PsychoPathology

• Deviation from Social Norms, 2. Failure to Function Adequately, 3. Statistical Infrequency, 4. Deviation from Ideal Mental Health

Abnormality seen as Behaviour that breaks unwritten rules about acceptable conduct. behaviour is unexpected by other group members and offends the other members of that society in some way (any behaviour abnormal if it goes against the accepted, expected and approved ways of behaving in a society.)

The main difficulty with this definition is that social norms change and vary as times change. What is socially acceptable now may not have been socially acceptable 50 years ago. For example, today homosexuality is acceptable but in the past it was included under ‘sexual and gender identity disorders’ in the DSM. Furthermore, people who were initially affected by the social norm may show eccentric behaviour, until the social norms finally changed.This means that people would be classed as abnormal at the times for being homosexual and showing eccentric behaviour, but not in these times as the social norms have changed. This lack of consistency reduces the reliability of this definition of abnormality. This definition of abnormality has been criticised because social norms differ between cultures. In order words, norms are culturally relative. For example, hearing voices is viewed as a deviation from social norms in our cultures but in others, its accepted and seen as a “God given gift”. This is a problem as it is argued a reliable definition should be consistent between cultures. One strength of this definition is that it is a more appropriate definition of abnormality, especially when compared to the ‘statistical infrequency’ definition. This is because it distinguishes between desirable and undesirable behaviour and the effect the behaviour has on others. For example, spending a lot of time washing your hands may not be statistically infrequent, but it can have a more damaging effect on the person and their loved ones compared to a behaviour that would be classed as statistically frequent; so abnormal

Failure to function adequately means that a person is unable to deal with the demands of everyday living. Not functioning adequately causes distress and suffering for the individual, and may cause distress for others. Rosenhan & Seligman criteria: MUSIC Maladaptive behaviour – this refers a behaviour where a person is stopping themselves from progressing Unconventionality (odd) – so in order to be abnormal their behaviour needs to be odd in someway Suffering - they suggest that an abnormal person should be suffering in someway Irrational – this refers to instances where someone may act a certain way which people can’t understand Unpredictability and loss of control – most people tend to behave in a fairly predictable way on the other hand an abnormal person is expected to act in an inappropriate manner. The more features a person shows the more abnormal theyre seen to be

patients perspective- checklist One strength of the definition is that it recognises the patient’s perspective. This allows us to view the mental disorder from the point of view of the person experience it. For example, the level of distress experienced by the patient is considered when defining their behaviour as abnormal. This suggests that failure to function adequately is a useful criterion for assessing abnormality as it provides a checklist which patients can use to help them perceive their level of functioning. X The definition is limited by cultural relativism. For example, long periods of grief after bereavement is more acceptable in some cultures than others. This means that exactly the same behaviour could be defined as abnormal because it is viewed as a failure to function in one culture, yet functioning adequately in another. This is a problem because for the definition to be classed as reliable, the same behaviour should be viewed consistently between cultures. Individual differences the issue of individual differences. for example, one person who hears voices may be abke to function adequately, whislt someone w the same symptoms may not be able to. this means that even tho they have the same sympotms, they would be diagnsoed differently according to this definition, questioning validity

A persons trait, behaviour or thinking would be considered to be abnormal if it was found to be numerically rare. the characteristics of the behaviour are less common. focuses on the quantity of behaviour measured in standard deviations from the mean rather than the quality. (statistically rare requires us to examine a normal distribution curve in order to identify what proportion of people share the characteristics or behaviour being looked at. In statistical terms, human behaviour is abnormal if it falls outside the range that is typical for most)

X One strength of the statistical infrequency definition is that it is an objective way to define abnormality, as a clear ‘cut off’ point has been agreed. This makes it easier to decide who meets the criteria to be labelled as abnormal in comparison to other definitions, and prevents misdiagnosis of people into thinking theyre abnormal which may cause them more harm than good. Therefore this definition is seen as less subjective than the other definitions. . X The main problem with this definition is that there are many abnormal behaviours that are actually quite desirable. For example, very few people have an IQ of over 150, yet it would not be suggested that having a high IQ is undesirable. Equally, there are some normal behaviours that are undesirable. For example, experiencing depression after a painful experience is quite common, yet it is undesirable. This is a problem when planning treatment as only undesirable behaviours need to be identified. Therefore, the definition would never be used alone to make a diagnosis. X The statistical infrequency definition may be culturally biased. This is because there are some behaviours that are statistically infrequent in some cultures but are more frequent in others. For example, one of the symptoms of schizophrenia is claiming to hear voices. However, this is an experience that is common in some cultures. This is problematic as the statistical infrequency definition would class these individuals as abnormal even when they were displaying normal behaviour, so the definition can only be used to define abnormality in some cultur

attempts to define the criteria required for normality. absence of signs of mental health used to judge abnormality . the more criteria someone fails to meet, the more abnormal they are. Six characteristics by Jahoda PRAISE P - perception of reality - should be able to see the world as it is R - resistance to stress - being able to cope with stressful situations A - self-Attitude - High self-esteem and a strong sense of self-identity. I - Independence) - They should function as independent individuals. S - Self-actualisation (personal growth) – Being focused on the future and on fulfilling their potential. E Environmental Mastery – The ability to adjust to new situations; functioning at work and in relationships with others. The fewer of these qualities you have, the more abnormal you are seen to b

holistic approach One strength of this definition is that it offers a holistic perspective on mental disorders. This is because the definition focuses on the positives rather than the negatives. this is ecause it looks at a range of characteristics, looking at more aspects of a person that can affect their health and wellbein. furthermore, it focuses on the positive aspects, which can help an idnivudal have a higher self esteem - X The definition may be culturally biased(ethnocentric). This is because the ideals of mental health are not applicable to all cultures. For example, the criterion of self-actualisation is relevant to members of individualistic cultures but not collectivists’ cultures, where individuals strive for the greater good of the community rather than for self-centred goals. This is a problem because for the definition to be classed as reliable, the same behaviour should be viewe consistently between cultures. **subjective diagnosis ** One of the major criticism of this definition is that it is unclear how many criteria need to be lacking before we are seen to be ‘deviating from ideal mental health’.In order to make this decision, a subjective judgement must be make. In other words, it is left to individual psychiatrists to judge whether someone is deviating enough to be diagnosed and this could lead to inconsistency. This lack of objectivity means that this definition of abnormality is rarely used in the real world.

Phobias are a type of anxiety disorder. All phobias are characterised by excessive fear and anxiety, triggered by an object, place or situation. The extent of the fear is out of proportion to any real danger presented by the phobic stimulus. however limitation is that not all phobias are trigered by a traumatic experience, phobias may have a biolical bases which

Panic: in response to the presence of a phobic stimuli. Panic can be in the form of behaviours such as crying, screaming, running away or freezing. Avoidance: As anxiety increases by being close to the feared situation, it is natural to avoid certain situations where the object will be. Disruption of Functioning: Anxiety and avoidance responses are so extreme that they severely interfere with the ability to conduct everyday working and social functioning.

Anxiety: An unpleasant state of high arousal which makes it very difficult to experience any positive emotions. The anxiety experienced can be long term. It is due to the presence of or anticipation of feared objects and situations. Fear: The emotional responses of fear which accompanies many phobic stimuli is often extremely unreasonable. For example, an individual’s fear of spiders will involve a very strong emotional response to a tiny, harmless spider. This fear is disproportionate to the actual danger posed by the spider.

Irrational beliefs: Sufferers often hold irrational beliefs in relation to the phobic stimuli. also very resistant to rational arguments, Selective attention: Sufferers will often look intently at a phobic stimulus and find it very difficult to look away from them. It is usually useful to keep our attention on something dangerous so we can react to the threat quickly. However, it is not useful when the fear is irrational as this can interfere with day to day life.

Behaviourists argue that like any behaviour, phobias are learned through the environment. The Two-Process Model (A01) According to the two-process model (Mowrer, 1960), phobias are acquired (learned in the first place) by classical conditioning and maintained (continue) because of operant conditioning. Classical conditioning: initiation (how phobias are acquired) A phobia is acquired through the association of a response such as fear with a stimulus. This learnt response is now trigerred whenever they see the stimulus. the phobia is generalised to similar situations. Operant Conditioning: (how a phobia is maintained) phobia maintained as its reinforced by feeling calm eg when avoiding the stimulus With negative reinforcement, an individual avoids a situation that is unpleasant. avoiding the phobic stimulus allows them to escape the fear and anxiety that they would have suffered if they had remained. This reduction in fear reinforces the avoidance behaviour and maintains the phobia.

A strength of the behaviourist explanation of phobias is that there is supporting evidence. Watson and rayner demonsated the process of classical conditonign in forming a phobia in little albert who was conditoned to fear white rats. this shows classical conditoning ivolvement in acquing a ohobia, and he later generlsised his phobia onto any small white object sgowing operant. howver case study- cant be generalsied The behaviourist explanation of phobias has practical applications. There are several behavioural therapies which use the principles of conditioning to successful treat phobias. For example, ‘systematic desensitisation’ (which uses classical conditioning to ‘unlearn’ previously learned phobias) has been shown to be an extremely successful therapy for a range of different phobias. Evidence to support this comes from McGrath et al (1990) who found that 75% of phobic patients showed an improvement in their symptoms after treatment. The success of these treatments strengthens the validity of the behaviourist explanation of phobias. The behaviourist explanation has also been criticised because it fails to explain the cognitive aspects of a phobia. For example, a person in a lift may think ‘I could become trapped in here and suffocate’. This irrational thought may trigger a phobia, which hasnnt been taken into consideragion, shwoing environemntal reductionism. This is a weakness as the behavioural explanation is failing to explain a vital component of the disorder, and cognitive psychologists would argue that cogntive factors play a huge role in the developing of a phobia. An approach that incorporates both the behavioural and cognitive components of a phobia is therefore required in order to provide a thorough explanation of the disorder.

behavioural therapy designed to gradually reduce phobic anxiety through the principles of classical conditioning,counterconditioning, which leads to eventual extinction. (new response to the phobic stimulus is learned (phobic stimulus is paired with relaxation instead of anxiety). There are three processes involved in SD. 1. Anxiety Hierarchy – list designed by the therapist and phobic client into an order of least feared to most feared situations. the client and therapist will identify fearful situations involving a phobic stimulus such a seeing a picture of phobic stimulus or seeing one in a eg jar and will rank these from lowest to highest. 2. Relaxation -client will use relaxation by controlling their breathing. showing them a picture of phobic stimulus and encouraging the client to use their calming technique(s) to relax and not moving on until they are relaxed. fear and relaxation cant coexist so known as reciprocal inhibition 3. Exposure – patient is exposed to a phobic stimulus/ anxiety hierachy whilst in a relaxed state. The patient starts at the bottom of the fear hierarchy, and when they can remain relaxed at that level, they progress onto the next level. Over several sessions, the patient gradually moves their way up the hierarchy, SD is successful when the patient can maintain relaxation in the most feared level on the hierarchy. Exposure can be done in two ways: ◦ In vitro – the client imagines exposure to the phobic stimulus. ◦ In vivo – the client is actually exposed to the phobic stimulus.

Evidence, McGrath ✓ A strength of systematic desensitisation is that it has been proven to be effective at treating phobias. For eg, McGrath reported that 75% of patients showed an improvement in their symptoms after systematic desensitisation. This evidence is a strength because it shows that systematic desensitisation can be used to treat the majority of sufferers, and that the effects are long lasting. Low attrition rates, less traumatic A second strength of systematic desensitisation is that sufferers tend to prefer it to the alternative behavioural therapy of ‘flooding’ and is more successful than flooding. This is largely because it does not cause the same degree of trauma as flooding and allows people to make progress in small steps rather than that require by the therapist. This is supported by the fact that SD has low attrition rates(the number of people dropping out of treatment is low as gradual exposure allows respite). This matters because SD is able to help a higher number of patients than flooding. It also empowers sufferers to choose a therapy that is most acceptable to them. Not effective for phobias w evolutionary component a limitation is that it isn’t effective for all phobias. for example, phobias which an individual hasn’t acquire through personal experience, are less successfully treated with s.f. This is reinforced by Ohman, who suggested that s.d may not be as effective in treating phobias that have an underlying evolutionary component. this is a weakness as it demonstrates its only useful for certain specific phobias, which may not have a detrimental effect on an individua w a phobia w an innate basis. restricted in its usefulness

Flooding immediate exposure to the phobic phobic stimulus until extinction of fear response occurs. prevention of avoidance Usually one long session is used in which the patient experiences their phobia at its worst, while at the same time practising relaxation. Flooding stops phobic responses very quickly. This may be because the patient cannot avoid the stimulus. Therefore they quickly learn that the phobic stimulus is harmless. In classical conditioning terms, this processes is called ‘extinction’ A learned response (CR) is extinguished when a CS (e.g. dog) is encountered without the UCS (e.g., being bitten), resulting in the CS no longer producing the CR (fear).

Evidence effective as S.D, but sig quicker ✓ One strength of flooding is that it is a cost effective treatment for phobias. Research has shown that that flooding is just as effective at treating phobias as SD, however it is significantly quicker (Ougin, 2011). This is a strength as patients are free of their symptoms as soon as possible, and this makes the treatment cheaper than SD. traumatic, high attrition rates X Perhaps the most serious issue with flooding is that it is a highly traumatic experience for patients. The problem is not that flooding is unethical (as patients will have given consent) but that patients are often unwilling to see it through to the end. also has higher attrition rates. This is a limitation of flooding because time and money are sometimes wasted preparing patients only to have them refuse to start or complete treatment. not effective for phobias w cognitive components X Finally, although flooding is highly effective for simple (specific) phobias, the treatment is less effective for other types of phobias, including social phobia and agoraphobia. This is because behavioural treatments are unable to treat the irrational thinking that is more common with these complex phobias. This suggests that other forms of treatment, such as CBT, which treats the irrational thinking, may be a more effective method of treating social and agoraphobia. This is a problem because it appears that flooding is restricted in its usefulness to just specific phobia

Disruption of Sleep and Eating - Depression is associated with disruption in our normal eating and sleeping behaviours. Insomnia (reduced sleep) and hypersomnia (increased need for sleep) are common and appetite can also increase or decrease with depression, which can lead to weight loss or gain. Loss of energy - Some depressed people have reduced energy resulting in fatigue, lethargy and high levels of inactivity e.g. they may struggle to get out of bed and do usual daily activitie

Depression is classified as a mood disorder characterised by low mood and low energy levels. DSM-5 distinguishes between major depressive disorder, which is severe but often short term, and persistent depressive disorder, which is longer term and/or recurring.

Sadness - Sadness is the most common description people give of their depressed state, along with feeling empty. Associated with this, people may feel worthless, hopeless and/or experience low self-esteem. Anger - Negative emotions can, also be shown in the form of anger. This anger can be directed as aggression towards oneself (e.g. self-harming) or towards others (e.g. close family member

Focusing and dwelling on the negative - People with depression often view themselves, the world and the future in negative ways. They may have a bias towards reporting unhappy events in their lives rather than happy events. Such negative thoughts are irrational i.e. they do not accurately reflect reality. Poor Concentration - Sufferers often find themselves unable to stick to a task or make decisions (indecisiveness). This is then likely to interfere with a sufferer’s work and ability to communicate.

Compulsive Behaviours - Sufferers feel compelled to repeat certain behaviour in order to reduce anxiety. behaviours are externally visible and repetitive. eg hand-washing,tidying/ordering. compulsions are external components because they are behaviours. Avoidance - OCD sufferers may avoid situations which usually trigger their anxiety. The aim being to reduce anxiety through avoidance.