Abnormality

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Definitions

Deviation from social norm - In a society where behaviour is deemed acceptable by majority of the society.

  • Times change quickly so opinions need to aswell, subjective
  • Even within society there are many different social norms and who decides?

Faliure to function adequately - an individuals inability to cope in every day life. People distancing themselves to deal with their mental illness.

  • People live different lives (subjective) and have different coping thersholds and who judges

Deviation from ideal mental health - Jahoda catagorised mental health into 6 common factors

Self attitudes, personal actualisation, intergration, autonomy (independant), accurate perception of relaity and mastery of the environment.

  • Historical biased, opinions would have changed since then
  • May be more factors and doesn't take into account individual differences
  • Nearly impossible to meet all criteria, many people would be classed as abnormal.
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The Biological Approach

Assumes abnormality is caused by physical factors (changes in the body):

  • Brain damage: abnormal behaviour will occur if the structure or functioning of the brain is damaged in some way
  • Infection: abnormalities may be caused by infection. Research suggests that 14% of schizophrenia cases may be linked to exposure to the flu virus in the womb (virus remains dormant until puberty).
  • Neurotransmitters: these are chemicals that carry signals between brain cells, too much or too little may result in psychological disorders (too much dopamine can leads to depression).
  • Genetics: research has shown that schizophrenia has a genetic basis, studies on identical twins show a 48% chance of developing schizophrenia if one twin has the condition

There is evidence from brain scans and biochemistry that abnormal brain function can cause mental illness (extreme scientific credibility). Easily tested.

Reductionist, doesn't take into account other factors (factors that could cause mental illness)

Treatments based on this approach are more reliable than psychological therapies.

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Treatments

Biological approach proposes cause lies in underlying physiological processes in the body.

Antipsychotic drugs:

  • Primarily used to combat schizophrenia by blocking action of neurotransmitter dopamine in the brain.
  • Conventional blocks action of the dopamine in the brain by binding to but not stimulating it's receptors.
  • Atypical temporarily occupy dopamine receptors, then rapidly dissociating to allow normal dopamine transmission (have lower side effects).

Side effects include poor concentration, blurred vision and reduction in salvation.

Antidepressants:

  • Increase availability of seretonin (depression linked with lack of this neurotransmitter)
  • SSRI common, blocks transporter mechanism that re-absorbs seretonin.

Anti anxiety: BZs and BBs

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Treatments

Require very little effort from patient so they are more likely to go through with it properly, showing they are more effective due to success rates as people continue treatment due to ease and how fast acting it is.

Temporarily deals with the symptoms and not the cause, so when patients stop taking the drugs the effectiveness ceases and symptoms begin to come back.

Placebo effects: Kirsch reviewed 38 studies of anti-depressants and found those who recieved placebos fared almost as well as those getting real drugs however other studies have shown the real drugs to have stronger effects going against the placebo effect.

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Treatments

ECT (electroconvulsive therapy)

  • Used when other techniques inaffective it is used.
  • An electrode is placed above the temple and patient is injected to make them temporarily unconcious and paralysing the muscles to prevent fractures during treatment.
  • Small amount of electric current is passed through the brain for less than half a second to produce a seizure.

Supports of ECT claim effectiveness, therefore can be life saving with severe depression that could have lead to suicide. Benefits seen greater than risk.

60-70% of patients get better after treatment, found by Comer. However other studies have shown patients relaspe after 6 months suggesting that the treatment isn't effective in the long run.

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The Behavioural Approach

Assumes that all behaviour is learnt through conditioning.

  • Operant conditioning - learnt through reinforcement.
    E.G. Anorexia - they see an image and a friend comments on how nice it looks they will begin to not eat to try look like the image 
  • Classical conditiong - learning occurs through association
    E.G. Phobias - as a fear of flying your incoditioned stimulus is crashing and the neutral stimulus is flying and the unconditioned response would be feared, leading to having a fear of flying.
  • Social learning - behaviours learned by seeing others being rewarded and punished
    E.G. Anxiety - Child's parent suffers so doesn't leave the house (seen as rewarded) Child replicates because they see parent being rewarded.

Many ideas of this approach comes from animals so it assumes the same laws can apply to humans. 

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Evaluation

A lot of evidence to support it is based on animals, therefore findings have been generalised to humans. This means human and animal differences can make the approach inaccurate.

The behavioural approach can be seen as reductionist because it seeks to explain behaviours as simply as it can but ignoring the role of biology, emotion or thinking. Suggesting it is too simple in explaining psychopathology.

This explaination has been criticised for its limited view fo the factors that may cause abnormal behaviour. They tend to not take into consideration the role of cognitive, therefore this is a very limited explanation so may not be used by many people.

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Treatments

Systematic de-sensitisation:

Believes abnormal behaviour is learnt so focuses on altering that behaviour. Developed by Wolpe.

Gradually introduces client to object or event they feel anxiety towards. It expands the exposure time to it.

3 stages:

  • Relaxation:
    Teaches client things such as controlled breathing so they are calm and relaxed.
  • Creationg of scenes:
    Here they think of scenarios involving the thing they fear creating a hierachy to work through until it reaches the thing they fear most (could fear dog, least feared could be a picture of a dog).
  • Working through hierachy:
    They master each stage as relaxed as they can then move onto the next one. 
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Treatments

  • Successful at treating simple and specific phobias and has been shown through many studies showing that it is reliable.
  • Breaches ethical guidelines, clients may feel distress when thinking of phobias therefore clients need to be highly monitored and ensured they have given full consent.
  • It is quick and requires very little effot meaning it is less time consuming and convenient so patients will stick too it increasing it's success rate.
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The Psychodynamic Approach

Believes that abnormal behaviour is determined by underlying/unresovled cpsychological conflicts.

Focuses on childhood experiences or conflicts between different parts of the Tripartite personality.

  • ID= pleasure principle
  • Ego= reality principle
  • Super ego= sense of right and wrong

The ego mediates between the ID and super ego, but if this conflict isn't managed by the ego then problems occur. Freud said everyone suffers from these conflicts so we are all abnormal to some degree.

During the conflicts, the ego tries to protect us with ego defences (conflicts create anxiety):

Repression (repel the thoughts into your unconcious), regression (revert back to immature behaviour), projection (blame someone else), displacement (focus anxiety on something else), suppression (pretend it isn't happening) and interllectualisation (thinking of it objectively)

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The Psychodynamic Approach

Little Hans:

It explain how mental illness occurs due to unconcious anxieties, he projected one source of anxiety onto another.

Evaluation:

  • A lot of this approach is based on case studies and this is just a detailed insight on an individual and they will have unique characteristics. Therfore it cannot be generalised as an explanation of behaviour.
  • Common critism is that he was sexist, his theory was definitely sexually unbalanced. In victorian society hhowver was cultural bias so boys were favoured in research. It can therefore not be applicable to girls and women.
  • A strength to the approach is that it has been very influential, this has stimulated further research and influenced many pyschologists (E.G Ainsworth and attachment types). This is positive as ir has improved out overall understanding of psychopathology.
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Treatments

Psychoanalysis:

Focuses on thoughts and feeling and making the unconcious, concious.

Access to the unconcious: Free association

This is where the patient says whatever comes to their head and the therapist notes them down and offers interpretation.

Dream analysis:

This is where the client writes down their dreams, thinks of associations, considers the relationships with the people in the dream, look at emotions and then look for common symbols. This should help find what the dream is trying to show about your unconcious.

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Treatments

Evaluation:

  • The longer the treatment is carried out for the better the results are. Research has been carried out on long term treatments and it was concluded that longer treatments are better meaning that as a long treatment process it is the more effective way to be cured.
  • The apporach is based on the idea the individuals being unaware of factors causing their behaviour. This is found on an unconcious level, therefore what the patient recalls cannot be proved that they are not false memories making the approach unreliable on the patients behalf.
  • There is evidence for an against the treatment being effective. Some say the therapy made patients worse than what they were and others have found it very successful. Due to contridictory evidence it means the therapy is unreliable.
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The Cognitive Approach

Said abnormal behaviour is caused by faulty thinking. Ellis developed ABC model to explain it. A is activating event, B is the belief and C in the consequence.

Beck's suggested the cognitive triad as he believed depression was caused by negative thoughts. 3 forms are: negative views of the world, future and yourself.

This approach believe the individual is in complete control therefore only the person can control their thoughts so they need to alter their thinking and their abnormality will be cured.

Evaluation:

  • Offers a useful explanation for disorders, so the approach considers their thoughts and beliefs could be part of the reason they have the disorder. Therefore it enables patients to take control over their life and make a positive change.
  • Can be seen as a reductionist, tries to explain complex behaviours as just faulty thinking, ignoring biological reasons therfore the approach is too simplistic.
  • Unclear whether abnormality causes faulty thinking or the other way round, so can be argued the approach focuses on the symptoms rather than the problem therefore not finding the real cause.
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Treatments

Cognitive Behavioural Therapy:

Focuses that an idea of the problem is a result of irrational (unhealthy) thinking rather than rational (healthier). First identify things states in the ABC model to your situation, by altering B it will result in a positive consequnce.

You then look at the logical side, does this way of thinking make sense (logical disputing), then look is there proof for your belief (emprirical disputing) and finally think is this way of thinking helping me (pragmatic disputing).

Evaluation:

  • Effective for different disorders, meta analysis conducted and found treatment is very effective therefore can be used for variety of disorders and still be effective.
  • Does not neccesarily need a therapist present meaning patients can cure themselves in their own time and own pace.
  • Reduces ethical issues as the client is in control and actively taking part so they feel empowered as the are curing themselves.
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