Definitions Of Abnormality.
DEVIATING FROM SOCIAL NORMS:
Abnormal behaviour is classed as bevaviour that goes against approved and accepted ways of behaving. Abnormality is therefore a relative concept. Behaviour could just be eccentric. Maybe used for political/social control of behaviour and norms. May vary over time.
FAILURE TO FUNCTION ADEQUATLEY:
Bevaviour is Abnormal if it interferes with the ability to pursue a goal or can't engage in normal behaivour. More practical definition. Context important. Failure to function may be for other reasons. Some disorders (OCD) do not impair function.
DEVIATION FROM IDEAL MENTAL HEALTH:
First attempts to define Mental Health and Abnormality is what deviates from this. JAHODA:- Ideal mental health; Self acceptance, potential for growth and development, accurate perception of reality and positive interpersonal relationships. JOHODA's characteristics reflect a western view of ideal mental health. Represents an Ideal state. Unclear of how much you must deviate to be abnormal.
This approach views mental disorders as being caused by some underlying abnormal physiology.
- BRAIN DAMAGE: Strucure of the brain is altered by infection or injury.
- BIOCHEMISTRY: Neurotransmitters are chemicals that transfer nerve impulses from 1 neurone to another.There are 100's. 2 commonly studied: DOPAMINE->Excess associated with SCHIZOPHRENIA. SEROTONIN->Lack of asscotiated with Depression.
- GENES: Some mental disorders have a strong genetic basis. Tendency or Predisposition to suffer a mental disorder can be passed in the genes. SHIELDS: The CONCORDANCE RATE (probabilty that a pair of individuals will have the same characteristics because one does) was 48% for IDENTICAL TWINS compared to 9% for ordinary siblings.
Evaluation: Biological Approach may be able to pinpoint Brain Damage or Neurotransmitters BUT cannot always determine CAUSE. Evidence from Brain Scanning and Drug Treatments support approach. BUT seen as REDUCTIONIST as assumes biological changes are most important.
WATSON et al: Monkeys isolated from thier groups tended to show marked reduction in in blood Serotonin levels. for this reason a DIATHESIS (genetic predisposition) - STRESS (paired with environmental triggers) MODEL used.
Biological Approach. THERAPIES:
- PSYCHOSURGERY: Aims to DISCONNECT the Thinking/Planning part of the brain from the AMYGDALA. EGAS MONIZ: 1st prefrontal lobotomy. Nobel prize. 6% didn't survive. FREEMAN: ICE-PICK lobotomy. 40 000 - 50 000 patients.Last Resort.
- EVALUATION: Benificial in alleviating symptoms of severe anxiety or OCD. MAJOR ETHICAL ISSUES- damage irriversible. Changes to personality unpredictable.
- ECT: Gradually passing Electric currents through the brain. MANFRED: Schizophrenic diabetic patient went into Hypoglycemic shock. Electric current passed through and afterwards he noticed reduction in schizo symptoms.
- EVALUATION: Quick and Effective. Requires informed consent. No scientific Basis. Ethical Issues.
- DRUGS: ANTI-ANXIETY: Benzodiazepines.Increase action of GABA, quietens brain. ANTI-DEPRESSANTS: SSRI's Increases Serotnin levels. ANTI-PSYCHOTICS: Phenothiazines. Block dopamine receptors.
- EVALUATION: Effective. Can be paired with other techniques. But SUPRESSES symptoms DOESNT CURE.
SIGMAND FRUED: Behaviour is motivated by INTERNAL or psychological forces. Abnormality is caused by an IMBALANCE in the internal forces and unresolved conscious conflicts.
3 MAIN PARTS TO PERSONALITY:
- ID: Unconscious. Raw animalistic instincts.
- EGO: Conscious. Delays Gratification of Instincts.
- SUPER EGO: Conscience. Internalises morals and makes us feel guilty.
4 main ways Unconscious mind turns conflict into an acceptable form:
- PARAPAXES: Slips of the tongue. money problems? "Pass money" instead of honey
- DREAMS: Dream in Symbolic form MANIFEST content rather than the Real worry LATENT content.
- NEUROTIC SYMPTOMS: Too many traumatic memories have been repressed & threaten overwhelm EGO.
- DEFENCE MECHANISMS: REPRESSION forcing dangerous memories away. DISPLACEMENT transfer feelings onto something innocent. DENIAL. RATIONALISATION. REACTION FORMATION thinking the opposite. SUBLIMATION substitute activity. PROJECTION displacing onto someone else. REGRESSION reverting to child-like behaviour. ISOLATION seperating thoughts & emotions.
Psychodynamic Approach Cont.
PSYCHOSEXUAL DEVELOPMENT: A Child goes through a series of stages where the INSTINCTIVE ENERGY of the ID looks for GRATIFICATION in the EROGENOUS ZONES.
If a child is DEPRIVED or OVER GRATIFIED at a stage they may become FIXATED and this will effect adult behaviour. STAGES:
- ORAL: 0-18months. Pleasure gained from SUCKING/BITING. Fixated- Gratification through smoking or over dependance.
- ANAL: 18 months-3years. Pleasure gained from RETAINING/EXPELLING feaces. Fixation- may lead to OCD
- PHALLIC: 4-5years. Pleasure from genital stimualtion. OEDIPUS/ELECTRA COMPLEX. Foundation of SUPER EGO. Penis Envy in girls.
- LATENCY: 5+ sexual felings diverted from self onto potential partners
EVALUATION: Approach looks at underlying cause. Individual. Impossible to test scientifically. DETERMINISTIC as views behaviour as determined by instincts.
LITTLE HANS: Developed phobia of horses when at 5yrs saw a horse pulling a carriage fall over and got scared it had died. FRUED concluded that HANS was experiencing OEDIPAL complex which had displaced onto horses. Fear of horses represents fear of being Castrated by his father and horses blinkers reminded of Dad's glasses.
Psychodynamic Approach. THERAPIES:
- FREE ASSOCIATION: client talks freely about whatever they wish. This removes cecorship of EGO so it can be explored.
- ANALYSIS OF DREAMS: FREUD: Dreams are the royal road to the unconscious. DREAM WORK is converting LATENT content to MANIFEST content through displacement and symbolisation.
- ANALYSIS OF TRANSFERENCE: Client might transfer feelings towards others and the anaylst must find the source of this.
- ANALYSIS OF RESISTANCE: resistance of a subject: turning up late, joking, changing subject, getting distracted. indicate important area's being supressed.
- EVALUATION: Time consuming. Expensive. Not suitable for all disorders like Schizo.
HERMAN RORSCHACH: INK BLOT TEST. Employed in diagnosing underlying thought disorders and differentiating Psychotic from Non-Psychotic thinking.
EVALUATION: Validity questioned. Support for it says it brings insight into subjects thoughts.
This approach views Abnormality as the cause of LEARNING Maldaptive Behaviour.
- Classical Conditioning: This is learning by ASSOCIATION. PAVLOV: Dogs, salivate, bell. WATSON & REYNER: Classically conditioned a 11 month old child to fear fluffy animals! paired his fear of loud noises with a white fluffy rat.
- Operant Conditioning: This is learning through REINFORCEMENT. SKINNER rats. Believed behaviour like depression is reinforced and is therefore repeated. MOWRER: phobia's learnt by classical conditioning are maintained by Operant conditioning.
- Social Learning: BANDURA: Humans learn thrugh OBSERVATION and MODELLING behaviour. Along with VICARIOUS REINFORCEMENT - behaviour seen to be rewarded is learnt.
EVALUATION: Focuses on behaviour being MALADAPTIVE instead of abnormal. Convincing explanations of phobias. Therapies are unethical and de-humanising. REDUCTIONISTIC reduces explanations for behaviour to simple reward and punishment. DETERMINISITIC. SIMPLISTIC.
Behavioural Approach. THERAPIES:
- SYSTEMATIC DISENSITATION: WOLFE: Therapist attempts to replace the fear response with an alternative harmless response. A HIERARCHY of events listed and then taught RELAXATION techniques. VISUALISATION - go through list from least uncomfortable to most and use techniques taught.
- FLOODING: WOLFE forced teen girl with phobia of cars into a car and drove around, she was hysterical at first but calmes down and was no longer scared by end of ride.
- AVERSION THERAPY: Using Classical conditioning to pair an addiction with fear or disgust.
- TOKEN ECONOMY: ARLON & AZRIN: Founders. Used with Schizophrenic pateints, rewarded them for work and care and behaviour significantly improved.
This Approach views Abnormal behaviour as distortions in our thinking process
ELLIS: Maladaptive behaviour results when people operate on MISGUIDED/INACCURATE assumptions or IRRATIONAL beliefs.
BECK: Errors in thinking underpin mental disorders.
- NEGATIVE TRIAD: Negative view of SELF, the WORLD and the FUTURE.
- ATTRIBUTIONAL STYLE: depressed people tend to attribute negative events to INTERNAL instead of external factors it was my fault. SPECIFIC instead of global i'll never be able to do anything. STABLE instead of unstable ever again.
EVALUATION: Clinically useful. Effective. Supporting evidence. Narrow focus. Limited effectiveness. Measuring COGNITION difficult.
Cognitive Approach. THERAPIES:
R ational - E motive B ehavioural Therapy:
ELLIS: RESTRUCTURE clients faulty belief system by ACTIVLEY DISPUTING false beliefs through RATIONAL CONFRONTATION. Behavioural techniques used too.
BECKS COGNITIVE RESTRUSTURING THERAPY:
GENTLY point out ERRORS IN THINKING and encourage patients to REALITY TEST for themselves. behavioual techniques also used.
EVALUATION: Ignores Genetics. less time consuming and more cost effective then psychoanalysis. Effective for Depression & Anxiety. COMBINATION of BEHAVIOURAL and COGNITIVE elements.