Psychopathology
- Created by: amylynnyates
- Created on: 28-03-18 12:37
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- Psychopath-ology
- Definitions of Abnormality
- Deviation from Social Norms
- norm: an expected form of behaviour. holds societies together: living is more predictable and safe if we all follow
- some norms are explicit and written: fundamental to society and punished by law e.g. respect other's property
- also unwritten, strong expectations:eating with knife and fork
- a way of defining a behaviour as abnormal is the way it breaks from social norms - ppl who behave undesirably labelled as social deviants, so intervention can take place
- Evaluation
- real life application in diagnosis of anti-social personality disorder - useful way of thinking about abnormality
- considers situational norms: behaviour seen as normal in one setting is abnormal in another: nudist beach
- definition seeks to protect society from the effects of an individual's abnormal behaviour
- social norms are specific to cultures - behaviour abnormal in one place may be normal in another (eating dogs)
- social norms vary over time - homosexuality used to be a mental disorder until 1990
- Not all behaviours that break social norms are a sign of psychopathology: fine line between eccentric and abnormal
- Failure to Function Adequately
- sees individuals as abnormal when their behaviour suggests they cannot cope with everyday life
- Rosenhan and Seligman suggest personal dysfunction has a number of features, the more they have the more likely they are abnormal
- Observer discomfort: another's behaviour causes distress to the observer
- Unpredictability, irrationality (behaviour cannot be explained in a rational way)
- Maladaptiveness: struggles to adjust to situations, personal suffering and distress (failure to cope with everyday life distresses the individual)
- Evaluation
- Global assessment of functioning scale (GAF) is measured on a scale, allows us to see what degree someone is abnormal and assess if they need help
- focuses on observable behaviour which is easy too see
- provides a practical checklist used to assess levels of abnormality - straightforward to diagnose someone
- Some psychopaths appear as normal: Harold Shipman murdered over 200 of his patients yet appeared normal and respectable
- sometimes its normal to suffer distress (loved one dies, grieving is psychologically healthy)
- Subjective: doesn't consider individual perspective - bright clothing is normal for eccentrics
- need to consider context: starving yourself meets the criteria but its normal in a hunger strike
- Deviation from ideal mental health
- looks for absence of mental well being: any deviation from what is normal is abnormal
- Jahoda devised 6 characteristicof ideal mental health - absence indicates abnormality
- Positive attutire towards self, self-actualisation (full potential), Autonomy (independent, self reliance)
- Resisting stress (coping), accurate perception of reality, environmental mastery (adapt)
- the more characteristics failed to meet, the more abnormal
- Evaluation
- emphasised positive achievements instead of undesirable things, also considers them as a whole not specific behaviour
- criteria over demanding - most people fail to meet these so would be seen abnormal - more of a set of ideals
- states what is needed for normality - allowing goal setting and personal growth
- Subjective criteria - vague and difficult to measure, e.g. difficult to assess someones self esteem, person doing diagnosis just guessing
- Culturally biased definition as based on western ideas of ideal mental health & poor people may struggle more in achieving
- collectivist cultures focus on communal goals rather than personal so this would not help diagnose their abnormality
- Culturally biased definition as based on western ideas of ideal mental health & poor people may struggle more in achieving
- emphasised positive achievements instead of undesirable things, also considers them as a whole not specific behaviour
- Statistical Infrequency
- abnormality: the number of times a behaviour deviates from the statistical average
- the less frequently a behaviour occurs, the more likely it is abnormal: the majority are normal and the minority are abnormal
- any individuals who fall outside the 'normal distribution' (usually 5% of the population) are perceived as abnormal
- Evaluation
- Objective - using data with an agreed cut off point avoids confusion and bias
- different mental health workers can view behaviours in the same way: useful part of clinical assessment - provides statistical evidence of mental disorder
- Requires a decision about the point statistical behaviour becomes statistically abnormal - not clear when how energetic a child is becomes abnormal
- Not all infrequent behaviours are abnormal: highly intelligent people are statistically rare but not abnormal
- Not all abnormal behaviours are infrequent: about 10% of people suffer depression, meaning its so common its normal according to the definition
- cultures differ in what they call normal: cannot judge one culture with the norms of another
- Deviation from Social Norms
- Behavioural Approach - explaining and treating phobias
- Phobias
- a type of anxiety disorder - extreme and irrational fears out of proportion to any actual risk
- 5-10% of the Uk population have phobias , mostly females
- DSM V recognises the following types of phobias
- Specific Phobia - anxious in presence of particular object/situation
- Social phobia: can effect their quality of life as they get anxious in social situations
- Agrophobia: anxious when they leave home/ a safe place, hate crowds
- Symptoms
- Cognitive
- attention - difficult for them to look away from the phobic stimulus
- Irrational beliefs In reaction to the phobia stimuli
- behavioural symptoms
- panic in response to the phobia stimulus: crying, screaming, running away
- Avoidance - efforts made to avoid phobia to reduce anxiety occurrence
- endurance: remains with phobias stimulus but feels high anxiety levels
- Emotional symptoms
- Anxiety and fear - individual cannot relax
- Unreasonable response: not appropriate to the actual danger posed
- Cognitive
- Explaining phobias
- behaviourists suggest phobias are explained using the two process model
- 1) phobias are acquired through direct classical conditioning / indirect SLT
- 2) maintenance of phobias through operant conditioning
- 1) Classical Conditioning
- associating a neutral stimulus (initially have no fear) with a unconditioned stimulus (naturally triggers a reflex fear response)
- Supporting evidence (Pavlov's dogs)
- Food (UCS) causes salivation (UCR) - a reflex response
- Bell is a NS, but when put with the food the dog associates them. When repeated the bell (CS) produces saliva (CR)
- Supporting Evidence - Little Albert
- Wanted to condition Albert to fear a white rat by pairing it with a loud noise
- he initially had no fear of rats, but once repeatedly paired with a loud noise he became afraid
- this generalised to similar white fluffy objects - shows classical conditioning can create phobias
- Wanted to condition Albert to fear a white rat by pairing it with a loud noise
- can occur indirectly through SLT - e.g. observing someone being bitten by a dog can cause a fear response to dogs
- 2) Phobia maintained through operant conditioning
- involves learning through the consequences of behaviour - good outcome means more likely to be repeated
- pleasant outcome known as positive reinforcement, escaping something unpleasant known as negative reinforcement
- Pioneered by Skinner
- phobic response is unpleasant, so avoidance acts as negative reinforcementin removing these feelings of anxiety
- this means they are more likely to continue avoiding the phobic stimulus
- this makes the phobias resistance to extinction because constant avoidance reinforcing responses are carried out
- this means they are more likely to continue avoiding the phobic stimulus
- phobic response is unpleasant, so avoidance acts as negative reinforcementin removing these feelings of anxiety
- Evaluation of explanations
- A lot of supporting evidence: lil Albert supports the idea that phobias can be learned through classical conditioning
- Bandura and Rosenthal electric shocked participants every time a buzzer sounded, and they eventually showed a fear response to the sound of the buzzer
- theory predicts a trigger event from the past is involved - the moment the fear and stimulus were associated. supported by SiNardo et al who found over 60%of people w/ dog phobias could refer to a particular experience
- however in a control group 50% of people had experienced a fearful event but not developed a phobia - individual differences not explained by theory
- supported by effectiveness of behavioural treatments: systematic desensitisation explains how u need to prevent a patience from avoiding and reinforcing their phobia
- can be combined with biological explanations to give a better understanding of phobias, gene vulnerability makes conditioning more likely
- some aspects not considered: evolutionary explanation, Bounton shows we acquire phobias through dangers In our evolutionary past (snakes, the dark) - more to it than conditioning alone
- Reductionist - neglects cognitive processes, attention bias and distorted thoughts
- A lot of supporting evidence: lil Albert supports the idea that phobias can be learned through classical conditioning
- behaviourists suggest phobias are explained using the two process model
- Treating phobias
- Systematic desensitisation
- based on classical conditioning, aims to gradually reduce phobic anxiety
- instead of anxiety, patient learns to be relaxed-counterconditioning (you cannot be in a state of relaxation and fear at the same time)
- three processed involved in SD:
- The anxiety hierarchy: patient and therapist put a least to post frightening list together related to the phobia to create anxiety
- Relaxation: taught to relax deeply
- exposure: hierarchy is worked through, move on when they can stay relaxed in that stage, either VR or real life
- Relaxation: taught to relax deeply
- The anxiety hierarchy: patient and therapist put a least to post frightening list together related to the phobia to create anxiety
- Evaluation
- Patients prefer it to flooding - does not have as much trauma, relaxation pleasant - low refusal rates
- Effective - Gilroy et al followed up 42 patients who had SD treatment, found effective and long lasting effects compared to a control group
- Rothbaum et al found the advantage of VRET - patient doesn't have to leave the room, phobic stimuli more controlled - reducing harm and embarrassment
- Flooding
- forcing the phobic individual to face their phobia - lasts until the fear response disappears
- there is a limit to how long the body can sustain a fear response, so they have to calm down in the presence of the stimulus
- in terms of conditioning, the learned response is extinguished when the CS is encounter without the UCS - no longer produces the CR
- sometimes uses VR for ease
- effectiveness proven by Wolpe - used flooding to remove a girls phobia of being in cars by driving her around for 4 hours until she relaxed
- Evaluation
- cost effective and quicker due to less sessions
- less effective for some phobias - social phobias are more cognitive & they experience unpleasant thoughts which flooding cannot solve
- highly traumatic - patients often quit mid treatment which can worsen their phobia and waste effort
- not suitable for patients with bad health - extreme anxiety can be stressful on the body - hear attacks
- Systematic desensitisation
- Phobias
- The Biological Approach To Treating OCD
- Obsessive compulsive disorder is an anxiety related condition where people experience frequent obsessive thoughts and worries (irrational)
- the only way to release this anxiety it to perform compulsive behaviours ( prevent harm to themselves and others)
- compulsions are repeated physical behaviours, any relief they cause is only temporary and often reinforce the obsession, worsening the cycle of OCD
- Symptoms of OCD
- Cognitive symptoms
- obsessive thoughts: 90% experience this, they recur over and over again e.g. this has germs
- Attentional bias: focus on anxiety generating stimuli - hyper vigilance
- aware of their obsessions but still have catastrophic thoughts
- Behavioural symptoms
- Compulsions are repetitive - feel compelled to keep repeating
- Compulsions reduce anxiety: manage anxiety produced by obsessions
- avoidance: try and reduce anxiety by keeping away from trigger, hinders every day life
- Emotional symptoms
- anxiety and distress - compulsions and obsessions can be frightening and overwhelming
- OCD is often accompanied by depression- anxiety produces low mood
- irrational guilt and disgust
- Cognitive symptoms
- Genetic Explanation
- focuses on an individual's vulnerability to OCD and how it is inherited through genetic transmission from parents to offspring
- genetically researched through twin studies and family studies with correlation statistics and concordance rates, more recently gene mapping is used
- Lewis conducted a family study - assessed 50 patients with OCD, found 37% had parents with OCD and 21% had siblings with it
- shows OCD runs in families providing genetic evidence. according to the diathesis stress model, certain genes pre dispose people to developing the disorder
- Nestadt et al reviewed twin studies and found 68% of MZ twins shared OCD compared to to 31% of DZ twins - strong evidence for a genetic influence on OCD
- researchers have more recently identified genes that create a vulnerability for OCD Called candidate genes
- some involved in regulating the development of the serotonin system
- Samuels et al used gene mapping on OCD sufferers with hoarding behaviour and found a link to chromosome 14 marker, suggests different variations of genes can cause OCD in different people
- Taylor did a meta analysis and found up to 230 genes may be involved in OCD: OCD is Polygenic
- Evaluation of the genetic explanation of OCD
- variety of evidence from twin studies, metal analysises ect
- we have not pinned down all the genes involved - too many candidate genes, each variation only increases the chance by a fraction - cannot predict OCD due to genetic makeup
- MZ rates not 100% - if it was pure genetic it would be so there must be other factors involved
- Cromer et al found over half OCD patients had a traumatic past - and the more traumatic, the worse the OCD - need to focus on environmental causes
- twin studies overlook the fact that MZ twins may be similar in terms of their shared environment not just genes - more so than DZ twins
- if a disorder was genetic the symptoms would be the same, however they differ from person to person
- Biological reductionism - simplistic focusing on genes, overlooking the holistic complexity of the whole person and ignoring other possible factors
- Biological Approach to Treating OCD
- treatments based on correcting the biological abnormalities seen to cause OCD
- drug therapy is the most common - aims to increase/ decrease levels of / activity of neurotransmitters in the brain
- SSRI's (selective serotonin reuptake inhibiters)
- work at the synaptic gap (end of a neuron), any neurotransmitter left in the synaptic gap after diffusion is reabsorbed back to the pre synaptic neuron
- Bio explanation says OCD is caused by too little serotonin, so SSRI's intervene the re uptake process so serotonin stays in the receptor sites longer
- iBrand names include prozac and 3-4 months of daily use has an impact
- can be combined with other drugs such as tricyclics which target serotonin and dopamine and noradrenaline- but more powerful so side effects increase
- only used when patients do nit respond to SSRI's
- Evaluation of Biological treatments
- effective treatment: Soomro et al reviewed studies comparing SSRI's to placebos, found ti was effective and mores when combined with CBT - however they no don cure but reduce symptoms
- cheap and don't require a therapist, meaning they are less disruptive to a patient's life
- side effects: loss of sexual appetite, irritability, disturbance to sleep - reduces effectiveness bc people stop taking them before it begins to work - also can heighten suicidal thinking
- drug companies sponsor research - may not be honest about dangers
- Other causes and treatments: traumatic life event cause cannot be treated bt drugs, CBT would be more beneficial
- Definitions of Abnormality
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