Psychology IB Abnormality Notes

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ABNORMAL NOTES

Discuss the extent to which biological, cognitive, and sociocultural influence abnormal behavior

Introduction

  • What is abnormal behavior, and how it can be looked at under biological, cognitive, and sociocultural viewpoints
  • Its hard to diagnose and fully diagnose a person as there may be: cultural differences, different cultural beliefs, cultural bound syndromes
  • Hard to classify abnormal, some say abnormal is something away from the normal, so someone who is 2 meters tall is abnormal?
  • Picture is still mysterious
  • In order to diagnose and treat a person with mental health issues we need to better understand the causes or etiologies of those issues. There are many different explanations for conditions like, for example, depression and eating disorders. Despite the variety of theories and the conflicting evidence that exists about what causes certain illnesses, there are a number of successful, tried and tested treatments based on certain theories. An example of this would be drug treatments, including SSRIs like Prozac for the treatment of major depression. However, not only do many of these treatments spark controversy,  there is also no one simple explanation for any type of mental health issue and psychologists/psychiatrists need to take a multi-axial approach to diagnosing and treating people who need help. This multi-axial approach has developed from the recent trend towards a more hollistic view of care, which comes from a greater appreciation of how these factors combine to affect a state of mental health.  In order to effectively support people, professionals must appreciate the wide-ranging influences on a person’s behavior, which encompass socio-cultural, cognitive and biological factors. They need to investigate the many facets of their lives, relationships and health which could have a bearing on their mental state. Researchers need to be aware of the diathesis-stress relationship of the various influences or causes when seeking to explain why one person develops a particular condition and why another person does not.

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  • Biological factors influencing abnormal behavior
  • Biological factors influencing bulimia– develop the explanation first BEFORE describing a study.
  • Twin, family research supports notion that bulimia could be inherited. Still in early stages. Twins share 100% of the genes, families also share a percentage of their genes, so it makes sense to suppose that if there is a higher concordance rate between twins and family members, then genetics could well be a determining factor.

  • Genetics (brand of biology studying the heredity and variation of organisms)
  • Kendler et al 1991: 
  • Aim: whether genetics had an effect of bulimia nervosa in families
  • Method: gathering data of 2000 female twins
  • Results:  concordance rate of 23% in MZ twins, and 9% in DZ twins. In all studies, higher concordance rate in MZ than DZ twins, but it varies from 23% - 83%
  • Conclusion: genetics may have an effect on people getting bulimia. However people may be secretive when asked about bulimia, therefore self-reporting data is not reliable
  • Strober 2000: first-degree relatives of woman with bulimia are 10 times more likely than average to develop the disorder
  • Problems with twin research and family researches:
  • May be because they were raised in the same environment,
  • Unethical, may have joined twins of families together that didn’t expect so
  • Useful to study, similar genetics
  • Generalized
  • The fact that MZ twins had higher concordance rates of chances of having bulimia is between 23% to 83%, it shows that it may not be too reliable
  • Neurotransmitters
  • Delgado and Moreno
  • Aim: investigating levels of noradrenaline and serotonin in patients suffering from major depression
  • Method: brain scans to check levels of noradrenaline and serotonin
  • Results: abnormal levels of noradrenaline and serotonin in patients suffereing from depression
  • Evaluation point:
  • Abnormal level of neurotransmitters may not cause depression,
  • However it may indicate that depression may influence the production of neurotransmitters
  • Neurotransmitters – the efficacy of certain drug treatments that act on the process of neurotransmission strongly supports the idea that certain conditions are caused by imbalances of these chemicals in our nerves. SSRIs like Prozac are widely prescribed for people with major depression and have without doubt helped many people to live happier, healthier lives.

  • Are these imbalances a cause or a symptom?
  • Weight gain/loss is symptom of depression and serotonin plays a part in controlling appetite so could contribute to this effect. This could also contribute to eating disordered behaviour.

           Psychomotor agitation, fidgeting are a symptoms of depression which could have a biological cause.

  • Diathesis stress model – Current ideas err towards the fact that you may have the genetic predisposition to a particular condition, but it will only emerge if one is exposed to certain environmental stimuli. So despite the success of certain treatments like SSRIs, many believe that they do not necessarily deal with the real cause of a condition which could be socio-cultural or due to cognitive dissonance. Biological explanations are often considered too reductionist.
  • Also why is it that certain conditions are experienced more by one cultural group/gender than another? For example,  Latah, Koro – cultural bound syndromes.  Why, according to the statistics, do more women experience depression, EOs than men? Does this emerge from biology or culture?

  • Drugs are extensively used to cure patients nowadays
  • SSRI is used to cure depression -
  • Increase serotonin levels without messing up levels of noradrenaline

  • Evaluation point:
  • Drug treatments work, which supports the idea of neurotransmission imbalance. Abnormal level of neurotransmitters may not cause depression, According to Burns, there is inadequate evidence to support the idea that this is the cause. Lacasse and Leo agree, stating that the brain is far more complex and misunderstood for the cause to be merely an imbalance of this kind.

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  • Cognitive factors influencing abnormal behavior
  • Cognitive factors influencing abnormal behavior
  • The way that people think affecting their behavior (schemas)
  • psychological disturbances come from irrational and illogical thinking
  • People who have depression and bulimia think depressed thoughts and have distorted cognitions. Suicidal ideation, guilt, “weight of the world” on their shoulders. Bulimics often are described as having dichotomous thinking processes and as “musturbators” …”everything must be perfect”, “ I must be or behave like this”. Depressed moods can lead to cognitive symptoms.
  • Cognitive theorists like Ellis and Beck believe that cognitive distortions and irrational beliefs can lead to depressed or anxious moods.
  • The way that we think of ourselves may be affected by the levels of serotonin and dopamine in our brains or do our thinking styles affect the levels of neurotransmitters in our brains? We do not know for sure.
  • There is a wealth of evidence to support the idea that (CBT) Cognitive Behavioural Therapy helps people to become well. This is a form of psychotherapy that challenges a person’s beliefs, helping them to rationalize distorted cognitions. If it works for many, this suggests that by changing the way we think we can “feel” better, so cognitive distortions can be a contributory cause. However this therapy does not work for everyone, which suggests the causes of a condition for some is more complex.
  • People in some cultures may not think that depression is common, and that depression is more related to somatic problems. Therefore they would not consider of the importance of thinking "positively" to cure and decrease the chances of depression.

  • The way that people think affecting their behavior (schemas)
  •  psychological disturbances come from irrational and illogical thinking
  • Alloy et al: 1999
  • Aim:  whether cognitive patterns may affect one's thinking
  • Method: following a sample of young American's in their twenties for 6 years, and they had to take a thinking style test, then they were placed in "positive thinking group" and "negative thinking group"
  • Results: 1% of the people in the positive thinking group developed depression, and 17& of the people in the negative thinking group developed depression
  • Conclusion: link between cognitive style and development of depression, and that identification of negative thinking patterns may eventually help prevent depression

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  • Sociocultural viewpoints

Sociocultural viewpoints. Is the difference in the incidence of certain mental illnesses between men and women or people from different cultures due to differences in the status and treatment of women or men or specific cultural groups in certain parts of the world? An explanation of gender differences could be due to the fact that the figures come from medical data and women are more likely to go and see a doctor than men.

Perhaps women are more ready and willing to admit to needing help and therefore seek it out more readily. Are cultural/gender differences in the “experience” of a condition to do with levels of access to health care facilities, education and awareness, media influence?

The media also may play a part in cognitive distortions regarding body image.

  • Viewpoint on the perfect body image
  • Perfect body figure has changed from large bodies and curvy bodies to thin
  • Increase in cultural emphasis on thinness as an ideal body shape in Europe, US, Japan
  • Sanders and Bazalgette 1993:
  • Aim:   the influence of media in dolls towards chilren
  • Method:  analyse and create life size figures of Barbie, Sindy, and Little Mermaid
  • Results:  the dolls all had tiny hips and waists, and exagerrated inside leg measurements
  • Conclusion: at a young, children are already influenced and have a pressure towards their ideal shape, and allows their dolls to be their models, and this may increase their thought towards the need of dieting.
  • If the media is a key factor to explain why certain conditions like eating disorders develop, one could ask why is it that only certain people experience EOs, when we are all exposed to very similar media influences? This supports the notion of a genetic predispostion and a biological influence.
  • Less people with abnormal problems because e.g. they are in China, they will consider people as depressed when they have somatic problems rather than emotional problems because in China, people think that having mental problems is a great stigma
  • Data comes mainly from medical data and for sure attitudes towards mental illness vary from culture to culture, Certain parts of the world will have more discriminatory attitudes towards mental illness and people may not want to be stigmatized.
  • China, for example – mental health issues often related to a somatogenic explanation – one related to key themes in Chinese medicine of  Yin and Yang and “balance” .  (Kleinman 1982)

  • Marsella (1979) – argued that affective symptoms of lonliness, isolation, sadness are symptoms of Western civilizations.
  • Social origins of depression in women
  • Brown and Harris
  • Aim: finding out the social origins of depression in women
  • Results: 29/32 women who became depressed had experienced severe life event, but 78% of those who did experience a severe life event did not become depressed
  • Life events resembling previous experiences would most likely lead to depression
  • Evaluation of Brown and Harris
  • People had different coping abilities of their events
  • Life events resembling previous experiences would most likely lead to depression. However not all the women who d experienced traumatic life events developed depression. Suggests innate predisposition.

Conclusion

  • link biological, cognitive and sociocultural together
  • We cannot always be certain of the statistics due to cultural issues

No one single cause. We are all unique. Influences on us vary profoundly from person to person. Huge array of variables that can affect behavior. Treatment successes have helped professionals to build a clearer picture of factors that influence the development of these illnesses but etiologies are complex and multi-faceted. Professionals need to be flexible and open-minded and provide a range of treatments and therapies to help someone back to a state of  mental health effectively and to use an eclectic approach.

Evaluate psychological research relevant to the study of abnormal behavior

Introduction

  • Different types of psychological research studies used to study abnormal behavior
  • When researchers are gathering the symptoms of a disorder, they look for
  • Affective symptoms (emotional elements), fear, sadness, anger
  • Behavioral symptoms (observational behaviors) crying, physical withdrawal from others
  • Cognitive symptoms: ways of thinking, pessimism, personalization, self image
  • Somatic symptoms: physical symptoms, facial twitching, stomach cramping
  • Or using the DSM (Diagnostic and Statistical Association) and ICD (international classification of diseases)
  • Focus on research studies related to the reliability and validity of different etiologies of abnormal behaviors

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  • Interviews
  • Advantages
  • Gathering qualitative data
  • Can be in depth or very brief
  • A positive attitude may help get more information off the patient as they are more comfortable to talk about their problems, making it easier to diagnose them
  • It may be influenced by the researcher themselves, where some patients may feel more comfortable speaking to their own race, etc.
  • May lead to sensitive and distressing problems
  • CBT counseling session:
  •  counseling service provided by the British government
  • Helps people get better from abnormal behavior
  • Writes people treatment plans to help them recover

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  • brain scans
  • PET or CAT (especially in cases of schizophrenia or Alzheimer's disease)
  • Artificial environment, therefore the participants may act differently
  • Act under demand characteristics
  • Expensive, requires expert
  • Ethical findings on abnormalities in the brain
  • Useful, because you can look at brain activity to see to what extent brain activity has effects on abnormal behavior
  • Lindstroem et al:
  • Aim: whether schizophrenic patients had differences in dopamine levels
  • Method: PET scan of 10 patients with schizophrenia and 10 healthy controls. Inject patients with I-DOPA, which is used in production of dopamine
  • Results:  I-DOPA was taken up more quickly in patients with schizophrenia, suggesting that more dopamine was used for production
  • Evaluation of Lindstroem:
  • Not easy to find out levels of neurotransmitters accurately- lots of experiments have been done to see If the levels go up or down when something changes, but it doesn’t show accurate amount of change
  • Scans are open to interpretation
  • Given us an insight into schizophrenia
  • Now we can deal with those patients easier knowing that they have different dopamine levels

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  • Observations being faulty
  • Confirmation Bias- when doctors know that they are having a patient, they may already think that they have a problem, therefore they will look at them differently and consider them as people with mental problems
  • Rosenhan: this research shows that the "patients" who were emitted into psychiatric hospitals could not leave even though they have told the doctors that it was an experience
  • The nurses and doctors thought that it was part of their symptoms as a schizophrenic
  • When the researchers were taking notes of the experiment, the nurses made observations and noted them as "writing behavior", and they are making assumptions that they have mental problems
  • Naturalistic observations
  • Demand characteristics influences observation if the people know that they are being looked at, therefore they may act upon self-fulfilling prophecy

  • Conclusion
  • Many researches may lead help find out different abnormalities of people
  • Important to remember the accuracy and reliability of the data

Discuss the concepts of normality and abnormality

Introduction:

  • Psychological disorders: abnormal behavior
  • Difficult to define abnormal behavior, therefore its hard to diagnose
  • Find out the problem through the patient's symptoms that they exhibit or report
  • Abnormality: subjective experience of felling "not normal"
  • E.g. feeling intense anxiety, unhappiness, stress
  • Often need to seek help
  • Consider when behavior violates social norms or makes others anxious
  • Cultural diversity affects how people view social norms (behavior expectations with in a group)
  • Some cultures may consider it being abnormal, whilst another culture disagree

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  • Importance of Diagnosis
  • Important to give a correct diagnosis, as it leads to the patient's recovery
  • Psychiatrists & psychologists follow a diagnostic manual
  • No clear definition of normality or abnormality
  • Therefore symptoms of them both may be different between individuals, social, cultural groups
  • Whether you're normal or not is based on subjective impressions
  • Definitions of normality are part of the diagnostic process
  • Relying on subjective assessment of clinicians and diagnostic tools of classification systems
  • Behavioral measures: intelligence, short- term memory are normally distributed (the distribution from a NORMAL sample of people will fall within a bell-shaped curve)

  • Problem using this statistic of bell curves because some things are statistically normal (obesity) but is not desirable or healthy behaviors
  • Some people may describe abnormality as something different from usual
  • How about people who are over 2 m
  • How about people who can cook special foods
  • Or some statistically rare (high IQ) is not dysfunctional (nothing wrong)

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  • Subjective psychiatrists
  • Subjective experience of distress is not a reliable indicator of serious psychiatric problems, since patients with schizophrenia can be unaware of their condition
  • The following are difficulties with diagnosing a patient with abnormal behavior by Rosenhan and Seligman 1984
  • How the person is living
  • Suffering (distress / discomfort?)
  • Maladaptiveness ( person engaging in behaviors making life difficult / helpful )
  • Irrationality (comprehensive? Or unable to communicate reasonably)
  • Unpredictability (acting in an unexpected way by themselves or by others)
  • Social judgment
  • Vividness and unconventionality (experiencing different things)
  • Social Norms
  • Observer discomfort (acting uneasy to make it difficult for others to watch them or the observers feeling embarrassed)
  • Violation of moral or ideal standards (habitually break the accepted ethical and moral standards of the culture)
  • Social judgment may fail to consider diversity in how people live their lives
  • Increase awareness of how psychiatric diagnosis of ethnic minorities have been misapplied since doctors don’t understand their cultural norms
  • People often make incorrect judgments of people's abnormalities as some of the symptoms of one abnormal behavior may cross into another symptom

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  • mental health criteria for people to follow
  • Jahoda 1958's six characteristics of mental health representing a normal character
  • Efficient self perception
  • Realistic self esteem and acceptance
  • Voluntary control of behavior
  • True perception of the world
  • Sustaining relationships and giving affection
  • Self-direction and productivity
  • Problems with Jahoda's 6 characteristics
  • Unemployed lack a majority of those characteristics
  • This might account for much of the reported mental ill-health among unemployed people
  • Most of us would be somewhat abnormal with that list, since it is (to some extent) value judgments
  • What's considered psychologically normal depends on the society and the culture that the person is in
  • Criteria's are constantly changing, different viewpoints on abnormality. ADD CHANGE OVER TIME AND FROM PLACE TO PLACE
  • Change in views on abnormal behavior: homosexuality
  • Orthodox view: homosexuality was abnormal
  • Older version of diagnostic system reflected that society did not accept homosexuality
  • DSM III: homosexuality is only abnormal if the individual has negative feelings about his or her own sexual orientation
  • DSM IV: persistent marked distress about one's sexual orientation
  • Before 1960's, homosexuality was illegal
  • People's attitude have changed
  • This shows the problems behind classifying what's normal and what's abnormal

Conclusion

  • Hard to pick out who is normal, who is abnormal
  • Always be careful with diagnosis, as it may stigmatize people for a life time
  • Useful IMPORTANT / ESSENTIAL to diagnose, as people get treated and live a happier life

EXTREMELY DIFFICULT TO DEFINE - DO WE NEED TO DEFINE IT? THERE ARE DIAGNOSTIC TOOLS AVAILABLE TO HELP PSYCHIATRISTS TO AVOID BIAS AND SUBJECTIVITY AND DEAL WITH THE MANY EXCEPTIONS TO THE CRITERIA OUTLINED IN THIS ESSAY

Discuss validity and reliability of diagnosis

Introduction

  • Children are being diagnosed with "social anxiety disorder" , and at least 1 in 8 needs medical attention
  • Debatable whether medical attention is necessary - stress hormone cortisol is lower in shy children
  • Common to be shy in US - 42%
  • When children reach college, up to 51% of men, 43% women are "shy"
  • Phase of growing up? Or are so many people having problems
  • Validity: the degree to which the information is accurate (forms of measuring)
  • Reliability: quality of being dependable (repeats)

OK

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Accuracy of diagnosis and its effects

  • Relying on patients subjective description of the problem
  • Also using x rays, scanners, blood tests
  • Direct observations of the individual's behavior
  • Brain scanning techniques
  • Personality tests, IQ tests
  • Patients are interviewed with a checklist of questions
  • Mental health status examination is then completed with the clinicians evaluation of patients responses of the interview
  • Follow the standardized diagnostic system
  • DSM and ICD - classification systems used by western psychiatrists
  • Self fulfilling prophecy / discrimination may exist when people are giving a label
  • Those who have a wrong label will still suffer from self fulfilling prophecy
  • Scheff 1966: self fulfilling prophecy: people acting as they are expected to
  • Kleinmutz 1967: noting that there are limitations to interviewing patients
  • Information exchange blocked when the patient or clinician cannot respect each other
  • Intense anxiety / preoccupation on the part of the patient may affect the process
  • Clinician's unique style, experience
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  • When psychologists describe symptom of a disorder:
  • Affective Symptoms: emotional elements, fear, sadness, anger
  • Behavioral Symptoms: observational behavior, crying, physical withdrawal
  • Cognitive Symptoms: ways of thinking, pessimism, personalization, self image
  • Somatic Symptoms: physical symptoms, facial twitching, stomach cramping
  • If it is accurate, several clinicians (using the same system) can have the same diagnosis for the same individual
  • For classification systems to be valid, it should classify real pattern symptoms leading to effective treatment
  • Classification is descriptive, does not identify any specific causes for disorders
  • Difficult to make ...

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