DEFINITIONS OF ABNORMALITY- DSN
DEVIATION FROM SOCIAL NORMS (DSN) Every society has commonly accepted standards of behaviour e.g. queuing in shops. These social norms allow for the regulation of normal social behaviour and vary between cultures. Deviations from social norms is an indication of abnormality e.g. OCD (washing hands) or schizophrenia (hearing voices) and crying at a funny film.
- Deviation isn't always a sign of psychopathology e.g. superstitions or fancy dress
- They change over time e.g. homesexuality
- They are specific to certain cultures
Failure to Function Adequately (FFA)
FAILURE TO FUNCTION ADEQUATELY (FFA) Focuses on everyday behaviour of an individual e.g. wake up in the morning, go to work, etc. Deviating from a normal pattern of behaviour may be failing to function adequately e.g. severe depression- fail to get up in the morning, can't hold down a job.
Rosenman & Seligman's characteristics of abnormal behaviour:
- Observer discomfort: Causing others to feel upset or embarrassed e.g. alcoholics
- Unpredictability: e.g. a person over reacting
- Irrationality: Behaviour that doesn't fit expected norms e.g. not making sense/irrational
- Who decides the point at which someone is failing to function adequately and who defines what is adequate?
- Some people may find FFA a good thing e.g. eating disorders result in slimness = compliments
- FFA may not be linked to a psychological disorder. Holding down a job may be impossible due to economic conditions.
Deviation from Ideal Mental Health (DIMH)
DEVIATION FROM IDEAL MENTAL HEALTH - JAHODA Jahoda listed characteristics she felt indicated ideal mental health. An individual should be:
- In touch with their own feelings
- Resistant to stress
- Function as an autonomous (independent) individuals
- Show empathy and understanding towards others
If you deviate from these you are seen to be abnormal.
- According to the criteria, most of us can be classed as abnormal. Also, Jahoda is just one researcher, how can her classification be accurate?
- Theory bundles together mental and physical illnesses which can't be diagnosed the same way.
- The characteristics are rooted in Western societies, concepts recognised here are not recognised elsewhere e.g. autonomy
Abnormality involves a physical change to the body, usually the brain as this is the processing centre that controls all complex behaviour.
Body change can be caused by four main factors:
- 1) NEUROTRANSMITTERS (Biochemicals): These are chemicals that regulate the brain. Abnormal levels can lead to abnormality. Low levels of serotonin are associated with depression. High levels of dopamine are associated with schizophrenia. Drugs (i.e. amphetamines) can alter neurotransmitter levels. Amphetamines increase dopamine levels in the brain causing people to mimic schizophrenic symptoms.
- 2) GENETICS (Hereditary factors): If one twin has schizophrenia, there is a 48% concordance rate that the other twin may also develop it. If you have a first degree relative with depression, there is a 50% chance you will get it. If you have a second degree relative with depression, there is a 25% chance you will get it.
Biological Approach cont.
- BRAIN DYSFUNCTION: Phineas Gage was setting of a black powder charge when the explosion went off prematurely and sent a metre long iron bar through his skull. His personality soon changed. After the injury he grew irritable and suspicious, unable to keep a steady job.
- INFECTION: Bacteria and viruses can infect the brain, causing mental illness. Brown (2004) stated that women who contract flu during pregnancy may have children who develop schizophrenia in later life.
- (+) Modern techniques such as brain scanning have identified biological aspects of psychopathologies e.g. levels of biochemicals. Schizophrenic patients have loss of tissue in some areas of the brain.
- (+) Research= there is often an inherited component in psychopathologies e.g. schizophrenia
- (-) Reductionist- doesn't consider other factors e.g. environmental influences.
- (-) Concordance rates are never 100%, other factors must be involved
BIOLOGICAL TREATMENTS - ECT
ELECTROCONVULSIVE THERAPY (ECT): Either unilateral (electrode on one temple) or bilateral (electrodes on both temples). Patient is given a short acting anaesthetic and muscle relaxant before the shock is administered. Passing an electric current (0.6amps) through the brain, causing a deliberate seizure. This has an effect on several neurotransmitters in the brain. ECT is usually given 3 times a week for up to 5 weeks. Nowadays only recommended in the UK for the most severe depression.
- (+) An effective antidepressant treatment for patients unresponsive to other therapies.
- (-) Violent assault on the brain. Research suggests it can lead to long term memory impairment.
- (-) Individuals with severe depression may not be able to give fully informed consent.
PSYCHOSURGERY: Systematically damaging the brain in order to change behaviour. Most severe: frontal lobotomy used throughout the 1940-50s as a treatment for schizophrenia. This involves cutting pathways between higher and lower centres in the brain. Nowadays it is extremely rare. It is occassionally used for severe depression and OCD.
- (-) So rare that it's hard to judge the effectiveness
- (-) Didn't target specific symptoms, just made patients more manageable
- (-) Ethical issues: damage to the brain is irreversible and consequences unpredictable
DRUGS Schizophrenia: Laborit tested the drug chlorpromazine. He found it significantly reduced symptoms e.g. hallucinations and delusions. A relationship was found between chlorpromazine and the neurotransmitter dopamine. Schizophrenia was linked to raised levels of dopamine. Chlorpromazine reduces dopamine activity in the brain. Newer drugs such as clozapine have been introduced and seem to act on a wide range of neurotransmitters such as dopamine and serotonin.
Depression: Is linked to low levels of serotonin and noradrenaline. Monoamine-oxidase inhibitors (MAOIs) and tricyclic antidepressants were introduced. These raised levels of neurotransmitters serotonin and noradrenaline. In the 1990s a new class of antidepressants called selective reuptake inhibitors e.g. Prozac were introduced. These selectively raise levels of serotonin in the brain and were considered more effective.
- (-) Supress symptoms but don't cure disorder (-) Ethical issues involving informed consent
- (-) Side effects. Long term treatment with chlorpromazine often led to movement disorders
- (-) Problems with psychological and physical dependence
- (+/-) Effective in 50-60% schizophrenic patients and 60-70% depressed patients
PSYCHODYNAMIC APPROACH- Model of P.
Assumes behaviour reflects complex dynamic interactions between conscious and unconscious processes. Assumes behaviour is influenced by childhood experiences. Freud referred to his approach as psychoanalytic; it had 2 key elements: model of personality and psychosexual development.
Model of Personality
ID: unconscious energy we are born with. Most important aspect is libido. Operates on the pleasure principle and demands immediate satisfaction. Aims to gain pleasure and gratification at any cost. EGO: the conscious, rational part of the mind. Its function is to work out realistic ways of balancing the demands of the id in a socially acceptable way. It is governed by the reality principle. SUPEREGO: last part of the personality to develop. Distinguishes right and wrong. Seeks to perfect and civilise our behaviour, learned through identification with one's parents and others.
If ego fails to balance the demands of the id and superego, conflicts may arise and psychological disorders may result e.g. anxiety. The ego uses defence mechanisms e.g. repression/denial to protect itself while balancing their demands.
Oral Stage (birth- 18mnths): Id impulses are satisfied by feeding. Mouth is the focus (sucking then biting). Fixation at this point may lead to an adult gaining pleasure from oral gratification e.g. smoking, eating, etc.
Anal Stage (18mnths- 3yrs): Gratification focuses on the **** (retaining and expelling faeces). Fixation may lead to an obsession with hygiene and cleanliness, perhaps OCD.
Phallic Stage (3- 4/5yrs) : Focus is on the genitals and gratification comes through genital stimulation. Key stage in sexual development as gender differences are noticed. Oedipus complex: Boys develop love for their mother, leading to a fear of the father. The boy sees his father as a rival and produces a fear of castration. Elektra complex: Girl realises she has no penis, penis envy.
Latency Period (4/5yrs- puberty): Repression of sexual desires until puberty where sexual feelings become less focused on the self and instread are directed at potential partners.
Evaluation of Psychodynamic Approach
- (+) Very influential theory, now widely accepted with many studies on the effects of childhood sexual abuse on adult psychopathology
- (-) Didn't study children directly, just used case stdies
- (-) Concepts such as the id, defence mechanisms, etc, are almost impossible to test using conventional scientific methodology
- (-) Theory was developed in late 19th century Vienna, aspects are clearly related to the historical and cultural period
PSYCHODYNAMIC TREATMENTS (Psychoanalysis)
FREE ASSOCIATION: Client is encouraged to express anything that comes to mind. Free association leads to other thoughts and memories perhaps extending into childhood. Material should be uncensored. Freud believed this was a way to get around the defences put up by the ego and bring repressed material to the surface from the unconscious.
DREAM ANALYSIS: Freud claimed "dreams are the royal road to the unconscious" because when we are dreaming we gain an insight into our deepest, darkest thoughts, which we can't access while awake. Patients are encouraged to keep detailed dream diaries and the therapist will use this to gain an understanding of the patient's unconscious thoughts and will attempt to interpret common themes and recurring scenarios within dreams. They examine the issues over and over to attempt to gain greater transparency about the causes of the abnormal behaviour which leads to the patient being able to challenge their inner conflicts and overcome their problems.
PROJECTIVE TEST: Clients are required to project/impose their thoughts and associations on a stimulus. The most famous is the Rorschach Ink Blot test; the client is presented with a series of ink blots and asked what the shape means to them. Repeating this sees particular themes and patterns emerge
Evaluation of Psychodynamic Treatments
- (-) Only suitable for those who can express themselves well as treatment requires talking.
- (-) Extremely expensive to see Freud for one hour, he was very popular and only available to the upper class.
- (-) Time consuming, could take months or years and therefore not suitable as a fast effective treatment. Biological treatments such as drugs may be better suited for people.
- (-) Ethical issues: accessing the unconscious could cause the revival of stressful past issues.
Abnormality is caused by FAULTY THINKING. The problem is the way we think and interpret situations. The Cognitive Model says that you are the only person in control of your thoughts and therefore abnormality is your fault.
It emphasises cognitive distortions (dysfunctional thoghts) and deficiencies (absence of sufficient thinking and planning).
Beck & Ellis developed the cognitive approach with the assumptions that behaviour is heavily influenced by schemata, which develop on the basis of early experience.
Traumatic experiences in early life lead to the development of negative schemata e.g. abandoned child thinks 'I will never be loved'.
Negative schemata can lead to Negative Automatic Thoughts (NATs), where you look for problems as opposed to benefits.
NATs can be identified in the cognitive biases that depressed patients apply when interpretting situations, these prevent the person focusing on the positive side e.g. minimisation (minimising success) and maximisation (exaggerating small failures).
Cognitive Approach cont. and Evaluation
Ellis's ABC model: Activating Events in an individual's life cause people to develop certain Beliefs about themselves and the events. These beliefs result in Consequences such as feelings and actions.
- (+) Clear evidence for cognitive biases and dysfunctional thinking and beliefs in depression e.g. in a panic disorder, the individual may exaggerate anxiety sy,ptoms such as heart rate (Clark)
- (-) Ethical issues- puts the blame on the patient for their situation as they developed their faulty thinking. Particularly cruel if their negative perceptions are based on the reality of the situation they find themselves in.
- (-) Reductionist- takes no account of biological or genetic factors in psychopathology, reduces abnormality down to faulty thinking.
- (-) The idea of schemata and how they develop is rather vague and lacking detail.
COGNITIVE BEHAVIOURAL THERAPY (CBT): Challenges irrational and dysfunctional thought processes and changes them into positive thoughts. Teaches the client ways of acquiring coping strategies.
Beck's Cognitive Therapy: Therapist helps client identify negative thoughts. These thoughts are reviewed and negative automatic thoughts are recognised. The therapist then uses this material to challenge irrational cognitions by drawing attention to positive incidents, contradicting negative thoughts.
- Client is encouraged to keep a diary- identifying when and where negative thoughts occur.
- Discuss and challenge negative thought patterns with the therapist.
- Taught coping strategies (changing the behaviour) often by setting small goals, eventually overcoming the problem.
Cognitive Treatments cont. and Evaluation
Ellis's Rational Emotive Behaviour Therapy (REBT): Similar to Beck's therapy but the therapist is more confrontational and directly challenges and confronts irrational thoughts. Client is encouraged to understand how irrational their thoughts are and the consequence of thinking that way. REBT focuses on self-defeating beliefs that accompany events. The client is encouraged to dispute these beliefs, helping change them into rational beliefs.
- Logical disputing: self defeating beliefs do not follow logically from the information available.
- Empirical disputing: self defeating beliefs may not be consistent with reality.
- Pragmatic disputing: emphasises the lack of usefulness of self defeating beliefs.
(+) Combination of behavioural and cognitive elements (more holistic). Recognises cthe importance of complex cognitive processes. (+) CBT is cost effective and time saving. (+) Avoids in-depth probing associated with psychoanalysis- less damaging for clients. (-) Fails to address that the irrational environments in which clients exist continue beyond the theraputic situation e.g. bullying. These environments may continue to produce irrational thoughts.
Suggests the mind is completely unnecessary. We are born as 'blank slates' (tabula rasa). All behaviour is learned from the environment.
CLASSICAL CONDITIONING: People learn to associate two stimuli when they occur together. Accounts for many phobias e.g. a traumatic experience (nearly drowning) leads to the conditioning of fear to that particular situation (the ocean). Watson & Rayner conditioned an 11mnth old child known as Little Albert fo fear fluffy animals. They paired the presentation of a tame white rat with a sudden loud noise. The noise caused fear, an unconditioned reflex. Eventually he was conditioned to associate the rat with fear. He also became afraid of other fluffy objects similiar to the white rat such as a rabbit and a white dog, this is known as stimulus generalisation.
OPERANT CONDITIONING: Behaviour can be shaped through reinforcement via rewards/punishments. In adults, normal and disordered behaviour could be shaped by years of conditioning e.g. if a child finds that they get more attention from parents when they have a panic attack, these panic attacks may become more frequent leading to similar behaviour with their partner in later life. Skinner demonstrated this by rewarding pigeons for pecking a coloured disk, causing them to do it more often.
Behavioural Approach cont. and Evaluation
SOCIAL LEARNING THEORY: People can learn by observing and imitating human models that are rewarded for their behaviour. This is known as vicarious reinforcement e.g. anorexia can be watched in the media and imitated. Bobo Doll Study- children who saw adults play nice with the doll also played nice; when they saw the adults act violently towards the doll, they imitated.
- (+/-) Provides convincing explanations of some psychological disorders, including the role of classical conditioning in phobias and social learning in eating disorders. However for many people with phobias, there is little evidence of early fearful encounters that might lead to classical conditioning.
- (-) Reductionist- explains behaviour in terms of relatively simple learning principles, ignoring cognitive and emotional contributions to the development of psychopathology.
- (-) Explains all behaviour through learning experiences (nurture) and has no role for any genetic contribution (nature).
- (-) Heavily deterministic as it views human behaviour as simply a product of stimuli, rewards and punishments. There is no role for conscious choice.
Systematic Desensitisation: Patient lists situations from least to most fearful- creating an Anxiety Hierarchy. Therapist trains patient in deep relaxation techniques. The patient visualises situations whilst practicing relaxation. This could also be done using real life examples. Gradually therapist moves closer to the most feared situation.
- (+) Behavioural therapy e.g. Systematic Desensitisation can be effective in the treatment of phobias. Barlow et al found a 60-90% success rate for arachnophobics.
- (-) Effect might diminish once removed from the clinical lab setting and positive reinforcement from therapist. Possibly a high chance of relapse.
- (-) Doesn't target any psychological or emotional issues related to the disorder. Only focuses on learnt associations.