Psychopathology

Question 1

Statistical deviation

Answer 1

Occurs when an individual has a less common characteristic, for example being more depressed or less intelligent than most of the population

Question 2

Deviation from social norms

Answer 2

Concerns behaviour that is different from the accepted standards of behaviour in the community or society

Question 3

Statistical deviation example IQ and intellectual disability disorder

Answer 3

This statistical approach comes into its own when we are dealing with characteristics that can be reliably measured, for example intelligence. We know that, in any human characteristic, the majority of people scores will cluster around the average, and that the further we go above or below the average, the fewer people will attain that score.
This is called the normal distribution.
The average IQ is set at 100. Most people (68%) have an IQ in the range from 85 to 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

Question 4

Deviation from social norms – norms are specific to the culture we live in

Answer 4

Of course those social norms may be different for each generation and every culture, so there are relatively few behaviours that would be considered universally abnormal on the basis that they breach social norms. For example, homosexuality continues to be viewed as abnormal in some cultures and was considered abnormal in our society in the past

Question 5

Deviation from social norms example – antisocial personality disorder

Answer 5

A person with antisocial personality disorder (psychopathy) is impulsive, aggressive and irresponsible. According to the DSM–5 (the manual used by psychiatrists to diagnose mental disorder) one important symptom of antisocial personality disorder is an absence of prosocial internal standards associated with failure to conform to lawful or culturally normative ethical behaviour.
In other words we are making the social judgement that a psychopath is abnormal because they don’t conform to our moral standards. Psychopathic behaviour would be considered abnormal in a very wide range of cultures

Question 6

Statistical deviation evaluation points

Answer 6

Real life application
Unusual characteristics can be positive
Not everyone unusual benefits from a label

Question 7

Real life application evaluation of statistical deviation

Answer 7

A strength of statistical deviation is that it has a real life application in the diagnosis of intellectual disability disorder. There is therefore a place for statistical deviation in thinking about what are normal and abnormal behaviours and characteristics.
Actually all assessment of patients with mental disorders include some kind of measurement of how severe the symptoms are as compared to statistical norms. Statistical deviation is thus a useful part of clinical assessment

Question 8

Unusual characteristics can be positive evaluation of statistical deviation

Answer 8

IQ scores over 130 are just as unusual as those below 70, but we wouldn’t think of super intelligence as an undesirable characteristic that needs treatment. Just because very few people display certain behaviours does make the behaviour statistically abnormal but doesn’t mean it requires treatment to return to normal
This is a serious limitation to the concept of statistical deviation and means that it would never be used alone to make a diagnosis

Question 9

Not everyone unusual benefits from the label evaluation of statistical deviation

Answer 9

Another problem with statistical deviation is that, where someone is living a happy fulfilled life, there is no benefit to them being labelled as abnormal regardless of how unusual they are. So someone with a very low IQ but who was not distressed, quite capable of working, etc, would simply not need a diagnosis of intellectual disability.
If that person was labelled as abnormal this might have a negative effect on the way others view them and the way they view themselves

Question 10

Not a sole explanation evaluation of deviation from social norms

Answer 10

A strength of the deviation from social norms definition is that it has a real life application in the diagnosis of antisocial personality disorder.
There is therefore a place for deviation from social norms in thinking about what is normal and abnormal. However, even in this case there are other factors to consider, for example the distress to other people resulting from antisocial personality disorder. So in practice, deviation from social norms is never the sole reason for defining abnormality

Question 11

Cultural relativism evaluation of deviation from social norms

Answer 11

Another problem with using deviation from social norms to define behaviour as abnormal is that social norms vary tremendously from one generation to another and from one community to another. This means, for example, that a person from one cultural group may label someone from another culture as behaving abnormally according to their standards rather than the standards of the person behaving that way.
For example, hearing voices is socially acceptable in some cultures but would be seen as a sign of mental abnormality in the UK. This creates problems for people from one culture living within another culture group

Question 12

Can lead to human rights abuses evaluation of deviation from social norms

Answer 12

Too much reliance on deviation from social norms to understand abnormality can also lead to systematic abuse of human rights. Looking at the historical examples of deviation from social norms it it is pretty clear that these diagnoses were really there to maintain control over minority ethnic groups and women. (Black slaves – running away and women – sexual attraction to working-class men)
The classifications appear ridiculous nowadays – but only because our social norms have changed. More radical psychologists suggest that some of our modern categories of mental disorder are really abuses of peoples rights to be different

Question 13

Failure to function adequately

Answer 13

Occurs when someone is unable to cope with ordinary demands of day-to-day living

Question 14

Deviation from ideal mental health

Answer 14

Occurs when someone does not meet a set of criteria for good mental health

Question 15

When is someone failing to function adequately? Rosenhan and Seligman

Answer 15

They have proposed some signs that can be used to determine when someone is not coping.
-when a person no longer conforms to standard interpersonal rules, for example maintaining eye contact and respecting personal space
– when a person experiences severe personal distress
– when a person’s behaviour becomes irrational or dangerous to themselves or others

Question 16

Failure to function adequately example – intellectual disability disorder

Answer 16

One criteria for the diagnosis of intellectual disability disorder is having a very low IQ. However, a diagnosis would not be made on this basis only – an individual must also be failing to function adequately before diagnosis would be given

Question 17

What does ideal mental health look like? Jahoda

Answer 17

She suggested that we are in good mental health if we meet the following criteria:
– we have no symptoms or distress
– we are rational and can perceive ourselves accurately
– we self-actualise (reach our potential)
-we can cope with stress
– we have a realistic view 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

Question 18

Failure to function adequately evaluation points

Answer 18

Patient’s perspective
Is it simply a deviation from social norms?
Subjective judgements

Question 19

Patient’s perspective evaluation of failure to function adequately

Answer 19

A strength of failure to function adequately is that it does attempt to include the subjective experience of the individual. It may not be an entirely satisfactory approach because it is difficult to assess distress, but at least this definition acknowledges that the experience of the patient is important.
In this sense the failure to function adequately definition captures the experience of many of the people who need help. This suggests that failure to function adequately is a useful criterion for assessing abnormality

Question 20

Is it simply a deviation from social norms? Evaluation of failure to function adequately

Answer 20

In practice it can be hard to say when someone is really failing to function and when they just deviating from social norms. We might think that not having a job or a permanent address is a sign of failure to function adequately. But then what do we say about people with alternative lifestyles who choose not to have those things?
Similarly those who practice extreme sports could be accused of behaving in a maladaptive way, whilst those with religious or supernatural beliefs could be seen as irrational.
If we treat these behaviours as failures of adequate functioning, we risk limiting personal freedom and discriminating against minority groups.

Question 21

Subjective judgements evaluation of failure to function adequately

Answer 21

When deciding whether someone is failing to function adequately, someone has to judge whether a patient is distressed or distressing. Some patients may say they are distressed but may be judged as not suffering. There are methods for making such judgements as objective as possible, including checklists such as Global Assessment of Functioning Scale.
However, the principle remains that someone has the right to make this judgement

Question 22

Deviation from ideal mental health evaluation points

Answer 22

It is a comprehensive definition
Cultural relativism
It sets an unrealistically high standard for mental health

Question 23

It’s a comprehensive definition evaluation of deviation from ideal mental health

Answer 23

A strength is that is very comprehensive. It covers a broad range of criteria for mental health. In fact it probably covers most of the reasons someone would seek help from mental health services or be referred for help. The sheer range of factors discussed in relation to Jahoda’s ideal mental health make it a good tool for thinking about mental health

Question 24

Cultural relativism evaluation of deviation from ideal mental health

Answer 24

Some of the ideas in Jahoda’s Classification of ideal mental health are specific to western European and North American cultures. For example, the emphasis on personal achievement in the concept of self actualisation would be considered self-indulgent in much of the world because the emphasis is so much on the individual rather than the family or community. Similarly, much of the world would see independence from other people as a bad thing. Such traits are typical of individualist cultures

Question 25

It sets an unrealistically high standard for mental health evaluation of deviation from ideal mental health

Answer 25

Very few of us attain all Jahoda’s criteria for mental health, and probably none of us achieve all of them at the same time or keep them up for very long. Therefore this approach would see pretty much all of us as abnormal. We can see this as a positive or a negative.
On the positive side it makes it clear to people the ways in which they could benefit from seeking treatment – say counselling – to improve their mental health. At the other extreme, deviation from ideal mental health is probably of no value in thinking about who might benefit from treatment against their will

Question 26

Phobia

Answer 26

And irrational fear of an object or situation

Question 27

DSM-5 categories of phobia

Answer 27

Specific phobia
Social anxiety (social phobia)
Agoraphobia

Question 28

Specific phobia

Answer 28

Phobia of an object, such as an animal or body part, or situations such as flying or having an injection

Question 29

Social anxiety (social phobia)

Answer 29

Phobia of a social situation such as public speaking or using a public toilet

Question 30

Agoraphobia

Answer 30

Phobia of being outside or in a public place

Question 31

Behavioural characteristics

Answer 31

Ways in which people act

Question 32

Emotional characteristics

Answer 32

Ways in which people feel

Question 33

Cognitive characteristics

Answer 33

Refers to the process of thinking – knowing, receiving, believing

Question 34

Behavioural characteristics of phobias

Answer 34

Panic
Avoidance
Endurance

Question 35

Behavioural characteristics of phobias – panic

Answer 35

A phobic person may panic in response to the presence of the phobic stimulus. Panic may involve a range of behaviours including crying, screaming or running away. Children may react slightly differently, for example by freezing, clinging or having a tantrum

Question 36

Behavioural characteristics of phobias – avoidance

Answer 36

Unless the sufferer is making a conscious effort to face their fear they tend to go to a lot of effort to avoid coming into contact with the phobic stimulus. This can make it hard to go about daily life
For sample, someone with the fear of public toilets may have to limit the time they spend outside the Home in relation to how long they can last without the toilet. This in turn can interfere with work, education and social life

Question 37

Behavioural characteristics of phobias – endurance

Answer 37

The alternative to avoidance is endurance, in which a sufferer remains in the presence of the phobic stimulus but continues to experience high levels of anxiety. This may be unavoidable in some situations, for example for a person who has an extreme fear of flying

Question 38

Emotional characteristics of phobias

Answer 38

Anxiety
Example: arachnophobia
Emotional responses are unreasonable

Question 39

Emotional characteristics of phobias – anxiety

Answer 39

Phobias are classed as anxiety disorders. By definition then they involve an emotional response of anxiety and fear. Anxiety is an unpleasant state of high arousal. This prevents the sufferer relaxing and makes it very difficult to experience any positive emotion. Anxiety can be long-term. Fear is the immediate and extremely unpleasant response we experience when we encounter or think about the phobic stimulus

Question 40

Emotional characteristics of phobias – example: arachnophobia

Answer 40

Matt has a phobia of spiders. His anxiety levels will increase whenever he enters a place associated with spiders- this may be the spidery bit of a zoo or his own garden shed. This anxiety is a general response to the situation. When he actually sees a spider he experiences fear – a very strong emotional response directed particularly towards the spider itself

Question 41

Emotional characteristics of phobias – emotional responses are unreasonable

Answer 41

Emotional responses we experience in relation to phobic stimuli go beyond what is reasonable. So, for example, Matt’s fear or spiders involves a very strong emotional response to a tiny and harmless spider. This is wildly disproportionate to the danger posed by any Spider Matt is likely to meet in his shed

Question 42

Cognitive characteristics of phobias

Answer 42

Selective attention to the phobic stimulus
Irrational beliefs
Cognitive distortions

Question 43

Cognitive characteristics of phobias – selective attention to the phobic stimulus

Answer 43

If a sufferer can see the phobic stimulus it is hard to look away from it. Keeping our attention on something really dangerous is a good thing as it gives us the best chance of reacting quickly to a threat, but this is not so useful when the fear is irrational. A Pogonophobic will struggle to concentrate on what they’re doing if there is someone with a beard in the room

Question 44

Cognitive characteristics of phobias – irrational beliefs

Answer 44

A phobic may hold irrational beliefs in relation to phobic stimuli. For example, social phobias can involve beliefs like‘ I must always sound intelligent‘ or‘ if I blush people will think I’m weak‘. This kind of belief increases the pressure on the sufferer to perform well in social situations

Question 45

Cognitive characteristics of phobias – cognitive distortions

Answer 45

The phobic‘s perceptions of the phobic stimulus may be distorted. So, for example, an omphalophobic is likely to see bellybuttons as ugly and/or disgusting, and an Ophidiophobic mas see snakes as alien and aggressive looking