Abnormalities

Question 0

Deviation from Social Norms

Answer 0

Behaviour is viewed as abnormal if it does not fit in with the values and norms of that society e.g. A person who consistently cannot get themselves out of bad in the mornings to go to work because they are depressed.

Social Norms are learned during early socialisation and they differ between cultures; abnormal behaviour is usually judged negatively by society and will quite often be subject to censure or punishment

Question 1

What are definitions of abnormality?

Answer 1

Psychologists have identified various criteria that can be used to define behaviour as abnormal, these include Deviation from social norms, failure to function adequately, Deviation from Ideal Mental Health

Question 2

Evaluation of Deviation from Social Norms

Answer 2

Depends on context and degree

• How acceptable behaviour is judged is subjective and depends on who is doing it, where and when e.g. A student mumbling revision notes on the bus is more acceptable than someone who appears to have no reason to talk to themselves
• The important point here is that there is rarely any truly abnormal quality in the behaviour itself- abnormality is a function of the reaction to that behaviour by other people/society.

Question 3

Failure to Function Adequately

Answer 3

Under this definition, a person is considered abnormal if they are unable to cope with the demands of everyday life. E.g A person who is phobic of heights that she/he cannot go to their office on the 6th floor to do their job.

One of the main ways to identify how well an individual is functioning is through the Global Assessment of Functioning’, which provides a standardised scale for measuring quality of functioning; the higher the score out of 100, the more effectively the individual is functioning.

Question 4

Evaluation of Failure to Function Adequately

Answer 4

• Behaviour which is maladaptive on one level can sometimes be functional for that individual; e.g. Anorexics may enhance feelings of esteem by starving themselves (they feel more able to function in their day to day living by not eating)
• For people with eating disorders, normal eating behaviour could be a source of distress and may make normal functioning more difficult for them- who is to judge that they are not functioning adequately, especially if they don’t see a problem with it.

Question 5

Deviation from Ideal Mental Health

Answer 5

According to Jahoda (1958) it is more useful to define abnormality in terms of understanding what is normal behaviour rather than abnormal. Jahoda listed 6 characteristics of ideal mental health, and not possessing these would be seen as abnormal according to this definition.

• Being in touch with one’s own identity and feelings.
• Resistance to stress.
• Focused on the future and self-actualisation.
• Function as an autonomous individual and recognise their own needs.
• Have an accurate perception of reality, and be neither overly pessimistic nor overly optimistic.
• Be able to master the environment and adapt to change.

Question 6

Evaluation of Deviation from Ideal Mental Health

Answer 6

• Self-actualisation is a theoretically ideal concept that very few people are actually able to achieve. In order to self-actualise a person must reach the pinnacle of their abilities, ambitions and desires in life, but the majority of people comfortably settle for a situation somewhat below self-actualisation.
  
  • Being resistant to stress and not suffering from its consequences is an ideal state of mental health, however stress can actually be beneficial in some circumstances. Many sports people, actors, public speakers, etc actually perform better under a degree of stress.
  • Self-actualisation, personal autonomy, and recognising one’s own needs are particularly relevant to Western or individualistic cultures. Non-western or collectivist cultures value the success of a community rather than the individuals within it, yet they are not lacking in ideal mental health because of this.

Question 7

What are the Three Main Assumptions for the Biological Approach to Abnormality?

Answer 7

1) Biology, not the mind is what is important
2) Biological/Medical techniques will reveal the causes of abnormality
3) Behaviour has a genetic basis

Question 8

Biology, not the mind is what is important(Bio App)

Answer 8

Behaviour including abnormal behaviour is determined by genetic, psychological and neurological factors. Mental illnesses are simply physical illnesses that happen to have a cognitive, emotional or behavioral dimension.

Question 9

Evaluation (Biology, not the mind is what is important)

Answer 9

Treats the symptoms not the causes
- Critics suggest that therapies based on this approach treat symptoms not causes; because psychiatrists are not concerned with the ultimate reason for the patients illness they can never hope to offer the long term improvement that follows on from positive growth and change.

Question 10

Biological/Medical techniques will reveal the causes of abnormality (Bio App)

Answer 10

• Behaviour explained by neurontransmitters, brain structure and hormones
• Brain scans and studies of molecular biology of patients are the starting points fr the understanding of illness
• This contrasts with psychological approaches which see behaviour, thoughts or the mind as the starting point for understanding mental health disorders.

Question 11

Evaluation (Biological/Medical techniques)

Answer 11

Problems of cause and effect
- We can never be sure that changes in brain structure and chemistry(which are certainly real) are the cause or result of a given disorder.
E.g Research has shown that behaving in a depressed way may lead to biochemical changes in the brain in normal brains that resemble the patterns observed in genuinely depressed patients.

Question 12

Behaviour has a genetic basis(Bio App)

Answer 12

Abnormality can be inherited and often has a ‘genetic’ basis- twin studies and other techniques are an important tool in understanding the causes of mental disorders.

Question 13

Evaluation (Behaviour has a Genetic Basis)

Answer 13

Environment is always important
-Twin Studies which are used to support the biological model usually show that genetics are only one of the many factors involved and that environmental factors are nearly always as or more important. E.g. Two twins who split up at adulthood, one in England and one Australia. Twin in England suffered a serious heart attack so twin in Australia was asked to be tested and found to have the same condition despite their completely different lifestyles. This in all links to Nature vs Nurture debate

Question 14

What are the two biological treatments of abnormality?

Answer 14

1) Electroconvulsive Therapy

2) Chemotherapy/Drug Treatments

Question 15

Chemotherapy

Answer 15

This treatment approach is based on the idea that the psychological conditions will be cured if we can restore chemical imbalances in the brain.

 -Serotonin is a neurotransmitter that has been found to be involved in depression. A class of drugs called SSRIs (selective serotonin reuptake inhibitors) work by stopping nerve cells reabsorbing the serotonin they have released into the synapse, thereby increasing the amount of serotonin that is available. SSRIs are a very effective treatment for depression and include drugs 
such as Prozac (fluoxetine) and Seroxat (paroxetine).

• Benzodiazepine drugs are commonly used to treat stress, anxiety and high blood pressure. They work by blocking receptors that are usually activated by adrenaline and noradrenaline, meaning that the body is less able to produce extreme and unhealthy sympathetic nervous system responses.
• Another class of drugs that work on noradrenaline synapses is monoamine oxidase inhibitors (MAOIs). These stop the enzyme monoamine oxidase breaking down noradrenaline, and therefore increase the amount of noradrenaline that is available at the synapse. Low levels of noradrenaline in certain areas of the brain has been linked with depression, and so MAOIs are an effective antidepressant.
• Antipsychotic drugs, which are often used to treat schizophrenia, work by reducing the amounts of dopamine at synapses in certain areas of the brain.

Question 16

Evaluation (Chemotherapy)

Answer 16

Ethical Issues
-The use of drugs to treat mental illness raises many ethical concerns, particularly when they are used in mental institutions against a patent’s will. Critics have argued that the drugs are not effectively treating mental disorders, but instead are sedating patients to make them compliant and manageable.

Easy to use
-Drugs are easy to prescribe and require little motivation on the part of the user unlike other therapies such as psychoanalysis and CBT. Moreover, drugs are fast acting and can be effective in relieving symptoms in hours or days rather than the weeks or years of psychotherapies.

Question 17

What is Electroconvulsive Therapy (ECT)?

Answer 17

• Electroconvulsive Therapy is a technique which consists of running an electric current through the brain by inducing convulsion.
• ECT is usually given to people with severe depression who have not responded to other forms of treatment such as antidepressants.
• It is usually only given after the risks have been explained and with the persons consent, or in the extreme case when the persons life is at risk.

Question 18

How does ECT work?

Answer 18

Before treatment, the patient is anesthetized and given an injection of muscle relaxant so that patient does not cause/sustain damage during the treatment.
During treatment, a brief electrical current (70-130) is delivered to the brain via electrodes placed on the temples. The electrical current last for 1-4 seconds, and causes an epileptic-like seizure which can last for approximately a minute.
Most patients get a total of six to twelve ECT sessions with no more than two or three sessions per week. Patients do not remember the procedure once they wake up and after the anesthetic wears off.

Question 19

Evaluation (ECT)

Answer 19

Quick
-ECT is a quick and effective method of treating severe depression, and is particularly useful when depressed patients are in imminent danger of harming themselves or committing suicide. E.g. Comer found that 60-70% of patients showed improvement following ECT.

Side Effects of ECT
-When ECT was first used there were serious side effects, such as broken bones from the convulsions that the treatment causes. However modern use of the treatment is carried out under anaesthetic and with muscle relaxants so injuries are uncommon. There is often memory loss following treatment, but this has been reduced by only applying ECT to one hemisphere of the brain (unilateral) rather than both hemispheres. (Bilateral)

Question 20

What are the assumptions to the Psychodynamic Approach?

Answer 20

1) It’s all in the mind: (Tripartite Model of the Mind)
2) Early experiences is very important
3) The importance of the unconscious

Question 21

Its all in the mind (Psychodynamic App)

Answer 21

The roots of mental disorders can be found in the mind- this is different from the biological approach( which emphasises biological factors); the Behavioural Approach (Learned responses to stimuli) and the Cognitive Approach.

Question 22

Tripartite Model of the Mind(Psychodynamic)

Answer 22

Freud believed an adult’s personality consisted of three components that develop during childhood. These are the id, ego and superego.

ID
The id consists of sexual, aggressive instincts and is concerned with immediate gratification. The motivating force for the id is the libido, which is the body’s pleasure seeking (often sexual pleasure) force. The id is totally unconcerned as to how it gets what it wants, as long as gratification is achieved.

EGO
The ego is the rational part of the mind, and is concerned with behaving in a way that is socially acceptable. It operates on a reality principal, and ensures that the id gets what it wants but by socially appropriate and acceptable means. It must also balance the desires of the id with the control of the superego.

SUPER EGO
The superego is a person’s conscience, and is concerned with moral judgements and feelings of guilt. It will allow the id to get what it wants as long as it is not immoral to do so. The superego is the last part of the mind to develop.

The id, ego and superego can all contribute to abnormality, for example:

Weak ego: Well adjusted people have a strong ego that is able to cope with the demands of both the id and the superego by allowing each to express itself at appropriate times. If, however, the ego is weakened, then either the id or the superego, whichever is stronger, may dominate the personality.

Unchecked id impulses: If id impulses are unchecked they may be expressed in self-destructive and immoral behaviour. This may lead to disorders such as conduct disorders in childhood and psychopathic (dangerously abnormal) behaviour in adulthood.

Too powerful superego: A superego that is too powerful, and therefore too harsh and inflexible in its moral values, will restrict the id to such an extent that the person will be deprived of even socially acceptable pleasures. According to Freud this would create neurosis, which could be expressed in the symptoms of anxiety disorders, such as phobias and obsessions.

Question 23

Early experiences is very important(Psychodynamic App)

Answer 23

The roots of psychological disorders can be found in our early experience( typically before the age of 5). he Oepidus and Electra complexes are two very important early experiences.
(Little Hans)

Question 24

The importance of the unconscious(Psychodynamic App)

Answer 24

The focus of mental health is the unconscious not the conscious mind. Freud compared the mind to an Iceberg most of which is hidden away. For Freud the really important stuff happens unseen in the dark recesses of the unconscious.

Question 25

The Egos defence mechanisms(Psychodynamic App)

Answer 25

Ego defence mechanisms protect the ego from the potentially damaging demands of controlling the id and superego. There are 6 main defence mechanisms:

Repression: Unacceptable or traumatic desires, wishes, emotions and memories are hidden in the unconscious mind. The individual has no control over what is moved from the conscious mind to the unconscious one as it is an involuntary and automatic process. Once in the unconscious mind, the repressed memories still exert an influence over behaviour, but the person cannot consciously recall them.

Projection: This is where a person sees their own undesired personality traits in someone else. For example, an angry person may accuse another person of being angry when in fact they are not. At its extreme, projection can lead to feelings of paranoia.

Denial: This is simply where a person denies facts or events relating to them - e.g. the alcoholic that says they are not dependent on alcohol.

Regression: This is regressing to childhood behaviour as a response to anxiety or a traumatic event. Behaviours might include stamping and having tantrums when stressed.

Displacement: This is where feelings toward a particular person are diverted to someone else. E.g. a child who is angry at its parents may bully other children because he cannot take out his anger on his parents.

Sublimation: This is the process of transferring emotions about another person or situation onto something else - e.g. playing an aggressive sport such as rugby when you are angry or frustrated with your boss at work.

Question 26

Psychodynamic Evaluation

Answer 26

Empirical Evidence

• It is often claimed that Freuds ideas have generated little if any research support that can be viewed as valid.
• Claims are unfalsifiable e.g. If deny you gave an issue, then Freud would argue that your defense mechanisms were not allowing you to realise that you have an issue.

Population validity
-All case studies are middle class, Viennese women, so how much can we generalise?

+Some research support for Freuds ideas e.g. Adams (1996) ‘heterosexual’ males who scored highest on hostility to homosexuality were in fact more aroused by gay pornography than males who expressed lower levels of hostility.

Question 27

Psychoanalysis

Answer 27

Psychoanalysis is the name given to the therapy and associated techniques developed by Freud and his followers to treat a range of mental disorders.

Question 28

What is the objective of psychoanalysis?

Answer 28

To make the unconscious conscious. Freud believed that if painful or uncomfortable repressed memories could be brought into the conscious mind then the influence they excreted over the patients present life would disappear.

Question 29

How does Psychoanalysis work?

Answer 29

• Psychoanalysis is essentially a range of techniques that aim to bring repressed impulses and traumatic memories into the conscious awareness.
• Freud developed a number of specific techniques for the treatment of mental trauma which are still employed by psychoanalysts today.

Question 30

Name the three psychoanalysis techniques used?

Answer 30

1) Dream Analysis
2) Behaviour Interpretation
3) Free Association

Question 31

What is dream analysis?

Answer 31

Therapist analysing hidden symbolism in dreams to interpret the meaning behind it.

Question 32

What is behaviour interpretation?

Answer 32

Assessing motivations behind words and action e.g. “forgetting an exam or “slips” of the tongue

Question 33

What is Free Association?

Answer 33

Allowing their unconscious mind to break through into consciousness by saying anything and everything that enters their head without censoring or monitoring what they say.

Question 34

Psychoanalysis Evaluation

Answer 34

+Treats the root causes of the problem not just the symptoms as other treatments do e.g. Drugs, and therefore offers a long term cure.

• Eysenck suggests that psychoanalysis is entirely ineffective and no better than chance.
• Real risk of implanting false memories, especially during hypnosis, when individual is encouraged to find hidden explanations for their behaviour rooted in their chldhood.

Question 35

What are the assumptions of the Behavioural approach?

Answer 35

1) All behaviour (normal or abnormal) results from people, direct or indirect learning experiences.
2) Only observable behaviour is important
3) The present not the past is important

Question 36

All behaviour results from people (Behaviour App)

Answer 36

The main assumption of the behaviourist approach to understanding abnormality is that all behaviour, normal or abnormal, is learned from the environment. This means that if a behaviour is associated with a positive outcome it is likely to be repeated, but if is associated with a negative one it is unlikely to be repeated.

Classical Conditioning
Classical conditioning is learning by association. A full explanation of classical conditioning can be found here. An abnormal behaviour can be acquired by associating an environmental stimulus (e.g. a dog) with a biological response (e.g. pain and fear when bitten) so that every time a person that has been bitten by a dog subsequently sees a dog, they experience the fear they felt when they were bitten. In this case the person would develop a phobia of dogs.

Operant Conditioning
Operant conditioning is learning through reward and punishment. A full explanation of operant conditioning can be found here. An abnormal behaviour can be learned if that behaviour results in a positive reinforcement (rewarded by a pleasurable outcome) or a negative reinforcement (rewarded by removing an unpleasant condition). An example might be a person who gets what they want when they behave aggressively towards people. In this example the aggressive behaviour has been positively reinforced, and so the person is more likely to behave aggressively towards people in the future.

Question 37

Classical Conditioning of a Phobia

Answer 37

Watson and Rayner (Little Albert)
Loud Bang (UCS) -> Fear (UCR)
White Rat (NS) -> No response 
UCS + NS -> Fear(UCR)
White Rat (CS) -> Fear (CR)

Written Description
Little Albert was described as a happy and inquisitive child who was scared of very little. He was even happy to play with a pet white rat, however one thing that he was scared of was sudden loud noises. Watson & Rayner (1920) allowed Little Albert to play with the white rat and then at the same time made a loud metallic bang. They repeated this until, after just a few pairings of the loud bang and the white rat, Little Albert became scared of the white rat and would cry when it was given to him. This showed that a phobia could be learned through classical conditioning by simply pairing a pleasant stimulus and an unpleasant one.

Question 38

Only observable behaviour is important (Behaviour App)

Answer 38

• Behaviourist have little time for concepts such as the ‘mind’ or even cognitive process such as thought and memories
• For a behaviourist the focus of treatment should always be observable behaviour e.g symptoms
• For a behaviourists removing the symptoms means removing the problem- its the same thing.

Question 39

The present not the past is important(Behaviour App)

Answer 39

Behavioural therapy are concerned with present psychological functioning, i.e. how does present psychological functioning relate to the patients environment. Behaviourist do not see early childhood experiences as having particular significance in contrast to the psychodynamic approach

Question 40

Behavioural Approach Evaluation

Answer 40

Treats the symptoms not the causes
-Critics argue that because of the narrow focus on observable behaviour (symptoms) the underlying problem does not go away. Psychodynamics(Freud) psychologists suggest that if one set of symptoms are ‘dealt’ with the problem will inevitably appear in neither form as the underlying neurosis is left untreated (Symptoms Substitution)

Not all anxiety is learned

• Although the case of Little Albert suggests that phobias can be learned it doesn’t prove that phobias are always learned e.g. Most people have no recollection of a traumatic experience associated with their phobia.
• It may be that humans are ‘hard wired’ to learn to be fearful of certain kinds of stimuli and not others (e.g. snakes, spiders, heights and so on), which were dangerous to humans in their evolutionary past.

Question 41

What is Systematic Desensitisation?

Answer 41

Systematic Desensitisation is a form of therapy based on the principles of classical conditioning to treat phobias and other irrational fears.
The method tries to counter-condition the individual so that feeling of fear/ anxiety are systematically replaced with calmness.
Systematic desensitization works on the principle that anxiety and relaxation are incompatible responses and cannot co-exist, eventually anxiety will be extinguished.

Question 42

How does Systematic Desensitisation work?

Answer 42

1) This works by teaching the client relaxation techniques e.g. Guided Imagery, and construct a ‘fear hierachy’ starting with the least feared situation, progressing to the most feared situation imaginable.
2) With the support of the therapist, progress through the hierachy, using the relaxation techniques learnt to calm anxiety at each stage.
3) Progress from the least feared situation to the most feared situation can be achieved without the same intense fear response.

Question 43

Systematic Desensitisation Evaluation

Answer 43

High Success rate of SD with a wide range of individuals and is quick and relatively easy to implement compared to CBT or psychoanalysis treatments.

Question 44

What are the main assumptions of the Cognitive Approach?

Answer 44

1) Faulty Thinking
2) The individual is in control
3) The cognitive triad

Question 45

Faulty Thinking(Cog App)

Answer 45

Abnormality is simply ‘faulty’ or maladaptive thinking (obsessions, compulsions)-it is the way you think about the problem rather than the problem itself which causes the mental disorders.

Kendall problems are caused by distortions and discrepancies

• Cognitive Distortion: This states that information is not accurately processed (Exaggerated thinking e.g. massive problem)
• Cognitive Deficiencies: This is a lack of planning and thinking leads to inappropriate solutions (e.g. giving up after a set back)

Cognitive Approach

• Emphasises the role of cognitive process (beliefs, thoughts perception) in causing psychological disorders.
• Individuals can overcome mental disorders by learning to use more appropriate cognitions.
• Most contemporary psychological approach, and uses elements derived from other approaches (e.g. behaviours and biological)

Question 46

The individual is in control (Cog App)

Answer 46

• They have the power to change their thinking and must learn new ways of thinking about themselves and their lives.
• This is quite different from other approaches which are very deterministic and suggest that behaviours are controlled by external factors which the individual has no control over.

Question 47

The Cognitive Triad (Cog App)

Answer 47

• The cognition approach has been used successfully to explain depression e.g. Beck(1967) suggested that depression was a result of individuals interpreting everyday events negatively.
• A depressed student therefore may not focus on the many positive comments he receives, however, will pick up on all of the negative comments; this reults in him thinking negatively about himself, the world and his future.(Cognitive Triad)

Question 48

Cognitive Approach Evaluation

Answer 48

Unrealistic Beliefs
-A critism of the cognitive approach is that it could be argued that the thinking of anxious or depressed people is not always ‘faulty’ or unrealistic. E.g. Alloy & Abrahamson found that depressed individuals were actually more realistic in their oulook (sadder but wiser effect) rather than looking at life through rose tinted glasses.

Problem of cause and effect
-E.g. Is faulty thinking a cause or effect of mental disorder. However, the key thing is that we change the thinking pattern. What came first is less important to cognitive psychologists.

Question 49

What is Cognitive Behavioural Therapy(CBT)?

Answer 49

• CBT assumes that problems in thinking underlie psychological disorders; therefore by changing the thinking, you cure the disorder.
• By identifying the dysfunctional thinking patterns and finding alternative ways of thinking, the client can examine the beliefs and motivations that underlie the dysfunctional behaviour.
• It is assuemed that thinking and emotions are interrelated in a circular cause and effect relationship, in that thinking affects emotion and emotion affects thinking.

Question 50

How does CBT work?

Answer 50

• Essentially ,CBT involves a discussion between the therapist and client where faulty thought patterns are identified & challenged.
• The first task is to understand the problems through analysing the clients thoughts, behviour and feelings to identify unrealistic thought patterns and their impact on the clients life.
• The second task involves working out how to change these irregular patterns by teaching them a range of techniques that they can actively use to help achieve this goal.
• A therapy session involves both cognitive and behaviour elements, with homework between sessions to exchange the client to process and practise the techniques explored in the sessions.

Question 51

CBT Evaluation

Answer 51

+CBT offers fast acting and effective long term improvement in motivated patients, without many of the side effects associated with other treatments.

-Can be quite challenging for the patient s it places the individuals irrational thoughts at the centre of their problems, which in turn sometimes seems to blame the patient. Thus, it may not be appropriate for some types of people.