Abnormality Unit 2

Anti-psychotic drugs reduce the amount of dopamine going to the brain and this combats the symptoms of psychotic illnesses like schizophrenia.

Anti-depressant drugs such as SSRIs block the mechanism which reabsorbs serotonin, so this means that less serotonin is absorbed so more is available. This combats the symptoms of depression because low levels of serotonin can cause depression.

Anti-anxiety drugs à Benzodiazepines and Beta-Blockers

Strengths - It can save lives, only people who are severely depressed use this therapy. Therefore, if it works on them, it could prevent suicide.

Weaknesses - Side effects: memory loss, cardiovascular disorders

Process:

1. Patient is given a muscle relaxant and oxygen is administered before the therapy starts.

2. A small current is then passed through the brain lasting around half a second.

3.  This causes a seizure.

4. It changes the way that the neurotransmitters used to work.

We are still unsure about exactly how the therapy works, however research has shown that it has worked on people who are severely depressed.

1. The individual is in full control so the person may be wasting time trying to see what is wrong with them and focusing on themselves when they could be finding the root of their abnormality.

2. Cause or effect à we do not know whether maladaptive thoughts cause abnormalities or vice versa. Therefore, it is difficult to assume that maladaptive thoughts cause abnormalities.

3. Sometimes irrational thoughts may be more appropriate than rational ones if it is something that you have to think maladaptively about because you cannot think in the positive side of everything or else that is unrealistic. This is the sadder but wiser effect.

This therapy uses the psychodynamic approach to abnormalities to treat abnormalities. The process is:

1. Free association à the patient talks about whatever is in his/her mind to the therapist and why they think that they have this abnormality.

2. Dreams analysis is used – the therapist monitors the patient’s dreams to see if (s)he is having nightmares and nightmares about what to see how this could be linked to the abnormality.

3. The patient associates certain things that the patient is going through with the abnormality and goes over these issues again and again with the patient until the therapist knows more about the patient’s abnormality source. The point of the psychoanalysis is for the patient to make the thoughts and feelings in the unconscious conscious.

Strengths

The longer the psychoanalysis – the more effective it is because the therapist can go through more issues and look at the different ways in which the abnormality could have been caused.

Weaknesses

The therapist may plant false memories into the patient by mistake because the therapist may have said something which they thought is the cause of the abnormality and the patient may have agreed even though they cannot remember. This would have made the situation worse.

There is a reason why those memories are repressed à ethical issues – psychological harm that the patient is suffering from.

Strengths:

1. Research has shown that CBT (REBT) has been very effective in dealing with patients who suffer from depression.

This therapy is based on the cognitive approach to psychopathology. The process is:

1. The patient is taught that the abnormality is caused by faulty thinking and it is up to the patient whether or not the abnormality is going to remain.

2. The therapist disputes with the patient about whether or not the current beliefs are adaptive for the patient or not. There are 3 types of disputing – logic, pragmatic and empirical disputing – these ways of disputing the patient’s current beliefs involve asked the patient whether it is logical to think like that, where the evidence for their belief came from and whether or not their beliefs will benefit them in any way.

Strengths

1. Effective – research shows that it is effective for phobias

2. Psychological treatment which takes the least amount of time.

Weaknesses

1. Difficult to avoid bad habits – maybe the patient has a phobia of it and is used to it - even after the treatment, it will still be difficult for the patient to not have a phobia of it after years of having a phobia of it.

This therapy focuses on the behavioural approach to psychopathology.

Process:

1. The patient is taught how to relax in stressful situations and taught how to recognise a stressful situation.

2.  The patient and therapist make a desensitisation hierarchy which consists of scenarios which cause more anxiety than the previous scenario and this scenarios involve the thing that the patient has a phobia of.

3. The patient goes through each scene in the desensitisation hierarchy and relaxes during each scenario as well and when the patient is ready to move onto the next scene – the patient goes to the next scene which would cause more anxiety than the previous one.

Abnormalities are caused by maladaptive thoughts and it is because of these maladaptive beliefs which cause the abnormality.

This approach puts the individual in full control over the abnormality because if abnormalities are psychological, then the individual can deal with the abnormality himself.

Ellis’ ABC model:

A: Action à something happen, leading the person to believe something.

B: Belief à the individual could either think of the action in an adaptive manner or a maladaptive manner.

C: Consequence à if the individual thinks maladaptively, then that person will be more likely to behave maladaptively and if the individual thinks adaptively, then that person will be more likely to behave adaptively.

1. Very abstract concepts à the concepts are not very specific and therefore difficult to trust.

2. Lack of solid research support which shows that abnormalities can be caused by the unconscious.

3. Sexist – Freud’s’ concepts are mainly directed to males which means that it would be difficult to generalise and to use the psychodynamic approach to treat abnormalities that females have.

1. Some maladaptive actions may be adaptive for the person afterwards. An example is complaining, this would seem to be maladaptive. However, it would get the attention of others and may help that person out in that situation, so ‘failing to function adequately’ is not always something which causes abnormality.

2. Cultural relativism: In one culture – functioning adequately will be different to people than in another culture. For example, in Iraq, there are many places which have poor people and their idea of functioning adequately will be to be able to survive. Whereas in a rich part of America, their idea of functioning adequately will be to be able to do more than that such as sleeping comfortably etc.

If one cannot carry out basic tasks such as eating or sleeping – then they have failed to function adequately and they are abnormal. This is what this definition suggests.

Limitations

• P - Abnormal behaviours can also help us
• E - Behaviours that appear dysfunctional can also lead to helpful intervention from others
  
• E - E.g. depression may lead to extra attention, helping the person deal with stress in their life
• L - Suggests that behaviours that appear abnormal may be adaptive for an individual

• P - Explanation is limited
• E - Definitions of adequate functioning are related to cultural ideals of how life should be lived
• E - Likely to produce different diagnoses when applied to people from different cultures
• L - Explains cultural differences in diagnosis of abnormality, as lifestyle differences can be mis-interpreted as failure to function adequately

1. Not everybody has these attributes all the time. This would suggest that we are all abnormal to some extent.

2. Cultural relativism: the ideal mental health changes from culture to culture. For example in a culture where people are very poor, their ideal mental health would involve the basic necessities and nothing more. However, the idea mental health of people living in a rich part of America would include the necessities but also a lot of luxuries as well.

Jahoda identified main characteristics of ideal mental health. She suggested that if one doesn't have these attributes then they don't have ideal mental health and they are therefore abnormal.

• Managing stress effectively.
• Strong sense of identity.
• Actualisation of one’s potential.

Limitations

• P - Few people meet this criteria
  
• E - According to this definition, all of us would be decribed as abnormal to some degree
• E - It would be unusual to find people that satisfy all of the criteria all of the time.
• L - Need to ask how many criteria need to be absent before someone is viewed as abnormal

• P - Explanation is limited
• E - Most criteria apply mainly to individuals living in Western cultures
• E - Applying them to members of non-Western cultures would, therefore, be inappropriate
• L - Would lead to an over-diagnosis of abnormality in members of those cultures

Abnormalities can be passed on by:

• Genetic inheritance
  • Mental illness can be inherited via genes so that people who are related are more likely to develop the same disorders
  • Many genes for abnormal behaviours are the product of evolutionary adaptations despite the fact these are no longer usefull
  • There are low concordance rates for some (e.g. phobias) but high concordance rates for others (e.g. schizophrenia)
• Neurochemistry
  • Altered brain chemistry can lead to changes in the levels or activity of neurotransmitters
  • Low serotonin levels have been found in the brains of depressives and high levels of dopamine in schizophrenics
• Neuroanatomy
  • Abnormalities in the structure of the brain, caused by ageing disease ect. can lead to the development of abnormal behaviour
  • E.g.some schizophrenics have enlarged ventricles in the brain, indicating shrinkage of brain tissue around the ventricles

• P - Inconclusive evidence for the role of gentic inheritance
  
• E - If genetics were sole cause, twins with gentic predisposition for disorder, both become ill
• E - Gottesman & Shields found if 1 twin developed schiz. - 50% the other would develop it
• L - The diathesis-stress model can explain this - individuals inherit a vunerability for a disorder, but this only develops if the individual is exposed to stressful life conditions.

• P - Biological factors are not necessarily the cause of pathology
• E - Changes in neurochemistry could be the consequence of mental disorder not the cause
• E - In reseach on enlarged ventricles, its not clear whether the shrinkage of brain tissue is cause/consequence of schiz
• L - Suggests there isn't simple cause-and-effect relationship with bio influences & disorders

• P - Biological approach has led to successful treatments for mental illness
• E - E.g. drug treatments are based on our understanding of activity of neurotransmitters 
• E - Evidence some treatments are effective - e.g. WHO reports that there were higher relapse rates for schiz. treated with placebos
• L - As altering neurochemistry is successful with ridding abnormal symptoms, suggests the origin of symptoms is neurochemical

Distress is caused by conflict between the id, ego and superego. Ego defences can be used to reduce the anxiety caused by the conflict between the id and the ego. Ego defences include repression (moving unwanted thoughts into the unconscious) and regression (behaving like a child when faced with a difficult situation). If ego defences are used too much – this can cause abnormalities.

Abnormalities can be caused by the unconscious because in the past, that individual may have kept all of these unwanted thoughts and feelings to the unconscious so all of a sudden, that person may have an abnormality because of all these thoughts and feelings that they have dismissed.

Abnormalities can be caused by experiences that the individual has had when that person was a child because a child’s ego is not mature enough to deal with situations which deals with the problem itself so ego defences are used as a child and if this is repeatedly used as the child grows up, it could lead to an abnormality.

1.  Very limited view of looking at abnormalities because there are many other causes of abnormalities such as psychological, from the unconscious and genetic.

2. Inconclusive evidence because research has shown that a person who has a phobia of something does not remember having a previous experience with what that person has a phobia of and conditioning that to something negative.

3. The treatments deal with the symptoms and not the problem itself because the treatments would involve conditioning what the patient has a phobia of with something pleasant. This would only deal with the problem because it means that the patient will not be able to deal with other phobias, only that one.

Abnormalities can be caused by conditioning – we condition ourselves to have a phobia of something from before, sometimes without even realising it. So, we use classical conditioning to associate something to something that is negative and as a result, we have a phobia from it. 

Abnormalities can be caused by the situation that the person is in. For example somebody who suffers from agoraphobia will be more stressed about going outside to a place where they have never been than somebody who enjoys going outside.

The approach suggests that the reasons why people have abnormalities are because of other people and the environment in which they are in.

One can be regarded as abnormal if they deviate from social norms, i.e. they do not do what is regarded to be socially acceptable.

Limitations

• P - Deviation is related to context and degree
• E - Judgements of deviation are dependent on the context of behaviour
  
• E - Some behaviours are acceptable in one context but not in another
• L - There is no clear line between what is abnormal and what is harmless eccentricity

• P - Explanation is limited
• E - Defining behaviour as abnormal is pointless without also considering cultural context
• E - What is considered a diagnosable disorder in one, may be considered noral in another
• L - Means there are no universal standards for labelling behaviour as abnormal