Psychopathology - Advanced Information Flashcards
16 Marker Plan
Outline and evaluate the [STATISTICAL FREQUENCY] as a definition of abnormality [16 marks]
AO1
AO1 – STATISTICAL INFREQUENCY
- Abnormal behaviours = rare and few people have
- Mathematical method. - Human attributes fall in normal distribution within population. So, there’s central average, and rest of population fall symmetrically above and below that mean.
- 5% that fall more than two standard deviations from the mean = abnormal.
- E.g., average IQ approx. 100. 95% of population have IQ in the region of 70 - 130. Small percentage (approx. 5%) IQ <70/>130 so statistically uncommon and so abnormal
Outline and evaluate the [STATISTICAL FREQUENCY] as a definition of abnormality [16 marks]
AO3
AO3 – DW, DW, HB, DW
+ Real life application. Diagnosing intellectual disability disorder (IDD). So, place for statistical deviation to identify abnormal behaviours and characteristics. Measurement of how severe their symptoms are compared to statistical norms. Therefore, statistical deviation is a useful part of clinical assessment.
- Some abnormal behaviour = desirable. E.g., few people IQ >150. People would like to be classed as a genius! Doesn’t distinguish between desirable and undesirable behaviour. So, need way of identifying behaviours both infrequent and undesirable.
- Cut off points subjectively determined. For example, people disagree on what constitutes an abnormal lack of sleep. However, since this is a symptom of depression, it is important to know where the cut-off point lies for a diagnosis to be made. This means that disagreements = difficult to define abnormality in terms of statistical infrequency.
- Labels aren’t necessary. E.g., someone with very low IQ may not be distressed and may be capable of working. Label of ‘IDD’ wouldn’t benefit them. This shows that labelling a person as abnormal could have a negative effect on their self-view and the way others view them.
Outline and evaluate the [DEVIATION FROM SOCIAL NORMS] as a definition of abnormality [16 marks]
AO1
AO1 – DEVATION FROM SOCIAL NORMS
- When behaviour doesn’t fit within what’s socially acceptable.
- Dependent on the culture which the behaviour occurs.
- Aren’t same across societies so what’s abnormal in one culture isn’t abnormal in another.
- Depends how deeply enriched/culturally important. However, slight deviations may not be regarded as abnormal if social norm isn’t considered important by society
- E.g., UK and queuing is norm
- Some social norms – implicit (laughing at funeral).
- Other asocial norms (causing disorder in public) policed by law.
- Paedophilia defined as abnormal as deviates from both implicit social rule and against law.
Outline and evaluate the [DEVIATION FROM SOCIAL NORMS] as a definition of abnormality [16 marks]
AO3
AO3 – DW, DW, HB, DW
+ Includes issue of desirability of behaviours. E.g., being genius statistically abnormal but wouldn’t’ want to include that in definition. Furthermore, narcissism (excessive interest /admiration of oneself) once viewed as deviation from social norm. Today, selfies common in society. Means social norms can be more useful than other definitions like statistical norms.
- Social norms vary over time. E.g., homosexuality was considered mental disorder in DSM. However, now considered socially acceptable. Means definition based on prevailing social morals and attitudes about what’s deemed to be ‘normal’ and ‘abnormal’. Too much reliance on such definitions could lead to systematic abuse of human rights due to attitudes people hold.
- Deviance related to behaviour’s context. E.g., wearing few clothes on a beach normal but abnormal at formal gathering. However, sometimes not clear line between abnormal deviation and harmless eccentricity. Means social deviance on own can’t offer complete definition of abnormality.
- Using to define behaviour as abnormal varies in communities. So, person from one cultural group may label someone from another cultural group abnormally according to their standards. E.g., hearing voices not seen abnormal in all cultures. Shows can be problematic to use social norms to define abnormal behaviours when diagnosing those from other cultures. Abnormality therefore culturally relative.
Outline and evaluate the [FAILURE TO FUNCTION ADEQUATELY] as a definition of abnormality [16 marks]
AO1
AO1 – FAILURE TO FUNCTION ADEQUATELY
- Individual not able to cope with everyday life. Acknowledges people may act differently but if they have a basic inability to manage in everyday life their behaviour is abnormal.
- Ability defined by Rosenhan and Seligman into seven sections: unpredictability, maladaptive behaviour, personal distress, irrationality, observer discomfort, violation of moral standards and unconventionality.
- The Global Assessment of Functioning Scale (GAF) measured how well individuals function in everyday life. Considers Rosenhan and Seligman’s sections plus occupational functioning.
- Schizophrenia abnormal – behaviours – hallucinations, delusions. Distressing to others even if not personally distressing.
- Abnormality diagnosis for someone with low IQ not made on own. Must fail to function adequately.
Outline and evaluate the [FAILURE TO FUNCTION ADEQUATELY] as a definition of abnormality [16 marks]
AO3
AO3 – HB, HB, DW, HB
+ Attempt to include subjective experience of individual. Acknowledges experience of patient and people around them is important. Captures experience of many of the people who need help. Suggests it’s a useful criterion for assessing abnormality.
- Some ‘abnormal; behaviours can be functional. E.g., depression may lead to extra attention. This attention is rewarding and therefore functional, even if generally regarded as abnormal. Means incomplete definition as fails to distinguish between behaviours that = dysfunctional and those that have some function for individual.
- Someone needs to decide if it’s the case. Sometimes people experience personal distress and recognise their behaviour is undesirable. However, sometimes people content with their behaviour, and it is others who are distressed by it. Means whether a behaviour defined as abnormal or not depends on who’s making the judgement which may be subjective.
- Hard to say if someone failing to function adequately and when just deviating from social norms. E.g., not having job/permanent address sign of failure to function adequately. So, what do we say about those who choose not to have those things? Similarly, those who practise extreme sports could be accused of being in a maladaptive way, whilst those with religious/supernatural beliefs could be seen as irrational. If we treat these behaviours as ‘failures’ of adequate functioning, risk limiting personal freedom and discriminating against minority groups.
Outline and evaluate the [DEVIATION FROM IDEAL MENTAL HEALTH] as a definition of abnormality [16 marks]
AO1
AO1 – DEVIATION FROM IDEAL MENTAL HEALTH
- Deviating from an idea of positive mental health. Defined in terms of Jahoda’s (1958) criteria of ideal mental health.
- Absence criteria for positive mental health indicates abnormality and potential mental disorder
- Positive attitude towards the self - linked to individual’s level of self-esteem. So, positive attitude should be at a good level, so the individual feels happy with themselves.
- Self-actualisation - being in state of contentment, feeling you’ve become the best you can be.
- Autonomy - having independence and self-reliance. Ability to function as individual and not depend on others.
- Resistance to stress - Individual shouldn’t feel under stress and should be able to handle stressful situations competently.
- Environmental mastery - can adapt to new situations and at ease at all situations in life
- Accurate perception of reality - how the individual sees world around them so should have a perspective that is like how others see the world. Focused very much on distortions of thinking some people, e.g., schizophrenics, may experience.
Outline and evaluate the [DEVIATION FROM IDEAL MENTAL HEALTH] as a definition of abnormality [16 marks]
AO3
AO3 – HB, DW, HB,HB
+ Very comprehensive. Covers broad range of criteria for mental health. Some would argue probably covers most reasons someone would seek help from mental health services/referred for help. Sheer range discussed in relation to Jahoda’s ideal mental health definition make it a good tool for thinking about mental health.
- Specific to Western European and North American cultures. Jahoda’s criteria based on Western cultures’ ideals and beliefs. Applying them to members of non-Western cultures would be inappropriate. E.g., concept of self-actualisation would seem self-indulgent in many areas of the world. Means criteria can only be applied within individualistic cultures (culture bound).
- Jahoda’s criteria is unrealistic. Few people satisfy all the criteria all the time. Therefore, everyone would be described as abnormal to a degree. We need to ask how many of Jahoda’s criteria must be absent before someone is judged as abnormal.
- Suggests mental and physical health – same. In general, physical illness have physical causes making them relatively easy to diagnose. However. Not all mental disorders have physical causes. This means it’s unlikely we can diagnose mental abnormality in the same way we can diagnose physical abnormality.
Describe and evaluate the behavioural approach to explaining phobias. [16 marks]
AO1
- Mowrer proposed two-process model based on behavioural approach to phobias. States phobia acquired (learned in the first place) by classical conditioning and continue because of operant conditioning.
- Watson and Raynor (20) aimed to demonstrate that irrational fear could be induced by classical conditioning. Used placid baby boy (‘Little Albert’) 9 months, showed no fear of a laboratory white rat.
- At 11 months did procedure aimed to induce fear. Whenever rat was placed in Albert’s lap, made a loud noise by banging together two steel bars behind Albert’s back. Did this 7 times.
- Loud noise = UCS, Albert crying = UCR, Rat = NS, Rat = CS, Albert’s fear = CR
- Negative Reinforcement - avoidance - see spider so likely to run away. Escape so reduces fear = negative reinforcer so continues avoiding spiders. Phobia therefore maintained.
- Mowrer suggested when we avoid phobic stimulus successfully escape fear and anxiety that would occur. Reinforces avoidance behaviour so the phobia is maintained.
Describe and evaluate the behavioural approach to explaining phobias. [16 marks]
AO3
AO3 –HB, DW, DW, HB
+ Good explanatory power. Explanation of how phobias can be maintained over time so has important implications for therapies as explains why patients need to be exposed to phobic stimulus. By preventing patients practising their avoidance behaviours stops being reinforced. This application to therapy is strength to the approach.
- Doesn’t explain development of all phobias. Some can’t remember an incident occurring that led to their phobia developing. Suggests different phobias may be result of different processes. However, Ost says it’s possible that such traumatic events did happen, but the phobic has forgotten/repressed them.
- Alternatively, doesn’t always develop after traumatic incident. E.g., DiNardo found not everyone bitten by a dog develops phobia. Diathesis-stress model says we inherit genetic vulnerability for mental disorders but only manifest if triggered by life event. Suggests dog bite only led to phobia in people with such a vulnerability.
+ Phobias have cognitive aspects that can’t be explained in a traditionally behavioural framework. E.g., person who thinks they may die if trapped in a lift might become extremely anxious and may trigger phobia about lifts. Shows irrational thinking also involved in development of phobias. Therefore, would explain why cognitive therapies can be more successful in treating phobias than behavioural treatments.
Describe and evaluate the use of the behavioural approach to the treatment of phobias. [16 marks]
AO1
- Systematic Desensitisation uses classical conditioning to gradually reduce anxiety around phobic stimulus.
- Aims to replace feelings of anxiety with relaxation; this term is known as counterconditioning.
- Impossible to be afraid and relaxed at the same time so relaxation prevents individual from experiencing fear. This is reciprocal inhibition as one emotion prevents the other.
- There are 3 steps:
o Anxiety Hierarchy - list by patient and therapist (least - most frightening)
o Relaxation - therapist teaches patient to relax as deeply as possible e.g control breathing
o Exposure - exposed to phobic stimulus in a relaxed state - Flooding also involves exposure without the gradual build up. Involves immediate exposure of the phobic stimulus.
- No option of avoidance so learns phobic stimulus is harmless (extinction).
- The conditioned stimulus no longer produces previously conditioned response of fear
Describe and evaluate the use of the behavioural approach to the treatment of phobias. [16 marks]
AO3
+ Evidence to show effectiveness. Gilroy (03) followed up 42 patients and a control treated for arachnophobia. 45-minute sessions whereas control treated by relaxation without exposure. Phobia assessed many ways e.g., spider questionnaire and assessing response to a spider. At both 3 and 33 months, treated group less fearful. Shows helpful in reducing anxiety. It also shows effects = long-lasting.
- Time-consuming. Person may not want to constantly be I therapy to overcome phobia that already interferes with their daily life. May also take a long time to overcome if they’re struggling to work their way up the hierarchy. Therefore, it may not be as effective as it should be.
+ Cost – effective. Studies compared flooding to cognitive therapies (Ougrin 11) and found flooding highly effective and quicker than alternatives. This quick effect is a strength as it means that patients are free of their symptoms as soon as possible and that makes the treatment cheaper due to having a much more immediate effect.
- Traumatic. It’s not because it’s unethical as the patients give consent but those patients are often unwilling to see it through to the end. Therefore, there are problems with ethical safeguarding because of the highly unpleasant experience as they experience high levels of anxiety due to the immediate exposure. The also limits flooding as time and money is sometimes wasted only to have them refuse to start/complete treatment.
Discuss the biological approach to explaining OCD [16 marks]
AO1
- Genetic - genes involved in vulnerability to OCD. Lewis (36) observed patients. 37% - parents with OCD, 21% with OCD. Runs in families
- Diathesis-stress model – genetic vulnerability and environmental stress that trigger OCD.
- Candidate genes cause vulnerability. One of the genes = 5HTI-D beta involved in efficiency of transport of serotonin across synapses.
- OCD is polygenic. Taylor (13) up to 230 involved. Associated with action of dopamine as well as serotonin. Both involved in regulating mood
- Aetiologically heterogenous (different causes). One may cause OCD in one person, but different genes may cause disorder in another. Some evidence suggests different types of OCD maybe due to genetic variations.
- Neural – Some explained by reduction in function of serotonin system. Responsible for regulating mood. Low levels = no normal transmission and other processes affected. Mutation on SERT gene may contribute to this.
- Dopamine thought to be abnormally high. High dose drugs in animals induced stereotyped movements resembling compulsive behaviour.
- Decision making occurs in lateral frontal lobes. Abnormal functioning in frontal lobe = impaired decision making. Though to be responsible for hoarding disorder.
- Left parahippocampul gyrus may also be involved. Associated with processing unpleasant emotions. Found to function abnormally in those with OCD.
Discuss the biological approach to explaining OCD [16 marks]
AO3
AO3 –HB, HB,CW, HB
+ Despite twin studies suggesting OCD largely genetic, psychologists not successful in identifying all genes involved. There’s several involved and each variation only increases risk of OCD by a fraction. Consequence is genetic explanation unlikely to be useful as provides little predictive value about whether individual will develop OCD and if so, what type.
+ Evidence environmental factors can also trigger/increased risk of developing OCD. Cromer (07) found over half the OCD patients in their sample had a traumatic event in their past. Suggests OCD cannot be entirely genetic in origin. Therefore, by more productive to focus on environmental causes as more able to do something about these.
+ /- Serotonin-OCD link may simply be co-morbidity (two disorders together) with depression. Many people who suffer from OCD become depressed. This probably involves (not necessarily caused by) disruption to serotonin system. Could be that in those individuals with OCD that serotonin system disrupted as they are depressed as well. However, the fact that types of antidepressants that don’t work on the serotonin system have no effect on OCD suggests that serotonin directly involved in OCD not just in accompanying depression.
+ Shouldn’t be assumed that neural mechanisms cause OCD. There’s evidence to suggest various neurotransmitters and brain areas don’t function normally in patients with OCD. However, this isn’t the same as saying that this abnormal functioning causes OCD. These biological abnormalities could be a result of OCD rather than its cause.
Describe and evaluate the biological approach to treating OCD. [16 marks]
AO1
- Drug therapy aims to increase/decrease levels of neurotransmitters in the brain to increase/decrease neurotransmitter activity.
- As OCD thought to be cause by low levels of serotonin, drug treatment involves increasing levels. Antidepressant - SSRIs. Work on the serotonin system in brain by preventing re-absorption and break down of serotonin by pre-synaptic neuron. Means levels can increase and continue stimulating postsynaptic neuron.
- Typical does of Fluoxetine 20mg and given as capsule/liquid. Takes 3-4 months to have impact.
- If not, dose can be increased or combined with others.
- Tricyclics (older type) like Clomipramine have same effect but have more severe side-effects. Serotonin-noradrenaline reuptake inhibitors (SNRIs) also an option. Increase serotonin and noradrenaline.
