Psychopathology

• Psychopathology

  Describes a wide array of mental health conditions, including but not limited to depression, anxiety disorders, bipolar disorder, schizophrenia and various personality disorders
• Definitions of abnormality

  • Statistical infrequency
  • Deviation from social norms
  • Failure to function adequately
  • Deviation from ideal mental health
• Statistical infrequency

  Behaviours that are statistically rare should be seen as abnormal. Statistics are gathered which claim to measure certain characteristics and behaviours.
• Statistical infrequency - Evaluation

  Strengths

  • Can provide an objective way, based on data to define abnormality
  • No value judgments are made - Homosexuality was defined as mental disorder under early versions

  Limitations

  • Fails to distinguish between desirable and undesirable behaviour
  • Many rare behaviours or characteristics have no bearing on normality or abnormality
• Deviation from social norms

  A persons thinking or behaviour is classified as abnormal if it violates the (unwritten) rules about what is expected or acceptable behaviour in a particular social group
• Deviation from social norms - Evaluation

  Strength

  • Comprehensive - Covers a broad range of criteria, most of which is why someone would seek help from mental health services
  • Gives a social dimension to the idea of abnormality

  Limitation

  • Social norms can vary from culture to culture
  • Unrealistic - Most people do not meet all the ideals because few experience personal growth all the time
• Failure to function adequately

  Refers to an abnormality that prevents the person from carrying out the range of behaviours that society would expect
• Rosenhan and Seligman (1989) - Personal dysfunction features

  Seven features:

  • Breaking social norms
  • Observer discomfort
  • Unpredictability
  • Low self esteem
  • Personal distress
  • Unconventionality
  • irrationality
• Failure to function adequately - Evaluation

  Strengths

  • Provides a practical checklist of seven criteria individuals can use to check their level of abnormality
  • Matches the sufferers' perceptions

  Limitations

  • FFA might not be linked to abnormality but to other factors
  • Cultural relativism, what may seem as functioning adequately in one culture may not be adequate in another
• Deviation from ideal mental health

  Marie Jahoda (1958) suggested six criteria necessary for ideal mental health. An absence of any of these characteristics indicates individuals as being abnormal
• Jahoda (1958) - Deviation from ideal mental health

  Six characteristics:

  • Positive attitude towards self
  • Self-actualisation
  • Resistance to stress
  • Autonomy
  • Accurate perception of reality
  • Mastery of the environment
• Deviation from ideal mental health - Evaluation

  Strengths

  • Comprehensive definition
  • Goal setting

  Limitations

  • Very difficult to meet all the criteria (suggests very few people are psychologically healthy)
  • Cultural relativism
• Classification of mental disorders

  Psychiatrists often use the diagnostic and statistical manual of mental disorders (DSM) to classify mental disorders and diagnose patients - in the UK the ICD-10 is used (both contain descriptions, symptoms and other criteria)
• DSM-5 categories of phobia

  All phobias are characterised by excessive fear and anxiety, triggered by an object, place or situation. DSM recognises specific phobia, social anxiety and agoraphobia as categories of phobias
• Specific phobia

  Excessive, distressing and persistent or anxiety about a specific object or situation
• Social anxiety

  Phobia of social situations
• Agoraphobia

  Phobia of being outside
• Behavioural characteristics (How we behave)

  Panic - Panic in response

  Avoidance - Avoid the phobic stimulus

  Endurance - Individual chooses to remain in presence
• Emotional characteristics (How we feel)

  Emotional responses - Being unreasonable and irrational

  Anxiety - Unpleasant state of high arousal

  Fear - Immediate reaction
• Cognitive characteristics (How we think)

  Selective attention - To the source of the phobia

  Cognitive distortions - Person's perception of the phobia can often be distorted
• Acquisition of phobias: Classical conditioning

  Pavlov (1903) explained dogs learned to salivate in anticipation of being fed rather than when actually being fed. Can be used to explain acquisition of phobia where a natural response that causes fear becomes associated with a neutral stimulus, so that the neutral stimulus by itself causes a fear response
• Acquisition of phobia: Operant conditioning

  The conditioned (learned) stimulus evokes fears, and avoidance of the feared object or situation lessens this feeling, which is rewarding. The reward (negative reinforcement) strengthens the avoidance behaviour, and the phobia is maintained
• Acquisition of phobia - Evaluation

  • Empirical support to show how classical conditioning leads to the development of phobias (Watson and Rayner - Little Albert)
  • Behaviourist approach adopts a limited in the origins of a phobia, overlooks the role of condition
  • Tomarken et al - found ppl with a fear of snakes overestimated the correlation between fear and shock
• Treatment of phobias - Systematic desensitisation

  Type of behavioural therapy based on classical conditioning - therapy aims to remove the fear response of a phobia and substitute a relaxation response to the conditional stimulus gradually using counter-conditioning (Will lead to extinction of fear response)
• Systematic desensitisation process

  1. Patient is taught deep muscle relaxation techniques and breathing exercises step is very important because of reciprocal inhibition (tension is incompatible with relaxation)
  2. Patient creates a fear hierarchy starting with stimuli that create the least anxiety and building up in stages to most fear-provoking
  3. Patient works their way up the fear hierarchy using the relaxation technique as they move up the hierarchy
• In vitro exposure

  The client imagines exposure to the phobic stimulus
• In vivo exposure

  The client is actually exposed to the phobic stimulus
• Systematic desensitisation - Evaluation

  • It relies on the client's ability to be able to imagine the fear situation
  • Slow process (6-8 sessions average)
  • Highly effective where the problem is learned anxiety, but is not effective in treating serious mental disorders (depression or schizophrenia)
  • Studies have shown the only important part is the exposure to the feared object or situation - therefore flooding may be more effective
• Treatments of phobias - Flooding

  Works by exposing the patient directly to their worst fears - thrown in the deep end. Aims to expose the sufferer to the phobic object or situation for an extended period of time in a safe and controlled environment (generally uses vivo exposure)
• Flooding process

  At first the person is in a state of extreme anxiety, but eventually exhaustion sets in and the anxiety levels begin to go down - now they have no choice but to confront their fears and when the panic subsides, they realise they come to no harm
• Flooding - Evaluation

  • Not an appropriate treatment for every phobia, should be used with caution as it can actually increase fear
  • Wolpe (1969) case where clients anxiety intensified so much from flooding that she became hospitalised
  • Some people will not be able to tolerate the high levels of anxiety induced by the therapy
  • Method confirms hypothesis that phobias are so persistent because the object is avoided in real life
• Obsessive Compulsive Disorder (OCD)


  An anxiety disorder characterised by intrusive and uncontrollable thoughts (obsessions) coupled with a need to perform specific acts repeatedly (compulsions)
• Compulsions

  The repetitive behavioural responses intended to neutralise these obsessions, often involving rigidly applied rules
• Genetic explanations of OCD


  OCD seems to be a polygenic condition where several genes are involved in its development:
• The SERT gene - Genetic explanations OCD


  Serotonin transporter appears mutated in individuals with OCD, the mutation causes an increase in transporter proteins at a neuron's membrane - leads to an increase in the reuptake of serotonin in neuron which decreases the level of serotonin in the synapse
• The COMT gene - Genetic explanations OCD 


  Gene that regulates the function of dopamine - appears this gene is also mutated in OCD people. Mutation causes the opposite effect - the COMT gene causes a decrease in COMT activity and therefore higher level of dopamine
• Genetic explanations OCD - Evaluation

  • Carey and Gottesman (1981) - found identical twins showed a concordance rate of 87% for obsessive symptoms and features compared to 47% in fraternal twins
  • Higher concordance rate found for identical twins may be due to nurture
  • OCD may be culturally rather than genetically transmitted as family members observe and imitate each other
  • Genes alone do not determine OCD, only create vulnerability
• Neural explanations of OCD

  An overactive PFC causes an exaggerated control of primal impulses (excessive impulse to keep washing hands to destroy germs)

  Reduced serotonin and dopamine may cause OCD
• Serotonin


  Thought to be involved in regulating mood - OCD patients have low levels
• Dopamine


  OCD have high levels - high levels have been thought to influence concentration