Psychopathology: A-Level Psychology

• Statistical Infrequency

  -       Defining abnormality in terms of statistics

  -       Defining ‘abnormality’ in terms of number of times it occurs

  -       Statistics is about analysing numbers

  -       Usual behaviour is seen as normal

  -       Rare behaviour is seen as abnormal

  -       The average IQ is 100, only 2% have a score below 70

  -       Those individuals scoring below 70 are statistically unusual and diagnosed with intellectual disability disorder
• Strength of statistical infrequency: Real world application

  -       Useful in diagnosis

  -       E.g., Intellectual disability disorder requires a bottom 2% IQ

  -       It is also helpful in assessing a range of conditions

  -       E.g., the BDI assesses depression, only 5% of people score 30+ (severe depression)

  -       Statistical infrequency is therefore useful in diagnosis assessment processes
• Weakness of statistical infrequency: Unusual characteristics can be positive

  -       Statistical infrequency doesn’t necessarily mean abnormality

  -       IQ scores above 130 are unusual but not regarded as undesirable or needing treatment

  -       Therefore it cannot be the sole basis for defining abnormality
•  

  Weakness of statistical infrequency: Social stigma

  -       The ‘abnormal’ label isn’t necessary if someone is living a happy and fulfilled life

  -       The label of abnormality such as IPD may carry a social stigma

  -       This means labelling someone as abnormal based on statistical infrequency may do more harm than good
• Deviation to social norms

  -       When a person behaves in a way that is different from how they are expected to behave they may be defined as abnormal

  Societies make collective judgements about ‘correct’ behaviours in particular circumstances
• Deviation to social norms - cultural context

  -       Few behaviours are universally abnormal

  -       Definitions are related to cultural context

  -       This includes historical differences within the same society

  -       Homosexuality is viewed as abnormal in some cultures but not others and was considered abnormal in our society in the past
• Deviation to social norms - Anti-social personality disorder

  -       Formerly called psychopathy

  -       One feature is a failure to conform to ‘lawful and culturally normative ethical behaviour’

  -       A psychopath is abnormal because they deviate from social norms or standards 

  They also usually lack empathy 
• Strength of deviation to social norms: Real-world application

  -       Useful in diagnosis because it requires failure to conform to ethical standards

  -       Helpful in diagnosing schizotypal personality disorder which involves ‘strange’ beliefs and behaviour

  -       This means it is useful in psychiatric diagnosis
• Weakness of deviation to social norms: Situationally and culturally relative         

  -       People may label those from other cultures as abnormal using their own standards

  -       Hearing voices is acceptable in some cultures but would be seen as a sign of abnormality in the UK

  -       Difficult to judge deviation in another social context
• Weakness of deviation to social norms: Human rights abuses

  -       Reliance on deviation to understand abnormality can lead to abuse of human rights

  -       E.g., ‘nymphomania’ as a disorder used to control female behaviour

  -       However, we need it to diagnose conditions such as anti-social personality disorder

  -       This suggests it may do more harm than good because of the potential for abuse
• Failure to function adequately

  -       Abnormality may come at the point where they cannot deal with the demands of everyday life

  -       This is where they fail to function adequately

  E.g., not being able to maintain basic nutrition and hygiene standards, hold a job or maintain relationships
• Failure to function adequately - Rosenhan and Seligman 

  -       Proposed further signs of failure to cope

  -       When someone is not coping they:

  -       No longer conform to interpersonal rules, e.g., maintaining personal space

  -       They experience severe personal distress

  -       They behave in a way that is irrational or dangerous
• Failure to function adequately - Intellectual personality disorder

  -       Having a very low IQ is a statistical infrequency

  -       But diagnosis would not be made on this basis alone

  -       There would have to be clear signs that the person was not able to cope with the demands of everyday living

  Intellectual disability disorder is therefore an example of failure to function adequately
• Strength of failure to function adequately: Threshold for professional help

  -       Mind found in any given year, 25% of us experience some degree of symptoms of mental disorder

  -       Most of the time we press on but when we cease to function adequately people seek or are referred for professional help

  -       This means the failure to function criterion provides a way to target treatment and services to those who need them most
• Weakness of failure to function adequately: Can lead to discrimination or social control

  -       It is hard to distinguish between failure to function and a conscious decision to deviate from social norms

  -       Some people may choose to live off-grid as part of an alternative lifestyle choice or take part in high-risk leisure activities

  -       This means people who make unusual choices can be labelled as abnormal and their freedom of choice restricted
• Weakness of failure to function adequately - Can still be normal

  -       In some circumstances some of us can’t cope, such as bereavement

  -       However, professional help may still be requires to help adjust to bereavement

  -       This means it is hard to know when to base a judgement of abnormality on failure to function
• Deviation from ideal mental health

  -       Related to what makes someone ‘normal’ and psychologically healthy

  -       Anyone who deviates from this ideal may be identified as ‘abnormal’
• Deviation from ideal mental health - Jahoda

  -       Suggested the following criteria for ideal mental health

  1.     We have no symptoms or distress

  2.     We are rational and perceive ourselves accurately

  3.     We self-actualise

  4.     We can cope with stress

  5.     We have a realistic view of the world

  6.     We have good self-esteem and lack guilt

  7.     We are independent of other people

  8.     We can successfully work, love and enjoy our leisure
• Deviation from ideal mental health - Overlap

  -       Someone’s inability to keep a job may be a sign of their failure to cope with the pressures of work (failure to function)

  -       It could also be seen as a deviation from the social norm of working
• Strength of deviation from ideal mental health:  It is comprehensive

  -       Includes a range of criteria for mental health

  -       It covers most of the reasons we might need help with mental health

  -       Mental health can be discussed meaningfully with a range of professionals, e.g., psychiatrist or CBT therapist

  -       Therefore ideal mental health provides a checklist against which we can assess ourselves and others
• Weakness of deviation from ideal mental health: Culture bound

  -       Some criteria for mental health are limited to the US and Europe

  -       Self-actualisation is not recognised in most of the world

  -       Even in Europe there are variations in the value placed on independence (high in Germany, low in Italy)

  -       Difficult to apply the concept of ideal mental health from one culture to another

   
•  

  Weakness of deviation from ideal mental health: Extremely high standards

  -       Few of us attain all of Jahoda’s criteria for mental health

  -       An impossible set of standards can be disheartening

  -       However, having comprehensive criteria for mental health might be of value to someone wanting to improve their mental health

  This means it may be helpful for some but not others
• Phobias - Behavioural symptoms

  -       Panic may involve a range of behaviours such as crying, screaming or running away from the phobic stimulus

  -       Avoidance leads to considerable effort to prevent contact with the phobic stimulus, making it hard to go about everyday life

  -       Endurance is an alternative behaviour to avoidance, involves remaining with the phobic stimulus and continuing to experience anxiety
• Phobias - Emotional symptoms

  -       Anxiety is an unpleasant state of high arousal, preventing an individual relaxing and making it very difficult to experience positive emotion

  -       Fear is the immediate response we experience when we encounter or think about a phobic stimulus

  -       Emotional response is unreasonable, for example someone having a strong emotional response to a spider
• Phobias - Cognitive symptoms

  -       Selective attention to the phobic stimulus, for instance not looking away from the phobic stimulus

  -       Irrational beliefs, for example a spider eating you

  -       Cognitive distortions, in terms of unrealistic thinking
• Depression - Behavioural symptoms

  -       Unusual activity levels, for example being lethargic and not getting out of bed

  -       Disruption to sleep and eating behaviour, with reduced sleep (insomnia), increased sleep (hypersomnia) or increasing/decreasing appetite or weight

  Aggression and self-harm may be prevalent, as depression is associated with irritability
• Depression - Emotional symptoms

  -       Lowered mood, people with depression may refer to themselves as ‘worthless’

  -       Anger, with such emotions leading to aggression or self-harm

  Lowered self-esteem, with the person liking themselves less or self-loathing
• Depression - Cognitive symptoms

  -       Poor concentration, finding decision making or focusing on a task difficult

  -       Attention to the negative, focusing on negative aspects of situations and recalling unhappy memories

  -       Absolutist thinking, ‘black and white thinking’ -  when a situation is unfortunate it is seen as a disaster
• OCD - Behavioural symptoms

  -       Compulsions are repetitive, often ritualistic

  -       Compulsions reduce anxiety

  -       Avoiding things to reduce triggering of anxiety

   
• OCD - Emotional symptoms

  -       Anxiety and distress from unpleasant and frightening obsessive thoughts

  -       Depression, with low mood and lack of enjoyment

  Irrational guilt over a minor moral issue or disgust which is directed towards oneself or something external like dirt
• OCD - Cognitive symptoms

  -       Obsessive thoughts, with 90% of people with OCD reporting recurring intrusive thoughts, e.g., being contaminated by dirt or germs

  -       Cognitive coping strategies with some people with OCD using strategies to cope, 

  e.g., meditation

  -       Insight into excessive anxiety, including awareness that thoughts and behavior are irrational, with catastrophic thoughts and being hypervigilant
• Classical and operant conditioning in the two-process model

  -       Mowrer argued phobias are learned by classical conditioning and then maintained by operant conditioning

  – two processes are involved
• Acquisition of phobias by classical conditioning

  -       Classical conditioning involves association

  1.     UCS triggers a fear response (fear is a UCR), e.g., being bitten creates anxiety

  2.     NS is associated with the UCS, the dog did not previously create anxiety

  3.     NS becomes a CR producing fear, the dog causes a CR of anxiety following the bite
• Little Albert conditioned fear

  -       Watson and Rayner showed how a fear of rats could be conditioned in the ‘Little Albert’ study

  1.     Whenever Albert played with a white rat, a loud noise was made close to his ear, causing a fear response

  2.     The rat didn’t create fear until it has been paired together several times

  3.     Albert showed a fear response every time he came into contact with the rat
• Generalisation in little Albert

  Little Albert also showed a fear in response to other white furry objects including a fur coat and a Santa Claus beard
• Maintenance of phobias by operant conditioning

  -       Negative reinforcement is when an individual produces behaviour that avoids something unpleasant

  -       When a person with a phobia avoids a phobic stimulus they escape the anxiety that would have been experienced

  -       This reduction in fear negatively reinforces the avoidance behaviour and the phobia is maintained

  -       For example, if someone is scared of clowns they will avoids circuses, leading to relief and maintenance of the fear

   
• Strength of the two-process model: Real-world application

  -       Maintenance by avoidance helps explain why people with phobias benefit from exposure therapy

  -       Once avoidance behaviour is prevented, it ceases to be reinforced by the reduction of anxiety

  -       This helps avoidance behaviour decline

  -       This shows the value of the two-process approach because it identifies a means of treating phobias
• Weakness of the two-process model: Inability to explain cognitive aspects

  -       These explanations are geared towards explaining behaviour, here in the case of a phobic stimulus

  -       Phobias also have a significant cognitive element as people hold irrational beliefs about the stimulus
• Strength of the two-process model: Evidence

  -       De Jongh et al found that 73% of dental phobics had experienced a trauma, usually involving dentistry

  -       This is evidence of a link between bad experiences and phobias

  -       Further support came from the control group of people with low dental anxiety where only 21% had experienced a traumatic event of any kind

  This confirms that the association between stimulus and an unconditioned response does lead to the phobia
• Weakness of the two-process model: Doesn’t explain some phobias

  -       This is not true for all phobias

  -       Snake phobias still occur in populations where very few people have had any experience of snakes

  -       Not all frightening experiences lead to phobias

  -       Behavioural theories probably do not provide an explanation for all cases of phobia