Individual Differences (Abnormality)

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  • Individual Differences (Abnormality)
    • Defining & Explaining Abnormality
      • Deviation from social norms
        • Standards of acceptable behaviour set by social group (i.e. social norms)
        • Anything deviating from acceptable behaviour considered 'abnormal'
        • What is acceptable may change over time
        • Susceptible to abuse, e.g. excluding nonconformists/ political dissenters
        • Deviance hard to identify - related to context and degree
        • Cultural relativism - DSM includes culture-bound syndromes, acknowledging cultural differences in what's considered 'normal'
      • Failure to function adequately
        • Not being able to cope with demands of everyday life, e.g. going to work, eat in public, wash clothes
        • Abnormal behaviour interferes with day-to-day living
        • Individual judges when behaviour becomes 'abnormal'
        • Patient may feel content even though their behaviour is dysfunctional
        • Dysfunctional behaviour can sometimes be adaptive, e.g. depression = help from others
        • Cultural relativism - what's considered 'adequate' differs between cultures - may result in different diagnoses depending on the culture
      • Deviation from ideal mental health
        • Jahoda - use the same criteria as for physical illness (absence of signs of health)
        • Six categories: Self-Attitudes, Self-Actualisation, Integration, Autonomy, Accurate Perception of Reality, Mastery of Environment
        • Few people experience all these positive criteria - would be considered 'abnormal'
        • Mental illnesses don't always have physical causes = not the same as physical illnesses
        • Cultural relativism - Jahoda's criteria reflect individualist cultural ideas, e.g. autonomy
    • Approaches to Abnormality
      • Biological
        • Assumptions
          • Bodily systems used to explain behaviour
          • Mental disorder explained in terms of malfunctioning bodily systems
          • 'Medical model' because mental disorder seen as and treated like physical illness
        • Abnormality caused by physical factors
          • Genes - effects demonstrated through high concordance rates for mental disorders in MZ twins
          • Traits inherited - at one time they may have been adaptive
          • Neurotransmitters associated with mental disorder, e.g. serotonin and depression
          • Viral infection - Torrey identifie link between influenza and schizophrenia
        • Concept of mental illness invented as a form of social control (Szasz)
        • Causal model - not supported by individual differences, e.g. man schizophrenics have high dopamine levels but some don't
        • No evidence of 100% concordance rates for MZ twins, e.g. Gottesman and Shields estimated 50% for schizophrenia
        • Diathesis-stress model can explain role of biology and experience
        • Research Methods
          • Experiments to test effect of drugs - support causal role of neurotransmitters
          • Correlation, e.g. twin or family studies to produce concordance rates
        • Cultural Similarities
          • Depression found universally - supports evolutionaryview that it's inherited and linked to once-adaptive behaviour
      • Psychological
        • Cognitive
          • Assumptions
            • The mind is like a computer - processes information
            • Problems arise in the way that an individual thinks about the world
          • Abnormality caused by faulty thinking
            • Cognitive distortions include structures, content, processes and products
            • Ellis A-B-C model (Activating event, Belief, Consequence)
            • Rational beliefs = healthy consequences
            • Irrational beliefs = unhealthy consequences
            • Individual is in control of their thoughts = abnormality is the result of faulty control
          • Blames individual rather than situational factors - real causes may be overlooked
          • Way of thinking could be an effect, not a cause, e.g. depressed thinking may be because of depression
          • Faulty thinking may not be a cause but a vulnerability factor
          • Irrational beliefs may be realistic - Alloy and Abrahamson found depressives more realistic thinkers
          • Research Methods
            • Experiments - Thase et al compared effects of CT to effects of drugs
            • Meta-analysis - Smith and Glass combined results from many studies to show effectiveness of CT
        • Behavioural
          • Assumptions
            • All behaviour is learned
            • Maladaptive behaviours are acquired in the same way
          • Abnormality caused by learning
            • Strict behaviourists say that only behaviour is important, not thoughts/ feelings
            • Classical conditioning - learning through association
            • Operant conditioning - learning through the consequences of behaviour
            • Social learning - observation and vicarious rewards
            • Learning environments reinforce problematic behaviours, e.g. avoidant behaviour lowers anxiety = rewarding
            • Limited view of factors that cause mental disorder - CBTs include role of thought
            • Explanation flawed - not everyone with a phobia can identify a time when it was experienced and learned
            • Some phobias more likely to develop than others - biological preparedness a key factor rather than just learning (adaptation to evolve)
            • 'Symptom substitution' - although symptoms of a disorder may be behavioural, causes may not be
          • Research Methods
            • Experiments easily done - focus is on observable behaviours - can demonstrate the importance of consequences
            • Animal studies used to generalise to human behaviour
        • Psychodynamic
          • Assumptions
            • Individual's abnormal behaviour determined by underlying psychological conflicts (they're mostly unaware)
            • Freud was first to propose psychological causes for mental illnesses
          • Abnormality caused by unconscious, psychological factors
            • Unresolved conflicts between id, ego and superego result in ego defences (defence mechanisms)
              • Repression (putting unpleasant thoughts into the unconscious)
              • Projection (blaming someone else)
              • Denial
              • Displacement (venting anger elsewhere)
              • Regression (behaving like a child)
              • Intellectualisation
            • Early experiences, e.g. traumas, can lead to later disorders
            • Behaviour is unconsciously motivated
            • Abstract concepts - difficult to define and research id, ego and superego
            • Sexism - theory less well developed for women, partly due to historical background. Modern psychoanalysis has addressed  this
            • Difficult to prove or disprove the theory - theory often turns apparent disproof into support because of action of defence mechanisms
            • Research Methods
              • Case studies, e.g. Little Hans, Anna O. Rich in detail, lack generalisibility
              • Experiments - Fisher and Greenberg reviewed over 2500 studies of Freudian hypotheses - many received experimental support
    • Treating Abnormality
      • Biological Therapies
        • Drugs
          • Conventional antipsychotics used to combat positive symptoms of schizophrenia - they block action of dopamine in the brain
          • Antidepressants increase availability of serotonin (blocking its re-absorption of SSRIs
          • Anti-anxiety drugs, e.g. BZs, increase effect of GABA
          • Effective, e.g. better than placebos in schizophrenia treatment (WHO)
          • Relatively easy to use
          • Best used with psychotherapy
          • Some studies show placebo just as effective, e.g. Kirsch et al.
          • Tackles symptoms not problem = not a cure
          • Side effects, e.g. SSRIs linked to anxiety or increased aggression
        • ECT
          • Used for severe depression
          • Unconscious, relaxed patient given 0.6 amps for 1/2 second seizure
          • Unilateral (an electrode placed above non-dominant temple and in middle of forehead)
          • Bilateral (an electrode placed above each temple)
          • Can prevent suicide = benefits greater than risks
          • Effective - 60-70% patients improve (Corner), though Sackheim et al. claims 84% relapse within 6 months
          • Not clear why it works (may alter actions of neurotransmitters)
          • Some patients recover even with 'sham' ECT - suggests extra attention is important
          • Side effects, e.g. memory loss, increased levels of fear and anxiety
          • Ethical Issues
            • 50% of patients not well-informed about procedure
      • Psychological Therapies
        • Psychoanalysis
          • Seeks to recover repressed memories or unresolved conflicts
          • Free association - patients talk freely, regardless of relevance or importance
          • Dream analysis - patients tell therapists about their dreams and therapist looks for clues
          • Bergin analysed 10,000 records, 80% success
          • Longer treatments = better outcomes (Tschuschke et al.)
          • Based on psychoanalytic theory - theory is flawed
          • Fails to acknowledge individual differences - imposes the same theory on all
          • 'Repressed' memories likely to be false (Loftus - memories e.g. of sexual abuse planted by therapist)
          • Ethics
            • Stress from insights, problem of false memories and forced termination
        • CBT
          • Rational Emotive Behaviour Therapy (REBT, a form of CBT)
          • Irrational beliefs experienced as self-defeating thoughts
          • Challenge thinking using logical, empirical and/or pragmatic disputing
          • Patient moves from catastrophising to more rational thinking
          • Based on A-B-C model but adds D-E-F (Disputing = new Emotions and Feelings)
          • More effective than drugs alone
          • Useful for clinical and non-clinical groups
          • Also effective when delivered via computer
          • Doesn't address influence of external environment
          • Not suitable for all - e.g. some may reject its direct challenges
          • Ethics
            • May create moral conflicts, e.g. people with strong religious convictions
        • SD
          • Gradual exposure to feared stimulus
          • Based on counter-conditioning (teaching a behaviour that's incompatible with fear response)
          • May involve imagining feared situation followed by direct exposure
          • Steps
            • 1. Learn relaxation
            • 2. Construct de-sensitisation hierarchy
            • 3. Visualise each event while relaxing
            • 4. Work through hierarchy
            • 5. Eventually master fear
          • Quick, requires relatively little effort
          • Useful, e.g. for people with learning difficulties
          • 75% recovery for phobics when treated with SD (McGrath et al.)
          • Effective in treatment of aerophobics (Capafons et al.)
          • Deals with symptoms not cause - may cause symptom substitution
          • May be less effective for 'ancient fears' such as fear of the dark

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