Abnormalities

• Statistical Infrequency- When an individual has fewer common characteristics than those in the majority of the population.
• Deviation from social norms- Behaviour that is different from the accepted standards of behaviour in the community or society.
• Failure to function adequately- When someone is unable to cope with the demands of daily living
• Deviation from ideal mental health- When someone does not meet the criteria for good mental health.
• Statistical Infrequency-Strengths:

  -Real life application diagnosis clinical assessments measure severity symptoms.

  -Helps assess severity of disorder. E.g. allows to find out schizophrenia effects 1% general population. Considered statistically infrequent but also subtypes less frequent.
• Statistical infrequency-Weaknesses:

  -labelling individuals is distressing, can have negative impact. May limit opportunities + change how they are seen. e.g. high empathy seen as 'too sensitive'.

  -Unusual characteristics can be positive. High IQ= unusual but not undesirable/need treatment.
• Deviation from social norms-Strengths:

  -Real life application(Diagnosis APD).

  -Covers wide range criteria. Good tool thinking mental health.
• Deviation from social norms-Weaknesses:

  -Abuse of human rights/ way to maintain control over minority.

  -Cultural Relativism (can't apply to all cultures).
• Failure to Function Adequately-Strengths:

  -Provides practical checklist (7 criteria to assess abnormality levels).

  -Recognises+ matches sufferer's perceptions, capturing experiences. Most seeking help believe they're suffering problems interfering with function, so supports definition.
• Failure to function adequately-Weaknesses:

  -Harold Shipman.

  -May be linked to other factors e.g. grief or physical health.

  -Subjective, limits personal choice+ freedom.
• Deviation from ideal mental health-Strengths:

  -Broad range criteria.

  -Similar model to physical (retains consistency).
• Deviation from ideal mental health-Weaknesses:

  -Cultural relativism.

  -Too high standards for mental health.
• Statistical infrequency:

  1.       Intellectual disability disorder (IDD):

  Ø  Average IQ is between 85-115.

  Ø  Anyone below 70 is characterised as abnormal and likely to receive a diagnosis of IDD.

  Ø  Equally IQ scores of 130+ is considered abnormally high.
• Statistical Infrequency:

  1.       Schizophrenia:

  Ø  Only affects 1% of the general population, this is considered statistically infrequent.

  Ø  There are also subtypes which are even less frequent (such as hebephrenic or paranoid Schizophrenia).
• Deviation from social norms:

  Ø  Standards of normality are based on collective judgements in society.

  Ø  A person’s thinking or behaviour is classified as abnormal if it violates the (unwritten) rules about what is expected or acceptable behaviour in a particular social group.
• Deviation from social norms: 1.       Same-sex relationships were considered a mental illness and abnormal but only in a few places are they illegal and abnormal now.

  2.       In the UK personal space especially in public is considered a social norm. However, in Southern Europe it is common to stand much closer to strangers.

  3.       Antisocial personality disorder (APD) in the western cultures would be considered a breach of social norms. However, other cultures may view/encourage such behaviour as a sign of spirituality.
• Deviation from ideal mental health:

  Ø  Jahoda (1958) suggested that there were 6 criteria that needed to be fulfilled for ideal mental health (‘normality’). This is a criteria for ‘optimal living’. It’s suggested that the more criteria absent, the more serious the abnormality.
• Deviation from ideal mental health:

  Ø  The 6 criteria includes:

  1.       A positive attitude towards the self

  2.       Self-actualisation (strive towards full potential)

  3.       Autonomy (lack of dependence on others)

  4.       Resistance to stress

  5.       Environmental mastery (ability to adapt)

  6.       Accurate perception of reality

   
• Failure to function adequately:

  Ø  Rosenhan & Seligman (1989) suggested 7 criteria typical of FFA, the more features a person has the more they are considered abnormal. This includes:

  Ø  Personal distress (e.g., anxiety or depression)

  Ø  Unpredictability (displaying unexpected behaviours and loss of control)

  Ø  Irrationality
• Specific phobia

  Related to specific objects and situations.
• Agoraphobia

  Related to places and situations.
• Phobia:

  Emotional characteristic

  1.       Anxiety – unpleasant/high arousal preventing relaxation.

  2.       Unreasonable emotional response – strong response for something harmless – irrational to someone without phobia.
• Phobia:

  Behavioural characteristic

  1.       Panic – crying, screaming, freeze, run away

  2.       Avoidance – avoid coming into contact with stimulus, hard to go about daily life.

  3.       Endurance – conscious effort to stay with phobic stimulus and experience high levels of anxiety.
• Phobia:

  Cognitive characteristic

  1.       Selective attention – hard to look away, keep attention on stimulus for best response to threat.

  2.       Irrational beliefs – out of proportion beliefs to the real threat level.

  3.       Cognitive distortions – perceptions are not rational
• Depression:

  Emotional characteristic

  1.       Lowered mood – sad, lethargic, empty, worthless

  2.       Anger – towards themselves and others.

  3.       Lowered self-esteem – like themselves less – sense of self-loathing
• Depression:

  Behavioural characteristic

  1.       Reduced activity level – lethargic, socially withdrawn, spend more time in bed.

  2.       Disruption to sleep and appetite – increase or decrease

  3.       Aggression/self-harm – physical or verbal aggression
• Depression:

  Cognitive characteristic

  1.       Poor concentration – hard to start, stick to and finish tasks.

  2.       Absolutist thinking – black/white, all good/bad

  3.       Attending to/dwelling on the negative – pay attention to the negatives
• OCD:

  Emotional characteristic

  1.       Anxiety & distress – unpleasant emotional experiences frightening thoughts and urges.

  2.       Accompanying depression – low mood, lack of employment

  3.       Guilt & disgust – directed at themselves or external stimuli.
• OCD:

  Behavioural characteristic

  1.       Repetitive compulsions – urge to repeat behaviours otherwise something bad will happen.

  2.       Anxiety-reducing compulsions – repeating a behaviour to reduce their anxiety

  3.       Avoidance – stay away from triggering situations.
• OCD:

  Cognitive characteristic

  1. Obsessive thoughts – unpleasant reoccurring thoughts

  2. Cognitive strategies – coping strategies to manage anxiety and distract them.

  3. Insight into excessive anxiety – aware their obsessions and compulsions are irrational.
• Behaviourist explanation of phobias:

  1.       Mowrer (1960) – two process model:

  Ø  Acquisition of phobia occurs through classical conditioning - learning to associate something which we initially have no fear of (neutral stimulus), with something that already triggers a fear response (unconditioned stimulus).

  Ø  Maintenance of a phobia through operant conditioning - Negative reinforcement, by avoiding something unpleasant we are rewarded by not experiencing anxiety, which reinforces us to continue this behaviour.
• Behaviourist approach to treating phobias:

  1.       Systematic desensitisation:

  Ø  Based on the principles of classical conditioning – counterconditioning takes place to reverse the conditioned stimulus (phobic object/situation) back into becoming neutral.

  Ø  Small steps are identified and worked through, using scale of 1-10 for estimating fear/challenge. These steps can be real or imaginary. Only once the client has mastered one step can they move on to the next, finishing with the target behaviour.
• Systematic desensitisation:

  Ø  Occurs in three stages:

  Ø  Anxiety hierarchy – put together a list increasing from low to high anxiety situations.

  Ø  Relaxation – therapist teaches the patient to relax – e.g. deep breathing or drugs (e.g. Valium).

  Ø  Exposure – exposed to phobic stimulus while relaxed, working their way up the hierarchy until relaxed in high-anxiety situations.
• Systematic desensitisation:

  1.       Flooding:

  Ø  Involves exposing the patient to the phobic stimulus with no build-up – immediate and frightening. This removes avoidance behaviours because the patient is directly exposed to the phobic object.

  Ø  Biology behind flooding - Body goes into the "alarm stage": the heart beats faster, blood pressure increase, perspiration begins, and adrenalin is released into the blood. The body can only stay in the alarm stage for quite a short amount of time. After that, the heart rate slows back down, breathing becomes regular again and adrenaline levels drop.
• cognitive explanation of depression:

  Beck (1967) 3 parts cognitive vulnerability:

  ØFaulty information processing – tendency to focus on negative aspects of situation & ignore positives.

  ØNegative self-schema – Schema=Mental shortcut based on prior experience. Self-schema=Shortcut Individuals use to interpret themselves. If negative, they interpret information about themselves in negative way. Often developed from prior information from initial childhood criticism experiences.

  ØNegative triad – develops dysfunctional view, regardless of reality.
• Cognitive explanation of depression:

  Beck (1967) cognitive triad:

  Ø  person’s belief system. Self-fulfilling cycle:

  Ø  Negative view of the world – “The world is a cold hard place”.

  Ø  Negative view of the future which reduces any hopefulness and enhances depression – “there isn’t much chance the economy will grow “Negative view of the self which enhance depression due to low self-esteem – “I am a failure”.
• Cognitive explanation of depression:

  Ellis (1967) ABC model:

  Ø  Activating event – external negative trigger

  Ø  Belief – often irrational such as musturbation (must achieve perfection)

  Ø  I-can’t-stand-it-it is – things are a major disaster.

  Ø  Utopianism – life is always meant to be fair.
• Behaviourist approach to treating depression:

  1.       Beck – CBT:

  Ø  Helps patients alter their cognitions by challenging negative schemas to make them more resilient to everyday negative life events.

  Ø  Cognitive aspects - clarify the clients' problems, jointly identify the goals and create a plan. Aims to challenge negative, irrational, and automatic thoughts.

  Ø  Behavioural aspects - techniques to change their behaviour and make it more positive.

  Ø  Client as scientist’ – investigate the reality of their beliefs in the way a scientist would. 
• Behaviourist approach to treating depression:

  1.       Beck – CBT:

  Ø  Identify the automatic negative thoughts (ANTs) about the world, future and self.

  Ø  Challenge these thoughts to prevent them affecting feelings and behaviour – replace with better alternative thoughts (BATs).

  Ø  Help patients to test their negative beliefs through behavioural activation – setting homework.
• Behaviourist approach to treating depression:

  1.       Ellis – REBT:

  Ø  Helps patients change irrational beliefs into positive beliefs.

  Ø  Client might talk about how unlucky they have been or how unfair things seem. An REBT therapist would identify these as examples of utopianism and challenge these irrational thoughts.

  Ø  Extension of his ABC model to an ABCDE model.

  Ø  D – dispute (challenge).

  Ø  E – effect (new belief/positive consequence).