Psychopathology

• Definitions of abnormality:

  • statistical in frequency = any behaviour that is statistically rare is abnormal
  • example = IQ and intellectual disability disorder only 2% have an IQ below 70
  • +used in clinical practice as part of diagnoses and using Beck depression inventory
  • -makes assumption that abnormal characteristics are negative but having an IQ above 130 would rarely be looked down upon as a negative characteristic in need of treatment
• definition of abnormality:

  • failure to function adequately = an individual's behaviour will interfere in their functioning and cannot meet demands of day to day life
  • example = depression
  • +has a sensible threshold for when people need professional help as most people will have symptoms of mental health disorder to some degree at some time - treatments are targeted to those who need them most
  • -easy to label non-standard life choices as abnormal - for example travelling or favouring high risk activities, meaning people who make unusual choices are at risk of being labelled abnormal
• definitions of abnormality:

  • deviation from social norms = behaves in a way that is different from what we expect
  • example = OCD
  • +real world application - diagnosis of antisocial personality disorder failure to conform to culturally acceptable ethical behaviour e.g. aggression - classed as abnormal as it is not acceptable in most societies
  • -variability of social norms in different cultures and situations - experience of hearing voices is normal in some cultures but would be seen as a sign of abnormality in UK - difficult to judge deviation form social norms across different cultures
• definitions of abnormality:

  • deviation from ideal mental health = Jahoda suggested 8 criteria for ideal mental health (no ditress, realistic view of world, independent) anyone with one or more missing would be abnormal
  • example = depression
  • -sets unrealistically high standard for mental health
  • -some of Jahodas ideal mental health are specific to western europe and north america self actualisation would be considered self indulgent in some parts of the world
• behavioural characteristics of phobias:

  Panic, Avoidance

  emotional characteristics of phobias:

  Anxiety, emotional responses are irrational

  cognitive characteristics of phobias:

  selective attention(difficulty focusing on anything else), irrational beliefs
• behavioural characteristics of depression: changed activity levels, changed patterns in eating

  emotional characteristics of depression: lowered self-esteem, constant poor mood

  cognitive characteristics of depression: selective attention to negative events, absolutist thinking
• behavioural characteristics of OCD: compulsions, avoidance behaviour

  emotional characteristics of OCD: guilt, depression, anxiety

  cognitive characteristics of OCD: acknowledgement that their anxiety is irrational and excessive and obsessive thoughts
• behavioural approach to explaining phobias:

  • emphasises the role of learning in gaining a phobia
  • Mowrer suggested that phobias are acquired through classical conditioning and then maintained through operant conditioning (two process model)
  • classical conditioning involves learning to associate something which we initially have no fear with something that already triggers a fear response
  • avoiding phobic stimulus is negatively reinforced and likely to be repeated - maintaining phobia
• behavioural approach to explaining phobias evaluation: (two process model)

  +real world application in exposure therapies - used to develop systematic desensitisation and flooding - help people to unlearn fears

  -does not account for cognitive aspects of phobias - irrational beliefs

  +evidence for bad experience and phobias - little albert study - frightening experience with stimulus leads to fear of that stimulus

  -not all phobias stem from bad experiences - e.g. snake phobia few people have encountered a snake - biological preparedness
• behaviourist treatment for phobias: (flooding)

  • designed to reduce phobic anxiety in one session through immediate exposure to phobic stimulus - physically impossible to maintain state of heightened anxiety for a long time
  • +cost effective
  • -unpleasant experience - ethical - causing stress to clients
• behaviourist treatments of phobias: (SD)

  • reduce phobic anxiety through gradual exposure to phobia, starting by drawing up an anxiety hierarchy ordered from least to most nerve wracking and teaches patient relaxation techniques (breathing) only progressing to next level when remained calm at current level
  • +supporting research Gilroy followed 42 patients with 3 sessions of SD for spider phobia. control group was treated by relaxation. SD group were less fearful of spiders than the control group
  • +patients prefer it - low refusal rates and more likely to finish - increases effectiveness
• cognitive explanations of depression: Beck

  1. cognitive bias - people with depression are more likely to focus on negative aspects of a situation
  2. negative self schemas interpret info about themselves in a negative way - developed during childhood
  3. negative triad - cognitive bias and negative self schemas maintain negative triad - negative view of world, negative view of self, negative view of future
• cognitive explanations of depression: ellis

  abc stage model to explain how irrational thoughts can lead to depression

  A - activating event

  B - belief (interpretation of the event)

  C - consequence (rational belief = healthy emotional outcome)

  (irrational belief = unhealthy emotional outcome e.g. depression)
• cognitive explanation of depression evaluation (BECK)

  +applications in screening and treatment of depression - assessing cognitive vulnerability in young people - identify those most at risk and monitor them

  +existing evidence of supporting research - patients with depression were more likely to misinterpret info (cognitive bias) and feel hopeless about their future (negative triad) - findings support different aspects of becks theory
• cognitive explanation of depression evaluation (ELLIS)

  +real world applications - ellis's approach to cognitive therapy (REBT) therapist can change irrational beliefs by arguing with patient - relieve symptoms of depression - real world value

  -only explains reactive and not endogenous depression - many cases of depression are not traceable to life events - ellis's model can only explain some cases of depression
• cognitive approach to treating depression -

  Beck - CBT aims to identify and challenge irrational thoughts and treating depression - aims for patients to test reality of their beliefs - homework, patient as scientist

  Ellis - REBT identify patients thoughts and identify them as irrational - logical dispute (questions logic), empirical dispute (seeks evidence for thoughts) and patient homework (provide further counter-evidence for irrational beliefs
• cognitive treating depression evaluation:

  +evidence supporting effectiveness - compared with antidepressants CBT was just as effective + even more so when combined with drugs - widely seen as first choice in NHS

  -lack of effectiveness for severe cases of depression - can't motivate themselves to engage with CBT, unsuitable for clients with LD

  -high rates of relapse - concerns over long term effectiveness of CBT - 42% relapsed after 6 months

  -focus on patients present - other therapies focus on links into childhood - CBT may ignore important aspects of patients of depression experiences
• biological explanations of OCD: Genetic

  stress-diathesis model - some have a genetic vulnerability to depression Lewis 37% of OCD patients had parents with OCD and 21% had siblings with OCD

  SERT gene affects transport of serotonin which is associated with OCD, OCD is polygenic - 230 genes may be involved with OCD
• biological explanations of OCD: Neural

  if a person has low levels of serotonin then normal transmission of mood relevant info does not take place and a person may experience low mood

  some cases of OCD can be explained by a reduction in the functioning of the serotonin system in the brain this has been associated with abnormal functioning in the frontal lobes of the brain - this area is responsible for logical thinking and decision making
• biological treatments of OCD: SSRIs

  SSRIs prevent the reabsorption and breakdown of serotonin which effectively increases its levels in the synapse. this compensates for whatever is wrong with the serotonin system in OCD

  will start at lowest does and then gradually increase if symptoms do not improve