PSYCHOPATHOLOGY (ABNORMALITY) You will learn about: Definitions of Abnormality Theories of Abnormality Treating Abnormality

Abnormality is… A psychological condition or behaviour that departs from the norm or is harmful and distressing to the individual or those around them. Behaviours that violate society’s ideas of what is an appropriate level of functioning.

Learning Objectives Define : Deviation from the social norms By the end of this lesson you will be able to Define : Deviation from the social norms Identify: Some of the indicators of Deviation from the social norms adequately Identify: Two or more limitations to this definition

Definitions of Abnormality Deviation from Social Norms Abnormal behaviour is seen as a deviation from implicit rules about how one ‘ought’ to behave. Anything that violates these rules is considered abnormal.

Limitations Cultural: what it Acceptable behaviour in one culture may not be acceptable in another. Consistent through time: These ‘rules’ vary across time and across . What was acceptable behaviour 50 years ago may not be acceptable now,.

Behaviour that deviates From social norms is not always considered Limitations Behaviour that deviates From social norms is not always considered abnormal. E.g. eccentric behaviour, superstitious behaviour or dressing up for charity.

Limitations Deviations can Become political e.g. where certain regimes use diagnosis as a means of controlling those with opposing political views e.g. Russia

Test Your Knowledge Answer these questions on last weeks lesson. Define: What is meant by social norms? Describe: The deviation from social norms definition of abnormality? Identify: An example of behaviour which deviates from social norms? Explain: Three limitations of this definition?

Learning Objectives Define : Failure to function adequately By the end of this lesson you will be able to Define : Failure to function adequately Identify: Some of the indicators of the failure to function adequately definition Identify: Two or more limitations to this definition

Failure to Function Adequately Mentally healthy people are judged as being able to operate within certain acceptable limits. If abnormal behaviour interfered with daily functioning, it may be considered abnormal.

Limitations It is possible that some apparently dysfunctional behaviour is actually adaptive and functional for the individual, e.g. some anxiety disorders may lead to extra attention for the individual, and so are functional in reaching this goal.

Limitations Context – Behaviour that appears to be FFA may be normal depending on context e.g. political prisoners going on hunger strike. Outside factors causing the behaviour – economic factors, prejudice and discrimination may prevent people from acting normally. Coping normally – Some people namage to function normally despite being clinically diagnosed with psychological disorders.

Learning Objectives Define : Deviation from mental health By the end of this lesson you will be able to Define : Deviation from mental health Name: 4 characteristics of someone with normal mental health Identify: Two limitations to this definition

Deviation from Ideal Mental Health Abnormality is seen as deviating from the Ideal Person,

What is a Normal Person Jahoda – A normal person should be… In touch with their own identity and feelings. Resistant to Stress. Focussed on the future and self-actualisation Autonomous individuals with an accurate idea of reality. Empathy and understanding of others. positive attitude towards the self,

Limitations According to these criteria, most of us are abnormal in some way. We should instead ask how many of these need to be lacking before a person would be judged as abnormal.

However, it has been argued that Limitations Physical health vs Mental Health: Why are we looking at the idea person rather than looking at the problems presented. In Physical health we Always look at the area that is causing pain. However, it has been argued that there are non physical reasons for mental health problems therefore we need other methods of diagnosing it.

Limitations Cultural relativism: Jahoda’s characteristics are too westernised Individual Cultures: Work towards individual achievements (Self actualisation) Collective Cultures: Work towards the good of the group.

The Biological Model of Abnormality The medical/biological model of abnormality is the most widely accepted model of mental illness, because the dominant view in psychiatry is that mental problems are illnesses to be treated much like physical illnesses.

Learning Objectives By the end of this lesson you will be able to Define : The biological model of abnormality Identify: The four factors that may cause mental disorders Identify: Two strengths and two weakness of the biological approach. Janssen: Exclusively Dedicated to Mental Health

Four Possible Factors Infection: Torrey states that schizophrenia may be linked to mothers contracting a specific strain of influenza during pregnancy. Lies dormant until hormones released during puberty. Genetics: Research looks at twins. If one twin has schizophrenia there are high concordance rates that the other twin develops the disorder.

Genetics determine both biochemisty and neuroanatomy Biochemistry: Either too much or too little neurotransmitters. Schizophrenia may be the result of increased levels of dopamine. Brain damage: It has been shown that people with schizophrenia have enlarged ventricles in the brain which indicate shrinkage of brain tissue.

Biology/genetics distinction. Brain activity/chemistry can be inherited e.g. depression. But genetics are not the only cause of the problem. Everyday experiences can also affect your brain chemistry. A combination of stress and genetics may be needed to trigger psychopathology This is sometimes called the diathesis-Stress model.

Evaluation of the Biological Model Strengths: No Blame Approach – Because the cause of a person’s illness is a result of their biology they cannot be held responsible for their behaviour. Wealth of Scientific Knowledge – Brain scanning, drug therapies and genetics tests have all been proved as effective diagnostic tools and treatments. Treatments can be quick, inexpensive and effective e.g. antidepressants.

Evaluation of the Biological Model Weaknesses: Diathesis- Stress – genetics do not offer a complete explanation. Reductionist – It assumes that complex medical conditions can be broken down into simple biological explanations. Stigma – People will be labelled as having a ‘mental illness’ and this can affect other aspects of their lives when they become passive and give up responsibility for their illness. Treatments – Drugs are not effective for everyone. Research into Diagnosing Abnormality by Rosenham

Learning Objectives By the end of this lesson you will be able to Outline : How drug treatment works Explain: The process used in Electroconvulsive therapy Identify: Two strengths of biological therapies. Identify: Two weakness of biological therapies.

THERAPIES FOR THE BIOLOGICAL MODEL Used for Schizophrenia And bipolar depression Animated Minds :: The Light Bulb Thing

Drug therapy Drug therapy Electro - convulsive Treatment

Drugs for depression 1990’s, a new group of antidepressants were introduced. Selective Serotonin Reuptake Inhibitors (SSRIs), the most famous being Prozac, They block the reuptake of serotonin from the synaptic gap into the pre-synaptic neuron. MAOIs block an enzyme that destroys any excess serotonin in the synaptic gap

Drugs for schizophrenia Chlorpromazine acts by reducing dopamine activity on the brain However there is many side effect and therefor new drugs have been developed One of these is chlozapine, This drug work on a few different neurotransmitters, including dopamine and serotonin.

Electro-Convulsive Therapy (ECT) An electric shock of 70-130 volts is given to the patient’s brain, This would help relieve depression, however, it did produce memory loss.

Psychosurgery Involves separating or destructing brain parts, This is not a cure, but only relieves symptoms, Moniz, (1930), frontal lobotomy-he would separate frontal lobes-this reduced aggression and made individuals more placid.

Strengths Therapy- Biological therapies help relieve conditions and are cheap and easy to take. They act fast Support: The world health organisation state that schizophrenics do better with the drugs than a placebo drug. However not as good as a combination of drugs and CBT.

Weaknesses Therapy- This also raises ethical concerns. The drugs prescribed can produce an addiction. Also, the drugs may only suppress the symptoms and not cure the disorder. Also, the treatments like ECT are irreversible and there is issues of fully informed consent. Side effects: Memory loss with ECT and increased suicide thoughts with and increased anxiety; SSRI’s

The Psychodynamic model explains abnormality as the consequence of unresolved conflicts of childhood which are unconscious, and aims to treat mental illness by making the unconscious conscious, through the use of psychoanalysis.

Learning Objectives By the end of this lesson you will be able to Define : The psychodynamic model of abnormality Identify: The three different components of the personality structure Identify: The four basic principles that explain the development of abnormality.

Assumptions Mental disorder results from psychological rather than physical causes. Unresolved conflicts cause mental disorder. Early experiences cause mental disorder Unconscious motivations cause mental disorder

Personality Structure The id: This is the reservoir of unconscious and instinctual psychic energy including libido (life instinct). It works on the pleasure principle. The ego: This is our conscious self. It regulates interactions with our environment and works on the reality principle. The super-ego: this is our personal moral authority. It is formed when the child internalises societies moral and social norms.

The role of conflict Intra-psychic conflict between the id ego and superego can lead to anxiety. To protect ourselves we use ego defence mechanisms.

Defence mechanisms Activity: In your worksheet look at each of the situations and state whither the defence mechanism being used is Repression, Displacement or Denial. Extension activity Think of behaviour that your or your friends might use as a defence mechanism for each Repression, Displacement and Denial

Stages of development Oral: 0-18 months. The mouth is the focus of attention. Anal: 18 months – 3 yrs. Gratification focuses on the anus. This is the first time the child can exert control over their environment. Phallic: up to age 4 or 5. Gender differences are noticed. The most important feature is the Oedipus or Elektra complex. Latency from 4/5 until puberty. Psychosexual development is static emerging at puberty focussed on potential partners rather than self. YouTube - Fight for kisses.flv

Evaluation of Psychodynamic model Strengths The concept of the unconscious is widely accepted. He was first to suggest that adult abnormality is caused in childhood. He invented talking therapy. You can talk through your problems.

Evaluation of Psychodynamic model He over emphasised children’s sexuality and ignored other aspects of development. He based his theory on case studies of neurotic adults, but wrote about children’s development. It is impossible to test scientifically especially the concepts of unconscious, id etc. It is a product of its time – it was developed in late 19th century Vienna.

Learning Objectives By the end of this lesson you will be able to Outline : The Psychodynamic therapy for treating psychological disorders. Identify: Two Strengths of the psychotherapy. Identify: Two Weaknesses of the psychotherapy.

THERAPIES FOR THE PSYCHODYNAMIC MODEL Looks at uncounscious thoughts and childhood development Animated Minds :: My Blood is My Tears

Psychodynamic Therapy Dream Analysis Free Association Transferrence Therapist Interpretation

Free Association

Strengths First talking therapy which has been the foundation of other talking therapies including CBT as well as counselling It accepts humans as complicated beings and treats problems that have been caused during childhood. It tries to treat the underlying cause of the disorder rather than just the symptoms.

Weakness It takes a long time. Often appointments are 3 times a week for over 5 years. It is also expensive with therapies costing around £45 – £60 per session. It is not suitable for people who are unwilling to analyse their lives There are ethical issues due to the unpleasant memories clients will have to face

THE BEHAVIOURAL MODEL Emphasises the role of learning through operant and classical conditioning. Watson & Raynor (1920) classically conditioned an 11 month old child known as Little Albert to fear a white rat. The responses then generalised to all fluffy animals. Activity: in pairs consider the methodological issues of this study.

Classical Conditioning Involves unconditioned natural responses being paired with an unconditioned stimulus (bell) until this stimulus alone produces the response.

Conditioning and abnormality Classical conditioning has been said to account for the development of phobias. Seligman proposed the concept of preparedness – the idea that in our evolutionary history we became prepared to develop a fear of dangerous stimuli.

Operant conditioning Skinner (1974) demonstrated that rats could be taught voluntary responses by reward and punishment of behaviour. Different patterns of behaviour are taught through use of different schedules of reinforcement.

Social Learning Theory This is an extension of skinner’s work and suggests that we learn through observing another’s behaviour and it’s consequences. We imitate behaviour that we see rewarded – vicarious reinforcement.

EVALUATION OF THE BEHAVIOURAL APPROACH Man's balloon phobia deflated live on radio (18 April 2007) A Hertfordshire company helped cure a man live on radio of his 33-year phobia of balloons. Paul Reason, from Welwyn Garden City, suffered from balloon fear since the age of six when his mother burst one of the party pieces in front of his face. Mr Reason’s fear was so blown up out of all proportion that on one occasion he fainted when hundreds of balloons were released onto a dance floor at a party he was attending. Mr Reason’s children, Sophie and Joshua, who are now allowed to celebrate birthdays and Christmas with balloons. “The change is remarkable,” said Mr Key. “He had been on Valium for five years and he was crying in the car park before the show because he didn’t know what we were going to do.”

answer these three questions Can the behavioural approach explain this phobia? Does everyone who has a phobia have an incidence in their past that they can pin point as the cause? Can fear of balloons be related to evolutionary adaptiveness to help survival? Why

Evaluation of the Behavioural approach Treatments can be effective. Especially when treating phobia There is a lot of experimental evidence supporting the behavioural model However a lot of it has been conducted on animals or is unethical Treats the symptoms and not the cause, underlying fear is often transferred to another object after treatment of the original phobia

Strengths It lends itself to scientific examination. If we place a person in a situation then give them a reward we can see if their behaviour changes over time It has been very successful in treating phobia Support for the studies comes from the experiment on little Albert by John Watson.

Criticisms of the Behavioural approach Reductionism – It explains behaviour in simple forms ignoring cognitive (perception and intelligence) and emotional contributions. It ignores the role of genetics. In that phobia’s might be the result of too much dopamine It is deterministic – suggesting that all behaviour is pre-programmed through learning and there is no choice in how we act. We all however have free will.

Limitation Reductionist: Very limited view, as it thinks we are all blank sheets with no personality or individual thought processes Studies done on Animals: Not generalisable to humans The study that was done on little Albert was very unethical Treats the symptoms and not the cause: Fear is often displaced onto other phobias

Learning Objectives By the end of this lesson you will be able to Define : Identify:

THERAPIES FOR THE BEHAVIOURAL MODEL Systematic Desensitisation Used for Phobias Animated Minds :: Fish on a Hook

What is a phobia? An exaggerated fear of an object or situation According to the learning approach it is a learned response to a stimulus

An example in everyday life... How Ivan became phobic of walking in the forest

It is a step by step approach How does SD work? The client learns relaxations techniques It is a step by step approach The client works out a hierarchy of fear from the least frightening to the most frightening The client works through the hierarchy learning to use relaxation techniques in the presence of the feared object Fur Dog

THE COGNITIVE MODEL OF ABNORMALITY Ellis and Beck

Assumptions Unhappy or traumatic experiences in childhood create negative schemata. Negative schemata lead to negative automatic thoughts which are misplaced or false beliefs about ourselves. All behaviour is influenced by schemata; facts or beliefs held about situations, but mostly about ourselves e.g. “Iam a nice person”.

Beck’s model of depression Negative view about self, world and future A negative cognitive Triad.

Attributional style Behaviour is seen as internal or external in cause ‘ It’s my fault’. Or It’s your fault Behaviour is seen as specific or global ‘It’s only happening here and now’ Behaviour is stable or unstable ‘I must always act this way, it is appropriate’.

Ellis’ ABC Activating events: Seeing a large dog Beliefs about those events: Dogs bite Consequences: feelings and actions: Panic

Individual is in control Free will: In contrast to the other models where something outside the individual is responsible for the abnormality Cognitive psychologist believe it is the individual control over their own negative thinking. People must change the way they think

Evaluation of the cognitive model There is clear research evidence for cognitive bias and dysfunctional thinking. Cognitive therapy is very effective. It ignores biological and genetic factors. The problem e.g. depression may cause the faulty thinking rather than the other way around.

Criticism for the cognitive model Sometimes negative thoughts are an accurate view of the world. This is called depressive realism.

Learning Objectives By the end of this lesson you will be able to Outline : Cognitive Behavioural Therapy Identify: Two strengths of CBT Identify: Two weaknesses of CBT

THERAPIES FOR THE COGNITIVE MODEL Can be used for Obsessive compulsive disorder Animated Minds :: Over and Over (and Over) Again

CBT Therapy is normally once a week for a period of between 6 weeks to months. Therapist and client work together to evaluate the usefulness of thought patterns and resulting behaviour. Therapist helps client find a more positive way of looking at life and encourages them to enjoy life by doing more things they like.

Rational Emotive Therapy Albert Ellis: We need to challenge our irrational belief in order to change our behaviour Logical disputing: Look at your thought patterns and see if they make sense Empirical disputing: Try and find prove to support your irrational thoughts Pragmatic disputing: Look at how these beliefs do not have any usefulness in our lives.

Strengths REBT is a successful treatment: Engels et al found in a meta analysis study the REBT was very good for Obsessive-compulsive disorders and social phobia Reliability: It can be used by all sorts of people, both normal and people with psychological disorders. It has been successful with all age group and genders, older people and children find this therapy useful

Weakness It does not always look at the cause of the irrational thoughts. Reality: There are many things in a persons life which are negative and thinking of them as positive would not meet with the reality of the situation. It takes a lot of effort to change your belief system and sometime people find it to difficult.