Abnormality

What is deviation from social norms?

Behaviours that deviate from the unwritten rules about how one 'ought' to behave.

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Why is the deviation from social norms explanation limited?

Defining behaviour as abnormal is pointless without considering cultural context e.g. schizophrenia would be seen as a gift in zulu culture There are no univeral standards for labelling behaviour as abnormal.

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How is deviation related to context and degree?

Judgement depends on context for example, walking around in a bikini on a beach holiday would be normal, but in a cold country it would not be. Also there's no line between what is eccentric and what's abnormal.

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What is faliure to function adequately?

When abnormal behaviour interferes with daily functioning e.g. if depression or anxiety stops a person from leaving their home.

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How can abnormal behaviours help us to function? (evaluation)

Can lead to helpful intervention from others e.g. depression may lead to extra help. Behaviours that appear to be dysfunctional could be adaptive for an individual.

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How is the failure to function adequately explanation limited?

Because they're related to cultural ideals of how life should be lived. Likely to produce different diagnoses when applied to people from different cultures. Lifestyle differencs can be misinterpreted as failure to function adequately.

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What is deviation from ideal mental health?

Positive mental health is defined in terms of Jahodas criteria (six characteristics) including Integration and Self attitudes. Absence of the criteria indicates abnormality.

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Whats the main critisism of deviation from ideal mental health?

Few people can achieve all the criteria, all of us would be abnormal to some degree. Need to ask how many criteria need to be absent before someone is seen to be abnormal.

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Why is the deviation from ideal mental health explanation limited?

Because the criteria mainly apply to individuals in western cultures. Inappropriate to apply them to other cultures as it may lead to over diagnosis of abnormality.

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What is the behavioural approach to abnormality?

Believes that behaviours are acquired as a result of life experiences and assumes that abnormal behaviours are learned through operant and classical conditioning and social learning.

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How is the behavioural approach critisised for having a limited view on factors?

It ignores important influences that may contribute to abnormal behaviour such as genetics and emotional influences.

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What is the counter evidence that challanges the behavioural approach to abnormality?

Explanation of phobias focus' on conditioning yet many people cannot remember an incident that lead to this.Some basic anxieties e.g. fear of heights may be 'hard wired' into the brain because they provided a survival advantage to distant ancestors.

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What is the cognitive approach to abnormality?

Explains psychopathology in terms of irrational and negative thinking about the world. Mental Disorders arise out of distortions in the way that people think about a situation and faulty control.

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What's the ABC model?

Part of the cognitive approach. A - acitvating event. B - the belief (rational or irrational). C - the consequence (healthy or unhealthy)

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What is the cognitive triad?

Links to the ABC model. Show's that there's a vicious cycle. Negative view of self leads to a negative interpretation of experience which then leads to a negative view of the future, cycle starts again.

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Why is 'blaming' the patient, a weakness of the cognitive approach?

It overlooks factors which may be beyond the patients ability to change e.g. lives of depressed people are usually extremely stressful and deficient in financial and social resources.

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Faulty thinking may be a consequence rather than a cause of psychophathology, expand on this weakness of the cognitive approach

It is possible that an idivudial develops negative thinking as a result of their disorder. Lewinsohn et al measured distorted congnitions and found no difference between thouse who eventually developed depression and those that did not.

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What is the biological approach to abnormality?

Assumes that mental disorders are caused by physical factors. It may be due to genetic inheritence, neuroanatomy, neurochemistry or viral infection

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Explain genetic inheritence in relation to the biological approach

Suggests mental illness may be inherited so that people who are related are more likely to develop the same disorders e.g. there's a high concordance rate for schizophrenia however not for phobias.

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Explain neuroanatomy in relation to the biological approach

Abnormalities in the structure of the brain can be caused by ageing disease etc. Some schozophrenics have enlarged ventricles in the brain and shrinkage of brain tissue around the ventricles.

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Explain neurochemistry in relation to the biological approach

Altered brain chemistry may lead to abnormality, particularly changes to the activity of neurotransmitters. Low levels of serotonin have been found in the brains of depressives and high levels of dopamaine in the brains of schizophrenics.

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Explain viral infection in relation to the biological approach

Mothers of some schizophrenics had contracted a strain of the influenza virus during pregnancy. The virus appears to remain dormnat until puberty when hormones may activate it and cause the symptoms of schizophrenia

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There is inconclusive evidence for the role of genetic inheritence in the development of psychopathology, explain this critisism of the biological approach

If genetic inheritance was the sole cause, if one identical twin was mentally ill, the other must be too. Gottesman and Shields: one twin developed schizophrenia there's a 50% chance of the other twin developing it.

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Biological factors may not be a cause but a consequence, explain this critisism of the biological approach

Low levels of serotonin may be a consequece of becoming depressed. In the research on enlarged ventricles it is not clear whether shrinkage is a cause or a causequence (e.g. of medication) Can't assume a cause-effect relationship.

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What is the psychodynamic approach to abnormality?

Assumes that mental disorders have psychological causes such as unresolved conflicts oof childhood which are unconcious.

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How do early experiences cause mental disorders? (psychodynamic approach)

The ego (concious rational part of personality) is not developed enough to deal with trauma such as the loss of a parent, this leads to the repression of emotions which may be re-experienced later in life due to more losses, could lead to depression.

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How can unconcious motivation cause mental disorders? (psychodynamic approach)

The unconsious mind exerts a poweful effect on behaviour. This frequently leads to distress as the person does not understand why they are acting in that particular way. The problem cannot be controlled until it is brought into concious awareness

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Why is there a lack of research support for the psychodymanic explanation of psychopathology?

Much of the support is individual case studies. However, Fisher and Greenberg looked at over 2,500 experimental studies many of which supported freud. Most claims cannot be disproved which is necessary for it to be seen as a scientific explanation

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Many od the key concepts are abstract, expand on this weakness of the psychodynamic approach

This makes them hard to demonstrate as they are not concrete entities e.g. id, ego and super ego. No way to know that a process such as repression is operating as it takes place at an unconsious level. Difficult to conduct research to demonstrate.

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What are the two biological therapies for the treatment of abnormality?

Drugs and Electroconvulsive therapy

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Explain how antipsychotic drugs work and give examples

Used to combat symptoms of psychotic illnesses e.g. schizophrenia. They block the action of dopamine so alleviate symptoms of schizophrenia. Conventional (bind to receptors without stimulating). Atypical (temporarily bind, allow normal transmission).

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Explain how antidpressant drugs work and give examples

Used to relieve symptoms of mood disorders such as depression. SSRIs prolong the action of serotonin at the synapse. Work by either reducing the re-absorption rate of a neurotransmitter or blocking the enzyme that breaks down the neurotransmitters.

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Explain how anti-anxiety drugs work and give examples

Benzodiazepines enhance the acitivity of GABA which causes changes within neurons in the brain making it harder for them to be stimulated. Beta blockers lower the activity of the sympathetic nervous system (heart beat, blood pressure)

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What research shows that drug therapies are effective in the treatment of mental disorders?

a WHO report found that antipsychotics were more effective than a placebo in treating schizophrenia. Drugs play an important role in the treatment of mental disorders, however, treatment with drugs alone is less effective than combined with others

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How could drug therapies be seen as better than psychological treatments such as stress inoculation?

Drugs are easy to use and require little effort from the patient, they do not have to spend hours attending therapy, it is less time consuming. So patients may be more likely to opt for this treatment.

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What is the main critisism of drug therapies?

Drugs have side effects. E.g. SSRIs may cause anxiety, nausea and sexual dysfunction. Antipsychotics also have side effects, 30% of patients have tardive dykinesia. The side effects may outweigh the inital disiorder.

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How does ECT work?

Consists of passing an electrical current through the brain to produce a seizure. Strength needed varies from person to person. ECT is delivered either unilaterally (electrode on temple of non-dominant side of brain) or bilaterally (one on each).

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Why does ECT work?

Neurotransmitter, causes release of neurotransmitters such as serotonin. Ant-convulsant, seizures teach the brain to try to resist them, dampen abnormally active circuits. Brain damage, causes memory loss/disorientation, illusion that problems gone

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What research suggests that ECT is effective in the treatment of depression?

Leiknes et al, reviewed data from 90 randomised control trials. Showed 'real' ECT was superior to the 'sham' ECT and antidepressants. Rose et al: people who found it helpful 30-80%. Reported lower satisfaction levels when conducted by patients.

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What is the main criticism of ECT?

It has side effects. Evidence that it can cause cognitive impairment, greater in those who received bilateral (Leiknes). A report found that 30% of patients said it left them with fear and anxiety. Reducing the risk means reducing the dose.

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What's the aim of psychoanalysis to treat abnormality?

To make the unconscious conscious and find the causes of a persons abnormal behaviour

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How does psychoanalysis work?

Three stages: free association, therapist interpretation and working through

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What is free association in psychoanalysis?

The patient expresses thoughts exactly as they occur, regardless of whether they appear to be unimportant. This reveals areas of conflict and brings repressed memories into consciousness.

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What is therapist interpretation in psychoanalysis?

Therapist draws tentative conclusions about the possible causes of the problem. Patients may resist the confusions or display transference where they recreate feelings associated with the problem and transfer them onto the therapist.

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What is working through in psychoanalysis?

Patient and therapist examine issues to gain greater clarity concerning the causes of their behaviour. Produces the greatest changes in the patient and is a distinguishing feature of psychoanalysis.

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What research supports the effectiveness of psychoanalysis in the treatment of abnormal behaviour?

DeMaat et al reviewed studies, concluded that it produced significant improvements in symptoms, maintained years after the treatment. Cogan and Porcerelli compared patients at the beginning/end, latter had lower scores in depression/anxiety.

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How is psychoanalysis culturally biased against people from non-western cultures?

Sue & Sue argued that members of asian cultures tend to discuss intimate matters with family. May not value insight. In China a person who is depresses avoids the thoughts that cause distress rather than being willing to speak about them openly.

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Explain the issue of false memories in relation to psychoanalysis

Critics claim that therapists are not recovering repressed memories but planting false ones e.g. of sexual abuse. Loftus showed that it is possible to induce false memories which can become vivid. Assumes patients accurately recall repressed memories

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What are the three main components of systematic desensitisation?

Relaxation training: patients are taught how to relax, usually with a muscle relaxation method. Desensitisation hierarchy: stimuli ordered according to amount of anxiety they cause. Counterconditioning: each item on the hierarchy is presented.

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What are some means of confronting the feared situation used in systematic desensitisation?

'in vitro' exposure: through imagination and visualisation of the feared situation. 'in vivo' exposure: actual encounters with the feared situation. 'modelling' - vicarious e.g. patient observes someone else going through SD for the same phobia

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Why is SD being relatively quick a strength?

It requires less effort on the patients part so they are more likely to persevere, making treatment more likely to succeed. SD can also be self administered using computer simulations, Chandler found this was effective in the treatment of agoraphobia

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What kind of anxiety disorders in SD effective for?

McGrath et al, estimated 75% effective in patients with specific phobias such as arachnophobia. Capafons et al found that people with acrophobia had less anxiety after SD than control group and showed lower physiological signs of fear in flight sim.

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What is the aim of rational emotive behaviour therapy (REBT)? (cognitive)

Helps the client understand the irrationality of their thinking and the consequences of thinking this way. Aims to help them change their self defeating thoughts and as a result become happier and less anxious.

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How does REBT work?

Tries to change irrational beliefs about the activating event in to rational beliefs and therefore produce healthy consequences. Patient is encouraged to dispute their irrational belief. DEF (disputing leads to an effective attitude and new feelings)

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Explain the three types of disputing in REBT/cognitive therapy

Logical - shown that their beliefs do not follow logically from the information available. Empirical - client shown that their beliefs are not consistent with reality. Pragmatic disputing - client shown the lack of usefulness of their beiefs

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What's a strength of REBT/cognitive therapy?

Usefulness not limited to those suffering from mental disorders, useful for others e.g. students with exam anxiety. Effective even in the absence of a therapist. Yoichi et al developed a computer based programme based on REBT that is effective.

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REBT is effective in the treatment of different disorders, give evidence to support this

Meta analysis by Engels et a showed it to be effective with both OCD and agoraphobia. Also effective on 'non targeted variables' e.g. blood pressure (physiological changes) as well as targeted variables e.g. feelings of anxiety.

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How many REBTs influence be limited?

It cannot change environments, clients may be in an abusive marriage or work with an overly critical boss which reinforces dysfunctional thoughts/behaviours. Shows the irrational thoughts may not always be irrational - the environment needs to change

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Abnormality

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