Psychopathology

Question 1

Definition of Abnormality

Answer 1

A psychological/ behavioural state leading to impairment of interpersonal functioning and/or distress to others.

Question 2

Definitions of Abnormality: Statistical infrequency

Answer 2

Statistical norms: any commonly seen behaviour or characteristic amongst the population.
Statistical infrequency: rare occurrences among the population.

-Someone is abnormal if their trait, thinking or behaviour is statistically rare & infrequent.
-This is an objective, mathematical method.

Question 3

Normal distribution

Answer 3

A symmetrical spread of data frequency that forms a bell-shaped pattern.
The mean, median & mode are all located at the highest peak.

Question 4

IQ & intellectual disability disorder

Answer 4

-Average IQ is set at 100.
-Most people (68%) have a score ranging from 85-115.
-Only 2% have a score below 70.
-These individuals are ‘abnormal’ and can receive a diagnosis of a psychological disorder - intellectual disability disorder (IDD).
-95% fall within 2 standard deviations of the mean.

Question 5

Strength of SI: Useful in clinical practice

Answer 5

-Used in clinical as part of formal diagnosis & to assess severity of symptoms.
-E.g. IDD requires an IQ of below 70z
-Beck depression tool is used to assess severe depression with a score of 30+ (top 5%) of respondents.

Shows value of SI criterion is useful in diagnosis.

Question 6

Limitation of SI: Unusual characteristics can be positive

Answer 6

Statistical infrequent characteristics can be positive too.
-People with an IQ above 130 is also unusual, but not considered abnormal.
-Being unusual at one end of the psychological spectrum does not necessarily someone abnormal.

Not sufficient as a sole basis to define abnormality.

Question 7

Strength of SI: Benefits of ‘abnormality’

Answer 7

-Someone who has a low IQ and is diagnosed with IDD can access support services or someone with high BDI may access therapy.

-Counter: Not all statistically unusual people benefit from labels. Someone with a low IQ who can cope with their lifestyle may not need a label. Leads to social stigma & self-fulfilling prophecy.

Question 8

Definitions of Abnormality: Deviation from social norms

Answer 8

Social norms: unwritten rules for acceptable behaviour, but also can be policed by laws.
Deviation from social norms: defines abnormality by behaviour thats different from the accepted standards in society (against the norm).

Question 9

Norms are culturally specific

Answer 9

-Few behaviours that would be considered universally abnormal on the basis that they breach social norms.
-E.g. homosexuality was considered abnormal in our culture and is still viewed that way in some cultures & is even illegal.
-> April 2019, Brunei introduced law that make sex between men and women offence punishable by stoning to death.

Question 10

Example: antisocial personality disorder

Answer 10

-A person with this is impulsive, aggressive & irresponsible.
-According to DSM-5 (manual by psychiatrists to diagnose mental disorder), an important symptom of antisocial personality, is absence of pro social internal standard (failure to conform to lawful/acceptable behaviour).
-Social judgement that psychopaths abnormal for not conforming to our moral standards.

Question 11

Strength of Deviation from social norms: Useful in clinical practice

Answer 11

-Key defining characteristic of antisocial personality, is failure to conform to acceptable behaviour (ie. recklessness,aggression).
-These are deviating from norms.
-Also plays part in diagnosis of schizotypal personality disorder where the term ‘strange’ is used to characterise the thinking, behaviour & appearance of people with the disorder.

Shows value in psychiatry.

Question 12

Limitation of Deviation from social norms: Cultural & situational relativism

Answer 12

Limited due to variability between norms in diff cultures and situations.
-A person from 1 cultural group may label someone from another group abnormal to their standards.
-E.g. hearing voices is the norm in some cultures as messages from ancestors/religious messages, but would be a sign of abnormality in UK.
-E.g. Finishing food on a plate is respectful in British culture, but in India, it’s a sign of hunger.
-Aggressive and deceitful behaviour is not acceptable in family, but more so in context of corporate deal-making.

Difficult to judge deviations across cultures and situations.

Question 13

Limitation of Deviation from social norms: Norms change

Answer 13

A behaviour that broke social norms in 1950, may be normal today.
-E.g. an unmarried mother in 40s, would break norms and classified abnormal, and these women were sectioned as ‘moral imbeciles’ and society demanded they give up their babies.
-The individuals don’t change, but the classification of behaviour does.

Lacks reliability as it doesn’t consistently produce an accurate definition of aboral behaviour over time.

Question 14

Definitions of abnormality: Failure to function adequately

Answer 14

Maladaptiveness: failure to fucntion adequately.
-States abnormal behaviour is when an individual can’t cope with everyday life.
-Acknowledges people may act differently if they can’t manage everyday life.

Question 15

Rosenhan & Seligman (1989) - 7 features

Answer 15

Focusses on; no conforming to standard interpersonal rules, severe personal distress and irrational behaviour.

7 features:
1. Personal distress
2. Maladaptive behavuour
3. Unpredictability
4. Irrationality
5. Observer discomfort
6. Violation of moral standards
7. Unconventionality

Question 16

Intellectual disability disorder

Answer 16

-One definition isn’t enough to make a diagnosis, an indivisible must also be failing to function adequately before being given a diagnosis.
-Elements from all 4 definitions should be used.

Question 17

Strength of FTFA: Represents threshold for help

Answer 17

Represents a sensible threshold for when people need professional help.
-Most of us have symptoms of mental disorder from time to time.
-Charity mind says around 25% will experience a MH issue.
-Tends to be when it’s extremely severe, and we can’t function, that people seek help.

Criteria means treatment & services can be targeted to those who need them most.

Question 18

Limitation of FTFA: Discrimination & social control

Answer 18

Easy to label non-standard lifestyle choices as abnormal.
-Hard to say who’s functioning inadequately & who simply deviates from norms.
-E.g. someone who doesn’t have a job/address might be FTF but some may want to live “off-grid.”
-E.g. some people favour high risk leisure activities which could be classed irrational.

Means people who make unusual choices are at risk of being labelled abnormal and their freedom of choice may be restricted.

Question 19

Limitation of FTFA: FTF may not be abnormal

Answer 19

Some circumstances where most of us fail to cope for a period of time (ie. Bereavement).
-Might be unfair to label someone because of how they react to difficult circumstances.

-However, someone’s distress, irrational ti etc is no less real simply due to a clear cause.
-And, some may require professional help to adjust to circumstances like bereavement.

Sometimes necessary to label someone abnormal, but not always clear when to do so.

Question 20

Definitions of abnormality: Deviation from Ideal mental health

Answer 20

-Another way to look at this is to ignore abnormality and focus on what makes anyone ‘normal’.
-Once we have an idea of how psychologically healthy we can be, we can see who deviates from this.

Question 21

Ideal mental health - Jahoda (1968)

Answer 21

Good mental health if:
-No symptoms or distress
-Rational and perceive selves accurately
-Self-actualise
-Cope with stress
-Realistic view of the world
-Good self-esteem & lack guikty
-Independent
-Successfully work, love & enjoy leisure

Question 22

Strength of IMH: Comprehensive definition

Answer 22

-Jahoda’s definition included criteria for distinguishing MH from mental disorder.
-Covers most the reasons why we might seek help with MH.
-Means MH can be discussed with professionals who take diff theoretical views (ie. Medically trained psychiatrist might focus on symptoms whereas a humanistic counsellor might focus on self-actualisation).

Means IMH provides checklist against which we can assess ourselves against.

Question 23

Limitation of IMH: Culture-bound

Answer 23

Different events are not equally applicable across a range of cultures.
-Some of Jahoda’s criteria are based on context of US & Europe.
-Concept of self-actualisation is central to individualist cultures rather than collectivist cultures who prioritise community.
-In Germany, there’s more independence but in Italy, there’s less.
-Definitions of success, socially and economically differs.

Means it’s difficult to apply concept of IMH across cultures.

Question 24

Limitation of IMH: Extremely high standards

Answer 24

-Few of us achieve all of his criteria for MH, and probably none acheuve all of them at the same time or keep them up for long.
-Disheartening to see an impossible set of standards to live up to.

-However, having a comprehensive set of criteria to live up to may be of practical value to help someone improve their MH.

Question 25

Phobias

Answer 25

Phobia: irrational fear of an object or situation.
-apart of ‘anxiety disorders’.
-virtually any object can become a fear object.

Question 26

DSM-5 categories of phobia

Answer 26

-Specific phobia: phobia of an object, (animal or body part) or of situation (flying).
-Social anxiety (social phobia): phobia of social situation (public speaking/toilet).
-Agoraphobia: phobia of being outside or in a public place.

Question 27

Behavioural characteristics of Phobia

Answer 27

Panic:
-may cry, scream, run away.
-children might freeze, cling etc.

Avoidance:
-unless person makes conscious effort to face their fear, they tend to make an effort to avoid contacting phobic stimulus.
-makes it hard to go about daily life.
-E.g. person who fears public toilets, may limit their time outside.

Endurance:
-opposite of avoidance.
-person remains in presence of phobic stimulus.
-E.g. person with arachnophobia may remain in room with spider and keep a wary eye on it.

Question 28

Emotional characteristics of Phobias

Answer 28

Anxiety:
-involve an emotional response of anxiety (unpleasant state of arousal).
-prevents a person relaxing and makes hard to experience positive emotions.
-long term.

Fear:
-immediate & extremely unpleasant response we experience when we encounter/ think about phobic stimulus.
-more intense but lasts shorter periods than anxiety.

Emotional response is unreasonable:
-anxiety/fear is much greater than is ‘normal’ & disproportionate to any threat posed.
-E.g. a person with arachnophobia will have a strong emotional response to a tiny spider.

Question 29

Cognitive characteristics of Phobias

Answer 29

Selective attention the phobic stimulus:
-keeping attention on phobic stimulus gives best chance of reacting quickly to a threat.
-not useful when fear is irrational (beards).

Irrational beliefs:
-person with phobia may good unfounded thoughts in relation to phobic stimuli.
-cannot be easily explained or have basis in reality.
-E.g. “if I blush, people will think I’m weak.”

Cognitive distortions:
-inaccurate perceptions that are unrealistic.
-E.g. person who’s ophidiophobic may see snakes as alien & aggressive-looking.

Question 30

Depression

Answer 30

Depression: a mood disorder where an individual feels sad, has a low mood or loses interest in usual activities.
-To be diagnosed, you must present 5 symptoms and have either low mood or loss of interest in activities, for more than 2 weeks.

Question 31

DSM-5 categories of depression

Answer 31

-Major depressive disorder: severe but often short-term depression.
-Persistent depressive disorder: long-term or reoccurring depression, including sustained major depression & what used to be called dysthymia.
-Disruptive mood dysregulation disorder: childhood temper tantrums.
-Premenstrual dysphoric disorder: disruption to mood prior to and/or during menstruation.

Question 32

Behavioural characteristics of Depression

Answer 32

Activity levels:
-Lethargic (low energy levels) and can be extremely severe.
-Psychomotor agitation where individuals struggle to relax and may pace up and down a room.

Disruption to sleep & eating:
-Insomnia or hypersomnia (premature waking or increased need to sleep).
-Appetite changes leading to increase or decrease in weight.

Aggression or self-harm:
-Physically or verbally aggressive.
-Can be directed at self or others.
-Leads to ending relationship, jobs etc.

Question 33

Emotional characteristics of Depression

Answer 33

Lowered mood:
-Defining an emotional element of depression that’s more pronounced, than simple lethargic and sadness.
-Often describe selves as ‘empty’ or ‘angry’.

Anger:
-Tend to experience more negative emotions and less positive.
-Frequently angry and can be directed at others.
-Lead to aggressive or self-harming behaviour.

Lowered self-esteem:
-Liking themselves less than usual.
-Can be extreme ie. self loathing/hating themselves.

Question 34

Cognitive characteristics of Depression

Answer 34

Poor concentration:
-Unable to stick with a task.
-Likely to interfere with daily life/work.

Attending to & dwelling on the negative:
-Focus on all the negatives in their life.
-Negative view of the world & expects things to end of badly.
-Negative view of self ie. worthless.
-Bias towards recalling unhappy memories rather than positive.
-Negative schemas.

Absolutist thinking:
-Seeing situations as complete disorders (black&white).
-If a situation is unfortunate, they tend to see it as absolute disorder.

Question 35

Obsessive-compulsive disorder (OCD)

Answer 35

OCD is an anxiety disorder.
1. Obsessions: persistent intrusive thoughts (cognitive aspect) - internal.
2. Compulsions: repetitive behaviours (behavioural aspect) - external.

Question 36

DSM-5 categories of OCD

Answer 36

OCD: characterised by either obsessions and/or compulsions. Most people have both.
Trichotillomania: compulsive hair-pulling.
Hoarding disorder: compulsive gathering of possessions & the inability to part with anything.
Excoriation disorder: compulsive skin-picking.

Question 37

Behavioural characteristics of OCD

Answer 37

Compulsions are repetitive:
-ie. handwashing, praying, counting.

Compulsions reduce anxiety:
-attempt to manage anxiety produced by obsessions.
-compulsions respond to fear.
-behaviour is often irrational.

Avoidance:
-avoid situations that trigger their anxiety.
-can lead to avoiding ‘normal’ day to day situations.
-ie. may avoid public toilet to compulsive handwashing.

Question 38

Emotional characteristics of OCD

Answer 38

Anxiety & distress:
-unpleasant emotional experience due to powerful anxiety.
-unpleasant & frightening.
-urge to repeat behaviour causes anxiety.

Accompanying depression:
-low mood & lack of enjoyment.
-compulsive behaviour can provide some relief from anxiety (often brief).

Guilt & disgust:
-irrational guilt.
-disgust (can be directed at something external or at self).

Question 39

Cognitive characteristics of OCD

Answer 39

Insight into excessive anxiety:
-aware their obsessions are irrational, but uncontrollable.
-can experience catastrophic thoughts about worst case scenarios.
-Hyper-vigilant: maintain constant alertness & focus on potential hazards.

Obsessive thoughts:
-90% with OCD have obsessive, recurring, irrational thoughts.
-ie. contamination by dirt.

Cognitive coping strategies:
-adopting strategies to deal with obsessions.
-ie. religious anxiety.
-can make person appear abnormal & is distracting.