Approaches to Psychopathology


The Biological approach

What is the biological approach?

The idea that abnormality is caused by phyisical factors such as genetic inheritance and genes, or viral infections. It assumes that all mental illnesses are related to some change in the body - they are like physical disorders and so can be treated in the same way

Genetic inheritance 

Abnormalities in brain anatomy or chemistry are sometimes due to inheritance factors - genetic inheritance - that are passed from parent to child 

It can be studied by identical twins - genetically the same - it provides a concordance rate for mental disorders some have low concordance (phobias) some are high (schizophrenia)

Genes leading to abnormal biochemisty

Genes tell the body how to funtion - if the biochemistry in our body is unblanaced it may lead to abnormal behaviour 

High levels of seratonin are correlational to anxiety, low leves of seratonin is assosiated with depression

Genes determine the structure of the brain also - schizophrenics are found to have enlarged spaces in the brain (shrinkage of brain tissue)

Viral infection 

Some viral infections in the womb may later cause mental diseases - Torrey found that mothers with particular strain of influenza during pregnancy had children with schizophrenia - virus may lay dormant in infants brain until hormones set it off when older

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Evaluation of the biological approach

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Evaluation of the biological approach

Humane or inhumane?

The medical model led to a more humane way of treating psychiatiric patients in the 18th century - mental illness was previously blamed on evil inside a person - recent critics however suggest the medical model is inhumane. Szaz argued that illness did not have a physical basis so it shouldn'e be treated in the same way 

Cause and effect?

Available evidence is not strong enough to place physical causes on a mentl disorder such as schizophrenia - schizophrenia often thought to be a result of too many dopamine receptors but it has been found that they have reduced dopamin elevels in some brain tissues (so may be excess and deficiences in different parts of brain)

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What is the beahavioural approach into psychopatho

Based on behaviour 

This model concentrates nly on a persons behaviour - a response a person makes to their environment. 

They may be extrenal (compulsove behaviours) Or internal (feelings) 

Abnormal behaviours are learned through conditioning/social learning 

All behaviour is determined by external events. Abnormal behaviour is no different from normal behaviour in terms of how it is learned. 

Learning behaviour theory can be used to explain many mental disorders where the characteristics are behavioural. Aracnaphobia shows both external and internal behaviours - avoiding spiders, feeling scarred of spiders

Learning environments 

May increase/reinforce problematic behaviours - depressive tendncies may elict help/attention from others 

-Drug taking may occur if they judge that it will be rewarded by their peers, people may develop a fear of flying if they watch a programme on a plane crash

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Evaluation of the behavioural approach

It has a limited view

The factors that affect abnormality are limited, they ignore the role of cognition in the onset and in the treating of abnormality

Counter evidence for the approach

It does lend itself to scientific explanation, scientific research doesn't always support the approcah --A fear isn't always due to a past experience/learned experience in life (when research conducted found no correlation)

in contrast may phobias have come from past experience Seligman procided an explanation for this. He suggested some basic anxieties may be 'hard wired' into the brain due to survival instinct from ancestors (so we are bilogically prepared for danger)

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The cognitive approach

Abnormality is caused by faulty thinking 

Assumes that thinking, expectations and attitudes, direct our behaviour - mental behaviour is therefore a reult of disorded cognitions - therefore it isn;t the problem itself but the way we think about things 

Ellis reffered to faulty and irrational thinking as the ABC model 

Active event (sight of large dog)

B = Belief (rational or irrational - dog is harmless/will attack me)

C = Consequence (rational belief leads to to healthy emotions)

The individual is in control

The cognitive approach portrays the individual as being in control of their own actions because the individual is control of their own cognitions - abnormality therefore is the result of faulty control

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What are limitations of the cognitive approach?

Blames patients rather than situational variables 

Suggests it is the patient who is resposible for an illness - overlooking situational factors suh as family issues or how life events have contributed to the patients mental disorder

Consequence rather than cause 

It is unclear whether thoughts cause feelings or feelings cause 'faulty thinking' - a depressed individual may induce a way of thinking negatively or thinking negatively may induce depression 

Irrational beliefs may be realistic

Not all irrational beliefs - Alloy and Abrahamson suggested that depressive realists see things for what they really are (real people tend to see the world through rose coloured glasses) 

They found that depressed people gave more accurate estimates of the liklihood of a disaster than normal control groups 

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Biological Therapies

Drug treatments - antipsychotic drugs

Conventional antipsychotic drugs e.g. chlorpromazine are mostly used to combat positive symptoms of schizophrenia by blocking the dopamine neurotransmitter by binding to but not stimulating a response. 

Atypical antipsychotic drugs only temporarily block the receptors to dissasociate and allowing noramal dopamine to bind to have normal transmittions. - they have lower side effects (e.g. movement of mouth involuntary)

Antidepressant drugs

Depression thought to be insufficient nuerotransmitters (seratonin) being produced in nerve endings. They work by stopping neurotransmitters from being reabsorbed or blocking the enzyme which breaks them down - insures enough nuerotransmitters available to stimulate neighbouring cells

SSRI's are the most common form - they block the transporter mechanism that reabsorbs seratonin into the presynaptic cell = more seratonin left in the synapse to prolong it's activity making the transmittions to the next impulse easier


Research inidcates they work - WHO reported that relapse rates after one year were highest 55% when schizophrenics were treated with placebos, 25% with chlopromazine and 2-23% when mixed with family intervention

Ease of use - requires little effort to the user (than therapies eg) although a mixture is better


Placebo effect - drugs have a psychological effect (people believe they make them better so they feel it) Kirsch et al reviewed 38 studies of antidepressants found those with placebos faired almost as well as those with real drugs 

Tackles sypmtoms rather than problem - effectiveness stops after drug use stops - problem lies within the person

Side effects - all have side effects 

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ECT - biological therapies


Used for severely depressed patients who are at risk to themsleves and others, it is  a quick solution that proves effective (more so than drugs)

How does it work?

Electrode placed above temple and second in the middle of forehead, (or each temple)

Injected with short lasting innoculation- so unconscious when happens - and given nerve blocking agent - paralysing muscles to stop them contracting and causing fractures

A small electric current lasting half a second is passed through brain (produces seizure lasting up to one minute)

Usually 3 times a week with patient between 3-15 treatments

why does it work?

Abrams concluded that we're no closer to understanding why it works (studied for 50 years) - changes the way the brain works but unsure how - it alters with chemical messengers to stimulate underactive transmitters but unsure how

Eval- strengths

Can save lives -  it's effective especially for severe depression which works when other treatments do not = life saving x sucide 

very effective - Corner found that 60-70% ECT improved after treatment - but 80% relapse after treatment withing 6 months


Sham ECT - mostly real ECT patients recovered but those without shock (some) also showed improvement

Side effects - impaired memory, cardiovascular changesand headaches (Datto)

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Psychodynamic approach

Mental diorders are a result of physcological factors

Freud believed that the origins of a mental disorder lie in the unresolved conflicts of childhood that are unconscious - outcome of psychological conflicts

unresolved conflicts cause mental disorder

COnflicts between the id, ego, and superego cause anxiety.

The ego protects itself with ego defences - if overused can create disrupted behaviour (a young boy may resulf to regression if a new child is born due to the new maternal neglect)

Ealry experiences cause mental disorder

In childhood th geo is not developed enough to deal with traumas and they are repressed (may repress felings of loss to death of parent and become depressed later in life)

Unconscious motivations cause mental disorders

Ego defences (represseion) exert pressure through subconsciously motivated behaviour - Frued proposed that memories are very hard to retreive from the unconscious and it consists of memories and other information - unconscious exerts powerful effect on conscious mind/actions. 

Id superegeo, and ego 

Id - is the irrational primitive mind - it is ruled by the pleasure principle and is used for selfish needs to immediately satisfy needs

Ego - is the conscious rational part of the personality - develops by end of infants first year as a child interacts with the constraints of reality

Superego - develops between 3 and 6 and embodies our sense of conscience and sence of right and wrong 

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Psychological therapies; psychoanalysis

Repression and the unconscience mind 

Based on the idea that memories are repressed in the unconscious so have to trace back to the root - problems with relationships now may trace back to issues with making relationships as a child

Free association

Expressing thoughts exactly as they occur (even if irrelevant) - Frued believed that the associations are useful as they are caused by the unconscience factors that analysis tries to uncover 

Therapist interprits the thoughts with the patient who corrects,rejects and adds further thoughts and feelings

Therapost  interpritation

They listen carefully as patient talks - looks for cluesand draws possible conclusions about causes - subject may try to alster discussions to try and avoid painful topic or may display transferrance where they transfer and conflicts onto the therapist (e.g. as if they were a dispised parent)

Working through

It is not a brief therapy - meet up 3/4 times a week over several years to try and examine the same issues over and over again to gain clarity 

Allows patient to understand the influence behind their neurotic behaviour (past and present). Helps them to gain a measure of control over their inner conflicts

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Systematic de-sensitisation

SD -Gradually introducing a patient to a stimuli that they feel anxious about a bit at a time so it isn't overwhelming. First developed by Joseph Wolpee in the 1950's on the principle of counterconditioning

How does it work?

  • Step 1; patient taught how to relax muscles completely
  • Step 2; Therapist and patient create a de-sensitisation heirachy (series of imagined scenes) 
  • Step 3; works way through hierachy visualising each anxiety-evoking event while mixing it with the relaxing response
  • Step 4; Once one step is mastered in the hierachy they move on to the next
  • step 5; once the patient has mastered all the steps in the heirachy they master the situation that caused them to seek help in the first place

Use of SD-In the early days they would learn to confront their feared situation directly by learning to relax in the presence of it or with pictures - this sometimes proved to be worsening so they imagined it instead. Ollendick et al, found SD particularly useful for treating psychological problems in which anxiety is the main difficulty (phobias, shyness)

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Systematic de-sensitisation EVAL


  • Appropriateness of treatment - it isgood at it's uses such as treating anxiety 
  • It requires less time and effort on the patient than other therapies - more successful outcomes more quickly as it's directly to the problem
  • Effectiveness - studies have shown that the therapy does what it's set out to do, McGrath et al. found that 75% of people with phobias respond to SD


  • Symptom substitution SD may appear to solve a problem but it only elimintaes or supresses symptoms = may result in symptom substitution (other symptoms appearing) 
  • Langevin however, says their is no supporting evidence for this
  • Reduced effectiveness of symptoms; Ohman et al suggested that SD may not be as effective in treating anxieties as they have an underlying survival instinct, that have been aquired through personal experience, ancient fears are hard to shift (helped ancestors survive)
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Cognitive Behavioural Therapy

REBT - rational emotive behavioral therapy

  • Albert Ellis developed REBTbased on the idea that individuals develop self defeating habbits due to faulty beliefs about them&world around them
  • REBT helps patients understand irrational thoughts (e.g. wanting to be liked; negative feedback sends them into depression) by providing more effective problem solving methods

How does it work?

  • REBT uses A-B-C model (A- action) (B- belief) (C- consequence)
  • It tries to change the irrantional belief into a rational one (it's impossible to be liked by everyone)
  • Leads to more positive outlook on life/emotional state
  • Challenging irrational beliefs - focussing on self defeating beliefs by encouraging the patient to dispute them - logical disputing beliefs do not follow logically from the info available, Empirical disrupting defeating beliefs may not be consistent with reality, Pragmatic disrupting emphasises the lack of usefulness in self-defeat
  • A-B-C -> D-E-F, D = disputing (challenge current beliefs) E= effective attitude (being rational) F=feelings (more positive, less negative)
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Cognitive Behavioural Therapy EVAL


  • Effectiveness - Meta analysis of 28 studies Engles et al found it's useful for a number of disorders, including obsessive compulsive/social phobia (more effective than de-sensitisation)
  • Appropriatness - Not only useful for clinical populations but for non clinical (lack of assertiveness)
  • Delvivered via computerYoichi et al developed a computer programme for PC assisted counselling - limits each session to 50 minutes and adds A-B-C instructions as well as homeowrk (thinking of dis/adv of every self-disbelief thought they have)


  • Irrational environments - marraige, death, family life NOT addressed 
  • Not suitable for all - doesn't always work (sometimes don't actually use the therapies instructions, suggested ellis)
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