psychopathology

• statistical infrequency

  - abnormality is defined as behaviour or characteristics that are extremely rare

  - occupies the extreme ends of a normal distribution curve,

  uses up-to-date statistics

  - uses median, mean, mode to determine was is ‘typical’ data

  - uses standard deviation to determine what is abnormal

  - e.g low IQ defined as intellectual disability disorder; OCD as a rare disorder
• statistical infrequencyis a good starting point for diagnosis

  those who are more than 2 SD from the average are diagnosed with intellectual disability disorder
• deviation from social norms

  anyone who deviated from socially created norms (standards of acceptable behaviour) is classed as abnormal
• failure to function adequately


  when a person is unable to cope with the demands of everyday life their behaviour may cross the line between normal and abnormal

  
  

  - unable to meet basic standards of nutrition and hygiene

  - cannot maintain relationships or a job

  
  

  when a person experiences severe personal distress or causes others severe stress is a good marker to determine if someone is coping or not
• deviation from ideal mental health


  deviation from characteristics required to meet on Jahoda's criteria of ideal mental health

  criteria:

  - ability to self-actualise

  - realistic view of the world and ourselves

  - independent of other people

  - having environmental mastery
• cultural relativism


  behaviour cannot be judged outside the context of the culture it originates from
• emotional characteristics of depression


  - Loss of interest and pleasure in activities

  - Feelings of worthlessness and low self-esteem

  - Feelings of despair and lack of control over life
• behavioural characteristics of depression


  reduced energy levels, disruption to sleep and eating behaviour, aggression and self-harm
• cognitive characteristics of depression

  poor concentration, attention to and dwelling on negative, absolutist thinking
• emotional characteristics of phobias

  - persistent and excessive fear

  - anxiety and panic

  - unreasonable emotional responses
• behavioural characteristics of phobias

  panic, avoidance, freezing
• cognitive characteristics of phobias


  - Selective attention towards the phobic stimulus

  - Irrational beliefs

  - Recognition that their fear is excessive or unreasonable
• emotional characteristics of OCD


  Anxiety and distress, accompanying depression, guilt and disgust, shame and embarrassment
• behavioural characteristics of OCD

  compulsions and avoidance (of anxiety triggers)
• obsessions


  intrusive and recurring thoughts that cause distress
• compulsions


  repetitive behaviours performed to reduce anxiety
• cognitive characteristics of OCD


  Obsessive thoughts, cognitive strategies to deal with obsessions, insight into excessive anxiety
• phobia


  irrational fear of an object or situation that produces a conscious avoidance
• agoraphobia


  fear of open or public places - severe agoraphobia sometimes cannot leave house
• social phobia


  fear of a social situation such as public speaking
• the two process model


  phobias are acquired through classical conditioning

  - association made between object or situation and fear

  
  

  and obtained through operant conditioning

  - person avoids phobic stimulus

  - maintained through negative reinforcement through avoidance behaviour
• little albert


  aim was to establish whether emotional responses such as fear could be conditioned. whenever little albert played with a white rat, a loud noise was made in his ear. the rat didn't cause fear until it was paired with the noise, through classical conditioning he started associating the rat with fear.
• the two-process model has real-world application


  the idea that phobias are maintained by avoidance is important in explaining why people with phobias benefit from exposure therapies such as SD and flooding therapy

  - once avoidance behaviour is prevented it ceases to be reinforced by the reduction of anxiety and therefore avoidance behaviour declines

  - shows the value of the two-process model because it identifies a means of treating phobias
• link between phobias and bad experiences


  - 73% of dental phobics had experienced a trauma involving dentistry- control group of people with low dental anxiety where only 21% had experienced a related traumatic event- highlights association between a stimulus and an unconditioned response leading to a phobiaHowever,not all phobias appear following a bad experience- snake phobias occur in populations where very few people have any experiences of snakes- not all frightening experiences result in phobias- behavioural theories don't provide an explanation for all phobias
• incomplete explanation of phobias


  the two process model explains phobic behaviour in the case of avoiding the phobic stimulus

  - we know that phobias have a significant cognitive component such as people having irrational beliefs about the phobic stimulus that requires further explanation

  - evolutionary factors may have an important role in phobias

  - we easily acquire phobias of things that have been a source of danger in our evolutionary past

  - phobia of the dark or snakes

  - it's adaptive to acquire such fears

  - biological preparedness is the innate disposition to acquire certain fears
• diathesis-stress model - phobias


  proposes that we inherit a genetic vulnerability for developing mental disorders however they will only manifest if triggered by a stressor such as a life event

  - not everyone who has been bitten by a dog develops a phobia of dogs which can be explained because they aren't biologically predisposed to develop phobias
• systematic desensitisation


  aims to gradually reduce anxiety through counterconditioning. the conditioned (phobic) stimulus is paired with relaxation which replaces the conditioned response of fear
• recipricol inhibiton


  process of inhibiting anxiety by substituting a competing response as two competing emotions cannot occur at the same time
• anxiety hierarchy


  constructed by patient in which feared situations are arranged from least to most anxiety provoking
• relaxation stage in SD


  therapist teaches the patient to relax using techniques such as deep breathing and meditation. they then work through the anxiety hierarchy and at each level is exposed to the phobic stimulus in a relaxed state.

  this is repeated over several sessions, starting at the bottom of the hierarchy. treatment is successful when the patient can stay relaxed in situations high on the anxiety hierarchy
• SD is not appropriate for all phobias


  - SD may not be effective in treating phobias that have an underlying survival component

  - fear of the dark

  - these fears have an evolutionary benefit rather than a phobia which has been acquired through personal experience
• comparison of SD to CBT


  SD is a relatively fast process that requires less effort from the patient than other treatments such as CBT which requires a lot of resilience from the patient in trying to understand their behaviour and apply insights

  - lack of thinking in SD means the technique is also useful for people who may lack insight into their motivation or emotions, such as children
• SD useful for people with learning disabilities


  the main alternatives of SD are unsuitable for people with learning disabilities

  - cognitive therapies require a high level of ration thought and flooding therapy is distressing

  - SD doesn't require understanding or engagement on a cognitive level and it's main aim is to teach relaxation which isn't distressing

  - SD often most appropriate treatment for some people
• effectiveness of SD


  researcher followed up on 42 patients who had SD for spider phobia and found that they were less fearful than a control group

  - second researcher concluded that SD is effective for the three types of phobias, and further research suggests that SD is likely to be helpful in treating phobias
• SD is overly reductionist


  - overlooks other factors therefore more likely to make errors

  - Wolpe developed systematic desensitisation and treated woman for fear of insects

  - no improvement in symptoms

  - he later discovered that her husband, who she had not being getting along with, was given insect as a nickname

  - lower level explanations can be dangerous for individuals
• flooding


  clients are directly exposed to the phobic stimulus repeatedly which allows them to see that there's no basis for their fear

  
  

  success of the therapy leads to the extinction of the fear when the CS no longer produces CR of fear

  - this stops phobic responses as they may not have the option to avoid the stimulus
• flooding is cost-effective


  not an expensive form of therapy yet is clinically effective. Flooding can be successful in just one session meaning more people can be treated at the same cost by flooding than SD or other therapies which may take longer
• individual differences - flooding


  it can be a highly traumatic procedure therefore it may not be suitable for every patient and some may quit during the treatment which reduces the effectiveness of the outcome- both patients and therapists rate flooding as more stressful than SD, thus there are ethical concerns about knowingly causing stress to clients, and the traumatic nature of flooding also leads to higher attrition rates compared to SD therefore patients must give informed consent to go ahead with treatmentHowever,for those patients who complete the full course of flooding therapy, the process appears to be an effective treatment and is relatively quick
• symptom substitution - flooding


  behavioural therapies don’t treat the cause meaning that symptoms are treated not removed and they can reappear in different forms

  However, symptom substitution is largely theoretical and there’s only relatively poor empirical evidence to support it
• less effective for some types of phobias


  - less effective for phobias such as social phobias because there's a cognitive aspect to it such as low self-esteem

  - CBT may be a more effective treatment for social phobias as it challenges irrational thoughts meaning it will challenge where the patient's irrational thoughts have stemmed from and help them to develop more rational ones