Topic 6: Psychopathology Flashcards
Definitions of abnormality
1) Statistical Infrequency
2) Deviation from social norms
3) Failure to function adequately
4) Deviation from ideal mental health
Cultural Relativism
The view that behaviour cannot be judged properly unless it is viewed in the context of the culture in which it originates.
Statistical infrequency
Definition:
A mathematical way of explaining and identifying abnormal behaviour. Abnormality is defined as those behaviours that are extremely rare (beyond 2 standard deviations of the mean is considered abnormal behaviour)
- occupies the extreme ends of a normal distribution curve (beyond 2SD’s from mean)
- uses up-to-date statistics
- eg low IQ defined as intellectual disability disorder; OCD as a rare disorder
Evaluation:
Strengths:
- Objective - Using numbers (scientific measure) so you’re either normal or abnormal, there’s no in-between or uncertainty.
- Can be used as baselines for things like IQ
- Real life applications - i.e. growth charts and percentiles used to track the development of children.
- Easy to use, can identify potential abnormalities that can then be put into context using other definitions of abnormality.
Weaknesses:
- SI does not distinguish between desirable and undesirable behaviours. Just because a behaviour is uncommon that doesn’t necessarily mean it is undesirable or abnormal.
- The cut-off point is subjective - who decides where to separate normality from abnormality?
- SI must be used in conjunction with another method to diagnose an abnormality
- cultural bias: behaviour that are statistically infrequent in one culture may be statistically more frequent in another. No universal rule for labelling abnormal behaviour. could lead to misdiagnosis or inappropriate labelling of individual .
Deviations from social Norms
Definition:
deviation from social norms is behaviour which goes against/contravenes unwritten rules/expectations (in a given society/culture) –
Evaluation:
Strengths:
- does distinguish between desirable and undesirable behaviour as social rules are established in order to help people live together, according to this definition, abnormal behaviour is behaviour that damages others.
- Acknowledges differences in cultures.
Weaknesses:
- Deviance is related to context and degree
- susceptible to abuse - what is considered socially acceptable changes over time. Danger of creating definitions based on prevailing social morals or attitudes and is deviating from social norms always a bad thing?
Failure to function adequately (FFA)
Definition:
Ppl are judged on their ability to go about daily life. If they can’t do this and are also experiencing distress (or others are distressed by their behaviour) then it is considered a sign of abnormality.
- failure to function adequately is behaviour which causes personal distress/anguish OR inability to cope with everyday life/maladaptiveness
- behaviours such as not being able to hold down a job, maintain a relationship, personal hygiene, etc
- failure to follow interpersonal rules
Rosenham and Seligman suggest the following characteristics define FFA:
- Suffering
- maladaptiveness (danger to self)
- Vividness & unconventional
- Unpredictability & loss of control
- Irrationality/incomprehensibility
- causes observer discomfort
- Violates moral/social standards
Evaluation:
Strengths:
- provides clear guidelines for the classification and diagnosis of abnormality as it is focused on observable signs that an individual is not copinge.g. lack of hygiene, clear behavioural distress signals.
- acknowledgement of the individual’s subjective experience, particularly for those struggling to cope with daily life and seeking help. This approach is patient-centred, considering mental disorders from the sufferers’ perspective.
- it enables those close to the sufferer—such as family, friends, or colleagues—to be the first to recognize when something is not right, prompting them to either approach the person directly or seek help from relevant authorities. This early detection can be crucial for timely intervention and support
Limitations:
- FFA is not always indicative of MH issues, e.g. people with OCD may find that their compulsive behaviours calm them and help them to better cope with their day.
- Many ppl engage in behaviour that is maladaptive/harmful or threatening to self (e.g. adrenaline sports, smoking and alcohol, skipping classes) but we don’t class them as abnormal.
- perceptions of normality and the capacity to function vary significantly across individuals and societies, influenced by political, religious, or personal beliefs. Consequently, judgments about an individual’s ability to function normally may differ based on these factors
Deviation from ideal mental health
Definition: Deviation from ideal mental health is behaviour which fails to meet particular criteria for psychological wellbeing
Marie Jahoda came up with characteristics of ideal mh (the more criteria someone fails to meet, the more abnormal they are):
- Autonomous - independent & self regulating.
- Self-attitudes - Having high self-esteem & a strong sense of identity
- Personal growth & actualisation - you are able to develop and function to your full capability.
- Integration - Resistance to stress / ability to cope with stressful situations.
- Reality - You don’t lose focus of what is real and important. Can still show empathy w/o losing a sense of reality.
- Mastery of Environment - you are able to judge, problem solve & adapt to new situations. This includes building relationships both personal and at work.
Evaluations:
- Unrealistic criteria: I.e. self-actualisation involves the practical barriers many individuals face due to external factors such as financial constraints, societal norms, and personal circumstances. Considering self-actualization as the ultimate achievement in one’s career or finding the perfect job that aligns with individual skills and passions would mean that very few individuals reach this pinnacle, and thus based on Jahod’a strict criteria, a significant proportion of the global population would be defined as metnally ill for simply operating within the limitations imposed by their social and economic environments.
- It is a positive approach and has influence on humanistic approaches
- CULTURALLY BIASED: CULTURAL CONTEXT AND THE IDEAL MENTAL HEALTH MODEL: Jahoda’s ideal mental health model aligns more closely with the values of individualistic societies than collectivist ones. This model presupposes self-actualisation, autonomy, and personal growth are universal priorities. However, these criteria may not hold the same significance in collectivist societies, where communal goals and the group’s well-being often precede individual achievement.
- SUBJECTIVITY IN MEASURING MENTAL HEALTH: Accurately assessing someone’s perception of reality or their level of self-actualization poses challenges. Consider the diverse perspectives on what constitutes reality: Is a worldview centred around atheism and nihilism more valid than one founded on religious faith and determinism?
- SCIENCE VERSUS PHENOMENOLOGY: As a cornerstone of humanistic psychology, the ideal mental health model is characterized by its emphasis on subjective experience and the inherent potential of individuals to grow and achieve personal well-being, meaning that the model operates outside the boundaries of traditional scientific inquiry, which relies on empirical evidence, testability, and falsifiability. Humanistic theories, including ideal mental health, are often criticized for their lack of empirical grounding and the difficulty of subjecting them to scientific verification or falsification.
- STRESS CAN BE GOOD: According to Jahoda’s criteria, an individual’s ability to resist stress is a hallmark of ideal mental health. However, the Yerkes-Dodson Law suggests that this view may be overly simplistic and does not account for the complexity of human experiences with stress. Suggests the model may be oversimplistic.
Phobias
Definition: A group of mental disorders characterised by high levels of anxiety in response to a particular stimulus or group of stimuli. The anxiety interferes with normal living.
Emotional characteristics: Persistent fear, which evokes feeling of anxiety and panic.
Behavioural characteristics: Avoidance or fight, flight or freeze response.
Cognitive characteristics: The irrational nature of the person’s thinking and resistance to rational arguments. selective attentionwill cause them to become fixated on the object they fear. Irrational beliefs and thinking.
Depression
Definition: A mood disorder where an individual feels sad and/or lacks interest in their usual activities.
Emotional characteristics: Potential feelings of sadness, worthlessness, hopelessness, low self-esteem, despair, anger and/or hurt. Loss of interest.
Behavioural characteristics: Shift in activity level - could experience reduced energy and tiredness (increased lethargy); become increasingly agitated and restless; Withdrawal from activities that were once enjoyed (anhedonia); neglecting personal hygiene. Difficulties sleeping (insomnia) or sleeping too much (hypersomnia), loss or gain of appetite, leading to loss or gain of weight. Aggressive acts – towards others or oneself, e.g. self-harm.
Cognitive characteristics: Negative thoughts and irrational beliefs
OCD
Definition: An anxiety disorder where anxiety arises from both obsession (persistent thoughts) and compulsions (repeated behaviours). Compulsions are a response to obsessions and the person believes the compulsions will reduce anxiety.
Emotional characteristics: Obsessions and compulsions are a source of anxiety and distress and can cause feelings of embarrassment, shame and disgust.
Cognitive characteristics: Recurring intrusive thoughts (obsessions) that are perceived as inappropriate or forbidden. Awareness that behaviour is irrational.
Behavioural characteristics: Repetitive and uncontrolled compulsive behaviours, performed to reduce anxiety created by obsessions.
Two-process model
A behavioural approach to explaining phobias developed by mowrer
The two-process model is a theory that explains the two processes that lead to the development of phobias - they begin through classical conditioning and are maintained through operant condition.
- classical conditioning: Initiation learning through association
- Operant conditioning: maintenance
learning through reinforcement or punishment. The avoidance of the phobic stimulus reduces fear and is thus reinforcing (negative reinforcement).
Social Learning as an explanation for phobias
Phobias may be acquired through modelling the behaviour of others.
Support by Bandura and Rosenthal buzzer experiment: A model acted as if he was in pain every time a buzzer sounded. Later on, those PPs who observed this showed an emotional response to the buzzer, demonstrating an acquired ‘fear’ response.
Evaluation of the two-processing model
Strengths:
- Useful for developing therapies e.g. exposure therapies such as flooding and systematic desensitisation, counter-conditioning.
- Little Albert experiment - John B Watson support for classical condition in initiating phobias. He paired a white rat (NS) with a loud noise (UCS). When Albert saw a white fury rat now he cried (CR) presumably because the object was now associated with fear. The fear was also generalised to other white fluffy objects.
Weaknesses:
- Some phobias don’t follow a traumatic experience e.g. a person may have a fear of snakes without having ever encountered a snake. This suggests some phobias have no been acquired through learning, weakening the explanation.
- Biological preparedness: We may be pre-disposed to some phobias, such as snakes or spiders, which would have given human ancestors a survival advantage. This means the capacity for certain phobias is ‘hard-wired’, and therefore not learnt. Phobias of guns and cars which are far more dangerous to humans today, are very rare, perhaps because these things were not present in human’s evolutionary past.
- reductionist: For example, the two-process model suggests that complex mental disorders such as phobias are caused solely by our experience of association, rewards and punishment Ignores cognitive factors: The cognitive approach offers an alt. argument that phobias may develop as a consequence of irrational thinking, which has led to cognitive therapies such as CBT, which is some situations can be more successful than behaviourist treatments.
- deterministic - For example, the Two-Process model suggests that when an individual experiences a traumatic event and uses this event to draw an association between a neutral stimulus and an unconditioned response they will go on and develop a phobia. ignores individual free will.
- The study that Di Nardo conducted showed that 60% of the dog-phobic participants erienced at least one frightening event/situation involving a dogbut a similar percentage in the non-phobic control group also recalled such experiences, indicating that a frightening experience alone is not sufficient to cause a phobia.The Two Process model also can’t explain the 40% of dog-phobic pps that could not recall a traumatic expereince yet still had a phobia of dogs.
What are the theories to treat phobias?
- Flooding
- Systematic desensitisation
- Counter-conditioning
Flooding
- A form of behavioural therapy used to treat phobias.
- A client is immediately exposed to (or imagines) an extreme form of the threatening situation without the ability to avoid it.
- exhaustion of phobic response: Flooding involves purposely triggering a state of fight or flight until the individual can no longer maintain that response and their body relaxes, while still in the presence of the phobic stimulus.
- Results: Extinction of the fear due to association with relaxation
Step 1: Patient taught how to relax muscles completely
Step 2: Patient masters the feared situation that caused them to seek help in the 1st place in one long session.
Systematic desensitisation
a form of behavioural therapy used to treat phobias, where a client is gradually exposed to (or imagines) the threatening situation under relaxed conditions until the anxiety reaction is extinguished.
- based on classical conditioning – counterconditioning
- Involves relaxation training – fear and relaxation cannot coexist (reciprocal inhibition)
Step 1: Patient taught how to relax their muscles completely.
Step 2: Therapist + Patient create a desensitisation hierarchy - A series of situations, each one causing a little more anxiety than the previous one.
Step 3: Patient gradually works their way through the desensitisation hierarchy, while engaging in relaxation responses.
Step 4: Once patient can remain relaxed while exposed to the situation they are ready to move onto the next.
Step 5: Patient eventually masters the feared situation that caused them to seek help in the first place.
Evaluation of Flooding
Strengths:
- Choy et al. reported flooding to be more effective than SD. However, Craske et al, 2008 concluded equal effectiveness.
- Faster and cheaper than SD.
Weaknesses:
- Ethical issues as can be highly traumatic for patients and has no right to withdrawal.
- Symptom substitution as it removes the symptoms but not the cause, which may resurface in another form.
- Individual differences as it’s not suitable for every patient i.e. puts patients with certain health conditions as risk.
- Wolpe (1969) recalled a case with a patient in which the patient became so anxious that she was hospitalised.
Evaluation for Systematic Desensitisation
Strengths:
- McGrath et al (1990) found that 75% of patients with phobias respond to SD.
- Can be self-administered
- more ethical than flooding
- The person is in control and can take it at their own pace.
Weaknesses:
- Not appropriate for all phobias such as those with an underlying evolutionary survival component.
- May make a phobia worse if not fully completed or carried out correctly.
- SD is time-consuming, when compared to alternatives such as flooding, as the person with the phobia needs to be trained in relaxation techniques and gradual exposure can take many sessions
- progress in therapy may not generalise outside of the clinical setting when the person with the phobia must face their fear without the support of the therapist
- may not be appropriate for more generalised ‘free-floating’ phobias, such as social phobia, where there is no obvious target behaviour so difficult to devise a hierarchy
- Symptom substitution
The cognitive Approach to explaining depression
- Ellis’ ABC model (1962)
- Beck’s Negative Triad (1967)
Ellis’ ABC model
- Proposed by Albert Ellis
- A cognitive approach to understanding mental disorder, focusing on the negative effect of irrational beliefs on emotions.
- Activating event
- Irrational Belief
- Consequences of belief (IB’s lead to unhealthy emotions)
- The source of IB’s lies in Musturbatory thinking - thinking that certain ideas or assumptions must be true in order for an individual to be happy ( he belief by some individuals that they must absolutely meet often perfectionist goals in order to achieve success, approval, or comfort). Such assumptions are bound to lead to disappointment and potentially depression.
Beck’s Negative Triad
A cognitive approach to understanding depression, focusing on how negative expectations (schema) about the self, world and future lead to depression
1) Depressed people have acquired a negative schema during childhood.
2) These negative schemas are activated when the individual encounters a new situation that resembles the original situation where the schema was learnt.
3) This leads to systematic cognitive bias is thinking - individual over-generalises and draws overall conclusions on their self-worth based on small pieces of negative feedback.
4)Negative schemas and cognitive biases maintain what beck calls the negative triad
Evaluate Beck’s negative triad
Strengths:
- Bates et al. (1999) found that depressed PPS who were given negative automatic-thought statements became more and more depressed. Support that -ve lead to depression.
- Practical Applications in therapy - CBT
Weaknesses:
- Blames the client, which gives the client power to change but may lead them to overlook situational factors that have contributed to the md.
- Alternative explanations - The biological approach, research supports the role that low levels of the nt serotonin in depressed people and has also found that a gene related to this is 10x more common in ppl with depression (Zhang et al, 2005)
Evaluate Ellis’ ABC model
Strengths:
- Hammen and Krantz found that depressed PPs made more errors in logic when asked to interpret written material than did non-depressed PPS.
- Bates et al. (1999) found that depressed PPS who were given negative automatic-thought statements became more and more depressed. Similar to Elllis’ idea of musturbatory thinking.
- Practical Applications in therapy - CBT
Limitations:
- Blames the client, which gives the client power to change but may lead them to overlook situational factors that have contributed to the md.
- Alternative explanations - The biological approach, research supports the role that low levels of the nt serotonin in depressed people and has also found that a gene related to this is 10x more common in ppl with depression (Zhang et al, 2005)
Cognitive Behavioural Therapy (CBT)
A combination of cognitive therapy (a way of changing maladaptive thoughts and beliefs) and behavioural therapy (a way of changing behaviour in response to these thoughts and beliefs)
Rational Emotive Behavioural Therapy (RBT)
A form of CBT developed by Ellis with the aim of turning irrational thoughts into rational ones by focusing on resolving emotional and behavioural problems.
Ellis’ extending his ABC model to add:
D: Dispute irrational thoughts and beliefs
E: Effective disputing = effective attitude to life
F: New Feelings (emotions) produced
REBT focuses on challenging the irrational beliefs and replacing them with effective rational beliefs. For example:
- Logical disputing: Does thinking in this way make sense?
- Empirical disputing: Where is the proof that this belief is accurate?
- Pragmatic disputing: How is this belief likely to help me?
