4.1.4 - Psychopathology

    Subdecks (2)

    Cards (118)

    • Statistical infrequency
      Abnormality is defined as behaviour or characteristics that are rare/uncommon/unusual
    • Statistical infrequency
      • Occupies the extreme ends of a normal distribution curve, e.g. low IQ defined as intellectual disability disorder
      • The average IQ is ___ Most people (68%) range between ___ Only 2% have a score below 70
    • Statistical infrequency relies on the use of up-to-date statistics
    • Statistical infrequency
      • Useful in diagnosis, e.g. intellectual disability disorder requires an IQ in the bottom 2%
      • Helpful in assessing a range of conditions, e.g. the BDI assesses depression, only 5% of people score 30+ (= severe depression)
      • Means statistical infrequency is useful in diagnostic and assessment processes
    • Unusual characteristics can be positive, some statistically infrequent behaviour is desirable/highly regarded, e.g. high IQ
    • A very low depression score on the BDI would not be seen as abnormal, despite being unusual or at one end of a psychological spectrum
    • Statistical infrequency may only form part of assessment and diagnostic procedures and not the sole basis for defining abnormality
    • Deviation from social norms
      • All societies make collective judgments about what counts as 'normal'/usual/typical behaviour
      • Any behaviour that does not conform to accepted/expected standards is undesirable and abnormal
    • Deviation from social norms
      • Norms vary from culture to culture
    • A person from one culture may label someone from another culture as abnormal using their standards rather than the person's standards
    • Hearing voices is socially acceptable in some cultures but would be seen as a sign of abnormality in the UK
    • It is difficult to judge deviation from social norms from one context to another
    • Not all behaviour that deviates from social norms is a sign of illness, e.g. speeding
    • Human rights abuse carries the risk of unfair labelling and used for social control, e.g. drapetomania (black slaves running away) were a way to control enslaved people and avoid debate
    • Deviation from social norms is necessary for diagnosing conditions such as anti-social personality disorder, where the societal norm is a defining factor
    • Deviation from ideal mental health
      • Absence of signs of mental health used to judge abnormality
      • Failure to meet (Jahoda's) criteria − inaccurate perception of reality; problems with self-actualisation; inability to cope with stress; negative attitude towards self; lack of autonomy/independence; poor environmental mastery, self actualisation
      • The more criteria someone fails to meet, the more abnormal they are
    • Criteria for deviation from ideal mental health are too demanding - most people would be judged abnormal based on this definition; many aspects not being met is a normal part of life
    • Deviation from ideal mental health criteria reflect Western cultural norms of psychological 'normality', e.g. self-actualisation (could be seen as self-indulgent/selfish) and independence (drawing upon and communicating support, could be seen as mentally healthy instead)
    • Success in our working, social and personal lives may vary in different cultures
    • Failure to function adequately
      • Abnormality judged as inability to deal with the demands of everyday living e.g. not being able to hold down a job, maintain relationships or maintain basic standards of nutrition and hygiene
      • Behaviour is maladaptive, irrational, unpredictable or dangerous
      • Behaviour causes personal distress and distress to others
    • Many mental disorders do not cause personal distress; many behaviours, e.g. smoking, are maladaptive but not a sign of psychological abnormality
    • What is considered adequate in one culture might not be so in another
    • Failure to function adequately might not be linked to abnormality but to other factors, e.g. failure to keep a job may be due to the economic situation not to psychopathology
    • Failure to function adequately is context dependent; not eating can be seen as failing to function adequately but prisoners on hunger strikes making a protest can be seen in a different light
    • Phobias
      An extreme and irrational fear of an object / situation / activity that leads to avoidance
    • Categories of phobias (DSM-5)
      • Specific phobia: of an object/body part/situation (e.g. enclosed spaces or heights)
      • Social phobia: of a social situation e.g. public speaking
      • Agoraphobia: being outside or public space
    • Behavioural characteristics of phobias
      • Panic
      • Avoidance
      • Endurance
    • Emotional characteristics of phobias
      • Anxiety
      • Fear
    • Cognitive characteristics of phobias
      • Selective attention
      • Irrational beliefs
    • Two-process model of phobia development
      • Development of phobia through classical conditioning – association of fear/anxiety with neutral stimulus to produce conditioned response; assumes experience of traumatic event; generalisation of fear to other similar objects; one trial learning
      • Maintenance of fear through operant conditioning – avoidance of phobic object/situation is negatively reinforcing; relief as reward/primary reinforcer
    • Many people with phobias cannot identify incident/trauma e.g. snake conditioning is not the only way fears are acquired, some phobias have an evolutionary aspect − a biological preparedness
    • The two-process model is a reductionist approach, other factors such as cognitive irrational beliefs/catastrophising, psychodynamic explanation (unconscious conflict, ego displace onto something external e.g. Little Hans), diathesis-stress may also play a role
    • Systematic Desensitisation (SD)
      • Anxiety hierarchy created by client and therapist designing a list or hierarchy of frightening/ stressful events or objects
      • Relaxation training, e.g. breathing techniques, imagery or meditation. It is impossible to be afraid and relaxed and afraid at the same time, one emotion prevents the other→ reciprocal inhibition
      • Gradual exposure to the anxiety hierarchy
      • At each stage, if the client becomes upset they can return to an earlier stage and regain their relaxed state
      • Exposure: to phobic stimulus, a new response is learned→ e.g. relaxation =counterconditioning
    • Flooding
      • Immediate/direct/full exposure, no build up
      • Flooding sessions are usually longer than SD sessions, e.g. 2-3 hrs. Sometimes only 1 session is needed to cure a phobia
      • Prevention of avoidance. Example
      • Until they are calm/anxiety has receded/fear is extinguished
    • Systematic Desensitisation and Flooding are reductionist approaches to treatment
    • Systematic Desensitisation is effective, Gilroy (2003) followed up 42 people with a spider phobia in 3 45min sessions. At both 3 and 33months the SD group were less fearful
    • Flooding has high attrition rates, which raises ethical concerns and questions about its effectiveness
    • Flooding is cost-effective
    • Comparison between Systematic Desensitisation, Flooding, and alternative therapies would be useful
    • Obsessive Compulsive Disorder (OCD)

      • An anxiety disorder characterised by obsessions (recurring and persistent thoughts) and/or compulsions (repetitive behaviours)
      • The DSM system recognises OCD and a range of related disorders, where repetitive behaviour is accompanied by obsessive thinking