Dysfunctional Behaviour

ICD 10 & DSM IV - Dysfunctional Behaviour (Diagnosis)

The ICD 10 is the classification system now used by the world health organisation. Whereas the DSM IV is a classification system developed by the American Psychiatric Association. The ICD 10 is updated regularly to take into account historic and cultural variations in disorders. Each disorder is listed with a description and a list of features, it then says how many features need to be present and how long for before a diagnosis can be made. The DSM was developed as a practical guide to clinical diagnosis and is a multi-axle tool. It considers the type of disorder, the patients general health as well as any social or environmental problems that may contribute to the symptoms making it a more holistic tool. 

Rosenhan - Dysfunctional Behaviour (Diagnosis)

Statistical infrequency - 'Abnormality' would refer to any behaviour that is not seen very often in society.

Deviation from social norms - If society does not approve of the behaviour then it is dysfunctional.

Failure to function adequately - If a person is not functioning in a way that enables them to live independently in society.

Ideal mental health - Having a positive view of yourself, be capable of personal growth, resistant to stress, able to adapt to the environment, accurate view of reality.

Ford & Widiger - Dysfunctional Behaviour (Diagnosis)

They aimed to find out if clinicians were stereotyping genders when diagnosing disorders. A self report where health practioners were given a scenarios and asked to make a diagnosis. 266 psychologists took part with a mean age of experience of 15.6 years. An independent design as each participant was given a male, female or sec unspecified case. Case studies given of patients with anti social personality disorder or histrionic personality disorder. Therapists asked to diagnose the illness from a list of symptoms. ASPD was correctly diagnosed 42% in males and 15% in females. Females with ASPD were misdiagnosed with HPD 46% of the time whereas males were only misdiagnosed with HPD 15% of the time. This therefore suggests that practioners are biased by stereotypical views of genders.

Watson & Raynor - Dysfunctional Behaviour (Explanation)

The behavioural approach would explain dysfunctional behaviour as being due to traumatic childhood and past experiences and learned behaviour from role models. Watson aimed to see if it was possible to induce fear of a previously neutral object through classical conditioning. He conducted a case study of Little Albert In a controlled laboratory. He was the son of a wet nurse and before the study had no fear of a rat, rabbit, cotton wool etc. Every time he reached for the rat a steel bar was struck which made a loud noise and scared Little Albert. As he kept being tested he still showed a fear of the rat and it was also transferred to other object such as a Santa clause mask and a dog. The fear also reoccurred in a bigger different room as Little Albert still cried and tried to crawl away. This therefore shows us that it is possible to condition fear through classical conditioning, fear transfers to similar objects and time did not remove the fear response. Due to Little Albert being taken away from the hospital they did not have chance to debrief him.

Gottesman & Shields - Dysfunctional Behaviour (Explanation)

The biological approach would explain dysfunctional behaviour as being due to brain damage, genes and chemicals. Gottesman aimed to review research on genetic transmission of schizophrenia. In total there were 711 participants in the adoption studies and in the twins studies 210 pairs of MZ (identical) twins and 319 DZ (non identical) twins. Concordance rate of having schizophrenia for MZ and DZ twins was compared. The adoption studies found an increase of schizophrenia in adopted children if their biological parent had it. Biological siblings of children with schizophrenia showed a much highe percentage (19.2%) compared with adopted siblings (6.3%). There was a higher concordance rate for it in MZ twins than DZ twins. 58% chance for MZ twins and 12% for DZ twins. There is obviously a significant genetic input but with concordance rates below 100% there must be some interaction from the environment.

Beck - Dysfunctional Behaviour (Explanation)

The cognitive approach would explain dysfunctional behaviour as being due to faulty thinking. Beck aimed to understand cognitive disorders in patients with depression. Clinical interviews with 50 patients diagnosed with depression, 16 men and 34 women, aged 18 to 48 all middle or upper class and compared with 31 non depressed patients. They found certain themes appeared in depression patients that did not appear in non depressed patients. For example the main key differences were that depressed patients had lower self esteem, anxious, unlovable, self blame and overwhelming responsibilities. This suggests that even in mild depression patients have cognitive distortions that deviate from realistic and logical thinking.

McGrath - Dysfunctional Behaviour (Treatment)

McGrath aimed to treat a girl with a specific noise phobia using systematic desensitisation. It was a case study of Lucy a 9 year old girl who had a fear of sudden loud noises. In the first session she constructed a hierarchy of feared noises and she was taught breathing and imagery to relax. Throughout she rated her fear from 1 to 10. She eventually associated the loud noise with relaxation making her feel calm. By Lucys final and tenth session all her ratings of herfear of noises had dramatically decreased. Therefore this suggests that noise phobias in children are amenable to systematic desensitisation. But this does not mean all phobias may work in the same way.

Karp & Frank - Dysfunctional Behaviour (Treatment)

Karp and Frank compared drug treatment with non drug treatment for depression. This was a review article of previous research into the effectiveness of single treatments and combined drug and psychotherapy treatments of depression. All women diagnosed with depression. Patients tested before and after treatment. Studies found that adding psychological treatments to drug therapies did not increase the effectiveness of the drug therapy. Occasionally though it did mean less attrition if combined therapies were used and people were more likely to continue with the treatment. This shows that drug therapy is the most effective for the treatment of depression. 

Beck et al - Dysfunctional Behaviour (Treatment)

Beck aimed to compare the effectiveness of cognitive therapy and drug therapy. It was a controlled experiment with participants allocated one of two conditions. Random allocation to either the cognitive therapy or drug therapy. 44 participants took part who were all diagnosed with depression. For 12 weeks patients either had therapy sessions twice a week or drugs depending on the condition. They found that both groups showed significant decrease in depression but the cognitive therapy group showed greater improvement and the drop out rate for cognitive therapy was only 5% compared with 32% in the drug treatment group. This suggests cognitive therapy leads to a better treatment of depression shown by fewer symptoms reported and observed and also better adherence to treatment.