Psychopathology Flashcards
Definitions of abnormality - deviation from social norms
Abnormality is based on social context. Society has unwritten rules and when people violate these unwritten rules and deviate from social norm it could indicate a mental illness. When a person behaves in a way that is different from how they are expected to behave they may be defined as abnormal. Societies and social groups make collective judgements about ‘correct’ behaviours In particular circumstances.
Three types of consequences of behaviour - there are relatively few behaviours that would be considered universally abnormal therefore definitions are related to cultural context. This includes historical differences within the same society. Eg homosexuality is viewed as abnormal in some cultures but not others and was considered abnormal in our society in the past.
Examples of deviation from social norms
Antisocial personality disorder- one important symptom of Antisocial personality disorder (psychopathy) is a failure to conform to ‘lawful and culturally normative ethical behaviour’. A psychopath is abnormal as they deviate from social norms or standards. They generally lack empathy.
Anorexia breaks rules of eating behaviour
Schizophrenia
Strengths of deviation from social norms
It takes situational norms into account eg it’s ok to wear a bikini at the beach but not in a shopping centre.
Developmental norms are taken into account eg for young children it’s ok to cry and scream in public but for an adult this would be seen as a disorder.
Deviation from social norms - AO3 - real world application
Deviation from social norms is used in the diagnosis of antisocial personality disorder because this requires failure to conform to ethical standards eg aggression and deceitfulness. This also plays a part in the diagnosis of schizotypal personality disorder where the term ‘strange’ is used to characterise the thinking, behaviour and appearance of people with the disorder. This shows that the deviation from social criteria has value in psychiatry.
Deviation from social norms - AO3 - limitation - cultural relativism
Norms vary across cultures it is not normal for a man to wear a skirt but it may be in Scotland. Diagnosis and mental disorders are classified in different ways in different cultures. Culturally relative as a person from one culture may label someone from another culture as abnormal using their standards rather than the persons standards. Eg hearing voices is socially acceptable in some cultures but would be seen as a sign of abnormality in the UK. This means it’s difficult to judge deviation from social norms from one context to another.
Deviation from social norms - AO3 - changes over time
Homosexuality was classed as a mental disorder in 1973 version of the DSM-11. So was considered abnormal in the past and continues to be seen as abnormal and illegal in some cultures eg April 2019 Brunei made a new law that sex between 2 men punishable by stoning to death.
Definitions of abnormality - statistical infrequency definition
Defining abnormality in terms of statistics. This is the idea that behaviours that are statistically infrequent are seen as abnormal. Is based on the notion of normal distribution curve for all behaviour and those that appear in the extremes eg are statistically infrequent indicate mental illness. Normally about 5% of population fall outside the curve (2 standard deviation points away from the mean) eg IQ
Statistics are about numbers. According to the statistical definition any relatively usual behaviour or characteristic can be thought of as ‘normal’ and any behaviour that’s unusual is ‘abnormal’. This is what is meant by statistical infrequency. We can eg say that at any one time only a small number of people will have an irrational fear of buttons or believe for no good reason that their neighbours are zombies.
Statistical infrequency definition - example
IQ and intellectual disability disorder - intelligence is a characteristic that can be reliably measured. Like in any human characteristic the majority of peoples scores will cluster around the average and the further we go above or below that average, fewer people will attain that score. This is called normal distribution. The average IQ is set at 100. In a normal distribution most people - 68% have a score, in this case IQ, in the range from 85- 115. Only 2% of people have a score below 70. Those individuals scoring below 70 are very unusual or ‘abnormal’ and are liable to receive a diagnosis of a psychological disorder - intellectual disability disorder IDD
Statistical infrequency definition - AO3 - limitation - unusual characteristics can be positive
If very few people display a characteristic then the behaviour is statistically infrequent but that doesn’t mean we would call them abnormal. IQ scores above 130 are just as unusual as below 70, but not regarded as undesirable or needing treatment. This means that although statistical infrequency can be part of defining abnormality it can never be its sole basis.
Statistical infrequency definition - AO3 - strength - real world application
Statistical infrequency is useful in diagnosis eg intellectual disability disorder because this requires an IQ in the bottom 2%. It is also helpful in assessing a range of conditions eg the BDI assesses depression only 5% of people score 30+ = serve depression. This means that statistical infrequency is useful in diagnostic and assessment processes.
Statistical infrequency definition - AO3 - limitation not everyone benefits from labels
Some unusual people may benefit from being labelled abnormal to access support but when living a happy life not everyone benefits from being labelled as abnormal when they have infrequent behaviour. Pointing out their abnormality may make them more upset than not paying attention to it at all eg someone with a low IQ may live a happy life and not benefit at all by being diagnosed with an abnormality so means definition can weaken quality of life and not always improve it.
Definitions of abnormality - failure to function adequately
When an individual cannot cope with everyday life meaning they are suffering some abnormality. A person may cross the line between normal and abnormal that they cannot deal with the demands of everyday - they fail to function adequately.
For instance not being able to maintain basic standards of nutrition and hygiene, hold down a job or maintain relationships.
Failure to function adequately - rosenhan and seligman 1989 proposed further signs to failure to cope
Suggested six criteria any combination of which could indicate a persons behaviour is abnormal.
Maladaptiveness - behaviour stopping individuals from attaining life goals both socially and occupationally. Addictions can be maladaptive if they stop you going to work. Evaluation - some behaviours such as being homelessness is maladaptive but this does not mean you have a mental illness.
Personal distress - behaviour that causes personal stress to the sufferer eg not being able to keep a job so limited income. Eg depression. Evaluation - in some cases it is normal eg if a relative died and showing no distress is deemed abnormal.
Observer discomfort - displaying behaviour causes discomfort to observers eg not keeping good hygiene so it is unpleasant to be around that person. Families of people with alcohol addiction can experience observer discomfort.
Unpredictability - unexpected behaviours characterised by loss of control eg schizophrenia can make people behave unpredictably. However someone’s behaviour may only be unexpected because we are unaware of the reasons behind it so it might not be mental illness.
Irrationality - behaviour not explained rationally eg bipolar disorder can cause irrational thoughts and behaviour. Evaluation - Darwin considered irrational in his time but evolution is rational now so it changes like social norms
Unconventionality - displaying behaviour violating social norms. Evaluation - depression too common to meet criteria. Rare behaviours eg genius is abnormal but are not problematic behaviours so not helpful.
Failure to function adequately - example - alcoholics and IDD
Alcoholics suffer maladaptive behaviour as they cannot function.
Intellectual disability disorder - one of the criteria for diagnosis is low IQ (a statistical infrequency). However a diagnosis would not be made on this basis only - an individual must also be failing to function adequately before a diagnosis would be given.
Failure to function adequately - AO3 - limitation - psychopaths go undetected
Psychopaths like Harold shipman are mentally ill but by this definition function very well in society so would not be diagnosed. It can’t detect psychopaths. Harold killed his patients but functioned normally in society/ high functioning
Failure to function adequately - AO3 - culturally relative
What is functioning normally in one culture should not be used to judge behaviours in other cultures. Criteria is likely to result in different diagnoses when applied to people from different cultures.
Failure to function adequately - AO3 - strength - it represents a sensible threshold for when people need professional help
Most people have symptoms of mental disorders to some degree. According to mental health charity mind around 25% of people will experience a mental health problem in any given year. However many people press on in the face of fairly severe symptoms. It tends to be at the point that we cease to function adequately that people seek professional help or are noticed and referred to for help by others. This criterion means that treatment and services can be targeted to those who need them most.
Failure to function adequately - AO3 - limitation - easy to label nonstandard lifestyle choices as abnormal
In practice its hard to say when someone is really failing to function and when they have simply chosen to deviate from social norms eg not having a job or permanent address may seem like failing to function and for some it would be. However people with alternative lifestyles choose to live ‘offgrid’ this means people who make unusual choices are at risk of being labelled as abnormal and their freedom of choice may be restricted.
Failure to function adequately - AO3 - limitation - failure to function adequately may not be abnormal
Some circumstances in which most of use fail to cope for a time eg bereavement. It may be unfair to give someone a label that may cause them future problems just because they react normally to difficult situations. On the other hand the failure to function is no less real just because the cause is clear. Also some people need professional help to adjust to circumstances like bereavement.
Definitions of abnormality - deviation from ideal mental health
It looks at what is normal. A different way to look at normality and abnormality is to think about what makes someone ‘normal’ and psychologically healthy. Then identify anyone who deviates from this ideal.
deviation from ideal mental health - jahoda 6 criteria
It looks for signs of wellbeing if you have all 6 of these you are fine but if you are missing one you could have a mental illness. Jahoda 1958
Autonomy - independent of other people. Self reliance and the ability to function as an individual.
Positive view of self - good self -esteem and lack guilt
Resisting stress - can cope with stress, individual not feel under stress and should be able to handle stressful situations.
Self-actualisation - strive to reach our potential being in a state of contentment, feeling that you are the best you can be.
Accurate perception of reality - realistic view of the world, no distortions, have a perspective that is similar to others who see the world
Environmental mastery - coping with charge of environment and adapt to new situations and be at ease with all situations.
deviation from ideal mental health - overlap with failure to function adequately
We can think someone’s inability to keep a job as either a failure to cope with the pressures of work or as a deviation from the ideal of successfully working
deviation from ideal mental health - AO3 - limitation - extremely high standards
Very few of us attain all of jahodas criteria for mental health and probably none of us achieve all of them at the same time or keep them up for very long. It can be disheartening to see an impossible set of standards to live up to. However having such a comprehensive set of criteria for mental health might be of value to someone wanting to improve their mental health. This means that a comprehensive criteria for ideal mental health may be helpful for some but not for others.
deviation from ideal mental health - AO3 - limitation - cultural relativism
The criteria are based on western views like autonomy whereas in some societies women cannot make their own choices. Self-actualisation only applies to individualistic cultures not collectivist cultures. Using this criteria we would find a higher incidence of abnormality among non western cultures and even non-middle class society groups. The different elements are not equally applicable across a range of cultures. Some of jahodas criteria for ideal mental health are firmly located in the context of the US and Europe generally. Even in Europe there are variations in the value placed on independence (high in Germany and low in Italy). Additionally what is defined as success in our working, social and love-lives is very different in different cultures. Difficult to apply the concept of ideal mental health. From one culture to another.
deviation from ideal mental health - AO3 - strength - criteria is highly comprehensive
Ideal mental health includes a range of criteria for distinguishing mental health from mental disorder. It covers most of the reasons we may seek help for mental health so means an individuals mental health can be discussed meaningfully with a range of professionals who might take different theoretical views eg a medically trained psychiatrist might focus on symptoms whereas a humanistic counsellor may be more interested in self actualisation. Means ideal mental health provides a checklist against which we can assess ourselves and others and discuss psychological issues with a range of professionals.
Clinical characteristics - Behavioural characteristics of phobias
- panic - may involve a range of behaviours such as crying, screaming or running away from the phobic stimulus. Children may freeze, be clingy or tantrum
- avoidance - considerable effort to prevent contact with the phobic stimulus. This can make it hard to go about everyday life
- endurance - involves remaining with the phobic stimulus and continuing to experience anxiety
What are phobias
Anxiety disorders characterised by extreme irrational fears eg specific phobias (object), social phobias (social situations) and agoraphobia (outside)
Clinical characteristics - Emotional characteristics of phobias
- anxiety - an unpleasant state of high arousal. Prevent an individual relaxing and makes it very difficult to experience positive emotion.
- fear - immediate response we experience when we encounter or think about a phobic stimulus.
- emotional response is unreasonable - disproportionate to the threat post e.g. a person with arachnophobia will have a strong emotional response to a tiny spider.
Clinical characteristics - cognitive characteristics of phobias
- selective attention to the phobic stimulus - a person with a phobia finds it hard to look away from the phobic stimulus.
- Irrational beliefs - phobias may involve beliefs eg ‘if I blush people will think I’m weak’
- cognitive distortions - perceptions of a person with a phobia may be inaccurate and unrealistic e.g. bellybuttons appear ugly
Behavioural approach to explaning phobias - the two process model
Classical and operant conditioning. Mowrer (1960) argued that the acquisition of phobias is through classical conditioning and they are maintained through operant conditioning.
Behavioural approach to explaining phobias - the two process model - accquitsion by classical conditioning
Classical conditioning involves association. Learning to associate something we have no fear of NS with something that already triggers a fear response UCS.
1. UCS triggers a fear response (fear is a UCR) eg being bitten creates anxiety
2. NS is associated with the UCS eg being bitten by a dog (the dog previously did not create anxiety)
3. NS becomes a CS producing fear (which is now the CR). The dog becomes a CS causing a CR of anxiety/fear following the bite.
Behavioural approach to explaining phobias - the two process model - accquitsion by classical conditioning - example of little Albert
Watson and Rayner (1920) showed how a fear of rats could be conditioned in ‘little Albert’
1. Whenever Albert played with a white rat (NS) , a loud noise was made close to his ear using an iron bar. The noise (UCS) caused a fear response (UCR)
2. Rat (NS) did not create fear until the bang and the rat had been paired together several times
3. Albert showed a fear response (CR) every time he came into contact with the rat (now a CS)
Generalisation of fear to other stimuli - eg Little Albert also showed fear in response to other white furry objects including a fur coat and a Santa Claus beard.
Behavioural approach to explaining phobias - the two process model - maintenance through operant conditioning (negative reinforcement)
Operant conditioning takes place when our behaviour is reinforced or punished.
Reinforcement tends to increase the frequency of the behaviour. This is true for both negative and positive reinforcement.
Negative reinforcement- an individual produces behaviour that avoids something unpleasant and this results in a desirable consequence which means the behaviour will be repeated.
Mowrer suggested that we avoiding the phobic stimulus we escaped the fit and anxiety and this reduction in reinforces the avoidance behaviour so the phobia is maintained.
Reduction negatively reinforces the avoidance behaviour and the phobia is maintained .
Behavioural approach to explaining phobias - the two process model - maintenance through operant conditioning (negative reinforcement) - example - dogs
Phobia of dogs is maintained by avoiding situations where dogs may be present = negative reinforcement. Such situations would reduce anxiety associated with dogs so avoiding them makes avoidance response likely to happen again..
