Psychopathology notes

• 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

  • Takes into account the patient's perspective, 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 statistics, as is the case with statistical infrequency
• Failure to function adequately definition


  • May lead to the labeling 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 seeks 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 definition of abnormality

  Instead of focusing on abnormality, it looks at what would comprise the ideal mental state of an individual, including being able to self-actualise one's potential, having an accurate perception of ourselves, not being distressed, being able to maintain normal levels of motivation to carry out day-to-day tasks and displaying high self-esteem
• The main issue with this definition of abnormality is that it may have 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
• This definition, just like deviation from social norms, suffers from cultural relativism
• 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 (the emotional consequence of the physiological response of panic) and an unawareness that the anxiety experienced towards the phobic stimulus is irrational (from an evolutionary perspective, the phobic anxiety is not proportionate to the threat posed by the stimulus)
• Cognitive characteristics of phobias

  • Selective attention to the phobic stimulus, irrational beliefs and cognitive distortions
• Selective attention


  The patient remains focused on the phobic stimulus, even when it is causing them severe anxiety. This may be the result of irrational beliefs or cognitive distortions
• 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, therefore it may often appear grossly distorted or irrational
• Behavioural characteristics of depression


  • Changed activity levels (may result in psychomotor agitation or an inability to wake up and get out of bed in the morning), aggression towards oneself and towards others (which may be verbal or physical), and changed patterns of sleeping and eating (insomnia and obesity on one end of the spectrum, whilst constant lethargy and anorexia may appear on the other)
• Emotional characteristics of depression

  • Lowered self-esteem, constant poor mood (lasting for months at a time and high in severity, therefore not simply 'feeling down'), and high levels of anger towards oneself and towards others
• Cognitive characteristics of depression

  • Absolutist thinking, attention towards negative events (patients with depression often recall only negative events in their lives, as opposed to positive), and poor concentration (the consequent disruptions to school and work add to the feelings of worthlessness and anger)
• Behavioural characteristics of OCD

  • Compulsions (repetitive and intrusive thoughts focused around the stimulus which reduce anxiety through being a method of acting upon obsessive thoughts) and avoidance behaviour (this avoidance behaviour is once again negatively reinforced in terms of classical conditioning because an individual who avoids the specific stimulus will avoid the anxiety associated with having to carry out compulsive behaviours)
• Emotional characteristics of OCD

  • Guilt and disgust, depression due to the constant compulsion to carry out compulsive/repetitive behaviours (which often interferes with day to day functioning and relationships), and anxiety associated with the acknowledgement that their obsessive thoughts are irrational, but despair at the fact that they will always lead to compulsive behaviours
• Cognitive characteristics of OCD


  • The patient's acknowledgement that their obsessions are excessive and irrational (a hallmark of OCD), the development of cognitive strategies to deal with obsessions (such as always carrying multiple bottles of hand sanitiser) and obsessive thoughts (these are repetitive, focus on the stimulus, are intrusive, cause excessive amounts of anxiety and lead to compulsive behaviours)
• Behavioural Approach to Explaining Phobias

  1. Mowrer suggested that phobias are acquired through classical conditioning and then maintained through operant conditioning

  2. Watson and Rayner demonstrated how Albert associated the fear caused by a loud bang with a white rat

  3. Operant conditioning takes place when behaviour is rewarded or punished: For example, phobics practice avoidance behaviours, meaning that they avoid the phobic stimulus. By avoiding this phobic stimulus, they avoid the associated fear. By avoiding such an unpleasant consequence, the avoidance behaviour is negatively reinforced and likely to be repeated again, hence maintaining the phobia
• Behavioural Approach to Explaining Phobias

  • Good explanatory power - The main advantage of this theory is that it can explain the mechanism behind the acquisition and maintenance of phobias, which classical or operant conditioning alone cannot do. This translates to practical benefits in systematic desensitisation and flooding
• Buck suggested that safety is a greater motivator for avoidance behaviour rather than simply avoiding the anxiety associated with the phobic stimulus
• Seligman suggested that we are more likely to develop phobias towards prepared stimuli (stimuli which would have posed a threat to our evolutionary ancestors) than unprepared stimuli
• Systematic Desensitisation


  1. A behavioural therapy designed to reduce phobic anxiety through gradual exposure to the phobic stimulus, based on the principle of counterconditioning (learning a new response to the phobic stimulus, i.e. one of relaxation rather than panic)

  2. The patient and therapist draw up an anxiety hierarchy, the patient learns relaxation techniques, and they work their way up the hierarchy, only progressing to the next level when they have remained calm in the present level
• Systematic desensitisation is suitable for many patients, including those with learning difficulties, and has low refusal and attrition rates
• Flooding


  A behavioural therapy designed to reduce phobic anxiety in one session, through immediate exposure to the phobic stimulus in a secure environment from which the patient cannot escape without the option of practising avoidance behaviour
• Flooding relies on the principle that it is physically impossible to maintain a state of heightened anxiety for a prolonged period, meaning that eventually the patient will learn that the phobic stimulus is harmless
• Flooding is compared to cagn
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