Psychopathology: Understanding Abnormality and Mental Health
Hello future psychologists! Welcome to one of the most interesting (and often challenging) topics in introductory psychology: Psychopathology.
This chapter is all about defining, understanding, and treating psychological disorders like phobias and depression.
Don't worry if the vocabulary seems heavy—we will break down these complex ideas into simple steps. By the end, you'll be able to explain why defining "abnormal" is so difficult and how major therapies work. Let's dive in!
3.1.3 Definitions of Abnormality
The first major hurdle in psychopathology is deciding who is "abnormal" and who is not. There is no single, easy checklist! Psychologists use four main criteria to define abnormality.
1. Statistical Infrequency (Statistical Deviation)
What it is: Defining abnormality as behaviour that is statistically rare or uncommon in the population. The further a trait or behaviour deviates from the statistical average (the norm), the more abnormal it is considered.
- Example: Most people score between 70 and 130 on an IQ test. If someone scores below 70, they are statistically infrequent and might be diagnosed with an intellectual disability.
Quick Review: If almost nobody does it, it's abnormal.
Limitation to consider: Some statistically rare behaviours are highly desirable (e.g., having a genius-level IQ or running an Olympic-level marathon). This definition doesn't distinguish between desirable and undesirable rarity.
2. Deviation from Social Norms
What it is: Behaviour that goes against the unstated rules and expectations of a specific society or culture. These are standards about how one "ought" to behave.
- Example: In many Western societies, constantly talking to yourself loudly in the street might be considered abnormal. In a different context, like a ritual, it might be expected.
Key Concept: Social norms are culturally relative. What is normal in one culture or time period may be abnormal in another. (Did you know? Homosexuality was classified as a mental disorder in the DSM until 1973, showing how norms change.)
Limitation to consider: This definition can lead to violations of human rights if societies use it to control or silence non-conformists.
3. Failure to Function Adequately (FFA)
What it is: An inability to cope with the demands of everyday life. If a person cannot function independently, experience severe distress, or cause distress to others, they may be judged as abnormal.
Psychologists look for signs that a person is struggling. These might include:
- Inability to maintain basic hygiene or nutrition.
- Severe personal distress (e.g., constant anxiety or sadness).
- Maladaptive behaviour (behaviour that prevents them from achieving goals).
Analogy: Think of a car that fails to function adequately—it can't get you from A to B. A person failing to function adequately struggles with the daily tasks required to live a normal life.
Limitation to consider: Who decides if someone is suffering? What looks like FFA (e.g., not having a job) might be a deliberate lifestyle choice (e.g., choosing a minimalist lifestyle).
4. Deviation from Ideal Mental Health (DIMH)
What it is: This definition focuses on the positive—defining what "perfect" psychological health looks like. If a person deviates significantly from these positive criteria, they are considered abnormal.
Marilyn Jahoda (1958) outlined criteria for ideal mental health. Key aspects include:
- Self-Actualisation: Striving to achieve one's full potential.
- Resistance to stress.
- Accurate perception of reality.
- High self-esteem and a strong sense of identity.
Memory Trick: Think of this as the "Perfect Human" checklist. If you don't check all the boxes, you deviate from the ideal.
Limitation to consider: These criteria are often unrealistic. How many people achieve perfect self-actualisation or are completely free from stress? It sets the bar too high, making most people seem "abnormal."
Key Takeaway for Definitions: No single definition works perfectly. In practice, psychologists usually rely on a combination of these definitions, particularly Failure to Function Adequately and Deviation from Social Norms, combined with professional manuals (like the DSM or ICD).
3.1.3 The Defining Characteristics of Phobias and Depression
Once we define abnormality, we need to understand specific disorders. We look at characteristics often categorised as Emotional, Behavioural, and Cognitive (EBC).
A. Phobias
A phobia is defined as an irrational fear of an object, situation, or animal. This fear is disproportionate to the actual danger.
Emotional Characteristics:
- Anxiety and Fear: Persistent, excessive, and unreasonable fear. The anxiety prevents the person from relaxing.
Behavioural Characteristics:
- Avoidance: The most prominent behaviour. The sufferer actively tries to avoid the phobic stimulus. (e.g., someone with a spider phobia will check every corner of the room or refuse to enter the basement.)
- Panic: Crying, screaming, freezing, or fainting when faced with the stimulus.
Cognitive Characteristics:
- Irrational Beliefs: The phobic knows their fear is excessive or unreasonable, but they cannot control the anxious thought process.
B. Depression
Depression is characterised by a persistent lowering of mood and loss of interest in life.
Emotional Characteristics:
- Low Mood: Feeling sad, empty, or miserable.
- Loss of Pleasure (Anhedonia): Inability to experience joy or take part in activities once enjoyed.
Behavioural Characteristics:
- Activity Levels: Often reduced energy, withdrawal from work/social life, or sometimes agitation.
- Sleep and Appetite: Significant changes (insomnia or oversleeping; loss of appetite or overeating).
Cognitive Characteristics:
- Negative Thoughts: Thoughts of worthlessness, guilt, and self-blame.
- Poor Concentration: Difficulty making decisions or focusing.
- Suicidal Ideation: Recurrent thoughts of death or suicide.
Key Takeaway for Characteristics: Phobias are primarily dominated by avoidance, while depression is dominated by a persistent negative mood and cognitive deficits.
3.1.3 The Behavioural Explanation and Treatment of Phobias
The behavioural approach explains phobias entirely through learning—specifically, conditioning.
The Explanation: The Two-Process Model
Developed by Mowrer (1960), this model argues phobias are acquired (started) by Classical Conditioning and then maintained (kept going) by Operant Conditioning.
Step 1: Acquisition by Classical Conditioning
This involves learning by association. A neutral stimulus (NS) becomes associated with an unconditioned stimulus (UCS) that naturally causes fear (UCR).
Example: Little Albert Study (Watson & Rayner)
- White Rat (NS) + Loud Noise (UCS) = Fear/Crying (UCR)
- After repetition: White Rat (CS) = Fear/Crying (CR)
The phobia is born when the neutral object is paired with the unpleasant experience.
Step 2: Maintenance by Operant Conditioning
Operant conditioning involves learning through consequences (rewards or punishment). Phobias are maintained by negative reinforcement.
- When a person encounters the phobic stimulus (e.g., a spider), they experience anxiety (unpleasant feeling).
- They avoid the spider (behaviour).
- The avoidance behaviour leads to a desirable outcome: the anxiety is removed (negative reinforcement).
Since the act of avoidance reduces the unpleasant feeling, the behaviour is repeated, and the phobia is maintained because the sufferer never learns the stimulus is harmless.
Behavioural Treatment for Phobias (Systematic Desensitisation)
Systematic Desensitisation (SD) is a gradual therapy based on Classical Conditioning. It works on the principle of counter-conditioning—the patient learns a new response (relaxation) to the phobic stimulus.
The Steps of SD:
- Relaxation: The therapist teaches the patient deep breathing and muscle relaxation techniques. This becomes the new conditioned response (CR).
- Hierarchy Construction: The patient and therapist create an Anxiety Hierarchy—a list of situations related to the phobia, ranked from least frightening to most frightening. (e.g., 1. Thinking about a spider. 10. Holding a large spider.)
- Exposure (Desensitisation): The patient is gradually exposed to each step of the hierarchy while practising relaxation. They cannot move up the hierarchy until they are completely relaxed at the current step. This process is called reciprocal inhibition (you cannot be anxious and relaxed at the same time).
Encouraging Note: SD is generally effective and very suitable for patients who prefer a calm, step-by-step approach.
Behavioural Treatment for Phobias (Flooding)
Flooding involves immediate and intense exposure to the phobic stimulus without gradual build-up.
- The patient is immediately exposed to the most frightening situation on the hierarchy (e.g., being locked in a room with a snake).
- This intense exposure prevents the possibility of avoidance.
- Since the patient is unable to escape, anxiety levels peak. However, after time, the anxiety naturally begins to drop (due to exhaustion and the realisation that no harm is coming to them). This process is known as extinction.
Common Mistake to Avoid: SD is gradual exposure combined with relaxation. Flooding is immediate and intense exposure until anxiety subsides naturally.
Key Takeaway for Phobias: The behavioural approach sees phobias as purely learned responses (acquisition and maintenance). Treatments (SD and Flooding) aim to unlearn the fear through exposure.
3.1.3 The Cognitive Explanation and Treatment of Depression
The cognitive approach argues that mental disorders are caused by faulty or irrational thought processes.
Explanation 1: Beck’s Negative Triad (1967)
Aaron Beck proposed that depression stems from a negative schema (a blueprint of beliefs) that leads to systematic negative biases in thinking. This forms the Negative Triad, focusing on three components:
- The Self: "I am worthless and flawed."
- The World: "The environment is hostile and demanding."
- The Future: "Things will never get better."
Analogy: People with depression wear "negative sunglasses"—they interpret every experience, themselves, and their future, in the worst possible light, even if evidence suggests otherwise.
Explanation 2: Ellis’s ABC Model (REBT)
Albert Ellis developed the Rational Emotive Behavioural Therapy (REBT), based on the idea that it is not external events (A) that cause our emotional consequences (C), but our irrational beliefs (B) about those events.
The Model:
- A = Activating Event (e.g., failing a test).
- B = Beliefs (e.g., *Irrational belief:* "I must always succeed, and failing this test proves I am a useless person.").
- C = Consequences (e.g., Severe depression and giving up studying).
Ellis calls irrational thoughts 'musturbatory beliefs'—beliefs about what we *must* achieve (e.g., I must be approved by everyone). When these unrealistic expectations are not met, depression results.
Treatment: Cognitive Behavioural Therapy (CBT)
CBT is the most common psychological treatment for depression. It aims to identify and change irrational thoughts and dysfunctional behaviours.
Core Components:
- Challenging Irrational Thoughts: The therapist works to dispute the patient's negative thinking (the 'B' in Ellis’s model or the Negative Triad in Beck’s model). This involves empirically checking the facts behind the beliefs. (e.g., "Where is the evidence that failing this test makes you a useless person?")
- Behavioural Activation: Patients are encouraged to engage in pleasant activities (even when they don't feel like it) to challenge their negative expectations (a behavioural component).
- Homework: The patient is often set tasks between sessions (e.g., recording positive events or monitoring negative automatic thoughts) to bring therapy into the real world.
Did you know? The goal of CBT is not just to feel better, but to teach the patient to become their own therapist, giving them tools to cope with future negativity.
Key Takeaway for Depression: The cognitive approach focuses on internal mental processes (thoughts, schemas, interpretations). CBT provides a structured, practical way to challenge these negative patterns and replace them with rational, adaptive ones.