social norms criterion has value in psychiatry.
• Limitation of deviation from social norms

  This is the variability between social norms in different cultures & different situations. A person from one cultural group may label someone from another group as abnormal using their standards rather than the person's standards. Also, Social norms differ from one situation to another. Aggressive and deceitful behaviour in the context of family life is more socially unacceptable than in the context of corporate deal-making. This means that it is difficult to judge deviation from social norms across different situations and cultures.
• Failure to function adequately

  Occurs when someone is unable to cope with ordinary demands of day-to-day living.
• Deviation from ideal mental health

  Occurs when someone does not meet a set of criteria for good mental health.
• Failure to function adequately

  David Rosenhan and Martin Seligman (1989) have proposed some signs that can be used to determine when someone is not coping. These include:

  • When a person no longer conforms to standard interpersonal rules, for example maintaining eye contact and respecting personal space.
  • When a person experiences severe personal distress.
  • When a person's behaviour becomes irrational or dangerous to themselves or others.
• Deviation from ideal health

  Marie Jahoda (1958) suggested that we are in good mental health if we meet the following criteria:

  • We have no symptoms or distress.
  • We are rational and can perceive ourselves accurately.
  • We self-actualise (strive to reach our potential).
  • We can cope with stress.
  • We have a realistic view of the world.
  • We have good self-esteem and lack guilt.
  • We are independent of other people.
  • We can successfully work, love and enjoy our leisure.
• Strength of failure to function criteria

  It represents a sensible threshold for when people need professional help. Most of us have symptoms of mental disorder to some degree at some time. However, many people press on in the face of fairly severe symptoms. It tends to be at the point that we cease to function adequately that people seek professional help or are noticed and referred for help by others. This criterion means that treatment and services can be targeted to those who need them most.
• Limitation of failure to function criteria

  It is easy to label non-standard lifestyle choices as abnormal. In practice it can be very hard to say when someone is really failing to function and when they have simply chosen to deviate from social norms. E.g. those who favour high-risk leisure activities or unusual spiritual practices could be classed, unreasonably, as irrational and perhaps a danger to self. This means that people who make unusual choices are at risk of being labelled abnormal and their freedom of choice may be restricted.
• Strength of ideal mental health criteria

  It is highly comprehensive. It includes a range of criteria for distinguishing mental health from mental disorder. In fact it covers most of the reasons why we might seek help with mental health. This in turn means that an individual's mental health can be discussed meaningfully with a range of professionals who might take different theoretical views. This means that ideal mental health provides a checklist against which we can assess ourselves and others and discuss psychological issues with a range of professionals.
• Limitation of ideal mental health criterion

  The different elements are not equally applicable across a range of cultures. Some of the criteria are firmly located in the context of the US and Europe generally. In particular the concept of self-actualisation would probably be dismissed as self-indulgent in much of the world. Even within Europe there is quite a bit of variation in the value placed on personal independence. This means that it is difficult to apply the concept of ideal mental health from one culture to another.
• Phobias

  An irrational fear of an object or situation.
• Behavioural characteristics 


  Ways in which people act.
• Emotional characteristics 


  Related to a person's feelings or mood
• Cognitive characteristics

  Refers to the process of 'knowing', including thinking, reasoning, remembering, believing.
• The DSM System

  There are a number of systems for classifying and diagnosing mental health problems. Perhaps the best known is the DSM. This stands for Diagnostic and Statistical Manual of Mental Disorder and is published by the American Psychiatric Association. The DSM is updated every so often as ideas about abnormality change. The current version is the 5th edition so it is commonly called the DSM-5. This was published in 2013.
• DSM-5 categories of phobia

  All phobias are characterised by excessive fear and anxiety, triggered by an object, place or situation. The extent of the fear is out of proportion to any real danger presented by the phobic stimulus. The categories are:

  • Specific phobia - phobia of an object, such as an animal or body part, or a situation such as flying
  • Social anxiety (social phobia) - phobia of a social situation such as public speaking or using a public toilet.
  • Agoraphobia - phobia of being outside or in a public place.
• Behavioural characteristics of phobias

  • Panic e.g. crying or running away
  • Avoidance
  • Endurance e.g. keeping a wary eye on a spider if its in the same room
• Emotional characteristics of phobias

  • Anxiety
  • Fear
  • Emotional response in unreasonable
• Cognitive characteristics of phobias

  • Selective attention to the phobic stimulus
  • Irrational beliefs
  • Cognitive distortions
• Depression

  A mental disorder characterised by low mood and low energy levels.
• DSM-5 categories of depression

  All forms of depression and depressive disorders are characterised by changes to mood. The categories of depression are:

  • Major depressive disorder - severe but often short-term depression.
  • Persistent depressive disorder - long-term or recurring depression, including sustained major depression and what used to be called dysthymia.
  • Disruptive mood dysregulation disorder - childhood temper tantrums.
  • Premenstrual dysphoric disorder - disruption to mood prior to and/or during menstruation.
• Behavioural characteristics of depression

  • Activity levels (lethargic or oppositely psychomotor agitation)
  • Disruption to sleep and eating behaviour (e.g. Insomnia, hypersomnia, rise or fall in eating)
  • Aggression and self-harm
• Emotional characteristics of depression

  • Lowered mood
  • Anger
  • Lowered self-esteem
• Cognitive characteristics of depression

  • Poor concentration
  • Attending to and dwelling on the negative (glass half Empty mindset)
  • Absolutist thinking (unfortunate situations viewed as disasters)
• OCD (obsessive-compulsive disorder)

  A condition characterised by obsessions and/or compulsive behaviour. Obsessions are cognitive whereas compulsions are behavioural.
• DSM-5 categories of OCD

  These disorders all have in common repetitive behaviour accompanied by obsessive thinking.

  • OCD - characterised by either obsessions (recurring thoughts, images, etc.) and/or compulsions (repetitive behaviours such as handwashing). Most people with a diagnosis of OCD have both obsessions and compulsions.
  • Trochotillomania - compulsive hair-pulling.
  • Hoarding disorder - the compulsive gathering of possessions and the inability to part with anything, regardless of its value.
  • Excoriation disorder - compulsive skin-picking.
• Behavioural characteristics of OCD

  • Compulsions are repetitive
  • Compulsions reduce anxiety
  • Avoidance
• Emotional characteristics of OCD

  • Anxiety and distress
  • Accompanying depression
  • Guilt and disgust
• Cognitive characteristics of OCD

  • Obsessive thoughts
  • Cognitive coping strategies (e.g. meditation)
  • Insight into excessive anxiety (Aware compulsions are not rational)
• Behaviourist approach

  A way of explaining behaviour in terms of what is observable and in terms of learning.
• Two-process model

  An explanation for the onset and persistence of disorders that create anxiety, such as phobias. The two processes are classical conditioning for onset and operant conditioning for persistence.
• Classical conditioning

  Learning by association. Occurs when two stimuli are repeatedly paired together - an unconditioned (unlearned) stimulus (UCS) and a new 'neutral' stimulus (NS). The neutral stimulus eventually produces the same response that was first produced by the unconditioned (unlearned) stimulus alone.
• Operant conditioning

  A form of learning in which behaviour is shaped and maintained by its consequences. Possible consequences of behaviour include positive reinforcement, negative reinforcement or punishment.
• The two-process model

  Orval Hobart Mower (1960) proposed the two-process model based on the behavioural approach to phobias. This states that phobias are acquired (learned in the first place) by classical conditioning and then continue because of operant conditioning.
• Acquisition of phobias by classical conditioning

  • Classical conditioning, as demonstrated by John Watson and Rosalie Rayner in their 1920 study with "Little Albert," involved creating a phobia in a 9-month-old baby by associating a neutral stimulus (a white rat) with an unconditioned stimulus (a loud noise) that elicited fear, leading to Albert developing a fear response not just to the rat but also to similar furry objects.
• Maintenance of phobias by operant conditioning

  • Classical conditioning responses usually decrease over time, but phobias last longer. Mower attributed this to operant conditioning, where behaviors are reinforced (rewarded) or punished. Reinforcement increases behavior frequency; negative reinforcement occurs when avoiding unpleasant situations leads to desirable outcomes. Mower indicated that avoiding a phobic stimulus reduces fear and anxiety, reinforcing the avoidance behaviour and maintaining the phobia.