Welcome to Clinical Psychology and Mental Health!
Hi there! Welcome to one of the most fascinating parts of your Psychology course. In this chapter, we are going to look at what it actually means to be "abnormal" or "mentally ill." We’ll explore three specific conditions: Phobias, Depression, and OCD. For each one, we will look at how they look (characteristics), why they happen (explanations), and how we fix them (treatments). Don't worry if some of the terms seem a bit "sciencey" at first—we’ll break them down step-by-step!
1. How do we define "Abnormality"?
Before we can treat someone, we have to decide if their behaviour is actually "abnormal." Psychologists use four main ways to define this:
A. Statistical Infrequency
This is the "numbers" approach. If a behaviour is rare, it’s abnormal. Imagine a Normal Distribution Curve (a bell-shaped graph). Most people are in the middle. If you are at the very ends (the top or bottom 2.2%), you are statistically infrequent.
Example: Having an IQ of 130+ or below 70 is rare, so it's considered abnormal.
B. Deviation from Social Norms
Every society has unwritten rules (norms) about how to behave. If you break these rules, people think you are abnormal.
Example: Walking down a busy street talking loudly to yourself or wearing a bikini to a funeral.
C. Failure to Function Adequately
This looks at whether a person can cope with everyday life. Can they hold down a job? Do they have basic hygiene? Are they causing themselves distress?
Example: Someone so depressed they cannot get out of bed to go to work or wash themselves.
D. Deviation from Ideal Mental Health
Instead of looking for what is "wrong," this approach looks at what is "right." A researcher named Jahoda listed criteria for perfect mental health, such as having a positive self-image and being able to handle stress. If you lack these, you might be abnormal.
Memory Tip: PRAISE (Personal growth, Reality perception, Autonomy, Integration, Self-attitudes, Environmental mastery).
Quick Review Box:
• Statistical = Is it rare?
• Social Norms = Is it socially "weird"?
• Functioning = Can they cope with life?
• Ideal Mental Health = Do they lack "wellness"?
Common Mistake to Avoid: Don't assume "abnormal" always means "bad." Being a genius is statistically rare (abnormal), but it's a good thing!
2. The Characteristics of Disorders
To diagnose someone, doctors look for three types of characteristics. We call these the B-E-C characteristics:
B - Behavioural (How they act)
E - Emotional (How they feel)
C - Cognitive (How they think)
Phobias
• Behavioural: Panic (crying, screaming) and Avoidance (going out of your way to stay away from the spider/clown/height).
• Emotional: Excessive, unreasonable fear and anxiety.
• Cognitive: Selective Attention (you can't look away from the object) and irrational beliefs.
Depression
• Behavioural: Changes in sleep (too much or too little), changes in appetite, and lower activity levels.
• Emotional: Lowered mood (feeling "empty"), anger, and low self-esteem.
• Cognitive: Poor concentration and Absolutist Thinking (seeing everything as "all good" or "all bad").
OCD (Obsessive-Compulsive Disorder)
• Behavioural: Compulsions (repetitive actions like hand washing) used to reduce anxiety.
• Emotional: Extreme anxiety and distress, often accompanied by guilt or disgust.
• Cognitive: Obsessions (recurrent, intrusive thoughts, e.g., "the house is burning down").
3. Phobias: The Behavioural Approach
Behaviourists believe we learn phobias from our environment. They use the Two-Process Model to explain this.
How Phobias Start: Classical Conditioning
We learn to associate something we aren't afraid of with something that scares us.
Example: If a dog (Neutral Stimulus) bites you (Unconditioned Stimulus), you feel pain (Unconditioned Response). Now, you associate the dog with pain, so the dog becomes a Conditioned Stimulus that causes Fear (Conditioned Response).
How Phobias Stay: Operant Conditioning
We maintain the phobia through Negative Reinforcement. Every time you avoid a dog, your anxiety goes down. This "reward" of feeling less anxious makes you more likely to avoid dogs in the future. The fear never goes away because you never face it!
Treating Phobias
1. Systematic Desensitisation (SD): A slow, step-by-step process. The patient learns Relaxation Techniques, creates an Anxiety Hierarchy (from a photo of a spider to holding a spider), and works their way up while staying calm.
2. Flooding: The "deep end" approach. The patient is exposed to their worst fear immediately (e.g., being in a room with a spider) for a long time. They eventually realise they are safe because the body cannot stay in a state of panic forever.
Takeaway: We learn phobias through association and keep them through avoidance. SD is gentle; Flooding is fast but intense!
4. Depression: The Cognitive Approach
Cognitive psychologists believe depression is caused by faulty thinking. It’s not what happens to us, but how we think about what happens.
Beck’s Negative Triad
Aaron Beck suggested depressed people have a "negative schema" (a pessimistic lens). They have three types of negative thoughts:
1. Negative view of the Self ("I am a failure").
2. Negative view of the World ("Everything is against me").
3. Negative view of the Future ("Nothing will ever get better").
Ellis’s ABC Model
Albert Ellis said depression is caused by Irrational Thoughts.
A - Activating Event: Something happens (e.g., you fail a test).
B - Beliefs: Your interpretation (e.g., "I must be perfect, and since I failed, I am worthless").
C - Consequences: You feel depressed.
Treating Depression: CBT
Cognitive Behavioural Therapy (CBT) is the most common treatment. The therapist helps the patient "catch" their irrational thoughts and "challenge" them.
Analogy: The therapist acts as a "scientist" and asks the patient for evidence. If the patient says "No one likes me," the therapist might ask for proof of a time a friend was nice to them.
Did you know? CBT is often called "the gold standard" of therapy because it focuses on giving the patient tools to help themselves in the future!
5. OCD: The Biological Approach
The biological approach says OCD is caused by physical factors in the body, like genes or brain chemistry.
Genetic Explanations
OCD is polygenic, meaning it isn't caused by one single "OCD gene," but by many different genes (up to 230!). It is also aetiologically heterogeneous, which is a fancy way of saying different groups of genes might cause OCD in different people.
Neural Explanations
1. Neurotransmitters: Low levels of Serotonin are linked to OCD. Serotonin is like a "brake" in the brain; without enough of it, thoughts can spiral out of control.
2. Brain Structure: Some people with OCD have an overactive Orbitofrontal Cortex (OFC). This part of the brain notices "errors" or "worries." If it's too active, it sends constant "danger" signals to the rest of the brain.
Treating OCD: Drug Therapy
The main treatment is SSRIs (Selective Serotonin Reuptake Inhibitors).
How they work (Step-by-Step):
1. Serotonin is released into the gap (synapse) between neurons.
2. Usually, the sending neuron re-absorbs the serotonin.
3. SSRIs block this re-absorption.
4. This keeps more serotonin in the gap, so it can keep sending the "calming" signal to the next neuron.
Summary: OCD is in the body. It’s caused by complex genes and low serotonin. We treat it by boosting serotonin levels with pills like Prozac.
Final Encouragement: You've made it through! Clinical Psychology is a huge topic, but if you remember the Characteristics, Explanations, and Treatments for each of the three disorders, you are well on your way to success in your AQA exam!