psychopathology Flashcards
what is statistical infrequency?
an ovbious way to define something as normal or abnormal is according to the no of times we observe it, so statistics.
this definition says only usual behaviours or characteristics can be normal and behaviour different to this is abnormal - a statistical infrequency.
at any one time only a small no of people will have an irrational fear of buttons
an example of statistical infrequency is IQ and intellectual disability disorder. intelligence is a characteristic that can be reliably measured. we know that in any human average the majority of scores cluster around the average and the further above or below the average the further people have that score - normal distribution.
the average IQ is 100 with most being at 85-115. theres only 2% under 70 so they are unusual/ abnormal and are likely to get a diagnosis of intellectual disability disorder.
what is the strength of statistical infrequency?
a strength is real life application, for example in the diagnosis of intellectual disability disorder. there is therefore a space for statistical infrequency in thinking about whats normal or abnormal behaviours and characteristics. all assessments of patients with mental disorders include some sort of measurement of symptom severity compared to statistical norms. this makes statistical infrequency a useful part of clinical assessment.
what are the 2 weaknesses of statistical infrequency?
one weakness is that unusual characteristics can be positive like a high IQ of over 130. this is equally as unusual as below 70 IQ but we dont see it as undesirable or needing treatment. just because very few display certain behaviours making them statistically abnormal doesnt mean they need treatment to return to normal. this means statistical infrequency cant be used alone for diagnosis.
another weakness is that not everyone unusual benefits from a label. if someone is living a happy fulfilled life theres no point of labelling them as abnormal regardless of unusualness. so someone with a low IQ but they are not distressed (e.g. can work) wouldnt need a diagnosis of intellectual disability and if they are labelled as abnormal they may get a negative effect on the way they and others view them.
what is deviation from social norms?
this is when people behave different from how we expect people to behave. groups of people choose to define behaviour as abnormal on the basis it offends their sense of what is acceptable - they make collective judgements as a society on whats right. ‘norms’ are specific to the culture we live in so theres relatively few behaviours that are universally abnormal on the basus they breach social norms e.g. homosexuality.
an example is antisocial personality disorder APD (psychopathy) which is impulsive aggressive and irresponsible. according to the DSM-5 an important symptom of APD is an ‘absence of prosocial internal standards associated with failure to conform to lawful or culturally normative ethic behaviour’. in other words we are making the social judgement that a psychopath is abnormal as they dont conform to our moral standards. psychopathic behaviour would be considered abnormal in a very wide range of cultures.
what are the 3 weaknesses of deviation from social norms?
one weakness is its not a sole explanantion. even though it does have real life application in diagnosing APD so theres place for it in thinking about whats normal or abnormal. but, even in this case there are other factors to consider e.g. the distress to others resulting from APD. so in practice, deviation from social norms is never the sole reason for defining abnormality.
another weakness is cultural relativism. a problem for using deviation from social norms to define behaviour as abnormal is that social norms vary from generations and communities. so a person from one culture may label someone from another culture as abnormal to their standards instead of to the standards of the person behaving that way e.g. hearing voices is normal (socially acceptable) in some cultures but not the UK. this creates issues for people living in a different culture to their own.
the last weakness is that it can lead to human rights abuses. too much reliance on ‘deviation’ to understand abnormality can lead to systematic abuse of human rights. history shows diagnoses can be there to maintain control over minority ethnic groups and women. classifications can appear ridiculous nowadays and this is only due to our social norms changing. more radical psychologists suggest some modern categories of mental disorders are actually abuses of peoples rights to be different.
what is failure to function adequately?
this is when you cant cope with the ordinary demand of everyday life so cross the line from normal to abnormal. might decide someones not functioning adequately when they are unable to maintain basic standards of nutrition and hygiene or cant hold down a job or maintain relationships.
rosenhan and seligman 1989 proposed signs to detremine when someones not coping - no longer conform to standard interpersonal rules like eye contact, experience severe personal distress, behaviour is irrational or dangerous to themselves or others.
an example is intellectual disability disorder where one criterion is low IQ (a statistical infrequency) but a diagnosis of this only occurs if failure to function adequately is also present.
what is the strength of failure to function adequately?
the strength is the patients perspective. it attempts to include the subjective experience of the individual. may not be entirely satisfactory approach as its hard to assess distress but it acknowledges that the experience of the patient is important. it captures the experience of many people who need help so its a useful criterion for assessing abnormality.
what are the 2 weaknesses of failure to function adequately?
a weakness is is it simply a deviation from social norms? it can be difficult to distinguish failure to function from deviation from social norms. not having a job is failure to function, but whatif we choose this alternative lifestyle. or those who do extreme sports are behaving in a maladaptive way, those with religious or supernatural beliefs are irrational. if we treat these behaviours as failures to adequately function we risk limiting personal freedom and discriminating against minority groups.
another weakness is subjective judgements. deciding if someone is failing too function adequately means someone has to judge if a person is distressed or distressing. some patients may say they’re distressed but may be judged as not suffering. theres methods for making judgements as objective as possible like checklists. but the principle remains that someone has the right to make this judgement.
what is deviation from ideal mental health?
this is when someone doesnt meet the criteria for good mental health, so it ignores what makes someone abnormal and focuses on what makes them normal.
jahoda 1958 said we are in good mental health if we meet these criteria:
we have no symptoms or distress, we are rational and can perceive ourselves accurately, we self-actualise, we can cope with stress, we have realistic views of the world, we have good self esteem and lack guilt, we are independent of other people, we can successfully work love and enjoy our leisure.
there is some crossover from deviation from ideal mental health and failure to function adequately, so we can think of someones inability to keep a job as failure to cope with pressures of work or as a deviation from the ideal of successfully working.
what is 1 strength of deviation from ideal mental health?
a strength is that its a comprehensive definition. it covers a broad range of criteria for mental health - it probably covers most of the reasons someone would be referred for help or seek help from mental health services. the sheer range of factors discussed in relation to jahodas ideals make it a good tool for thinking about mental health.
what are 2 weakness of deviation from ideal mental health?
one weakness is cultural relativism. some of the ideas in jahodas classification are specific to Western Europe and north American cultures e.g. the emphasis on personal achievement in self actualisation would be considered self indulgent in much of the world, as the emphasis is on the individual not family or community. similarly much of the world see independence from others as bad, such traits are typical in individualistic cultures.
the other weakness is it sets unrealistically high standards. very few would get all of jahodas criteria and probbaly none would get them all at the same time or keep them up for long, so this approach would see most as ‘abnormal’. this can be positive or negative. on the positive side it makes it clear to people the ways they can benefit from seeking treatment to improve their mental health. but the negative is that deviation from mental health is probably of no value in thinking about who might benefit from treatment against their will.
explain phobias
a phobia is an irrational fear of an object or situation.
the dsm-5 says phobias are characterised by excessive fear and anxiety triggered by objects/places/situations.
extent of fear is out of proportion to any real danger presented by the phobic stimulus. DSM recognises 3 categories - specific phobia of object or situation.
social anxiety is the phobia of a social situation.
agoraphobia is a phobia of being outside or in a public place.
explain the behavioural characteristics of phobias
this is the way people act so their response to high levels of anxiety and try to escape. fear repsonse in phobia is the same as with any other fear even if the level of fear is irrational/
panic - phobic person panics in the presence of the phobic stimulus e.g. crying, screaming, running away.
avoidance - tend to go to lot of effort to avoid coming into contact with phobic stimulus making it hard to go about daily life like work, education, social life.
endurance - sufferer stays in presence of phobic stimulus but continues to expeerience high levels of anxiety. this can be unavoidable e.g. flying.
explain the emotional characteristics of phobias
anxiety - phobias are classed as anxiety disorders so have emotional repsonse of fear and anxiety. anxiety is unpleasant state of high arousal stopping relaxing and positive emotions. it can be long term.
fear is the immediate and unpleasant response when experience or think about phobia e.g. arachnophobia so increased anxiety in place associated with spiders but fear if they see spider.
emotional responses are unreasonable in relation to the phobic stimulus so huge emotional response to a tiny harmless spider.
explain the cognitive characteristics of phobias
this is the way people process information. if you have a phobia you process information on the phobic stimulus differently from other objects.
selective attention to phobic stimulus - may see it and its hard to look away from. keeping attention on something dangerous is good but not useful if the fear is irrational.
irrational beliefs - in relation to phobic stimuli e.g. social phobia ‘if i blush theyll think im weak’ causing higher pressure in social situations.
cognitive distortions - phobics perception of phobic stimulus may be distorted.
explain the behavioural approach to explaining phobias
emphasises role of learning in the acquistion of behaviour (focus on what we can see). helps explain behavioural parts rather than cognitive or emotional.
mowrer 1960 proposed the two-process model. states phobias are acquired by classical conditioning and continue due to operant.
explain the behavioural approach to explaining phobias - classical
acquisition by classical - learn to associate something of which we initially have no fear of (neutral stimulus NS) with something that triggers a fear response already (unconditioned stimulus US).
watson and rayner 1920 created a phobia in 9 month ‘little albert’. albert showed no unusual anxiety at the start of study and when shown a white rat he tried to play with it. the experimenters set out to give him a phobia. the rat was presented and they made a loud frightening noise by banging an iron bar close to alberts ear. the noise is US which creates unconditioned response (UR) of fear. rat (NS) and noise (US) encountered close together. NS gets associated with US and both now produce the fear response - albert frightened when he sees the rat. rat is now learned conditioned stimulus (CS) with a conditioned response (CR).
then generalised conditioning is then generalised to similar objects. tested albert by showing him other furry objects like non white rabbit, fur coat and watson in cotton ball santa beard. albert displayed distress at the sight of all of these.
explain the behavioural approach to explaining phobias - operant
maintenance by operant - responses acquired by classical usuallytend to decline over time but phobias are normally long lasting. mowren explains this as a result of operant conditioning.
operant takes place when our behaviour is reinforced (rewarded) or punished. reinforcement tends to increase frequency of a behaviour. this is true of negative and postive reinforcement.
in negative the individual avoids an unpleasant situation. such behaviour results in a desirable consequence which means behaviour is repeated. mowrer suggest whenever we avoid a phobic stimulus we avoid or escape the fear and anxiety we would have suffered if we had remained there. this reduction in fear reinforces the avoidance behaviour so the phobias maintained.
what is the strength of the behavioural approach to phobias?
a strength is that it has good explanatory power. the 2 process model was a definite step forward as it went beyond watson and Rayners concept of classical conditioning. it explained how phobias could be maintained over time and this had important implications for therapies as it explains why patients need to be exposed to the feared stimulus. once a patient is prevented from practicing their avoidance behaviour, the behaviour stops being reinforced so it declines. the application to herapy is a strength of the two process model.
what are the 2 weaknesses of the behavioural approach to phobias?
one weakness is that theres an alternative explanantion for avoidance behaviour. not all avoidance behaviour is a result of anxiety reduction, at least in more complex ones like agoraphobia. evidence to suggest at least some avoidance appears to be motivated by more positive feelings of safety. so motivating factors of choosing not to leave house is not to avoid phobic stimulus but to stick with safety. explains why some with agoraphobia can leave their house with a trusted person and have little anxiety but can’t go alone (buck 2010). this is a problem for 2 process model which suggests avoidance is motivated by anxiety reduction.
another weakness is its an incomplete explanation of phobias. even if we accept classical and operant are involved in development and maintenance of phobias there are some aspects of phobic behaviour that require further explaining. bounton 2007 points out that evolutionary factors probably have an important role in phobias but 2 factor theory doesnt mention this. for example, we easily acquire phobias of things that have been a source of danger in our evolutionary past like snakes. its adaptive to acquire such fears. seligman 1971 called this biological preparedness - innate predisposition to acquire certain fears. but its quite rare to develop a fear of cars or guns which are more dangerous to most people today than snakes. presumably this is because theyve only existed very recently so we arent biologically prepared to learn fear responses to them. the phenomenon of preparedness is a serious problem for the 2 factor theory as it shows theres more to acquiring phobias than simple conditioning.
explain the behavioural approach to treating phobias - systematic desensitisation
systematic desensitisation (SD) is a behavioural therapy designed to gradually reduce phobic anxiety through classical conditioning. if a sufferer can learn to relax in the presence of phobic stimulus theyll be cured. so a new response to the phobic stimulus is learnt (paired with relaxation not anxiety).
learning of a different response is called ‘counterconditioning’. its also impossible to be afraid and relaxed at the same time so one emotion prevents another - ‘reciprocal inhibition’.
explain the behavioural approach to treating phobias - systematic desensitisation 3 processes
there are 3 processes involved.
1. the anxiety hierarchy is put together by patient and therapist. they create a list of situations related to phobic stimulus that cause anxiety and arrange them in order from least to most frightening (arachnaphobe the least is picture of tiny spider and most is holding a tarantula).
2. relaxation where the therapist teaches the patient to relax as deeply as possible. may be breathing excersises or learning mental imagery techniques like imagining themselves in relaxing situation or meditation. can get relaxation with drugs like valium.
3. exposure so the patient gets exposed to the phobic stimulus when in a relaxed state. takes place across several sessions starting at bottom of hierarchy. when patient can stay relaxed in presence of lower levels, they move up hierarchy. treatment is successful when patient can stay relaxed in situations high on anxiety hierarchy.
what are the 3 strengths of systematic desensitisation?
one strength is its effective. research shows SD is effective in treatment of specific phobias e.g. gullefer 2003 followed 42 patients treated for a spider phobia in 3 45min sessions of SD. phobia was assessed on several measures including spider questionnaire and by assessing response to a spider. control group treated by relaxation with no exposure. at 3 months and 33 months after treatment the SD group were less fearful than relaxation group. strength as shows SD is helpful in reducing anxiety in spider phobia and effects are long lasting.
another strength is suitable for a diverse range of patients. alternatives to SD (flooding and cognitive therapies) arent well suited to some e.g. sufferers of phobia with learning difficulties which may make it ahrd to understand whats happening in flooding or to engage with cognitive therapies that require the ability to reflect on what your thinking. for those patients SD is most appropriate.
the last strength is its acceptable to patients. a strength to SD is that patients prefer it. if given a choice between SD and flooding they tend to prefer SD which is largely as it doesnt cause the same degree of trauma as flooding. may also be because SD has some elements like the relaxation. this is reflected in the low refusal rates and low atrrition rates of SD.
explain the behavioural approach to treating phobias - flooding
flooding invoves exposing phobic patients to their phobic stimulus with immediate exposure to a very frightening situation. so an arachnophobe may have a large spider crawl over them for an extended period. flooding sessions tend to be longer than SD sessions with one session being 2-3 hours long so sometimes only 1 long session is needed to cure phobia.
it works by stopping a phobic response very quickly. without the option of avoidance behaviour the patient quickly learns the phobic stimulus is harmless, in classical conditioning terms this process is called ‘extinction’. a learned response is established when conditioned stimulus CS (e.g. dog) is encountered without the US (being bitten). the result is CS no longer produces conditioned responses of fear.
in some cases the patient may achieve relaxation in presence of phobic stimulus as exhausted by their own fear response.
explain the behavioural approach to treating phobias - flooding ethics
flooding isnt unethical per se but it is an unpleasant experience so its important that patients give fully informed consent to this traumatic procedure and that they are fully prepared before the flooding. patients are normally given the choice between SD and flooding.
what is the strength of flooding?
the strength is that its cost effective. its at least as effective as other treatments for specific phobias. studies comapring flooding to cognitive therapies (ougrin 2011) have found flooding is highly effective and quicker than alternatives. the quick effective is a strength as it means patients are free of their symptoms as soon as possible so makes treatment cheaper.
