Psychopathology – Paper 1

A01 – Green A03 – Purple

Definitions of Abnormality √
Characteristics of Phobias √
Explaining Phobias: The Behavioural Approach √
Treating Phobias: The Behavioural Approach √
Characteristics of Depression √
Explaining Depression: The Cognitive Approach √
Treating Depression: The Cognitive Approach √
Characteristics of OCD √
Explaining OCD: The Biological Approach √
Treating OCD: The Biological Approach √
 Definitions of Abnormality:
Statistical Infrequency
• = When an individual has a less common
characteristic, for example being less intelligent
than most of the population

Example:
• IQ
• In an IQ test, the majority of peoples scores will
cluster around the average. The further above or
below the average, the fewer people that obtain
the scores. (called ‘Normal Distribution’)
 Evaluation: Statistical Infrequency
(Strength)
• (P) – It is an objective method
• (E) – It has a mathematical nature
• (E) – It is clear what is defined as
normal/abnormal – there is no opinion
involved
• (L) – Therefore there is no bias
 Evaluation: Statistical Infrequency
(Weakness)
• (P) – Unusual characteristics can be positive
• (E) – High IQ scores are just as ‘unusual’ as the
low ones, but you wouldn’t consider super-
intelligence as an undesirable characteristic that
needs treatment
• (E) – Few people displaying certain behaviours
does make the behaviour statistically abnormal
but it doesn’t mean that it requires treatment to
return to normal
• (L) – Therefore it is a weakness as it could never
be used alone to make a diagnosis.
 Definitions of Abnormality:
Deviation from Social Norms
• = Behaviour that is different from the
accepted standards of behaviour in a
community or society.

Example:
• Homosexuality
• Used to be a deviation from social norms but
as society has changed its opinions, it has
become more acceptable.
 Evaluation: Deviation from Social
Norms (Weakness)
• (P) – Cultural Relativism
• (E) – The social norms vary in each generation
and in each community.
• (E) – For example, hearing voices in socially
acceptable in some cultures but would be
seen as a sign of mental abnormality in the
UK.
• (L) – This creates problems for people from
one culture living within another culture.
 Evaluation: Deviation from Social
Norms (Strength)
• (P) – It is flexible – dependent on situation and
age
• (E) – For example, it is a social norm to wear full
clothing while shopping, but a swimming
costume is suitable at the beach
• (E) – It is socially acceptable to drink milk out of
the bottle if you are a baby, but not as an adult
• (L) – Therefore, the social norms are flexible so
therefore it is dependent on each individual
person.
 Definitions of Abnormality:
Failure to Function Adequately

• = When someone is unable to cope with

ordinary demands of day-to-day living

Example:
• Not maintaining a basic standard of nutrition
or hygiene
 Evaluation: Deviation from Social
Norms (Strength)
• (P) – It takes a subjective approach
• (E) – It takes the patients perspective into
consideration
• (E) – However, it is difficult to actually assess
the amount of distress experienced
• (L) – Overall, this definition captures the
experience of many of the people who need
it, suggesting that it is a useful criterion for
assessing abnormality.
 Evaluation: Deviation from Social
Norms (Weakness)
• (P) – Subjective judgements
• (E) – Someone has to decide whether a
patient is distressed or distressing.
• (E) – One person may find a situation
distressing that another person does not. For
example, not being able to go to work or eat
regular meals.
• (L) – Therefore this is a weakness as it
depends on who is making the judgements.
 Definitions of Abnormality:
Deviation from Ideal Mental Health
• Jahoda (1958)
• = When someone does not meet a set criteria for
good mental health

Ideal Mental Health includes:

• Coping with stress
• Being rational
• We can cope with stress
• We have a good self esteem
• We are independent
 Evaluation: Deviation from Social
Norms (Weakness)
• (P) – Cultural relativism - Some ideas are specific
to Western European and North American
cultures – they are culture-bound
• (E) – E.g. the emphasis of personal achievement
and self-actualisation would be considered self-
indulgent in much of the world as the emphasis is
on the self rather than the family or community.
• (E) – Some cultures would see independence as a
bad thig
• (L) –
 Evaluation: Deviation from Social
Norms (Strength & Weakness)
• (P) – It has an unrealistic criteria
• (E) – It is difficult to achieve all the items at
the same time and keep them all up
• (E) – However, it focuses on positives and
desirable characteristics rather than the
undesirable
• (L) – Therefore, this definition has advantage
as it is the only positive definition, however, it
is unrealistic.
 Characteristics of Phobias
• = an irrational fear of an object or situation
Behavioural Emotional Cognitive

Panic Anxiety Irrational beliefs

Avoidance Unreasonable emotional Selective attention to the

responses phobic stimulus

Endurance Cognitive distortions

(sufferer remains in the
presence of phobia and
keeps high anxiety levels )
 Behavioural Approach to explaining
Phobias

Two-process Model -
(Mowrer – 1960):

• = states hat phobias are acquired by classical

conditioning then continued because of
operant conditioning .
 Behavioural Approach to explaining
Phobias
Acquisition by classical conditioning:
• = Learning to associate something which we initially have no fear
(neutral stimulus) with something hat already triggers a fear
response (unconditioned stimulus)

Little Albert Study – Watson and Rayner (1920)

• Created a phobia in 9 month old baby
• When presented with white rat, made a loud noise
• Noise= UCS (unconditioned stimulus)
• Fear = UCR (unconditioned response)
• Rat = NS (neutral stimulus)
• UCS + NS = UCR
• Rat now = CS (conditioned stimulus)
• Fear = CR (conditioned response)
• Albert displayed signs of fear towards other furry objects e.g. cotton
balls
 Behavioural Approach to explaining
Phobias
Maintenance by operant conditioning:
• = takes place when our behaviour is reinforced/rewarded.
• Positive reinforcement increases the frequency of the
behaviour
• Negative reinforcement = individual avoids an unpleasant
situation.
• Behaviour results in a desirable consequence so the
behaviour will be repeated
• Whenever we avoid a phobic stimulus we successfully escape
the fear and anxiety that we would have suffered if we had
remained – therefore the reduction in fear reinforces the
avoidance behaviour so the phobia is maintained.
 Evaluation: Behavioural Approach to
explaining Phobias (Weakness)
• (P) – Classical conditioning might not be the only
explanation
• (E) – People with phobias often recall a specific
incident when their phobia appeared e.g. being
bitten by a dog
• (E) – However, some do not Sue et al suggested
that different phobias may be the result of
different processes. – Agoraphobics = specific
incident. Arachnophobics = cite modelling as the
cause
• (L) – Therefore this questions the value of
classical conditioning.
 Evaluation: Behavioural Approach to
explaining Phobias (Weakness)
• (P) – It is an incomplete explanation of phobias
• (E) – Evolutionary factors have an important role in
phobias but the two-process model doesn’t mention it
• (E) – We easily acquire phobias which have been a
source of danger in our evolutionary past (the dark,
snakes). Seligman called this biological preparedness.
However, we are not typically scared for cars or guns –
which have only existed recently but are actually more
dangerous.
• (L) – Therefore, this is a problem for the two-process
theory as it shows there is more to acquiring phobias
than just conditioning
 Behavioural Approach to treating
Phobias
Systematic Desensitisation:

• = used to gradually reduce phobic anxiety

through classical conditioning. If the sufferer
can learn to relax in the presence of the
phobic stimulus, they will be cured
(counterconditioning). This is because it is
impossible to feel afraid and relaxed at the
same time, so one emotion prevents the other
(reciprocal inhibition)
 Behavioural Approach to treating
Phobias
Systematic Desensitisation PROCESS:

1. Anxiety Hierarchy: patient and therapist list

situations related to phobic stimulus from least
frightening to most (e.g. seeing a picture of a
spider, holding a tarantula).
2. Relaxation: therapist teaches patient how to relax
(e.g. breathing exercises)
3. Exposure: Patient is exposed to phobic stimulus
while in a relaxed state and work up anxiety
hierarchy.
Treatment is successful when the patient can stay
relaxed in high anxiety situations.
Evaluation: Systematic Desensitisation
(Strength)
• (P) – Suitable and acceptable to patients
• (E) – The alternatives (flooding and CBT) are
not well suited to patients with learning
difficulties. But SD is probably the most
appropriate for them. Flooding = difficult to
understand. CBT = hard to engage with.
• (E) – Most patients would pick SD over
flooding as it is not as traumatic
• (L) – Therefore SD has lower refusal and drop
out rates
Evaluation: Systematic Desensitisation
(Strength)
• (P) – It is effective
• (E) – Gilroy (2003) followed 42 patients with a
questionnaire who had been treated for spider
phobias in sessions of SD. A control group was
treated by relaxation without exposure.
• (E) – At both 3 months and 33 months, SD group
were less fearful than the relaxation group
• (L) – This is a strength as it shows that SD is
helpful in reducing anxiety and has long lasting
effects.
 Behavioural Approach to treating
Phobias
Flooding:
• = Involves immediate exposure to a very
frightening situation.
• Flooding sessions are typically longer than
SD’s, but often only one session is required.
• It works by stopping the phobic response very
quickly  without the option of avoidance,
the patient quickly realises that the phobic
stimulus is harmless (extinction)
 Evaluation: Flooding (Strength &
Weakness)
• (P) – It is cost effective
• (E) – Flooding is highly effective and quicker
than alternatives, therefore cheaper
• (E) – However, there are less effective for
some types of phobias e.g. social phobias
because they have cognitive aspects
• (L) – Therefore, although it is a cheaper
treatment, it might not always be as effective.
 Evaluation: Flooding
(Weakness)
• (P) – It is traumatic for patients
• (E) – Patients are often unwilling to see it
through the end – therefore and time money
are sometimes wasted
• (E) – Therefore it is important that patients
give fully informed consent.
• (L) – Therefore, although it is not unethical, it
is often so traumatic that patients do not
continue with treatment.
 Characteristics of Depression
• = characterised by low mood and low energy levels

Behavioural Emotional Cognitive

Low activity levels Lowered mood Poor concentration

Disruptive sleeping and Anger Dwelling on the negatives

eating patterns

Aggression to themselves Lowered self-esteem Absolutist thinking

and others (black and white thinking)
 Cognitive Approach to explaining
Depression
Beck (1967)
Faulty information processing:
• Focusing on negatives and ignoring the positives
• Catastrophising small problems
Negative self-schema:
• Schema = a collection of information developed through
experience – mental framework for the interpretation of
sensory information
• If we have a negative self-scheme,
we interpret all information about
ourselves in a negative way
The Negative Triad:
Evaluation: Beck’s Cognitive Approach
to explaining Depression (Strength)
• (P) – Practical Application
• (E) – Has been used for CBT – all cognitive
aspects of depression can be identified and
challenged in CBT
• (E) – Therapists can challenge them and
encourage the patient to test whether their
thoughts are true
• (L) – This is a strength because it has
developed a successful form of therapy.
- Can also be used alongside drug treatment.
Evaluation: Beck’s Cognitive Approach
to explaining Depression (Weakness)
• (P) – It blames the client rather than the
situational factors
• (E) – It is a strength because it gives the client the
power to change the way things are.
• (E) – However, the therapist may overlook
situational factors, e.g. family problems, that may
explain the disorder.
• (L) – Therefore it is a weakness as it does not
consider how the client could change physical
aspects of their living environment to improve
situations
 Cognitive Approach to explaining
Depression
Ellis’s ABC Model (1962):
• Good mental health is a result of rational thinking –
thinking that allow people to be happy and free of
pain.

• A – Activating Event: irrational thoughts are triggered

by external evens
• B – Beliefs: Irrational beliefs e.g. we must always
succeed or achieve perfection
• C – Consequences: There are emotional and
behavioural consequences
Evaluation: Beck’s Cognitive Approach
to explaining Depression (Strength)
• (P) – Practical Application
• (E) – Has been used for CBT – all cognitive
aspects of depression can be identified and
challenged in CBT
• (E) – Therapists can challenge them and
encourage the patient to test whether their
thoughts are true
• (L) – This is a strength because it has
developed a successful form of therapy.
- Can also be used alongside drug treatment.
 Evaluation: Ellis’s ABC Model
(Weakness)
• (P) – Not all irrational beliefs are unrealistic
• (E) – Alloy et al (1979) suggested that
depressive realists tend to see things for what
they are – normal people tend to see the
world through rose-coloured glasses
• (E) – They found that depressed people gave
more accurate estimates of the likelihood of a
disaster than the ‘normal’ control group.
• (L) – Therefore, it challenges the effect of
irrational thoughts in depression.
 Cognitive Approach to treating
Depression
CBT – Cognitive Behavioural Therapy:
• Begins with initial assessment of patient with
therapist to work out joint goals and problems.
• They identify negative and irrational thoughts

Beck’s Cognitive Therapy:

• Aim: to identify automatic thoughts about the
world/self/future (negative triad). Therapist
challenges these thoughts.
• Patients have to test the reality of their negative
beliefs – ‘homework’/complete assignments
outside of therapy sessions.
 Cognitive Approach to treating
Depression
Ellis’s REBT – Rational Emotive Behaviour Therapy:
• An extension of ABC Model – ABCDE
• D – Dispute: to argue/challenge irrational thoughts
• E – Effect: to change the irrational belief and break the
link between negative life events and depression

• Behavioural Activation: becoming more active and

engaged in activities
• Unconditional Positive Regard: Convincing client that
they are valued – to changed attitudes about
themselves.
 Evaluation: Cognitive Approach to
treating Depression (Strength)
• (P) – It is effective
• (E) – March et al (2007) compared effects of CBT
with antidepressant drugs and a combination of
the two in 327 adolescents
• (E) – After 36 weeks, 81% of CBT group, 81% of
antidepressant group and 86% of CBT plus
antidepressant group were significantly
improved.
• (L) – Therefore it is a strength as it showed that
CBT was just as effective as medication and
helpful alongside medication in treatments
 Evaluation: Cognitive Approach to
treating Depression (Strength)
• (P) – Success may be due to the therapist-patient
relationship
• (E) – Rosenzweig (1936) suggested the different
between CBT/Systematic Desensitisation and
other treatments is the relationship built
between the therapist and patient.
• (E) – It may be the quality of this relationship
that determines success rather than the
technique used
• (L) – Therefore, simply having the opportunity to
talk to someone who will listen may be what
matters most.
 Characteristics of OCD
• = Characterised by obsessions and/or compulsive behaviour

Behavioural Emotional Cognitive

Compulsions: Anxiety and distress Obsessive thoughts

1. Compulsions are
repetitive
2. Compulsions to
Accompanying Cognitive strategies to
reduce anxiety
depression deal with obsessions
(e.g. meditating)
Avoidance Guilt and disgust
Biological Approach to explaining OCD
Genetic Explanations:

Candidate genes = genes that create vulnerability

for OCD.
• SERT gene  regulates serotonin (a
neurotransmitter which enables message transfer
across synapses)
• COMT gene  regulates production of dopamine

• OCD is polygenic  not caused by one single

gene but several
 Evaluation: Genetic Explanations
(Strength)
• (P) – Supporting evidence from twin studies
• (E) – Nestadt (2010) reviewed previous twin
studies and found that 68% of Mz twins
shared OCD compared to 31% of Dz twins
• (E) – This therefore suggests that there is a
genetic influence on OCD
• (L) – Therefore this is a strength as it supports
the idea that genetics take an important role
in explaining OCD.
 Evaluation: Genetic Explanations
(Weakness)
• (P) – Environmental factors can also trigger OCD
development
• (E) – Cromer et al (2007) found that over half
OCD patients had traumatic events in their past,
and that OCD was more severe in those with
more than 1 trauma
• (E) – This suggests that OCD cannot be entirely
genetic in origin
• (L) – Therefore it may be more productive to
focus on environmental causes because we are
more able to do something about these
Biological Approach to explaining OCD
Neural Explanations:
Abnormal levels of neurotransmitters:
• Dopamine  high in OCD sufferers
• Serotonin  lower levels in OCD patients

Abnormal brain circuits:

• Caudate nucleus  suppresses signal from the OFC
• OFC  sends signals to thalamus about things deemed
worrying.
• When the caudate nucleus is damaged  it fails to
suppress minor ‘worry’ signals
 Evaluation: Neural Explanations
(Strength)
• (P) – Supporting evidence
• (E) – For example, some antidepressants work
purely on the serotonin system
• (E) – These drugs are effective in reducing
OCD systems. Antidepressants without
serotonin do not reduce systems
• (L) – Therefore suggest that the serotonin
system is involved in OCD.
 Evaluation: Neural Explanations
(Strength & Weakness)
• (P) – PET scans can be used
• (E) – Allows researchers to investigate specific
areas of the brain more accurately, and OCD
sufferers do seem to have excessive activity in
the OFC
• (E) – However, we cannot be sure if the
changes in the systems are a result of suffering
from the disorder or the cause of it
• (L) –
 Biological Approach to treating OCD
Drug Therapy:
• Aims to increase/decrease levels of neurotransmitters
in the brain to increase/decrease their activity.

SSRI’s (Selective Serotonin Reuptake Inhibitor):

• Antidepressants are used to reduce the anxiety
associated with OCD.
• Serotonin is released into a synapse from one neuron.
It targets receptor cells on the receiving neuron at
receptor sis and it is reabsorbed by the initial neuron
sending the message
• In order to increase levels of serotonin at the synapse,
this re-uptake is inhibited.
 Biological Approach to treating OCD
Drug Therapy:
Alternatives to SSRI’s:

• Tricyclics block the transporter mechanism that re-

absorbs serotonin and noradrenaline into the pre-
synaptic cell once it has fired. Therefore, more
neurotransmitters are left in the synapse, prolonging
their activity. They have more severe side effects.
• SNRIs  Serotonin-Noradrenaline Reuptake Inhibitors.
They increase levels of serotonin as well as
noradrenaline.
• Combining SSRI’s with CBT
 Evaluation: Biological Approach to
explaining OCD (Strength)
• (P) – Drug therapy is effective
• (E) – Soomro (2009) reviewed studies
comparing SSRI’s to placebos  all 17 studies
sowed better results for SSRIs than placebos.
• (E) – Effectiveness is greatest when SSRI’s are
combined with CBT. 70% of patients notice
symptoms decline
• (L) – Therefore most patients find drugs
helpful for their OCD
 Evaluation: Biological Approach to
explaining OCD (Strength & Weakness)
• (P) – Drugs are cost-effective and non-disruptive
• (E) – Sufferers can take the drugs without
engaging with the hard work of psychological
therapy.
• (E) – However, many drugs have side effects e.g.
blurred vision and indigestion
• (L) – Therefore, although drugs seem to be the
most cost-effective form of treatment,
sometimes they are not as effective as people
stop taking the medication to avoid these side
effects.