Abnormal Psychology Clinical Psychology understand, prevent and relieve psychological distress or dysfunction to enhance and promote well-being

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1 Abnormal Psychology Clinical Psychology understand, prevent and relieve psychological distress or dysfunction to enhance and promote well-being Includes: - research into mental illness, psychological assessment, psychotherapy Types of approaches Psychodynamic - theories propose that the human personality is shaped and driven by internal forces, and that human motivations and actions can only be understood through the investigation and analysis of how these internal forces interact with human life experiences - includes Psychoanalysis (Freud) and psychodynamic therapies Humanistic - therapy that emphasizes the basic goodness of human beings and their drive for creativity and self-actualization - Client-centered therapy, Gestalt therapy Cognitive - Our negative thought patterns cause depression, anxiety and some other mental disorders. Cognitive Therapy helps patients by making them aware of these beliefs, how they produce so many problems, and then working to change these dysfunctional beliefs. - Cognitive therapy, rational-emotive therapy Behavioural - Treatment that focuses on changing or reducing the occurrence of some maladaptive behaviour as opposed to simply examining the unconscious conflicts or aspects associated with the maladaptive behaviour - Classical conditioning (aversion therapy), Operant conditioning (positive reinforcement, punishment), Modelling (social skill training) Biological drug therapy, psychosurgery etc. 1) Psychoanalytic theory Freud - focuses on the importance of the unconscious mind Dictates that behaviour is determined by your past experiences that are left in the Unconscious Mind (people are unaware of them). This perspective is still based on Freud's psychoanalytic perspective about early experiences being so influential on current behaviour Freud distinguish between conscious, preconscious and subconscious 2) Behavioural approach Classical conditioning organism learns to associate 2 stimuli such that one comes to elicit a response that originally was elicited only be the other Operant conditioning organism learns to behave on consequences reinforcement strengthens behaviour and punishment weakens it All behaviour, whether adaptive or maladaptive, is acquired by classical or operant conditioning

2 Behavioural therapy: based on classical conditioning Behavioural modification: based on operant conditioning Shared principle: removing the symptom removes the underlying neurosis/cause Behavioural therapies Systematic desensitization - Relax, then gradually introduce phobic object - Exposure leads to extinction - E.g. Little Peter Implosion (imagined) - Exposure to phobic object at top of desensitisation hierarchy instead of gradual exposure accompanied by relaxation - Gets patient to imagine their most terrifying form of contact - Increase in anxiety, eventually patient becomes habituated - Extinction occurs because patient cannot undertake usual escape/avoidance behaviour Flooding (in vivo) - Person is exposed to phobic object for a sustained period of time (in vivo) - by exposing you to your fear, you will eventually see it as less fearproducing Example: Aversion therapy Classical conditioning a) Stimulus: Nausea-inducing drug (unconditioned stimulus) Response: Nausea/Vomit (unconditioned response) b) Stimulus: Nausea-inducing drug + Alcohol (unconditioned stimulus +alcohol) Response: Nausea/Vomit (unconditioned response) c) Stimulus: Alcohol (conditioned stimulus) Response: Nausea/Vomit (conditioned response) Behavioural modification based on Operant conditioning Aim: to increase or decrease the frequency of a response a) Specify the behaviour to be changed b) Specify a goal c) Measure a baseline rate over several days d) Decide on a strategy (i.e. what behaviour to reinforce) e) Plan treatment f) Begin treatment g) Measure the treatment rate/progress over several days h) Change the programme if necessary Reinforcement increases commitment to schedule The token economy (TE) is based on principle of secondary reinforcement Tokens give for socially desirable/acceptable behaviours as they occur Pros:

3 Tokens can be given immediately after some desirable behaviour therefore bridging very long delays between the target response and the primary reinforce Tokens make it easier to give consistent and effective reinforces when dealing with a group of individuals Cons: Tokens may work by encouraging staff to observe behaviour systematically not because the tokens act as reinforces of the patients behaviour Ethical problems often necessary to deprive patients of some amenity before it can be earned with tokens 3) Cognitive and Cognitive Behavioural Therapy Cognitive behavioural therapy (CBT) application of the cognitive model of a particular disorder with the use of a variety of techniques designed to modify the dysfunctional beliefs and faulty information processing characteristic of each CBT: attempt to change cognition to change emotions and behaviour by targeting cognitive biases Dysfunctional or maladaptive patterns of thinking (schemata) are challenged and replaced with more adaptive ways Cognitive restructuring leads to emotional and behavioural changes, not just an abstract cognitive goal Increasing objectivity distinguish fact from evaluation of facts from fiction Example: Anxiety disorders Anxiety multidimensional phenomenon whose manifestations correlate during fear Physiological Arousal: adrenaline, fight or flight Behaviour mediated by learning, prior experience Cognition thinking patterns, attention, beliefs Adaptive vs maladaptive generalisation, excessive and inappropriate to situation to the extent that social, occupational and interpersonal functioning suffers Cognitive Theories Beck (1976) anxiety is an appropriate emotional reaction to the occurrence of threatening thoughts, usually concerning future dangers Beck says our emotional reactions are essentially a function of how we construe the world (interpret and predict) Depressed individuals feel as they do because their thinking is dominated by negative schemas tendency to see the world negatively These negative schemas fuel by cognitive biases that cause the person to misperceive reality Cognitive Schemata - Latent information processing structures

4 - Developed from past experiences - When active select relevant environmental details and provide a longterm interpretation - Systematic distortion of experience Abnormal anxiety over activation of schemata that encode and process threat related information Beck, Emery & Greenberg (1985) model of anxiety Proportional to perceived P (threat) x perceived cost or awfulness of danger Inversely proportional to perceived ability to cope and the perceived rescue factors Target Maintenance factors to prevent extinction Main cognitive biases in Beck s theory of depression Arbitary inference conclusion is drawn in the absence of sufficient evidence or any evidence at all - Example: a man concludes he s worthless because its raining the day he s hosting an outdoor party Selective abstraction a conclusion drawn on the basis of just one of many elements in a situation - Example: a worker feels worthless when a product doesn t work, even though she s only one of several people who contributed to making it Over-generalisation an overall sweeping conclusion drawn on the basis of a single, perhaps trivial event - Example: a student regards his poor performance in a single class on one particular day as final proof of his worthlessness and stupidity Magnification & Minimisation the significance of a certain event is exaggerated or minimised - Example: a man believe he s completely ruined his car (magnification) when he sees a small scratch on the rear bumper. A woman believes herself to be worthless (minimisation) despite a succession of praiseworthy achievements Attentional biases in anxiety McNally et al (1990) Method: Stroop Paradigm test that demonstrates interference in task reaction time. This particular test uses words that name colors, but then print those names in a color different from the one being named substitute words with threat-related words

5 Rational emotive therapy Ellis (1962) ABCD model Theory of cause and remediation of maladaptive emotional responses and behaviour Emotional responses and behaviours (C) are caused by the beliefs (B) which are activated by events (A) For example: Irrational belief it is a necessity that I be loved and approved by everyone for everything I do Rational alternative although we prefer approval to disapproval, our selfworth need not depend on the love and approval of others Behavioural changes in anxiety Behaviour prevents disconfirmation Normal: avoidance of a feared stimulus adaptive Anxiety: avoidance behaviours to prevent harm occurrence disconfirmation of faulty belief For example: a person who fears spider thinking they will bite and is anxious and avoids seeing or touching any spider will fail to disconfirm the faulty belief that spiders will bite due to avoidance behaviour Cognitive Behavioural model Basic principle: address the maintenance factors to deal with the disorder Alters cognition and behaviour 4) Evaluating psychotherapeutic efficacy a) Outcome measures b) Distinguish between placebo and treatment effects c) Different psychotherapies in different disorders Randomised clinical trial (RCT) clients randomly assigned to treatment or control conditions, and the treatment and control groups are compared on outcome measures Case studies: useful particularly if objective data collected before during and after therapy but difficult to generalise conclusions from individual case Survey large number of people who have been in therapy and measure reactions to their experience Effectiveness depends on type of disorder

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