Psychopathology Flashcards
Pathology
The study of the causes of disease
Psychopathology: Abnormality
In order to protect and/or treat people with an abnormality, psychologists need to be able to define them as having abnormal psychopathology
Statistical infrequency
This is deciding if a behaviour is abnormal by looking at the numher of times we observe it.
A statistically rare behaviour would be seen as ‘abnormal.’
Any ‘usual behaviour’ is ‘normal’ and any behaviour that is different is ‘abnormal.’
A very unusual behaviour or trait will be…
More than 2 standard deviations from the mean
Strengths of statistical infrequency
Statistical infrequency is an obvious and relatively quick and easy way to define abnormality.
Real-life application: It’s relatively easy to determine abnormality using psychometric tests developed using statistical methods.
Most patients with a mental health disorder will undergo a psychometric measure,ent of their symptoms in comparison to the norm
Limitations of statistical infrequency
Desirability of behaviour: Many behaviours are rare, but considered highly desirable(it’s difficult to know how far you have to deviate from the average to be considered abnormal)
Benefits of a label: Someone living a happy, fulfilled life may not benefit from a label, regardless of how abnormal they may be considered. In fact, a label of ‘abnormal’ could be detrimental, not helpful.
Social norms-
Society sets up rules for behaviour based on a set of moral standards(social norms). These norms are culturally specific e.g. homosexuality was considered a mental disorder in USA until 1973 and was legalised in 1967 in the UK.
Deviation from social norms
Any deviation is seen as abnormal, when a person behaves in a way which is different from what we expect.
Antisocial personality disorder characteristics
Lacking empathy, aggression, being impulsive and irresponsible
Example of deviation from social norms
Antisocial Personality Disorder
Symptoms in diagnosing antisocial personality disorder
According to the DSMV, one important symptom in diagnosing antisocial personality disorder is an absence of ‘pro-social internal standards associated with failure to conform lawful or culturally normative ethical behaviour.’
Strengths of deviation from social norms
Real life application in terms of diagnosks
Limitations of deviation from social norms
Historical issues: Until early 20th century, unmarried women who became pregnant were interred in mental institutions.
Cultural issues:
Japan- you’re deemed insane if you do not want to work
Social control: This approach has been used as a form of social control, for example, black slaves running away were diagnosed with drapetomania.
Maladaptive behaviour
Self harm
Roseham and Seligman failure to function adequately criteria
1) Personal distress
2) Maladaptive behaviour
3) Irrationality and incomprehensibility
4) Unpredictability and loss of control
5) No longer adheres to interpersonal rules/observer discomfort
6) Violation of moral standards
Strengths - failure to function adequately
Patient’s perspective - attempts to include the subjective experience of the individual. Although an individual’s assessment of their own distress may be very subjective, it does at least acknowledge the experience of the patient as important.
Failure to function adequately - who decides what an acceptable level of functioning is:
Deciding whether someone is distressed or something is distressing is subjective. Some patients, although they may say they’re distressed, may be judged as not suffering
Failure to function adequately - context of the behaviour
Some people engage in behaviours that could be considered maladaptive or harmful to self, but we wouldn’t class them as abnormal.
People who have alternative lifestyles may appear to function inadequately, for example, a New Age traveller not having a permanent address.
Failure to function adequately - some people have psychological disorders, but still function adequately
Some people who are classified as failing to function, for example people with antisocial personality disorders, function very well.
After a bereavement, most people find it difficult to cope normally, but this does not make them abnormal.
Failure to function adequately - labelling
A label gives a stigma that may stick around long after the problem has gone. Can affect employment prospects and personal relationships.
Deviation from ideal mental health
Jahoda(1958) said it was better to focus on the positive aspects of mental health rather than the negative, so this is seen as a positive attempt to define abnormality.
PRAISE:
Any one of these criteria not met, there’s a deviation from ideal mental health:
1) Personal growth(Self actualisation: should reach your potential).
2) Reality perception(should onow what’s real).
3) Autonomy(should be independent and our ability to make our own decisions)
4) Integration(to fit in with society and cope with stressful situations)
5) Self attitudes(should be positive:high self esteem)
6) Environmental mastery(adjusting to new situations and solving new problems at work)
Strength of
PRAISE
Comprehensive - covers a broad range of criteria. This makes us aware of all the different factors which can affect mental health.
Limitations of PRAISE
Cultural relativism(autonomy’s valued in Western individualist cultures, but less so in non-Western collectivist cultures).
Difficult, if not impossible to meet all the criteria, therefore is everyone mentally unhealthy?
e.g. Self-actualisation - Sadly very few people reach their full potential.
Three of the most common mental disorders
Depression
Phobias
Obsessive-compulsive disorder
Phobia
An anxiety disorder, which interferes with daily living. It is an instance of irrational fear that produces a conscious avoidance of the feared object or situation.
Specific phobia
Phobia of an object elg. an animal/body part/situation
Social anxiety
Phobia of a social situation such as public speaking
Agoraphobia
Phobia of being outside or in a public place
DSM-V Criteria(phobia)
- Marked and persistent fear of a specific object or situation
- Exposure to the phobic stimulus nearlt always produces a rapid anxiety response
- Fear of the phobic object or situation is excessive
- The phobic stimulus is either avoided or responded to with great anxiety
- The phobic reactions interfere significantly with the individual’s working/social life
Emotional characteristics of phobias
Anxiety from fear of the phobic stimulus
Unreasonable response(disproportionate to danger posed)
Behavioural characteristics of Phobias
1) Panic - crying, screaming, running away
2) Avoidance - takes a lot of effort to avoid stimulus which affects day to day life
3) Endurance - if you remain in the presence of stumulus experiencing high anxiety
Cognitive characteristics of phobias
Selective attention - hard to look away from the stimulus
Irrational beliefs - social phobia - ‘If I blush I am weak’ increases pressure on person to perform in social situations.
Cognitive distortions - perceptions of the stimulus are distorted
The Two Process Model
The behavioural approach emphasises the role of learning in the acquisition of behaviour.
Hobert Mowrer(1960) proposed the two process model based on the behavioural approach to phobias.
This states phobias are acquired through classical conditioning and maintained through operant conditioning
Phobia - maintenace by operant conditioning
Responses due to classical conditioning tend to fade over time.
However, phobias tend to be long lasting.
Mowrer explained this as a result of operant conditioning.
When we avoid a phobic stimulus, we avoid the fear and anxiety that is associated with it, reinforcing the avoidance behaviour and the phobia is maintained.
Supporting evaluation for behavioural approach: Good explanatory power
The two process model was a step forward when it was proposed in the 1960’s.
Explains how phobias can be maintained over time, and this has important implications for therapies.
Once a patient is prevented from practising their avoidance behaviour, the behaviour ceases to be reinforced and it declines.
Behavioural approach - alternative explanation for avoidance behaviour
Not all avoidance behaviours associated with phobias seems to be the result of anxiety reduction.
Evidence to suggest at least some avoidance behaviour appears to be motivated more by positive feelings of safety.
Agoraphobia - motivating factor is choosing an action(e.g. not leaving the house) is not so much to avoid the phobia stimulus, but to stick with the safety factor(Buck,2010)
Behavioural approach: evaluation of an incomplete explanation of phobias
Bounty(2007) suggested evolutionary factors probably have an important role in phobias:
1. Phobias(such as the dark) could be acquired by a source of danger in the past.
2. It’s adapted to acquire such fears.
3. Seligman(1971) called this the biological preparedness - the innate predisposition to acquire certain fears
Systematic desensitisation
This is a behavioural therapy designed to gradually reduce phobic anxiety through the principle of classical conditioning.
If the client can learn to relax in the presence of the phonic stimulus, they will be cured.
A new response is learnt - this is called counter conditioning.
This therapy aims to extinguish an undesirable behaviour by replacing it with a more desirable one.
Reciprocal inhibition
We cannot feel fear and relaxed at the same time
How systematic desensitisation works:
- The client works out a hierarchy of fear from the least frightening to the most frightening(functional analysis)
- The client learns relaxation techniques(progressive muscle relaxation)
- The client is exposed to the phobic stimulus, while in a relaxed state. Start at the bottom of the hierarchy and work through to the highest.
Positive evaluation: Systematic desensitisation- Effective in reducing public behaviour
Gilroy et al(2003)-42 patients treated for a spider phobia in three 45 minute sessions,compared to a control group who were treated by relaxation without exposure.
At 3 months and 33 months, the treatment group were less fearful than the relaxation group.
Positive evaluation - systematic desensitisation(it is suitable for a diverse range of phobias)
Some people with anxiety disorders also have learning disabilities.
It can be difficult for people to understand other therapies, such as flooding or CBT, that require the ability to reflect on what you are thinking.
Systematic desensitisation is the most appropriate therapy.
Positive evaluation for systematic desensitisation:it is acceptable to patients
Patients prefer systematic densitisation, as it is not as traumatic as flooding. It also includes some elements which are pleasant - relaxation.
Reflected in low refusal rates and low attrition rates.
Flooding
Involves immediate exposure to a frightening experience.
There is no option of avoidance and the patient quickly learns the phobic stimulus is harmless - extinction.
Sometimes, the patient may achieve relaxation in the presence of the phobic stimulus, because they become exhausted by their own fear response.
Ethical safeguards: negative evaluation for flooding
Flooding is an unpleasant experience, so it’s important patients give fully informed consent and should be fully prepared for the session.
Flooding evaluation: It is less effective for some phobias
Social phobias and agoraphobia do not seem to show as much improvement, due to:
Complex and cognitive aspects
Anxiety and unpleasant thoughts
CBT would be more useful
Flooding evaluation: the treatment is traumatic for patients
It can be highly traumatic for the patient, and they’re often willing to see it through until the end.
Time and money are therefore wasted.
Flooding evaluation: symptom substitution
Common criticism for flooding and SD.
One phobia disappears and other replaces itl but this is said to occur if the unconscious impulses and conflicts responsible for the original symptom are not dealt with effectively
Flooding is cost effective: positive evaluation
Ougrin(2011) have found flooding is highly effective and quicker than other treatments for specific phobia, which also makes it cheaper.
