psychopathology 1 Flashcards
what is abnormality?
behaviour which is considered deviant from what is considered normal
what are definitions of abnormality?
ways to identify if a person’s behaviour deviates from normal behaviour
what are the four definitions of abnormality?
-statistical infrequency
-deviation from social norms
-failure to function adequately
-deviation from ideal mental heath
what does the statistical infrequency definition argue?
that behaviours that are statistically rare should be seen as abnormal
when is something classed as statistically rare?
it depends on normal distribution:
-most people will be around the mean for the behaviour, with declining amounts of people away from the mean
-any individual who falls outside ‘the normal distribution (usually about 5% of the population) are perceived as being abnormal
how is abnormality determined?
(statistical infrequency)
abnormality is determined by looking at the distribution of a particular behaviour within society
example of an abnormality that can be defined with statistical infrequency:
IQ
statistical infrequency: IQ
-if we took a representative sample of adults in the UK, we would find approx 65% of adults with an IQ score somewhere between 85 and 115 (considered normal as it is what most people score)
-only 2.5% of the sample would have scores that fall at either extreme of the normal distribution curve
(eg: there would be 2.5% with a very low score and 2.5% with a very high score)
ends of the IQ spectrum:
-both ends of the spectrum would be considered “abnormal” because so few people achieve these scores
-those in the bottom 2.5% are likely to be labelled as having intellectual disability disorder (mental retardation)
IQ - statistical infrequency
(percentages)
-around 68% of people fall between 15 points of 100
-around 95% of people fall between 30 points of 100
-less than 5% are at the extremes
strength of statistical infrequency as a definition of abnormality:
an objective measure of abnormality and a useful assessment tool
ao3 / strength - an objective measure of abnormality and a useful assessment tool
P - an objective measure of abnormality and a useful assessment tool
E - due to its mathematical nature, it’s clear what’s defined as abnormal (2.5%)
↳ it allows for those with severe symptoms of a mental illness to be identified by comparing to statistical norms / eg: the Beck depression inventory (BDI), a score of 30+ (top 5% of respondents) is widely interpreted as indicating severe depression
L - this is a strength because statistical deviation is a useful part of clinical assessment and it is not based on subjective opinion so it is free from bias
criticisms of statistical infrequency as a definition of abnormality:
-the definition fails to distinguish between desirable and undesirable behaviours (not all infrequent behaviours are abnormal)
-not all abnormal behaviours are infrequent
-there is no consideration of cultural differences
ao3 / criticism - the definition fails to distinguish between desirable and undesirable behaviours
P - not all infrequent behaviours are seen as abnormal
E - IQ scores over 130 are just as unusual as those below 70, but we wouldn’t think of super-intelligence as an undesirable characteristic that needs treatment
↳ just because certain characteristics are statistically abnormal doesn’t mean they requires treatment to return to normal
L - this is a serious limitation to the concept of statistical infrequency and means it would never to used alone to make a diagnosis
ao3 / criticism - not all abnormal behaviours are infrequent
P - not all abnormal behaviours are infrequent
E - some behaviours are seen as abnormal even though they are statistically frequent
↳ (eg: depresssion) 27% of elderly people are thought to suffer from depression and 25% of the population will experience depression or mental illness at some point in their lives
L - therefore the statistical infrequency definition of abnormality is not always accurate as it can’t always identify abnormal behaviour
ao3 / criticism - there is no consideration of cultural differences
P - there’s no consideration of cultural differences
E - beliefs about abnormality differ between cultures, what is acceptable in one culture may be seen as abnormal in another
↳ this definition argues that the population of the world are contained within the normal distribution
↳ this means that an abnormality could be seen as widespread in one culture because of its comparison with the rest of the world (eg: hearing voices of spirits is highly valued in some cultures but a western society would view this as abnormal behaviour)
L - therefore the definition of statistical deviation is culturally relative
what are social norms and who are they set by & followed by?
rules that society has about how people should think and behave
↳ set by that social group, and followed by those socialised in that group
what two things can social norms be?
explicit (set down as conducts or laws, breaking these rules may result in punishment)
implicit (understood but not stated formally)
what is cultural relativism?
the idea that cultural norms and values are culture specific and no-one culture is
superior to another culture
↳ this means there are few behaviours would be considered universally abnormal on the basis that they breach social norms
what is deviation from social norms as a definition of abnormality?
-any behaviour that varies from social norms in that community may be seen as abnormal to that society
what is the difference between statistical infrequency and deviation from social
norms?
the deviation from social norms definition distinguishes between socially desirable and undesirable behaviours
what is an example of deviation from social norms?
antisocial personality disorder (or psychopathy)
how does a person with antisocial personality disorder act?
the person is impulsive, aggressive and only pleases themselves
an important symptom of antisocial personality disorder:
(in the DSM)
an absence of prosocial internal standards and a failure to conform to lawful or culturally ethical behaviour
why do we define psychopaths as abnormal based on deviating from social norms?
psychopaths don’t conform to our moral standards
strengths of deviation from social norms:
-the definition is flexible dependent on the situation and time
-it is a useful definition
ao3 / strength - the definition is flexible dependent on the situation and time
P - the definition depends on the situation and time, it allows the consideration of the social dimensions and desirability of a behaviour (statistical infrequency doesn’t)
E - a social norm is to wear full clothing whilst out shopping, but a bikini is acceptable on a beach
L - this is a strength because it allows for our understanding that a behaviour may be normal or desirable in one situation but not another
↳ this means that this definition may be preferred over statistical infrequency
ao3 / strength - it is a useful definition
P - one strength of deviation from social norms is its usefulness
E - deviation from social norms is used in clinical practice
↳ the key defining characteristic of antisocial personality disorder is the failure to conform to culturally normal ethical behaviour
↳ these signs of the disorder are all deviations from social norms
L - this shows that the deviation from social norms criterion has value in psychiatry
criticisms of deviation from social norms:
-the definition is culturally relative
-social norms change over time
ao3 / criticism - the definition is culturally relative
P - the definition is culturally relative
E - cultural relativism means it applies to culture where the definition was created.
↳ social norms and judgements will always vary from culture to culture
↳ what is considered normal in one culture may be abnormal in another
↳ (eg: the experience of hearing voices is the norm in some cultures (as messages from ancestors) but would be seen as a sign of abnormality in the UK
L - this suggests that this definition cannot be applied universally to label abnormal behaviour because every culture is different, which could lead to different assumptions of what abnormality is
↳ this means that this definition of abnormality is not standardised
ao3 / criticism - social norms change over time
P - an issue is that social norms change over time
E - this means that behaviour that would have been defined as abnormal in one era is no longer defined as abnormal in another
↳ eg: homosexuality was considered a psychological disorder by the World Health Organisation until 1992, but today it is not
↳ this is an example of groups of people being called abnormal for simply failing to meet social norms → problematic
L - this means that we cannot truly define any certain act as ‘abnormal’ because as norms change, therefore so must our beliefs about what constitutes’ abnormal’ behaviour
Mark is a practising Pagan. He lives alone and works as an IT consultant, doing most of his work at home and communicating via the Internet. His IQ is 145 (placing him in the top 1% of the population) and measures of depression are around average.
- Based on statistical deviation and deviation from social norms, would you say that there is a case for judging Mark to be abnormal? Explain your answer.
According to the statistical infrequency criterion, there is a case for Mark being abnormal.
↳ his IQ places him in the top 1% of the population, which is very unusual
According to the deviation from social norms criterion Mark may also be considered abnormal
↳ he has relatively little direct contact with other people and practises a religion that is low in social acceptability (in most circles)
- why is there a good case for not classifying Mark as abnormal at all?
-on the other hand, measures of Mark’s mental health are in the normal range and he earns a good living
-his religion is best considered a lifestyle choice and although his IQ is unusual, it is a positive characteristic
↳ based on this information Mark would not be considered abnormal
what is failure to function adequately as a definition of abnormality?
this definition perceives individuals as abnormal when their behaviour suggests they cannot cope with the demands of everyday life
↳ if a person can’t cope with demands and is also experiencing distress (or others are distressed by their behaviour) then it is considered a sign of abnormality
examples behaviours of someone who is functioning adequately:
-eating regularly
-washing clothes
-being able to communicate with others
-having some degree of control over your life
what are examples of features of abnormality?
(+ who proposed them)
D - distress (someone’s behaviour causes distress to themselves or discomfort for others observing their behaviour)
U - unpredictable behaviour (when someone’s behaviour is unexpected and does not fit the situation)
M - maladaptive behaviour (where someone’s behaviour isn’t good for them)
↳ this characteristic is central to the FFA definition
I - irrational behaviour (a person’s behaviour doesn’t make sense to other people)
(rosenhan & seligman -1989)
(
what is an example of someone who meets the features of abnormality?
-someone who is suffering from depression may struggle to get out of bed in the morning and go to work & find it difficult to communicate with family
-consequently, they would be considered abnormal as their depression is causing an inability to cope with the demands of everyday life (going to work), while their behaviour may also causing distress and discomfort to family members and friends
which example do we use in exams for failure to function adequately?
schizophrenia:
-a person can have disturbing hallucinations which can lead to bizarre behaviour
-individuals experience distress and they can be irrational and unpredictable around other people
strength of failure to function adequately:
it’s relatively easy to judge objectively through an assessment of criteria
ao3 / strength - it’s relatively easy to judge objectively through an assessment of criteria
P - it’s relatively easy to judge objectively through an assessment of criteria (WHODAS)
E - individuals rate themselves on a scale of 1-5 on 36 measures → this gives a quantitative measure of functioning
↳therefore, practitioners can decide who needs psychiatric help (treatment) for their mental abnormality in an objective way
L - this improves the validity of this definition
criticisms of failure to function adequately:
-this definition does not apply to everyone whose behaviour is abnormal
-many people engage in behaviour that is maladaptive/harmful or threatening to self, but we don’t class them as abnormal
ao3 / criticism - this definition does not apply to everyone whose behaviour is abnormal
P - this definition does not apply to everyone whose behaviour is abnormal
E - abnormality is not always accompanied by dysfunction → eg: psychopaths can commit murder and still appear normal
↳ harold shipman was an English doctor (eventually diagnosed with psychopathy) who killed at least 215 patients over the 23 years whilst maintaining a respected appearance (he functioned adequately)
↳ therefore he would not meet the criteria for abnormality for this definition
E - some people with clinical depression, for example, are usually able to work, look after their families and behave rationally (therefore they wouldn’t meet the criteria)
L - this casts doubt on failure to function adequately as a valid measure of abnormality
ao3 / criticism - many people engage in behaviour that is maladaptive/harmful or threatening to self, but we don’t class them as abnormal
P - many people engage in behaviour that is maladaptive/harmful or threatening to self, but we don’t class them as abnormal
E - partaking in adrenaline sports, smoking, drinking alcohol, skipping classes doesn’t make someone abnormal
↳ behaviour must be considered in context before it can be judged as failure to function adequately
↳ eg: going on a hunger strike would cause personal distress but it is not necessarily psychologically abnormal
L - it is important to view a behaviour with the aspects that have lead to it (context) as solely looking at the behaviour may lead to the wrong conclusion
how does deviation from ideal mental health as a definition of abnormality work?
-rather than identifying what is abnormal, Jahoda researched and identified six characteristics considered as good signs of mental health
-an absence of these characteristics indicates abnormality
when is deviation from ideal mental health more extreme?
the more of the criteria an individual fails to meet, the further away from normality they are
what are jahoda’s characteristics of mental health?
-positive attitudes towards the self
-self actualisation of ones potential
-resistance to stress (coping strategies)
-personal autonomy (independence)
-accurate perception of reality
-mastery of the environment
example used for deviance from ideal mental health
depression
how does depression illustrate deviance from ideal mental health?
-sufferers generally have low self-esteem (negative attitude to one’s self),
-they can struggle to make decisions
(not autonomous)
-they experience high levels of stress concerning their low mood condition
(not showing resistance to stress)
strengths of deviance from ideal mental health:
-it takes a comprehensive, positive and holistic stance to abnormal behaviour
ao3 / strength - it takes a comprehensive, positive and holistic stance to abnormal behaviour
P - it takes a comprehensive, positive and holistic stance to abnormal behaviour
E - firstly, the definition considers the whole person, taking into account a multitude of factors that can affect their health and well-being
↳ secondly, it also focuses on positive and desirable behaviours, rather than considering just negative and undesirable behaviours of mental illness
L - it is comprehensive, covering a broad range of criteria
criticisms of deviation from ideal mental health:
-jahoda proposed unrealistic criteria
-the criteria has issues with cultural relativism
ao3 / criticism - jahoda proposed unrealistic criteria
P - jahoda’s criteria is unrealistic
E - there are times when everyone will experience stress and negativity, for example, when grieving following the death of a loved one
↳ according to this definition, these people would be classified as abnormal, regardless of the circumstances which are outside their control
L - with the high standards set by these criteria, the amount required to be absent for diagnosis to occur must also be questioned
↳ these factors cast doubt on the validity and application of this definition
ao3 / criticism - the criteria has issues with cultural relativism
P - the criteria has issues with cultural relativism
E - some of the criteria for ideal mental health could be considered western in origin
↳ for example, her emphasis on personal growth and development may be considered overly self-centred in collectivist cultures
L - this therefore makes the definition culturally bound and not applicable
overall evaluation of definitions of abnormality:
-the development of criteria takes a nomothetic approach by identifying a list of factors through which to diagnose abnormal behaviour
↳ yet, everyone is an individual, so perhaps an idiographic approach to this area of psychology might be more fruitful
ethnocentricity is another issue with defining abnormality, especially regarding Jahoda’s criteria for ideal mental health
manuals for diagnosis:
DSM-V:
-mainly used in USA
-used by psychiatrists when diagnosing mental disorders
ICD-10:
-devised by the WHO
neurosis
-the sufferer does not lose touch with reality
-they are aware their symptoms are unusual and have insight into their disorder
psychosis
-sufferer loses touch with reality, has no insight, is unaware their symptoms are unusual
(usually severe mental disturbance with impaired emotion and thought)
what are the three diagnostic features of phobias?
-intense, persistent, irrational fear of a particular object, event or situation
-response is disproportionate and leads to avoidance of phobic object, event or situation
-fear is severe enough to interfere with everyday life
which three categories of phobias does the DSM recognise?
SPECIFIC PHOBIAS -
of animals, events, situations
SOCIAL PHOBIAS -
of social situations
AGORAPHOBIA -
of public crowded places, of leaving safety of home
who are phobias more common in?
in general:
-more common in women than men, in particular agoraphobia
-social phobia is most prevalent in adolescence and agoraphobia in middle age
specific phobias:
-excessive anxiety (panic attacks) with regard to specific objects or situations, leading to avoidance
-generally the least disruptive of the anxiety disorders
when are specific phobias diagnosed?
if they interfere with everyday life
social phobia:
-extreme fear of embarrassment or humiliation (fear of being judged by others, making mistakes, being in front of others)
-it only becomes a clinical condition if it interferes with everyday life
-usually begins in adolescence or early childhood
agoraphobia:
-fear of open spaces
-usually thought to start by unexpected panic attack in public
-feel better in own home
-affects 2-3% of population
3 aspects/symptoms of phobic sufferers:
behavioural: how a person acts around the feared object or situation
emotional: how a person feels when experiencing anxiety
cognitive: how a person thinks about phobic stimul
phobias - behavioural symptoms
1) avoidance
-interferes with persons normal routine,(normal fears do not interfere with everyday living)
2) freezing
phobias - emotional symptoms
1) excessive and unreasonable fear
2) anxiety/distress in the presence of or in anticipation of a specific object/situation (disproportionate to the level of danger posed)
phobias - cognitive symptoms
1) irrational beliefs (and resistance to rational arguments)
2) recognition that the fear is excessive/unreasonable (not in children)
3) selective attention - if a person with a phobia is presented with an object or situation they fear, they will find it difficult to direct their attention elsewhere
Children are prone to phobias, including some that may appear downright odd to us as adults. One phobic stimulus is buttons.
Eloise has a phobia of buttons. She refuses to wear any clothes with buttons and she even refuses to go into clothes shops where there are likely to be clothes with buttons. When questioned, Eloise says that this is because of the extreme anxiety that buttons cause her. She also says that she believes that buttons will always pinch her skin and that this will leave a bruise.
Identify the behavioural, emotional and cognitive aspects of Eloise’s fear.
behavioural:
(avoidance) she refuses to go into clothes shops where there are likely to be clothes with buttons
emotional:
(anxiety) buttons cause her extreme anxiety
cognitive:
(irrational beliefs) she believes that buttons will always pinch her skin and that this will leave a bruise
BEHAVIOURIST EXPLANATION OF PHOBIAS
according to the behavioural approach, phobias can be caused by…
1) classical conditioning
2) operant conditioning
two model process:
mowrer (1947) proposed a two-process model, to explain how phobias are acquired through classical conditioning and maintained through operant conditioning
acquisition of a phobia -
classical conditioning
the initial acquisition of the fear is thought to be conditioned by associating a neutral stimuli (something you didn’t initially fear) with either a traumatic experience or a false alarm
which research supports the acquisition of a phobia through classical conditioning?
little albert
who conducted the little albert study?
watson & rayner (1920)
aim of the little albert study:
to investigate whether a fear response could be learned through classical conditioning in humans
method of the little albert study:
-11-month-old child called ‘Little Albert’. -before the experiment, watson & rayner noted that albert showed no response to various objects, in particular, a white rat
-in order to examine if they could induce a fear response, watson & Rayner struck a metal bar with a hammer behind Little albert’s head, causing a very loud noise which startled him, every time he went to reach for the rat
-they did this three times
results of little albert study:
after the conditioning, whenever they showed little albert the white rat, he began to cry
conclusion of the little albert study:
-this experiment demonstrated that a fear response could be induced through the process of classical conditioning in humans
-in addition, little Albert also developed a fear towards similar objects, including a white Santa Claus beard
-the experiment revealed that little albert had generalised his fear to other white furry objects
how was albert conditioned? (simple steps)
loud noise (UCS) → fear (UCR)
rat (NS) → no response
rat (NS) + loud noise (UCS) → fear (UCR)
rat (CS) → fear (CR)
support for acquisition of phobias through classical conditioning (1997)
DiGallo et al found that 20% of people who have had a bad traffic accident came to have a phobia about travel, not wanting to go into cars and choosing to stay at home rather than travel
how did mowrer suggest that fears were maintained through the two process model? (steps)
operant conditioning:
approaching the phobic object/situation produces the CR (anxiety)
-escaping the phobic object/situation reduces anxiety
-this acts as a (negative) reinforcer, so the more the person avoids the phobic object/situation the more likely they will continue to do so
(other people may unwittingly reinforce avoidance)
Zelda has a phobia of dogs. As a child she was once bitten by a dog belonging to a family friend. Now when she thinks about dogs she experiences anxiety and she becomes very afraid whenever she sees a dog close up. This is particularly bad when she is approached by a German Shepherd.
Zelda avoids dogs whenever possible.
Using the two-process model explain how
Zelda might have acquired her phobia and how it might be maintained. Refer to the processes of classical and operant conditioning in your answer.
Acquisition:
after her childhood experience of being bitten, Zelda learned to associate being bitten (US) with dogs (NS) by classical conditioning
↳ dogs’ then became a CS producing fear of dogs (CS)
Maintenance:
since then she has experienced anxiety towards dogs so she has avoided them
↳ when she successfully avoids dogs her anxiety declines
↳ tis reinforces her avoidance behaviour and so by a process of operant conditioning she has maintained her phobia
Agoraphobia is phobic anxiety towards leaving the sufferer’s home environment. This is a serious problem because it prevents the sufferer going about their normal daily life.
Amina suffers from agoraphobia. She is a keen A level student but she is struggling to attend college because of the acute anxiety she suffers when attempting to leave her house in the morning. Her phobia began shortly after being mugged. Actually Amina finds she can leave the house as long as someone else is with her, but her parents leave for work early and she lives in the opposite direction of college from her friends.
- Explain how Amina’s agoraphobia might have been acquired and maintained according to the two-process model.
Acquisition
-after being mugged, Amina learned to associate the unpleasant experience of being mugged (UCS which produces fear) with going outside (NS) by a process of classical conditioning.
-being mugged led to the CR anxiety, when Amina goes out
-this anxiety towards going out is a conditioned response
Maintenance
-whenever she makes the decision to stay in Amina’s anxiety declines
-this reinforces her avoidance behaviour
-so by a process of operant conditioning she has maintained her agoraphobia
A clinical psychologist is interested in whether her agoraphobic patients are able to leave their home with relatively little anxiety provided a safe person is with them. She finds that of the last 15 agoraphobic patients she worked with 10 benefited from a trusted companion while 5 did not.
This study could be described as a natural experiment. Explain in what way this might be a natural experiment.
This could be called a natural experiment in the sense that there is an independent variable (the presence of a trusted companion) and a dependent variable (benefit).
However, the researcher is not manipulating the independent variable, just looking at two existing groups.
How could you conduct this same study as a field experiment?
To conduct this as a field experiment a researcher would have to randomly allocate patients to one of two conditions. In the experimental condition the patients would attempt to leave the house with a trusted companion and in a control condition they would attempt to leave the house alone. Their anxiety would be measured in each condition and compared.
Outline one ethical issue a psychologist would need to consider when carrying out this study. (2 marks)
This would raise the ethical issue of harm and distress. This is because the patient would be asked to leave their house, an action known to cause them anxiety.
strengths of the behaviourist explanation
-it has practical applications in its application to therapy
-evidence supports the behavioural explanation of phobias, that phobias occur following a traumatic experience
ao3 / strength - it has practical applications in its application to therapy
P - the behavioural explanation has practical applications in its application to therapy
E - the behaviourist ideas have been used to develop treatments, including systematic desensitisation and flooding
↳ systematic desensitisation helps people to unlearn their fears, using the principles of classical conditioning, while flooding prevents people from avoiding their phobias and stops the negative reinforcement from occuring
L - consequently, these therapies have been successfully used to treat people with phobias, providing further support for the effectiveness of the behaviourist explanation and the value of the two-process approach
ao3 / strength - evidence supports the behavioural explanation of phobias, that phobias occur following a traumatic experience
(+ however)
P - research evidence supports the behavioural explanation that phobias occur following a traumatic experience
E - watson & rayner (1920) demonstrated classical conditioning in the formation of a phobia in Little Albert, who was conditioned to fear white rats
↳ by pairing the rat (NS) with the loud noise (UCS) the UCR of fear was produced & conditioned
(this supports the idea that classical conditioning is involved in acquiring phobias in humans and that acquisition of phobias can occur after a bad experience)
however -
-not all phobias develop after a bad experience
-some common phobias such as snakes, occur in populations where people have few experiences with snakes, let alone traumatic experiences
-also, not all frightening experiences lead to phobias
↳ this means that an association between phobias and frightening experiences is not as strong as we would expect if behavioural explanations were complete
criticisms of behavioural explanations of phobias
the behaviourist explanation of phobias neglects the importance of the role of cognition (thinking) in phobias
ao3 / criticism - the behaviourist explanation of phobias neglects the importance of the role of cognition (thinking) in phobias
P - the behaviourist explanation of phobias neglects the importance of the role of cognition (thinking) in phobias
E - phobias may develop as a result of irrational thinking and beliefs about the phobic stimulus, not just learning
↳ eg: sufferers of claustrophobia may think they’ll suffocate in a lift → this is an irrational thought
↳ these are not taken into consideration in the behaviourist explanation
L - furthermore, the cognitive approach has also led to the development of CBT, a treatment which is said to be more successful than the behaviourist treatments (this means that the behaviourist approach cannot explain all symptoms of phobias)
how does the behavioural explanation of phobias link to issues and debates?
reductionism:
-behaviourist explanations have been criticised for offering an extremely reductionist viewpoint of the factors that may cause phobias
-these explanations reduce complex behaviour of phobias down to constituents (eg: stimulus-response links) → simplistic
-it would be more appropriate to acknowledge a holistic view of phobias where other components can be considered (e.g. biological, evolutionary, cognitive explanations) and understand how they interact together to explain the acquisition and maintenance of phobias
environmental determinism
-ignores the role of individual free will in the formation of phobias
-not every person bitten by a dog develops a phobia of dogs, for example, so other processes must be at play
nomothetic approach
-the behavioural approach is a nomothetic approach (has created universal laws regarding the formation and maintenance of phobias)
-if we accept individual cognition plays a part, a more idiographic approach may be effective
what are the two behavioural approaches to treating phobias?
-systematic desensitisation
-flooding
how to behavioural treatments link to the two process model?
in his two-process model of phobia acquisition, mower suggests that phobias are acquired as a result of classical conditioning and maintained by operant conditioning
behavioural treatment therefore aims to:
1. reduce phobic anxiety through the principle of classical conditioning
2. reduce phobic anxiety through the principle of operant conditioning
the principle of systematic desensitisation:
wolpe (1958) states that two competing emotions cannot occur at the same time so if fear is replaced with relaxation the fear cannot continue
(so one emotion prevents the other. this is called reciprocal inhibition)
what is systematic desensitisation?
-a behavioural therapy designed to gradually reduce phobic anxiety through classical conditioning
-counter-conditioning is used to unlearn the maladaptive response phobic stimuli by eliciting another response (relaxation)
-if a person can learn to relax in the presence of the phobic stimulus they will be cured - is impossible to be afraid and relaxed at the same time
what is counterconditioning?
a new response to the phobic stimulus is learned (phobic stimulus is paired with relaxation instead of anxiety)
what is reciprocal inhibition?
the process of inhibiting anxiety by substituting a competing response, in this case, relaxation
what are the three components to systematic desensitisation?
1) fear/anxiety hierarchy
2) relaxation training
3) gradual exposure
fear/anxiety hierarchy
-with the help of a therapist, clients construct an anxiety hierarchy
-feared objects or situations linking to the phobic stimuli are ranked from the least to the most feared).
relaxation techniques
-th patient is trained in relaxation techniques, so that they an relax quickly and as deeply as possible
-breathing techniques, mental imagery techniques
gradual exposure
-the patient is then exposed to the phobic stimwhilst practicing the relaxation techniques (feelings of tension and anxiety arise)
-due to the theory of reciprocal inhibition, a person is unable to be anxious and relaxed at the same time and the relaxation should overtake the fear
-the patient starts at the bottom of the fear hierarchy and when the patient can remain relaxed in the presence of the least feared stimulus, they gradually progress to the next level
-the patient gradually moves their way up the hierarchy until they are completely relaxed in the most feared situation
(at this point systematic desensitisation is successful and a new response to the stimulus has been learned, replacing the phobia)
strengths of systematic desensitisation
-research evidence demonstrates the effectiveness of this treatment for phobias
ao3 / strength - research evidence demonstrates the effectiveness of this treatment for phobias
P - research evidence demonstrates the effectiveness of this treatment for phobias
E - mcGrath et al. (1990) found that 75% of patients with phobias were successfully treated using systematic desensitisation
↳ this was particularly true when using in vivo techniques in which the patient came into direct contact with the feared stimulus rather than simply imagining (in vitro)
L - this shows that systematic desensitisation is effective when treating specific phobias, especially when using in vivo techniques
criticism of systematic desensitisation:
systematic desensitisation is not effective in treating all phobias
ao3 / criticism - systematic desensitisation is not effective in treating all phobias
P - systematic desensitisation is not effective in treating all phobias
E - patients with phobias that weren’t developed through a personal experience (classical conditioning), aren’t effectively treated using systematic desensitisation
↳ some psychologists believe that certain phobias have an evolutionary survival benefit and are not the result of learning
↳ a further issue is that SD is not as effective if the fear is more abstract e.g. fear of being judged by others
L - this highlights a limitation of systematic desensitisation, which is ineffective in treating evolutionary phobias (innate) and abstract phobias
what is flooding?
-if directly exposes clients to the phobic stimuli without a gradual build up in an anxiety hierarchy and without relaxation
-It involves immediate exposure to a very frightening situation
how long are flooding sessions?
-flooding sessions are typically longer than SD sessions, one session lasting 2-3 hours
-sometimes only one long session is needed to cure a phobia
what does flooding lead to?
extinction
-without the option for avoidance behaviour, the patient quickly learns that the phobic stimulus is harmless
steps of extinguishing:
1) the conditioned stimulus is encountered without the unconditioned stimulus
2) the conditioned stimulus no longer produces the conditioned response (fear)
3) as exhaustion sets in for the individual they may begin to feel a sense of calm and relief, which creates a new positive association to the stimulus
ethics of flooding:
-flooding isn’t unethical → patients give their informed consent so they know exactly what is involved
-it’s an unpleasant experience and a patient has to be properly prepared
-a patient would normally be given the choice of systematic desensitisation or flooding
strength and criticism of flooding:
-provides a cost-effective treatment for phobias
-can be highly traumatic for patients
ao3 / strength - provides a cost-effective treatment for phobias
P - it provides a cost-effective treatment for phobias
E - a therapy is cost effective if it is clinically effective but not costing the NHS a large sum of money
↳ research has suggested that flooding is equally effective to other treatments, but takes much less time in achieving these positive results
↳ in some cases, flooding can work in as little as one session as opposed to 10+ for SD
L - this is a strength of the treatment because patients cure their phobias more quickly & it is therefore more cost-effective for health service providers who do not have to fund longer options
(benefits economy)
ao3 / criticism - can be highly traumatic for patients
P - although flooding is considered a cost-effective solution, it can be highly traumatic for patients since it purposefully elicits a high level of anxiety
↳ patients and therapists rate flooding as significantly more stressful than SD
↳ it is not unethical as patients provide fully informed consent, but many do not complete their treatment because the experience is too stressful (high attrition rates)
L - therefore, initiating flooding treatment is sometimes a waste of time and money if patients do not engage in or complete the full course of their treatment and so therapists may avoid this treatment
