Chapter 7

About

Psychopathology

This chapter explores an extremely important area within psychology— psychopathology. Psychopathology is the scientific study of mental disorders including their classification and their underlying causes; it is also known as abnormal psychology.

What is abnormality? If clinicians are to treat patients with mental disorders, they need to distinguish between normal and abnormal behaviour. However, first they must define abnormality. Mental disorder has been likened to physical illness—for example, having a cold is an abnormal and undesirable state. We will consider that definition a little later.

Why do some people have mental disorders and others don’t? Are mental disorders “caught” in the same way you catch a cold, or do they depend on genetic factors and/or personality? We will explore mental abnormality and its potential undesirability in this chapter.

Most definitions of abnormality and our explanations for mental disorder are based on Western beliefs. In recent years, however, there has been a growing recognition that it is very important to consider cultural and sub-cultural differences. We will be discussing these issues.

Later in the chapter, we will discuss three common and important mental disorders: phobias, depression, and obsessive–compulsive disorder (OCD). We will focus on their various characteristics or symptoms. After that, we consider how these disorders can be explained and, most importantly, how they can be treated.

What you need to know

The specifications for AS and A-level year 1 are the same for this topic, so you will need to cover everything in this chapter.

Psychopathology will be examined in Paper 2 of the AS exam and Paper 1 of the A-level exam.

  • Definitions of abnormality (see page 265 of the textbook)
  • Behavioural, emotional and cognitive characteristics of phobias, depression and obsessive-compulsive disorder (OCD) (see page 277 of the textbook)
  • Behavioural approach to explaining and treating phobias (see page 284 of the textbook)
  • Cognitive approach to explaining and treating depression (see page 295 of the textbook)
  • Biological approach to explaining and treating obsessive-compulsive disorder (OCD) (see page 305 of the textbook)

Flashcards

Key Terms

Abnormality - an undesirable state producing severe impairment in a person’s social and personal functioning, often causing anguish. Abnormal behaviour deviates from statistical or social norms, causes distress to the individual or others, and is seen as a failure to function adequately.

Agoraphobia - excessive fear of being in open, public, or enclosed spaces leading to avoidance of such spaces.

Automatic thoughts - negative thoughts or ideas that seem to arise spontaneously in the minds of depressed individuals.

Behaviour therapy - an approach to treatment using basic learning techniques to change maladaptive behaviour patterns into more appropriate ones.

Bipolar disorder - a mental disorder involving a mixture of depressive and manic episodes.

Client-centred therapy - a form of humanistic therapy introduced by Rogers and designed to increase the client’s self-esteem and reduce incongruence between self and ideal self.

Clinician (or clinical psychologist) - a person who works in clinical psychology, concerned with the diagnosis and treatment of abnormal behaviour.

Cognitive schema - organised information stored in long-term memory and used by individuals to form interpretations of themselves and the world in which they live.

Cognitive triad - the depressed person’s negative views of the self, the world, and the future.

Cultural relativism - the view that to understand and judge another culture it must be viewed from within that culture, and not from the perspective of the observer’s own culture.

Culture-bound syndromes - patterns of abnormal behaviour found in one or a small number of cultures.

Deviation from social norms - behaviour that does not follow accepted social patterns or unwritten social rules. Such violation is considered abnormal. These norms vary from culture to culture and from era to era.

Extinction - elimination of a conditioned response when the conditioned stimulus is not followed by the unconditioned stimulus or a response is not followed by a reward.

Failure to function adequately - a model of abnormality based on an inability to cope with day-to-day life caused by psychological distress or discomfort.

Fear hierarchy - a list of feared situations or objects, starting with those creating only small amounts of fear and moving on to those creating large amounts of fear; used in the treatment of phobias.

Flooding - a form of therapy in which patients are exposed to the object or situation they fear for lengthy periods of time until their anxiety level has reduced substantially; more often called exposure therapy.

Generalisation - in classical conditioning, the tendency to transfer a response from one stimulus to another that is quite similar.

Humanistic psychology - an approach to psychology that focuses on higher motivation, self-development, and on each individual as unique.

Ideal mental health - a state of contentment that we all strive to achieve.

Interpretive bias - the tendency to interpret ambiguous stimuli or situations in significantly more threatening ways than most other people.

Irrational beliefs - emotionally-laden thoughts that are false or incorrect; in depressed individuals, these beliefs are mostly inflexible and extreme.

Major depressive disorder - a mental disorder characterised by symptoms such as depressed mood, tiredness, and lack of interest and pleasure in various activities.

Memory bias - the retrieval of relatively more negative or unpleasant information than positive or neutral information from long-term memory.

Meta-analysis - a form of analysis in which the data from several related studies are combined to obtain an overall estimate.

Negative reinforcement - a form of operant conditioning in which a response (e.g. avoidance) is strengthened by being followed by prevention or removal of the aversive or phobic stimulus.

Obsessive–compulsive disorder - a mental disorder involving recurrent intrusive thoughts (obsessions) and repetitive behaviours (compulsions) produced in response to obsessions.

Over-generalisation - the error of assuming that a single negative

experience indicates that numerous similar experiences will occur in future (e.g. a single failure indicates that the individual will always fail).

Psychopathology - the scientific study of mental illness or mental disorders including their classification and identification of the causes of mental disorders.

Reciprocal inhibition - the process of inhibiting anxiety by substituting a competing response.

Safety behaviours - actions taken by phobic individuals to reduce their fear/anxiety level and prevent feared consequences.

Self-actualisation - fulfilling one’s potential in the broadest sense.

Self-esteem - the feelings that an individual has about himself or herself.

Serotonin - a neurotransmitter that influences emotional states.

Social norms - the explicit and implicit rules that specify what forms of behaviour, beliefs, and attitudes are acceptable within a given society.

Social phobia - a disorder in which the individual has excessive fear of social situations and often avoids them.

Specific phobia - a strong and irrational fear of a given object (e.g. snake; spider) that is often avoided.

Statistical frequency - behaviours that are statistically rare or deviate from the average/statistical norm are classified as abnormal.

Systematic desensitisation - a form of behaviour therapy in which the fear response to phobic stimuli is replaced by a different response (e.g. muscle relaxation).

Weblinks

http://www.learner.org/series/discoveringpsychology/21/e21expand.html A 25-minute programme on psychopathology, from the “Discovering Psychology” series, exploring the major types of mental illness. Schizophrenia, phobias, and affective disorders are described, along with the major factors that affect them—both biological and psychological.

http://www.nhs.uk/LiveWell/Mentalhealth/Pages/Mentalhealthhome.aspx This NHS mental health website has a menu of mental disorders and information about them.

http://www.bbc.co.uk/science/0/22020430 A BBC website with clear information about depression.

http://www.mind.org.uk/information-support/types-of-mental-health-problems/phobias/#.VRPI8o1FCUk This MIND website gives a good outline of phobias, and the next page gives some types of phobias.

http://www.youtube.com/watch?v=pVt0k9IPQ-A&feature=player_embedded#! A video about John Watson and his Little Albert experiment.

http://www.beckinstitute.org/history-of-cbt/The Beck Institute for Cognitive Behavior Therapy website, with more about CBT and its history, including a video interview with Aaron T. Beck.

https://www.youtube.com/watch?v=YeFl3l74QZA A neat and quick outline of the biological view of mental illness.

Discussion Points

Throughout AQA Psychology you may have noticed self-assessment questions in orange text in the margins. These are discussion points, designed to help you think about the key issues and research in the text, and to consider how you can apply psychology to real life. Although in many cases there is no correct answer to these questions, we have provided some example discussions that could arise from thinking about some of these points. They should also help you structure your thinking on the topic in question.

1. In what ways are you abnormal?

This is not a foolish or an insulting question! It is a good one for psychology students and psychologists to consider, partly because we do have a tendency to interpret “normal” as “what I do/am like”, and partly because the terms “normal” and “abnormal” are misused so often in everyday life.

To answer this, we have to consider exactly what we mean by “abnormal”. Does abnormal mean unusual? Well, in what way are you, a wonderful individual, unusual? Does this make you psychologically abnormal?

Does abnormal mean you are socially unacceptable, because you break social norms? A question to ask is whose social norms you are breaking, as such norms vary culturally and with age group. So if you are conforming to your own group’s norms, would this make you abnormal from another group's viewpoint? What about when you look at members of a different group with different norms—do you label them as abnormal?

And what about failing to function adequately? Who decides what adequately means? And if you have a broken leg and can’t get around as normal, e.g. if you can’t do your job, are you then abnormal? Or if you are having a bad patch, are feeling low and despondent for a couple of weeks, and unable to concentrate, is this a failure in your mental health?

See also Eysenck’s AQA Psychology, pages 265–277.

2. Think of an occasion when you felt helpless or worthless. Could you try to reinterpret the occasion in a more positive way?

Situations with the potential to make individuals feel worthless occur frequently but they affect different people at varying levels.

Situations such as a relationship ending, for example, can make people feel depressed because of the thoughts that they have following the incident. It is difficult to think very positively when this occurs but it is possible to think a little more positively through identifying unhelpful thinking patterns to arrive at a more rational standpoint. Therapists also encourage patients to imagine what a friend would say to them or how they would view the situation as an outsider. This can be understood by various examples:

  • “Everything is ruined, they were perfect and I’ll never find anyone else as good.” This is an example of “all or nothing” thinking where things are either amazing or dreadful. A friend would suggest that you focus on the faults of the relationship and consider more positive opportunities in the future.
  • “I’ll probably have to spend Christmas on my own, that will feel really lonely.” This is an example of “catastrophising”. For most people this is very unlikely!
  • “I’m hopeless at relationships, nothing works out for me, and people always dump me!” This is an example of “overgeneralising”. The use of the words nothing and always suggests the person is extending an example of “being dumped” to the whole of their life. If they were to consider the evidence for the statement it would probably be quite weak.

These examples illustrate how thoughts can shape an individual’s perception of an event and that depressive or anxious thought patterns can be identified and changed for a healthier outlook on a situation.

See also Eysenck’s AQA Psychology, page 297.

3. In what ways might a person’s thoughts about themselves influence the way they react in a particular situation?

People’s cognitions (thoughts) can easily affect how they react in a given situation. During our childhood and beyond, we begin to process information in various ways and our brains can get used to a certain way of dealing with new information. These include thoughts about ourselves. Different past experiences are processed and remembered and then used again when we come to process new information.

Therefore, in a particular situation, a person will use previously processed information about themselves to make sense of what is going on around them. For example, they may have been in a similar situation before and remembered how someone reacted to them or how they reacted. This may make them more or less confident in that situation.

For example, if a depressive had a previous situation where people reacted negatively to what they did or said, when placed is a similar situation, they may easily expect the same reaction to happen again.

See also Eysenck’s AQA Psychology, page 280.