Psychopathology

Definitions of abnormality

Deviation from social norms is when someone does not abide by what society considers normal. A strength is that this distinguishes what is desirable and what is not, taking society into consideration. However, different countries have different norms and therefore this explanation may not have cross cultural validity, and societal norms change over time, affecting temporal validity.

Failure to function adequately is when the abnormality prevents someone carrying out a range of expected behaviours. Rosenhan and Seligman found abnormality to be irrational, unpredictable and their daily routines are affecting by maladaptive behaviour. A strength is that it considers the individual and is easilt observable by these criteria. However, FFA may be linked to social-economic problems rather than psychological problems so context must be considered, as well as the culture it is occurring in as failures may be considered differently elsewhere

Deviation from ideal mental health is when someone does not meet the criteria set by Jahoda which states someone must have high self esteem, self actualisation, ability to cope with stress,  amongst other factors. However, it is culture bound and difficult to meet all 6 criteria. 

Statistical infrequency is behaviour that is rare. It has practical applications but some abnormal behaviours are desirable

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Disorders

Phobias: a type of anxiety disorder with a persistent fear of an object or situation which the differe goes to great lengths to avoid. Emotions associated include fear, anxiety and panic. Cognitive characteristics include irrational thoughts and being able to recognise the fears are excessive and unreasonable. Behaviours include freezing, avoidance and feeling faint.

Depression: a mood disorder where the individual feels sad for most of the day, and lacks interest in their usual activities. Emotions include persistent sadness, loss of interest and pleasure in normal activities, and feelings of worthlessness. Cognitive characteristics include a negative view on the world and negative self beliefs. Behaviours include hyperinsomnia (sleep a lot) or insomnia (no sleep), loss of appetite or increase in appetite and self harm or suicide.

OCD: an anxiety disorder involving obsessions (persistent thoughts) and compulsions (repetitive behaviours). Compulsions are a response to obsessions. Emotions include anxiety, distress and embarrassment. Cognitive characteristics include intrusive and repetitive thoughts in the form of obsessions and doubts. Behviours include compulsions such as washing, counting or checking things. 

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Learning explanations of phobias and evaluation

Classical conditioning: the phobia is the association of two unrelated stimuli. The neutral stimulus is the phobic object; the unconditioned stimulus is experiencing something unpleasant; the unconditioned response is the fear. Over time, the neutral stimulus becomes the conditioned stimulus, and the unconditioned response of fear becomes the conditioned response. 

Operant conditioning: the phobia is maintained through negative reinforcement because avoiding the object provides relief as it removes fear. 

Watson and Rayner: showed classicial conditioning and phobias as fear of the rat happened because it was accompanied by a loud noise.

Research to support from Watson and Rayner

Led to successful treatments such as systematic desensitisation 

Ignores the role of biology and evolution such as innate phobias as they are not learnt from the environment 

Ignores all cognitive factors that make the fear irrational

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Treatment of phobias

Systematic Desensitisation: learning to associate the phobic item with relaxation, through counterconditioning, relaxation techniques and desensitisation hierarchy. 1) The patient is taught to deeply relax. 2) A desensitisation hierarchy is constructed. 3) Work gradually through the hierarchy, starting with the thing they fear the least, using counterconditioning and relaxation techniques. 4) Once that fear is overcome, the next most feared thing is approached. 5) Once they have mastered all steps the phobia is cured!

Flooding: The patient is immediately exposed to the thing they fear the most, for a long period of time. This makes the anxiety of the fear reduce the longer they stay, breaking the classical conditioning as they learn the fear is not realistic. 

Research to support from McGarth, who found that 95% of patients with phobias respond to SD. 

The treatments treat the root cause of the problem rather than purely the symptoms like biological drug treatments. It also means that the treatment is going to last longer.

Flooding has ethical implications due to extreme levels of stress and anxiety

Does not work for innate, survival based fears

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Cognitive causes of depression and evaluations

Mustabatory thinking: the source of irrational thinking. Certain assumptions must be true for an individual to be happy

Ellis' ABC model: faulty and irrational thinking prevents an individual from behaving in adaptive way. A is for Activating agent, B is for Beliefs being irrational, C is for Consequence (healthy or not)

Negative schemas: developed through a negative experience in life and causes negative views on life through interactions with others. The negative schema of expecting to fail happens when new situations are occuring that are similar to previous ones

Becks Negative Triad: negative view of self, future and world

Successful treatment with CBT shows that negative thinking must be in part, a cause of depression

Biological approach disagrees because and suggests mental illness is due to lack of serotonin

Lack of conclusive cause and effect, are irrational thoughts a cause or symptom? 

The approach blames the individual rather than any situational factors, the disorder may worsen

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Cognitive treatment of depression and evaluation

CBT: adjust patients thought processing by focusing on the impact of thoughts on behaviour.

1) Trusting relationship developed. 2) Patient explains problems freely 3) Common problems identified using thought catching 4) Ideas challenged using Logical Disputing, challenging whether beliefs make sense, Empirical Disputing, questioning whether there is any evidence of accuracy, and Pragmatic Disputing, enquiring whether the belief is helpful. 5) Strategies are developed, such as practicing techniques taught, behavioual activation by doing thing they used to enjoy and noting down when their irrational thoughts occur.

Hollon: Participants given CBT, drugs, behavioural activation or a placebo. Found that 49% responded well to drugs, 48% to CBT, 76% to behavioural activation. Proved that psychological treatments work just as effectively as biological treatments. 

Research to support from Hollon shows psychological treatments are just as effective.

This is an ideographic treatment as it focuses on and can be tailored to an individuals needs

Time consuming so the patient may tire of it and not complete it

Doesnt work for those whose depression is biologically based.

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Biological approach to OCD and evaluations

Neurotransmission: dopamine is associated with learning pathways and there are high levels of it in people with OCD. This means obessions and compulsions temporarily curing them are learnt faster. Serotonin is associated with happiness and anxiety levels and there are low levels of it in those with OCD. This means anxiety levels are constantly higher. 

Genetics: The COMT gene regulates the production of dopamine and it results in higher levels of dopamine. The SERT gene regulates the transportation of serotonin and leads to lower levels of it. Billet: concordance rates are 68% in identical twins and 31% in DZ twins.

Diathesis stress model: we are genetically predisposed to attain a behaviour but in order for its onset, there must be an environmental trigger. The genes increase a chance but it requires stimuli.

Biological structures: In a normal process, worry signals are sent from the orbifrontal cortex to the caudate nucleus. The nucleus suppresses the signals and the thalamus takes no action. In an OCD process, the caudate nucleas is faulty so does not suppress the worry signals, causing panic 

Research to support from Billet and successful drug treatments show there is biological basis

Concordance rates are never 100% so there must be other factors and it ignores other factors 

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Biological treatments of OCD and evaluation

SSRIs: type of anti-depressant that block the reuptake of serotonin at the synapse. Serotonin is still made but it results in an increased concentration of serotonin at receptor sites

Tricyclics: type of anti-depressant that also block the reuptake of serotonin and noradrenaline. They have more severe side effects than SSRIs

Benzodiazapines: reduce anxiety by slowing down neurotransmission through enhancing activity of GABA. GABA locks to receptor sites to increase the flow of the chloride ions into a neuron, making the stimulation of that neuron harder

Koran: SSRIs and Olanzapine combined showed OCD symptoms scores to drop by 16% overall. Shows that simultaneous drug therapies can be better.

Research to support from Koran showing effectiveness of drug treatment

Drugs are cheaper and also self administered. This makes them more accessible and improves the economy as people can get back to work faster

Side effects can lead to discontinuation and they are palliative as they treat only the symptoms, meaning the chance of relapse is much higher. It is also nomothic and everyone is treated as though they all have the same symptoms.

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