Psychopathology

• Definitions of abnormality


  • Deviation from social norms
  • Social norms are unwritten behavioral expectations that vary depending on culture, time and context
  • Social deviants are individuals who break the norms of their society and are seen as abnormal
• Examples of behaviors showing high cultural specificity are tolerance to homosexuality, religious experience and public displays of emotion
• Evaluations using social norms does not impose a western view of abnormality on other non-western cultures
• Diagnosing abnormality according to social norms can be inappropriate for example people from afro caraban background living in the UK are seven times more likely to be diagnosed with schizophrenia
• Failure to function adequately


  When individuals cannot cope with the day-to-day challenges of daily life such as maintaining personal hygiene
• Features of failure to function adequately


  • They show maladaptive behavior
  • Their irrational, unpredictable actions go against their long-term best interests
  • They show personal anguish and observers feel discomfort in their presence
• Evaluations of failure to function respects the individual and their own personal experience which is something that other definitions such as statistical infrequency and deviation from social norms cannot do
• Failure to function adequately only includes people who cannot cope, psychopaths often function in society in ways that benefit them personally having low empathy can lead to success in business and politics
• Statistical infrequency


  Someone is mentally abnormal if their mental condition is very rare in the population
• The normal distribution curve shows a population's average spread of specific characteristics
• One element of diagnosis of intellectual disability disorder in the DSM 5 is having 70 IQ points or fewer, just over 2% of the population
• Individuals who are assessed as being abnormal according to statistical infrequency have been evaluated objectively, this is better than other definitions that depend on the subjective opinion of a clinician
• Not all statistically rare traits are negative, for example IQs of 130 are just as statistically rare as IQs of 70
• There are common mental health conditions like anxiety, the NHS found 17% of people surveyed met the criteria for a common mental health disorder
• Deviation from ideal mental health

  A humanistic definition by Joda in 1958 rather than defining abnormality it defines features of ideal mental health and deviation from these indicates abnormality
• The six features of ideal mental health


  • Environmental mastery
  • Autonomy
  • Resisting stress
  • Self-actualisation
  • Positive attitude to yourself
  • Accurate perception of reality
• This is a holistic definition as it considers multiple factors in diagnosis and provides suggestions for personal development, it's too strict to set of criteria to define mental health as it's challenging to achieve all of the requirements at any one time
• Most people would be defined as abnormal according to this definition
• Characteristics of phobias, depression and OCD


  • Phobias: Behavioral avoidance, physically adapting normal behavior to avoid phobic objects, panic, failure to function, emotional anxiety, cognitive irrational thoughts
  • Depression: Behavioral reduction in activity level, change in eating behavior, emotional sadness, cognitive poor concentration, negative schemas
  • OCD: Behavioral compulsions, avoidance, emotional anxiety, cognitive obsessions, hypervigilance
• The behavioral approach to explaining and treating phobias

  1. Acquisition: Classical conditioning suggests a phobic object changes from being a neutral stimulus with no fear response to a conditioned stimulus with a fear response

  2. Maintenance: Operating conditioning suggests avoidance behavior leads to a reduction in anxiety which is a pleasant sensation, this negative reinforcement strengthens the phobic response

  3. Generalization: A conditioned fear response is also experienced in the presence of stimuli that similar to the conditioned stimulus
• Behaviorist principles have been practically applied to counterconditioning therapies, systematic desensitization and flooding, as these treatments are effective
• Humans also don't often display phobic responses to objects that cause the most pain in day-to-day life such as knives or cars, however phobias of snakes and spiders are more common, these phobias may be better explained by evolutionary theory
• Counterconditioning therapies


  1. Systematic desensitization: The therapist first teaches relaxation techniques then progresses through an anxiety hierarchy from the least feared presentation to the most

  2. Flooding: Immediate and full exposure to the maximum level of the phobic stimulus, this will cause temporary panic in the client until a temporary panic has stopped due to exhaustion
• Compared to flooding, systematic desensitization is a more pleasurable experience for the client as they limit their anxiety, however flooding isn't appropriate for older people
• Both systematic desensitization and flooding are more effective in treating specific phobias than social phobias
• The use of VR allows a wider range of phobias to be treated, 83% of participants treated with VR exposure to spiders improved compared to 0% to the control
• The effects of systematic desensitization and flooding may be limited to the controlled environment of a therapist's office and may not translate to real world experiences
• The cognitive-behavioral approach to explaining depression


  • Beck's negative triad: Persistent automatic negative bias about the self, the world, and the future
  • Ellis's ABC model: A is the activating event, B is the belief about A, C is the consequence of the belief
• Grisoli and Terry found women with negative thinking styles were the most likely to develop postpartum depression, this supports the idea that faulty thinking leads to depression
• People with bipolar depression experience manic phases where they feel extremely happy, over excited, confident and focused, this is a problem for Beck's theory which explains depression is due to negative schemas which are resistant to change
• CBT and drug therapy both had an effectiveness rate of 81% after 36 weeks of treatment, the fact these treatments are successful suggest the underlying cognitive explanations they have based on are valid
• Some people with depression are too severely depressed to engage with the demands of CBT, completing homework, challenging irrational thoughts and attending sessions require motivation and commitment
• The biological approach to explaining OCD


  • Genetic explanation: OCD is inherited, genetic analysis has revealed around 230 separate candidate genes found more frequently in people with OCD
  • Neural explanation: Low serotonin levels, overactive worry circuit in the brain including the orbital frontal cortex, basal ganglia system and thalamus
• The concordance rate for monozygotic twins is 68%, not 100%, suggesting there must be some role for the environment in OCD
• The dysaestress explanation combines a genetic vulnerability to OCD with an environmental stressor needed for the disorder to develop
• Drug therapies for OCD


  1. SSRIs: Selective serotonin reuptake inhibitors, inhibit the reuptake of serotonin in the synapse

  2. Benzodiazepines: Work by enhancing the neurotransmitter GABA, slowing the central nervous system

  3. Tricyclics and SNRIs: Increase serotonin and norepinephrine, can be effective when SSRIs fail but have more side effects
• SSRIs significantly reduced symptoms of OCD compared to placebos between 6 and 17 weeks post treatment, suggesting drug therapy is effective in the short term
• Most research studies on drug therapies are conducted by the pharmaceutical companies that created them, potentially biasing results in comparison to psychological therapies like CBT
• Drug therapy is relatively inexpensive to the NHS and potentially more convenient for patients, but can have a range of potential side effects