Biological and Psychological Models of Abnormality

Psychology Notes for AS & A2 AQA Specification A

Module 2 Individual Differences -Biological and Psychological Models of Abnormality

	Biological Model This is the dominant model in our society today. This model defines abnormality as mental illness – "sick in the head" – the brain is not working in the way that it should. Mental illness can be treated in hospital with drugs and surgery. The symptoms are looked at and then an attempt at cure is made with prescriptions. Mental illness does not show up in blood tests or x-rays, there are no bodily symptoms, it is "all in the head". There are no physical tests, which poses problems for doctors. They can only classify, diagnose and treat according to the symptoms presented. There is a book known as ICD (International classification of diseases) that lists symptoms for all psychological diseases. It has its equivalent in every country, but they conflict with each other and therefore cannot be totally accurate. Neurosis A neurotic is somebody who has a problem that they are aware of: "I am depressed", "I'm having strange thoughts", "I have a phobia" etc. Psychosis A psychotic is not aware of their abnormality or illness. It may take over and the sufferer becomes detached from the world around them, as in Schizophrenia. There are two types of psychosis, Organic and Functional: Organic psychosis is where something is wrong with the brain – either caused by a hit on the head, tumour or infection etc. Functional psychosis is where there appears to be no physical reason, but the person is functioning in a different way, loses contact with the world. Mental Retard A mentally retarded person has "the mind of the young", and this may be caused by anything: accident, illness, etc. Schmidt & Fonda 1956 Schmidt and Fonda made up 426 sets of case notes from different patients and sent them all to leading psychiatrists, asking them to study the notes and diagnose the patients. The replies all differed, proving that your diagnosis depends on who you see, not the symptoms. Beck 62 Beck decided to re-test the work that Schmidt & Fonda had done, to see if attitudes had changed (there had been a public outcry at the previous research). Beck said he wanted to show the world that the profession went by the book. He "cheated" – altered the notes – so that duplicate sets were included under different patients, e.g. notes 1 and 105 would be the same. Unfortunately his results returned similar to those of Schmidt & Fonda – some doctors gave different diagnoses to the same symptoms. Wittenborn 61 Wittenborn went through records in psychiatric hospitals and showed that some patients had been given the same diagnosis, but had no symptoms in common. At this point the public were starting to lose faith – is this a science, or guess work?. People were seeing different doctors to get different results, and this started to undermine the medical profession. Rosenhan 1973 Rosenhan conducted a study known as "On being sane in insane places". One of the common symptoms of schizophrenia is hearing voices, which say many things. He selected eight people with no history of psychiatric problems: student, doctor, housewife, builder etc. He sent the participants to different psychiatric hospitals with a referral from himself: "I'm sending this patient to you because they said they are hearing voices, can you help them". The participants were given instructions to behave normally, do their best on any tests they were given and answer every question as honestly as possible. They were asked only to withhold their occupation, and say "yes" when asked if they had heard voices, but reply "no" when asked if they still heard voices. When asked what voices, they said banging or crashing. Rosenhan wanted to see what diagnoses they would be given. All the patients were diagnosed as schizophrenic, and some stayed in hospital for two months. The discharge papers for these patients all said "Schizophrenia". It is interesting to note that other patients thought the participants were sane, but none of the staff did. One participant kept a diary, resulting in "obsessive note taking phenomena" being added to his case notes by a doctor. Another asked to go home as he was tired, and this resulted in "evidence of delusions of persecution" being added to his notes. Unsurprisingly, this study received massive (bad) publicity, but the plot thickens… Rosenhan waited a year, then wrote to one of the leading psychiatric hospitals apologising for the embarrassment caused, and asking if he could put it right. He told the hospital that he was giving fair warning that he would send fake patients to the hospital in the next month.During the following month, 193 patients went for assessment at this hospital, and they claimed to have spotted 41 fakes. Very interesting, as Rosenhan sent nobody! Existential Approach A man called Thomas Szosz reacted against the medical model and set up an anti psychiatric movement. He claimed that mental illness does not exist, only physical illness. He created the existential approach – that to understand someone, you have to walk in their shoes, live their life. Some people's way of coping is to withdraw, fantasise. He said that Schizophrenia is a sane approach to an insane life, that people do what they have to do, to cope. Behavioural Approach Otherwise known as John Watson's "black box" theory. Behaviourists believe that abnormal behaviour is learned, in the same way as other behaviour. If a person has been conditioned to provide a certain response to a situation, they can be "counterconditioned" to produce normal responses, in effect they can re-learn an appropriate response. Cognitive Approach This best-known approach was developed by Albert Ellis (A + B = C, and don't forget D). The approach here is that it is not wrong behaviour, but wrong patterns of thinking that cause the problems. The approach, therefore is to re-learn thinking patterns. Cognitive / Behavioural Approach Looks at changing both thought patterns and behaviour. Psychodynamic Model This approach believes that something happened in the past that the person is unable to deal with, and this causes the problems in the present. The memory is buried, or repressed, and has gone into the unconscious mind. According to Freud, the Unconscious mind is 2/3 of the total mind, the conscious being 1/3. The preconscious is the small part between the two. The purpose of Psychodynamic therapy is to make the unconscious conscious. Ego Defence Mechanisms The Ego puts either the desires (Id) or rules (Super Ego) into unconsciousness to make its job easier as it cannot satisfy both. Denial and Repression are examples of EDMs. Slips of the tongue – Freudian slips Truth sneaks out when least expected – it has not passed through sensors / filters: come straight from the unconscious. Free Association Flowing conversation – let it go wherever it goes. The idea is that the patient may make statements they did not intend to and the therapist picks these out of the conversation for analysis. Word Association A list of unconnected words is read and the patient says the first word that comes into their mind. E.g. "milk" might illicit the response "drink". Here the therapist is looking for "odd" associations, e.g. "father" might illicit the response "punishment". Dream Analysis Patients keep a diary, and the therapist looks for hidden meanings or things that might be symbolic of what is happening in the unconsciousness. The diary is interpreted in the light of what is known of the patient by the therapist. All these approaches are effective, but only to a very small degree. Projective Testing The theory is that we project our own inner feelings onto other people and things. A good example is the famous inkblot tests. These contain no picture or hidden meaning, but Freud thought people would project their own feelings, and looked for a developing pattern when a patient was shown many of these drawings. Another example of projective testing is the TAT test, which was not developed by Freud himself, but by followers of the Psychodynamic approach. An ambiguous photograph is shown to the patient, and they are then asked to "tell the story". E.g. a photograph of an old man and a young girl on a park bench: Grandfather's day out or potential dirty old man? Again, many pictures are shown and the therapist looks for a theme. Regression This is where the patient is asked to re-live parts of their life and examine them in detail, including their thoughts and feelings both at the time, and now.


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