Conceptual Issues Flashcards
Abnormality
Statistical rarity, deviance, distress, and dysfunction.
Abnormality - drastically rarity
Any deviation from the norm is abnormal (but this definition includes many positive characteristics that are rare eg. gifted musicians)
Abnormality - deviance
Behaviour is abnormal if socially unacceptable (but need to avoid oppressing non-conformist behaviours).
Abnormality - distress
Behaviour is abnormal if it causes significant distress to the individual (but some individuals are not distressed by their dysfunctional behaviour).
Abnormality - dysfunction
Behaviour is abnormal if it interferes with an individual’s functioning in life (but how functional an individual is depends on societal expectations).
Mental disorder
Defined as behaviours that may be statistically rare, distressing, unacceptable to society.
But also behaviours that stem from an underlying dysfunction or illness.
Historical background of biological perspective
Prior to the twentieth century ‘insanity’ was considered a single disease.
Emil Kraepelin challenged this single-disease concept of insanity.
Kraepelin classified behaviours according to their known causes (if known), or simply described behaviour of their causes were unknown.
Causation from the biological perspective
In the late 19th century the cause of a type of disorder (general paresis of the insane) characterised by hallucinations and delusion, was shown to be a biological disease (syphilis) - not quite true!
Further research demonstrated associations between certain syndromes and localised brain damage eg. Broca’s area
As a result of these findings, by the end of the 19th century the medical profession was confident in finding biological causes of mental illness.
Treatment from the biological perspective
Early biological treatments were not based on scientific evidence and as such were ineffectual (eg. cold baths, bleeding).
Early 20th century treatments included electroconvulsive therapy (ECT) and psychosurgery eg. lobotomy
Effective medications arrived in the 1950s.
Contemporary biological perspectives
Current theories focus on identifying the causes of mental disorders and have concentrated mainly on two areas:
Structural brain abnormalities as seen in people with schizophrenia and other disorders (eg. enlarged ventricles).
Neurochemical imbalances.
Contributions of the biological perspective
There has been significant advancement in the development of effective drug treatments for a wide range of disorders.
Today there is a better understanding of the role of brain structure and neurochemisty in the aetiology of mental disorders.
Limitations and criticisms of biological perspective
Much of the evidence for the biological causation of mental disorders is inclusive.
High rates of relapse after an individual stops taking medication.
Side effects of some medications have been underestimated.
Current biological perspectives assume a categorical approach to classification rather than a dimensional approach.
Psychoanalytic perspective
Developed by Sigmund Freud in the late 19th century.
Posits that much of the reason for human behaviour lies in the unconscious and is therefore not accessible to awareness.
Human behaviour involves a complex interaction between the id, ego, and superego.
Key concepts of psychoanalysis - the unconscious
The id: driven by instincts, mainly of sexual and aggressive nature.
Ego: conscious, realistic, aims to balance the desires of the id with reality.
Superego: seeks to uphold individual and societal moral standards.
Failure to manage conflict results in anxiety which is dealt with through defence mechanisms.
Classification and causation from psychoanalytic perspective
All behaviours are the result of conflict among the id, ego and superego (anxiety).
Defence mechanisms
Neuroses and psychoses
Neurosis
According to psychoanalytic theory, set of maladaptive symptoms caused by unconscious conflict and it’s associated anxiety.
Psychosis
State involving a loss of contact with reality in which the individual experiences symptoms such as delusions and hallucinations.
Treatment from psychological perspective
Dream analysis
Free association
Transference
Behavioural perspective
Argues that psychology should concern itself with readily measurable stimuli and responses.
Emphasises that the causes of behaviour are observable and identifiable in the immediate environment.
Behaviours, both normal and abnormal, are the result of classical conditioning and operant conditioning.
Key concepts of behaviourism
Operant conditioning
Classical conditioning
Classification and causation from behavioural perspective
According to the behavioural perspective, both normal and abnormal behaviour is the product of learning.
Usually adaptive eg. avoid negative consequences by fear. But can become maladaptive (anxiety/phobias)
Treatment from behavioural perspective
Involves learning new responses and extinguishing old responses.
May also involve becoming habituated to previously avoided stimuli.
Treatments include: aversion therapy, systematic desensitisation, and the use of token economies.
Aversion therapy
Treatment that involves the pairing of an unpleasant stimulus with a deviant or maladaptive source of pleasure (eg alcohol) in order to induce an aversive reaction to the formerly pleasurable stimulus.
Systematic desensitisation
Behavioural technique that aims to reduce the client’s anxiety through progressive, imaginal exposure to feared stimuli paired with the induction of a relaxation response.
Token economy
Treatment application of operant conditioning in which individuals receive tokens for exhibiting desired behaviours that can be exchanged for privileges and rewards; tokens are withheld with the individual exhibits unwanted behaviour.
Limitations of behavioural perspective
Oversimplifies the understanding of human existence.
Ignores things that make us human eg beliefs, hopes, values, memories etc.
Only looks at the observable.
Cognitive perspective
Dysfunctional ways of thinking are the cause of abnormal behaviours.
Not advertise events per se that cause abnormal behaviour, but how the person interprets these events.
Albert Ellis’s ABC model.
Albert Ellis’ ABC model
A: event
B: beliefs or interpretation of the event
C: emotional and behavioural responses to event
Rational-emotive therapy.
Aaron Beck - cognitive perspective
Emphasised the cognitive distortions that he had observed, particularly in patients suffering from depression.
Cognitive distortions include:
black and white thinking,
selective thinking (looking on the dark side),
over-generalising,
catastrophising.
Treatment from cognitive perspective
Cognitive restructuring
Behavioural experiment
Cognitive restructuring
Cognitive technique in which the client learns to identify, challenge and replace their dysfunctional beliefs with more realistic or helpful beliefs.
Behavioural experiment
Cognitive technique in which the client participates in a planned activity in order to test the accuracy of their beliefs
Cognitive-behavioural approach
Incorporates aspects of contemporary behaviourism and cognitivism.
Currently the dominant psychological approach.
Treatment from cognitive-behavioural perspective
CBT
Involves helping clients identify and replace unhelpful cognitions
Has been empirically validated as an effective treatment for a wide variety of psychological disorders.
Humanistic perspective
Theories based on the view that the natural tendency of humans is towards growth and self-actualisation.
Abnormality arises as a result of societal pressures to conform to dictates that clash with a person’s self-actualisation process.
Key concepts of the humanist perspective
Carl Rogers
Self-actualisation
Unconditional positive regard
Maslow’s hierarchy of needs
Classification and causation from humanistic perspective
Lack of unconditional positive regard and resulting lack of self-actualisation is the core of all psychopathology.
Treatment from humanistic perspective
Person-centred therapy.
Client receives unconditional positive regard from therapist in order to attain self-actualisation.
Sociocultural perspective
Argues that abnormal behaviours are best understood in terms of the social environment of the individual.
Focus on the importance of family functioning, social networks, access to social resources, cultural values and influences etc.
Advantages of diagnosis
Improves communication among professionals (diagnosis communicates to others the suspected causes and most effective treatments).
Clarifies the essential features of disorders to other professionals and wider society.
Disadvantages of diagnosis
Mental disorders are simply theoretical constructs (not like physical diseases) and are not independent of changing social values (eg homophobia).
Diagnosis may be harmful through stigmatisation.
The development of the DSM system - DSM l and ll
Published by the American Psychological Association.
Heavily influenced by psychoanalytic models - lacked reliability and validity
Based on unproven and untestable assumptions about the aetiology of disorders.
Development of DSM - DSM lll
Seen as a significant advancement in classification.
Adopted a neo-Kraepelinian descriptive approach to classification (describes observable features, until underlying causation is identified by further research).
DSM-5 improvements
Differential diagnosis (determining which of two or more possible diagnosis is appropriate). Improved levels of interrater reliability.
DSM-5 difficulties
Diagnostic instability (individuals often move from one disorder to another over time).
Lack of treatment specificity (same treatment is effective for variety of disorders).
High level of comorbidity (co-occurrence of two or more disorders in the same person).
Also need to ascertain the applicability of diagnostic criteria across cultures.
