Abnormality

Abnormality

Defining Abnormality
1. DEVIATION FROM SOCIAL NORMS
  1. Behaviour is abnormal if it goes against what MOST people in society would consider acceptable (undesirable/antisocial behaviour).
  2. AO2
    1. X culturally relative
      1. Behaviour seen as deviant in one society may be seen as acceptable in another, for example in some parts of East Asia, a culturally bound syndrome(Koro) exists. Plus in many parts of the world eating disorders do not exist.
    2. X era dependant
      1. Social norms change over time, based on social morals of a particular period of time. For example homosexuality was regarded as a psychiatric illness until 1973, but it isn't now.
    3. X not always a sign of psychopathology
      1. social norms relate to the context of behaviour and there is not a clear line between abnormal deviation&harmless eccentricity. For example wearing a bikini is fine on the beach, but not to a funeral.
2. FAILURE TO FUNCTION ADEQUATELY
  1. This definition utilises degrees of abnormality on a continuum. x< features you cannot fulfil the more abnormal(much more realistic)
  2. ROSENMAN &SELIGMAN identified a number of characteristics that can define abnormal behaviour.
    1. Maladaptive/dysfunctional behaviour(interferes with ability to lead normal life)
    2. Observer discomfort(causing unease&discomfort to others)
    3. Unpredictable behaviour(unexpected&out of control)
    4. Irrational behaviour(not based on any logic or reason)
  3. X not all people who suffer from a mental illness are aware
  4. X based on subjective judgement
  5. Easy to measure(GAF scale)
  6. X cultural factors
3. When clinicians diagnose an individual as abnormal/suffering from a disorder they use the Global Assessment of Functioning Scale (GAF). This assesses how well the person is functioning in various areas of their life. People are rated on a scale of 1-100 (1-10 being the lowest level of functioning=serious danger of harming self or othersORpersistant inability to maintain personal hygieneORserious suicidal act with clear expectation of death.
4. DEVIATION FROM IDEAL MENTAL HEALTH(Jahoda 1958)
  1. 1.personal growth(the extent to which an individual develops their full capabilities)
  2. 2.reality of perception
  3. 3. autonomy(being independent and self regulating)
  4. 4.integration(being able to cope with stressful situations)
  5. 5.self attitudes(having high self esteem and a strong sense of identity)
  6. 6.environmental mastery(involving the ability to love, function at work and in interpersonal relations, adjust to news situations&solve problems.
  7. Jahoda's idea is positive so it can be used effectively in therapy=real life/practical application.
  8. X culturally relative e.g.high self esteem is good=individualistic cultures
  9. X subjective
  10. X wouldn't everyone violate these ideal standards at some point in their life?
BIOLOGICAL approach
1. 1.BIO-CHEMISTRY- brain produces neurotransmitters=passage of electrical messages across neurons in brain, too much or not enough of specific NT's=mental disorder.
2. 2.ANATOMY OF BRAIN- changes in brain structure e.g.enlarged ventricles can lead to mental disorders e.g.schizophrenia.
3. 3.GENETIC INHERITANCE- twin studies comparing monozygotic and dyzygotic, Gottesman found that chance of: children of suffererd developing=13%, developing when you have a fraternal twin with disorder=17%, developing if you have an identical twin with disorder=48%. This suggests that genetics do play a part in schizophrenia.
4. GAZER ET AL(2000) took MRI scans of people with schizophrenia and compared these with MRI's of people not with SCH, he concluded that individuals with schizophrenia have significantly enlarged ventricals.
5. Supporting evidence is scientific and objective.Results are less influenced by bias.
6. X cannot say that imbalance of NT's cause a disorder, it is merely establishing a relationship(correlational)
7. X biological approach argued to=reductionist as ignores other factors, reduces all explanations purely to a biological level.
8. X no evidence that disorderd are caused PURELY by genetic inheritance, if genetics were the cause of SCH then we would expect a concordance rate of 100%, bu not so other factors must be involved.
9. Practical applications- drugs to balance NT's
BEHAVIOURAL APPROACH
1. CONSEQUENCES- Skinner states reinforcement&punishment, means that abnormal behaviour had been shaped by the consequences it has received. Seligman claimed that some cases of depression can be explained through his theory 'learned helplessness'
  1. 'learned helplessness'- H brings attention thus reinforcement from other people. We therefore learn to be helpless even when help is offered.
2. IMITATION(social learning theory)- an extension of operant conditioning, observing powerful role models will cause us to imitate any abnormal behaviour if we witness the behaviours being rewarded.
  1. VICARIOUS REINFORCEMENT=when we see others rewarded for behaviour(indirect reinforcement).
3. ASSOCIATION(learning theory) develop a conditioned response e.g.a phobia, to a certain stimuli.
4. WATSON&RAYNER(1920)- worked with 11 month old 'Albert, first tested his response the white fluffy objects. He showed no fear, next they created a conditioned response by striking a four foot steel bar with a hammer to startle him when he interacted with the fluffy objects. They repeated this 3 times,&did the same a week later. Now when they showed the fluffy white rat to Albert he began to cry, they had conditioned a fear response in him(association).
5. X supporting evidence is unethical&is a lab exp=artificial results.
6. Scientific approach as is based on behaviour that can be observed and measured.e.g.visible symptoms of a mental disorder.
7. X MENZIES&CLARKE(1993) found that 2% of kids who suffered from a water phobia reported a conditioning experience with water.
PSYCHODYNAMIC APPROACH(FREUD)
1. 1.Negative early experiences- traumatic events or problems with the parent-child relationship, these experiences remain in our unconscious mind and create conflict(which may turn into a mental disorder as struggle to cope).
2. 2.Unconscious conflict in the mind- Id,Ego&the super ego. Relationship between them is hostile&can lead to an abnormality. If super ego is too strong it could create excessive self pursecution which could lead to depression.
3. 3.Faulty defence mechanisms/excessive use=emotional problems.
  1. Denial- we refuse to admit&accept reality.
  2. Repression- emotions/memories are forced into the unconscious mind.
  3. Displacement- diverting emotions onto someone/thing else as unacceptable to express them.
  4. Projection- own unacceptable faults are attributed to someone else.
  5. Regression- responding childishly in the face of anxiety.
  6. X does not resolve conflict
4. X unscientific(cannot be observed)
5. MAIER&LACHMAN(2000) surveyed3000 adults&found symptoms of depression were more common in those who'd lost a parent in childhood due to death or divorce.
6. X too much emphasis on the past, even if childhood plays a part in abnormality, that does not mean that adulthood does not play a part.
COGNITIVE APPROACH
1. All mental disorders are the result of irrational thought processes.
2. ALBERT ELLIS's ABC model- A=activating events, B=the belief that may be ir/rational, C=the consequence. rational>positive consequences, irrational.negative(i.e. symptoms)
3. AARON BECK's approach sees depression as a result of negative thinking about themselves/a situation. Depression caused by cognitive errors. Beck also believed that these errors in cognitive thinking may have been caused by negative experiences in childhood.
  1. Cognitive errors
    1. Arbitary Inference- a conclusion based on insufficient evidence/none, e.g. "my car broke down because I am a worthless person".
    2. Selective abstraction- a conclusion based on many aspects of a situation, e.g." I forgot to put salt in the potatoes which ruined the whole dinner party, I'm a useless host".
    3. Over generalisation- based on a single often trivial event, a teacher assumes that he is no good at his job because one student fell asleep in class.
4. X many studies into this approach are correlational.
5. TEMPLE-WISCONSIN STUDY found that negative beliefs may play a part in the development of depression. A sample of first year uni students(none suffering depression)were assessed every 4 months. After 2.5 years suggest that students who thought negatively were more likely to develop depression. 17% of high risk pts compared 1% low risk pts.
6. RIMM&LITVAK- found that in a controlled setting, if you manipulate individuals into thinking negative/irrationally they=more anxious&depressed.
7. Practical application- proved very effective at dealing with a wide range of disorders including depression, aim of therapy=rationalise thoughts.
THERAPIES
1. Electro Convulsive Therapy- patient given anaesthetic&a muscle relaxant, electrodes placed on temple(unilateral or bilateral, small amount of electric current (between 70&150 volts) with an amplitude of 0.6 amps is administered for about half a second. This produces convulsions and seizures that last for roughly 1 minute, The procedure is normally repeated 2-3 times a week for up to 4 weeks.
  1. PETRIDES(2001)found that between 65%&85% of patients with depression showed improvements following ECT.
  2. PAGNIN conducted a meta-analysis looking at ECT patients and found that it is more effective for depression than anti-depressants(a mixture works best).
    1. X not a full treatment
  3. X not a treatment for all abnormalities, just depression&sometimes schizophrenia.
  4. X unethical
2. Drug therapy
  1. SSRI's(selective serotonin re-uptake inhibitors)such as Citalopram can be prescribed to patients suffering depression, they work by blocking the re-uptake of serotonin, so more can be absorbed through the synapses.
    1. Possible side effects include: loss of appetite, insomnia, migraines
  2. Neuroleptics such as Clozapine are prescribed to treat schizophrenia by blocking the D2 receptors, stopping dopamine from being absorbed through the synapses(lowering dopamine levels).
    1. Possible side effects include: tardive dyskinesia, enlarged breasts, shorter life span.
  3. Benzodiazepines such as Valium are used to treat any form of anxiety/panic disorders, they work by increasing the NT GABA which decreases the other NT's such as serotonin.
    1. Possible side effects: 'chemical straightjacket'
  4. KELLER ET AL found that 50-65% of people who suffer from psych disorders improve when given drugs.
  5. Easy to administer&control, patients do not need to be constantly supervised(so more practical than 'talking therapies')
  6. X drugs do not cure the illness
  7. X ethical issues/side effects
3. Psychological therapy
  1. WOLPE(1958-1969)Systematic desensitisation
    1. 1.Functional analysis involves the client and therapist constructing a fear hierarchy(list of situations in which the client would feel anxiety) through fear analysis.
    2. 2.Relaxation training involves the therapist teaching the client different techniques for relaxing including:breathing control, muscular tension.
    3. 3.Graduated Exposure involves the client gradually being brought into more contact with their phobic object over a course of 6 to 12 sessions(encouraged to use relaxation techniques until completely able to relax at that level). Treatment is complete once the client has reached their treatment goals.
    4. In vitro=the client imagines exposure, In vivo=the client is actually exposed to the phobic stimulus
    5. Reciprocal Inhibition- anxiety is inhibited by a feeling or response that is not compatible with the anxiety,
    6. DENHOLTZ, HALL&MANN found that 60% of clients who were treated for a flying phobia continued to fly during the 3.5 year follow up.
    7. BARLOW found between 60%-90% success rate for clients treated for a spider phobia and injection phobia.
    8. X ROSEN, GLASGOW&BARRERA found that clients treated with SD for nimal phobias were as likely as the control group to continue to avoid the feared animals.
    9. X SD could be a stressful experience for the client, they are not always protected from harm. BARLOW&DURAND(1995) found that overexposure of the phobic stimulus during the early stages of treatment can intensify the phobia.
  2. Psychoanalysis involves making unconscious conflicts conscious again so that: the patient gains insight&can deal with it in a healthy way(through various techniques)
    1. Free association involves the patient talking to therapist about anything that comes to mind, its crucial in revealing their unconscious mind, patient may show: Resistance(changing subject), Transference(acting towards therapist as though he were the despised parent). Therapist must interpret free association to help patient gain insight.
    2. Dream Analysis involves the patient being encouraged to recent dreams&these are analysed by therapist to reveal unconscious conflicts that have been repressed.
      1. Wish fulfilment=attempt to resolve a conflict through the unconscious(material can be sensitive so is encoded), Manifest content=content as we recall it, Latent content=the interpreted meaning, Dream Work=exploring the meaning of dreams as it is distorted, Catharsis=the release of pent up emotion when the patient brings repressed material into conscious awareness.
    3. Projective Tests involve patients projecting or imposing their own thoughts and associations on a particular stimulus. The most famous=Rorschach ink blot test, patients shown a series of ink blots&asked what the shape means to them. Particular themes will emerge during therapy revealing unconscious anxieties&conflicts.
    4. BERGIN found that Psy had a success rate of 83%, showing that the majority of patients are helped by this treatment.
    5. X LUBORSKY&SPENCE found that certain clients are more likely to benefit from Psy therapy than others. These clients are referred to using the acronym YAVIS(Young, Attractive, Verbalisation, Intelligent, Successful)
    6. X Ethical Issues(may create more emotional harm than good)
  3. Cognitive Behavioural Therapy(loosely based on ABC model)aims to help rationalise irrational thinking as this helps remove mental health concerns.
    1. Disputing Belief Systems- instead of the client basing their behaviour on unrealistic aims like mastabatory thoughts, you may challenge them to think of ANYONE that's brilliant at everything(so challenging their existing irrational beliefs).
      1. Role Play can be used to get the client to play an active role in their recovery. For example getting the client to argue against their own irrational beliefs about their spider phobia. The clients is now arguing that it is irrational.
        Teach clients better ways of coping with symptoms, this is called "coping strategy enhancement" and can empower clients. With some schiz patients we may teach them how to better handle their hallucinations(false sensations)e.g.they may be encouraged to drown out accusatory voices by wearing headphonesORplaying really loud music(help cope in short term).
        client may be asked to complete'homework assignments'which require them to act how they were previously unable to do e.g.someone suffering from high levels of social anxiety may be told to initiate conversations with two people and make a record of what happened to bring back to the therapist. The tasks will get increasingly more difficult.
    2. ELKIN ET AL studied 120patients and found that whilst drugs tended to be the most effective therapy for severe depression, cognitive therapy is longer lasting than BZ's
    3. X CBT does not work for everyone, Ellis believed that some patients were not putting their revised beliefs into action, or that people simply do not want the direct advice that CB therapists give out.
    4. ENGLES ET AL conducted a meta-analysis and found that CBT is an effective treatment for a number of disorders(OCD&socialETC)
    5. Works to treat a range of abnormalities so is not only beneficial for people suffering from mental health disorders but also sufferers of anxiety/phobias.

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	Created by mrsdaydream almost 11 years ago