Paper 1: Topic 4: Psychopathology Flashcards
What are the 4 different definitions for abnormality
-statistical infrequency
-deviation from the social norms
-failure to function adequately
-deviation from the ideal mental health
Define statistical infrequency
Someone is abnormal if their mental condition is very rare in the population. objectively using statistics, comparing the individual’s behaviour to the rest of the population.
abnormal if its frequency is more than two standard deviations away from the mean incidence rates represented on a normal distribution curve so falls out of the range of the normal distribution
Define deviation from social norms
an unwritten expectation of behaviour passed through socialisation
-can vary from culture to culture and change over time.
-people who’s behaviour deviates from these societal expectations on how ‘normal’ people behave, may be seen as abnormal or social deviants
Define failure to function adequately and example
The individual is defined as abnormal if they cannot cope in their everyday lives, including their ability to interact with the world and meet their challenges
Eg: Failure to maintain basic nutrition, hygiene and relationships
Define deviation from the ideal mental health and who developed criteria of the ideals
abnormality is the absense of signs of good mental health
those who do not meet the particular criteria for psychological well-being are abnormal.
Positive definition and comes from a humanistic perspective, focusing on ways to improve and become a better person rather than dysfunction or deficit.
Jahoda developed criteria of these ideals
1) Accurate perception of reality
2) Positive attitude to themselves (good self-esteem and lack of guilt)
3) Self actualisation – reach potential
4) Resistance to stress
5) Environmental mastery
6) Be independent of other people (autonomy)
Give an example of statistical infrequency
IQ is measured in a normal distribution so people who score outside of the normal distribution can be defined as abnormal
Below 70 are abnormal and diagnosed with intellectual disability disorder
Give an example of deviation from social norms
-Someone walking around streets of London naked can be seen as abnormal but it’s normal in certain remote African tribes
-Acceptance of homosexuality
-Face and hair covering
-level of modesty in clothing choices
Who proposed the signs of failure to function adequately
Rosenhan & Seligman
Proposed the following signs:
-not conforming to interpersonal rules (eye contact)
-experience of severe personal distress
-behaviour is irrational or dangerous to themselves/others
What’s the strength and limitation of the definition of statistical infrequency
Strength
P: it is an appropriate measure in certain circumstances
Eg: IQ is measured in terms of normal distribution for those who are two or more standard deviations below the mean or less than 70 can be considered abnormal and can be diagnosed with intellectual disability disorder
Becks Depression inventory (BDI) measures depressive traits, and a score of >30 indicates severe depression
Ex: definition has real life application as it is used as a real measure for certain behaviors
L: increases validity as it’s an objective measure to define abnormality.
Limit:
P: many abnormal behaviours are desireable.
Eg: very few people have an IQ over 150, but having such an IQ is not undesirable. there are some common behaviors that are seen to be undesirable
Ex: for example, experiencing depression is relatively common but the disorder is considered abnormal and undesirable
Link: so we’re unable to distinguish between desirable and undesirable behavior.
What’s the strength and limitation of the definition of deviation from social norms
Strength:
P: it can be useful for clinical practice.
Eg: key defining characteristic of antisocial personality disorder is the failure to conform to culturally acceptable ethical standards
Ex: deviation from social norms is helpful in diagnosing schizotypal personality disorder involving ‘strange p’ beliefs and behaviour
Link: means that it’s useful in psychiatric diagnosis
Limit:
P: social norms change across time periods and therefore it is not consistent across time
Eg: homosexuality is today socially acceptable in most western cultures but I’m the past it was a classification in the DSM and even illegal In the UK before 1967 and considered a mental illness until 1973
Ex: whether someone is defined as abnormal is then dependant upon the prevailing social morals and attitudes
Link: can then produce inconsistent results across history so the measure lacks temporal validity
What’s the strength and limitation of the definition of failure to function adequately
Strength:
P: it takes into account the patient’s subjective perspective.
Eg: allows us to view the mental disorder from the point of view of the person experiencing it
Ex: relatively easy to judge objectivity because we can list behaviours eg: can dress themselves and prepare meals, and check whether a person is functioning
L: therefore if treatment and support is required it can be specific to the patients needs
Limit:
P: it requires an objective judgement of a way of life
Eg: some may not see unemployment as a failure to function adequately, but others of an alternative lifestyle may disagree. Those who enjoy extreme sports may also be seen to be behaving in a maladaptive way
Ex: if we treat these as ‘failures’ of adequate functioning, we might be limiting personal freedom and discriminating minority groups
Link: posing a challenge for this definition because it may depend on who is making the judgement rather than the behaviour itself
What’s the strength and limitation of the definition of deviation from ideal mental health
Limit:
P: it sets high standards for mental health which may be unachievable for most people
Eg: less people achieve full ‘self actualisation’. It’s hard to even be sure what this is for each person. So this definition says a large number of people have aspects of abnormality
Ex: so the criteria is difficult to measure for example how easy is it to assess whether someone has the capacity for personal growth
Link: therefore its argued that this definition is not usable when it comes to defining abnormality but may be better within the field of positive psychology at criteria to strive for.
Strength:
P: the criterion is highly comprehensive
Eg: Jahoda’s concept includes a wide range of criteria, and covers most of the reasons people seek mental health support
Ex: allows mental health to be discussed meaningfully with a range of professionals with different theoretical views, eg psychiatrist or CBT therapist
L: ideal mental health provides a checklist against which we can assess and discuss psychological issues
Define cultural relativism
idea that one cannot judge behaviour properly unless it is viewed in the cultural context from which it originated.
Lack of cultural relativism can result in the norms of the home culture being used to assess the behaviour of individuals from another culture – example of ethnocentrism.
Give 2 examples of cultural relativism
-Australia in the early 1970s homosexuals were given electric shocks to cure them of their illness
-China people fear the wind as it is believed by some to carry negative energy (yin)
Give the limitation of all 4 abnormality definitions relating to cultural relativism
P: A limitation of [deviation from ideal mental health, statistical infrequency, failure to function adequately, deviation from social norms] definition of abnormality is that it does not consider cultural relativism.
statistical infrequency:
Eg: symptoms of Schizophrenia (hearing voices) are common and not considered abnormal in some cultures. Whereas in other cultures hearing voices is seen less typically.
E - This shows that some behaviours can be more statistically frequent in some cultures compared to others.
deviation from social norms:
Eg: the DSM which is used to diagnose disorders is largely based on Western social norms.
E – This shows that what is classed as abnormal is based on Western social norms and it ignores Eastern social norms and values and it is therefore ethnocentric to use the DSM to classify people from Eastern cultures as abnormal.
failure to function adequately:
Eg: The idea of whether a patient is functioning is related to cultural ideas of how people should live their lives and this could be class dependant.
E : This may explain why lower-class and non-white patients are diagnosed with mental disorders more often – because their lifestyles are different from those who are making the definitions.
deviation from ideal mental health:
E – For DIMH, some of Jahoda’s criteria are specific to European and American cultures, they are culture-bound. For example, self- actualisation is more common in individualistic cultures. Whereas collectivist cultures may see independence as a negative thing.
E – Therefore, generalising this definition may be seen as ethnocentric as it is judging the concept of “normal” by Western and therefore individualistic standards.
Link: therefore it doesn’t consider cultural differences and therefore cannot be used as a universal explanation of abnormality due to ethnocentrism
What are the 2 diagnostic manuals most commonly used in psychiatry?
Books which are used by professionals to diagnose/categorise mental disorders:
1) DSM – diagnostic statistical manual, published by American Psychiatic Association
2) ICD – International statistical classification of diseases. Published by World Health organisation (WHO)
What are the 3 categories of symptoms that you need to be aware of?
Emotional – feelings
Behavioural – actions
Cognitive – thoughts
Phobias:
What is the definitions of a phobia?
Persistent irrational fear that is disruptive to everyday life of a specific situation, object or activity (a stimulus) so is avoided or endured with distress
Phobias:
What are the 3 categories of phobias recognised by DSM-5?
Specific phobia – phobia of an object, eg: animal or body part, or a situation eg: flying or injections
Social phobia (social anxiety) – phobia of a social situation eg: public speaking
Agoraphobia – phobia of being outside or In a public space
Phobias:
What are the diagnostic criteria for phobias for DSM-5?
> 6 months, intensity, distress
Presence of the emotional, behavioural and cognitive responses is almost always triggered in repossess to the phobic stimulus for a period of 6 months or more
Phobias:
Describe the emotional (feelings) symptoms associated with phobias
Anxiety - phobias involve the emotional response of anxiety: high arousal
Fear - immediate and unpleasant response when we encounter or think about a phobic stimulus
Unreasonable - disproportionate to any threat posed
Phobias:
Describe the behavioural (actions) symptoms associated with phobias
Panic - can cause shortness of breath, shaking, and high heart rates
Avoidance - show effort to avoid the phobic stimulus (which can affect their daily life, e.g. reducing amount of sleep)
Endurance - person chooses to remain in the presence of the phobic stimulus; eg a person with arachnophobia staying in a room with a spider to keep an eye on it, rather than leaving.
Phobias:
Describe the cognitive symptoms associated with phobias
Selective attention – person finds it hard to look away from phobic stimulus
Irrational beliefs – phobic person doesn’t respond to evidence eg: scared of flying even if flying is less dangerous than driving so phobia isn’t reduced
Cognitive distortions – thoughts about the phobic stimulus are distorted eg: someone with arachnophobia sees spiders bigger than what they really are
Define cognitive
How people process info in relation to the phobic stimulus – thoughts
Depression:
What is the definition of a depression?
Mental health disorder that’s characterised by Persistent sadness & lack of interest in pleasure in previously rewarding or enjoyable activities. It can disturb sleep and appetite; tiredness and poor concentration are common
Depression:
What are the 4 categories of depression recognised by DSM-5?
Major depressive disorder – severe but short term depression
Persistent depressive disorder – long term or recurring depression, including sustained major depression (dysthymia)
Disruptive mood dysregulation disorder – childhood temper tantrums
Premenstrual dysphoric disorder – disruption to mood prior to and/or during menstruation
Depression:
What are the diagnostic criteria for depression for DSM-5?
5 symptoms every day, 2 weeks
(Depressed mood most of the day, nearly every day, anhedonia, and at least 5 of the listed symptoms persisting for at least 2 weeks)
Depression:
Describe the emotional symptoms associated with depression
Low mood (required symptom: - feeling ‘empty’ and ‘worthless’ or ‘hopeless
Anhedonia - loss of interest or pleasure in hobbies and activities that were once enjoyed; may be accompanied by avolition (loss of motivation to perform goal-directed activities)
Anger - directed towards others or self – comes from the general feeling of being emotionally hurt
Low self-esteem - can lead to self-loathing
Depression:
Describe the behavioural symptoms associated with depression
Low activity level / reduction in energy - sufferers show a sense of tiredness, desire to sleep, and lower activity; can be the opposite: psychomotor agitation
Disrupted sleep (insomnia or increased sleep)
Disrupted eating (appetitive changes) - eat more or less
Aggression/self-harm - increased irritability; can become verbally or physically aggressive; can lead to ending a job or relationship; self harm can result in cutting or suicide attempts
Depression:
Describe the cognitive symptoms associated with depression
Poor concentration - can’t focus on a task as much as normal and find it difficult to make decisions
Attention to the negative – negitive thoughts including negative self-beliefs such as guilt and a sense of worthlessness
Absolutist thinking - See things as ‘black and white’ – can catastrophise situations, seeing something unfortunate as an absolute disaster
Memory bias - cognitive bias of remembering unhappy events more easily – negitive schema
OCD:
What is the definition of a OCD?
Obsessive compulsive disorder
Common mental health condition where someone had Obsessive thoughts (internal) & compulsive behaviours (external)
OCD:
What are the 4 categories of OCD recognised by DSM-5?
OCD - obsessive, recurring thoughts, images, and or compulsions (repetitive behaviours, such as handwashing)
Trichotillomania - compulsive hair-pulling
Hoarding disorder - compulsive gathering of possessions and the inability
to part with anything, regardless of value
Excoriation disorder - compulsive skin-picking
OCD:
What are the diagnostic criteria for OCD for DSM-5?
> 1hr/day; distress
Presence of obsessions, compulsions or both, which are time-consuming (>1hr per day), or cause significant distress of impact daily functioning
OCD:
Describe the emotional symptoms associated with OCD
Anxiety & distress - Obsessive thoughts are intrusive and frightening. The urge to compulsively repeat behaviour produces anxiety.
Depression - OCD is often accompanied by depression; compulsive behaviour can bring relief, but is short-term only
Guilt/disgust - often aware that their obsessive thoughts are irrational and that their compulsive behaviours are abnormal. Alternatively, they can suffer guilt over minor moral issues. Disgust may be direct towards the self, or externally, like dirt.
OCD:
Describe the behavioural symptoms associated with OCD
Repetitive/ritualistic compulsive behaviours - feel compelled to act on their obsessive thoughts with repetitive behaviours acts, called compulsions, such as handwashing. behaviours are repetitive, unpleasant, and interfere with daily life.
Anxiety (compulsions reduce anxiety) - caused by obsessions
Avoidance - avoid situations which trigger obsessions and compulsions, e.g. avoiding obsessive thoughts about germs by not emptying their bin
Describe the cognitive (thoughts) symptoms associated with OCD
Obsessive thoughts - obsessions are intrusive/recurring/unwanted thoughts. 90% of OCD sufferers experience them. repetitive, unpleasant, and interfere with daily life. They are present on most days, for a period of 2 weeks or more
Hypervigilance - selective attending and increased awareness of source of obsession in new situations
Cognitive coping strategies - eg a religious person tormented by guilt may respond by praying or meditating, which helps manage anxiety, but can become a distraction
Insight / Sufferer is aware these obsessive thoughts are irrational - aware that their cognitions are irrational. Despite this they maintain constant alertness and focus on potential hazards.
What is the behavioural approach?
- learning theory which states all behaviors are learned through interaction with the environment through conditioning.
- Behaviour is a response to environmental stimuli.
Behavioural approach:
What is classical conditioning?
Learning through association
Two stimuli are repeatedly paired together and the neutral stimulus eventually produces the same response as the unconditioned stimulus alone
Behavioural approach:
Explain the famous research associated with classical conditioning?
Pavlovs salivating dogs:
1) UCS (food) -> UCR (salivating)
2) UCS + NS (bell) -> UCR (salivating)
3) CS (bell) -> CR (salivating)
Watsons Little Albert
researchers initiated a phobia of a white rat when he learned to associate the rat (NS) with a loud noise (UCS). The phobia was then generalised to other white, furry items including Santa Claus’ beard
Conditioned - learnt through pairing
Unconditioned - automatic and not learnt
Neutral stimulus - paired with a response (UCR) to become a conditioned stimulus paired with a response (CR)
Behavioural approach:
What is operant conditioning?
Learning through consequences
Behavioural approach:
Explain the famous research associated with operant conditioning?
Skinners box:
- Positive reinforcement: behaviour that is rewarded is reinforced (repeated)
- Negative reinforcement: behaviour that avoids an unpleasant stimulus (eg shock) is reinforced (repeated)
- Punishment: behaviour that is results in an unpleasant outcome (shock) will not be repeated
Behavioural approach:
What is Mowrer’s (1960) two process model?
used learning theory to propose the behavioural explanation of phobias
It explains avoidance behavior but not phobic cognitions.
2 process model:
-Phobias are acquired or initiated through classical conditioning
-Phobias are maintained or continued through operant conditioning
Behavioural approach:
How are phobias initiated?
a phobia is acquired through learning an association
(classical conditioning)
Eg: can explain why someone develops a fear of dogs after being bitten:
Eg:fear of dogs
Being bitten (UCS) -> automatic fear (UCR).
dog (NS) is associated with being bitten (UCS) then the dog (now CS) then produces a fear response (now CR) on its own
Behavioural approach:
How are phobias maintained?
through operant conditioning which takes place when behaviour is reinforced
Eg: the likelihood of a behaviour being repeated is increased if the outcome is rewarding – positive reinforcement
- person avoids a feared object to reduce anxiety -> negative reinforcement because a person avoids the situation to escape from an unpleasant situation
- Such behaviour results in a desirable consequence which means the behaviour will be repeated
Behavioural approach:
Strengths of the behaviour approach as an explanation of phobias and two process model
Strength:
P: there’s supportive empirical case study evidence
Eg: Watson and Rayner used classical conditioning to create a phobia in an infant called Little Albert. Researchers iniated a phobia of a white when he learnt to assossiated the rat (NS) with a loud noise (UCS). Phobia was generalised to other white fury items like Santas beard.
Ex: supports CC as little Albert had no phobias before experiment. He developed the fear when pairing the loud noise with the whiter rat
L: increases validity of theory that phobias are learnt not innate as proposed by evolutionary explaination, as theory predicted the research findings
Strength of 2 process model
P: evidence for a link between bad experiences and phobias
Eg: De Jongh (2006) found that 73% of dental phobics had experienced a trauma, mostly involving dentistry
Ex: Further support came from the control group of people with low dental anxiety, where only 21% had experienced a traumatic event
Link: This supports the proposal that the association between stimulus (dentistry) and an unconditioned response (pain) can lead to a phobia
Behavioural approach:
Limitations of the behaviour approach as an explanation of phobias
Limit:
P: it does not offer a complete explanation of phobias
Eg: Bounton highlights that evolutionary factors could play a role in phobias, especially if the effects of a particular stimulus (e.g. snakes) could have caused pain or even death to our ancestors. Consequently, evolutionary psychologists suggest that some phobias (e.g. snakes and heights) are not learnt but are in fact innate, as such phobias acted as a survival mechanism for our ancestors
Ex: This innate predisposition to certain phobias is called biological preparedness (by Seligman) and casts doubt on the two‐process model since it suggests that there is more to phobias than learning as it doesn’t explain phobic cognitions
L: Whilst the behavioural explanation of phobias may explain the development of some phobias it does not explain ones that appear to be innate and have not been learnt through experience.
P: ignores the role of cognition (thinking)
Eg: Cognitivists argue that phobias develop as a result of irrational thinking, not just learning. For example, sufferers of claustrophobia may think ‘I am going to be trapped in this lift and suffocate’, which is an irrational thought that is not taken into consideration in the behaviourist explanation
Ex: Cognitive behavioural therapy (CBT) which is a treatment for phobias is suggested to be a more successful treatment than the behaviourist treatments which could indicate that the cognitive component of developing phobias is more important than the stimulus-response link.
L: challenges the validity of the behavioural explanation and suggests that the cognitive explanation of phobias may be a more appropriate one
Behavioural approach to treating phobias:
What are the 2 behavioural treatments / therapies
Systematic desensitisation
Flooding
Behavioural approach to treating phobias:
What treatment is systematic desensitisation and flooding behavioural treatments based on?
Counterconditioning:
A new response to the phobic stimulus is learned by pairing with relaxation instead of anxiety
Behavioural approach to treating phobias:
Define systematic desensitisation
Form of therapy for phobias that involves establishing a fear/anxiety hierarchy and teaching patients relaxation techniques. Use of relaxation at every level of the hierarchy gradually causes extinction of the fear.
