Abnormal Psychology Learning Outcomes

1. To what extent do biological, cognitive and sociocultural factors influence abnormal behavior?
Abnormal Behavior: Depression (Major Depressive Disorder)
o Affective disorder (mood)
o Unipolar depression (fluctuates between normal to depressed)
Socio-cultural etiologies of depression
A. Diathesis Stress Model - Claims that depression may be a result of inherited predisposition and events
from the environment (hence dia-thesis, two explanations).

Lewinsohn et al (01)
- Studied adolescents whom all experienced many negative life events over a 12 month period
- Those who had strongly negative attributions at the start of the study were much more likely to develop
major depression

B. Vulnerability Model (Brown)
- Losing either parents at a young age
- Lack of confiding relationship
- More than 3 young children at home
- Unemployment
Brown & Harris Social origins of depression in women
- Studied 458 women who received hospital treatment for depression between 18-65
- 82% of those who became depressed had recently experienced severe life changing events
- 33% experienced severe life changing events in the non-depressed group
- 23% working class women became depressed within the past year
- 3% in the middle class
- Those with young children were at a higher risk of becoming depressed
- C: Life events that resembled previous experience were more likely to trigger depression

C. Symptoms of depression in different cultures Marsella
- Affective symptoms (sadness, loneliness, isolation) are typical to individualist cultures
- Collectivist cultures have a stronger and tighter social network to support individuals
o Somatic (physical) symptoms are more common (headaches. Etc)
Prince Depression in Africa and Asia
- Claim that no sign of depression in Africa and Asia and it rose from westernization in colonial countries
- Depression is not the same globally

Cognitive Etiologies
A. Learned helplessness and hopelessness (Seligman)
- You are helpless therefore lowering ones self esteem
- Explains withdrawal and link to faulty attribution

Seligman Learned Helplessness Dog Study (Depression)
- Dog trapped in an enclosed area, shocked with electrodes; low wall enclosed open
- Dog did not move although wall was open



B. Faulty Attribution Abramson)
- Negative mind set / Self blame & guilt
- Pessimists
- Attribute negative events to internal, stable and global hence affecting self esteem

C. Negative self schema (Beck)
- Develops early on in life
- Relies heavily upon parental influences
- Negative self schema, new event interpreted negatively regarding yourself.

D. Cognitive Triad (Beck) Self <=> World <=> Future
- Self I am going to do really bad in my coursework
- World Everyone probably thinks I suck
- Future I am going to fail my course

Biological etiologies
A. Neurotransmitter-Serotonin
- Responsible for our Mental Wellbeing (Happiness)/Depression
- During the process of neurotransmission, not all Serotonin gets absorbed by the Post-Synaptic neuron.
- The extra Serotonin is taken back into the Pre-Synaptic neuron through Active Reuptake; or
- The Serotonin gets broken down by Monoamine Oxidase (MAO), which causes a low level of Serotonin
being absorbed by the Post-Synaptic neuron.
- Low level of serotonin in the Post-Synaptic neuron means impulse cannot be started.
- Diathesis Stress Model (Physical vulnerability to stress)

Teuting Depression & Serotonin
- Individuals with depression asked to provide urine sample and was found significant lower levels of
serotonin in the participants with depression

B. Genetics
- Monozygotic twins -> identical twins.
100% same genes = If twin A has something, twin B must have it.
- Dizygotic twin -> fraternal twins/siblings.
50% similar genes.
- If there is a genetic aspect to behavior, a high concordance rate would be expected from Monozygotic
twins.
- Different types of genetic studies: Twin studies, Family studies, and Adoption studies
-
Correlational study - Genetics research mostly done through correlation study.
Procedures of correlational genetic studies
i. Correlational genetic studies are all done in a similar manner.
ii. Observation of pairs of twins or families.
iii. For twin studies, both Monozygotic (MZ) and Dizygotic (DZ) twins, both reared together and apart, will be
used.
iv. Compare concordance rate of depression through the means of percentage.

Twin studies
v. If it were a wholly genetic disorder the concordance rate for MZ twins should be 100 per cent and for DZ
twins 50 per cent.
vi. Otherwise, other factors must be involved.

Family studies
vii. Similarly to twin studies, if depression was caused by genetic factors, we would expect it to run in families.
viii. The closer you are genetically to someone in your family, the more likely you will be to have depression.
Genetics studies grid
Researcher
Research
for
# of
pairs
Subjects Concordance rate
Price
Bipolar
depression
97
MZ
twins
Reared together 68%
Reared apart 67%
119 DZ twins 23%
Allen
Unipolar
depression
- MZ twins 40%
- DZ twins 11%
Bertelsen, Harvald and
Hauge
Unipolar
depression
- MZ twins 80%
- DZ twins 16%
McGuffin et al.
Unipolar
depression
117
MZ twins 40%
DZ twins 20%
Gershon
Unipolar
depression
- First degree relative
ix. Individuals with a first degree relative
with depression was about two to
three times higher than in the general
population.
x. Social learning theory might be a
possible explanation.
Wender
Unipolar
depression
- Adopted children
Adopted children who went on to develop
depression had biological parents that were
eight times more likely to have depression
than their adoptive parents.



2. Evaluate psychological research (that is, theories and/or studies) relevant to the study of abnormal
behavior
Rosenhan On being sane in insane places
- Reliability and Validity of diagnosis
- 8 participants, 5 male and 3 female attempted to be admitted in the psychiatric ward about hearing
voices.
- Stopped showing pseudo-symptoms after admittance
- Made notes of life in the ward and tested the behavior by asking when departure would be
- Participants diagnosed with schizophrenia and no staff suspected sanity & patients deprived of human
rights
Follow up
- Informed psychiatric institute of pseudo-patients; no pseudo-patients sent
- 193 patients judged; 41 were confidently identified as fake, 23 suspected by psychiatrist, 19 by members
as well
- Claims that psychiatrist cant reliably tell the difference between insane and sane
Seven Criteria of Abnormality Seligman & Rosenhan
Condition Explanation
Suffering
Distress or discomfort.

Maladaptiveness Engage in behaviour that made life more difficult.
Irrationality
Incomprehensible, cannot communicate in a reasonable
manner.
Unpredictability Act in ways that are unpredictable.
Unconventionality Experiencing things that are different.
Violation of moral and ideal standards Breaking ethical and moral standards.
Observer discomfort Acting in ways that makes other feel discomfort.
Evaluation and criticism:
- They are value judgments about mental health, i.e. they reflect the ideals and values of the person who
constructed the list.
- A psychopath, for example, often has a very positive attitude to self, but his amoral behavior is likely to be
seen very negatively by others.
- Ambiguity and subjectivity in defining terms e.g. reality and positivity.
- There are people who are normal that does not fulfill the characteristics and people that are abnormal
that fulfill the characteristics.
- Influenced by cultural attitudes.
- Too idealistic, only a few individuals can achieve the idealistic self.
- Too difficult to measure, too vague to diagnosis.
Classification/Diagnosis systems
- Classification systems are supposed to be objective.
- Traditional medical model in psychiatry is now assumed to be reductionist.
- Most psychiatrists use a biopsychosocial approach in diagnosis and treatment.
Diagnose based on symptoms.
- Affective (mood) symptoms
- Behavioural symptoms
- Cognitive (thought process) symptoms
- Somatic (physical) symptoms
- Based heavily upon abnormal experiences and belief reported by patients.
- Agreed by a team of professionals.
- Explains why Classification/Diagnosis systems are often updated and revised.
Strengths of classification systems
- Statistical diagnosis
- Quantifiable
- Ability to identify disorders based on symptoms therefore suitable treatment can be applied
Weakness of classification systems
- Ethical consideration is the main weakness of Classification systems
- The effects of labeling
- Leads to stigmatization
- Prejudice and discrimination
- Self labeling can lead to Self-fulfilling prophecy
- Person diagnosed with disorder act according to the label
DSM Diagnostics and Statistical Manual of Mental Disorders
A handbook used by psychiatrists in the US to identify and classify symptoms of psychiatric disorders.
Standardized system in diagnosis based upon patients clinical and medical conditions psychosocial stressors the
extent that a persons mental state interfere with their daily life
Five axis of the DSM
Axis 1: Clinical Syndromes
Axis 2: Developmental and Personality Disorders Axis 3: Medical Conditions
Axis 4: Psychosocial stressors
Axis 5: Global assessment of functioning
Ethical concerns regarding the DSM
- Better to regard those suffering from mental disorders as sick rather than morally defective.
- Removes responsibility from the patient.
- Does not completely prevent patients from being labeled.


3. Examine the concepts of normality and abnormality
Normality what is considered normal to a group of people
Abnormality:
1. It is maladaptive (harmful) and/or disturbing to the individual
2. It is disturbing to others.
3. It is unusual a characteristic not shared by many members of the population.
4. It is irrational; it doesnt make sense to the average person.
Insanity reasons to differentiate between those people who can be held entirely responsible for their crimes and
those people who have a psychological disorder that cannot be held fully responsible. (NGRI)
DSM doesnt include etiology or treatments, but provides ways to diagnose patients of such disorders.
Deviation from the norm (Statistical infrequency)
- Unusual behaviors are sometimes desirable e.g. geniuses
- Undesirable behavior are sometimes normal e.g. depression
- Having disorders without breaking social norms.
- Norm differs due to culture, age. Criteria are not universally applicable.
Who decides the extent of deviation from norm?
- Causes ethical issues
- Social labeling
- Discrimination
- Violation of human rights
Social deviation
- Normality defined by the standards of social behaviour.
- Variation of norms in different demographic/social groups.
- Situational norms: Acceptable depending on situation
- Developmental norm : Acceptable depending on development.
- Norms changes according to prevailing moral values e.g. Homosexuality, Divorce
- Pressure on becoming the norm.
- Conforming to the norm without internalising it.
- Repressed to a point where one develops a disorder.
Dysfunction and distress
- Behaviour disrupts that ability to work and/or to conduct satisfying relationship with people.
- Not all mental disorders are accompanied by distress (anti-social personality disorder).
- Not all distress are disorders (grief).
- Certain elements jointly determine abnormality, when they co-occur, then it is symptomatic. (Rosenhan
and Seligman)

Criterias of Abnormality
4. Discuss validity and reliability of diagnosis
Purpose of diagnosis
- Identify abnormal disorders so treatment can be applied accordingly.
- Provides investigation opportunities into the etiologies of disorders.
Methods of diagnosis
Biological tests
- Brain scans
- Blood tests
Psychological tests
- IQ test
- Personality test
- Cognitive tasks
- Interviews
- Observations
Reference to the Classification System (e.g. DSM, ICD)
Classification/Diagnosis systems
Strengths of classification systems
Weakness of classification systems
Reliability
- Whether the same disorder is diagnosed every time.
- Inter-rater reliability: whether different diagnosticians get the same diagnosis. ie. how objective the
diagnostic criteria is.
- Test-retest: whether repeating the diagnosis will give a different result between each time.
Cooper et al Clip shown to psychiatrist form NY and London. NY psychiatrist diagnosed schizophrenia more;
London diagnosed mania or depression
Beck Two psychiatrist diagnosed 153 patients and agreement matched up 54%. Vague diagnoses and process.
Validity
- Confirmation bias: Psychiatrists puts emphasis on factors that hint patients disorders and overlooks other
possible factors.
- FAE: Over attributing the causes to the dispositional factors.
- Self-fulfilling prophecy: Patient gets labeled as having a certain disorder and act according to the label
Rosenhan On being sane in insane place
Temerline Authority on diagnosis
- Two groups of participants listened to same taped interview about a person describing own life; normal
life
- 1 group was told by a psychiatrist that he thinks the man was psychologically healthy; the other group tol
he was psychotic
- Participants who were told normal, gave normal diagnostic
- Participants told psychotic gave psychotic diagnosis
- Influence and Authority affects perception

5. Discuss cultural and ethical consideration in diagnosis (for example, culturalvariation, stigmatization)

6. Describe symptoms and prevalence of a disorder from two of the following groups:
a. Anxiety disorders
b. Affective disorders
c. Eating disorders
Obsessive Compulsive Disorder (OCD) (anxiety disorder)
Symptoms
International Classification of Diseases 10th edition (ICD 10)
- Recurrent obsessional thoughts or compulsive acts.
- Obsessional thoughts
- Ideas, images, impulses that enter the individuals mind repeatedly in a stereotyped form.
- Extremely distressing, the sufferer often tries, unsuccessfully, to resist them.
- Compulsive acts
- Stereotyped behaviours that are repeated.
- They are not inherently enjoyable neither do they result in the completion of particularly useful tasks.e.g.
excessive washing or cleaning.
Diagnostics and Statistical Manual of Mental Disorders 5th edition (DSM IV)
- Obsessions
- Recurrent and persistent thoughts, impulses or images that are experienced.
- Preoccupation with sexual, violent or religious thoughts.
- Compulsions
- Repetitive behaviours that are aimed at reducing distress or preventing dreaded event or situation.
- Extreme hoarding
- Nervous rituals (e.g. opening and closing a door a certain number of times before entering or leaving a
room)
- For most of the time during the current episode, the person does not recognize that the obsessions and
compulsions are excessive or unreasonable.
Prevalence
- Fourth most common mental disorder
- In US, one in 50 adults suffers from OCD
- About one third to one half of adults with OCD report a childhood onset of the disorder (suggests that the
continuum of anxiety disorders across the life span).
- OCD is equally common in men and women. But the disorders onset is reported to occur earlier in men
than women.
- Lifetime prevalence in community surveys of about 2-3% (Robins et.al. 1984).

Eating Disorder Anorexia
Types: Restricting (no binging) & Binge or Purge style
Symptoms
- Hardly eating (fasting long-term)
- Purging or Binging frequently
- To the extent of how much binging and fasting is what differentiates it from Bulimia
Prevalence:
- 50% of people with eating disorder meet criteria for depression
- Only 1 in 10 men and women with eating disorders receive treatment. Only 35% of people that
receive treatment for eating disorders get treatment at a specialized facility for eating disorders.
- Up to 24 million people of all ages and genders suffer from an eating disorder (anorexia, bulimia and
binge eating disorder) in the U.S.
- Eating disorders have the highest mortality rate of any mental illness.
Students
- 86% report onset of eating disorder by age 20; 43% report onset between ages of 16 and 20.6
- Anorexia is the third most common chronic illness among adolescents
- 95% of those who have eating disorders are between the ages of 12 and 25.8
- 25% of college-aged women engage in bingeing and purging as a weight-management technique.
- 42% of 1st-3rd grade girls want to be thinner (Collins, 1991).
- 81% of 10 year olds are afraid of being fat (Mellin et al., 1991).
Men:
- An estimated 10-15% of people with anorexia or bulimia are male.
- Men are less likely to seek treatment for eating disorders because of the perception that they are
womans diseases.
- Among gay men, nearly 14% appeared to suffer from bulimia and over 20% appeared to be anorexic.
Collins, M.E. (1991). Body figure perceptions and preferences among pre-adolescent children. International Journal
of Eating Disorders, 199-208.
Mellin, L., McNutt, S., Hu, Y., Schreiber, G.B., Crawford, P., & Obarzanek, E. (1991). A longitudinal study of the
dietary practices of black and white girls 9 and 10 years old at enrollment: The NHLBI growth and health study.
Journal of Adolescent Health, 23-37.
Women: An estimated 0.5 to 3.7 percent of women suffer from anorexia nervosa in their lifetime.
According to a study done by colleagues at the American Journal of Psychiatry (2009), crude mortality rates were:
- 4% for anorexia nervosa
Crow, S.J., Peterson, C.B., Swanson, S.A., Raymond, N.C., Specker, S., Eckert, E.D., Mitchell, J.E. (2009) Increased
mortality in bulimia nervosa and other eating disorders. American Journal of Psychiatry 166, 1342-1346.
Athletes:
- Risk Factors: In judged sports sports that score participants prevalence of eating disorders is 13%
(compared with 3% in refereed sports).
- Significantly higher rates of eating disorders found in elite athletes (20%), than in a female control
group (9%).
- Female athletes in aesthetic sports (e.g. gymnastics, ballet, figure skating) found to be at the highest
risk for eating disorders.
- A comparison of the psychological profiles of athletes and those with anorexia found these factors in
common: perfectionism, high self-expectations, competitiveness, hyperactivity, repetitive exercise
routines, compulsiveness, drive, tendency toward depression, body image distortion, pre-occupation
with dieting and weight.



7. Analyze etiologies (in terms of biological, cognitive and/or sociocultural factors) of one disorder from
two of the following groups:
a. Anxiety disorders
b. Affective disorders
c. Eating disorders
Obsessive Compulsive Disorder (OCD) (anxiety disorder)
Biological etiologies of OCD
A. Genetic predisposition
McKeon And Murray OCD prevalence: relatives of OCD patients more likely to suffer from anxiety disorders
B. Neurological factor
- An affected neurological pathway that regulates aggression, sexuality and bodily excretions.
- The pathway includes the following three regions of the brain:
o Orbital frontal cortex (later referred to as OFC)
o Thalamus
o Caudate nucleus
- Caudate Nucleus acts as a break, suppressing signals that triggers anxiety (worry signals) from the
OFC to the Thalamus, preventing it from hyperactivity.
- Damaged Caudate Nucleus therefore increases signals between OFC and Thalamus, resulting in
increased anxiety.
- Patients with OCD display obsessions and compulsions related to aggression, sexuality, and
contamination, much like what this neurological pathway deals with.
- The primitive nature of this neurological pathway explains why patients with OCD are often irrational.
Baxter et al Observed brain function in patients with OCD after successful treatment; PET use and indicated right
Caudate Nucleus more active in patients after treatment
C. Neurotransmission
- Patients with OCD responds positively to SSRI, suggesting that an imbalance of Serotonin maybe the
cause of dysregulation of the neurological pathway.
- Low Serotonin levels may cause misinterpretation and over-reaction to external stimulus.
- Leading to flawed cognition, developing into obsession.
- Lowering Serotonin levels with M-CCP (meta-Chlorophenylpiperazine) made the symptoms worse.
(Hollander et al.)
- Anti-depressants, which increases serotonin levels, can reduce OCD symptoms. (Pigott et al.)
Cognitive etiologies of OCD
- Distorted cognition formed during early stages of life may have led to OCD.
A. False belief/Schema
- Exaggerated responsibility in preventing misfortunes or harm to others.
- The belief that certain thoughts should be controlled
- The belief that having a thought or urge to do something will increase its chances of coming true.
- Tendency of overestimating danger.
- Perfectionist.
- Compulsive routines are responses for the anxiety caused by these obsessions.
- Argued to be a learned, conditioned process to neutralise the anxiety.
- The relaxing feeling motivates the repetition of the compulsive routines.
- Patients with OCD believe that there will be negative consequences if compulsive routines are not
carried out.
B. Cognitive Triad (Theorist: Beck)
- Becks Cognitive Triad suggests that patients with OCD have choose to generated their own obsessive
thoughts

Socio-cultural etiologies of OCD
Sullivan Factors Related to OCD
- Participants selected through convenience sampling and surveyed: 51 F, 24 M
- Results supports the following hypothesis:
- Females reporting more OC behaviors.
- Participants with greater stress level reporting more OC behaviors.
- Results do not support the following hypothesis:
- First born and only children reporting more OC behaviors.
- Students with external locus of control reporting more OC behaviors.
- Difference in the amount of OC behaviors among students in Science majors/minors vs. Liberal
Arts/humanities majors/minors.


8. Examine biomedical, individual, and group approaches to treatment
Different treatments = different therapies = different perspective.
Individual
Psychoanalytic Therapy Freudian approach of therapist sitting and writing down while patient is lying on the bed.
- Focus is to identify underlying cause of the problem
- Symptom substitution are a symptom to outward manifestations of deeper problems..
- Use of hypnosis, free association, and dream analysis; relying heavily on the interpretation of the
therapists and inherent subjectivity
- Disagreement=resistance; meaning painful process of coming to terms with deeply repressed,
troubling thoughts, people are thought to try to protect themselves through resistance.
- Insight therapy highlighting importance of the patients/clients gaining an understanding of their
problems
Humanistic Therapy helping people to understand and accept themselves and strive to self-actualize
- Belief in free will of the individual
- Carl Rogers client-centered therapy, belief that unconditional positive regard is essential to healthy
development, making clients accept and take responsibility for themselves
- Non-directive approach of making the client choose a course of action for themselves without help;
clarifies the feeling only by active listening
- Existential therapy help clients achieve meaningful perception of their lives by supporting them
formulate a vision of their lives as worthwhile
Behavioral Therapy All behavior is learned
- Counterconditioning (Mary Cover Jones) unpleasant conditioned response is replaced with a
pleasant one
- Successful with phobias Joseph Wolpe systematic desensitization, teaching clients to replace
feelings of anxiety through relaxation; effective b/c learning through classical conditioning is
strengthened by repeated pairings
o Covert, then vivo desensitization
- Flooding can be vivo first, then covert. Addresses the most frightening scenario first.
- Aversive conditioning pairing a habit a person wishes to break with an unpleasant stimulus such as
electric shock or nausea
- Token economy desired behaviors are identified and rewarded with tokens
Cognitive Therapy Changing schema
- Cognitive therapy (often used for depression) gets clients to engage in successful routes
- Cognitive triad peoples beliefs about themselves, their worlds, and their futures making negative
positive
Cognitive-behavioral Therapy
- Type: Rational emotive behavior therapy (Albert Ellis) look to expose and confront the dysfunctional
thoughts of their clients; focuses on how and what clients think but also on what they do.
- Asked to engage in homework and demonstrating logical and illogical thinking
Group Therapy
- As stated above
- Family therapy finding revealing patterns of interactions between family with the whole family
helpful in revealing the patterns of interaction between family members and altering the behavior of
the whole family
- Self-help groups group therapy that doesnt require a therapists but works of others experiences
Biomedical
- Chemotherapy: psychopharmacology
- Electroconvulsive therapy electric current is passed through both hemispheres of the brain




9. Evaluate the use of biomedical, individual, and group approaches to the treatment of one disorder.




Nov 2011
1. Compare and contrast individual and group approaches to treatment.
2. Describe psychological research (theories and/or studies) relevant to diagnosis.
Evaluate the psychological research (theories and/or studies) relevant to diagnosis that you
have described.
3. For one affective or eating disorder, discuss the relationship between etiology and therapeutic
Approach
May 2011
1. Discuss how biological and sociocultural factors influence one anxiety, affective or eating disorder.
2. Discuss cultural and ethical considerations in diagnosis.
3. Compare and contrast one biomedical and one individual approach to treatment.
Abnormal psychology

1. There are controversies surrounding the concept of abnormality.

With reference to this statement, discuss the concepts of normality and abnormality.

2. Describe the symptoms and prevalence of one psychological disorder.

Discuss cultural and/or gender variations in the prevalence of one psychological disorder.

3. Discuss how

biological, or

cognitive, or

socio-cultural

factors influence psychological disorders.