Psycopathology

Question 1

What is the deviation from social norms definition of abnormality?

Answer 1

Abnormal behaviour is described as any behaviour that deviates from social norms- the unwritten rules of society (e.g wearing clothes in public).

Question 2

Evaluate the deviation from social norms definition of abnormality

Answer 2

The definition draws a line between desirable and undesirable behaviours and labels individuals behaving undesirably as social deviants. Adhering to social norms means society is ordered and predictable.
However, these norms will vary across cultures, ages, and even gender. This means that the definition is limited and lacks temporal validity.

Question 3

What is the failure to function adequately definition of abnormality?

Answer 3

The failure to function adequately definition sees individuals as abnormal when their behaviour suggests they cannot cope with everyday life, or are unable to experience the usual range of emotions, leading to an inability to function properly. It focuses on individual suffering, and clinicians use the global assessment of functioning scale (GAF) to asses how well individuals cope with everyday life.
Rosenhan and Seligman suggest that personal dysfunction has 7 features- personal distress, maladaptive behaviour, unpredictability, irrationality, observer discomfort, violation of moral standards, and unconventionality.

Question 4

Evaluate the failure to function adequately definition of abnormality

Answer 4

The GAF provides an objective measure allowing clinicians to see the degree of a person’s abnormality. The definition recognises the personal experience of sufferers, and allows for intervention from others as failure to function adequately behaviour is observable to others.
However, abnormality is not always accompanied by dysfunction. (E.g Harold Shipman). The definition also fails to recognise that there are times when it is normal to suffer distress and not function properly (grief). “Normal functioning” varies from culture to culture so abnormal functioning from one culture should not be used to judge another.

Question 5

What is the deviation from ideal mental health definition of abnormality?

Answer 5

The deviation from ideal mental health definition sees abnormality as a failure to meet the criteria for perfect psychological well-being. Jahoda (1958) devised 6 characteristics that indicated normality. More deviation from the characteristics meant more abnormality- positive attitude towards oneself, self actualisation, autonomy, resisting stress, accurate perception of reality, environmental mastery.

Question 6

Evaluate the deviation from ideal mental health definition of abnormality

Answer 6

The definition emphasises positive achievements rather than failures and distress.
However, the criteria can be seen as over-demanding, vague, difficult to measure, and not realistic to remain constant.

Question 7

What is the statistical infrequency definition of abnormality?

Answer 7

Behaviours that are statistically rare are seen as abnormal, depending on normal distribution- a symmetrical spread of frequency data. Statistical deviation occurs when an individual has a less common characteristic.

Question 8

Evaluate the statistical infrequency definition of abnormality

Answer 8

The definition provides evidence and justification for psychiatric assistance as it is objective and doesn’t rely on value judgements.
However, it is not clear where to draw the line of abnormality. Also, some rare behaviours are desirable, not abnormal. The definition also does not consider cultural factors, statistic normality varies.

Question 9

What is depression and its characteristics?

Answer 9

Depression is an affective mood disorder characterised by sufferers exhibiting at least 5 of the symptoms, everyday for at least 2 weeks.
The characteristics can be behavioural (actions)- insomnia, loss of energy, self destructive behavior; emotional (feelings)- feeling isolated or worthless, loss of interest or pleasure, anger; or cognitive (thoughts)- poor memory, diminishing concentration, recurrent thoughts of death.

Question 10

Outline one cognitive approach to explaining depression (Beck’s negative triad)

Answer 10

The cognitive approach explains depression in terms of faulty and irrational thought processes- the maladaptive cognitions that underpin maladaptive behaviours.
Beck believes people become depressed because the world is seen negatively through negative schemas (cognitive framework-collection of thoughts), due to early traumatic experiences. Beck’s negative triad then shows how an individual may then expect to fail in situations similar to when the schema was learnt, providing a negative framework to view life in a pessimistic way. (Negative views about the world=negative views about the future=negative views about oneself).

Question 11

Outline another cognitive approach to explaining depression (Ellis’ ABC model)

Answer 11

Ellis suggested that depressives blame external events for their unhappiness and their interpretation of these events is the cause for their distress.
A- activating event- getting fired at work
B- belief- irrational beliefs like “you are a failure”
C- consequence- emotional response and depression
Musturbatory thinking=the source of irrational beliefs. The three most irrational beliefs are “I must be approved by important people, I must do well or I am worthless, The world must give me happiness”. These irrational beliefs need to be challenged as holding them can cause depression.

Question 12

Evaluate both cognitive approaches to explaining depression

Answer 12

The cognitive approach has useful applications for treating depression- e.g CBT. It acknowledges other aspects, such as genes, developments, and early experiences which can lead to thinking patterns for depression.

Question 13

What is cognitive behavior therapy (CBT)?

Answer 13

CBT is the main psychological treatment used to help treat depression, based on the cognitive model.
1) therapist helps depressed patient identify negative thoughts and keep a diary (thought-catching)
2) therapist challenges dysfunctional cognitions by drawing to positive incidents (however small)
3) reality testing- homework is set between sessions to counteract every negative thought with something positive, showing they are irrational and unrealistic
4) Beck also uses behavioural techniques to encourage positive behaviour
5) small positive goals are set to encourage a sense of personal effectiveness and achievement.

Question 14

Evaluate cognitive behaviour therapy (CBT)

Answer 14

CBT encourages a sense of personal achievement. It gives patients control over their thoughts, and helps them gradually and safely. It can be paired with drugs for the interactionist approach (biological and cognitive treatment combined).
However, it can be expensive and takes time. It requires the patients to be able to recognise negative thoughts, and to be able to trust their therapist with them.

Question 15

What are phobias and their characteristics?

Answer 15

Phobias are a type of anxiety disorder characterised by uncontrollable, extreme fears involving anxiety levels that are unproportionate to actual risk. Phobias generally originate in childhood and lesson in adulthood, and can be either learned from experience or genetically transmitted.
Symptoms can be behavioural- freezing, fainting, avoidant response, disruption of functioning, immediate fear response to phobic stimulus; emotional- persistent excessive high levels of anxiety; or cognitive- irrational nature of thoughts, awareness of their overstated anxiety levels.

Question 16

Outline the behavioural approach to explaining phobias

Answer 16

The two-process model explains how phobias are learnt through experience.
1) Classical conditioning (CC) causes a stimulus to become associated with a response. Social learning theory (SLT) describes the observation and imitation of another person with a phobia (e.g a child watching and learning from a parent).
2) Operant conditioning explains how phobias are maintained. Avoiding or escaping from the feared object acts as a negative reinforcer (the reward being the reduction of anxiety). This reinforces the avoidance response.

Question 17

Evaluate the behavioural approach to explaining phobias

Answer 17

The behavioural approach to explaining phobias is supported by the study of “little albert” (watson+raynor), which presented that an infant had been classically conditioned to fear an animal when presented simultaneously with a sound, through association of the fear response. However, the behavioural approach is weakened by the fact that it doesn’t account for the role of cognitive factors in the development and maintenance of phobias.
Another research support is a study by Di Gallo, who reported that around 20% of people experiencing traumatic car accidents developed a phobia of travelling in cars (CC), and made avoidance responses such as not travelling in cars to see friends (OC). However, the behaviourist approach is weakened by the fact that not everyone experiencing traumatic events develops phobias, and not everyone with a phobia has witnessed a traumatic event.

Question 18

Outline and evaluate systematic desensitisation as a treatment for phobias

Answer 18

Systematic desensitisation (SD) is the main behaviourist treatment for phobias developed by Wolpe. It is based on classical conditioning with patients learning in stages (on the fear hierarchy) to replace fear responses with feelings of calm rather than previous associations between phobic objects and fear. It takes roughly 6-8 sessions to go from least to most feared types of contact with phobic stimuli, by either imagining scenarios (in vitro desensitisation) or actual contact (in vivo desensitisation). It can take time, and therefore can be expensive. Confronting phobias using the imagination is a limitation as there is no guarantee it will work in real life, and some patients may not have vivid enough imaginations. However, it is seen as more ethical than flooding as it uses a progressive, step-by-step, gradual approach. Jones used SD to eradicate “little peter”’s phobia of white fluffy objects, and he eventually developed affection for the rabbit.

Question 19

Outline and evaluate flooding as a treatment for phobias

Answer 19

Flooding is a behaviourist therapy also known as implosion. Patients go straight to the top of their fear hierarchy, and imagine or have contact with their most feared scenarios. Flooding aims to expose the sufferer to the phobic stimuli for an extended period of time in a safe and controlled environment, as fear is a time limited response. The person will go from a state of extreme anxiety and panic to a new association between the feared object and something positive, like calm feelings. It is a quicker process than SD and therefore cheaper. Wolpe used flooding to remove a girls phobia of being in cars by driving her around for 4 hours until her hysteria was eradicated, demonstrating effectiveness of the treatment. It prevents reinforcement of phobias through escape or avoidance behaviours. However, it could be traumatic, and make the phobia worse. It could also be dangerous for those with heart conditions.

Question 20

What is OCD and its characteristics?

Answer 20

OCD is an anxiety disorder characterised by persistent, intrusive, recurrent, unpleasant thoughts and repetitive, ritualistic behaviours. Obsessions are forbidden visual images or thoughts that aren’t based in reality, leading to feelings of extreme anxiety. Compulsions are intense, uncontrollable urges to repetitively perform tasks and behaviors, as an attempt to reduce distress.
Symptoms can be behavioural- inability for everyday functioning, social impairment; emotional- extreme anxiety and distress, short-term relief, recurrent emotions; or cognitive- persistent thoughts, uncontrollable urges, attentional bias in anxiety-generating stimuli, realisation of inappropriateness, recognised as self-generated.

Question 21

Outline and evaluate one biological approach to explaining OCD (genetic explanations)

Answer 21

OCD is inherited through genetic transmission, with research originally focused on twin and family studies. Recent studies show that particular gene combinations (OCD is polygenic) make some individuals more vulnerable to developing OCD than others.
COMT gene causes a decrease in COMT activity, so a higher level of dopamine. SERT gene affects transport of serotonin, creating lower levels, which have been implicated with OCD.
Research shows that genetics is not the sole explanation for OCD. Development of the disorder may depend on environmental triggers, as not all identical twins both have OCD- Nestadt found that they have 68% concordance of OCD. Also, some types of OCD may be more genetic than others, OCD originating in childhood is more genetic in nature than those originating in adulthood.

Question 22

Outline and evaluate one biological approach to explaining OCD (neural explanations)

Answer 22

Some forms of OCD have been linked to breakdowns in immune system functioning (e.g Lyme’s disease), indicating an explanation through damage to the neural system. PET scans show low levels of serotonin activity in the brains of OCD patients. Drugs that increase serotonin activity have been found to reduce the symptoms of OCD.
OCD sufferers can have high activity levels in the orbital frontal cortex. The brain area initiates impulses and turns them to obsession, resulting in compulsive behaviour.
There is research support for the neural explanation as it is objective. Pichichero reported that case studies from US national institute of health showed that children with throat infections often displayed sudden indication of OCD symptoms.

Question 23

Outline and evaluate the biological approach to treating OCD

Answer 23

Drugs are the most common form of biological therapy. Antidepressants (prozac) elevate levels of serotonin and cause the orbital frontal cortex to function at more normal levels. Treatment usually lasts 12-16 weeks.
Anti-anxiety drugs (xanax) enhance the activity of GABA which slows down the central nervous system and has a quietening effect on many brain neurons.
Although drugs may not cure OCD, they reduce obsessive thoughts and compulsive behaviour to a level for a more normal lifestyle. They are relatively cheap and don’t require a costly therapist, and are found to be consistently effective in reducing OCD symptoms. However, they many have side effects like sleep pattern disturbance, headaches, loss of appetite, and irritability, so could cause other disorders and are less suitable for children.

Question 24

What is positive and negative reinforcement?

Answer 24

Positive reinforcement is an outcome of a behaviour that is pleasant. Negative reinforcement is an outcome of a behaviour that results in escaping something unpleasant.