Deviation from Social Norms
Deviation from Social Norms
Not following the implicit and explicit rules set by society, that have moral reasoning. This includes behaviors that are incomprehensible.
Deviant or abnormal?
Some people choose to take part in deviant behaviour, does this make them abnormal?
Abnormal or Criminal?
It can be difficult to distinguish between those who do criminal acts and those who have psychological disorders, as many criminals do horrific things, with 'sane' reasoning.
Changes in time and Geography
This definition is susceptible to subjectivity of that time e.g. homosexuality was an abnormality 50 years ago.
Failure to Function Adequately
When someones psychological state stops their daily routine and fufilling their repsonsibilities to society e.g. depression makes one tired, then they are so tired they cant go to work. This includes any behaviour that causes harm to others.
Criminality- In cases such at Peter Sutcliffes, a mass serial killer, the person can carry out completely normal day to day taks, and uphold a job. Does this mean his murderous habits aren't abnormal?
Choice to function inadequately- hunger strikes ae chosen for make a point- but you wouldn't call protesters abnormal.
Inadequate function in a situation- e.g. when very frightened or scared, you may not be able to move- does this make you abnormal?
Causality- perhaps the failure to function causes the abnormality e.g. a disabled person being unable to function leads to them being depressed.
Deviation from Ideal Mental Health
Definition- straying from these categories
- P- ositive attitude to oneself
- A- ccurate perception of reality
- P-ersonal Autonomy
- E-nvironmental Mastery
- R-esistance to Stress
- S-elf Actualisation
- Very few people reach self-actualisation, including the billions who are living in poverty. Does this make them psychologically abnormal?
- Everyone goes through periods which have negative attitude towards oneself, even if it is brief. Does this make us all abnormal?
- Collectivist cultures would think of personal autonomy as a strange idea, because they rely on eachother so much. A more cooperative and generous person is desirable. Therefore this definitition lacks populational validity.
Biological Approach to abnormality
Mental disorders are caused by physioloigcal, chemical or genetic abnormalities and processes.
Abnormal behabiour may occur if the structure of the brain is damaged by disease, physical trauma, imparing neurons and psychological transmitting.
Biological Psychology Evaluation
- The imbalance if neurotransmitters are key to certain mental disorders e.g. an excess of dopamine is found in schizophernia sufferers, depression by less serotonin. Also, hormone scan play a role, with higher levels of cortisol found some patients with depression.
- Monozygotic twins (identical) have 46% concordance rate of contracting schizophrenia if their twin has, compared to 20% with dizygotic twins. This supports the idea that mental disorders are initiated by genetics (however, since the concordance isn't 100%, there must be other factors too.)
- Testability- biological treatments can be rigorously tested, unlike the psychodynamic approach.
- Medicine- found a 67% remission rate with some antidepressants.
- Doesn't offer an explanation just treatment.
- MZ twins didnt have 100% concordance- there must be other factors
- placebo effect could explain the remission rate with drugs
Biological Treatments (Chemotherapy)
- MAOI'S- Monoamine Oxidase Inhibitor.
These block the action of the enzyme that breaks down serotonin, making it more available to the next neuron.
- SSRIS- Selective Serotonin Reuptake Inhibitors
These block the reuptake shoot next to the dendron of a neuron. It stops serotonin from being sucked up, so its more available for the axon of the following neurotransmitter.
block the D2 receptor sites on the axon of a neuron, so dopamine cannot be absorbed. This reduces the effect of dopamine, and as a result, stops the hallucinations associated with schizophrenia.
Biological Treatments (Chemotherapy) evaluation
- Efficacy- Many people respond very well to chemotherapy for mental disorders. They also work very quickly which is useful for extreme circumstances such as a very powerful schizophrenic attack.
- Dependency and addiction- people can often become dependent on drugs, so doctors try not to prescribe them for long periods. Addiction can also occur, when the person cannot function at all without the drug.
- Resistance- with some drugs the bpdy builds up a resistance, so the patient has to take higher doses. This can also increase side effects.
- Treats symptoms not the cause- Drugs do not look at the root cause of the mental disorder, so when treatment stops, the disorder will often come back.
- Ethics- drugs have been used in the past to subdue patients who were opposed to regimes in institutions. Sometimes it is hard to regulate when a drug is given- to calm a pateint down for their own good, or for the staff?
Biological Treatments (ECT)
ECT- Electric Convulsive Therapy
A course of treatments is given. The patient lies on the bed, is anaethetised and given a muscle relaxant. They then recieve a current through their brain using electrodes (usually only through one side, to reduce memory loss). Patients wake up and don't remember the treatment.
We are unsure why ECT works.
Side effects include memory loss and headaches.
Biological Treatments (ECT Evaluation)
- Efficacy- Very quick form of treatment, that can be quick to see results for 60-70% of patients.
- Should only be used in a last case scenario, when drugs and therapy have not worked.
- We are unsure to how it works
- Ethical issues- Since we don't know how it works, we are unable to to get fully informed consent. Depression can also make you unable to give consent from a clear state of mind. It also used to be used as punishment in mental institutions.
- 60% of patients relapse within one year of the treatment.
- Studies have been done to show that the care and attention is key to the treatment, as participants who recieved a placebo also recovered (though not as effectively as those who recieved full treatment.)
Psychodynamic Approach to abnormality (THE PSYCHE)
- The id- This is the impulsive part of our brain that does things for pleasure and reward. An overactive id can lead to conditions like psychopathy.
- The ego- This balances the id and the superego. If its weak it allows either part to dominate.
- The superego- This restricts the id, ad if it is overactive it can lead to anxiety and OCD.
Psychodynamic Approach (Psychosexual stages)
Oral- the infant learns to satisfy oneself through the mouth. If there is over gratification in this phase, smoking or alcoholism can develop later on. If it is undergratified, eating disorders can develop.
Anal- the infant learns to retain or expel faeces. Overgratification or undergratification can lead to excessive hoarding or OCD/anxiety.
Phallic (inc. oedipus and electra complexes)- the infant is attracted to the opposite sex parent, and wants to engage is sexual behavior with them. A rivalry begins between then the same sex parent. The girls develop 'penis envy' which is later converted to the desire to have a child. Overdevelopment can lead to sexual deviancy, and underdevelopment, anxiety.
Psychodynamic Approach (Defence Mechanisms)
These help the ego balance demands of the id and the superego. If they become to prevalent or over-developed, they can cause mental disorders
- Repression- Prevents selfish and unacceptable desires from becoming concious. Any guily act will be complete unconciously, and the person will have no recollection.
- Denial- The person will completely refuse to believe or admit to certain events.
- Regression- Reverting back to childish behaviours to help cope with a present situation.
- Sublimation- Diverting emotions onto someTHING else e.g. a sport.
- Projection- Accusing others of what you are feeling.
- Displacement- Diverting emotions onto someONE else, so they feel what you feel.
Psychodyamic approach evaluation
- Case studies- Freud had various patients who he treated with the psychodynamic approach that showed reduction in neurotic symptons e.g. the Rat Man and Little Hans
- Influence- Freud began interest in research in psychology, and also the idea that those suffering with mental disorders should be treated with patience and professionalism.
- Untestable- the abstract ideas within freudian theory are difficult to compute, and to test with meaningful experimental design. Case studies lack population validity, and the improvement could be due to the extra time and attention given to sufferers.
- Focuses on early experiences rather that recent or present issues e.g. what if someone was suffering from depression after the death of loved one.
- Dream Analysis
According to psychodynamic theory, unconcious confilcts are revealed in dreams. The job of the therapist is to interpret the symbolism (manifest content) into their true meaning (latent content.)
- Free Association
Patients are encourage to talk freely without any editing or censorship. This will reveal underlying conflicts and uncomfortable wishes. The therapist pieces together the words and offers an interpretation. This leads to catharis- an expression of pent-up emotion, removing its psychological effect.
The client unconciously prjects characteristics of important people onto the therapist. Repressed feelings are revealed and this reduces neurotic symptoms. The analyst must remain neutral and not partake in countertransference.
- Effectiveness- it is more effective more mild cases of disorders; mroe extreme case had less consistent improvement. It is also much less effective for disorders such as schizophrenia.
- First studie's data found it was almsot entirely pointless, but when reanalysed with new criteria, it was found 83% of patients improved with pschoanalysis compared to 30% in the control group.
- Very expensive and time consuming- people can be in psychoanalysis treatment for years, and this is very costly. This means it is limited to certain wealthier people, who can complete a course effectively.
- Behaviourists argue it focuses too much on what causes the behaviour, and doesn't spend enough time changing it.
- The analyst has a lot of power over the patient, and the patient is expected to accept any interpretation handed to them.
- Its concepts are abstract and vague, so are difficult to test scientifically.
Behavioural Approach Features
3 features of learning-
When a neutral stimulus becomes associated with an unconditioned response until it can cause that repsonse alone.
Someone begins to associate the fear of falling with tall buildings, and therefore avoids them and is afraid of them.
The future occurence of a behaviour relies on the consequences of that behaviour. If a child is rewarded with chocolate or a cuddle when frightened, they will be frightened again.
If a child seens their parents be afraid, they will soon imitate this resonse.
Behavioural Approach Evaluation
- offers a good explanation for phobias
- many practical treatments e.g. systematic desensitisation has shown great improvements in people.
- focus on behaviour removes the stigmatizing labels of mental health disorders, because it creates objectivity within the diagnosis.
- ignores biological reasoning, depsite various experiements showing a correllation between the excess or lack of certain neurotransmitters and mental disorders.
- Focuses on symptoms and not the cause in treatment, so it may not be useful for people with many phobias.
The aim it to replace an maladaptive (unhealthy) response to a stimulus to an adaptive (healthy) response.
Relaxation: Patient is taught to completely relax using muscle and breathing techniques.
Hiearchy of anxiety-provoking situations: The individual imagines a series of anxiety-provoking situations, starting the the least anxiety to the most.
Reciprocal Inhibition: Two emotional states cannot exist together, so the patient must be completely relaxed with one situation before moving to another. If anxiety returns, the procedure is halted, and they return to an earlier, relaxed situation. Over a number of sessions, the individual tolerates situations that previously produced anxiety.
Complete Treatment:The treatment in completed when the client is completely desensitised from the entire hierarchy.
Systematic Densensitisation Evaluation
Quick- compared to the psychoanalysis, systematic densensitisation can see results very quickly. This is useful for people who are being stoppped from daily life by their disorder.
Many patients have found that this treatment has been effective.
It can be performed in vitro(imagined) or in vivo (in real life). In vitro has the advantage that it may cause less anxiety than in vivo- but in vivo is generally recognised as more effective.
Focus on symptoms: only looks at symptons and doesnt teach any coping strategies unlike CBT
this could lead to symptom subsitution- focusing your fears onto a new object or situation.
usefulness is limited e.g. cannot treat schizophrenia
Cognitive Approach Features
4 key points:
- Faulty thought processes can lead to illogical errors, irrational beliefs and negative throughts.
- Key distortions in thinking: Over-generalisation (I got a B on that test, I am so stupid,) Exaggeration (Mary ignored me today so I must be the worst person ever,) Polarized Thinking (I am completely worthless until everyone loves me.)
- Maladaptive responses lead to maladaptive behaviour and psychological problems. Adaptive responses lead to logical, healthy behaviour and success.
- The Cognitive Triad-- Negative throughts revolve around a) Oneself b) The world c) The future
Ellis had little sympathy for those with depression, as he throught they were indulging in negative throught processes.
Cognitive Approach Evaluation
- Research Evidence: Gustafson (1992) found that people with psychological disorders such as depression and anxiety do also have irrational thought processes. Lots more research has been found.
- Gives the patient control and repsonsibility, allowing them to be proactive about their recovery.
- Many practical applications e.g. CBT
- Cause and Effect- Critics argue that illogical thinking could come from the psychological disorder, rather than causing it.
- Responsibility on the patient could actually make them anxious and even more out of control, if they think they are causing it. We should be careful about 'blaming' them.
- Completely ignore Biological research.
Cognitive Behavioural Therapy
Aims- to replace irrational, negative thoughts with more rational realistic ways of thinking.
Cognitive element: to get the client to be aware of their irrational, negative thoughts.
Behavioural element: get the client to recognise the consequences of their behaviour, and develop goals in aways to rationalise thinking and improve behaviour.
Beck's cognitive therapy- A D UL T
Activity scheduele is drawn up to make the client more active and confident.
Diary is kept to help recongise negative thoughts, which the therapist helps combats
UnderLying thought processes are analysed and helps the client recognise and challenge them.
Testing and challenging the negative attitudes in real life; the client is encouraged to carry on pleasurable activities.
Cognitive Behavioural Therapy Evaluation
- Diverse applications: CBT is very widely used for various issues
- Quick and effective
- Empowers self-help strategies that can be applied to any situation.
- Therapist and pateint are equals working together rather than psychoanalysts who are impartial.
- CBT has been found to be atleast as effective as drugs
- Ethics are good, because the patient and therapists cooperate on strategies.
- expensive to train therapists
- rigorous on the client; not a quick fix, as they need to have an active part. This could be difficult with vulnerable people.
- not useful for some disorders
- does not address underlying issues