Transcript File - the Durham School Psychology Department!

Individual
Differences
(psychopathology)
Revision
Syllabus
INDIVIDUAL 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
EVALUATION
• 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?
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
EVALUATION
•
•
•
•
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 TriPartitie personality which may lead to
symptoms of mental illness
–
•
–
•
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
Phobias?
Treatment should therefore take a
psychological focus and aim to uncover
and overcome repressed unconscious
trauma
–
•
E.g? Dominant Id? Dominant Super Ego?
Early trauma may lead to abnormal
use of DEFENCE MECHANISMS
SUPORTING EVIDENCE that MDs are
caused by early trauma and unconscious
conflict
Psychological Explanation 2
BEHAVIOURAL
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
•
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
Psychological Explanation 3
COGNITIVE
EVALUTION
•
•
•
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…
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…
–
Cognitive triad
–
Maximisation / minimisation
–
Selective Abstraction
–
i-cant-stand-it-itis
•
TOO SIMPLISTIC…
–
Musterbation
•
PRACTICAL APPLICATIONS…
Treating abnormalities
THERAPIES
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 1
ELECTRO-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
EVALUTION
•
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
•
EVIDENCE OF EFFECTIVENESS
•
ETHICAL ISSUES – major negative
side effects including…
•
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…
–
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 1
Based on the Psychodynamic Approach
PSYCHOANALYSIS
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…
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)
–
Ideal client (YAVIS)?
Psychological Therapy 2
Based on the Behavioural Approach
SYSTEMATIC DESENSITISATION
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…
•
•
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
Psychological Therapy 3
Based on the Cognitive Approach
COGNITIVE BEHAVIOUR THERAPY
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)
•
•
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
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)