ABNORMALITY

• Definitions of Abnormality

  What does statistical infrequency mean?

  Behaviours fhat are extremely rare and found in very few people when compating
• Strengths and limitations of statistical frequency

  1. The cut off point is subjectively determined eg with sleep

  2. Some abnormal behaviour is desirable eg IQ

  3.Statistical frequency is sometimes appropriate eg IQ for mental disabilities
• Definitions of Abnormality

  Deviation from social norms

  Anything that violates unstated rules on how a person should behave eg manners and personal hygiene
• Strengths and limitations of deviation from social norms

  Negatives

  1. Susceptible to abuse- eg homosexuality norma change over time

  2.Deviance is related to context and degree eg wearing a bikini at the beach vs in a class

  3. Culture relativism - eg in a tribe heating houses is normal

  Positives

  1. Does take into account desirable and undesirable behaviour

  2.Takes into account effect of persons behaviour on others

  3. Helps society live together
• Definitions of abnormality

  Failure to function adequately


  Ability to go about daily life without causing distress to self or others

  
  

  If failing to function will show behaviours:

  .Dysfunctional behaviour

  .Personal distress

  .Observer discomfort/distress to others

  .unpredictable behaviour

  .irrational behaviour
• Strengths and limitations of failure to function adequately

  Negatives

  1. Who judges -patient may not be able to judge if they can cope

  2. Behaviour may be quite functional -attention from disorders can be rewarding for individual

  3. Cultural relativism

  Positives

  1.Recognises the subjective experience of the patient
• Definitions of abnormality

  Deviation from ideal mental health

  Jahoda - healthy person should fit 6 criteria

  1.Self attitudes

  Having high self esteem and identity

  2.personal growth and self actualisation

  Extent development of full capabilities

  3.integration

  Being able to cope in situations

  4.Autonomy

  Being independent and self regulating

  5. Accurate view of reality

  Having realistic judgment on self and others

  6. Environmental mastery

  Ability to function, love and adapt
• Strengths and limitations of deviation from ideal mental health

  Negatives

  1.unrealistic criteria - how many to be considered abnormal and immeasurable

  2. Cultural relativism

  Positives

  1.mental health same as physical

  Looking for criteria to diagnose

  2. Is a positive approach

  Focuses on positives
• What is the definition of phobias

  A group of mental disorders

  Characterised by high anxiety levels to stimuli

  Interferes with living
• What is the definition of depression

  A moody disorder

  Individual feels sad if lacks interest

  Experience negative emotions

  Irrational thinking

  Lowered activity levels

  Difficulty with concentration and sleeping
• What is the definition of ocd

  An anxiety disorder

  Arises from obsessions (thoughts) and compulsions (behaviour) repeated

  Doing compulsions relieves anxiety
• What are the behavioural characteristics of phobias?

  1. Panic

  Panic in responses to stimulus eg crying

  2.Avoidance

  Go to extreme lengths to avoid can interfere with life

  3. Endurance

  Remains in presence of phobia but has high levels of anxisty
• 1. Panic

  Panic in responses to stimulus eg crying

  2.Avoidance

  Go to extreme lengths to avoid can interfere with life

  3. Endurance

  Remains in presence of phobia but has high levels of anxiety
• What are the emotional characteristics of phobias?

  1.Anxiety

  Caused by emotional response and makes it hard for positive emotions in response to stimulus
• What are the cognitive characteristics of phobias?

  1.Irrational beliefs

  Sufferer has irrational belief about phobia

  2. Cognitive distortions

  Persons perception of phobia distorted
• What are the behavioural characteristics of depression


  1. Activity levels

  Reduced levels of energy sufferers withdraw from work

  Sometimes opposite and struggle to relax

  2.Disruption to sleep and eating behaviour

  May experience insomnia

  Or increases need for sleep

  Appetite and eating may increase or decrease

  3.Aggression and self harm

  Often irritable and verbally aggressive

  Nah show physical aggression like self harm
• What are the emotional characteristics of depression

  1. Lowered mood

  Feeling prolonged sadness and lethargic and empty

  2.Anger

  Can be directed at self or others eg self harm

  3. Lowered self-esteem

  Can be self hatred
• What are the cognitive characteristics of depression

  1. Poor concentration

  May find it hard to stick to task and make decisions which can interfere with work

  2. Attending to and dwelling on the negative

  Sufferers pay attention to negative

  Glass half empty

  Bias towards recalling unhappy events

  3. Absolutist thinking

  Tend to see bad situations as an absolute disaster
• What are the behavioural characteristics of OCD

  1.Compulsions

  -compulsions de repetitive

  -compulsions reduce anxiety

  2. Avoidance

  May avoid situations to reduce anxiety
• What are the emotional characteristics of OCD?

  1. Anxiety and distress

  Powerful anxiety and obsessive thoughts are unpleasant

  2. Accompanying depression

  Anxiety is accompanied by low mood and not enjoying activities

  3. Guilt and disgust

  Disgust towards external or themselves
• What's re the cognitive characteristics of OCD?

  1. Obsessive thoughts

  90% of sufferers

  Constant recurring thoughts of germs or if doors locked

  2. Cognitive strategies to deal with obsessions

  Like meditation or prayer

  3.insight into excessive anxiety

  Are aware thoughts are irrational
• How is the behavioural approach to explaining phobias explained by the two process model

  1. Classical conditioning - initiation

  - phobia is acquired through association by a neutral stimulus eg eat and a loud noise an unconditional stimulus

  2. Operant conditioning - maintenance

  - behaviour repeated which increases anxiety and avoidance of stimulus
• Evaluation of the behavioural approach to explain phobias

  1. Good explanatory power

  Explains why patients need to be exposed to phobia

  2. Phobias don't follow a trauma

  Some people aren't aware of bad experience relating to phobia going against idea of conditioning

  3. Diathesis stress model

  Some people have a genetic vulnerability to phobias

  4. Biological preparedness

  Response learned like flight or fight if considered life threatening like a snake
• What is systematic desensitisation as a behavioural approach to treating phobias?

  Therapy designed to gradually endure anxiety and get patient to relax

  3 processes:

  1. The anxiety hierarchy

  Put together by patient and therapist of situations related to phobic stimulus least- most

  2. Relaxation

  Therapist teaches patient to relax through techniques

  3. Exposure

  Patient exposed to stimulus in relaxed state can take a few sessions
• Evaluation of systematic desensitisation

  1. It is effective

  Research shows ss is effective for specific phobias

  2. It is suitable for a diverse range of patients

  For example people with learning difficulties may struggle with flooding

  3. It is acceptable to patients

  Patients prefer it as it doesn't cause same amount of trauma as flooding

  Negatives

  1. Not appropriate for all phobias

  May not be effective for phobias with a survival component like fear of dark or animals

  2. Symptom substitution

  When one phobia disappears another may appear
• What is flooding as a behavioural approach to treating phobias

  Alternative treatment to sd

  1 long session when phobia is experienced at its worst- continue till fully relaxed

  Treatment can be conducted irl or virtually

  Sessions lasts 2/3 hrs and relaxation techniques are taught

  Adrenaline has a time limit and patient gradually relaxes
• Evaluation of flooding


  Positives

  1. It is cost effective

  Ougrin 2011- flooding more effective then CBT and cost effective as takes little time

  Negatives

  1. Individual differences

  Can be very traumatic so patients may quit reducing effectiveness

  2. Less effective for certain phobias

  Social phobia has specific cognitive element

  3. Traumatic

  Flooding is highly traumatic so money and time can be wasted
• What's becks cognitive approach to explaining depression

  Negative schema :

  Tendency to adopt negative view of world

  Can be caused by childhood or rejection

  Can be activated by new situation

  The negative triad:

  1. The self

  2. The world

  3. The future
• How does ellis' abc model explain the cognitive aspect of depression

  ABC model:

  A- activating event

  Eg getting fired at work

  B- Belief

  Believing it's your fault

  C- consequence

  Irrational beliefs lead to unhealthy emotions

  
  

  Mustabatory thinking

  Ideas must be approved for an individual to be happy

  . I must be approved or accepted by important people

  . I must do well or very well or I'm worthless

  . The world must give me happiness or I will die
• Evaluation of the cognitive approach to explaining depression

  Positives

  1. Support for the role of irrational thinking

  Krantz :

  Depressed participants make more logical errors

  Bates et al:

  Depressed participants giving negative thoughts gave more negative statements negative thinking leads to depression

  Negatives

  1. Cause and effect

  Cause and effect can't be established don't know wether negative thoughts cause depression or opposite

  2. Irrational beliefs may be realistic

  Alloy and Abrahmson

  Depressed people give more accurate views

  3. Biological approach

  Cognitive approach goes against it as biological approach suggest depression is caused by neurotransmitters

  Zhang et al:

  Low levels of serotonin in depressed people

  4. Blames the client rather than situational factors

  Suggests client is to blame therapist may overlook things like family issues
• What is the definition of CBT

  A combination of cognitive therapy( thoughts) and behavioural therapy
• What does DEF mean in Ellis' abc model for challenging irrational thoughts

  D= Disputing irrational thoughts and beliefs

  E= the Effects of disputing and Effective attitude to life

  F= new Feelings that are produced
• How is a patient encouraged to dispute irrational beliefs

  1. Logical disputing

  Does thinking this way make sense

  2. Empirical disputing

  Where's proof this belief is accurate

  3. Pragmatic disputing

  Will this belief help me
• How can CBT be positive

  1. Homework

  Clients are asked to complete homework as it tests irrational beliefs with positives

  2 behavioural activation

  Encourages depressed people to participate in positive activities

  3. Unconditional positive regard

  Successful therapy requires therapist to always be positive which helps to change irrational beliefes
• Evaluation of the cognitive approach to treating depression

  Positives

  1. It is effective

  March et al:

  Compared CBT with antidepressants

  327 adolescents

  81% of CBT group improved

  81% of anti depressants improved

  86% of both improved

  Proves CBT just as effective as medication

  Negatives

  1. CBT may not work for the most severe cases

  People with severe depression may not be motivated to do cbt and may need antidepressants

  2. Success may be due to the therapist patient relationship

  Rosenzweig:

  Differences of psychotherapy may be quite small

  Relationship may determine success

  3. Some patients really want to explore their past

  Part of cbt is to focus on present and future which some clients may find frustrating
• What are the genetic explanations of OCD

  The COMT gene:

  May contribute to OCD

  one form of COMT gene common for people with OCD

  this variation produces lower activity of the COMT gene and higher levels of dopamine

  The SERT gene:

  Affects transport of serotonin

  Mutation of genes where 6/7 family members had OCD
• What is the Diathesis stress explanation of OCD

  . Genes such as SERT can be caused by depression and post traumatic stress

  . Certain gene can cause vulnerability however environmental factors affects

  . Some people could possess the COMT and SERT genes but won't develop OCD unless a trigger
• What are the neural explanations of OCD

  1. Abnormal levels of neurotransmitters

  Dopamine levels abnormally high-drugs which enhance dopamine levels induce stereotypical OCD behaviour

  Serotonin too low- antidepressants help

  2. Abnormal brain circuits

  Decision making circuits impaired

  Abnormal function of the lateral of the frontal lobes of the brain

  Frontal lobes responsible for decision making

  Left parahippocampal gyrus associated with unpleasant emotions functions abnormally in OCD
• Evaluation of the biological approach to treating OCD


  Positives

  1.Family and twin studies :

  Nestadt et al:

  Chances of developing OCD increases if in the family

  First degree relative- 5X more likely

  OCD has genetic links

  Billett et al

  Identical twins twice as likely to get OCD if twin had it as same genetics

  2. Supporting evidence for neural explanations

  Antidepressants that work with serotonin are effective

  Cause identified is correct

  Negatives

  1. Concordance rates never 100% so environmental factors play a role in OCD

  2. Cause and effect

  Can't be sure wether neurotransmitter imbalances cause OCD or opposite

  3. Twin studies are flawed as genetic evidence

  Twins share same environmental which can impact
• How is drug therapy used to treat OCD

  Medication can help to reduce symptoms like antidepressants or anti anxieties

  Drugs are given to increase levels of sedition