Psychopathology

• Definitions of Abnormality:
• Statistical infrequency:

  • A disorder is abnormal if its frequency is more than two standard deviations away from the mean incidence rates represented on a normally-distributed bell curve
  • Used in clinical diagnoses of mental health disorders to assess severity
  • Assumes any abnormal characteristics are automatically negative
• Failure to function adequately:

  • If a person's current mental state prevents them from leading a 'normal' life
  • Includes not obeying social and interpersonal rules, being in distress, and displaying dangerous behavior
• Deviation from social norms:

  • 'Abnormal' behavior based on straying away from social norms specific to a culture
  • Diagnoses vary significantly between cultures, leading to discrimination and social control
• Deviation from ideal mental health:

  • Focuses on what would comprise the ideal mental state of an individual
  • Criteria include self-actualization, accurate self-perception, lack of distress, normal motivation, and high self-esteem
• Characteristics of Phobias:
• Behavioural characteristics:

  • Panic, avoidance, endurance
• Emotional characteristics:

  • Anxiety, unawareness of irrationality towards phobic stimulus
• Cognitive characteristics:

  • Selective attention, irrational beliefs, cognitive distortions
• Characteristics of Depression:
• Behavioural characteristics:

  • Changed activity levels, aggression, changed patterns of sleeping and eating
• Emotional characteristics:

  • Lowered self-esteem, constant poor mood, high levels of anger
• Cognitive characteristics:

  • Absolutist thinking, selective attention towards negative events, poor concentration
• Obsessive-Compulsive Disorder (OCD):
• Behavioural characteristics:

  • Compulsions, avoidance behavior
• Emotional characteristics:

  • Guilt, disgust, depression, anxiety
• Cognitive characteristics:

  • Acknowledgement of excessive and irrational anxiety, development of cognitive strategies, obsessive thoughts
• The Behavioural Approach to Explaining Phobias:
• Mowrer's theory:

  • Phobias acquired through classical conditioning and maintained through operant conditioning
  • Good explanatory power, explains acquisition and maintenance of phobias
• Alternative explanations:

  • Buck's safety as a motivator for avoidance behavior
  • Seligman's theory of developing phobias towards 'prepared' stimuli
• The Behavioural Approach to Treating Phobias:
• Systematic desensitisation:

  • Reduces phobic anxiety through gradual exposure to the phobic stimulus
  • Relies on counterconditioning and reciprocal inhibition
• Systematic desensitisation:

  • Patient and therapist create an anxiety hierarchy together, from least to most nerve-wrecking situations involving the phobic stimulus
  • Patient learns relaxation techniques like breathing and meditation to use at each anxiety level
  • Patient progresses through hierarchy, moving to next level only when remaining calm at present level
  • Phobia is cured when patient can remain calm at highest anxiety level
• Supporting evidence for systematic desensitisation:

  • Gilroy et al. followed 42 patients treated with systematic desensitisation for spider phobia
  • Compared to control group of 50 patients who only learnt relaxation techniques
  • Systematic desensitisation group showed reduction in symptoms at 3 and 33 months, supporting effectiveness of flooding
• Systematic desensitisation suitable for many patients, including those with learning difficulties:

  • Anxiety disorders often accompanied by learning disabilities
  • Patients may not make full cognitive commitment for cognitive behavioural therapy
  • Systematic desensitisation a suitable alternative for them
• Flooding:

  • Behavioral therapy to reduce phobic anxiety in one session through immediate exposure to phobic stimulus
  • Occurs in secure environment where patient cannot escape
  • Patient exposed to phobic stimulus without option of avoidance behavior
  • Relies on principle that heightened anxiety cannot be maintained for prolonged period
• Cost-effective:

  • Ougrin compared flooding to cognitive therapies and found it to be cheaper
  • Phobia typically cured in one session, allowing patient to continue normal life
• Less effective for complex phobias:

  • Social phobias involve anxiety and cognitive aspect
  • Cognitive therapy may be more appropriate for distal causes of phobia
• Biological explanation of OCD:

  • Genetic vulnerability through diathesis-stress model
  • OCD polygenic, involving up to 230 genes
  • Associated with neurotransmitters like dopamine and serotonin
• Supporting evidence for genetic basis of OCD:

  • Nestadt et al. found 68% of identical twins share OCD compared to 31% of non-identical twins
  • Strongly suggests genetic basis for OCD
• Too many candidate genes:

  • Over 230 candidate genes for OCD pose difficulty in assessing which genes have greatest influence
• Selective serotonin reuptake inhibitors (SSRIs):

  • Prevent reuptake and breakdown of serotonin, increasing concentration in synapse
  • Continually stimulate post-synaptic neuron
• Tricyclics:

  • Reserved for those not responding well to SSRIs
  • Increase concentration of noradrenaline neurotransmitter in brain
• Limitation of drug therapy:

  • Serious side effects like erection problems, weight gain, tremors, increased heart rate, aggressiveness
• Cost-effectiveness of drug treatments:

  • Increased knowledge can reduce time off work through sick days
  • Helps organizations like NHS save money
• Strength of drug use:

  • Cost-effective and non-disruptive compared to psychological treatments
  • Patients can discreetly manage symptoms and lead normal life