Psychopathology

• Statistical infrequency


  Implies that 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
• Statistical infrequency is almost always used in the clinical diagnoses of mental health disorders as a comparison with a baseline or 'normal' value
• Statistical infrequency makes the assumption that any abnormal characteristics are automatically negative, whereas this is not always the case
• Failure to function adequately definition of abnormality


  If a person's current mental state is preventing them from leading a 'normal' life, alongside the associated normal levels of motivation and obedience to social norms, then such individuals may be considered as abnormal
• Failure to function adequately definition of abnormality

  • Takes into account the patient's perspective, and so the final diagnosis will be comprised of the patient's (subjective) self-reported symptoms and the psychiatrist's objective opinion
  • May lead to more accurate diagnoses of mental health disorders because such diagnoses are not constrained by statistical limits, as is the case with statistical infrequency
• Failure to function adequately definition of abnormality


  • May lead to the labelling of some patients as 'strange' or 'crazy', which does little to challenge traditional negative stereotypes about mental health disorders
  • Not everyone with a mental health disorder requires a diagnosis, especially if they have a high quality of life and their illness has little impact upon themselves or others
• Deviation from social norms definition of abnormality

  'Abnormal' behaviour is based upon straying away from the social norms specific to a certain culture
• Mental health diagnoses based on the deviation from social norms definition have historically led to discrimination, as a mechanism for social control
• The deviation from social norms definition suffers from cultural relativism
• Deviation from ideal mental health definition of abnormality


  Focuses on what would comprise the ideal mental state of an individual, including being able to self-actualise, having an accurate perception of ourselves, not being distressed, being able to maintain normal levels of motivation to carry out day-to-day tasks and displaying high self-esteem
• Deviation from ideal mental health definition of abnormality

  • Jahoda may have had an unrealistic expectation of ideal mental health, with the vast majority of people being unable to acquire, let alone maintain, all of the criteria listed
  • Suffers from cultural relativism as the concept of self-actualisation may be viewed differently in individualist vs collectivist cultures
• Behavioural characteristics of phobias

  Panic, avoidance and endurance
• Panic


  The patient suffers from heightened physiological arousal upon exposure to the phobic stimulus, caused by the hypothalamus triggering increased levels of activity in the sympathetic branch of the autonomic nervous system
• Avoidance


  Avoidance behaviour is negatively reinforced (in classical conditioning terms) because it is carried out to avoid the unpleasant consequence of exposure to the phobic stimulus
• Endurance


  This occurs when the patient remains exposed to the phobic stimulus for an extended period of time, but also experiences heightened levels of anxiety during this time
• Emotional characteristics of phobias

  • Anxiety
  • Unawareness that the anxiety experienced towards the phobic stimulus is irrational
• Cognitive characteristics of phobias

  • Selective attention to the phobic stimulus
  • Irrational beliefs
  • Cognitive distortions
• Selective attention


  The patient remains focused on the phobic stimulus, even when it is causing them severe anxiety
• Irrational beliefs


  May be the cause of unreasonable responses of anxiety towards the phobic stimulus, due to the patient's incorrect perception as to what the danger posed actually is
• Cognitive distortions


  The patient does not perceive the phobic stimulus accurately, and it may often appear grossly distorted or irrational
• Behavioural characteristics of depression


  • Changed activity levels
  • Aggression
  • Changed patterns of sleeping and eating
• Emotional characteristics of depression

  • Lowered self-esteem
  • Constant poor mood
  • High levels of anger
• Cognitive characteristics of depression

  • Absolutist thinking
  • Selective attention towards negative events
  • Poor concentration
• Behavioural characteristics of OCD

  • Compulsions
  • Avoidance behaviour
• Emotional characteristics of OCD

  • Guilt
  • Disgust
  • Depression
  • Anxiety
• Cognitive characteristics of OCD

  • Acknowledgement that their anxiety is excessive and irrational
  • Development of cognitive strategies to deal with obsessions
  • Obsessive thoughts
• Behavioural approach to explaining phobias

  Phobias are acquired through classical conditioning and then maintained through operant conditioning
• Behavioural approach to explaining phobias

  • Watson and Rayner demonstrated how Little Albert associated the fear caused by a loud bang with a white rat
• Behavioural approach to explaining phobias

  • Good explanatory power - Can explain the mechanism behind the acquisition and maintenance of phobias
  • Alternative explanation for avoidance behaviour (Buck) - Safety is a greater motivator for avoidance behaviour, rather than simply avoiding the anxiety associated with the phobic stimulus
  • Alternative explanation for the acquisition of phobias (Seligman) - We are more likely to develop phobias towards 'prepared' stimuli which would have posed a threat to our evolutionary ancestors
• Behavioural approach to treating phobias - Systematic desensitisation

  1. Gradual exposure to the phobic stimulus, with the patient learning relaxation techniques to counteract the anxiety

  2. Patient works their way up an anxiety hierarchy, only progressing to the next level when they have remained calm in the present level
• Behavioural approach to treating phobias - Systematic desensitisation

  • Gilroy et al. followed up 42 patients treated in three sessions of systematic desensitisation for a spider phobia, showing a reduction in their symptoms compared to a control group
• Reciprocal inhibition


  It's impossible to be both relaxed and anxious at the same time
• Systematic desensitisation


  1. Patient and therapist draw up an anxiety hierarchy

  2. Therapist teaches patient relaxation techniques

  3. Patient works their way up through the hierarchy

  4. Phobia is cured when patient can remain calm at the highest anxiety level
• Systematic desensitisation


  • Gilroy et al. followed up 42 patients treated in three sessions
  • Compared to a control group of 50 patients who learnt only relaxation techniques
  • Systematic desensitisation group showed a reduction in their symptoms
• Systematic desensitisation


  • Suitable for many patients, including those with learning difficulties
  • More acceptable to patients, as shown by low refusal and attrition rates
• Flooding


  Behavioural therapy designed to reduce phobic anxiety in one session, through immediate exposure to the phobic stimulus
• Flooding relies on the principle that it is physically impossible to maintain a state of heightened anxiety for a prolonged period, meaning that eventually, the patient will learn that the phobic stimulus is harmless
• Flooding is cost-effective


  Ougrin compared it to cognitive therapies and found it to be cheaper
• Flooding is less effective for complex phobias


  Social phobias involve both anxiety and a cognitive aspect, so cognitive therapy may be more appropriate
• Beck's cognitive theory of depression

  Patients have a cognitive vulnerability towards developing depression, through faulty information processing, negative self-schemas and the cognitive triad of automatic negative thoughts