UNIT 2

Definitions:

• Deviation from social norms.- a persons thinking or behaviour is classified as abnormal if it violates the (unwritten) rules, norms
• Failure to function adequately - a person is considered abnormal if they  are unable to cope with demands of everyday life, they may be unable to perform the behaviours necessary for day-to-day living.
• Deviation from ideal mental health - requires us to decide on the characteristics we consider to mental health.

Characteristics indicating mental health -

• Resistant to stress
• Positive view of the self
• Capability for growth and development
• Acurate perception of reality
• Positive friendships and relationships
• Autonomy and interdependance

OCD:

• Obsessive thoughts deviated by compulsive behaviours.
• World health organisations - rated in top 10 most diabiliating disorders.

PSYCHOPATHS:

• Lack of empathy and understanding
• No emotion
• Manipulating
• Exploit others without guilt or remorse

AGROPHOBIA - where a person of open spaces to the extent where that it interferes with everyday life.

• Anxiety
• Racing heart
• Panic/worry
• fear of open spaces

SCHIZOPHRENIA

+ VE symptoms - hearing voices and delusions

-VE symptoms - inactivity and lack of emotion or behaviour responsiveness.

DEPRESSION

Depressed mood, apathy and disrupted sleeping patterns.

Explanations of abnormality:

• Viruses
• Inherited
• Chemical imbalance in the brain
• Lots of stress
• Damage to the brain
• Traumatic experience

3 assumptions in relation to biological model of abnormality:

• GENETICS
• BIOCHEMICAL
• INFECTIONS/VIRUSES

Biochemical - Nerots - controls whether the next neuron fires or not and allows electrical messages to pass along them.

TOO MUCH dopamine - Schizophrenia  TOO LITTLE serotonin - depression

If they are balanced equally then you will function normally.

DIFFERENT SIZE OF THE BRAIN MAY CAUSE ABNORMALITY

Genteic Cause of Variation - most important cause of gentic variation as it mixes up genetic materials. WE INHERIT ABNORMALITY THROUGH OUR GENES - used to expalin depression and schizophrenia - born pre-disposed to develop it.

Infections/Viruses - when a pregnant woman contracts a virus it can lead to the child being born and later developing an abnormality. Links between flu virus and schizophrenia.

Evaluation of the model/studies -

STRENGTHS:

• Lead to successful treatments for disorders like depression and schizophrenia such as drugs and ECT.
• Lead to solid explanations for why people develop disorders like schizophrenia and depression and shown in research such as twin studies.

LIMITATIONS:

• REDUCTIONIST - takes a whole range of abnormal behaviour and reduces it to being explained purely by biology therfore it ingores nurture/social factors that could cause abnormality.

Biological Therapies -

ECT:

• Electro Convulsive Therapy
• 1930's - schizophrenia
• 1950's - depression
• Small electric current through brain which feels like a seizure, brain and behaviour convulsions.
• Only used in the UK for the most severe cases of depression and used as last reort if other therapies havent worked.

DRUGS:

• Typical - CHLORPROMAZINE- originally sedative, reduces post op stress, reduced symptoms - hallucinations,delusions and thought disorder. Reduced dopamine activity in brain.
• ATypical - CLOZAPINE - as affective but fewer side effects, trets positive and negative symptoms and acts on dopamine and serotonin.

Biological Therapies -

DRUGS:

• MONOAMINE - oxidase inhabitors, tricyclic antidepressants
• Prozac - reduces serotonin levels.

Evaluation of biological therapies -

Strengths:

• Fast working
• Can be life saving

Weaknesses:

• May have to pay for them
• Side effects
• Normally short term
• May become dependant on drugs
• Depressed/schizophrenic patients may not be able to give informed consent.

• Much of behaviour is driven by UNCONSCIOUS motives.
• CHILDHOOD is a critical period in development.
• Mental disorders arise from unresolved, inconscious CONFLICTS originating in childhood.
• Resolution occurs through accessing and coming to terms with REPRESSED ideas and conflicts.

A = id - pleasure principle - UNCONSCIOUS

B = super ego - moraltiy priciple - PRECONSCIOUS

C = ego - reality principle - CONSCIOUS

ID - present a birth - new born baby is completely selfish.

EGO - develops by the age of 3 - child becomes aware that other people have feelings and that it cant always have its own way.

SUPER EGO - appears around the age of 5 - sense of morality passed on by parents - child internalises this.

SIGMUND FREUD

If the ego fails to balance the ID abnormality can occur such as - conflicts may arise and psychological disorders may result. Dominance of the id impulses may lead to destructive tendencies, pleasereable acts and unihibited sexual behaviour.

If the ego fails to balance the super ego - the indivisual may be unable to experience any form of pleasureable gratifiction.

DENIAL:  a defense mechanism in which the existence of unpleasant internal or external realities is kept out of conscious awareness.

REPRESSION: the unconscious exclusion of painful impulses, desires or fears from the conscious mind.

Oral -

• Birth - 18 months 
• Mouth - main focus of pleasure at this stage
• Child enjoys tasting and sucking
• Oral aggressive - hostile and verbally abusive
• Successful completion of this stage is demonstarted by weaning - eating independantly

Anal -

• 18 months - 3 years
• Anally retentive - very tidy,stubborn, likes orders and being in control
• Anally expulsive - generous but disorganised, doesnt like to follow rules
• Defaciation is main source of pleasure
• Successful completion marked by potty training

Phallic -

• The oedipus complex takes place in this stage - boy wants his mother as his 'primary love object', wants his father out of the way then fears that father knows this and will castrate him as punishment then he identifies with the father to stop castration anxiety.
• The electra (female oedipus) complex takes place in this stage 
• Comes after anal stage - lasts until 4 or 5 - focus on the genitals and gratification comes through genital stimulation.

Latency -

• Age 6 - puberty
• Sexual urges sulimated into sports and other hobbies
• Focus on developing same sex relationships
• Lull before the storm of puberty
• No particular requirements for successful completion.

• Puberty into adulthood 
• Task is to develop healthy adult relationships
• Focus on genitals but not to same extent as phallic stage
• should happen if earlier stages have been negotiated successfully

FREE ASSOCIATION:

• Technique used in Freudian psychoanalysis
• Client encouraged to express anything that comes into their mind
• Follow any association that occur to them
• 'Talking cure'

DREAM ANALYSIS:

• Technique used in Freudian psychoanalysis
• Pherapist uses the dream work to interpret the manifest content of the dream and uncover latent content
• Processes such as displacement and symbolisation distort the latent content into the manifest content

DISPLACEMENT: when a person shifts his/her impuslses from an unacceptable target to a more acceptable or less threatening target.

SYMBOLISATION: something visible that by association or convention represents something else that is invisible. (cupboards, tunnels and ships represent the vagina)

Manifest content - dream imagery as reported by the dreamer to uncover the meaningful, latent content, the therapit uses dream work.

PROJECTIVE TESTS: not in freuds original ideas, Ink block tests decoded responses to identify source of abnormality.

EVALUATION -

• Long
• Expensive
• People need training
• Not suitable for all disorders
• Ethical issues in confronting clients with perhaps distressing material during the course of analysis 
• Accepts that human beings are complicated and that many adult disorders may have their roots in childhood and in repressed material

Fixation at..

• oral stage can lead to smoking, biting nails and eating
• anal stage can lead to OCD
• phallic stage can lead to phobias.

• Based on the principals of Classical Conditioning.
• Aim of Behavioural therapy is to remove the association between fear and the object/situation.

Systematic Desensitisation - Replace fear with an alternative & harmless response, construct a hierachy of fearful situations arranging them in order from least to most fearful, the client will then be trained in methods of relaxation. Client is then brought gradually into contact with the phobic stimulus, following the hierarchy previously established with the therapist.

Flooding - aims to remove the learned association between the stimulus and the response. The procedure is inescapeable exposure to the feared object or situatin, lasts until the faer response disppears because the client can see that none of the dreaded consequence they fear actually happens then assumes that very high levels of fear/anxiety cannot be substained and will eventually fall. Evaluation: Very fast if it works, if the sessions end too soon the anxiety levels will still be high and may have the opposite effect.

Aversion therapy - aims to create an undesireable association, mainly used for addictions, used in the 1950's to try and 'cure' homosexuality. It focuses on the symptoms not the deeper underlying causes of behvaiour.

• Abnormality is a result of faulty cognition (thinking).
• It's the way we think about the problem. rather than the problem itself, that is the cause of the disorder.
• Mental disorders can be overcome by learning to use more appropriate ways of thinking.
• The aim is to think positively and rationally.

• NEGATIVE VIEWS ABOUT THE WORLD (everyone is against me because im worthless)
• NEGATIVE VIEWS ABOUT ONESELF (i'm worthless and inadequate)
• NEGATIVE VIEWS ABOUT THE FUTURE  (I'll never be good at anything)

They can also  be seen in the attributions that depressed people make  (referring to our interpretations of why things happen)

Similar to Becks approach.

A: ACTIVATING EVENT - Mary and her boyfriend split up .

B: BELIEFS (About A) - Rational thoughts - Mary tells herself that although it is a sad situation they were not compatiable and she may learn from the experience or Irrational thoughts - Mary tells herself that the break up is her fault and that she is not lovable, and so she will fail at all her future relationships.

C: Consequences (of B) - Desirebale Emotions - Marys feels sad, but hopeful that she will have successful future realtionships - Desireable Behaviour - Mary looks forward to forming new healthy relationships and tries to learn from her experience or - Undesireable Emotions - mary feels guilty that she spoilt the relationship and that she is unlovable - Undesireable behaviour - Mary resolves not to form new relationships as she will only fail and get hurt again.

• Developed by Beck.
• Aim to teach clients to rethink and challenege their negative perceptions/cognitions.

STAGE 1:

Therapist and client agree on the nature of the problem and goals for therapy.

STAGE 2:

Therpaist challeneges the clients negative thoughts.

Client engages in behaviour between sessions in attempt to challenge these negative thoughts.

Aim is for client to realise these thoughts are irrational. Homework - Diary.

The cognitive part of the therapy involves identifying the faulty or irrational thinking processes that are affecting the client. This is done through questioning and getting the client to give examples of situations, what they would think and what they would do. During the cognitive part, the therapist develops ideas about what the client’s irrational beliefs are but does not challenge these directly.

The behaviour part of the therapy involves setting homework for the client to do. The therapist gives the client tasks that will helpthem challenge their own irrational beliefs. the idea is that the client identifies their own unhelpful beliefs and proves them wrong. As a result their beliefs begin to change.

• Clear evidence for cognitive biases and dysfunctional thinking and beliefs in depression and anxiety disorders.
• Very effective for anxiety disorders and depression.
• The idea of schemata and how they develop is rather vague and lacking detail.
• Takes no account of biological or genetic factors in psychopathology.
• Empahises the important role of cognitive factors in psychological disorders.
• Sopjme disorderd such as depression may lead to dysfunctional thinking rather than the other way round.
• Negative thougths sometimes reflect an accurate view of the world  - referred to as depressive realism.

DEPRESSIVE REALISM: this refers to the fact that beliefsand thoughts of the depressed person can be a rational reflection of reality rather than irrational and maladaptive.

SCHEMATA: organised syatems of knowledge that we use to understand and interpret the world.

Definition: a stressor is any stimulus or situation imposing demands on an individual.

The transactional model defines stress as an imbalance between the percieved demands of a stressor and coping ability.

HPA - Hypothalamic-pituraty-adrenal axis

SAM - Sympatho-adrenomedullary axis

Studies - 

Cohen et al(1993) - His aim was to investigate the rate of general life stress on vunerability to the common cold virus. His procedure consisted of 394 participants who were asked to fill out questionnaires on the number of stressful life events they had experienced the year before. 3 scores combined into the 'STRESS INDEX'. Then they were exposed t the common cold which lead to 82% becoming infected. He found that the chance of developing a cold was significantly care related with stress index stress which lead to the conclusion that life stress and negative emotions reduce the effectiveness of our immune system. To evaluate Evans and Eddington support the results, it was an indirect study ad it was a good sample size - can generalise results. 

Evans et al. (1997)

• Found that vunerability to illness results from chronic stress, ie when stress is prolonged, such as a divorce.
• Acute stress - from meeting short deadlines doesnot have this effect.

A score of more than 300 was associated with serious health problems such as diabetes, lukemia and strokes as well as everyday problems such as headaches and colds.

Two sclaes were developed to investigate life changes and levels of stress:

1. Social readjustment rating scale, by Holmes and Rahe:

• ABOUT THE STUDY - patients with heart disease, reported significant life events in the preceeding year. Death of spouse was 100 and Marriage was 50. They were asked to rate impact on 43 life events(394 participants) and compare to marriage.
• RESEARCH STUDY - 2,500 male US navy personell followed for 7 months. relationship between life events and stress.
• EVALUATION - done in the US - cant be generalised - culture specific, longitudinal study - participant attrition and some distress may of been caused to the navy personells when it came to the participants recalling the traunmatic life events.

2. Hassels and uplifts scale by Kanner et al (1981):

• ABOUT THE STUDY - for most, unless they are very unlucky, major life events by their very nature are rare. Problems arise of day-to-day living - hassels. Uplifts can counteract the negative effects of the hassels.
• RESEARCH STUDY - De Longis found daily hassels cause more health problems.
• EVALUATION - Jandoff supports daily hassels.

• Home-work interface - a source of stress in the work place, in which employees try to balance the competing demands of home and work responsibilities.
• Work-life balance - the idea that in a civilised society everyone should strive for a healthy blance between work responsibilities and life outside of work.
• Decision latitude - the sense of control an individual has over there workload and how it is organised - high decision latitude is associated with a lower vunerability to stress related illnesses.

MARMOT ET AL. -WHITEHALL I:

• Lowerpaid workers had twice as much illness.
• Participants - London based civil servants.
• Differences in risk factors (low paid tended to smoke etc) accounted for about a quarter of this difference.
• Clear differences between workers were found with regards to heart problems and mortality rates.

WHITEHALL II:

• 7000 participants were originally free from heart problems and followed for 5 years.

TYPE A vs HARDY PERSONALITY

Type A - ROSEMAN(1976) studied 3,154 middle aged men of the west coast of the US. they were categorised as either type A or type B by a structured interview. As participnats answered the questions, the trained interviewer also noted behaviour signs of type A pattern. E.G. rapid finger tapping, restlessness pace of talking.

Participants were followed for 8.5 years. During that time there were 257 heart attacks, 69% of which were type A. 

Rosenman concluded that the high TAB L TYPE B Behaviour, individuals was vunerable to heart disease.

METHODOLOGICAL ISSUES: Culturally & gender specific, high ecological issues and findings should be generalised with caution.

ETHICAL ISSUES: Gave informed consent and were debriefed at the end of the study.

HARDY PERSONALITY -

Introduced by KOBASA(1979) - 3 basic elements:

• Control - this is the idea that you can influence events in your life by including stressors.
• Commitment - this is the individuals sense of involvement purpose in life.
• Challanege - refers to the idea that changes in life should be viewed as an opportunity rather than a source of stress.

Supported by beasley.

• Research into TAB suggest that Type A people are actually less vunerable to stress than first thought. Characteristics of TAB are actually components of hardiness so it also contains aspects of hardiness.

PSYCHOLOGICAL METHODS - 

CBT : Cognitive Behavioural Therapy

• Aims to change faulty thinking patterns or cognitions into more rational realistic ways of thinking. 

E.G. - deadlines being manageable, bosses being too demanding and worklife balance.

MEICHENBALM'S STRESS INOCLLATION TRAINING (SIT) - A cognitive behavioural approach to managing the -ve effects of stress. Consists of 3 stages:

1. Conceptualisation.

2. Skills training & Rehearsal.

3. Application in the real world.

HARDY PERSONALITY -

Introduced by KOBASA(1979) - 3 basic elements:

• Control - this is the idea that you can influence events in your life by including stressors.
• Commitment - this is the individuals sense of involvement purpose in life.
• Challanege - refers to the idea that changes in life should be viewed as an opportunity rather than a source of stress.

Supported by beasley.

• Research into TAB suggest that Type A people are actually less vunerable to stress than first thought. Characteristics of TAB are actually components of hardiness so it also contains aspects of hardiness.

Conceptualisation: Working with a therapist to identitfy the sources of stress.

Skills training & Rehearsal: Acquiring specific skills to address the situation.

Application in the real world: Encouraged to apply skills and techniques to the real world.

EVALUATION -

+

• Very effective.
• Deals directly with the source of stress.
• Outs you in control and teaches you skills to deal with stress.

-

• Wont work for everyone.
• Can be expensive.
• Takes commitment.
• Takes a long time to work and practise.

3 stages:

• Focusing - therapist encourages the client to focus on the physiological symptoms associated with stressful situations - identified sources of stress to help them acquire new skills and strategies for coping with stress.
• Reconstructing Stressful situations - client encouraged to think about recent stressful situations - how they might turn out worse or better.
• Self improvement - to improve the clients sense of self efficiency.  

+ 

• effective
• helps them cope - targets appraisal

-

• involves time , commitment and money.

Appropriate for people in acute stress states or those who need rapid treatment because they may be vunerable to heart attack, stroke or blood pressure problems. 

They may include the use of anti-anxiety drugs such as Benzodiapines (BZs) - acts on the brain and increases the action of the neurotransmitter called GABA which reduces the activity of the other neurotransmitters. 

• Reduce general arousal
• Help treat insomnia
• People may develop dependance on these drugs.
• Relatively safe in an overdose.
• Fully informed consent needed. 

Beta-blockers (BBs)

• Reduce levels of phsiological arousal, heart rate and blood pressure.
• Act on heart and blood system.
• Reduces activation of the cardiovascular system.
• No severe side effects.
• Have a life saving function.

• Attempt to change voluntary controlled behaviour, rather than reflexive behaviours involved in classical conditioning.
• T1 - Token Economy - increasing desired behaviour by positive reinforcement, mostly used in institutions. It aims to reduce levels of anti social behaviour 0 tokens given as rewards which can be exchanged for sweets, cigarettes etc.
• T2 - Social Learning Theory - Cognitive element, the patient observes others in the presence of the phobic stimulus who are responding with relaxtion rather than fear to the phobic stimulus. Patients are asked to imitate the model(s) and relive their phobias.

EVALUATION -

• ignores any genetic or biological factors in psychological disorders
• SLT takes more complex view of human behaviour
• reductionist approach to complex behaviour as stimulus-response 'machines'
• token economy can improve behaviour and reduce anti social behaviour

CONFORMITY - the tendancy to change what we do (behaviour) or think and say (attitudes) in response to the influence of others or scial pressure, this can be real or imagined.

NORM - unwritten rules e.g. go to the end of the que and manners.

Types: Identification and Internalisation

Explanations - Normative and Informational social influence - when the 2 are combined its the dual process dependancy model.

AMBIGUOUS - no obvious answer

UNAMBIGUOUS - the answer is obvious

Referent social influence - conforming with a group of friends and following their expectations because you value membership of the group.

KELMANS 3 TYPES OF CONFORMITY:

• Compliance - where the person conforms publicly with behaviours or the views expressed by others in the group but continues privately to disagree - e.g. laughing at a joke but not finding it funny. ASCH's EXPERIMENT
• Identification -