psychopathology

• Statistical infrequency


  According to the statistical definition, any relatively usual behaviour or characteristic can be thought of as "normal", and any behaviour that is unusual is "abnormal"
• IQ and intellectual disability disorder

  • In a normal distribution, most people (68%) have a score (in this case IQ) in the range from 85 to 115. Only 2% of people have a score below 70. Those individuals scoring below 70 are very unusual or abnormal, and are liable to receive a diagnosis of a psychological disorder- intellectual disability disorder (IDD)
• Statistical infrequency


  • It is useful in clinical practice, both as part of formal diagnosis and as a way to assess the severity of the individual's symptoms
  • Infrequent characteristics can be positive as well as negative
  • Not all statistically unusual people benefit from labels
• Deviation from social norms


  Groups of people (hence 'social') choose to define behaviour as abnormal on the basis that it offends their sense of what is 'acceptable' or the norm
• Homosexuality


  • Was considered abnormal in our culture in the past and continues to be viewed as abnormal and illegal in some cultures (e.g in April 2019, Brunei introduced new laws that make sex between men an offence punishable by stoning to death)
• Antisocial personality disorder (psychopathy)

  • A person with antisocial personality disorder is impulsive, aggressive and irresponsible. According to the DSM-5, one important symptom is an 'absence of prosocial internal standards associated with failure to conform to lawful and culturally normative ethical behaviour'
• Deviation from social norms


  • It is useful in clinical practice, as it is used in the diagnosis of disorders like antisocial personality disorder and schizotypal personality disorder
  • It is variable between social norms in different cultures and even different situations
  • It carries the risk of unfair labelling and leaving people open to human rights abuses
• Failure to function adequately


  A person may cross the line between 'normal' and 'abnormal' at the point when they can no longer cope with the demands of everyday life
• Intellectual disability disorder


  • One of the criteria for diagnosis is having a very low IQ (a statistical infrequency), but an individual must also be failing to function adequately before a diagnosis would be given
• Failure to function adequately

  • It represents a sensible threshold for when people need professional help
  • It is easy to label non-standard lifestyle choices as abnormal
  • Failure to function may not always be abnormal, e.g. in response to difficult circumstances
• Deviation from ideal mental health


  We consider what makes anyone 'normal' by looking at deviation from ideal mental health
• Criteria for ideal mental health (according to Marie Jahoda)

  • No symptoms of distress
  • Rational and can perceive ourselves accurately
  • Self-actualise (strive to reach our potential)
  • Can cope with stress
  • Have a realistic view of the world
  • Have good self-esteem and lack guilt
  • Are independent of other people
  • Can successfully work, love and enjoy our leisure
• Deviation from ideal mental health

  • It is a highly comprehensive definition that covers most reasons why we might seek help with mental health
  • Its different elements may not be equally applicable across cultures
  • The standards are extremely high and few people may attain them
• Cognitive distortions


  The perception of a person with a phobia may be inaccurate and unrealistic
• DSM-5 categories of depression

  • Major depressive disorder
  • Persistent depressive disorder
  • Disruptive mood dysregulation disorder
  • Premenstrual dysphoric disorder
• Behaviour changes in depression

  • Reduced activity levels
  • Disruption to sleep and eating behaviour
  • Aggression and self-harm
• Emotional characteristics of depression

  • Lowered mood
  • Anger
  • Lowered self esteem
• Cognitive characteristics of depression

  • Poor concentration
  • Attending to and dwelling on the negative
  • Absolutist thinking
• DSM-5 categories of OCD

  • OCD
  • Trichotillomania
  • Hoarding disorder
  • Excoriation disorder
• Behavioural characteristics of OCD

  • Compulsions are repetitive
  • Compulsions reduce anxiety
  • Avoidance
• Emotional characteristics of OCD

  • Anxiety and stress
  • Accompanying depression
  • Guilt and disgust
• Cognitive characteristics of OCD

  • Obsessive thoughts
  • Cognitive coping strategies
  • Insight into excessive anxiety
• Acquisition of phobias by classical conditioning

  1. Neutral stimulus paired with unconditioned stimulus

  2. Neutral stimulus becomes conditioned stimulus
• Maintenance of phobias by operant conditioning

  1. Avoidance of phobic stimulus reduces anxiety

  2. Avoidance behaviour is reinforced
• The two-process model does not account for the cognitive aspects of phobias
• Not all phobias appear following a bad experience
• Behavioural models provide individual explanations for phobias, but evolutionary theory may better explain general aspects
• Systematic desensitisation


  1. Anxiety hierarchy

  2. Relaxation

  3. Exposure
• Systematic desensitisation is effective for specific phobia, social phobia and agoraphobia
• Relaxation


  The therapist teaches the child to relax as deeply as possible. It is impossible to be afraid and relaxed at the same time, so one emotion prevents the other. This is called reciprocal inhibition.
• Relaxation techniques


  1. Breathing exercises

  2. Mental imagery techniques

  3. Meditation

  4. Drugs such as Valium
• Exposure


  1. Client is exposed to the phobic stimulus while in a relaxed state

  2. Starts at the bottom of the anxiety hierarchy

  3. Moves up the hierarchy as client can stay relaxed

  4. Treatment is successful when client can stay relaxed in situations high on the anxiety hierarchy
• Systematic desensitisation (SD)


  • Evidence of effectiveness
  • Can be used to help people with learning disabilities
  • Can be conducted in virtual reality
• Flooding


  • Exposing people with a phobia to their phobic stimulus but without a gradual build up in an anxiety hierarchy
  • Involves immediate exposure to a very frightening situation
  • Flooding sessions are typically longer than systematic desensitisation sessions
• How flooding works


  • Stops phobic responses very quickly
  • Client quickly learns that the phobic stimulus is harmless
  • Client may achieve relaxation due to exhaustion from their own fear response
• Flooding is not unethical but it is an unpleasant experience so it is important that clients give fully informed consent to this traumatic procedure and that they are fully prepared before the flooding session
• Evaluation of flooding


  • Cost-effective
  • Traumatic
  • Symptom substitution
• Beck's negative triad


  • Faulty information processing
  • Negative self scheme
  • Negative view of the world, the future and oneself
• Beck's cognitive model of depression suggests that a person develops a dysfunctional view of themselves because of three types of negative thinking that occurs automatically, regardless of the reality of what is happening at the time
• Evaluation of Beck's cognitive model of depression

  • Research support
  • Real-world application
  • A partial explanation