Psychopathology Flashcards
(41 cards)
Whats psychpathology
Psychopathology is the scientific study of psychological disorder
- psycho for psychological
- and pathology, wch means study of the causes of diseases.
In the case of physical disorders,
- doctors identify certain signs and symptoms to determine when one is ill.
-
- In case of psychological disorders, the issue = how do we identify when someone is ‘ill’
- in what way does their behaviour differ from what’s normal, i.e. is it abnormal?
How is abnormality described as a deviation from social norms ?
Most of us notice ppl whose behaviour is a deviation from social norms,
- i.e. wher we act diff from how we expect people to behave.
Groups of people (hence social norms) choose to define behaviour
- as abnormal on basis that it offends sense of what is ‘acceptable’ or the norm. - We are making a collective judgement as a society about what is right.
-
Norms are specific to culture we live in
- Of course those social norms may be diff for each generation and every culture,
- so there is relatively little behaviour thats considered universally abnormal
- on the basis that they breach social norms.
> Eg, homosexuality continues to be viewed as abnormal in some cultures
> was considered abnormal in our society in the past.
How is antisocial personality disorder an example of deviation from social norms
A person with antisocial personality disorder (psychopathy) is impulsive, aggressive and irresponsible.
- According to tDSM-5 (the manual used by psychiatrists to diagnose mental disorder)
- an important symptom of antisocial personality disorder is
- an ‘absence of prosocial internal standards associated with
failure to conform to lawful or culturally normative ethical behaviour’.
»_space; In other words we make the social judgement that
»_space; a psychopath is abnormal as they don’t conform to our moral standards.
> Psychopathic behaviour wd be considered abnormal in a very wide range of cultures.
EVALUATION of deviation from social norms as describing abnormality
— can be used to justify removal of ‘unwanted ppl’ from society.
- eg, opposing a particular political regime cd be said to be abnormal.
— what is considered acceptable or abnormal can change over time.
- eg, recently as 1974, homosexuality was classified in the
- Diagnostic and Statistical Manual of Mental Disorders (DSM) as a disorder
- But, the diagnosis was dropped as homosexuality wasn’t as infrequent as thought,
- homosexuals dont differ from heterosexuals in psychological well-being
How do we describe abnormality as failing to function adequately
A person may cross the line between ‘normal’ and ‘abnormal’
- when they cant fulfill demands of everyday life
- and they fail to function adequately.
We might decide that someones functioning adequately
- when are unable to maintain basic standards of nutrition and hygiene.
- also are not functioning adequately if cant hold down a job/maintain relationships with ppl round them.
..
• When is someone failing to function adequately?
Rosenhan and Seligman (1989) proposed some signs that are used to determine when one is not coping.
1) When one no longer conforms to standard interpersonal rules, eg eye contact and respecting personal space.
2) When one experiences severe personal distress.
3) When one’s behaviour becomes irrational/dangerous to themselves or others.
Eg. intellectual disability disorder
- One criteria is having a very low IQ (a statistical infrequency).
- But a diagnosis wd not be made on this basis only - one must also be failing to function adequately before diagnosis given.
EVALUATION of failure to function adequately as describing abnormality
- Is it simply a deviation from social norms
In practice, can be hard to say when one is really falling to function
and when they are just deviating
• judgements
- When deciding if one is failing to function adequately, one has to judge if a patient is distressed.
> Some may say they are distressed but may be judged as not suffering.
> very subjective
>
+ BUT this definition recognises subjective experience of the patient,
allowing us to view mental disorder from pov of person experiencing it.
+ are methods of making such judgements as objective as possible
»_space; as we can list behaviours (can dress self, can prepare meals)
- from tools like the Global Assessment of Functioning Scale.
>
whats statistical infrequency/how can abnormality be described as a deviation from statistical norms
An obvious way to define anything as ‘normal” or ‘abnormal’
is according to number of times we observe it - statistics are about numbers.
According to the statistical definition
- any relatively usual behaviour/characteristics can be thought of as ‘normal’,
and any behaviour that is diff to this is ‘abnormal’.
>
> This is statistical infrequency.
We can, eg, say at any one time only a small number of people will have an irrational fear of buttons.
..
Example: IQ and intellectual disability disorder
- This statistical approach comes in when dealing with characteristics that can be reliably measured, intelligence.
- We know, in any human characteristic, most ppls scores will cluster round average,
- and the further we go above/below average, the fewer people will attain that score.
This is called the normal distribution.
diagram 1
What are evaluation problems describing abnormality in terms if statistical frequency
— doesn’t take account of desirability of behaviour, its just frequency.
- eg, a very high IQ is abnormal, as is a very low one,
- but a high IQ is desirable unlike a low one.
- is statistically abnormal but but doesnt always mean it requires treatment
— There’s no definite cut-off point where normal behaviour becomes abnormal behaviour.
— Some behaviours considered psychologically abnormal are quite common (e.g. mild depression.)
- Hassett and White (1989) argue you cant use statistical infrequency
- to define abnormality bc some abnormal behaviours are common.
How do we describe abnormality as a Deviation from ideal mental health
A diff way to look at normality/abnormality is to ignore issue of what makes one abnormal
but think abt what makes one ‘normal’.
> Ie we can consider deviation from ideal mental health.
Once we have ideas of being psychologically healthy we can begin to identify who deviates from this idea.
> Abnormality is absence of criteria for good mental health (as in physical illness).
> The more criteria are missing the more serious the abnormality.
..
What does ideal mental health look like?
Jahoda (1958) said we are in good mental health if we meet following criteria:
• We have no symptoms of distress
• We are rational and can perceive ourselves accurately
• We self-actualise (reach our potential)
• We can cope with stress
• We have a realistic view of the world
• We have good self-esteem and lack guilt
• We are independent of other people
• We can successfully work, love, enjoy our leisure
Inevitably theres overlap between
- what we call deviation of social norms
- and what we call failure to function adequately.
So we think of one’s inability to keep a job
as a failure to cope with pressures of work
or as a deviation from ideal of successfully working.
Evaluation of deviation from ideal mental health as a description of abnormality
+ It is a comprehensive (dealing with all elements) definition
• covers a broad range of criteria for mental health.
- probably covers most reasons one wd seek/referred for help from mental health services
- range of factors discussed in relation to Jahoda’s ideal mental health
- make it a good tool for thinking about mental health.
— sets unrealistically high standards for mental health
- Very few attain all Jahoda’s criteria for mental health, and
- none of us achieve all at same time/keep them up for long.
-
+ BUT shows ppl the ways they cd benefit from seeking treatment
- say counselling - to improve their mental health.
— they’re subjective
- the ideas of what is required for each will differ from person to person.
What are phobias
All phobias are characterized by excessive fear/anxiety
> triggered by objects, places or situations
>
> in phobias, the extent of the fear is out of proportion
to any real danger presented by the phobic stimulus
DSM(5) recognises these categories of phobia and related anxiety disorder
• Specific phobia:
phobia of an object, like an animal or body part,
or a situation like flying or having an injection.
• Social anxiety (social phobia):
phobia of a social situation
Like public speaking or using public toilet.
• Agoraphobia:
phobia of being outside or in public place.
Behavioural characteristics of PHOBIAS
Behavioural: ways in which people act
We respond to things/situations we fear by behaving in particular ways.
> by feeling high levels of anxiety and trying to escape.
> The fear responses in phobias are same as we experience for any other fear
> even if level of fear is irrational - out of all proportion to the phobic stimulus.
..
1) Panic
A phobic person may panic in response to presence of phobic stimulus.
- Panic may involve behaviours like crying, screaming or running away.
- Children may react slightly differently, like by freezing, clinging or having a tantrum.
2) Avoidance
Unless the sufferer is making a conscious effort to face the fear
- they tend to go to a lot of effort to avoid contact with stimulus.
- This can make it hard to go about daily life.
3) Endurance
The alternative to avoidance is endurance, - in wch a sufferer remains in presence of the phobic stimulus
- but continues to experience high levels of anxiety.
- may be unavoidable in some situations, eg for a person who has an extreme fear of flying.
Emotional characteristics of PHOBIAS
Emotional: ways in which people feel
1) Anxiety
Phobias are classed as anxiety disorders.
- they involve an emotional response of anxiety and fear.
- Anxiety is an unpleasant state of high arousal;
> prevents sufferer relaxing and makes hard to experience positive emotion.
Anxiety can be long term.
Fear is the immediate and unpleasant response we experience
when encounter/think of phobic stimulus.
..
2) Example: arachnophobia
Matt has a phobia of spiders
> anxiety levels increase whenever enters a place associated with spiders - eg his own garden shed.
> This anxiety is a general response to the situation.
When he actually sees a spider he experiences fear
- a very strong emotional response directed particularly towards spider itself.
..
3) Emotional responses are unreasonable
The emotional responses we feel due to phobic stimuli go past whats reasonable.
> So, eg Matt’s fear of spiders involves a strong emotional response to a tiny and harmless spider.
> is wildly disproportionate to danger posed by any spider Matt may meet in his shed.
Cognitive characteristics of PHOBIAS
Cognitive: the process of thinking - knowing, perceiving, believing.
The cognitive element is concerned with
ways ppl process info abt phobic stimuli diff from other objects or situations.
..
1)Selective attention
If a sufferer can see phobic stimulus its hard to look away from.
- Keeping our attention on smth dangerous is a good thing as gives is best chance of reacting quick to a threat
- but not so useful when fear is irrational.
A pogonophobic will struggle to concentrate on what they are doing
if theres someone with a beard in room.
..
2)Irrational beliefs
A phobic may hold irrational beliefs in relation to phobic stimuli.
- eg, social phobias can involve beliefs like ‘I must always sound intelligent’ or ‘If I blush people will think I’m weak.
- This belief increases pressure on sufferer to perform well in social situations.
..
3)Cognitive distortions
The phobic’s perceptions of phobic stimulus may be distorted.
- So, eg, an omphalophobic is likely to see belly buttons as ugly/disgusting,
- and an ophidiophobic may see snakes as alien/aggressive looking.
Whats depression?
All forms of depression and depressive disorders
are characterised by changes to mood.
- The latest version of DSM (DSM-5)
recognises following categories of depression and depressive disorders.
• Major depressive disorder:
- severe but often short-term depression.
• Persistent depressive disorder:
- long-term or recurring depression, including sustained major depression
- and what used to be called dysthymia (mild but long-term depression).
• Disruptive mood dysregulation disorder:
- childhood temper tantrums.
• Premenstrual dysphoric disorder:
- disruption to mood prior to and/or during menstruation.
Behavioural characteristics of DEPRESSION
Behavioural: ways in which people act
Behaviour changes when we suffer an episode of depression
1) Activity levels
Typically sufferers of depression have reduced levels of energy,
- introducing knock-on effect, with sufferers withdrawing from work, education and social life.
- can be so severe that the sufferer cannot get out of bed.
In some cases depression can lead to opposite effect
- known as psychomotor agitation. Agitated individuals struggle to relax and may end up pacing up and down a room.
..
2)Disruption to sleep and eating behaviour
Depression is associated with changes to sleeping behaviour.
- Sufferers may experience reduced sleep (insomnia), particularly premature waking,
- or an increased need for sleep (hypersomnia).
Similarly, appetite and eating may increase or decrease, leading to weight gain/loss.
> such behaviours are disrupted by depression.
..
3)Aggression and self-harm
Sufferers of depression are often irritable, and can be verbally/physically aggressive.
- may have serious knock-on effects on a number of aspects of their life.
- like one experiencing depression may display verbal aggression by ending a relationship/quitting a job.
Depression can also lead to physical aggression directed against self.
This includes self-harm/suicide attempts.
Emotional characteristics of DEPRESSION
Emotional: ways in which people feel
1)Lowered mood
the word ‘depressed in everyday life describes having a lowered mood, ie feeling sad.
> Theres more to clinical depression than this.
Lowered mood is still a defining emotional element of depression
- but more pronounced than in daily experience of feeling lethargic and sad.
- Patients describe themselves as ‘worthless’/’empty’
..
2) Anger
Although sufferers experience more negative/fewer positive ones in episodes of depression,
- this experience of negative emotion is not limited to sadness.
- Sufferers also experience anger, sometimes extreme.
- can be directed at self or others.
..
3) Lowered self-esteem
Self-esteem is emotional experience of how much we like ourselves.
- Sufferers of depression tend to report reduced self-esteem
- This can be quite extreme, with some sufferers of depression describing a sense of self-loathing, i.e. hating themselves.
Cognitive characteristics of DEPRESSION
Cognitive: the process of thinking - knowing, perceiving, believing.
The cognitive aspect of depression is concerned with ways ppl process info.
- Ppl suffering/suffered from it process info abt several aspects of world
- differently from normal ways those without depression think
..
1)Poor concentration
Depression is associated with poor levels of concentration.
- sufferer may find themselves unable to stick with a task as usually would,
- or may find it hard to make decisions that they wd normally find easy.
- Poor conc and decision making are likely to interfere with the individual’s work.
..
2)Attending to and dwelling on the negative
- When suffering a depressive episode ppl pay more attention to negative than happy povs
- they have a bias to recalling negative events than happy; the opposite bias that most people have when not depressed.
..
3)Absolutist thinking
Most situations are not all-good or all-bad,
- but when a sufferer is depressed they tend to think in these terms.
> ‘black and white thinking’.
This means that when a situation is unfortunate they tend to see it as an absolute disaster.
Whats OBSESSIVE COMPULSIVE DISORDER (OCD)
The DSM system recognises OCD and a range of related disorders.
> these disorders have in common a repetitive behaviour accompanied by obsessive thinking.
• OCD:
- characterised by either obsessions (recurring thoughts, images, etc.)
- and/or compulsions (repetitive behaviours such as hand washing).
- Most ppl with OCD have both obsessions and compulsions.
• Trichotillomania:
- compulsive hair pulling.
• Hoarding disorder:
- the compulsive gathering of possessions
- and the inability to part with anything, regardless of its value.
• Excoriation disorder: compulsive skin picking.
Behavioural characteristics of ocd
Behavioural: ways in wch ppl act
• Compulsions
The behavioural component of OCD is compulsive behaviour.
Are 2 elements to compulsive behaviour:
- Compulsions are repetitive:
- typically sufferers of OCD feel compelled to repeat behaviour. (Eg hand washing.)
- Other common compulsive repetitions are counting, praying, tidying/ordering groups of objects such as CD collections or containers in a food cupboard. - Compulsions to reduce anxiety:
- around 10% with OCD show compulsive behaviour alone
- they have no obsessions, just a general sense of irrational anxiety.
-
- BUT, for most compulsive behaviours are performed in attempt to manage anxiety produced by obsessions.
- eg, compulsive hand washings are a response to obsessive fears of germs.
- Compulsive checking that a doors locked or a gas appliance is switched off, is response to obsessive thought that it might have been left unsecured.
..
• Avoidance
The behaviour of OCD sufferers may also be characterised by their avoidance
- as try reduce anxiety by keeping away from situations that trigger it.
- Sufferers of OCD try manage OCD by avoiding situations that trigger anxiety,
-
- eg sufferers who wash compulsively may avoid coming into contact with germs.
- BUT, this avoidance can lead ppl to avoid ordinary situations, like emptying bins,
- so itself interfere with a normal life
Emotional characteristics of OCD
Emotional: ways in which people feel
• Anxiety and distress
OCD is regarded as a particularly unpleasant emotional experience
- Due to anxiety that accompanies both obsessions and compulsions.
-
- Obsessive thoughts are unpleasant and frightening, and anxiety that goes with these can be overwhelming.
- The urge to repeat a behaviour (a compulsion) creates anxiety.
..
• Accompanying depression
OCD is often accompanied by depression, - so anxiety can be accompanied by low mood and lack of enjoyment in activities.
- Compulsive behaviour tends to bring some relief from anxiety but is temporary.
..
• Guilt and disgust
- As well as anxiety and depression, OCD can involve other negative emotions
- such as irrational guilt eg over minor moral issues,
- or disgust, wch may be directed against something external like dirt or at the self.
Cognitive characteristics of OCD
Cognitive: the process of thinking - knowing, perceiving, believing.
The cognitive approach is concerned with ways people process information.
> Ppl with OCD are plagued with obsessive thoughts but also adopt cognitive strategies to deal with them.
• Obsessive thoughts
For round 90% of OCD sufferers the major cognitive feature of their condition is obsessive thoughts,
- i.e. thoughts that recur over and over again.
- These vary from person to person but are always unpleasant.
- eg recurring thoughts are worries of being contaminated by dirt/germs
- or that a door has been left unlocked.
..
• Cognitive strategies to deal with obsessions
Obsessions are the major cognitive aspect of OCD,
- but ppl also respond by adopting cognitive coping strategies.
-
- eg, a religious person tormented by obsessive guilt may respond by praying or meditating.
- may help manage anxiety but can make person appear abnormal to others
- and can distract them from everyday tasks.
..
•Insight into excessive anxiety
ppl with OCD are usually aware that their obsessions/compulsions are not rational.
- This used to be a necessary characteristic for diagnosis,
- BUT recently there is a appreciation that amt of insight can vary between people
- and in the person across time/ situations. -
- eg, OCD sufferers may experience catastrophic thoughts abt worst case scenarios
- that might result if their anxieties were correct.
- also tend to be hypervigilant, i.e. they maintain constant alertness; keep attention on potential hazards.
Whats the behavioural approach to explaining phobias ; two process model and classical conditioning
The behavioural approach suggests that all behaviour is learned.
> For that reason its sometimes called the learning theory
> behaviourists use the word conditioning to mean learning; So smth thats unconditioned is unlearned and vice versa
..
• The Two-process model
The behavioural approach emphasises role of learning in acquisition of behaviour - The approach focuses on behaviour we can see.
- the key behavioural aspects of phobias are avoidance, endurance and panic.
- and The behavioural approach specifically is geared to explaining these
Hobart Mower (1960) proposed the two-process model
based on behavioural approach to phobias.
> states phobias are acquired by classical conditioning; continue due to operant conditioning.
> Acquisition by classical conditioning
involves learning to associate something of wch we initially have no fear (NS)
- with smth that already triggers fear response (UCS).
Watson and Raynor (1920) created a phobia in a 9-month-old baby called ‘Little Albert’.
- showed no unusual anxiety at the start of the study.
- When shown a white rat he tried to play with it.
BUT, experimenters gave Albert a phobia of fluffy things by association
How does the behavioural approach explain phobias with two process model (operant conditioning)
• Maintenance by operant conditioning
- Responses acquired by classical conditioning tend to decline over time.
-BUT, phobias are often long lasting.
Mower has explained this as result of operant conditioning
- Operant conditioning happens when our behaviour is reinforced
(encouraged i.e, rewarded) or punished.
- Positive and Negative Reinforcement tends to increase the frequency of a behaviour.
-
- In negative reinforcement an individual avoids a situation that is unpleasant.
> Such behaviour results in desirable consequence, wch means behaviour will be repeated.
Mower suggested whenever we avoid a phobic stimulus
we successfully escape fear and anxiety we wdve suffered if we had remained.
> reduction in fear reinforces avoidance behaviour and so phobia is maintained.
