Abnormality

• A social norm is a rule set by society and is standard acceptable behaviour.
• Behaviour that violates rules and moral standards of a given society is an example of deviating social norms.
  
  

Limitations with this definition: 

• This definition is bound by societies moral standards, however these standards change over time and are era dependent; i.e. pregnant unmarried women would previously be a deviation from social norms whereas now it is seen as acceptable.
• This approach is defined by the context of the behaviour.
• This definition is bound by culture, i.e. Trobriand Islanders have different norms and values to most.
• Most individuals have behaved in ways that society disapproved of, in which case this definition could be applied and referred to most people in society as abnormal.
• This definition is socially constructed meaning an objective definition of abnormal behaviour that's fixed and stable across all cultures will be impossible to achieve.

• Means a person is unable to live a 'normal' life or experience a 'normal' range of emotions, e.g. the ability to hold down jobs and relationships.
• A person's behaviour becomes maladaptive - this is behaviour that interferes with a person's ability to lead a normal everyday life.
•  Barlow & Durand (1998) investigated Billy, a 13 year old boy with no friends at school. Billy refused to attend school social and sports events and felt physically sick at the thought of being asked a question in class. At lunch, he would lock himself in a toilet cubicle and only felt comfortable around his parents. Billy was afraid of humilation and embarrassment and was later diagonised as having a 'social phobia'.

Limitations of this definition: 

• Not the whole picture - not a true definition of 'abnormality' but rather is a way of determining the extent of a persons problem and the likelihood that they need professional help.
• Exceptions - there are some exceptions to this definition, e.g. a student experience anxiety and/or stress due to exams would not be regarded as abnormal.

• Defines what's 'normal' and 'ideal' and natural mental health - anything deviating from this is seen as abnormal.
• Ideal mental health has been coined by Marie Jahode (1968). She defines 6 mental features people possess:

1.)  Positive attitudes towards self - tester of ability, self-respect.

2.) Innergration - the ability to cope with highly stressful situations.

3.) Personal Growth - striving to ones full potential based on work for Mascow's Self Actualization.

4.) Autonomy - the extent to which a person is reliant on their inner resources.

5.) Perception of reality - seeing yourself and the world around in realistic terms and not as an isolation.

6.) Adapting to environment - being flexible and adapting to situations, the ability to love, work, pay, etc.

Evaluation of Ideal Mental Health:

• It's positive and begins from a positive premise.
• Unclear how many characteristics are needed to be 'normal' and to what extent.
• Can be applied to children as they can't be fully autonaminous.
• The characteristics are not appropriate for all cultures.
• Jahode's characteristics are too idealistic, establishing criteria whereby most people are likely to be short of 'ideal' mental health isn't useful.

• The Behavioural approach is all about learning, it would argue that eating disorders are present due to learning this behaviour. 
• The three main assumptions of the model are: classical conditioning, operant conditioning and social learning theory. 
• Learning - all behaviour is learnt through the process of classical and operant conditioning. Classical Conditioning - a person may climb to the top of the hill, look down and experience a nausea/dizziness (response). This can make an association between looking down and the response which together creates a phobia.
  Operant Conditioning is learning through the consequences of behaviour. If behaviour is reinforced, then it may be increased - this is positive reinforcement. If sufferers of an eating disorder get praised for looking good, this will make them feel good and repeat the behaviour.
•  Social Learning Theory suggests that behaviours may be learnt via observation and imitation of others, especially role models.
• Behaviour - behavioural model assumes the mind is an unnessacary concept, only observable behaviour is important. 
• Unlearning - the model assumes that if we can learn behaviour, then we can also unlearn specific behaviour.

  Evaluation of Behavioural Model:

• + Testing - based on a theory that is able to test in a lab situation.
• + Therapy - very good especially with phobias & therapies are quite stressful.
• + Present - deals with the phobia itself in the present day rather than any childhood/underlying causing problems.
• - Free will - this approaches a mechanismistic view of humans as puppets who are controlled by their environment, doesn't include their free will.
• - Biology - the model underestimates the contribution of Biology.
• - Animals - much of the principles of learning has been tested out on animals and may not be applicable applying to complex human behaviour. 

• Aversion Therapy is a behavioural treatment that aims to get rid of an individuals undesirable habit by pairing the habit with unpleasant consequences. It's used to deal with addictions, e.g. an alcoholic is given an alcoholic drink which is laced with an emetic which naturally produces a nausea response. After a few pairings of alcohol and feeling nauseous, the person will now wish to avoid alcohol. This is suitable for addictions such as smoking and alcoholism and isn't suitable for mental illnesses such as severe depression and schizophrenia.

  Strengths of Aversion Therapy:

• Research Evidence - some studies have shown support for the claim that nausea paired with alcohol results in conditioned aversions.
• Combined Therapies - therapists who use aversive prodcedures tend to also use more positive techniques to teach new behaviours to replace those eliminated, it is good to combine therapies, e.g. with systematic desensitisation. 

   Limitations of Aversion Therapy:

• Ethical Issues - when clients agree to a therapy they cannot always anticipate what will happen during the course of therapy and many psychologists are unhappy about impliciting pain or discomfort on people when they asked for it.
• Systematic Desensitisation is a behaviour therapy that's used to treat phobias and anxieties. It uses reverse conditioning and aims to replace a maladaptive response by eliciting another healthier response. There are 5 stages: relaxation, hierarchy of anxiety, reciprocal inhibition, complete treatment and in vivo & in vitro. It starts with teaching one how to relax using muscle relaxation techniques, one then imagines a series of anxiety provoking situation, it starts with the least anxious onwards to most anxious. Anxiety and relaxation cannot occur at the same time, relaxation is associated with least anxiety provoking situation. Treatment ends when the patient is able to work through the hierarchy without anxiety.

  Strengths of Systematic Desensitisation:

• Research Support - evidence exists to show ability to tolerate stressed situations by reduction in anxiety.

  Limitations of Systematic Desensitisation:

• Quicker Alternatives - 'flooding' consists of a client exposed to a feared object/situation.
• Alternatives to imagination - procedure depends upon the individuals ability to imagine vividly the feared situations or objects, not everyone is able to do this.
• Symptom Substituion - systematic desensitisation is used commonly to treat phobias but psychoanalysists argue that a phobia is a symptom of an underlying condition and when one phobia is removed, another one will emerge in its place. 

• The Biological Approach argues Abnormality is like a physical illness and has a physical cause, e.g. like a cold. It is not caused by the environment. The approach has 4 main assumptions as to how it occurs: Biochemistry, Infection, Neuroanatomy and Genetics - BING!
• Biochemistry - psychological disorders may be due to an imbalance of chemicals in the nervous and endocrine systems. Neurotransmitters are chemicals that transmit nerve impulses from one cell to another. Some argue if these are out of balance in the nervous system then one could develop psychological disorders.
• Infection - medical profession recognises bacteria or viruses can cause physical illnesses such as flu. Some have argued germs or microorganisms can produce psychological disorders. Barr (1990) found schizophrenic tendencies in children whose mothers had flu when they were pregnant.
• Neuroanatomy - may cause abnormal behaviour if damaged brain structure. Mental deterioration can cause severe maladaptiveness, e.g. Alzheimer's. Evidence from post morterms shows the brains of schizophrenic individuals were different from normal individuals.
  
  
• Genetics - the presence of certain genes can predispose a person to psychological disorders and they're therefore more susceptible to the disorder.
  
  

  Evaluation of Biological Model:

• Scientific - it's founded upon and is respected as all of it is research used only and studies ******** sciences.
  
• Responsibility - an individual suffering from a mental illness could mean they're not responsible over their own actions as they may have genetically inherited it.
• Passive - can be passive if it's biological and can be persuaded to be passive patients.
• Reductionist - attempts to explain abnormality by breaking it down to a fundamental level, i.e. brain cells. It ignores other relevant factors such as loosing behavioural or thoughts that could affect mental health conditions starting.
• Diagnosis - suggesting there's always a biological cure could lead to an incorrect diagnosis, pills don't cure everything and some diagnosises have psychological bases.

Antidepressant Drugs:

• Monoanime-Oxide Inhibitors influence the serotonin neurotransmitter. MAOI's block the action of an enzyme that breaks down serotonin, increasing avaliability in the nervous system. This improves the sufferers mood by increasing avaliability of neurotransmitters.

Antipsychotic Drugs:

• Phenothiazines are used to treat Schizophrenia by blocking the D2 receptor for dopamine so there's less dopamine. They influence it by calming and making the symptoms of the sufferer less severe. This reduces hallucinations and delusions.

Strengths of Drugs:

• Time - quick and easy to take and are effective immediately or after 2 weeks.
• Effective for many and acceptability.

Limitations of Drugs:

• May just work through the placebo effect.
• Relapse - may just be treating symptoms of condition rather than actual cause.
• Side effects that may be considered worse than the symptoms.

Ethical Issues as highly criticised at the use of drugs for psychological problems, particularly in mental institutions where patients had no choice.

Electroconvulsive Therapy (ECT):

Patient lies on a bed and is given an anaesthetic and a muscle relaxant. A current of 70-130 volts is passed through their brain through electrodes. Usually, the current is only passed through one half of the brain - the non-dominant hemisphere to reduce memory loss from the dominant hemisphere. The current causes convulsions that last around one minute. When the patient wakes up, they don't remember the treatment. It's used commonly to treat severe depression and over 11,000 people were given ECT in England&Wales in 1999.

Strenghts of ECT: 

• Effective in the short term - a quick form of treatment compared with drugs or psychological therapies, 60-70% showed it was effective.

Limitations:

• Unclear how it works - unclear but may increase avaliability of certain neurotransmitters in the brain and secretions of hormones that may improve a depressed mood.
• Relapse - 60% of patients become ill/depressed again within one year.
• Side effects - serious side effects when ECT was first introduced including bone fractures and memory loss. Side effects have been reduced but still present opinions regarding safety.
• Unethical use - ECT has a history of abuse, being used to punish or control people in mental hospitals.

• Freud developed the model, he rejected the ideas of the biological approach. Mental illness is driven by unresolved unconscious conflicts in childhood.

  Structure of Human Personality:

• Freud argues there's 3 basic components of the human personality.
• The Id - impulsive part of personality, primarily concerned with survival. It works on the 'pleasure princple' n seeking to obtain pleasure and avoid pain and the id is unconscious.
• Ego - operates to the 'reality principle' and tries to balance the deamnds of our Id with what's practicle. This is a rational and logical part of the personality.
• Superego -  part of our unconscious mind which acts as 'society' or as a 'parental figure', operates to the morality principle - our sense of what's right and wrong. 
  
  
• Freud argued it was the role of the ego to balance the conflicting pressures of the Id and the Superego. If it didn't do its job properly, abnormality may occur.
  
  

  Stages of Development:

• Oral - forms of fixation include smoking, nailbiting, over eating and eating disorders.
• Anal - anus is primarily focus of pleasure - through retention and expression of pooing.
  Successfully potty trained is key factor in successful completion of this stage.
• Phallic - genitals are primary focus of pleasure. Children show interest in theirs and parents genitals. Freud argued powerful unconscious process is going on which he named Oedpius Complex (boys) or Electra Complex (girls).
• Latency - children focus on social activites rather than physical.
• Genital - children become focused on developing relationships with opposite sex.

  Defence Mechanisms:

• Unconscious mental processes which are triggered in response to anxiety. Used by the ego to protect stress or guilt. Repression involves forcing disturbing events into unconscious mind. Denial is a way of refusing to accept or appreciate something that's occured. Displacement is when an emotional response is redirected from one object to a 'safer' one, i.e. being angry with a parent but displacing anger into kicking a chair.

  Main Assumptions of Psychodynamic Model - CUPE:

• Freud believed all behaviour derived from unconscious forces and that abnormality was a result of either an imbalance in personality structure and fixation at one of the psychosexual stages or over use of defence mechanisms.
• Psychoanalysis Aims: bring repressed impulses and tramatic memories into conscious awareness, cure neurotic symptoms such as phobias or anxiety and facilitate insight into the conflicts and anxieties that are the underlying causes of abnormal behaviour.
• Dream Analysis: the unconscious is apparently revealed in dreams, one technique of psychoanalysis is the analysis of dreams. Freud believed repressed memories and impulses appeared in dreams in disguised form.
• Free Association: where clients are encouraged to allow their thoughts wonder and directly say whatever comes into their heads. This is as the idea of uncensored thoughts reveal underlying conflicts and uncomfortable or unfulfilled wishes which allows analysts to be able to piece together patterns of association and offer their/an interpretation of the clients words and behaviour. The analysts then helps make the thoughts that had been repressed avaliable to the clients conscious mind.
• Transference - an important part of psychoanalysis is when the client projects on to the analyst the characteristics that are unconsciously associated with parents or other important people. When this happens, repressed feelings towards an individual are directed towards the analyst who's 'standing in' for the indvidiaul. Repreated experiences of this sort helps reveal to the client their repressed feelings and neurotic symptoms will gradually disappear. 
  
  Strengths of Psychoanalysis:
• Psychoanalysis is considered more appropriate for treating neurotic disorders such as anxiety.
  
  

  Limitations of Psychoanalysis:

• Expensive - tends to be time consuming and expensive, takes place over a number of years and is only avaliable to those who can afford.
   
• Less suitable for psychotic disorders such as schizophrenia.
   
• Uncertainty if actually works - Eysenck suggested psychodynamic therapies such as psychoanalysis are a waste of time and money.
   
• Difficulty evaluating Effectiveness - may not be possible to evaluate psychoanalysis scientifically as concepts such as insight, transference and repression are vague and difficult to measure -> social desirability may come in here.

Assumptions of the Cognitive Model:

• Faulty Thinking - the model assumes abnormality is caused by faulty thinking, expectations and attitudes. The issue isn't the problem itself but it's the way you think about it. This can include over generalisations and magnification and minimization.
• Control - individuals are in control and it's the way they percieve and interpret an event that's occured.
• Cognitive Change - change is thinking patterns and these can change the way you think.

  Evaluation of Cognitive Model:

• + Past - model doesn't delve into the past and focuses on current thought.
• + Empowerment - emphasises that we are able to change the way we think.
  
  
• + Influential - approache is favoured by many fields of psychology.
  
  
• - Unscientific - some thoughts can't be observed and some suggest it's unscientific.
  
  
• - Biology - model ignores possible biological influences or behaviour.
  
  
• - Cause & Effect - uncertainty as to whether irrational beliefs cause anxiety disorders.  

• Cognitive Behavioural Therapy (CBT) is based upon the idea that thoughts equal behaviour if thoughts are negative then they can lead to maladaptive behaviour. The aim of CBT is to replace negative feelings with more maladaptive ones.
  Cognitive part - showing clients to become aware of their negative thoughts that contribute general daily dysfunction.
  Behavioural part - client and therapist both decide how faulty clients behaviour is and decide ways to change.
  Suitable for Depression and Anxiety, not suitable for Schizophrenia.
• Beck's cognitive therapy is used for depression:
  1.) client becomes aware of situation where they make negative assumptions
  2.) clients negative assumptions and thoughts are tested and challenged
  3.) client should eventually accept previous way of thinking was irrational and realistic
  
  
• Ellis' rational emotive therapy (REBT - Rational Emotive Therapy) - Albert Ellis:
  - Using the ABC model (Activation, Beliefs, Consequences) clients can develop things of curing themselves by setting themselves more possible goals that they can reach. 
  
  

  Strengths of CBT:

• Diverse Application - therapies are becoming more popular and diverse in their applications. They're increasingly becoming most widely used therapy amongst NHS as short term and economic.
• Appealing - appeals to clients who find insight therapies such as psychoanalysis as too threatening.
• Depression - research shows CBT is at least as effective as drugs in treating Depression.
• Ethics - CBT is a collaborative therapy that aims for a relatively equal relationship between client and therapist who are both agree what the problem is and what the therapy goals should be.
• Can be combined with other stratergies such as drugs.
  
  

  Limitations of CBT:
  

• Doesn't address underlying causes.