LENKA MILOJEVIC AS-Level Psychology Page 1 PSYCHOPATHOLOGY DEFINITIONS OF ABNORMALITY (AO1 + AO3) Definition 1: Statistical inferquency - Behaviour that is rarely seen as normal. - Defining abnormality in terms of STATISTICAL INFREQUENCY ‘statistics’ — the number of times something has been done. - Often given in percentages EXAMPLE IQ and intellectual disability disorder - The average is 100. - Individuals below 70 are diagnosed due to statistical infrequency (2%). over the general population. EVALUATION • REAL-LIFE APPLICATION - It’s a useful and required part of clinical assessment. It’s good for diagnosing a lot of disorders that include comparison to some statistical norms. • POSITIVE INFREQUENCY - Engaging in rare behaviour styles doesn’t necessarily mean a person requires treatment (e.g. IQ of over 130 isn’t undesirable). Shows that statistical infrequency isn’t enough to make a diagnosis. • LABELING - Some people with disabilities might live normal lives and not need a label emphasising their shortcomings. Definition 1: Statistical inferquency - Based on social context. - Societies and groups make DEVIATION FROM SOCIAL NORMS collective ‘judgements’ about ‘correct’ behaviours - Has cultural context as there are very few behaviours that are considered universally abnormal. - Has historical context (e.g. homosexuality) EXAMPLE Antisocial personality disorder (APD) - formerly known as ‘psychopathy’ - failure to conform to ‘lawful and culturally normative ethical behaviour’ EVALUATION • NEVER ENOUGH - Deviation isn’t the sole explanation to mental disorders (e.g. APD is an example, but it doesn’t take into consideration harming others) • CULTURALLY RELATIVE - what is considered abnormal varies from culture to culture (e.g. somewhere it’s ok to hear voices, in the UK it’s not) • HUMAN RIGHTS ABUSES - Too much reliance on this definition can lead to it. The question of eccentric vs. abnormal. Diagnoses were sometimes used for social control (nymphomania = women attracted to working class men; drapetomania = black slaves trying to escape) Definition 3: Failure to function adequately - Inability to cope with everyday FAILURE TO FUNCTION ADEQUATELY living and function adequately (e.g. not being able to keep a job, relationship, maintain hygiene…) - Rosenham and Seligman proposed signs of failure to cope: 1) Personal distress 2) Irrational/dangerous behaviour 3) Disregard interpersonal rules EXAMPLE Intellectual disability discorder - Even if somebody has a statistically rare low IQ, they can’t be diagnosed unless that doesn’t tamper with their ability to function. EVALUATION • PATIENTS’ PERSPECTIVE- Takes into account the patient’s feelings and experience. • ECCENTRIC VS ABNORMAL- People who do extreme sports or live alternative lifestyles may be considered abnormal this way. • SUBJECTIVITY - In spite of checklists and standardised procedure, there’s a question of whether psychiatrists should be allowed to judge the distress/suffering of a patient LENKA MILOJEVIC AS-Level Psychology Page 2 EVALUATION EXAMPLE - Any form of mental state that is different from the normal/ideal mental state - Marie Jahoda provided a list of Never keeping a job - May be a sign of deviation • CULTURALLY RELATIVE- Some of Jahoda’s HOWEVER… 1. No symptoms or distress 2. Rational and good selfperception 3. Self-actualisation 4. Coping with stress 5. Realistic view of the world 6. Good self-esteem and lack guilt 7. Independent 8. Successfully work, love, enjoy leisure - This could also be a sign of failure to function adequately. classifications are specific to Western European and North American (individualist) cultures where self-actualisation is valued over community. • UNREALISTIC - Most people deviate from ideal mental health, at times at least. • REAL-LIFE APPLICATION - Makes it clear to which ideal people should strive to achieve. Behavioural characteristics Emotional characteristics Cognitive characteristics Specific types of DSM categories 1) Panic 1) Fear + Anxiety 1) Selective attention to the phobic stimulus - behaviours like crying, screaming, - fear is the immediate 1) Specific phobia: fear of an object (e.g. animal or body part), or a situation (e.g. flying, having an injection) running away from the phobic stimulus 2) Avoidance PHOBIAS range, applicability etc. Covers most of the reasons someone would seek help from mental health services. from ideal mental health. criteria: DEVIATION FROM IDEAL MENTAL HEALTH • COMPREHENSIVE - The definition has a good - considerable effort to avoid coming into contact with the phobic stimulus - may make life difficult depending on experience - fear leads to anxiety - the phobic person cannot tear their attention away from the phobic stimulus in its presence 2) Unreasonable responses - 2) Irrational beliefs - e.g. social phobias may involve unreasonable responses, widely beliefs such as ‘if I blush people disproportionate to the threat will think I’m weak’ posed what the stimulus is 2) Social anxiety (social phobia): phobia of social situations (e.g. using a public WC, speaking in public…) 3) Agoraphobia: phobia of being outside or in public places 3) Endurance - Sufferer remains in the presence of the stimulus and endures the stress Behavioural characteristics Emotional characteristics Cognitive characteristics Specific types of DSM categories 1) Activity levels 1) Lowered mood 1) Poor concentration 1) Major depressive disorder: severe but short-term - They have less energy, get lethargic - More than feeling lethargic. - Sufferers would describe - Difficulty in simple decision a lot. - In severe cases they might not get out of bed. themselves as ‘worthless’ or ‘empty’. making. - Unable to stick with a task. 2) Absolutist thinking DEPRESSION 2) Disruption of sleep 2) Anger - Insomnia (reduced) - Hypersomnia (increased) - Aggression - Self-harm 3) Eating behaviour - Increase or decrease - Weight gain/weight loss - ‘black and white’ - An unfortunate situation seen as an absolute disaster 2) Persistent depressive disorder: long-term or recurring; includes sustained major depression and dusthymia (persistent mild depression) 3) Disruptive mood dysregulation disorder: childhood temper tantrums 4) Premenstrual dysphoric disorder: disruption to mood prior to and/or during menstruation LENKA MILOJEVIC OBSESSIVECOMPULSIVE DISORDER AS-Level Psychology Page 3 Behavioural characteristics Emotional characteristics Cognitive characteristics Specific types of DSM categories 1) Compulsions 1) Anxiety + Distress 1) Obsessive thoughts 1) OCD: repetitive behaviour and obsessive thinking - Ritualistic monotone behaviour - Reducing stress - Repeated actions - Overwhelming anxiety - Distress, fear at obsessive - 90% have these - Recurring intrusive thoughts 2) Avoidance 2) Guilt + Disgust - Managed by avoiding contact with - Irrational guilt over minor situations that trigger anxiety. thoughts (e.g. being contaminated by germs, dirt) moral issues - Disgust towards oneself/something external 2) Awareness of surplus anxiety - In spite of insight, they experience catastrophic thoughts and are hypervigilant (overaware) of their obsession BEHAVIOURAL APPROACH TO EXPLAINING PHOBIAS UCS→ UCR NS→ NR NS + UCS→ UCR CS→ CR THE TWO-PROCESS MODEL by Hobart Mowrer 1. CLASSICAL CONDITIONING (ACQUISITION) 2. OPERANT CONDITIONING (MAINTENANCE) 2) Trichotillomania: obsessive hair pulling 3) Hoarding disorder: compulsive gathering of possession and inability to par with things regardless of their value 4) Excoriation disorder: compulsive skin picking