Approaches to Abnormality

Belief that abnormality is caused by either:

• Brain Injury - degeneration, malfunction + damage to brain by injury or tumours
  • eg. Memory loss caused by degeneration of brain in Alzhiemers disease
• Infection - An infection which causes an illness can induce a secondary illness which has psychological effects
  • eg. There's a link between pregnant mothers who have the flu and their child having schizophrenia
• Neurotransmitters - an imbalance in the chemicals which carry information aorund the nervous system
  • eg. Too much serotonin is a contributor to the depressive state in bi-polar 
• Genetics - people may inherit a predisposition to an illness
  • eg. Mcguffin found a 46% concordance rate for depression in identical twins

Evaluation

• P - Modern technology allows us to investigate the brain of a mental patient and identify differences
• E - PET scans have shown the deterioration of the brain in patients with Alzhiemers
• C - This scientific explanation proves that biology has a part to play in abnormality

• P - Can be described as reductionist
• E - If disorders were entirely biological 100% of twins would share the same disorder rather than just 52%. Suggests environmental factors too
• C - The simplified approach does not explain all cases

• P - Drugs are often successful in treatments
• E - Drugs which restore the balance of seretonin have been successful in reducing depression
• C - This suggets that the theory behind the treatment is accurate. But they dont always work

Drugs

• Four gorups - anti-depressants, anti-anxiety, anti-manics and anti-psychotics
• Used to treat the neurotransmitter imbalance in brain
  • eg. Anti-depressants act on the lack of seretonin. Drug inhibits the site of the release of seretonin so that seretonin which did not attach to recieving receptor is not reabsorbed and it stays active longer

ECT

• Used to treat severe depression
• Involves a mild current passing through brain for a short time
• Patient given muscle relaxtant and anaesthetic to reduce risk of injury as shock induce seizure
• Patients recieve 6-9 treatments over a month

Evaluation

• P - Drugs dont work on everyone and success can be due to placebo effect
• E - 50-65% of group given drug for depression improved but 25-30% of group given placebo did
• C - Drugs may not be very effective and success psychological

• P - Drugs can cause serious side effects
• E - Drug for treating manic depression has 80% success rate but some dont take as dont like the 'flat' feeling
• C - Alternative treatments should be used first

• P - ECT can cause serious side effects
• E - 1/3 patients suffer memory loss which can be long term
• C - Do advantages outweigh disadvantages

Unconcious mind

• Abnormality is caused by conflict in your unconcious - between the ID, Superego and Ego
• ID - natural instincts we're born with, pleasure drive. If too strong someone is selfish and criminal
• Superego - Our conscience, moral principles which conflict with ID. If too strong, person feels guilty a lot, can lead to anxiety disorders.
• Ego - Attempts to balance the ID and Superego. If too weak, conflict is unbearable and can lead to a break down.
• The parts of the mind develop in childhood, so any traumatic experiences can have damaging consequences - psychosexual stages

Defence Mechanisms

• Used when the ego is too weak to cope with problems, but they resurface psychologically
• Denial - reject thoughts + feelings
• Suppression - Aware of thoughts but distract yourself from them
• Displacement - redirect your feelings onto something else
• Rationalisation - justify your thoughts and behaviour

Evaluation

• P - Approach is deterministic as blames behaviour on unconscious mind - out of control
• E - Freud believed that abnormality is caused by conflict in our unconscious mind, dismissing the idea of free will
• C - Individuals can't control this, so limits the usefulness of the explanation

• P - There's a lack of scientific supporting evidence
• E - Freud only ever used case studies to support his ideas. These were conducted by himself and he sometimes distorted results (experimenter bias) and they cant be generalised to others
• C - This limits the validity of the approach

• P - The theory is circular, it cant be disproved
• E - Behaviour which supported his theory was evidence for but if someone acted against his theory they has adapted coping mechanisms and still supported the theory
• C - This leans towards experimenter bias and questions the validity of the approach

Psychoanalysis

Free association

• Patient is relaxed and says what ever they think of no matter if it's illogical or nonsensical
• Therapist listens and analyses what they say, identifying what it represents in their unconscious - repressed feelings or thoughts
• Once the patient has been told, they can deal with their unconscious conflict in their mature state

Projection Test - Ink Blots

• Projection tests involve showing patient ambiguous images, sounds, words and scenarios. What you interpret reveals unconscious thoughts and feelings
• Inkblots are ambiguous image. Patient describes what they see
• Therapist records response and interprets unconscious thoughts
• Patient is made aware of the thoughts and can resolve them in mature state

Evaluation

• P - Treatment takes a long time and is very expensive
• E - Reseacrh as shown that longer and more intense treatments improve the outcome of patient, so patients are encouraged to continue for long time
• C - Recovery is therefore slow process with a lot of motivation needed. Many mentally ill patients struggle with motivation

• P - It's effectiveness is questionnable
• E - For specific anxities, like OCD, it can make the condition worse due to the deep thinking. It is also suggested that it is not the treatment but the attention recieved over long period which cures people
• C - Limits the validity and effectiveness of the treatment

• P - Treatments in the past have had bad consequences
• E - Some therapists have implanted false memories into mind of patients whilst they're in vulnerable state
• C - Raises ethical issues and makes treatment less valid

Idea that people learn to behave abnormally. By either:

• Classical conditioning - Learning by association

Learn to associate something with an emotion and can develop a phobia

Eg. Little Albert taught to fear white fluffy objects by banging steel bar whenever one was present

• Operant Conditioning - Learning through consequence

Choosing to repeat actions based on if rewarding or not. The attention recieved when you have an abnormality and the reduced responsibility may be seen as rewarding

• Social Learning Theory - Learning by observation and imitation

People observe role models and it they think consequences of behaviour is rewarding will imitate. This is vicarious reinforcement

Individual must be certain age to pay attention, remember, replicate and have motivation

Evaluation

• P - Strong supporting experimental evidence for classical conditioning
• E - For example Little Albert study. Taught to fear white fluffy objects, developed phobia
• C - Increases validity of approach

• P - There is supporting evidence for social learning theory
• E - Bobo doll experiments in which children watched role models be aggressive and then be punished or rewarded. Children imitated bahaviour of rewarded adults.
• C - Suggests children may imitate abnormal behaviour in their role models if rewarded

• P - May lack ecological validity because evidence is all lab based
• E - Little Albert experiement was very artificial, people do not learn phobias in that way in real life
• C - Approach may not be relevant to real life

Systematic Desensitisation

• Based on classical conditioning. Counter conditions phobias and anxities
• Involves 3 phases:
  • Therapist + client arrange hierarcy of fearful situations with least feared situation to be faced first increasing in difficulty up to most feared situation
  • Patient trained in deep muscle relaxtion techniques involving deep breathing
  • Patient is systematically exposed to first item on hierarchy. They gradually increase up the hierarchy once have reached relaxation with current item

Example - McGrath and Lucy

• Lucy has phobia of loud noises like party poppers, guns and bursting balloons
• Was taught relaxation then rated items on 'fear-thermometer'
• Was gradually exposed to loud noises from a distance which were gradually brought closer once was relaxed
• In first session was highly distressed by balloon bursting at end of corridor but by 5th session could pop balloon herself
• By end was much less fearful of loud noises

Evaluation

• P - The treatment is non-invasive and has no side effects
• E - Unlike drugs which can cause headaches/addiction or ECT which can cause memory loss, systematic desensitisation has no undesirable side effects and does not require to take anything or have physical treatment
• C - This means it has less serious consequences and may be better first treatment approach

• P - Many patients avoid it and like to try others first
• E - Requires patient to encounter their phobia which is highly distressing and difficult
• C - Drugs may be seen as a better option as require less effort

• P - It's been very successful in curing phobias
• E - 75% of patients are improved or cured by end
• C - Suggests treatment is very valid and effective

Belief that abnormality, such as depression, is caused by irrational thoughts and feelings

ABC Model

• Model of stressful events and how a normal and abnormal person would deal with them
• Activating Event - event which provokes thought and can be viewed differently. Eg. Breaking up with your partner
• Beliefs - individual has irrational or rational belief/attitude toward event. Eg. break up is end of the world or an opportunity
• Consequences - beliefs lead to desirable or undesirable behaviour and emotions. Eg. Feeling guilty and thinking you'll be alone forever or sad but optimistic

The Cognitive Triad - Abnormal mind is composed of:

• Negative view of self - "I'm undeserving and a failure"
• Negative view of future - "I'll always be unhappy"
• Negative view of world - "Everyone is against me"
• Minimise successes and maximising failures, thinking catastrophicaly
• Selective abstraction, only focus on negative, not whole picture
• All or nothing, only ever a success or failure

Evaluation

• P - Negative thoughts classed irrational may be realistic - depressive realism
• E - If diagnosed with terminal illness, depression or anxiety would be rational resonse
• C - Approach not relevant to all people

• P - Is reductionist, doesn't consider any other explanations other than irrational thought
• E - We know depression is linked to low levels of seretonin in the brain
• C - Not complete explanation of abnormality

• P - It is possible that irrational thought is not the cause of abnormality
• E - It may be that irrational thoughts are a consequence of the abnormality not the cause
• C - This limits the validity of the approach

Cognitive Behavioural Therapy (CBT)

• Assessment: Therapist identifies faulty/irrational thinking through questions and providing scenarios - how would they behave, think and feel in each scenario
• Goals are made for the patient
• Homework: Patient actively challenges irrational thoughts by keeping a diary of events to prove themselves wrong. Beliefs will gradually change
• Sessions: Patient visits therapist 5 - 20 times, once a week

Evaluation

• P - It is very effective, especially for depression
• E - Just as effective as drugs. Drugs=55% recovery CBT=52% recovery
• C - As it does not have undesriable side effects, it may be a better treatment and is valid

• P - Patient is actively involved in their recovery
• E - Homework requires active re-evaluation of thoughts. Avoids passive attitude which can happen with drugs
• C - People can get a boost out of independency and apply learnt skills to future situations

• P - Treatment is not effective for all people
• E - People with external locus of control will struggle to change thoughts and depressive realism may mean people feel worse if they keep diary of bad events
• C - This means it is not relevant for all individuals