Individual Differences

(psychopathology)Revision

SyllabusINDIVIDUAL DIFFERENCES

Defining and explaining psychological abnormality

•Definitions of abnormality (x3 - deviation from social norms, failure to function adequately, deviation from ideal mental health)

•Biological approach to psychopathology (genetics, neurotransmitter imbalance, brain damage)

•Psychological approaches to abnormality (psychodynamic, learning, cognitive)

Treating Abnormality •Biological therapies (ECT, Drugs)

•Psychological therapies (psychoanalysis, systematic desensitisation, CBT)

DEFINITION of Abnormality 1

DEVIATION FROM SOCIAL NORMS

• Behaviour is abnormal if it goes against what is generally accepted by society

• For example...

LIMITATIONS• Ignores the role of

CONTEXT– E.g.

• CULTURE SPECIFIC (ignores cultural relativism)– E.g.

• ERA SPECIFIC (e.g...)– E.g.

DEFINITION of abnormality 2

FAILURE TO FUNCTION ADEQUATELY• Behaviour is abnormal if it

prevents a person from living their day to day life (e.g. holding down a job, relationship, etc)

• Abnormal behaviour will fit into one of Rosenmans ‘7 features of abnormality’– These are… (NB – no

need to learn them all; learn 2/3 and make sure you can explain them and link in a mental ilness)

LIMITATIONS• Ignores the CONTEXT of

behaviour

• CULTURE SPEIFIC

• Some abnormal behaviours do not cause a person to ‘fail to function’ (i.e. A person can appear to live a normal life while suffering from some symptoms)

• Some normal behaviours fit into one or more of the seven features. E.g...

DEFINITION of abnormality 3

DEVIATION FROM IDEAL MENTAL HEALTH

• A person is abnormal if they do not possess the features of ideal mental health (i.e. their abnormalities prevent them from achieving ideal mental health).

• The fewer features a person has, the more abnormal they are!

• The features of ideal mental health are...– Again, learn 2/3 in detail

LIMITATIONS• CULTURE SPECIFIC

• It is impossible to achieve all features of ideal mental health – does this mean everyone is abnormal?

• Difficult to measures ideal mental health - SUBJECTIVE judgements needed

EXPLANATIONS of Abnormality

BIOLOGICAL• Genetic abnormalities• Neurotransmitter

imbalances • Neurological (brain)

damage / abnormality

PSYCHOLOGICAL• Psychodynamic • Behavioural • Cognitive

TIPS! •Outline the basic assumption / idea (1 sentence)•Explain the major KEY FEATURES / ideas•ALWAYS LINK IDEAS TO SPECIFIC EXAMPLES OF MENTAL DISORDERS / SYMPTOMS. e.g. “Depression can be explained in this way because...”•Bring in the basis of therapy if you can - “because of this assumption, therapy should...”

Biological Explanations

Biological Explanations• Mental disorders have a

somatic (physical) cause• Biological causes of

disorders include– Neuroanatomical

Abnormalities • Schizophrenia may be caused

by…– Neurotransmitter imbalances

• Schizophrenia may be caused by…

– Genetic abnormalities• Gottesman found a 48%

concordance for Schizophrenia across MZ twins. This was much lower for DZ twins, suggesting the disorder has a genetic basis

• Specific genetic abnormalities which may cause schizophrenia?

EVALUATION• EVIDENCE – lots!• INCOMPLETE – cannot explain the

examples of mental illness where there are NO biological abnormalities

– Could add in ‘determinism’ here

• TOO SIMPLISTIC – The biological approach ignores the role of important psychological and environmental factors which may contribute to disorders, e.g…

• CAUSE AND EFFECT ISSUES – Biological abnormalitites such as NT imbalances may be an effect of a mental illness not a cause.

• PRACTICAL APPLICATIONS – the biological approach has led to the development of very effective therapies such as drug treatments. The success of these treatments validates the biological theories

Psychological Explanation 1

PSYCHODYNAMIC• Root cause of psychopathology

is EARLY TRAUMA…• This is repressed into the

Unconscious and causes unconscious conflict

• Repressed trauma may cause abnormal development of the Tri-Partitie personality which may lead to symptoms of mental illness

– E.g? Dominant Id? Dominant Super Ego?

• Early trauma may lead to abnormal use of DEFENCE MECHANISMS

– Phobias?

• Treatment should therefore take a psychological focus and aim to uncover and overcome repressed unconscious trauma

EVALUATION• SUPORTING EVIDENCE that MDs are

caused by early trauma and unconscious conflict

– Freud ‘Little Hans’

– But…

• ABSTRACT, UNFALSIFIABLE CONCEPTS which cannot be tested scientifically

• INCOMPLETE – cannot explain disorders when there is no early trauma

• TOO SIMPLISTIC – ignores biological factors which may contribute to disorders, e.g…

• PRACTICAL APPLICATIONS – theory has led to the development of an effective therapy (Psychoanalysis). The success of this VALIDATES the assumptions

Psychological Explanation 2

BEHAVIOURAL• Abnormal behaviours are LEARNT

through environmental experiences • Abnormal behaviours can be learnt

thorough classical condition (CC) operant conditioning (OC) and social learning (SLT)

– CC - PHOBIAS are a result of associative learning when a neutral stimulus is paired with an unconditioned stimulus which causes fear/pain. E.g… (NB. Could bring in one trial learning, generalisation)

– OC - Abnormal behaviours may be REWARDED (positive reinforcement) so will be repeated. E.g. Symptoms of depression, Eating…

– SLT - Abnormal behaviour is firstly observed and then imitated if the behaviour is observed to be rewarded. E.g. OCD behaviours, Phobias

• Treatment should therefore focus on the observable and involve ‘counter learning’ or learning new, adaptive behaviours

EVALUATION• EVIDENCE - Watson and Rayner

‘Little Albert’ demonstrates phobias can be learnt through Classical Conditioning…

• INCOMPLETE - It cannot explain why some people have mental illness when there has been no negative learning experiences

• TOO SIMPLISTIC because…

• PRACTICAL APPLICATIONS – has led to the development of effective therapies such as systematic desensitisation. The success of these therapies VALIDATE the assumptions that some mental disorders are LEARNT

Psychological Explanation 3

COGNITIVE• Abnormal behaviours are a result

of IRRATIONAL (faulty) thinking and cognitions

• Faulty cognitions lead to cognitive distortions and irrational processing of information – this leads to symptoms of mental illness

• Ellis’ A-B-C model can help explain this…

• Depression is often linked to specific irrational thoughts including…

– Cognitive triad

– Maximisation / minimisation

– Selective Abstraction

– i-cant-stand-it-itis

– Musterbation

EVALUTION• EVIDENCE to support the view that

irrational thoughts cause mental disorders - CLARK – Patients with panic disorders often have exaggerated, irrational thoughts about situations

• CAUSE and EFFECT issues – it could be that having a mental illness causes irrational thoughts, not the other way around

• Based on ABSTRACT concepts such as cognitions and schemas which are unfalsifiable and difficult to test scientifically

• INCOMPLETE…

• TOO SIMPLISTIC…

• PRACTICAL APPLICATIONS…

Treating abnormalitiesTHERAPIES

BIOLOGICAL THERAPIES

• ECT• DRUGS

PSYCHOLOGICAL THERAPIES

• PSYCHOANALYSIS (based on the psychodynamic approach)

• SYSTEMATIC DESENSITISATION (based on the behavioural approach)

• COGNITIVE BEHAVIOUR THERAPY (based on the cognitive approach

TIPS! •When ‘DESCRIBING’ the treatments, always...

• Start with the theory and assumptions on which it is based• Outline the general aim• Describe the techniques/process involved

Biological Therapy 1ELECTRO-CONVULSION THERAPY (ECT)• BASED ON the bio approach which

assumes disorders have a physical basis and are caused by (for e.g.) imbalance of NT’s or neurological malfunction

• AIM is to stabalise neurological functioning (ECT is thought to alter NT level / functioning)

• TECHNIQUES / PROCESS

– Electrodes placed on head (TWO types?)

– Low voltage shock given (approx?)

– Causes convulsions and seizures

– A typical course of ECT would involve…

EVALUTION

• EVIDENCE OF EFFECTIVENESS

• ETHICAL ISSUES – major negative side effects which have to be taken into account before the therapy, including…

– Cost vs benefit analysis?

• LIMITED – only effective for certain disorders, such as...

Biological Therapy 2

DRUG TREATMENT• BASED ON the bio approach

which assumes disorders have a physical basis and are caused by (for e.g.) imbalance of NT’s or neurological malfunction

• AIM To stabalise NT levels and/or improve neurological functioning

• TECHNIQUES / PROCESS

• Be specific and talk about how certain ‘groups’ of drugs work. – ANTI – PSYCHOTICS work by

lowering levels/action of...

– ANTI – DEPRESSENTS work by increasing levels/action of…

EVALUTION• EVIDENCE OF EFFECTIVENESS

• ETHICAL ISSUES – major negative side effects including…

– Cost vs benefit analysis?

• CONTROL NOT CURE (do not treat the root cause and ignore important psychological factors)

– Chemical Straightjacket. We know they are not a cure because…

– So a better therapeutic option would be to…

• PRACTICAL ADVANTAGES

Psychological Therapy 1Based on the Psychodynamic

ApproachPSYCHOANALYSIS• BASED ON the psychodynamic

approach, which argues disorders are caused by repressed trauma which leads to unconscious conflict

• AIM identify repressed trauma and help a client overcome it

• TECHNIQUES / PROCESS

• Be specific and talk about how certain ‘groups’ of drugs work.

– Free association (include reference to resistance and what this shows)

– Projective Tests (explain why they are used and what the therapist and client does)

– Dream analysis (explain symbolism, how the therapist tries to uncover latent content and what this is)

EVALUTION• EVIDENCE OF EFFECTIVENESS

• ETHICAL ISSUES – uncovering repressed trauma may cause high anxiety for the client

• PRACTICAL ISSUES – requires a trained professional and is a lengthy, expensive process

• DOES FOCUS ON ROOT CAUSES however positive effects take time to occur and it ignores potentially important factors (e.g. bio abnormalities). A combination therapy (with drugs) may the best approach because…

• NOT SUITABLE FOR EVERYONE – it is a complex therapy based on talking so it is not suitable for…

– Ideal client (YAVIS)?

Psychological Therapy 2Based on the Behavioural Approach

SYSTEMATIC DESENSITISATION• BASED ON Learning / behavioural

approach, which suggests disorders are learnt from environmental experiences.

• AIM To unlearn / replace the maladaptive learning with alternative, normal feelings. Normally used to treat..

• TECHNIQUES / PROCESS

1. Client taught relaxation techniques

2. Functional Analysis - Client and therapist create a fear hierarchy, which is…

3. Graduated exposure, which involves...

• Can be done IN VITRO or IN VIVO

EVALUTION• EVIDENCE OF EFFECTIVENESS

• ETHICAL ISSUES – does cause some trauma BUT the use of graduated exposure significantly reduces this

• PRACTICAL ISSUES – requires a trained professional and is a lengthy, expensive process

• MAY NOT DEAL WITH ROOT CAUSES – indicated by symptom substitution. Also, ignores important factors which may contribute to disorders (e.g. biological abnormalities). So it should be used in combination with…

Psychological Therapy 3Based on the Cognitive Approach

COGNITIVE BEHAVIOUR THERAPY• BASED ON the assumptions of the

cognitive approach which suggest psychopathology is the result of irrational thoughts and cognitive distortions

• AIM To identify a clients irrational thoughts, challenge these (i.e. prove they are irrational) and replace them with more rational ones

• TECHNIQUES / PROCESS

1. Guided Discovery - Identification of irrational beliefs (including the establishment of a therapeutic alliance)

2. Challenging and disputing irrational beliefs (e.g. through experiments, empirical disputing – explain these)

3. Replace, restructure and application – replace the irrational beliefs with more rational ones, help the client apply these and adapt if necessary

EVALUTION• EVIDENCE OF EFFECTIVENESS (e.g.

Ellis)

• ETHICAL ISSUES – can be quite confrontational (when demonstrating beliefs are irrational) which may cause anxiety for client BUT it does avoid the in depth analysis associated with psychoanalysis

• PRACTICAL ADVANTAGES – limited to a relatively small number of sessions and is completed in a few weeks, making it less expensive, time consuming. BUT it still requires a well trained therapist…

• FOCUSES ON ROOT CAUSE – effective in the long term as it deals with the cause of the mental illness (irrational thoughts) and teaches cognitive behavioural techniques which can be applied by the client in the future. However, It may ignore key factors (e.g. bio abnormalities)

KEY STUDIES• GOTTESMAN - meta analysis of family studies• One other study which supports biological assumptions

– E.g. Brain Scans; Case study (such as Phineus Gage, Clive Wearing)

• FREUD – case of “little Hans”• WATSON AND RAYNER – “Little Albert”• CLARKE - Irrational thoughts and anxiety• PETRIDES / PAGNIN - Effectiveness of ECT• A study into the effectiveness of drugs• BERGIN - Effectiveness of psychoanalysis• BARLOW - Effectiveness of SD• ELLIS - Effectiveness of CBT (note the advantages of CBT

over other treatments)

Other Tips!DEFINITIONS

– ALWAYS show how/why a disorder or symptom is classed as abnormal according to the definition in question

– Remember, no need to learn all 7 features of abnormality in the FFA definition or all of the features of ideal mental health in the DIMH definition

– Evaluation questions likely to focus on LIMITATIONS of the definitions

EXPLANATIONS

– ‘Key features’ & ‘assumptions’ – same thing!

– Always link to a disorder

– Mention the basis of treatments as a descriptive point

• “because of this assumption, treatments should involve...”– Note evaluation points that can be applied to all explanations (but be

specific to the explanation)

TREATMENTS

– Remember - (1) Based on... (2) Aim is to... (3) Techniques involved / process is...

– Again, look for ‘common’ evaluation points (but again be as specific as you can and APPLY)