Psychopathology

Deviation from Social Norms.

-Rules and expectations of behaviour are called social norms

-Anyone who deviates are regarded as abormal.

EVALUATION:

-Deviating is not always a sign of psychopathology

-Social norms vary over time (homosexuality)

-Culturally Relative: Social norms are specific to particular cultues or societies. Therefore a behaviour can be seen as abormal in one culture may be a orm in the other.

-Norms of a society may have apolitical dimension. People may disagree with a policy may be deemed abnormal and locked up. So this definition can be used as a form of policitial control.

-Unable to experience normal emotions or engage in normal behaviours. When these dysfunctional behaviours interferes with daily functioning and the individual is able to see that they are suffering then they can diagnosis themselves.

Characteristics

- Unpredictible, uncontrollable, irrational behaviours

-Maladaptiveness interferes with routines

EVALUATION 

-Some behaviours may be normal depending on the context (prisoners on a hunger strike)

-Isn't always a psychological disorder but it could be down to stress of personal problems

-Culturally relative: Patterns of behaviours vary from cultures, so they may see 'failure to function adequately' in different ways.

Works on the idea that abnormality hould be based on infrequency: if it occurs rarely than it is abnomal. Therefore human attributes should fall into normal distribution within the population.

POSITIVE:

-Intutive: It is often an accepted definition for the world and has face validity.

-Objective: It is clear what is defined as abnormal and normal. There is no clear bias.

-Useful Overview: Looks at the whole picture, taking the whole population into account. This gives useful insights into the whole picture of a partiular characteristic.

NEGATIVE:

-Inflexible: States that scpres in the top and bottom (2.5%) of the pop are abnormal, but there are some behaviours which are deemed abnormal but do not fit in the percentage.

-Abnormal behaviours occur frequently: Depression, 25% of a population will experiene a mental issue at some point.

-Culture: Abnormalities could be wide spread in one culture because of its comparison to the rest of the world.

There are descriptions of normality and if some one does not fit within this, then their behaviour is abnormal. The individual should experience all of these criteria given by JAHODA, for optimum ideal mental health.

-Positive attitude towards self,  Self actualisation,  Autonomy,  Resistance to stress,   Environmental mastery and accurate perception of reality.

POSTIVE: Focuses on what is helpful and desirable for the individual rather than the other way around. It also allows for clear goals to be set and focused upon to achieve ideal mental health. (Jahoda: To achieve normality)

NEGATIVE: The criteria is impossible to achieve, and using this defiinition the majority of the population would be considered abnormal. This approach is also ethnocentric as non-western ultures cannot relate to the criteria outlined, which means the definition is not global. Finally it is subjective as it is difficult to state if someone has reached/fulfilled the criteria

Behaviour characteristics: 

Avoidance: Immediate response is to avoid it when presented with the feared object/situation

Panic: When unable to avoid it, results in panic, causing high levels of stress and and freezing. This is a component of of the flight or fight response. The freezing response is an adaptive response to make a predator think that their prey is dead.

Emotional Characteristics: Emotional response is triggered by the presence of feared object, whichis excessive in relation to the danger actually posed.

Excessive and Unreasonable fear  &   Anxiety and Panic.

Cognitive Characteristics

Selective attention: Fixated on the feared object because of their irrational beliefs

Irrational thniking: The phobia is defined by their irrational thinking towards the object.

The Two Process Model: Emphasises the role of learning in the development of phobias. Mowrer (1960): Phobias are learnt through classical conditioning and then continue because of operant conditioning.

He suggested that whenever we avoid a phobic stimulus we successfully escape the fear/anxiety reinforces the avoidance behaviour so the phobia is maintained.

Supporting Evidence: Watson & Little Albert. 11 month year old boy presented with various stimuli but showed no fear. A fear was induced. The fear was then developed to similar items such as santa's bread, fur coats etc. (Evaluation: Unethical, No informed consent, Unreblicable)

Evaluation of Explanation:

-Ignores biological explanations

-Deterministic as it suggesr that avoidance behaviour is motivated by anxiety reduction and any traumatic experience can lead to a phobia.

-Uses the principles of classical conditioning to replace a phobia with a new response

3 Critical components: 1)Fear Hierarchy: Client nd therapist work together and make  fear hierarchy, where they rank the phobic situation from least to most terrifying. 2) Relaxation Training: Is taught relaxation techniques, for example breathing techniques. 3) Reciprocal Inhibition: They are then exposed to their phobic situation, while relaxed as two emotional states cannot exist at the same time, so the relaxation takes over the fear.

EVALUATION: It's time consuming and expensive

SUPPORTING EVIDENCE: McGrath et al: Found that 75% of patients with phobias were successfully treated usin systematic desesitiation. However not effective in all phobias as some are developed through a persons experience so are not effetively treated.

Some phobias have an evolutionary survival benefit and not a result of personal experience which shows it is not successful in treating evoluntionary phobias

-More extreme behavioural therapy. Person is exposed to the most fightening situation immediately.The person is unable to avoid their phobia and through exposure, anxiety levels decrease. It Can take two forms VIVO: Actual exposure, VITRO: Imaginary exposure

-Patient is taught relaxation techniques and then these techniques are applied to their most feared situation either direct exposure or imagined exposure.

EVALUATION: -Cost effective: OURGIN found that compared to other techniques including systematic desesnisation and cognive therapies, it is significantly quicker.

-Highly traumatice and causes high levels of anxiety. Although patients provide informed consent, many do not finish their treatments as it is too stressful. So it could be a waste of time and money.

-Less effective for other types of phobias including social phobias and agoraphobia. Therefore complex phobias cannot be treated and may be more responsive to other forms of treatment.

Behaviour: Distrubances with their sleeping patterns, loss of energy, changes in appetite and weight gain/loss.

Emotional: Depressed mood, feelings of sadness/worthlessness and lack of interests in pleasure.

Cognitive: Diminished ablility to concentrate, focus on negatives and difficultly in paying attention and are often slower in making decisions.

Ellis' ABC Model: Good mental health is the result of rational thinking. The three model stage, is used to explain how irrational thoughts lead to depression.

A: Activating Event, an event that occurs. E.g a friend in the corridor at school ignores you, despite the fact that you said hello

B: Beliefs. Your interpretation of the event which could be rational or irrational.

C: Consequences: Irrational beliefs leads to unhealthy emotional outcomes including depression.

EVALUATION:  + Lead to therapies, including (CBT) and (REBT)

BOURY et al: Found that patients with depression were more likely to interpret info negatively (cognitive bias) and hopless about their future (negative triad). This does not explain the origin of irrational thoughs and ignores other factors such as genes that can cause depression

Beck's Cognitive Triad: Beck developed a cognitive explanation of depressrion which has 3 components

COGNITIVE BIAS: Beck found tht depressed people focus on negative aspects of a situation. They are prone to misinterpreting information.

NEGATIVE SELF-SCHEMAS: Interpret information about themselves negatively which can lead to cognitive biases

NEGATIVE TRIAD: Neative self-schemas and cognitive biases maintain the negative triad and an irration view of ourselves, our future and the world. For people with depression, these thoughts occur automatically and are symptomatic of depressed people.

-Involves both cognitive an behavioural elements. Cognitive elements aim to identify irrational amd negative thoughts and replce them with positive thoughts.Behaviourl elements encourages patients to test their beliefs through behavioural experiments and homework.

-CBT includes: Initial assesment, Goal setting, Identifying negatie thoughts and homework.

BECK'S COGNITVE THERAPY: Therapists will help that patient to identify negative thoughts. They will work together to challenge these irrational thoughts. The patient is encouraged to test the validity of their negative thouhts and set HW to test them.

ELLIS' RATIONAL EMOTIVE BEHAVIOUR THERAPY (REBT): Developed his ABC model to include D(dispute) & E(effective). The therapist will dispute the irrational beliefs to replace their irrational beliefs and replace them with positive effective beliefs. Including LOGICAL DISPUTE (Questions the logic of a person's thoughts), and EMPIRICAL DISPUTE (Where the therapist seeks evidence for a person's thoughts).

-Following a session the therapist may set HW. To allow them to identify their own irrational beliefs and then prove them wrong. As a result, their beliefs begin to change.

POSITIVE: 

-Research demonstrates it's effectiveness. MARCH et al found that it was as effective as anti-depression, in treating depression. However a combination of both treatments may be more effective.

NEGATIVE:

-Requires motivation and some sufferers may feel unmotivated to come, therefore the treatment will be uneffective

-Cannot be used as a sole treatment for severly depressed patients. Therefore an alternative treatment may be more effective as it does not require the same levels of motivation.

-Overemhasis on the role of cognitions, does not take into account other factors, for example: Someone in an abusive relationship do not need to change their negative belief but their environment (so the CBT will be ineffective).

Obsessions (reoccuring and persistent thoughts), Complusions (repetitive behaviours)

BEHAVIOUR CHARACTERISTICS: Repetitive, sufferers will often feel compelled to repeat a behaviour. Manage Anxiety, excessive behaviour caused by a fear which us a direct response to the obession.

EMOTIONAL CHARACTERISTIC: Anxiety caused by obessions. Depression. Low moods and loss of pleasure in everyday experiences which are interrupted by obsessie thoughts and repetitive complusions.

COGNITIVE CHARACTERISTIC: Obessessive thoughts. They know that their obessions and complusions are irrational and experience slective attention, directed towards the feared stimuli. Some adopt cognitve strategies to deal with their obessions, e.g praying over and over to avoid feelings of abnormality.

Genetic Explanations for OCD: Suggest that OCD is inherited and that individuals inherit specific genes which cause OCD. Genetic explanations have focused on identifying particular genes which are implicated in OCD and two genes have been linked to OCD.

COMT GENE: Associated with the production of OCD and regulates the neurotransmitter dopamine. One variation of the COMT gene results in higher levels of dopamine and this variations is more common in patients with OCD, in comparison ti people without OCD.

SERT GENE: Second gene which has been implicated in OCD is the SERT gene, which is linked to the neurotransmitter serotonin and affects the transport of the serotonin, causing lower levels of serotoninh, which is also associated with OCD (and depression).

Neural Explanations of OCD: Suggests that abnormal levels of neurotransmitters (serotonin and dopamine) are implicated in OCD.

NEUROTRANSMITTERS: Serotonin regulates mood and lowers levels of serotonin are associated with mood disorders. Some causes of OCD are also associated with reduced levels of serotonin which is caused by the SERT gene. Further support for the role of sertonin in OCD comes from examining anti-depressants, which found that drugs which increase levels of serotonin are effective in treating patients with OCD. In addition, Dopamine has also been implicated in OCD, with higher levels of dopamine being associated with some of the symptons of OCD, in particular compulsive behaviours.

EVALUATION: Lewis examined patients with OCD and found that 37% of patients with OCD had parents with the disorder and 21% had siblings suffered with OCD. 

Anti-depressants typically work by increasing levels of the neurotansmitter serotonin, reduces OCD.

However ignore factors and is reductionist.

Biological treatments for OCD aim to restore biological imbalances. Treatments are based on the assumptions that chemical imbalances are the main cause of the problem.

ANTI-DEPRESSANT DRUGS: SSRIs are one type of anti-depressant which include drugs such as prozac.

1) When serotonin is released from the pre-synaptic cell into the synapse, it travels to the receptor sites on the post-synaptic neuron.

2) Serotonin which is not absorbed into the post-synaptic neuron is reabsorbed into the pre-synaptic cell.

3) SSRIs increase the level of serotonin avaliable in the synapse by preventing it from being reabsorbed into the pre-synaptic cell. 

4) This increases levels of serotonin in the synapse and results in more serotonin bein recived by the post-synaptic neuron.

-Anti-depressants improve mood and reduce anxiety which is experienced by those with OCD

Negative:

-Negative side effects

-Suppresses symptoms, does not get rid of them

Positive:

-Cost-effective, in comparison to treatmeats

-Drugs are non-disruptive in comparison to CBT treatments

-Soomro et al: Conducted researh in the effectiveness of SSRIs, in 17 trials and found they were more effective than placebos in the treatment of OCD.