psychopathology

• Abnormal behaviour


  Behaviour that is outside of unwritten societal norms, therefore deviating from social norms and standing out
• Social norms


  • May offend a group or be deemed inappropriate
• Szasz (1974) claims mental health definitions were a way of removing those that don't conform
• Abnormal behaviours


  • Homosexuality was illegal in the UK until 2014
  • Kleptomania was considered abnormal until it became legal
• Black slaves that weren't always submissive were considered abnormal
• Identifying abnormal behaviour

  Helps with mental health diagnosis and treatment, identifies people that need additional support
• Identifying abnormal behaviour


  Looks at individual differences, but social norms change over time and need to be updated, norms are culturally bound which can lead to bias, context of behaviours needs to be taken into consideration
• Statistical abnormality


  Behaviour is abnormal if it is statistically uncommon in frequency in society - looks at the distribution within society
• Statistical abnormality


  • IQ under 70 = intellectual disability disorder
  • IQ over 130 = genius (could be desirable behaviour)
• Using statistical measures to define abnormality


  Provides an objective measure, used to measure normal development of children (percentiles), uses scores from well established standardised tests
• Using statistical measures to define abnormality

  Some abnormal behaviour can be considered desirable, doesn't take into account cultural variations that could affect prevalence of a condition
• Deviation from mental health

  The absence of normal behaviour that deviates from having ideal mental health
• Ideal mental health


  • Positive view of self - high self esteem, resist stress, accurate view of reality, independent and self regulating, self actualisation and personal growth, environmental mastery - friendships, work, love, leisure time
• Deviation from ideal mental health


  If one of these factors is missing, a person will be classified as abnormal under this definition
• Deviation from ideal mental health

  Focuses on the desirable positive approach, takes the person as a whole into account, comprehensive explanation
• Deviation from ideal mental health


  Unrealistic criteria to meet all the time, people may have bad days or periods of high stress, criteria such as independence may not be supported in collectivist cultures (culturally bound)
• Failure to function adequately


  Unable to cope with the ordinary - unable to live independently, self care, work, dangerous to themselves, personal distress
• Failure to function adequately

  • Depression and intellectual disability disorder (IQ <70)
• Failure to function adequately


  Useful as it considers the subjective personal experiences of an individual (idiographic approach)
• Failure to function adequately


  Subjective assessment of someone's ability to function in everyday life, decision on diagnosis may be biased, to avoid this standardised scales such as the Global Assessment of Functioning scale should be used to maintain objectivity
• Phobias


  An irrational fear of an object or situation
• Types of phobias


  • Specific: fear of an object such as an animal or body part, or a situation such as dying or having an injection
  • Social: fear of situations such as speaking or acting in public
  • Agoraphobia: fear of being outside or in a public place
• Symptoms of phobias

  • Emotional: strong emotional responses to feared objects or situations, high feelings of anxiety
  • Behavioural: panic and need to escape, dizziness, nausea, sweating, high heart rate, shaking, shortness of breath leads to the fight or flight response
  • Cognitive: the way in which information is processed, selective attention, irrational beliefs and cognitive distortions
• Depression


  A long term mood affective disorder - characterized by low mood which must be present for at least 2 weeks, most common between 20-40 years old
• Types of depression


  • Major depressive disorder, persistent depressive disorder, disruptive mood dysregulation disorder, premenstrual dysphoric disorder, bipolar disorder
• Symptoms of depression


  • Emotional: anhedonia - loss of interest in activities, feelings of emptiness, hopelessness, low self esteem, sadness
  • Behavioural: reduced energy and activity levels, tiredness, agitation, changes in appetite and sleeping patterns (insomnia and hypersomnia)
  • Cognitive: negative self belief and concept, feelings of guilt, death or suicide, poor concentration having a constant focus on the negative
• Obsessive Compulsive Disorder (OCD)

  Gradual onset, especially during adolescence, can be as young as 6
• Criteria for OCD


  • Obsessions, 2. Compulsions, 3. Time consuming, 4. Not physiological effects of medication, 5. Not better explained by another disorder
• Symptoms of OCD


  • Emotional: anxiety, depression, feelings of irrational guilt, disgust directed at something external
  • Behavioural: compulsions are repetitive, such as checking, counting, washing, compulsions reduce anxiety caused by the obsessions
  • Cognitive: Obsessive thoughts affect 90% of OCD sufferers, thoughts recur over and over again, these are hedonic symptoms
• CBT cognitive element


  Identifies irrational thoughts and replaces them with rational ones
• CBT behavioural element


  Encourages patients to test their beliefs through home work
• CBT process


  1. Patient is assessed

  2. Irrational thoughts are identified with Beck's negative triad

  3. Evidence for and against thoughts is identified

  4. Old attitudes and beliefs are replaced with more effective new ones

  5. Patient tests the validity of their thoughts through homework
• REBT


  Rational, emotional, behavioural therapy, modified ABC model to include D (disputing), E (effects) and F (feelings)
• REBT therapists

  Encourage patients to have logical disputes (does this make sense?) and empirical disputes (seeking evidence)
• Mowrer (1960) two process model


  Explains phobias through classical conditioning (initiates phobia) and operant conditioning (maintains phobia through negative reinforcement of avoiding fearful situation)
• Watson + Reyner (1920) developed the Little Albert experiment
• Flooding


  Exposing the patient to the phobic stimuli with no gradual build up, over one session leads to extinction of the phobia
• Systematic Desensitisation


  Counter conditioning to learn to relax in the presence of phobic stimuli, anxiety hierarchy, relaxation, exposure
• Genes


  OCD is polygenic and over 230 genes are implicated in its development, candidate genes (SERT, COMT and 5HT1-0) affect serotonin and dopamine transport, diathesis-stress model - people have a genetic vulnerability which is affected by an environmental stressor
• Neural Correlates


  People with OCD have higher levels of dopamine and lower levels of serotonin, the frontal lobe and the orbitofrontal cortex are both overactive in the brains of people with OCD, this is what causes obsessional thoughts and behaviours