psychology- 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. This is used to assess the severity of the disorder e.g. the idea that Schizophrenia only affects 1% of the general population, but subtypes are even less frequent (such as hebephrenic or paranoid Schizophrenia)
• Statistical infrequency makes the assumption that any abnormal characteristics are automatically negative, whereas this is not always the case. For example, displaying abnormal levels of empathy (and thus qualifying as a Highly Sensitive Person) or having an IQ score above 130 (and thus being a genius) would rarely be looked down upon as negative characteristics which require treatment
• 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
• This occurs when the patient does not obey social and interpersonal rules (e.g. standing precariously close to others), are in distress or are distressing, and their behaviour has become dangerous (not limited to themselves, but may also pose a danger to others)
• 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. This 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
• A major weakness of using this definition of abnormality is the idea that it 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. Instead, such labelling could lead to discrimination or prejudice faced against them by employers and acquaintances
• 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. For example, in the nineteenth century within Great Britain, 'nymphomania' described the mental health disorder suffered by women who demonstrated sexual attractions towards working-class men. In reality, this diagnosis was simply made to prevent infidelity, cement the differences between social classes and further discriminate against women, thus being a reflection of a patriarchal society
• Due to its reliance on subjective social norms, this explanation also suffers from cultural relativism. One such example would be the hearing of voices which have no basis in reality, or 'hallucinations'. Some African and Asian cultures in particular would look upon this symptom positively, viewing it as a sign of spirituality and a strong connection with ancestors, as opposed to a symptom of Schizophrenia. This therefore suggests that the use of this definition of abnormality may lead to some discrepancies in the diagnoses of mental health disorders, between cultures
• Deviation from ideal mental health definition of abnormality


  Instead of focusing on abnormality, Jahoda looked at what would comprise the ideal mental state of an individual. The criteria include being able to self-actualise (fulfill one's potential, in line with humanism!), 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 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. This means that the majority of the population would be considered abnormal, even if they have missed a single criteria e.g. being able to rationally cope with stress (which most people would agree does not merit a diagnosis). Therefore, deviation from ideal mental health may be considered a very limited method of diagnosing mental health disorders
• This definition, just like deviation from social norms, suffers from cultural relativism. For example, the concept of self-actualisation, which suggests that we must each put ourselves first in order to achieve our full potential, may be viewed as selfish in collectivist cultures (e.g. China) where the needs of the group are valued more than the needs of the individual. On the other hand, self-actualisation may be a more popular concept in individualist cultures (e.g. the UK), where personal achievement is celebrated and the needs of the individual are greater than the needs of the group. This suggests that deviation from ideal mental health would only be accepted as a definition for abnormality in some (individualist) 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. Therefore, avoidance severely impacts the patient's ability to continue with their day to day lives
• 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. 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 e.g. mycophobia (a phobia of mushrooms) and rectaphobia (a phobia of bottoms)
• Behavioural characteristics of depression


  • Changed activity levels
  • Aggression
  • Changed patterns of sleeping and eating
• 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
• Acquisition and maintenance of phobias

  1. Classical conditioning

  2. Operant conditioning
• Acquisition of phobias


  • Watson and Rayner's experiment with Little Albert
• Operant conditioning


  A 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. For example, he uses the example of social anxiety phobias - such sufferers can venture out into public but only with a trusted friend, despite still being exposed to hundreds of strangers which would usually trigger their anxiety. This means that Mowrer's explanation of phobias may be incomplete and only suited for some
• Seligman suggested that we are more likely to develop phobias towards 'prepared' stimuli. These are stimuli which would have posed a threat to our evolutionary ancestors, such as fire or deep water, and so running away from such a stimulus increases the likelihood of survival and reproduction, and so this behaviour has a selective evolutionary advantage. This means that alternative theories can explain why some phobias (i.e. towards prepared stimuli) are much more frequent than other phobias (i.e. towards unprepared stimuli)
• Systematic desensitisation


  1. Gradual exposure to the phobic stimulus

  2. Learning a new response of relaxation rather than panic

  3. Reciprocal inhibition (impossible to be both relaxed and anxious at the same time)
• Gilroy et al. followed up 42 patients treated in three sessions of systematic desensitisation for a spider phobia. Their progress was compared to a control group of 50 patients who learnt only relaxation techniques. The extent of such phobias was measured using the Spider Questionnaire and through observation. At both 3 and 33 months, the systematic desensitisation group showed a reduction in their symptoms as compared to the control group, and so has been used as evidence supporting the effectiveness of flooding
• Systematic desensitisation is suitable for many patients, including those with learning difficulties. Anxiety disorders are often accompanied with learning disabilities meaning that such patients may not be able to make the full cognitive commitment associated with cognitive behavioural therapy, or have the ability to evaluate their own thoughts. Therefore, systematic desensitisation would be a particularly suitable alternative for them
• Behavioural therapy


  Designed to reduce phobic anxiety through gradual exposure to the phobic stimulus
• Counterconditioning


  Learning a new response to the phobic stimulus i.e. one of relaxation rather than panic
• Reciprocal inhibition


  It's impossible to be both relaxed and anxious at the same time