psychopathology

?

Definition of statistical infrequency

Statistical infrequency - occurs when an individual has a less common characteristics (more depressed or highly intelligent) 

statistical norms - any behaviour or characteristics which is deemed as 'normal' - established by different social groups. 

example; intellectual disability disorder requires an IQ in the bottom 2% of the population. 

68% of people have an IQ ranging from 85 to 115 - deemed as 'normal'. 2% of population have an IQ below 70. 

1 of 31

Evaluation of statistical infrequency

real life application

  • influencial in diagnosing intellectual disability disorders. 
  • makes is easy to define what is 'normal' and 'abnormal' 
  • before diaagnosis every patient is compared with statistical norms.

Unusual characteristics can be positive

  • IQ scores over 130 as unusual as those below 70 - super intelligence is a desirable characteristics. 
  • just because people dont display certain behaviours, it does not make them abnormal
  • statistical infrequency alone cannot be used to make diagnosis 

Not everyone unusual benefits from a label 

  • if someone is living a happy life despite being 'abnormal' the label could negatively affect them.
  • someone with a low IQ who is not distressed would not benefit from being labelled as being intellectually disabled
2 of 31

Definition of deviation

Deviation from social norms - is the term used to explain behaviour that is different from the accepted standards of behaviour in a community or society. 

example; antisocial personality disorder involves socially unacceptable behaviour. DSM-5 says one common symptom of antisocial personality disorder is 'absence of prosocial internal standards associated with failure to conform to lawful or culturally normative ethical behaviour'

3 of 31

Evaluation of deviation

not a sole explanation 

  • it has real life application in diagnosing conditions such as antisocial personality disorder 
  • deviation from social norms enables people to establish what can be defined as 'normal' behaviour 
  • other factors should be taken into consideration e.g. the distress the behaviour could cause to other people

Cultural relativism 

  • social norms differ between generations and cultures. 
  • someone may be labelled as behaving abnormally but in their own culture that behaviour may be recognised as normal. e.g. hearing voices is common in some Aftrican cultures. 

can lead to human rights abuses 

  • over reliance on deviation can lead to human rights abuses e.g. Drapetomania was a diagnosis of black slaves who ran away. 
  • some categories of mental disorders put a label on people being different. 
4 of 31

definition of failure to function adequately

adequate functioning - when someoens behaviour is deemed as 'normal', they are able to meet common day to day needs e.g. personal hygiene, cleaning etc.

failure to function - when someone can no longer cope with the demands of day to day life, they are said to be failing to function. e.g. if they cannot hold down a job. 

When is someone failing to function? 

Rosenham and Seligman proposed some signs which showed that someone is failing to function; 

  • when they can no longer conform to standard interpersonal rules e.g. eye contact 
  • when someone experiences severe personal distress 
  • when behaviour becomes irrational or dangerous to themselves / others. 

example; a diagnosis of antisocial personality disorder cannot be made unless someone is also failing to function adequately.

5 of 31

Evaluation of failure to function

patients perspective 

  • strength is that it attempts to take into consideration the patients subjective experience. it capturs experiences of people who need help. - useful criterion for defining abnormality
  • a weakness is that it is not clear on how to define distress due to individual difference - but tries to take into account the patients individual perspective 

is it just a deviation from social norms? 

  • it is difficult to differentiate between whether someone is failing to function or whether they are just deviating from social standards 
  • people who take part in maladaptive behaviours e.g. sky diving are not saikd ot be failing tol function.  Compared to those who practice religious/supernatural beliefs are said to be abnormal. 
  • risk of limiting personal freedom and discriminating against minorities

subjective judgement

  • someone has to make a judgement on whether a patient is distressed. Global assessment of functioning scale attempts to make definition objective. 
6 of 31

Deviation from ideal mental health

mental health - characteristics of a physiologically healthy person. 

What does good mental health look like? 

Jahoda said certain criteria needs to be meet for someone to be deemed as mentally healthy 

  • showing no symtoms of distress 
  • we are rationale and can properly percieve ourselves 
  • we self actualise (reach our full potential) 
  • we can cope with stress 
  • we hold a realistic view of the world 
  • we have good self esteem and lack guilt 
  • we are independent 
  • we can successfully work, love and enjoy leisure 

deviation from ideal mental health - failing to meet the above criteria means can be defined as deviating from ideal mental health. 

7 of 31

Evaluation of deviation from mental health

its a comprehensive definition 

  • a strenth is that it covers a broad range of criteria which need to be met. 
  • covers most reasons as to why someone may seek mental health support. 
  • it is a good tool for thinking about mental health 

cultural relativism 

  • some ideas proposed by Jahoda are specific to Westen norms of ideal mental health 
  • the idea of self actualisation may be deemed as self indulgent in some cultures - collectivist cultures which place value on community 
  • some cultures may deem being independent of other people as a bad thing 

sets an unrealistically high standard for 'good' mental health 

  • very few people realistically meet all the criteria proposed by Jahoda - so everyone could be said to be mentally unhealthy
  • strength - shows people areas which they could seek help for improvement in. However it makes it unclear of who actually needs help and who doesn't. 
8 of 31

Phobias

DSM categories of phobias; 

Phobias are characterised by excessive fear and anxiety triggered by an object, place or situation. 

  • specific phobia - phobia of an object e.g. body part or a situation e.g. flying 
  • social anxiety - phobia of social situation e.g. public speaking 
  • agoraphobia - phobia of being outside or in a public place. 

Behavioural characteristics 

  • panic - someone may panics when in the presence of the phobic stimuli. Behaviours may include; screaming, crying. Children may; freeze, cling or have tantrums 
  • Avoidance - sufferers tend to go out of their way to avoid the phobic stimulus. For example, someone who does not like public toilets may avoid going to them. 
  • Endurance - when the sufferer remains in the presence of the phobic stimulus but their anxiety levels remain very high. 
9 of 31

Phobias

Emotional characteristics 

  • Anxiety - Phobias are classed as anxiety disorders. Anxiety is an unpleasent state of high arousal. - prevents sufferers from being able to relax. Fear is the immediate response. e.g. arachnophobia. 
  • Emotional responses are unreasonable - the sufferers responses are often unreasonable. - may be a dramatic reaction to small thing e.g. small spiders 

Cognitive characteristics

  • selective attention to phobic stimulus - when suffers focus all of their attention to the stimulus when in the presence of it.  - find it hard to concentrate on other things. 
  • irrational beliefs - beliefs in relation to the stimulus are often irrational e.g. someone who is aracnophobic may think if they go near a spider, they will die. 
  • cognitive distortions - the sufferers perception of the phobic stimulus is often distorted e.g. an ophidiophic may see snakes as being aggressive and alien looking.
10 of 31

Depression

DSM-5 categories of depression - all depressive disorders are characterised by changes of mood.

  • major depressive disorder - severe but often short term depression
  • persistent depressive disorder - long term or recurring depression - can be sustained
  • disruptive moos dysregulation disorder - childhood temper tantrums 
  • premenstrual dysphoric disorder - mood disruption prior/during menstruation

Behavioural characteristics 

  • Activity levels - sufferers often experience reduced energy levels, often lathergic -some may struggle to get out of bed. Some may withdraw from work, education of social life. Psychomotor agitation - struggling to relax, may end up pacing. 
  • disruption to sleep and eating behaviour - sufferers may experience reduced sleep (insomnia)  e.g. premature waking. Some may experience hypersomnia (increased need to sleep. 
  • eating behaviour - appetite may increase or decrease. leading to weight gain/loss
  • Aggression and self harm - sufferers are very irritable and can become verbally or physically aggressive. The anger can often be self inflicted - self harm, attempted suicide. 
11 of 31

Depression

Emotional characteristics 

  • lowered mood - sufferers experience lowered mood e.g. feeling sad. Patients describe themselves as feeling worthless and empty
  • anger - sufferers experience negative emotions more than positive ones, they may experience frequent anger - directed at themselves or others. 
  • lowered self esteem - sufferers report lowered self esteem and can lead to self loathing.

cognitive characteristics 

  • poor concentration - depression is associated with low concentration levels. Sufferers may find it difficult to focus on a task or find it hard to make a decision. 
  • attending to/ dwelling on the negative - sufferers focus more on the negative aspects of their lives and situations. - ignore positives. See the glass as half empty. Recall unhappy events
  • Absolutist thinking - sufferers view the world as being black and white - when a situation is unfortunate, they view it as an absolute disaster. 
12 of 31

obsessive compulsive disorder

DSM-5 categories of OCD 

  • OCD - characterised by obsessions (recurring thoughts, images), and/or compulsions (repetetive behaviours e.g. hand washing) - most ppl have both.
  • trichotillmonia - compulsive hair pulling
  • excoriation disorder - compulsive hair pulling.   

Behavioural characteristics 

  • Compulsions are repetetive - suffers are often compelled to repeat behaviours e.g. counting
  • compulsions reduce anxiety - around 10% of people show compulsive behaviour without the obsessions. Compulsive hand washing is done to reduce anxiety of germs
  • avoidance - sufferers may attempt to avoid the stimulus that could trigger their OCD. sufferers who compulsively wash hands tend to avoid touching things which could be associated with germs. 
13 of 31

obsessive compulsive disorder

Emotional characteristics 

  • anxiety and distress - OCD is regarded as unpleasent emotional experiences due to heightened anxiety which is experienced when sufferers are experiencing it. Obsessive thoughts can be frightening for some and anxiety can become overwhelming.
  • accompanying depression - anxiety can be accompanied by low moods and lack of enjoyment in activities. - compulsive behaviour tends to relieve the anxiety.
  • guilt and disgust - sufferers tend to express irrational guilt over minor moral issues. or may show extreme disgust directed towards things such as dirt.

Cognitive characteristics 

  • obsessive thoughts - 90% of sufferers experience obsessive thoughts, which are usually unpleasent. - worrying that the door is unlocked and intruders will come in.
  • cognitive strategies to deal with obsessions - people adopt coping mechanisms such as meditating or praying which help to manage the symptoms. 
  • insight into excessive anxiety - sufferers are aware that theyre obessions and compulsions are irrational. -sufferers think of the most catastropic thing that could happen in a situation.
14 of 31

Behavioural approach to explaining phobias

Two process model - phobias are aquired (learned) by classical conditioning and maintained by operant conditioning. 

aquisition by classical conditioning 

  • involves learning to associate something whci hwe initally have no fear of (neautral stimulus) with something which already triggers a fear response (unconditioned response).
  • John watson created a phobia in Little Albert - showed no initial anxiety. 
  • whenever a rat was presented infront of him, a loud bang would be made on an iron bar. - the noise was the unconditioned stimulus - which created an unconditioned response of fear. - when the rat (NS) and the US were encountered close together - a fear response was produced. - rat became conditioned stimulus which produced a conditioned response. - the fear was then generalised to any fluffy object. 

Maintanence by oprant conditioning

  • negative reinforcement - when the phobic stimulus is avoided = positive reinforcement when avoidance calms sufferer. 
  • these behaviours are repeated everytime therefore the phobia is maintained. 
15 of 31

Evaluation of behavioural approach - phobias

good explanatory power 

  • it explained how phobias could be maintained over a long time.
  • had important implications for therapies because it explained why patients needed to be exposed to the phobic stimulus. 
  • once avoidance behaviour was prevented, behaviour wouldnt be reinforced so would decline. 

alternative explanation for avoidance behaviour 

  • not all avoidance behaviour is to reduce anxiety - some people do it to feel safer. 
  • agoraphobics avoid going outside to feel safer - not to aboid phobic stimulus. 
  • explains why some agoraphobics can leave the house with a trusted person

incomplete explanation of phobias 

  • Bounton  - evaluationary factors are responsible for some phobias - not mentioned in model
  • there is an adaptive to aquire some fears and ppl have a biological preparedness to avoid things such as snakes. - innate predisposition
  • rare to be phobic of cars and guns which are more dangerous than snakes.
16 of 31

behavioural approach to treating phobias - systema

Systematic desensitisation - behavioural therapy designed to slowly reduce phobic anxiety - using the principle of classical conditioning.  - sufferer is taught to relax in presence of stimulus. 

a new response of relaxation is learned - counterconditioning. - one emotion overriders the other - reciprocal inhibition. 

  • anxiety hierachy - put together by patient and therapist. List of situations related to the phobic stimulus - in order of most frightening to least frightening. 
  • relaxation - therapist teaches the patient how to relax as much as possible. May involve breathing excercises or mental imagery techniques. Relaxation can be achieved using drugs e.g. valium 
  • exposure - patient is exposed to phobic stimulus whilst in a relaxed state. Which takes place across several sessions. - starting at the bottom of the hierachy and working itself up. 
  • - treatment is succesful when the patient can stay calm in the presence of the phobic stimulus. 
17 of 31

Evaluation of systematic desensitisation

it is effective 

  • Gilroy - followed up 2 patients who had been treated for spider phobia in three 45 minute sessions. - assessed using different measures - spider questionnaire and assessing the resposne to a spider. 
  • control group was used - using relaxation and no exposure. 
  • at 3 months and 33 months - exposure group were less fearful. 

it is suitable for a diverse range of patients 

  • flooding and cognitive therapies are not well suited for some patients.
  • some people who had phobias may also have learning disabilities - flooding can be overwhelming. - cognitive therapies also require reflexive thinking which may be hard. 

it is acceptable to patients 

  • most patients would choose systematic desensitisation  > flooding. bc it is less traumatic
  • systematic flooding also involves learnign techniques such as relaxation
  • it has lower refusal rates than flooding. 
18 of 31

behavioural approach to treating phobias - floodin

Flooding - involves exposure to phobic stimulus with no gradual build up. - immediate exposure - sessions are often very long - 2 - 3 hours. 

how does flooding work?

  • flooding stops phobic responses quickly. 
  • patient does not have option of avoidance so has to learn that the phobic stimulus is harmless
  • a in terms of classical conditioning - this is called extinction
  • a learned response is eliminated when a conditioned stimulus (a dog) is presented without the unconditioned stimulus (being bitten). - conditioned stimulus no longer produces conditioned response of fear. 
  • some patients may experience relaxation after a while. 

ethical safeguards

  • flooding is an unpleasent experience so patients should get fully informed consent and should be fully prepared to face the traumatic experience. 
19 of 31

Evaluation of flooding

it is cost effective

  • flooding is as effective as other treatments for specific phobias. 
  • flooding is highlyeffective when compared to cognitive therapies and is a quicker alternative
  • patients are free of symptoms quickly - cheaper alternative 

it is less effective for some types of phobias 

  • it is not that effective for phobias such as social phobias.
  • social phobias have cognitive aspects which flooding does not have e.g. sufferers also have unpleasent thoughts about the social situation. 

the treatment is traumatic for patients

  • flooding is a highly traumatic experience for patients. 
  • patients are often unwilling to see it through to the end. 
  • meaning that money and time are wasted if patients do not use it properly. 
20 of 31

Cognitive approach to explaining depression

Beck's cognitive theory of depression 

a way of explaining why some people are more vulnerable to getting depression

  • faulty information processing - selective attention to all negative aspects of any situation
  • negative self schema - schema is a 'package' of ideas and information. negative self schema is a negative outlook on aspects of our selfs. 
  • negative self triad of - the world, future and self.

Ellis' ABC model

conditions like anxiety and depression are caused by poor mental health and irrational thoughts. 

  • A Activating event - negative events/situations trigger irrational beliefs
  • B Beliefs - irrational interpretations of life events leads to irrational beliefs. Mustubation is the belief that we should always succeed. Utopiannism belief that life if meant to be fair. 
  • C Consequences - when an activating events causes irrational beliefs, the consequences are negative emotions of anxiety and depression.
21 of 31

Evaluation of Becks cognitive theory

has good supporting evidence

  • Grazioli and Terry, assessment of 65 pergnant woman for cognitive vulnerability and depression before and after birth. - those who were found to be cognitively vulerable were more likely to get post natal depression. 
  • Clark and Beck - reviewed research and found that there is solid evidence to support the theory. Cognitions can often be seen before the depression actually happens. 

Practical application in CBT

  • Becks explanation forms the base for cognitive behavioural therapy
  • all cognitive aspects can be identified and challenged in CBT. - aspects in negative triad are easy to identify. - therapist can challenge all of them. 

does not explain all aspectsof depression

  • Becks theory only explains the basics of depression
  • it cannot explain why some patients are deeply angry and suffer extreme emotions.
  • sufferers experience hallucinations and Cotard syndrome (thinking they're a zombie)
22 of 31

Evluation of Ellis. ABC model

a partial explanation 

  • reactive depression is what is caused by triggering events but not all depression starts of like that. 
  • some depression arises for no obvious reason and this does not get explained. 

it has practical application in CBT

  • challenging irrationalc beliefs can reduce the depression that someone is experiencing
  • explains how the irrational thoughts play a major part in depression 

it does explain all aspects of depression 

  • it does not explain the extreme anger that sufferers experience whilst they are depressed. 
23 of 31

cognitive approach to treating depression

CBT aims to treat depression through a range of cognitie and behavioural techniques. 

CBT - Becks cognitive therapy 

  • first therapist and patient identify negative thoughts about the world, future and self (negative triad) - so they can be challenged by the therapist
  • homework - patients set homework to test the reality of all their negative beliefs - they also take a note of all the positive things that happen in their day to day lives.

CBT - Ellis' rational emotibe behaviour therapy (REBT) - (ABCDE model)

  • central technique is to identify and dispute irrational beliefs
  • if patient is showing signs of utopianism the therapist can challenge these beliefs and have an argument with the patient to tell them that the thoughts are irrational
  • empirical argument - disputig whether there is actual evidence to show for patients irrational beliefs.

Behavioural activation - therapist may encourage patient to more active in day to day life.

24 of 31

Evaluatio of cognitive approach to depression

it is effective 

  • there is a lot of evidence which supports effectiveness of CBT
  • March et al - compared effectiveness of CBT and antidepressants and  the two combined in 327 adolescents. After 36 weeks of CBT, 81% of CBT group, 81%of antidepressent group and 86% of combined group showed significant improvements.
  • showing that CBT is as effective as medication.

CBT may not work for the most severe cases 

  • some sufferers can be so severly depressed that they cannot motivate themselves to get out of bed so do not go and attend CBT. Even if they do attend, they may not be able to fully engage.
  • in this case, antidepressants are probably best for patients - meaning that CBT cannot be used as the sole treatment for depression 

success may be due to therapist - patient relationship

  • a rapport is developed and sufferers have someone to talk to which alone may help.
25 of 31

Biological approach to explaining OCD

Genetic explanations genes create a vulnerability to developing OCD. 

Lewis - observation of 37% of OCD sufferers had a parent with it. 21% had siblings with it. Showing that it runs in families. Diatheses stress model explains how some people are more vulnerable. 

candidate genes 

  • specific genes create a vulnerability to OCD e.g. 5HT1-D is responsible for effeciency of transporting serotonin across synapse

OCD is polygenic 

  • OCD is caused by different variations of different genes. - up to 230 genes may be involved in determining if someone has OCD or not

different types of OCD 

  • aeotically heterogenous - different genes cause different types of OCD in ppl. 
26 of 31

evaluation of genetic explanations of OCD

there is good supporting evidence 

  • twin studies show that 68% of identical twins shared OCD and 31% of non identical twins shared OCD. 

too many candidate genes

  • twin studies suggest that there is a strong correlation between genetics and OCD but psychologists do not know all the genes which are actually invlolved.
  • each genetic variation only increases likelihood of getting OCD by a fraction.
  • genetic explanation provide little predictive value

environmental risk factors 

  • Cromer - found that over 50% of sufferers had experienced a traumatic event which made them develop OCD. 
  • it is better to focus of environmental factor because they are more predictable. 
27 of 31

Neural explanations of OCD

genes associated with OCD are highly likely to affect levels of key neurotransmitters as well as structures of the brain. 

role of serotonin 

  • serotonin is responsible for mood regulation
  • low levels of serotonin mean that mood relevant information does not get transmitted properly.
  • some cases of OCD can be explained by a reduction in the functioning of serotonin systems

decision making systems 

  • some OCD cases such as hoarding can be due to impaired decision making
  • abnormal functioning of the lateral sides of the frontal lobes can be a reason for impaired decision making 
  • frontal lobes are the parts of your brain which are responsible for logical thinking. 
  • left parahippocampal gyrus is associated with processing unpleasent emotions. 
28 of 31

Evaluation of neural explanations

there is some supporting evidence

  • some antidepressants which work solely on the serotonin system have been seen to reduce symptoms of OCD. 
  • OCD symptoms are similiar to some conditions which are biological in origin e.g. Parkinsons disease - showing that biological processes are also responsible for OCD.

it is not known which nerual mechanisms are involved 

  • research has identified other brain systems which are sometimes involved but there is not one system for OCD which has been found yet. 
  • so neural mechanisms are not fully understood

we should not assume the neural mechanisms cause OCD

  • there is evidence showing that OCD patiets have some abnormalyl functioning brain areas 
  • but this does not mean that the abnormal structures caused the OCD
  • OCD may have caused the abnormal functioning of neural structures.
29 of 31

Biological approach to treating OCD

drug therapies aim to increase or decrease neurotransmitter activity in the brain. 

SSRI's

  • selectie serotonin reuptake inhibitor
  • prevents serotonin reabsorption and breakdown meaning that there will be increased levels of serotonin in the synapse
  • daily dosage of Fluoxetine (20mg) is used - can be taken as liquid of capsules - takes 3 to 4 months for symptoms to go away

Combining SSRI's with other treatments 

  • SSRI's are often used in combination with CBT - drugs help emotional symptoms and feelings of anxiety and CBT helps patient to cope and understand their condition.

Alternative SSRI's 

  • Clomipramine - stronger than SSRI's, more sife effects, used if SSRI's do not work
  • SNRI's - increase serotonin levels and noradrenaline levels. 
30 of 31

Evaluation of drug treatments for OCD

effective at tackling OCD symptoms 

  • Soomro - review of studies comparing SSRI's to placebos - all 17 cases showed better overall outcome for those who had used SSRI's
  • effectiveness is greatest when the SSRI's are combined with therapies such as CBT
  • around 70% of ppls symptoms decline when drugs and CBT are used 
  • for remainign 30% - drug treatments or combinations of psychological treatments help

drugs are cost effective and non disruptive

  • drugs are cheap compared to psychological treatments - good value for NHS
  • drugs are not invasive so can be taken until symptoms decline without going to therapy

drugs can have side effects 

  • indegestion, blurred vision, loss of sex drive
  • side effects more common for clomipramine - 1 in 10 suffer erection problems, tremors and weight gain. 1 in 100 get very aggressive, suffer disruption to blood pressure & heart rhythm.
31 of 31

Comments

No comments have yet been made

Similar Psychology resources:

See all Psychology resources »See all Phobic disorders resources »