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
• The fact that mental health diagnoses based on this definition vary so significantly between different cultures has historically led to discrimination, as a mechanism for social control
• Due to its reliance on subjective social norms, this explanation also suffers from cultural relativism
• Deviation from ideal mental health

  Jahoda (1958) proposed this definition, which looks at what would comprise the ideal mental state of an individual
• Deviation from ideal mental health definition

  • 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
  • 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
• 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

  1. Phobias are acquired through classical conditioning

  2. Phobias are maintained through operant conditioning
• 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 may be a greater motivator than avoiding anxiety
  • Alternative explanation for the acquisition of phobias (Seligman) - We are more likely to develop phobias towards 'prepared' stimuli
• Behavioural approach to treating phobias - 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, only progressing to the next level when they have remained calm in the present level
• Systematic desensitisation


  • Relies upon the principle of counterconditioning - learning a new response to the phobic stimulus i.e. one of relaxation rather than panic
  • Works due to reciprocal inhibition - it's impossible to be both relaxed and anxious at the same time
• Supporting evidence for systematic desensitisation

  • Gilroy et al. followed up 42 patients treated in three sessions of systematic desensitisation for a spider phobia, and compared their progress to a control group of 50 patients who learnt only relaxation techniques
  • At both 3 and 33 months, the systematic desensitisation group showed a reduction in their symptoms as compared to the 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 showed a reduction in symptoms compared to the control group
• Systematic desensitisation


  • Suitable for patients with learning difficulties
  • More acceptable to patients with low refusal and attrition rates
• Flooding


  Behavioural therapy designed to reduce phobic anxiety in one session, through immediate exposure to the phobic stimulus
• Flooding occurs in a secure environment from which the patient cannot escape, so avoidance behaviour is not reinforced
• Flooding relies on the principle that it is physically impossible to maintain a state of heightened anxiety for a prolonged period
• Flooding is cheaper than cognitive therapies


  Because the patient's phobia will typically be cured in one session
• Flooding is less effective for complex phobias like social phobias, as cognitive therapy may be more appropriate