psychopathology Flashcards
what is psychopathology?
the scientific study of psychological disorders, psychiatrists identify signs and symptoms
how can abnormality be defined?
- deviation from social norms
- failure to function adequately
- deviation from ideal mental health
- statistical infrequency
These definitions provide a framework for identifying abnormal behaviour. They do not diagnose abnormality or categorise it. They are clues that someone’s behaviour may need monitoring or need further investigation.
what are social norms?
- created by people within society, specific to that society
- standards of acceptable behaviour within a given society, those within that social group adhere to these standards
- rules of behaviour, some are implicit where others are governed by law
examples of types of social norms
Examples of implicit norms: shaking hands when greeting someone, forming a queue to pay for something, not being late.
Examples of explicit norms: Animal Welfare Act 2006, Equality Act 2010.
deviation from social norms - a definition for abnormality
- Anyone who deviates from the socially/culturally created norms is classed as abnormal under this definition.
- Eg. those with antisocial personality disorder (APD) would be quickly picked up by this definition for their impulsive, aggressive, irresponsible behaviours
evaluation of deviation from social norms as a definition for abnormality
+ practical applications, quick and easy to use, successful framework, EG. impulsive acts caused by APD
- changing society, individuals deemed abnormal under one set of norms may find themselves considered normal by later norms, eg. homosexuality, lacks temporal validity
- cultural bias due to significant differences in normal between cultures, eg. the desirability of hearing voices or self harm, guilty of focusing on Western norms
- some people would be classed as abnormal despite choosing not to follow norms, eg. punks, the definition does not allow for differentiation between mentally abnormal and anti-conformist people
the sun dance
- the greatest religious ceremony of the Native Americans
- held every summer and lasted 4 days
- to secure the help and support of the supernatural powers
- towards the end of the ceremony, the dancers attached rawhide ropes through slits cut in their chests.
- The ropes were attached to a pole and the dancing continued until they were torn loose from the flesh.
- Any dancer who had a vision or heard voices was thought to be favoured by the spirits.
sharmans
- obtained their power from the spirits
- able to cure the sick, discover the whereabouts of an enemy, and recover lost/stolen property
- often the cause of illness was diagnosed as a foreign object in the patient’s body
- Bull All The Time, a Sharman of the Native American Cree people, cured several patients by sucking at the afflicted parts and pulling out respectively a bone, a black beetle, and a morsel of meat.
the dobuans
- Ruth Benedict’s description of the culture of the Dobuan islanders of Melanesia detailed how their society was characterised by a distrust of others, verging on what we would call paranoia.
- Eg. no one would leave a cooking pot unattended for fear of poisoning.
- Benedict describes one man as pleasant and helpful but was considered crazy by other members of society.
hallucinations, Nigel Copsey
- Nigel Copsey is a psychologist and ordained minister who spent two years studying the churches, temples, and mosques of ethnic minority groups in London’s East End.
- He found that many African Caribbean an Asian people refuse to talk about their religion to health workers for fear of being diagnosed as suffering from a psychological disorder.
- One pastor told him that many members of his congregation ‘heard voices’ and believed they were possessed by evil spirits. The pastor prayed alongside them to break the ‘spell’. Only if the voices continued did he admit the possibility of psychological disorder.
John Slater
- an eccentric (someone who deviates from established patterns of behaviour)
- once walked from Lands’ end to John O’Groats in his bare feet, wearing only striped pajamas and accompanied by his pet Labrador, Guinness
- has had a range of jobs from Royal Marines bandmaster to social worker to waiter
- For most of the past ten years, he has lived in a cave that is flooded by seawater at high tide. He says that he enjoys the ‘cathedral-like silence in caves’ as it helps him to think.
- his behaviour is unusual but it doesn’t indicate a psychological disorder.
study of eccentrics
According to a study of 1000 eccentrics - based on in-depth interviews, personality questionnaires and a range of tests which reveal psychological disorders - they had fewer disorders than the general population. Most eccentrics were happy and well-adjusted.
failure to function adequately - a definition for abnormality
Anything that interferes significantly with normal routine is considered abnormal. Distress or harm to the individual or others is also classed as abnormal. An individual may be aware or unaware of their failure to function adequately.
- the GAF scale
the GAF scale
The DSM-V includes a scale of 1-100 that measures how adequately a person is functioning. This is known as the Global Assessment of Functioning (GAF) scale. 1 represents serious risk to self/others and 100 represents perfect health.
evaluation of failure to function adequately as a definition for abnormality
- abnormality is not necessarily linked to dysfunction, people are capable of functioning whilst being abnormal which the definition does not account for
- sometimes there are exceptions where people appear to be failing to function but are not necessarily abnormal such as whilst grieving, while ill or in the run up to exams
- cultural differences/bias where someone seems to be demonstrating signs of failing to function in one culture but in their culture are behaving normally - definition is not comprehensive enough
- subjective interpretation, lack of inter-rater reliability eg. Rosenhan’s research in psych wards
deviation from ideal mental health - a definition for abnormality
- This definition was devised by Marie Jahoda (1958).
- also provided characteristics that an individual should exhibit in order to be normal.
- She said that an absence of good mental health should be used to judge abnormality. The more criteria someone fails to meet, the more abnormal they are.
- perceives abnormality in a similar way to how physical health is assessed
- looks for signs of an absence of wellbeing in mental health terms
Jahoda’s six criteria for ideal mental health
Pessimistic Snakes Are Really Acting Everyday:
- Positive attitude towards oneself
- Self-actualisation
- Autonomy
- Resisting stress
- Accurate perception of reality
- Environmental mastery
positive attitude towards oneself
- one of Jahoda’s six criteria for ideal mental health
- high self-esteem, self-respect, and a positive self-concept
- eg. self-harm, self-loathing, suicide attempts, lack of self-care
self-actualisation
- one of Jahoda’s six criteria for ideal mental health
- experiencing personal growth and development; ‘becoming capable of everything one is capable of becoming’
- eg. not setting goals or setting unrealistic/unachievable goals
autonomy
- one of Jahoda’s six criteria for ideal mental health
- being independent, self-reliant, and able to make personal decisions
- eg. anxiety over simple decisions, disability, unable to make decisions about anything without someone else or someone else having complete control over elements of your life
resisting stress
- one of Jahoda’s six criteria for ideal mental health
- having effective coping strategies and being able to cope with everyday anxiety-provoking situations
- eg. regular panic attacks, inability to think ahead without extreme anxiety
accurate perception of reality
- one of Jahoda’s six criteria for ideal mental health
- perceiving the world in a non-distorted fashion. Having an objective and realistic view of the world
- eg. believing controversial or damaging things, paranoia, delusions of grandeur, hallucinations
environmental mastery
- one of Jahoda’s six criteria for ideal mental health
- competence in all aspects of life and able to meet the demands of any situation; having the flexibility to adapt to changing life circumstances
- eg. balancing how to act in certain situations, unable to deal with/adapt to small changes, very rigid view
evaluation of deviation from ideal mental health as a definition for abnormality
+ comprehensive
+ positive, focusing on what meets normality
+ holistic
- exceptions to the rule with people meeting all of these but still being abnormal
- ‘autonomy’ doesn’t differentiate between disability and poor mental health
- subjectivity
- cultural bias - autonomy in collectivist cultures
normal distribution curve
also known as ‘bell curve’, represents the most probably event. All possible occurrences are equally distributed around the most probable event.
standard deviation
the measure of how spread out the data is.
statistical infrequency as a definition for abnormality
Statistically rare behaviours are considered abnormal; using the bell curve - those 2 standard deviation points from the mean (roughly 5% of the population) are considered abnormal.
evaluation of statistical infrequency as a definition for abnormality
+ it is objective and quantitative - more reliable
+ gives an overall view of a population
+ can be used as evidence in receiving treatment, to help people get support
- not all statistically infrequent behaviours are undesirable/abnormal eg. high IQ
- doesn’t consider cultural factors
- it’s not always clear where to draw the line for abnormality
guides for diagnosis
The ICD-10 (International Classification for Diseases) and the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) guide diagnosis. The ICD-10 is more widely used in Europe and the DSM-5 is frequently used in America but is focused on by the AQA spec.
history of diagnosis
1900 - roughly a dozen (12) recognised illnesses eg. hysteria, melancholy, broken heart syndrome, etc.
2013 - more than 300 recognised disorders (including many variations of the same illness/disorder)
types of characteristics and examples
- cognitive - thinking - eg. concentration, obsessions, intrusive thoughts
- emotional - feeling - eg. anxiety, lowered self-esteem, heightened emotional reactions
- behavioural - doing - eg. self-harm, panic attacks, sleeping patterns
what are phobias?
Phobias are characterised by excessive fear and anxiety. The fear is out of proportion. It is generally irrational. It interrupts the ability to lead a ‘normal’ life.
DSM-5 phobia definition
it gives three categories:
1. Specific Phobia - eg. needles, flying, spiders
2. Social Anxiety - eg. speaking to others, using a public toilet
3. Agoraphobia (fear of open spaces)
cognitive characteristics of phobias
- selective attention - looking for the phobic stimuli
- irrational belief - extreme beliefs/disordered thinking eg. ‘no one likes me’ - often leads to increased pressure on the phobic person (they’re generally about the phobic person)
- cognitive distortion - thinking things that aren’t necessarily realistic attributes of the phobic stimuli (generally about the phobic stimuli) eg. ‘spiders are evil’
emotional characteristics of phobias
- anxiety - unpleasant state of high arousal a person experiences in the presence of their phobic stimulus, can’t think positively, can’t feel any positive emotions, fear is immediate and extremely unpleasant
- unreasonable emotional responses - fear experienced is out of proportion with the danger posed
behavioural characteristics of phobias
- panic - crying, screaming, hyperventilating, freezing, etc
- endurance - remains in presence of stimulus and experiences high anxiety (an alt. to avoidance)
- avoidance - changing behaviours to avoid the stimulus eg. staying at home to avoid phobic stimulus
behavourist explanation of phobias
- The Two-Process Model (Mower, 1960)
- acquired through classical conditioning and maintained through operant conditioning
- learnt as a result of association then continue to exist due to negative reinforcement
process 1 in the two-process model
classical conditioning
Eg. for a fear of a dog:
US (pain) –> UR (fear)
US (pain) + NS (dog) –> UR (fear)
CS (dog) –> CR (fear)
process 2 in the two-process model
operant conditioning
Eg. for a fear of a dog:
1. Phobic response creates intense unpleasant feelings (anxiety/fear)
2. Escaping from the dog (avoidance) causes a reduction in anxiety/fear
3. A reduction in anxiety/fear, due to escape, is rewarding
4. Avoidance, therefore, acts as negative reinforcement
5. Leads to an increased likelihood of avoiding dogs in the future
generalisation
when a fear of one thing (eg. one dog because it bit you) generalises to a fear of all similar things (eg. all dogs)
extinction
the associated fear goes away, usually after exposure therapy
spontaneous recovery
for no apparent reason, the associated fear is reformed (after extinction)
evaluation of the two-process model
+ practical applications (identifying avoidance allows us to treat using exposure - credibility and usefulness)
- ignores cognitive factors like perception and interpretation which may explain why some people don’t develop a phobia despite a bad experience (eg. DiNardo)
- neglects the evolutionary aspect (preparedness)
- genetics may also play a role (eg. Ost, 1992)
- genetic may also play a role in explaining phobias
DiNardo
- the two-process model ignores cognitive factors like perception and interpretation
- DiNardo found that 56% of individuals with a dog phobia had had an unpleasant experience with a dog
- 50% of a control population without a dog phobia had also had an unpleasant experience
Seligman’s concept of preparedness
- suggests that we acquire phobias of things that have been dangers in our evolutionary past eg. animals rather than because of association
- we don’t develop fears of things that are current threats to us like guns despite their association with negative experiences, two-process model is only a partial explanation
Ost (1992)
- genetics may also play a role in explaining phobias
- found that 62% of ppts with a blood/injection phobia had a first degree relative with the same disorder despite prevalence in the general population being 3%
what is systematic desentization?
- named by Wolpe (1958)
- aims to extinguish an undesirable behaviour by substituting the conditioned response with another
- a form of counter-conditioning based on the principles of classical conditioning
- the key principle is reciprocal inhibition
what is reciprocal inhibition?
- where the fear response is substituted with relaxation
- it is impossible to experience two opposite emotions at once since one emotion prevents the other. Based on this, someone cannot be fearful and relaxed at the same time.
what are the aspects of systematic desentization?
- Relaxation - techniques taught/drug therapy given
- Anxiety Hierarchy - least to worst feared event
- Gradual Exposure - having the phobic stimuli present in accordance to the anxiety hierarchy and remaining relaxed
