psychopathology

• Deviation from Social Norms


  A behaviour which deviates from the norms or accepted standards within society and is therefore considered different/abnormal
• Social norms

  A set of rules for behaviour based on a set of moral and conventional standards within society and are judged by the dominant culture
• Statistical Infrequency


  A person's trait, thinking or behaviour is classified as abnormal if it is rare or statistically unusual. Any unusual behaviour will be more than two standard deviations from the mean, that is, it will be found in less than 5% of the population
• Failure to Function Adequately

  When a person can no longer cope with the ordinary demands of everyday life. This might be a lack of hygiene, poor nutrition, unable to work or can not maintain a relationship
• Deviation from Ideal Mental Health

  This judges mental health in the same way as physical health, a person requires certain attributes to be mentally healthy
• Characteristics of Phobias


  • Behavioural: Panic-crying, screaming, running away or freezing (fainting), flight/fight, Avoidance-effort to keep away from the phobic stimulus. Making it hard to go about daily life. E.g. public toilet fear (can't go out), Endurance-in unavoidable situations (i.e. flying) continuous and extreme anxiety
  • Emotional: Excessive fear and an unpleasant state of high arousal. Prevents sufferer relaxing and cannot experience positive emotion. Fear is immediate and extremely unpleasant response we experience when we encounter or think about the phobic stimulus
  • Cognitive: Irrational thoughts. Person knows that their fear is excessive. Thinking resists rational arguments about the phobia and they find it difficult to focus their attention elsewhere, known as selective attention
• Characteristics of Depression


  • Behavioural: Low levels of energy, lethargic (withdrawn from work, social life) in extreme cases they can't get out of bed, Psychomotor agitation-struggle to relax (pace up and down), Disruption to sleep (insomnia or hypersomnia), Appetite increase or decrease-affecting weight, Verbal aggression (ending a relationship or Job) or physical aggression (self-harm, suicide)
  • Emotional: Lowered mood (worthless, empty), Anger (at self or others) may lead to self-harming, Self-esteem is low (self-loathing)
  • Cognitive: Poor levels of concentration (unable to stick with a task), Pay more attention to negative aspects of a situation and ignore positives, Tend to recall unhappy events rather than happy ones
• Characteristics of OCD


  • Behavioural: Compulsions: compelled to repeat a behaviour and reduce anxiety, Coping strategies: praying - but can be distracting
  • Emotional: Characterised by anxiety-irrational fear (compulsions bring temporary relief), Can also experience depression
  • Cognitive: Obsessions: Intrusive thoughts-RECURRING over again, (i.e.. Being contaminated by dirt, door unlocked get hurt), Selective attention towards their anxiety
• Two Step Model (Mowrer, 1960)


  Classical Conditioning - Little Albert, Operant Conditioning - The behaviour is strengthened when an unpleasant consequence is removed. The sufferer avoids the anxiety by avoiding the situation which negatively reinforces their phobia
• Operant Conditioning


  The behaviour is strengthened when an unpleasant consequence is removed. The sufferer avoids the anxiety by avoiding the situation which negatively reinforces their phobia.
• Evaluation of Behavioural Approach
• Biological Preparedness


  • Seligman argues that phobias can develop without a traumatic event. He argues that animals including humans are genetically programmed to learn an association between dangerous stimuli & fear. Things that would be dangerous in the evolutionary past are more common than modern fears.
• DiNardo (1988) found that only 50% of dog phobics had a fearful experience and 50% had a fearful dog experience but no phobia.
• Systematic Desensitisation


  1. Stage One: The client is taught relaxation techniques.

  2. Stage Two: Construct a hierarchy of fear.

  3. Stage Three: The client works through each stage, using the relaxation techniques at every step. Only when the client can achieve the step and not feel anxious do they move up to the next one.
• Flooding


  The client is firstly taught relaxation techniques but then they are exposed to their fear for a long period time and in it's most fearful form. As adrenaline naturally decreases, a new stimulus-response link can be learned between the stimuli and relaxation.
• Effectiveness of Behavioural Treatments


  • Systematic desensitisation is 75% effective when treating phobias (McGarth, 1990). Choy et al (2007) reported that flooding and SD were effective but that flooding was the more effective of the two in treating phobias.
• Traumatic nature of Flooding

  • Flooding is an unethical treatment, as it can be highly distressing for the individual and one could argue that their right to withdraw is denied to them during the exposure.
• Cost Effectiveness of Systematic Desensitisation

  • Humphrey (1973) argues that SD is effective even when self administered, this makes it more cost effective.
• Beck's Negative Triad


  • 1. Faulty information processing: If depressed we tend to focus only on the negative aspects of life and ignore anything positive.
  • 2. Negative self schema: Interpret information about ourselves in a negative way.
  • 3. The Negative Triad: Negative view of the world, negative view of the future and negative view of the self.
• Ellis' ABC Model


  • A-Activating event
  • B-Belief. For depression, these beliefs are irrational.
  • C-Consequences. Rational belief's lead to healthy emotions and the ability to have a 'normal' life. Irrational beliefs lead to unhealthy emotions and could develop into depression.
• Beck's Depression Inventory (BDI) allows us to assess depressive symptoms in patients and develop cognitive therapies. Ellis developed REBT which can challenge irrational beliefs and relieve depressive symptoms.
• Boury et al (2001) monitored students negative thoughts with Becks BDI and found that depressives misinterpret facts and experiences in a negative fashion and feel helpless about the future.
• Ethical concerns with Cognitive Approach

  • Some say that the cognitive approach blames the patient for their depression, as it fails to acknowledge other influences other than their own irrational thoughts.
• Beck's Cognitive Therapy

  It aims to challenge irrational and dysfunctional thought processes by identifying and testing the negative beliefs. They may have homework to complete in which they record positive events.
• Ellis' Rational Emotive Behaviour Therapy

  Effective disputing can change the way we think about things and allow for more rational thought processes. It adds DEF steps to the ABC model: D = Dispute & Effect and F Feelings. Different types of disputing use logic, empirical evidence and pragmatic disputing (is this thought useful to me?)
• Effectiveness of Cognitive Treatments

  • March et al. (2007) compared CBT with drugs and a combination of the two in 327 adolescents. 81% of CBT improved, 81% of drug group improved and 86% of combination improved. CBT is just as effective as antidepressants and works well alongside drugs.
• Limitations of Cognitive Treatments

  • Cognitive therapy is time consuming and expensive and there can be waiting lists. Relapse rates can also be high in the long term. 53% within a year relapse (Shehzad Ali et al., 2017)
  • It can't be used for severe cases and so the patient must wait until drugs kick in and which make them more alert and motivated to take part.
• Genetic Explanations of OCD

  Lewis (1936) found that 37% of his OCD patients had parents with OCD and 21% had siblings with OCD. Suggesting OCD runs in families. The COMT gene regulates the production of dopamine and high levels of dopamine might be the cause of OCD. Mutations of the SERT gene affects the transport of serotonin, creating lower levels of the neurotransmitter. These lower levels are also implicated in OCD.
• Neural Explanations of OCD

  It is thought that dopamine levels are abnormally high and/or serotonin levels are low in people with OCD. When the caudate nucleus is damaged it fails to suppress the 'worry' signals and the thalamus is alerted constantly.
• Evaluation of Biological Explanations of OCD

  • Twin Studies: Nestadt (2000) reviewed twin studies and found 68% of monozygotic twins shared OCD as opposed to 31% of dizygotic, demonstrating a genetic cause.
  • Concordance Rates: Concordance rates are never 100%. The diathesis-stress model may be a better explanation, where we have a predisposition to OCD but environmental factors determine if we get it.
  • Animal Studies: Szetchman et al (1998) found if he increased rats' dopamine levels with drugs, they would display stereotypical behaviours resembling the compulsive behaviours found in OCD sufferers.
• Drug Therapies for OCD

  SSRI's (selective serotonin reuptake Inhibitors) are most commonly used for OCD. Drugs such Zoloft, Praxil and Prozac increase levels of serotonin in the synapse which reduces symptoms. If SSRIs are not effective after 3-4 months other drugs may be tried such as Tricyclics, which have the same effect on serotonin as SSRIs but have more severe side effects or SNRIS which increase serotonin and noradrenaline.
• Evaluation of Biological Treatments for OCD

  • Effectiveness: Soomro (2008) reviewed 17 studies where SSRI's had been used to treat OCD and found in some cases the SSRI was more effective than a placebo in reducing the symptoms of OCD.
  • Side Effects: SSRI's can cause headaches, nausea and insomnia which can mean that people stop taking the medication. The side effects of Tricyclics are more severe, including hallucinations and irregular heart beat and weight gain.
  • Cost Effectiveness: Drug therapies are relatively cheap when compared to psychological therapies. They also do not require much motivation from the patient to take them unlike cognitive therapies. However, they do only treat the symptoms of OCD not the root cause. If the patient stops taking them then the symptoms usually return.
• Evaluate deviation from social norms

  Social norms vary between cultures so it is difficult to judge abnormality.

  Social norms vary over time such as nymphomania was once used to control women.
• Evaluate statistical infrequency 


  Some infrequeby behaviours may be positive such as a high IQ.

  It has real world application in clinical practice such as Becks Depression Inventory which is used to determine the severity of depression.
• Evaluate failure to function adequately

  Cultural differences such as different perceptions of irrational behaviour- more lower class non white people get diagnosed with disorders.

  Some people may just choose alternative lifestyles such as living off grid or doing high risk sports.
• Evaluate deviation from ideal mental health

  It is unrealistic - many of us would struggle to meet many of the criteria making it almost impossible.

  Jahoda also helped society to see mental health as similar to physical health which helped reduce stigma around disorders.