Psychopathology

• One definition of abnormality is deviation from social norms. This is when a person behaves in a way that is outside of what we would expect. This can either be explicit (the law) or implicit (a social norm)
• An example of abnormality is antisocial personality disorder. A person with it might be impulsive, aggressive and irresponsible. This fits the definition of abnormality as it means the person does not conform to our moral standards.
• Another definition of abnormality is failure to function adequately. This is characterised by suffering, maladaptiveness, observer discomfort, unpredictability and irrationality.
• An example of failure to function adequately could be someone with schizophrenia. Because of their hallucinations they may suffer themselves and also cause discomfort to any observers because of their odd behaviour.
• Another definition of abnormality is deviation from ideal mental health. Jahoda's research into mental ill health suggested that ideal mental health is defined as positive attitudes toward the self, self-actualisation of one's potential, resistance to stress, personal autonomy, accurate perception of reality and adapting to the environment.
• A strength of deviation from ideal mental health is it gives individuals something positive to aim for. A weakness is that it lacks validity as many people without mental illness don't meet this criteria.
• The behavioural characteristics of a phobia include behavioural: panic, avoidance, emotional: anxiety, fear, cognitive: selective attention, irrational beliefs.
• The behavioural explanation of phobias suggests that phobias are learned through conditioning. The two process model explains that the phobias is acquired via classical conditioning and maintained via operant conditioning.
• Watson and Rayner did an experiment with little Albert on how phobias are acquired. They found support for the idea of classical conditioning as they showed him a white rat alongside a loud noise which created a fear response to the rat on its own. Stimulus generalisation also occurred where little Albert also showed fear to similar furry items like a rabbit and a dog. Internally valid but poor population validity.
• Systematic desensitisation is based on the belief that abnormality can be removed through counterconditioning. It uses a concept called reciprocal inhibition which is where a person learns to feel relaxed in the presence of a phobic stimulus. This works because it is impossible to feel fear and relaxation at the same time
• There are three stages to systematic desensitisation: the fear hierarchy, relaxation and exposure.
• Gilroy et Al examined 42 patients who had received systematic desensitisation for arachnophobia. Compared to a group that had only had relaxation technique training the therapy group showed less fear.
• A weakness of systematic desensitisation is that it is not appropriate for all phobias, such as those that have an underlying evolutionary survival component
• Scientific support for flooding: in 1970 a young girl who was afraid of cars was driven around for 4 hours. At first she was hysterical, but she soon calmed down and realised that she was not in danger. This cured her phobia.
• The behavioural characteristics of depression are: low activity levels, disruption to sleep and eating, aggression and self-harm.
• The emotional characteristics of depression are: lowered mood, anger and lowered self-esteem.
• The cognitive characteristics of depression are: poor concentration, focussing on the negative and absolutist or 'black and white' thinking.
• The cognitive approach suggests that negative thinking is caused by cognitive bias. For example, all or none thinking, arbitrary inferences, overgeneralisation, catastrophising, selective abstraction and excessive responsibility.
• The behavioural characteristics of OCD are compulsions such as excessive hand washing, and avoidance of anything that triggers anxiety.
• The emotional characteristics of OCD are anxiety and distress, accompanying depression, guilt and disgust.
• The cognitive features of OCD are obsessive thoughts, cognitive strategies and insight into excessive anxiety.
• Deviation from abnormality AO3:

  • Deviancy is related to subjective moral codes. What is abnormal varies between cultures and eras. There is little behaviour that would be considered universally abnormal due to breach of social norms. So the definition lacks cultural validity as a diagnosis wouldn't be universal.
  • This definition doesn't distinguish between eccentricity and abnormality. Some people may be socially deviant because they have chosen a non-conformist lifestyle. Therefore the definition lacks validity because it would diagnose mentally healthy people.
• FFA AO3:

  • May not be an accurate way to diagnose an abnormality because some people who have psych disorders can still function. E.g. people with antisocial personality disorder can be charming and manipulative which leads to success in relationships. So the definition is not a valid way to identify people who need psychological treatment.
  • A strength is that it considers the personal experiences of the patient by taking into account their level of suffering. It takes into account individual differences and only seeks to diagnose and treat people who are having a negative experience.
• One definition of abnormality is statistical infrequency. It uses the normal distribution curve with both extremes deemed abnormal and the middle regions as normal (95% of people). The cut-off point is put at +/- 2 Standard Deviations away from the mean on a measure of the behaviour. Any individual outside of this is considered abnormal. This approach works well when dealing with characteristics that can be reliably measured, e.g. intelligence. Only 2% of people have an IQ below 70. Those individuals scoring below 70 are liable to receive a diagnosis of ‘intellectual disability disorder’.
• Statistical Infrequency AO3:

  • weakness: stating that abnormalities are rare is not true. Many psychological disorders requiring treatment are actually very common, e.g. anxiety disorders affect around 18% of people. This is a problem for this definition because it would not accurately diagnose enough people with the condition as it is based on only the most infrequent 5%.
  • Strength: more objective than other explanations because it is less open to interpretation and bias; this means it is more likely to be reliable as all patients are being measured against a consistent standard.
• Deviation from ideal mental health AO3:

  • Strength: very comprehensive, takes a positive view by focussing on what is desirable. Covers a broad range of criteria which relate to the whole person. The big range of factors discussed in relation to ideal mental health makes it makes it clear to people the ways in which they could benefit from seeking treatment to improve their mental health
  • Weaknesses: characteristics are unrealistic and most people don't meet all of them, they are also based on western ideals e.g. individualistic cultures value personal autonomy more.
• The two-process model:

  • Classical conditioning - a person becomes fearful of a stimulus as they associate it with a past negative feeling or stimulus. At first it was a ‘neutral stimulus’. But at some point it became associated with something that does trigger a natural fear response. So the ‘neutral stimulus’ becomes ‘conditioned’ which results in the ‘conditioned response’ of fear.
  • Operant - An individual avoids a situation that may involve the phobic stimulus which results in a desirable consequence of no fear and so means the avoidance behaviour will be repeated (reinforced).
• Behavioural explaination of phobias AO3:

  • Strength: application to therapy. Systematic desensitisation helps people unlearn their fears through counterconditioning. However treatments which also focus on the thought processes, e.g. CBT, have been shown to be more successful than purely behaviourist treatments. So the explanation is reductionist as it focuses only on associations and consequences and not cognition.
  • weakness: it ignores biology. Many phobias are adaptive and based on survival mechanism, e.g. fear of snakes as they are deadly.
• Reciprocal inhibition is when a phobia is cured because a patient learns to become relaxed in the presence of a phobic stimulus. This works because it is impossible to be relaxed and afraid at the same time.
• Flooding stops phobic responses very quickly. This may be because, without the option of avoidance behaviour, the patient quickly learns that the phobic stimulus is harmless and that anxiety can only reach a peak and then begin to reduce. In classical conditioning terms this process is called extinction. A learned response is extinguished when the

  conditioned stimulus is encountered without the unconditioned stimulus. The result is that the conditioned stimulus no longer produces the conditioned response (fear).
• Cognitive explanation for depression AO1 - Ellis ABC model:

  A = Activating event: Irrational thoughts are triggered by external events. We get depressed when we experience negative events and these trigger irrational beliefs.

  B = (irrational) Beliefs: Mustubatory thinking is centred on unachievable assumptions that must be true in order for an individual to be happy e.g. to be liked by everyone.

  C = Consequences: When an activating event triggers irrational beliefs there are emotional and behavioural consequences. E.g, if you believe you must always succeed, then fail at something.
• Cognitive explanation for depression AO3 - Ellis' ABC model:

  strength - helps people understand their experience and provides a practical application for therapy such as ABCDE model of therapy

  weakness - link between cognitions and depression may be correlational not causal, other underlying causes like biology/trauma.
• Cognitive explanation for depression - Beck's negative triad AO1:

  • Individuals feel depressed because their thinking is biased towards a negative interpretation of the world, the future and themselves.
  • This is due to a negative 'self-schema' developed during childhood due to criticism. They will then expect to fail, feel responsible for misfortune and undervalue themselves due to this schema.
  • They are more likely to focus on the negatives in any situation. This results in them making faulty interpretations aka ‘cognitive biases’. Examples include All or none thinking and Catastrophising.
• Cognitive explanation for depression AO3 (Beck/Ellis):

  • Boury et al. monitored ps’ negative thoughts with the Beck Depression Inventory. A + correlation was found between negative thoughts and severity of depressive symptoms. However, correlations do not show cause and effect relationship as depression may cause negative thinking, not vice versa.
  • Reductionist - focus on faulty thought processes, ignoring other causes. However, has led to development of CBT which changes thought processes to reduce symptoms. CBT is found to be the best treatment, although it works best with drugs.
• Cognitive treatment for depression AO1:

  • Step 1 is for the therapist build a trusting relationship with the patient so they feel comfortable. They jointly identify goals and make a plan to achieve them.
  • The aim is to identify thoughts about the world, the self and the future – the negative triad. These then must be challenged by 'reality-testing'.
  • The patient may be set homework e.g. to record when people were nice to them. This is called the ‘patient as scientist’, testing the reality of their beliefs. Later, the therapist can use this evidence to prove the patient’s beliefs are incorrect.
• Cognitive treatment for depression AO3 strengths:

  • March et al. compared 3 groups of 300+ adolescents with depression. One received CBT only, one drugs only and the other both. After 36 weeks 81% of only CBT, 81% of onlydrugs and 86% of combined were significantly improved. So CBT was just as effective as medication and helpful in combination.
  • Very problem orientated, individuals are active collaborators so it is flexible in meeting individual needs. This takes into account individual differences so is effective for different people and does not involve negative side effects like drugs.
• Cognitive treatment for depression AO3 weaknesses:

  • Depression can be so severe that patients cannot motivate themselves for the hard cognitive work of CBT. In this case it is possible to treat patients with antidepressants and commence CBT when they are more alert and motivated. This suggests cognitions are not the only cause of depression.
  • Criticised for not examining a patient’s personal/family history. This is important; some psychodynamic psychologists suggest abuse may be a stress factor that triggers the disorder. However this makes it more ethical as it does not blame family members.
• Biological approach to explaining OCD AO1 - neural:

  • Neurotransmitters relay information between neurons. If a person has low levels of serotonin then normal transmission of mood relevant information does not take place and mood is affected. OCD has been linked to reduced levels of serotonin as antidepressants that increase serotonin levels are effective in reducing OCD symptoms.
  • OCD has been associated with impaired decision making. This may be because of abnormal functioning of the frontal lobe of the brain. The frontal lobe is responsible for logical thinking and making decisions.
• Biological approach to explaining OCD AO1 - genes:

  • Focuses on finding the specific candidate genes implicated vulnerability to OCD. OCD is a ‘polygenic’ condition; up to 230 genes are implicated. This may explain why there are varying types of OCD as genes may combine differently in each type.
  • Candidate genes: The SERT gene affects the transport of serotonin, creating lower levels. One study found a mutation of this gene in two unrelated families where 6/7 had OCD. The COMT gene regulates dopamine. The variation which leads to higher levels of it is more common in people with OCD.
• Biological approach to explaining OCD AO3 - research:

  • Lewis observed that of his OCD patients 37% had parents with OCD and 21% had siblings with OCD
  • Twin studies have found that 68% of identical twins shared OCD as opposed to 31% of non-identical twins who only share 50% of their genes.
  • Diathesis-stress model - certain genes dispose people to mental disorders but some stress is necessary to trigger them. Identical twin rates are 68% and not 100% which it would be if OCD were totally genetic. Therefore there must be some environmental causes of OCD so it isn't totally biological.