Abnormality

Psychopatholoagy- everything in this topic relates to being 'normal' therefore you need to know what 'normal' is to relate to abnormal behaviour

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  • Created by: hannah
  • Created on: 20-03-12 20:15

Definitions of abnormality

1) Deviation from social norms - deviating from how one 'ought' to act or deviating from any rules e.g. homosexuality in 1974. 

DISADVANTAGES- doesn't take into account cultural variations and very vague (no distinction between rare, slightly odd)

2) Failure to function adequately - judged on 5 criteria (if you are more than one then you're considered to be abnormal).. Dysfunctional behaviour/ Observer discomfort/ Unpredictable behaviour/ Irrational behaviour/ Personal distress

3) Deviation from ideal mental health - deviating away from 6 main criteria... Positive self attitude/ Self-actualisation/ Resistance to stress/ Personal autonomy (being in control)/ Accurate perception of reality/ Adaption to the environment

DISADVANTAGES- varies widely- in some cultures it is seen as abnormal for women to enjoy sex, some even remove ********

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Defining Abnormality

VARIES FROM CULTURES

Absolute- same frequency across cultures
Universal- present in all cultures
Culturally relative- unique to particular culture

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Biological Model of Abnormality

- ASSUMES PSYCHOLOGICAL DISORDERS ARE PHYSICAL ILLNESSES WITH PHYSICAL CAUSES 
- WHEN SAME SYMPTOMS OCCUR TOGETHER REPRESENTS SYNDROME OR DISORDER

Causes

Genetics- faulty genes cause disorders e.g. huntingtons disease (1% of public has a major disease) concordance rate = how far two things agree

Neurotransmitters- too many or too little of a neurotransmitter e.g. increase of dopamine linked to schizophrenia 

Infection- disorders caused by infections

Brain Injury- accidental brain damage can cause disorders 

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Studies of BMoA

Twin Studies (identical twins share 100% of genes, non-identical share 50%)

-Gottesman did meta analysis of 40 twin studies
-found identical twin with schiz gave you 48% chance of developing it too therefore schiz has a strong genetic base
- HOWEVER shows another factor must be involved as 100% of twins did not get it, family environment plays big role
- GOOD as field experiment therefore high ecological validity

Adoption Studies

-Heston
- 47 adopted childen whose bio mother had schiz were studied
-5 out of 47 became schizo which 0 of control grounp showing schiz is genetically based 

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Strengths and weaknesses of BMoA

+ Scientific basis in biology therefore lots of evidence
+ Biological therapies have helped many people

- Bio therapies raise ethical concerns
- Drugs can produce addiction
- No cause and effect
- Inhumane? Until 18th century mental illness was blamed on demons or evil#
- Painful memories
- Placebo's are withholding treatment.. lieing!

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Psychodynamic Model of Abnormality

- Based on id (pleasure, sex and aggression DEVIL), ego (reality), superego (morality ANGEL)
- Stages of develpoment... oral, anal, phallic, latency and genital stages
- Abnormal behaviour motivated by unconscious desires... issues originating from childhood
- Immature ego when young can't deal with conflict therefore reamerge when older
- Unconcious consists of memories that are too hard to bring to surface
- Problems cannot be resolved until brought to surface
- Defence mechanisms protects the ego

THE ICEBURG METAPHOR FOR THE BRAIN

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Strengths and weaknesses of PMoA

+ Unique approach
+ Offers help

- Abstract concepts... ego, id and superego are hard to define as act in unconscious (no way of knowing they occur)
- Sexism... Freud's theory was less developed for women
- Lack of reseach evidence... if person acts in the way Freud suggested it supports model however if they don't then it could be said it is in their unconscious!

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Studies on PMoA

- Little Hans aged 5 had become terrified of horses pulling carts due to unconscious anxieties of previous events. E.g heard a man saying don't put your finger near that horse' which caused him to ask his mum 'to put her finger on his penis'.

- Anna O suffered paralysis and Freud demonstrated physical symptoms had a psychological cause. Fear of drinking came from one event when a dog she didn't like drank from her glass.

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Behavioural Model of Abnormality

- Behaviours learnt through classical and operant conditioning
- Related to actions, NOT mind
- Learn through observation and mistakes in behaviour

Classic is thought to trigger different responses e.g. loud noise triggers fear
Operant is learning through consequences of actions e.g. anorexics lose weight and learn that by not eating they lose weight

STUDIES...

- Watson and Rayner experimented with 11 year old boy 'Little Albert' and made him scared of a white rat by producing a loud noise whenever he saw the rat

- Taste Aversions e.g. meat in curry makes you ill therefore whenever have curry again makes you feel sick 

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Strengths and weaknesses of BMoA

+ Scientific approach and therefore testable, however not as testable as the other approaches

- Limited view on factors that might cause abnormality
- Counter evidence and evidence for phobias is hard to find
- Treats symptoms and not causes therefore not long-lasting and suggests that even though the symptoms are behavioural, the cause may not be

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Cognitive Model of Abnormality

- Concentrates on thoughts and beliefs
- Assumes that behaviours are controlled by thoughts and beliefs therefore irrational beliefs cause abnormal behaviour
- Judged on the different cognitive functions-(Cognitive structures, Cognitive content, Cognitive processes, Cog products)

STUDIES...

- Ellis came up with the 'ABC model'- Disorders begin with ACTIVATING EVENT then turns into a BELIEF then leading to a CONSEQUENCE. 

- Beck identified the 'cognitive triad' and linked negative thoughts to depression. e.g. can't succeed in anything. About the world, themselves and the future. 

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Strengths and weaknesses of CMoA

+ Very useful approach for depression and anorexia. 

- Overlooks situational factors such as family problems in contribution to mental disorder
- Does faulty thinking lead to mental disorders or mental disorders lead to faulty thinking?
- Irrational beliefs may be realistic e.g. A and A suggested that depressives saw things for how they really were  

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Biological therapies DRUGS

DRUGS!
- Drugs can usually fix the bodies physcial disorder
Examples- Anit psychotics (major tranquilisers or phenothiazines) e.g. Chlorpromazine for Schizophrenia

WORK BY.., Block action of the neurotransmitter dopamine to not produce it. Antipsychotic temporarily occupy dopamine receptors and then rapidly disconnect to allow normal dopamine transmission.

Anti-depressants e.g. Tricylics, SSRIs like Prozac and MAOIs like Nardil.
Work by reabsorbing neurotransmitters into nerve endings. Reduce rate of re-absorbtion or block enzyme which breaks down neurot.

Anti-anxiety e.g. BBS (Beta blockers) WORK ON AUTOM,IC NS and BZS (benzodiazepines diazepam) WORK ON CNS

+ EFFECTIVE, EASY TO USE, THEY WORK
-  PLACEBO EFFECTS, SIDES EFFECTS, TREATS SYMPTOM AND NOT CAUSE

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Biological therapies ECT

ELECTROCONVULSIVE THERAPY

- used for people with major depression or catatonia (lack of activity) 

The procedure- 1) light anaesthetic, into muscle relaxed, 2) 70-150 volt shock lasting 0.4-1 second through electrodes places on head (both sides is bilateral, two on one is unilateral), 3) Causes seizure lasting up to a minute, 4) carried out 3/2 times a week for up to 12 treatments

HOW DOES IT WORK?- Benton says 1) its a punishment- rather get better than have ECT
2) Allows for restructing of life due to memory loss
3) Shock produces chemicals in brain which has a stronger effect than anti depressants (noradrenaline)

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ECT evaluation

- we dont know how it works
- desperate last choice
- punitive and abusive
- could be a repeat of earlier abuse (sexual abuse when young)
+ we dont know how asprin works but we still use it
+ anaesthetic more dangerous than the actual fit

DOES IT WORK?
- Buchan compared placebo ECT with real. Found real ECT had some effects but only for those with retardation. No benefits after 4 months with real and placebo.
- Sackheim found real ECT is better than placebo. Bilateral is more effective, ECT more effective than drugs. Using medication after can prevent relapse
- Breggin did not find any research for ECT that lasted longer than 4 weeks.

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Psychosurgery

- Brain surgery (but very rare)
- Lobotomy (incision into a lobe of the brain)
- Stops transmission of nervous impulses (for aggression)- caused people to act like zombies

CBT- cognitive behavioural therapy

Aims to identify negative and distorted thoughts and replace with realistic thoughts (goals are set and worked towards)

Cogntive Triad- someone who is depressed may think that they are unloved and may reject others. Someone who is anxious may view the world as dangerous.

FIVE STEPS OF CBT- 1) Build relationship 2) Assess and identify neg thoughts 3) Challenge neg thoughts 4) Develop problem solving  techniques and behaviours 5) Put in practice

NEGATIVE IS THAT ITS TIME CONSUMING

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REBT (rational emotive Behavioural therapy)

Developed by Albert Ellis

- Make the client believe that their thoughts are irrational and subsititute for more effective cognitions

ABC causes 1) logical disputing (does thinking this way make sense) 2) Empirical disputing (prove it is accurate) 3) Pragmatic disputing (how far is it likely to help)

CLINICAL- DIAGNOSED

NON CLINICAL- NON-DIAGNOSED

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Psychoanalytic (psychodynamic)

Aims to make the unconscious conflict conscious so that causes can be explored and worked through

- Once underlying issue and feelings have been expressed and addressed there is no need for symbolic behaviour to continue

Freud claims- 1) interpretation (dreams and behaviour) 2) Free association 3) Use of transferance

DREAMS ARE THE ROYAL ROAD TO THE UNCONCIOUS (OVERT DREAMS SUCH AS FALLING- DYING)

Clues to unconcious are given in ordinary behaviour - late for therapy shows aggression, early shows anxiety

+ Enduring theory - Bruch suggested that anorexia could be to avoid maturation

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Systematic Desensitisation

- a form of cognitive bt used to treat phobias and other behaviour problems involving anxiety. A client is gradually exposed to (or imagines) the threatening situation under relaxed conditions until the phobia is gone. 

By Joseph Wolpe in 1950s

1st) patient taught how to relax muscles
2nd) therapist and patient create desensitisation hierarchy- a series of imagines images 
3rd) gradually works their way through hierarchy
4th) once mastered a step in hierarchy they can move to next image
5th) patient eventually reaches feared situation and can overcome it

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Strengths and weaknesses of SD

+ quick and easy for the patient
+ research showed successful for range of anxiety disorders. e.g. 75% of patients with phobias respond to SD ( McGrath and al)

- suppressing symptoms may cause other symptoms to appear (symptom substitution)  
- Ohman suggested that SD may not be as effective in treating anxiety that have a survival component e.g. fear of the dark  - rather than personal experiences. 

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