Definitions of Abnormality

Definitions of Abnormality

• Statistical infrequency defines abnormality as a deviation more than two standard deviations from the mean incidence rates.
• Often used in clinical diagnoses to compare with a baseline, to assess the severity of disorders.
• It assumes abnormal characteristics are negative, which isn't always the case.
• The failure to function adequately definition, proposed by Rosenhan and Seligman (1989), suggests abnormality if a person's mental state prevents them from leading a 'normal' life, lacking motivation and obedience to social norms.
• A strength of this definition is that it takes into account the patient's perspective by including subjective symptoms and objective opinion for more accurate diagnoses, not constrained by statistical limits.
• A weakness of this definition is that it may lead to labeling patients as ‘strange' or ‘crazy', reinforcing negative stereotypes, and could cause discrimination and prejudice.
• Deviation from social norms suggests abnormal behavior is straying from social norms specific to a certain culture.
• There are general norms, applicable to most cultures, and culture-specific norms.
• Mental health diagnoses based on this definition vary across cultures, historically leading to discrimination for social control.
• Due to its reliance on subjective social norms, this explanation suffers from cultural relativism and hearing voices varies among African and Asian cultures.
• Deviation from ideal mental health, proposed by Jahoda (1958), focuses on the criteria for an ideal mental state, and this includes self-actualization, accurate self-perception, lack of distress, normal motivation, and high self-esteem.
• A main issue is that Jahoda's expectation of ideal mental health may be unrealistic, as the majority of people cannot maintain all criteria and is a very limited method of diagnosing mental health disorders.
• This definition, like deviation from social norms, it suffers from cultural relativism.

Characteristics of Phobias

• Behavioral characteristics include panic, avoidance, and endurance.
• Panic involves heightened physiological arousal caused by the hypothalamus activating the sympathetic nervous system.
• Avoidance occurs due to negative reinforcement, as it prevents exposure to the phobic stimulus, impacting daily life.
• Endurance happens when the patient remains exposed to the phobic stimulus for a prolonged period, experiencing heightened anxiety.
• Emotional characteristics include anxiety and unawareness that the anxiety is irrational.
• Cognitive characteristics include selective attention to the phobic stimulus, irrational beliefs, and cognitive distortions.
• Selective attention means the patient focuses on the phobic stimulus, even with severe anxiety.
• Irrational beliefs are the cause of unreasonable anxiety responses due to incorrect perception of danger.
• Cognitive distortions involve the patient not accurately perceiving the phobic stimulus.

Characteristics of Depression

• Behavioral characteristics include changed activity levels, aggression, and altered sleeping and eating patterns.
• Emotional characteristics include lowered self-esteem, constant poor mood, and high levels of anger.
• Cognitive characteristics include absolutist thinking (jumping to irrational conclusions), selective attention towards negative events, and poor concentration.

Characteristics of Obsessive-Compulsive Disorder (OCD)

• Behavioral characteristics include compulsions (repetitive thoughts reducing anxiety) and avoidance behavior, which is negatively reinforced.
• Emotional characteristics include guilt and disgust, depression, and anxiety associated with acknowledging irrational obsessive thoughts.
• Cognitive characteristics include acknowledging excessive anxiety, developing cognitive strategies, and having obsessive thoughts (repetitive, intrusive, causing anxiety, leading to compulsions).

The Behavioural Approach to Explaining Phobias

• Mowrer suggested phobias are acquired through classical conditioning and maintained through operant conditioning.
• Watson and Rayner demonstrated how Little Albert associated the fear caused by a loud bang with a white rat and after several repetitions, Albert associated the rat (CS) and fear (CR).
• This conditioning then generalized to other objects e.g. white fluffy Santa Claus hats.
• Phobics practice avoidance behaviors, meaning that they avoid the phobic stimulus and by avoiding this phobic stimulus, they avoid the associated fear.
• Mowrer emphasizes the importance of exposing the patient to the phobic stimulus and that the patient realizes that the phobic stimulus is harmless.
• Buck suggested safety is a greater motivator for avoidance behavior, rather than simply avoiding the anxiety associated with the phobic stimulus.
• Seligman suggested that we are more likely to develop phobias towards ‘prepared' stimuli and this increases the likelihood of survival and reproduction, and so this behaviour has a selective evolutionary advantage.

The Behavioural Approach to Treating Phobias

• Systematic desensitisation is a behavioural therapy designed to reduce phobic anxiety through gradual exposure to the phobic stimulus.
• It works due to reciprocal inhibition i.e. it's impossible to be both relaxed and anxious at the same time.
• Steps that occur here are the patient and therapist draw up an anxiety hierarchy together, made up of situations involving the phobic stimulus and the therapist then teaches the patient relaxation techniques e.g. breathing techniques and meditation.
• Gilroy et al. followed up 42 patients treated in three sessions of systematic desensitisation for a spider phobia, and showed a reduction in their symptoms as compared to the control group.
• Systematic desensitisation is suitable for many patients, including those with learning difficulties and has more acceptable to patients, as shown by low refusal and attrition rates.
• Flooding is a behavioural therapy designed to reduce phobic anxiety in one session, through immediate exposure to the phobic stimulus.
• This occurs in a secure environment from which the patient cannot escape, and this relies on the principle that it is physically impossible to maintain a state of heightened anxiety for a prolonged period

The Cognitive Approach to Explaining Depression

• Becks proposed that one has a cognitive vulnerability towards developing depression, through faulty information processing, negative self-schemas and the cognitive triad of automatic negative thoughts.
• Grazioli and Terry's evaluation of 65 pregnant women supports the link between faulty cognition and depression.
• An increased understanding of the cognitive basis of depression translates to more effective treatments through elements of the cognitive triad.
• Ellis' ABC model cannot explain all types of depression and the ABC model shares the same advantage as Beck's cognitive theory in that it provides a practical application in CBT.
• Both the ABC model and Beck's cognitive theory of depression share the same disadvantage in that they cannot explain all aspects of depression
• This poses a particularly difficult practical issue in that patients may become frustrated that their symptoms cannot be explained according to this theory and therefore cannot be addressed in therapy.

The Cognitive Approach to Treating Depression

• CBT aims to identify and challenge irrational thoughts, replacing them with more productive behaviors.
• Cognitive and Ellis's therapy aims for patients to test the reality of their beliefs, leading to a vigorous argument.
• Patients are encouraged to engage in enjoyable activities, to provide further counter-evidence for their irrational beliefs.
• March followed a group of 327 adolescents where 81%, 81% and 86% were the respective improvement rates for experimental conditions + CBT antidepressants, antidepressants CBT.
• CBT may not be an appropriate treatment for all cases of depression, therefore patients may become frustrated that they have such little input or say into how their therapy is brought about.

The Biological Approach to Explaining OCD

• The genetic explanation, through the diathesis-stress model, suggests that some have a genetic vulnerability towards developing depression.
• Lewis et al. found that of his OCD patients, 37% had parents with OCD and 21% had siblings with OCD and OCD is polygenic and aetiologically heterogenous, meaning that its origin has many different causes.
• Nestadt et al. reviewed previous twin studies of OCD and found that 68% of identical twins, compared to 31% of non-identical twins, share OCD.
• Ignores environmental factors as Cromer et al. found that of his OCD patients, over half had experienced a trauma in their lives.

The Biological Approach to Treating OCD

• SSRIs act on the serotonin system by preventing the reuptake and breaking down of serotonin by the presynaptic neuron.
• Tricyclics have a similar effect, but are reserved for those who do not respond well to SSRIs.
• SNRIs increase the concentration of the noradrenaline neurotransmitter in the brain but a limitation of drug therapy are the serious side effects.
• Increased knowledge about the effectiveness of certain drug treatments for OCD and cognitive treatments can reduce the time people take off work through sick days.
• A strength of such drug use is that it's cost-effective and non-disruptive.