Abnormal psychology - past and present

Question 1

What is psychotherapy? Compare to counselling.

Answer 1

Talking therapy which aims to help you deal with emotional problems and mental health disorders - change behaviours thoughts and feelings. Uses clinical methods developed by psychologists.

Counselling - focuses on behaviours and immediate problems whereas psychotherapy focuses on deeper meaning behind behaviours.

Question 2

Define Mental health and mental disorder.

Answer 2

mental health is a state of well-being. Person realises own potential, can cope with normal stress, work productively, contribute to community.

mental disorder is a syndrome characterised by clinically significant disturbance in individuals cognition, emotion regulation or behaviour.

Question 3

What are Heuristic’s four D’s which characterise someone as abnormal?

Answer 3

Deviation from statistical norm

Dysfunction - does the issue interfere with individuals life

Distress - how much distress does it cause individual

Danger - does this constitute a danger to themselves or others

Question 4

Limitations of the 4 D’s.

Answer 4

Cultural subjectivity, something that is viewed as normal in one culture may be viewed as abnormal in another

Potentially a 5th D - duration.

People may not believe they are dysfunctional, that they are distressed by an action, or that they pose a danger to themselves - subjective to individual.

Something that has become very normal, but is actually abnormal - undiagnosed. E.g., alcohol at university. Could become severe and affect academic work and health, yet undiagnosed.

Question 5

Prehistoric views on abnormality and how its treated.

Answer 5

Regarded behaviour as work of evil spirits - supernatural

Treated with Trephination - stone instrument is used to cut a circular section of the skull.

Exorcism - coax the evil spirit to leave, a shaman or a priest recites prayers and insult evil spirits.

Question 6

Greek and Roman views and treatments.

Answer 6

Hippocrates - illnesses have natural causes.
Imbalance of the 4 fluids/ humours: yellow bile, black bile, blood and phlegm.

treatments to restore balance - more vegetables, exercise, quiet life.

Question 7

Middle Ages views on mental health and how to treat

Answer 7

Abnormal behaviour as a result of demons and Satan’s influence.

Exorcism

Sometimes amounted to torture to rid the evil spirits.

Started to run hospitals for the mentally ill - asylums.

Question 8

Renaissance views on mental disorders and treatment

Answer 8

Asylums more common.

Began to recognise the physical causes of mental disorders.

Rise in consideration for human welfare. Pinel (1745-1826) unchaining inmates - advocated for moral guidance and humane techniques.

Dorothea Dix - Mental Hygiene Movement.

Question 9

Emergence of the modern view

Answer 9

Emil Kraepelin (1856-1926) - importance of brain pathology in psychological disorder. Created system for classifying symptoms into discrete disorders. Measured effects of drugs on disordered behaviour.

Began to treat with methods like lobotomy.

Question 10

What is the medical model?

Answer 10

Contemporary approach which suggests that behaviour is affected by changes in the brain and nervous system - viewed same way as physical illness.

Question 11

Implications of the medical model

Answer 11

dichotomy between ‘normal’ and ‘disordered’ states - some people have symptoms and are not diagnosed.

Biological factors primary with disorders - social and psychological factors not considered

Diagnosis treated not disorder - fails to recognise the experience of the person.

Question 12

Diagnosis and classification of disorders with medical model - benefits and issues

Answer 12

DSM 5 and ICD 10

Benefits:

• same diagnosis around the world
• same treatments
• research focuses on same condition around the world.

Issues:

• consistency between inter rater judgements.
• symptom overlap
• cross-cultural inconsistencies - something considered normal in one culture may not be normal in another.

Question 13

What is meant by ‘culturally bound syndromes’ in classification

Answer 13

Disorders specific to certain cultures

25 listed in the DSM 4, but the DSM 5 considers culture-related diagnostic issues for each condition and lists 9 ‘cultural concepts of distress’
E.g., “Ataque de Nervios” amoungst people of Latino descent. Symptoms include intense emotional upset, crying, trembling and aggression.

Question 14

Benefits of diagnosis

Answer 14

• patients find helpful as is explains what is happening to them
• not alone with disorder
• reduce guilt feeling amongst family and themselves
• guides treatment plan
• facilitates access to service and support

Question 15

One consequence of diagnosis that affects the way people are seen and treated. Provide evidence.

Answer 15

Labelling with Rosenhan’s pseudopatient study.
8 individuals presented to hospitals and reported auditory hallucinations. They were admitted into hospital with schizophrenia. In hospital they behaved as normal however still remained in the hospital for 7-52 days. No staff detected, however some patients did. When released they were classed as schizophrenia in remission.

Labels - self-fulfilling prophecy - when labelled behaviour fits into it.

Question 16

Study conducted by Harris et al. - self fulfilling and stigma’s

Answer 16

Pairs on boys aged 6-12 years placed into two groups perceivers (typically developing boys) and targets (typically developing and ADHD)
Perceivers were told that the other boy in their pair had behavioural issues and got into trouble
To measure boys were provided with questionnaire (e.g., how well did your partner do?) and behavioural data (interactions videotaped and rated)
Findings stigma:
Targets were more negatively described.
Perceivers were less friendly and spent less time talking to targets.
Findings self-fulfilling:
Targets gave themselves lower self-credit for task.
Reported lower enjoyment.

Question 17

Criteria needed for an alternative to the medical model

Answer 17

According to Bennet:

• no dichotomy between normal and disordered state
• considers social and psychological factors
• make individual the focus of treatment
• consider non-pharmological interventions as primary

Dimensional approach where mental disorders exist on a spectrum