psychopathology Flashcards
Behavioural characteristics of phobias:
Avoidance of the situation or object that is the source of the fear or opposite behaviour of freezing or fainting (part of stress response).
Avoidance can lead to disruption in normal routine, job, social life, relationships etc. This is how a phobia is different from more everyday fears that don’t affect your life.
The two-process model
First stage: Classical conditioning (explains why phobias develop).
Second stage: Operant conditioning (explains why phobias continue).
little Albert
Phobia learnt through association. Loud noise of steel bar being hit with hammer (UnConditioned Stimulus), produces UnConditioned Response of fear, White rat (Neutral Stimulus). By pairing the loud noise with the rat, the rat acquires the same properties as the UCS & produces the response of fear. The rat has become the Conditioned Stimulus & now produces fear on its own.The fear becomes the Conditioned Response.
Operant Conditioning: Maintenance
Explains why the fear continues & why people avoid the feared object. Rewards reinforce behaviour, avoiding the feared object will reduce fear. Reduction in fear is rewarding, therefore the person will repeat the behaviour and continue to avoid the object. What is the term for this process? This is known as negative reinforcement.
Evaluation of Behavioural Model - Strengths
The behaviourist approach to phobias is that the behaviourist model is based on scientific lab experiments that have found support for classical and operant conditioning. Eg Pavlov’s dogs & Skinner’s rats. This adds validity to the theory that other behaviours such as phobias can also be learnt. This viewpoint is supported by the case study of Little Albert who clearly learnt his phobia through the process of classical conditioning.
Evaluation of Behavioural Model - Strengths 2
A positive implication of the behaviourist approach to phobias is that it has led to effective treatments which show that abnormal behaviour can be reduced by unlearning behaviours. For example, systematic desensitisation and flooding both involve exposure to the phobia object/situation to help break the learnt association. SD has a 75% success rate demonstrating an important real life application to this model.
Why is the model deterministic?
The behavioural theory is also criticised for being deterministic This is because it suggests that people have no control over their phobia as it is determined by environment. For example, the theory says a learnt association WILL lead to a phobia when in fact it might not, eg you might be bitten by a dog but still not develop a dog phobia.
What other approaches could explain phobias?
The Evolutionary explanation suggests we are genetically programmed to make associations between potentially life-threatening stimuli and fear. This would have helped our early ancestors in the EEA to survive as it would have been adaptive to fear spiders, heights & strangers! Evolutionary theory explains why we rarely develop phobias of modern objects that are quite dangerous e.g. cars, toasters.
ABNORMALITY AS STATISTICAL INFREQUENCY
Abnormality is statistically rare (i.e. uncommon). Based on the idea that behaviour is normally distributed & it is argued that people who are 2 standard deviations above or below the mean (i.e. in the extreme 2.145% of the population) are abnormal.
ABNORMALITY AS DEVIATION FROM SOCIAL NORMS
A society has rules about what are acceptable behaviours, values & beliefs. Behaviour is abnormal if it deviates from some notion of what the society considers proper or acceptable. E.g. talking to oneself when walking down the street.
ABNORMALITY AS FAILURE TO FUNCTION ADEQUATELY
Behaviours that prevent people from coping with the demands of everyday life such as the ability to work, the motivation to care for themselves or form relationships are abnormal. Can be assessed using the Global Assessment of Functioning Scale (GAF). This is a scale from 0 -100.
ABNORMALITY AS A DEVIATION FROM IDEAL MENTAL HEALTH
Abnormal behaviour deviates from the ideal of how people should behave. This definition specifies the ideal and then suggests those who do not meet these criteria are abnormal.
a positive attitude towards oneself;
the opportunity to self-actualise (achieve one’s potential);
the ability to resist stress;
personal autonomy (not being too dependent on others);
an accurate perception of reality;
the ability to adapt to one’s environment.
AO3 : Inaccuracy of statistical data
This definition relies on having accurate statistical data for the population but there may are many reasons why statistical data may be inaccurate. There may be a problem of gender bias as women are more likely to seek help from their doctor for issues such as anxiety whereas males are more likely to bottle up their anxiety. Masculine stereotypes may prevent men from seeking help so statistics will suggest that more females suffer mental illness which might not be true. Statistical data may therefore reflect the likelihood of seeking help rather than the real number of cases. Therefore using statistics to differentiate between normality and abnormality is flawed.
social desirability for Statistical infrequency
Does not take into account desirability of the behaviour. Some abnormalities are frequent and yet still need treatment e.g. depression (item A). Many desirable behaviours e.g. genius or low anxiety are statically infrequent but are beneficial and do not require treatment.
AO3 ; Failure to function adequately
Many ‘normal’ people fail to cope at certain times, e.g. after a bereavement or before a stressful exam. In these situations if a person does cope we may consider them abnormal. Therefore, the definition is flawed as there are situations when not coping would not be abnormal.
Who should make the judgement about whether a person is functioning adequately?
A problem with this definition is that it involves making subjective value judgements about others as to what constitutes failure to function adequately. Who makes the judgement as to whether a person is not functioning adequately? There are ethical issues with doctors making judgements about other people’s functioning as it involves labelling people. But can the individual decide? People with schizophrenia & eating disorders often deny they have a problem.
Deviation from social norms – Cultural relativism
Social standards vary from culture to culture and one society’s norms should not be used to define another culture as abnormal. For example, in the Sun Dance ceremony, native American Indians would pierce their skin with skewers made of bone as an offering to improve their lives. Also in some countries people eat insects or practice sorcery. Whilst these behaviours seem abnormal to us, many people in the world would view Western behaviours as abnormal. Which of our behaviours might be considered abnormal by other cultures? Eg birth control, having only one wife and bottle-feeding infants. Therefore, using the definition of deviations from social norms may result in incorrect diagnosis of abnormality.
AO3 - Deviation from social norms
Social norms vary over time as a consequence of prevailing attitudes. E.g. until relatively recently it was not acceptable to have a child outside of marriage & single mothers were locked up in psychiatric institutions. Also homosexuality was once considered a mental illness & was listed in the DSM until 1973! Using deviation from social norms as a definition of abnormality therefore means that abnormality would be constantly changing over time.
Deviation from ideal mental health - Cultural relativism
Perceptions of reality are partly dependent on cultural and religious beliefs. Some cultures e.g. the Trobriand Islanders believe in flying witches and that in order to become pregnant women must be infused with spirits from the nearby island. In the West we would see these ideas as an inaccurate perception of reality and thus would diagnose mental illness. Therefore, using Jahoda’s criteria for ideal mental health may result in incorrect diagnosis of abnormality cross culturally.
AO3 - Deviation from ideal mental health
Perceptions of reality change with time with new knowledge, e.g. once people believed that the world was flat and in fact the first individuals who challenged this were considered abnormal. Therefore, in using this definition of abnormality would change over time and be inconsistent.
AO3 - deviation form ideal mental health 2
It has been suggested that an accurate perception of reality is not a characteristic of normal people. It is claimed that depressed patients perceive the world more accurately than clinically normal people. It appears that ‘normal’ people need to create ‘positive illusions’ in order to protect themselves from reality.
Depressed patients make much more accurate assessments of their place in the world. Therefore, the idea of accurate perception of reality as ideal mental health is flawed.
systematic dysensitisation
The individual initially constructs an anxiety hierarchy. Relaxation training is then given which aims to allow the patient to achieve complete relaxation. The patient is asked to imagine, as vividly as possible, the scene at the bottom of the hierarchy
They are told to relax at the same time. Then graded pairing is used in which they move up the anxiety scale. This only occurs when complete relaxation has been achieved. Another approach is to use graded pairing of the real stimulus. This is almost always more effective and longer lasting than the imagined technique.
systematic desensitisation - strength 1
The patient does not have to experience intense anxiety & they are in control of the treatment as they only move up the anxiety hierarchy when they feel relaxed. This means that there are no ethical issues. SD has a high success rate:
75% success with specific phobias
90% success for blood-injection phobias after 5 sessions of graded exposure. The treatment is most successful when real stimulus are used rather than imagined.
systematic desensitisation - strength 2
Relatively fast & requires less effort from the patient compared to other psychological therapies. Eg CBT requires patients to understand their thoughts and consequent behaviour and apply these insights. The lack of ‘thinking’ in systematic desensitisation means it can be successful with children & adults with learning difficulties. SD can be self administered. This has been shown to be as effective as therapist-guided therapy.
