Psychopathology

Question 1

What are the 4 definitions of abnormality?

Answer 1

1. Statistical infrequency
2. Deviation from the norm
3. Failure to function adequately
4. Deviation from ideal mental health

Question 2

What is statistical infrequency?

Answer 2

Where abnormality is defined as those behaviours that are extremely rare. For example, any behaviour found in very few people is considered to be abnormal. It is usually measured using a bell shaped curve or a distribution graph. We usually define people at either end of the graph as abnormal as this means they are more than 2 standard deviations away from the norm and so only represent 2% of the population.

Question 3

Why should duration and frequency be considered when looking at statistical infrequency?

Answer 3

Because traits like hearing voices would be considered more extreme if it happened every single day.

Question 4

What is the double evaluation about abnormal behaviours actually being desirable and then cultural differences?

Answer 4

The main issue is that there are many abnormal behaviours that are actually quite desirable.
For example, very few people have an IQ over 150 so it is considered to be abnormal. However, this trait is actually desirable and does not lead individuals to need any additional help. Equally, there are many undesirable behaviours that are considered to be ‘normal’. For example, depression is fairly common amongst the population which means it is considered to be within 2 standard deviations from the norm. This means that it can be overlooked when individuals with depression do actually require additional help and to be treated.
Therefore, using statistical infrequency to define abnormality means that we are unable to distinguish between desirable and undesirable behaviours.
Furthermore, behaviours that are considered to be ‘abnormal’ in some cultures may be an important part and even a desired characteristic in other cultures. For example, hearing voices is a symptom of schizophrenia and so it is considered abnormal in western cultures and a sign of poor mental health. However, in African cultures, this trait is very normal and even praised due to religious beliefs.
Therefore, this definition of abnormality should not be equally applied to all cultures and culturally relative considerations should be made instead.

Question 5

What is the evaluation about statistical infrequency being sometimes appropriate to use?

Answer 5

In some situations, it is appropriate to use statistical criterion to define abnormality.
For example, intellectual disability disorder is defined in terms of normal distribution using standard deviation to establish a ‘cut-off’ point for abnormality. Any individual with and IQ more than 2 standard deviations away from the mean, is considered to have a mental disorder. However, a diagnosis is only made in conjunction with failure to function adequately.
Therefore, this suggests that statistical infrequency is only used as one of a number of tools.

Question 6

What is the definition of failure to function adequately?

Answer 6

It is where individuals are judged on their ability to go about their everyday lives. If they cannot do this and they are also experiencing distress (or others are distressed by their behaviour) then it is considered a sign of abnormality.

Question 7

Who proposed characteristics of someone who is not functioning adequately?
And what are 4 examples?

Answer 7

Rosenham and Seligman 1989.
1. Maladaptive behaviour = where an individuals behaviour goes against their long term goals.
2. Observer discomfort= when the individuals behaviour causes distress to those around them by breaking the rules of societal expectations.
3. Irrationality= when it is difficult to understand the motivations behind someone’s unpredictable behaviour.
4. Personal anguish = where an individual is suffering with distress and anxiety.

Question 8

What is the evaluation about who makes the judgment of functioning adequately?

Answer 8

Who decides what is meant by failure to function adequately?
It may be that the individuals themselves can recognise that something is not quite right and that their behaviour has become undesirable and is causing them distress so they seek help. On the other hand, some individuals may be content with their situation and/or may be unaware they are not coping. In this case, others around them may be made to feel uncomfortable by their behaviour and so deem it to be abnormal. For example, some schizophrenics may be potentially dangerous but a symptom of schizophrenia is that they do not believe anything is wrong with them. A real life example of this is Peter Sutcliffe the ‘Yorkshire Ripper’.
Therefore, the limitation of this definition of abnormality is that the judgment depends on who is making it, meaning that it can be subjective.

Question 9

What is the evaluation about some behaviours actually being functional in failure to function adequately?

Answer 9

Another limitation is that some behaviours which are apparently ‘dysfunctional’ can actually be adaptive and functional for some people.
For example, some mental disorders like eating disorders and depression can manifest in ways which draw extra attention to those individuals. However, this attention can be adaptive as it can help them recognise a problem, get the help they need and find the root cause of the behaviours. These unusual behaviours may be used as coping mechanisms by those who are going through particularly difficult times in their lives. Additionally, transvestitism is considered a mental disorder, however those individuals probably regard it as being perfectly functional for them.
Therefore, failure to distinguish between functional and dysfunctional behaviours may mean that this definition is incomplete.

Question 10

What is the evaluation about WHODAS in failure to function?

Answer 10

It should be noted that on the positive side, this definition can be a useful means to judge abnormality.
For example, the DSM includes an assessment of ability to function called WHODAS (world health organisation disability assessment). It involves individuals rating items including things like ‘can dress self’ and ‘can prepare meals’ on a scale of 1 to 5 with a final score out of 180. Listing behaviours and rating them on a scale provides a quantitative measurement of functioning meaning an objective judgment can be made as to whether someone requires treatment. Furthermore, this assessment allows the subjective experience of the patients to be recognised as they give a rating that they identify with the most.
This definition of abnormality therefore, has a certain sensitivity and practicality to it.

Question 11

What is the definition of deviation from ideal mental health?

Answer 11

Abnormality is defined in terms of mental health, behaviours that are associated with competence and happiness. Ideal mental health would include a positive attitude towards the self, resistance to stress and an accurate representation of reality.

Question 12

Who proposed the 6 criteria for ideal mental health and what are the 3 points about her?

Answer 12

Marie Jahoda 1958
- Pointed out that physical illness is defined by the absence of signs of physical health like not having a normal temperature or blood pressure, and she suggested that we also apply this to mental illness.
- She reviewed things that had been said about good mental health and used them to devise 6 characteristics that enable people to be happy and behave competently.
- Her definition is from a humanistic perspective as it looks at how we can improve ourselves and become better people rather than on dysfunctional behaviours.

Question 13

What are Marie Jahoda’s 6 criteria for ideal mental health?

Answer 13

1. Self attitude= Having a high self esteem and strong sense of identity.
2. Personal growth and self actualisation= The extent to which a person develops their full capabilities.
3. Integration= Being able to cope with stressful situations.
4. Autonomy= Being independent and self regulating.
5. Having an accurate perception of reality.
6. Mastery of environment= The ability to ‘love’, function at work and in interpersonal relationships, adapt to new situations, and solve problems.

Question 14

What is the evaluation about Jahoda’s criteria being positive and humanistic?

Answer 14

One strength of Jahoda’s definition is that it takes a positive and holistic view.
Firstly, the definition focuses on positive and desirable behaviours rather than negative and undesirable traits. Jahoda’s criteria has real world applications. For example, it can be used as a basis for therapy and treatments with emphasis on the self as a whole and working towards goals such as self actualisation and integration. Her ideas were also used by Rogers 1959, who influenced counselling to take a more client centred approach.
Therefore, the strengths of this definition can be seen within its influences on humanistic approaches and the positive psychology movement.

Question 15

What is the evaluation about everyone being abnormal according to Jahoda?

Answer 15

One of the major criticisms of this definition is that according to the ideal mental health criteria, most of us would be abnormal.
It would be very difficult to achieve this criteria all the time. And according to Jahoda, most people would be diagnosed as abnormal as it is so unrealistic. For example, we all experience negativity and stress at times, especially if grieving a loved one for example. However, this definition suggests that these people would all be classified as abnormal irrespective of the circumstances. Furthermore, this criteria seems quite difficult to measure. For example, how easy would it be to assess capacity for personal growth?
Therefore, due to the high standards set by this criteria, the number of characteristics needed to be absent for a diagnosis should be questioned.

Question 16

What is the definition of phobias?

Answer 16

A group of mental disorders characterised by high levels of extreme anxiety produce in response to a stimulus or group of stimuli. They are instances of irrational fears that produce conscious avoidance of the feared object or situation.

Question 17

What are three examples of phobias?

Answer 17

1. Agoraphobia= the fear of being trapped in a public space with no escape. Common in middle age.
2. Social phobias= anxiety related to social situations like speaking to a new group or people or going to a party.
3. Specific phobias= Phobias of specific objects like spiders or snake, or of specific situations like heights or the dark.
   All phobias are more common in women.

Question 18

What are the behavioral characteristics of phobias (3)?

Answer 18

1. Avoidance= Physically avoiding phobic objects. E.g leaving the room that a spider is in.
2. Panic= Uncontrollable physical response usually when the feared object or situation appears suddenly. E.g screaming or hyperventilating.
3. Failure to function= Avoidance interfering with a person’s normal routine, work and relationships. This distinguishes phobias from less severe everyday fears.

Question 19

What are the emotional characteristics of phobias? (2)

Answer 19

1. Fear= The intense emotional state linked with the fight or flight response which causes the body to be unpleasantly alert for long and persistent periods. Likely to be excessive and uncontrollable.
2. Anxiety= An uncomfortably high and persistent state of arousal making it difficult to relax. Usually heightened when individual is likely to encounter phobia.
   These are both usually out of proportion to actual danger posed.

Question 20

What are the cognitive characteristics of phobias? (3)

Answer 20

1. Irrational beliefs= Negative mental processes that include exaggerated beliefs about the harm that the phobic object could cause them. E.g a person with aerophobia would not feel better knowing flying is the safest form of transport.
2. Reduced cognitive capacity= Where people with phobias cannot concentrate on everyday tasks like work due to the excessive attentional focus on phobic objects and the constant fear about the danger they are in.
3. Cognitive distortions

Question 21

What is the behavioural explanation of phobias and who proposed it?

Answer 21

The 2 process model proposed by Mowrer 1947.
The 2 process model says that phobias are acquired through classical conditioning (learning through association) and are maintained through operant conditioning (learning through consequences).

Question 22

Who is the key study for the acquisition of a phobia?

Answer 22

Watson and Rayner 1920
‘Little Albert’.
- They used an 11 month old infant who had no reaction to white furry objects to begin with.
UCS (banging a metal bar with a hammer behind his head to startle him)—> UCR (crying)
NS (rat) + UCS (banging bar every time he reached for the rat) ——> UCR (crying)
- They repeated this pairing 3 times and then again a week later.
CS (rat)———> CR (crying)
- They realised that the conditioned fear response could be generalised to other white furry objects.
- They also realised that the fear did not disappear overtime.

Question 23

How does operant conditioning lead to the maintenance of phobias?

Answer 23

Classical conditioning explains the acquisition, but can not explain why people continue to feel fearful and even avoid the phobic object.
Operant conditioning says: the likelihood of the behaviour being repeated is increased if the outcome is rewarding.

In terms of phobias, people will avoid the feared object or situation which reduces anxiety.
This reduced fear and anxiety is a pleasant sensation to negatively reinforces the belief that they should avoid the feared object. This strengthens the phobia and makes it more likely that they will avoid it again in the future.

Question 24

What is the evaluation about biological preparedness for phobias?

Answer 24

The fact that phobias do not always develop after a traumatic experience may be explained in terms of biological preparedness.
For example, Martin Seligman 1970 argued that animals, including humans are genetically programmed to rapidly learn associations between potentially life threatening stimuli and fear. These stimuli are known as ‘ancient fears’, things that would have been dangerous in our evolutionary past like heights, spiders and the dark. It would have been adaptive to rapidly learn to avoid such stimuli. This may explain why we are less likely to develop phobias of more modern objects such as toasters and cars which pose much more danger than a spider. But these objects were not a danger in our evolutionary history so we don’t.
Therefore, this suggests that the behavioural approach cannot fully explain all phobias.

Question 25

What is the double evaluation about support for classical conditioning Watson and Rayner?

Answer 25

Support for classical conditioning can be seen in research by Watson and Rayner 1920. Explain study. However, counter research by Di Nardo et al 1988 showed that conditioning events like ‘dog bites’ were common in people with a phobia of dogs (56%), however, they were equally common in people with no dog phobia (66%). This may be explained by the diathesis-stress model suggesting that we inherit genetic vulnerabilities to certain mental disorders but these disorders are only triggered by life events such as a dog bite. Furthermore, Mendes and Clark found that only 2% of children with a phobia of water could recall a negative experience with water and that 56% of parents told researchers that the phobia had been present since the first encounter with it. This suggests that dog bites only lead to phobias in people who are genetically vulnerable. Furthermore, whilst Watson and Rayner provided supporting evidence for classical conditioning, this evidence suggests that it is not a complete explanation for acquisition of phobias on its own.

Question 26

What are the 2 techniques used in behavioural treatment of phobias?

Answer 26

Flooding and systematic desensitisation.

Question 27

What are the 5 points about flooding?

Answer 27

Flooding is an alternative method. Rather than introducing the stimulus in a gradual progression using a hierarchy, the patient is fully immersed in the experience in one long session, experiencing their phobia at its worst. Immediately exposure is expected to cause an extreme panic response like screaming which is completely normal. However, the fear response uses energy and there is only so much adrenaline in the body to be used up, so eventually the client becomes exhausted and finally feels calm in the presence of the phobia. So a new stimulus-response link is learnt as the feared object is now associated with a non-anxiety response. This is based on operant conditioning as it is not reinforcing the behaviour of avoiding the phobia.

Question 28

What is reciprocal inhibition?

Answer 28

This is where fear and relaxation are 2 antagonistic emotions as you cannot feel 2 opposite emotions simultaneously. So the aim is replace the feeling of fear with relaxation.

Question 29

What are the 3 components of systematic desensitisation?

Answer 29

Counter conditioning: - This therapy is heavily based on counter conditioning as the patient is taught a new association that runs counter to the old one. - This is taught through classical conditioning as they are taught to associate the phobic stimulus with a new response (anxiety) which is incompatible with the undesirable response. - Joseph Wolpe 1958 also calls this reciprocal inhibition. Relaxation: - Firstly, the therapist teaches the client relaxation techniques such as slowed breathing, muscle relaxation and visualising peaceful scenes. Desensitisation hierarchy: - Gradually introducing the client to the feared situation with them in control of each stage is less overwhelming. - Therapist and client work together to create a graded series of anxiety provoking situations from least anxiety arousing to most like holding the phobia. - At each stage, relaxation techniques are practiced to make the situation more familiar and less overwhelming so the anxiety diminishes.

Question 30

What are the 5 steps of systematic desensitisation?

Answer 30

Stage 1: Client is taught to entirely relax muscles (a relaxed state is incompatible with anxiety). Stage 2: Together, they create a desensitisation hierarchy, a series of imagined scenes each one more anxiety provoking than the previous. Stage 3: Client gradually works their way through the desensitisation hierarchy, visualising each anxiety evoking scene whilst engaging in competing relaxation response. Stage 4: Once the client has mastered one stage (they can remain completely calm), they are ready to move on to the next. Stage 5: Patient eventually masters the feared situation that initially brought them to therapy.

Question 31

What is the evaluation about SD being successful with several phobias?

Answer 31

Research has shown that systematic desensitisation is successful with several different phobias. For example, McGrath et al 1990 reported that about 75% of patients with phobias responded well to SD. The key appears to be in having actual contact with the feared stimulus meaning that in vivo techniques are more successful than in vitro techniques like using photos and the imagination (Choy et al 2007). There are also a number of exposure techniques used together including the 2 mentioned above, and also modelling which is based on social learning theory where a patient watches someone coping well with the phobic stimulus (Comer 2002). Therefore, this demonstrates the effectiveness of SD but also the value of using a range of different exposure techniques.

Question 32

What is the evaluation about SD not treating all phobias?

Answer 32

However, whilst systematic desensitisation is successful with several types of phobias, it may not be effective in treating all phobias. For example, Öhman et al 1975 suggested that systematic desensitisation may not be as effective with phobias that have an underlying evolutionary component (like heights, dark and snakes) than with phobias acquired as a result of personal experiences. Additionally, both flooding and SD may be more effective in treating specific phobias (e.g fears of objects) rather than social phobias. It is generally easier to construct and gradually advance an anxiety hierarchy of object-related phobias, or undergo a complete and intense exposure to birds within a controlled setting than it is to reconstruct social situations or interactions using unfamiliar people in a therapist’s office. Therefore, behavioural treatments may be more effective in treating some types of phobias that are more physical, whereas other treatments like drugs may be more appropriate in tackling mental phobias like social ones.

Question 33

What is the evaluation about flooding not being for everyone due to individual differences?

Answer 33

A limitation of flooding is that it is not right for every patient or every therapist due to individual differences. For example, flooding can be a highly traumatic procedure. Patients are obviously warned of this beforehand, however, they may still choose to quit during the exposure which reduces the overall effectiveness of the therapy and once again, negatively reinforces the belief that escaping is the only way to subside anxiety. Furthermore, Wolpe 1969 recalled a patient who became so intensely anxious that she required hospitalisation. For this reason, flooding is not suitable for older patients, children, or individuals with heart problems. Therefore, individual differences in responding to exposure reduces effectiveness of the therapy, especially if they do not complete treatment which also results in a waste of money and time.

Question 34

What is the evaluation about phobia symptoms only being the tip of the iceberg?

Answer 34

Behavioural therapies may not work with certain phobias because the symptoms are only the tip of the iceberg. If the symptoms are removed, the cause still remains so the symptoms will simply resurface possibly in another form, known as symptom substitution. For example, according to the psychodynamic approach, phobias develop because of projection. Freud 1909 studied the case of Little Hans who developed a phobia of horses. The boy’s actual problem was an intense envy of his father which he could not directly express and so projected his anxiety onto the horse. The phobia was cured when the boy accepted his feeling towards his father. Therefore, this emphasises the importance of treating the underlying causes of a phobia rather than just the symptoms.

Question 35

What is depression?

Answer 35

Depression is where an individual feels sad or lacks interest in their usual activities. The DSM-V distinguishes between major depressive disorder and persistent depressive disorder which is longer term and recurring.

Question 36

What are the behavioural characteristics of depression?

Answer 36

1. Shift in activity levels= some individuals may experience a reduction in energy and wanting to sleep all the time whereas others may be agitated and restless so pace around rooms tearing at their skin. 2. Change in sleep= Some may want to sleep all day every day but others may have struggles sleeping and suffer with insomnia. 3. Change in eating= appetite may be significantly reduced leading to weight loss or may be significantly increased leading to weight gain

Question 37

What are the emotional characteristics of depression?

Answer 37

1. Sadness= the most common description of depression along with feeling empty, worthless, and low self esteem. 2. Lack of interest= Pleasurable activities and hobbies are now associated with feelings of despair and a lack of control. 3. Anger= often aimed towards others, coming from a place of hurt with a desire for retaliation, or reflected inwards causing self harm.

Question 38

What are the cognitive characteristics of depression?

Answer 38

1. Poor concentration= cannot give tasks their full attention due to constantly dwelling on negative thoughts and beliefs, being indecisive and struggling to choose between 2 options. 2. Absolutist thinking. 3. Dwelling on negative thoughts/negative schema.

Question 39

Why is the cognitive explanation appropriate for depression?

Answer 39

In terms of understanding abnormality, cognitive psychologists are most concerned with how irrational thinking leads to mental illness. Because depression is very much characterised by negative irrational thinking, cognitive explanations are particularly appropriate.

Question 40

What are the 2 cognitive explanations for depression?

Answer 40

Ellis’ ABC model 1962 Beck’s negative triad 1967

Question 41

What is the ABC model?

Answer 41

A cognitive explanation suggesting that individual’s irrational negative beliefs and misinterpretation of events causes their depression. A= Activating event. E.g mary and her boyfriend break up. B= Beliefs which may be rational e.g we weren’t right for each other but that doesn’t mean i am unlovable, or may be irrational e.g the break up was my fault because i don’t deserve to be loved. C = Consequences. Rational thinking leads to healthy emotions like acceptance and moving on, whereas irrational thinking leads to unhealthy emotions like depression and holding on to the past.

Question 42

What is mustabatory thinking and Ellis’ 3 examples?

Answer 42

Mustabatory thinking is where irrational belief systems stem from mustabatory thinking, thinking that certain things MUST be true in order for you to be happy. 1. I must do well or very well otherwise I am worthless. 2. I must be accepted and approved by the people that are important to me 3. The world must give me happiness otherwise I will die. People who hold these beliefs, will be at the very least, dissapointed and at the worst, depressed. The ‘musts’ need to be challenged.

Question 43

What did Beck believe about depression?

Answer 43

He believed that depressed people feel as they do because their thinking is biased towards a negative interpretation of the world and they have a lack of perceived sense of control.

Question 44

What are the points about negative schemas in Beck’s negative triad?

Answer 44

1. Depressed people develop negative schemas usually in childhood which creates a tendency to adopt a negative view of the world. 2. They may have developed due to a variety of reasons like parental and/or peer rejection, and teacher criticisms. 3. These schemas (e.g like expecting to fail) are activated when in a new situation which resembles the original conditions of when the schema was first formed. 4. These create a cognitive bias where people over generalise and draw sweeping conclusions due to one small negative comment. This is absolutist thinking.

Question 45

What is the negative triad?

Answer 45

Negative views of the self Negative views of the world Negative views of the future.