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  1. 1. Conclusions: Why people conformed •Asch interviewed some of his participants after a year and found they gave 1 of 3 answers: 1. Distortion of perception:  Small number of participants came to see lines in the same way as the majority 2. Distortion of judgement:  Felt doubt about accuracy of their judgement so they yielded to the majority view 3. Distortion of action:  Majority who conformed continues to privately trust their own judgement, but gave incorrect answers to avoid disapproval from other group members VARIATION HOW DID ASCH ALTER THIS? HOW DID THIS EFFECT CONFORMITY? Difficulty of the task  Made the differences between line lengths much smaller so the correct answer was less obvious  Level of conformity increased Size of the majority (what Asch found) Little conformity when majority = 1 or 2 individuals  conformity raised 30% when 3rd individual was added Further increases in the size did not really increase level of conformity  size is important but only up to a point Unanimity of majority  Real participant given support of another real participant or a confederate who had been instructed to give the correct answer throughout  Conformity levels dropped significantly, reducing errors from 32% to just 5.5% Research into conformity: Asch (1956) Aim: see how the lone ‘real’ participant would react to the behaviour of the confederates Procedure:  125 male American undergraduates Series of lines shown to participants  participants answered in same order (real participant answering last/second to last)  confederates give same incorrect answer on 12/18 trials Findings: On 12 critical trials, 36.8% of responses by ‘real’ participants = incorrect  ¼ never conformed on any of the trials  1% made mistakes when trial was conducted with no confederates (cannot explain high levels of conformity in main study) Research into Conformity AO1
  2. 2. Individual differences (may be gender differences in the tendency to conform) Explanation: Eagly + Carli (1981) • carried out a meta-analysis of 145 studies and found that women were generally more compliant than men LIMITATION because... • may be explained by differences in sex roles where women are more interpersonally-orientated than men, so are likely to conform to others • females complied more because they were less confident, not because they were more conformist Unconvincing confederates? (difficult for them to act convincingly when giving wrong answer) Explanation • Mori + Arai (2010) overcame this problem by giving participants glasses with special polarising filters • 3 participants in each group (confederates) wore identical glasses and the 4th wore different set • each participant viewed the same stimuli but one participant saw them differently STRENGTH because... • caused them to see that a different comparison line matched the standard line, SO the results closely matched Asch’s suggesting confederates in the original study acted convincingly Conformity or independence? Explanation: • one-third of the trials where the majority unanimously gave the wrong answer, produced a conforming response • in two-thirds of these trials the participants resolutely stuck to their original opinion despite being faced by an overwhelming majority expressing a different view STRENGTH because... • Asch believed rather than showing humans to be overly conformist, his study demonstrated a commendable tendency to stick to what we believe – show independent behaviour Conformity AO2 Validity • the fact that participants had to answer out loud in a group of strangers means that there were special pressures on them to conform, so that they did not sound stupid and were accepted by the group • Williams and Sogon (1984) tested people who belonged to the same sports club and found that conformity may be even higher with people you know Ethics: Deception + lack of informed consent • participants did not know they were being tricked, did not know the real purpose of the experiment, did not know the others were confederates • if told the true purpose of experiment it would have been pointless • could be overcome if researchers properly informed participants during debriefing that they had the right to withhold their data from the study
  3. 3. INTERNALISATION – going along with others because you have accepted their point of view as it is consistent with your own HOW DO INDIVIDUALS BEHAVE?(VALIDATION)  Examining their own beliefs to see if they or the others are right WHY DOES THIS LEAD TO CONFORMITY?  examination of groups beliefs may convince individual they are wrong and the group is right Particularly if individual has already tended to go along with the group  can lead to acceptance of the group’s POV both publicly and privately COMPLIANCE – going along with others to gain their approval/avoid their disapproval HOW DO INDIVIDUALS BEHAVE?(SOCIAL COMPARISON)  Concentrating on what others say or do so that they can adjust their own actions to fit in with them WHY DOES THIS LEAD TO CONFORMITY?  Identification with the majority is desirable  If there is a different between the individuals POV and the majority’s, they may go along with the majority without analysing why the different exists (= public compliance) Types of Conformity: Kelman (1958) Types of Conformity AO1 Differences COMPLIANCE MOTIVATING FACTORS: If an individuals prime motivation is to fit in with the rest of the group they may comply rather than internalise the groups attitude on a particular issue FUTURE BEHAVIOUR:  If an individual has adopted a particular response through compliance, they would only perform this in the future if monitored by other group members INTERNALISATION MOTIVATING FACTORS: If the prime motivation is to find the best way of responding in a particular situation, then internalising the group position may be seen as the most credible way of achieving this FUTURE BEHAVIOUR:  Likely to be performed whenever the issue arises, regardless of whether or not they are being monitored by other group members Compliance = public conformity Internalisation = public+private
  4. 4. Compliance – behaving like the majority without really accepting its point of view e.g. WW1 – friends joining the army so you do too NORMATIVE SOCIAL INFLUENCE: Based on the desire to be liked and accepted INFORMATIONAL SOCIAL INFLUENCE Based on the desire to be right DOES THE INDIVIDUAL AGREE WITH THE MAJORITY?  No, they ‘follow the crowd’ DOES THE INDIVIDUAL AGREE WITH THE MAJORITY?  Yes, because it is most likely to be right WHY DOES THE INDIVIDUAL GO ALONG WITH THE MAJORITY?  Humans are a social species and have a fundamental need for social companionship and a fear of rejection WHY DOES THE INDIVIDUAL GO ALONG WITH THE MAJORITY? Change our own point of view in line with the position of those doing the influence  public and private attitudes and behaviours change WHEN IS THIS TYPE OF SOCIAL INFLUENCE MOST LIKELY? Bullying Smoking Conservation behaviour (tidying up rubbish) WHEN IS THIS TYPE OF SOCIAL INFLUENCE MOST LIKELY?  the situation is ambiguous – right course of action is not clear  the situation is a crisis – rapid action is required  we believe others to be experts – we believe others are more likely to know what to do Social stereotypes  political opinion  mass psychogenic illness – copying symptoms Internalisation – changing both our public and private attitudes and behaviours e.g. WW1 propaganda posters INFORMATIONAL SOCIAL INFLUENCE Criticism/stud y Explanation How it supports Development of social stereotypes - Wittenbrink + Henly (1996)  participants exposed to -tive comparison info about African American (which they were led to believe was the majority view) later reported more negative beliefs about a black target individual  Exposure to other people’s beliefs has an important influence on social stereotypes Political opinion - Fein et al (2007) Supported role of informational social influence in political opinion by:  showing participants what was supposedly the reactions of their fellow participants on screen during a US Presidential debate  Produced large shifts in participants judgements of the candidate’s performance, showing power of informational influence in shaping opinion Explanations of conformity Criticism/stud y Explanation How it supports Bullying - Garandeau + Cillessen (2006)  Shown how groups with low quality interpersonal friendships may be manipulated by a bully so victimisation of another child provides group with a common goal  Creates pressures on all groups to comply  emphasises role of normative social influence on bullying Conservation behaviour -Schultz et al (2008)  Gathered data from 132 hotels where guests were staying for 1 week  randomly assigned rooms to experimental or control conditions  control = door hanger informed guests of environmental benefits of reusing towels  experimental = hanger also said ‘75% guests reuse towels every day’  Guests who received message that contained NI about other guests reduced their need for fresh towels by 25%  power of normative influence to change behaviour in positive ways NORMATIVE SOCIAL INFLUENCE
  5. 5. Variation What Milgram changed in experiment How did this affect obedience Proximity of the victim Both the teacher and the learner were in the same room Obedience rate dropped to 40% as the teacher was now able to experience the learner’s anguish Proximity of authority figure Experimenter left the room and gave subsequent orders over the phone Majority of participants defied the experimenter 21% continued to maximum shock level Presence of allies (two accomplices and real participant) shared task of teaching learner – reading words, saying if incorrect and giving shocks When the accomplice refused to carry on, only 10% proceeded to max shock level Aims/Procedure: Investigate whether ordinary people will obey a legitimate authority figure even when required to injure an innocent person • 40 male volunteer participants • confederates = authority figure + ‘learner’ • participants instructed to electric shock the learner each time they got a question wrong – shocks increased with each wrong answer • machine tested on participants to show it works • learner gave mainly wrong answers – at 300-315v they showed distress • participant instructed to continue • learner goes silent after Findings: • 65% continued to 450v • All participants went to 300v • only 5 (12.5%) stopped at that point Obedience AO1 Research into obedience: Milgram (1963) Further studies: Variations Conclusions: • ordinary people are obedient to authority, even when asked to behave in an inhumane way
  6. 6. Criticism Explanation Why a strength/limitation Realism Orne + Holland (1986) • doubt about the internal validity of Milgram’s research • participants have learned to distrust the experimenters because they know the purpose may be disguised • e.g. Milgram – participant is led to believe the ‘victim’ is not really suffering LIMITATION • because participants believed they were not causing harm, they were more prepared to give the shocks Generalisability Hofling et al (1966) • obedience may change when in more realistic settings • study in a hospital • nurses phoned by ‘Dr Smith who asked them to give 20mg (dosage was 2x recommended on the bottle) of Astroten to a patient – broke hospital regulations STRENGTH • 95% of nurses did as requested • shows obedience occurs in real life settings Issue Why was this an issue? How could this be justified? Deception and lack of informed consent • participants believed they were taking part in a memory test •Led to believe that they were shocking people causing pain • participants go debriefed – would be pointless to carry out this experiment without deception Right to withdraw • it was not clear to what extent participants felt they had the right to withdraw • experimenter ‘prods’ participants – “necessary to continue” • participants had the right to leave at any time Psycho- logical harm • many of the participants suffered psychological harm during the procedure  Cried and begged to stop • interviewed them again after a year: 84% felt glad to have participated  74% felt they had learned something of personal importance Obedience AO2 Ethical issues Other evaluation points
  7. 7. Agentic shift:  Agentic State: • being under the control of someone else and you will obey their orders even if they cause you distress Autonomous state: • being under one’s own control and having the power to make your own decisions How this links to Milgram’s study: • Milgram argued that people shift back and forth between agentic and autonomous states • Milgram claimed the individual no longer views himself as acting out his own purposes, but sees himself as an agent for executing the wishes of others (the experimenter) Explanations of why people obey AO1 Milgram (1974): why do people obey? Gradual Commitment: • becomes harder to resist the experimenters requirements to increase the shocks as they continue further in the experiment How this links to Milgram’s study: • having committed themselves to a particular course of action (shocks), it became difficult for Milgram’s participants to change their minds after they had given so many shocks Buffers: • reduces the impact/repercussions of the teacher’s (participant) actions on the victim How this link to Milgram’s study: • the teacher and learner were in different rooms, with the teacher protected (buffered) from having to see his victim + the consequences of the electric shocks Justifying obedience: • by offering an ideology, people will appear to be willing to surrender their freedom of action in the belief that they are serving a justifiable cause How this links to Milgram: • justification for giving shocks = science wants to help people improve their memory through the use of reward and punishment
  8. 8. The suggestion that Holocaust perpetrators were just ‘obeying orders’ is distressing for those who are or were affected by the HolocaustUnlike the experience of the Holocaust perpetrators who carried out their duties over months/years, Milgram’s participants experienced no more than half an hour in the lab and were subjected to constant pressure from the experimenter during that time Why is this a limitation of Milgram’s explanation? • scale and duration is completely different (to the Holocaust) • despite these differences, Milgram believed that the same psychological process (agentic shift) was at work in both situations Explanations of why people obey AO2 Monocausal emphasis Agentic Shift Consequences of an obedience alibi Why is this a limitation of Milgram’s explanation? • Milgram’s participants did not have many or any extraneous reasons to inflict harm (not knowing who the learner/victim was) • Milgram ignored anti- semitism Example: cannot compare the Holocaust to Milgram’s study Why is this a limitation of Milgram’s explanation? • excuses all war criminals of their crimes as Milgram says anyone would’ve done the same thing at the time • Milgram’s original claim that his work offered a situation explanation for Holocaust atrocities is no longer central in social psychology Goldhagen (1996) • identifies anti-semitism (hostility and prejudice against Jews) as the primary motivation for the actions of those involved in the annihilation of the Jews, rather than obedience Mandel (1998) • by focusing solely on obedience as an explanation for atrocities carried out in the Holocaust, Milgram ignored many other plausible explanations Mandel (1998) • believes the use of an ‘obedience alibi’ to explain such events has a number of negative consequences. Mandel (1998) • claims that Milgram’s obedience explanation, particularly when applied to the Holocaust, is oversimplified and misleading
  9. 9. Allen and Levine (1971) – showed that the type of support from the dissenter was important: • 3 conditions into an Asch type task • condition 1 – supporter had extremely poor vision (evident from glasses with thick lenses) = invalid social support • condition 2 – support had normal vision = valid social support • Both conditions were sufficient to reduce the amount of conformity, compared to a condition where there was no dissenter to support the lone participant • the valid social supporter had much more impact, showing that an ally is helpful in resisting conformity Asch – included a variation of his study using a dissenter • the dissenter gave social support to the participant and caused conformity rates to plummet How did the dissenter affect independent behaviour? • the social support they provided, provides the individual with a sense of independence which makes them feel more confident in their own decision, and more confidents in rejecting the majority position/view Independent behaviour AO1 Resisting pressures to conform Resisting pressure to obey 3 factors in Milgram’s study that affected independent behaviour: 1. Status/ location of study – when the study was moved away from the prestigious setting of Yale University to a downtown office, more people felt able to resist authority 2. Dissenters – another confederate is added but acts like they are on the participants side. Independent behaviour increases because the participant has an ally 3. Location of experimenter to participant – when the experimenter in in another room giving instructions over the phone, it is easier for the participant to resist obedience as there is less pressure on them
  10. 10. Independent behaviour AO2 Resisting pressures to conform (Asch) People’s resistance to conformity varies, and depends upon the type of view or judgement they are conforming to Resisting pressures to obey (Milgram) Resistance to obedience will also rely upon a number of individual characteristics • there is a difference between moral and physical judgements: EXPLANATION: • (physical) psychological costs associated with abandoning a personal position would be relatively minor compare to interpersonal benefits achieved as a consequence of fitting in with the rest of the group however if task involves judgements with a moral dimension, the costs to one’s personal integrity may be considerably higher LIMITATION because…  people may be more willing to maintain independence if they have to make moral rather than physical judgements • there are individual differences in obedience: EXPLANATION: • age, marital status, occupation and military experience had little influence on the person’s ability to resist the commands of the experimenter HOWEVER •Educational history and religious preference did.  less educated participants were less likely to resist the experimenters commands than those participants with at least a college degree.
  11. 11. Person believes their behaviour is caused primarily by fate, luck or by other external circumstances Locus of control Locus of controlinternal external Person believes their behaviour is caused primarily by their own personal decisions and efforts • A person’s perception of personal control over their own behaviour What do high internals believe? • perceive themselves as having a great deal of control over their behaviour, and are therefore more likely to take personal responsibility for it What do high externals believe? • perceive their behaviour as being caused more by external influences or luck What characteristics make high internals resistant to obedience? 1. High internals are active seekers of info that is useful to them, and so are less likely to rely on opinions of others 2. Tend to be more achievement-orientated and consequently are more likely to become leaders and entrepreneurs 3. Better able to resist coercion from others Twenge et al (2004) – meta-analysis • what did they find? Young Americans increasingly believe their lives are controlled by outside forces rather than their own behaviour  in the studies used in this meta-analysis, researchers found that locus of control scores has become substantially more external in student and child samples between 1960 – 2002 • Why are these implications important?  Suggest that the implications of this finding are almost uniformly negative, as externality is correlated with poor school achievement, decreased self-control and depression External locus of control Linz and Semykina (2005) – there are individual differences in locus of control -Used survey data collected from over 2600 Russian employees between 2000 – 2003 • What did they find? Significant gender differences, with men being more likely to exhibit an internal locus of control and a need for challenge  with women being more likely to exhibit an external locus of control and a need for affiliation/association • Why is this a limitation of the locus of control explanation?  The different genders had different types of locus of control
  12. 12. Minority influence & social change AO1 Social change = occurs when a society as a whole adopts a new belief or way of behaving which then becomes widely accepted as the ‘norm’ How can minority influence act as a force for social change? Their ability to organise, educate and mobilise support for their cause Moscovici (1976): Conditions necessary for social change through minority influence Drawing attention to an issue How does this cause social change? • being exposed to the views of a minority draws our attention to the issues being addressed. • If their views are different to the ones that we (+ the rest of the majority) currently hold, then this creates a conflict that we are motivated to reduce The Role of conflict • sometimes we cannot dismiss the minority as ‘odd’ or ‘abnormal’, so the conflict remains How does this cause social change? •We find ourselves examining the minority’s arguments more closely • This doesn’t necessarily result in a move towards the minority position, but it does mean we think more deeply about the issue being challenged Consistency • minorities tend to be more influential in bringing about social change when they express their arguments consistently (over time and with each other) How does this cause social change? • if members of a minority are consistent in their views and express this position consistently over time, then they are taken more seriously • if they express the same position consistently then they must really believe it to be true The Augmentation principle • if there are risks involved in putting forward a particular point of view, then those who express those views are taken more seriously How does this cause social change? • because members of the minority appear willing to suffer for their views, the impact of their position on other group members is increased or ‘augmented’ As a result, they are more likely to be influential in bringing about social change • by taking up a position opposing the majority, the minority are more likely to be subjected to abuse (publically and through the media) and sometimes prison or death
  13. 13. Condition How did the suffragettes use this? Drawing attention to the issue • suffragettes used a variety of educational, political and sometimes militant to draw attention to the fact that women were denied the same political rights as men The role of conflict • having been exposed to the views of suffragettes, members of the majority group would experience conflict as the suffragettes were advocating something quite different to the way things currently were Consistency • suffragettes were consistent in expressing their views, regardless of the attitudes of those around them. • their fight for the vote continued for 15 years, and even when imprisoned for civil disobedience, their protests continued in jail The augmentation principle • the fact that the suffragettes were willing to suffer to make their point, risking imprisonment or even death from hunger strike meant that they were taken seriously Minority influence & social change AO2 Strengths High external validity  High ecological validity Limitation: Minority influence doesn’t necessarily lead to social change Why? • minorities face the problem of being in a disadvantaged position of not only lacking social power but also being seen as different or ‘deviant’ in the eyes of the majority • Majority group members tend to disagree with minority as they didn’t want to be seen as deviant themselves  The influence of a minority therefore creates a potential for change rather than actual change Evidence for the validity of minority influence: SUFFRAGETTES Further evidence for validity: Terrorism (Kruglanski, 2003) Condition How does this link to terrorism? Consistency and persistence • the persistent suicide bombings by Palestinians terrorists are designed to demonstrate their commitment to overthrowing the Israeli occupation Augmentation • the personal costs of those willing to lay down their lives is commitment to their cause and others begin to take it more seriously
  14. 14. Sympathomedullary pathway Stage 1 In the initial shock response, the hypothalamus triggers activity in the sympathetic branch of the automatic nervous system – which is a branch of the peripheral nervous system The sympathetic branch becomes more active when the body is stressed and using energy Peripheral Nervous System Stage 2 The sympathetic branch stimulates the adrenal medulla within the adrenal glands, which releases adrenaline and noradrenalin into the bloodstream Blood pressure and heart rate increase to get blood quickly to areas of the body where it’s needed for activity The release of noradrenalin: Breathing rate increases so that more oxygen can be sent to the muscles Digestion decreases so that blood can be directed to the brain and muscles Muscles become more tense so that the body is physically responsive Perspiration increases so that the body can cool down and burn more energy Adrenaline – a hormone that is secreted by the adrenal medulla in response to stress and increases the heart rate, pulse rate, and blood pressure and raises the blood levels of glucose and lipids. Noradrenalin – a hormone secreted by the adrenal medulla, increasing blood pressure and heart rate, and by the endings of sympathetic nerves, when it acts as a neurotransmitter both centrally and peripherally.
  15. 15. Pituitary-adrenal system • A second system to produce a counter shock response for when the stress is long- term (e.g. Several hours or more) and the sympathomedullary response starts to use up the body’s resources. • Supplies the body with more fuel – like putting your body on red alert. The hypothalamus also triggers the release of CRH (Corticotrophin- releasing hormone) CRH stimulates the anterior pituitary gland to release a hormone called ACTH (Adrenocorticotrophic Hormone) ACTH travels through the body (through the bloodstream) and then stimulates the adrenal cortex of the adrenal glands The adrenal cortex then releases the corticosteroids (e.g. cortisol) which gives us energy by converting fat (in fatty tissue) into fatty acids and glycogen (stored in the liver) into glucose This energy is needed to replace that used up by the body’s initial reaction to the stress e.g. Running away (flight) Hypothalamus The part of the brain that responds to stress What is Stress? •Response that occurs when we think we can’t cope with the pressures in the environment. •If the pressures/demands cause stress, these are called STRESSORS. FIGHT FLIGHT •Stand your ground •Defend your position •Attack •Persevere •Move on •Retreat •Discard •Remove yourself •Give up
  16. 16. Marucha et al (1998): Exams and wound healing Aim – to see if stress from exams had an effect on the healing of a wound Procedure: • placed two 3.5mm punch biopsy wound on 11 dental students’ mouths • first wound timed in summer holidays • second wound placed 3 days before exams (6 weeks later) Findings/Conclusions: • wounds given before the exam took 40% longer to heal than wounds during the holidays  Suggests the stress of taking exams was enough to alter the healing process Brady et al (1958): Stress and the development of ulcers (monkeys) Procedure: • monkeys put in pairs • given electric shocks every 20seconds for 6 hour sessions • one monkey in each pair could push a lever to postpone each shock (executive monkey)  The other could not delay them Findings/Conclusions: The executive monkeys were more likely to develop ulcers and die This was due to the stress that they felt in trying to avoid them  this stress reduced the immune system’s ability to fight Kiecolt-Glaser et al (1984): Effect of exams on immune system of medical students Procedure: • blood samples taken one month before + during exams Before = low stress  During = high stress • immune system functioning assessed by measuring NK cell activity in blood samples • participants also completed questionnaire to measure their other life stressors Findings/Conclusions: • NK cell activity was significantly reduced in second blood sample compared to the first Suggests short-term, predictable stressors reduce immune system functioning, increasing likelihood of illness  students with highest levels of loneliness = lowest NK cell activity Stress-related illness: The immune system AO1 What is the immune system?  System of cells within the body that is concerned with fighting viruses and bacteria Short-term stressors – Exam stress: Further study:
  17. 17. Real-world applications Key points: • stress-coping behaviours can be taught to groups of all ages and backgrounds Techniques include deep breathing and expressive writing STRENGTH because...  People who use stress-coping behaviours generally report improvement in their physical and psychological well-being Evans et al (1994): stress can sometimes enhance the immune system Key points: • looked at activity of an antibody –SlgA – which helps protect against infection • arranged for students to give talks to other students (Active stress) Showed increase in SlgA, whereas levels of SlgA decreased during examination periods which stretched over several weeks LIMITATION because... short-term stress does not always decrease immune system functioning, but can also enhance it in some circumstances  (Evans) stress may have 2 effects on the immune system: • up regulation (increased efficiency) for short-term acute stress • down regulation for chronic stress Stress-related illness: The immune system AO2 Individual Differences: Gender + age differences in the stress/ immune system relationship Key points: • women show more adverse hormonal and immunological changes in the way they react to marital conflict • as people age, stress has a greater effect on immune- system functioning, making it harder for the body to regulate itself LIMITATION because...  People of different ages and gender will be effected differently Segerstrom and Miller (2004): Research Support Key points: • meta-analysis of 295 studies conducted over the past 30 years found... short-term, acute stressors can boost the immune system Long-term, chronic stressors led to suppression of the immune system  the longer the stress, the more the immune system shifted from potentially adaptive changes to potentially detrimental changes
  18. 18. Williams et al (2000): Anger and heart disease • conducted a study to see whether anger was linked to heart disease • 13,000 people completed 10 Q anger scale • Q examples = ‘hot headed?’, ‘feel like hitting when angry?’, annoyance at no recognition for good work?’ • no participants started out with heart disease. Findings/Conclusions: • after 6 years, 256 participants had experience heart attacks • those who scored highest on ager scale = over 2.5 times more likely to have a heart attack than those with low anger ratings • those who scored ‘moderate’ were 35% more likely to experience a coronary event Suggests that anger may lead to cardiovascular disorders  Williams concluded that ‘individuals who find themselves prone to anger might benefit from anger management training Russek (1962): Work-related stress and heart disease • looked at heart disease in medical professionals • Group 1 (GPs + anaesthetists) = classed as high stress • Group 2 (pathologists and dermatologists) = classed as low stress Findings/Conclusions: • found heart disease was greatest among GPs (11.9%) and lowest in dermatologists (3.2%) • this supports the view that stress is link to heart disease Stress-related illness: Cardiovascular and Psychiatric Disorders AO1 Cardiovascular Psychiatric Melchior et al (2007): Stress and depression • carried out a survey over 1 year among 1000 people in a wide range of occupations in NZ Findings/Conclusions: • 15% of those in high-stress jobs suffered a first episode of clinical depression or anxiety during that year, compared with 8% in low-stress jobs • women were generally worse affected than men • suggests high levels of stress lead to clinical depression or anxiety MacNair (2002): Stress and PTSD • Perpetration Induced Traumatic Stress (PITS) is a form of PTSD caused by being an active participant in causing trauma. • e.g. Soldiers where it is expected of them to kill
  19. 19. Sheps et al (2002): The effects of stress on existing conditions • focused research on volunteers with ischemia (reduced blood flow to the heart) • gave 173 men + women a variety of psych tests, including public speaking Findings: • their blood pressure soared dramatically, and in half of them, sections of the muscle of the left ventricle began to beat erratically • 44% of those with erratic heart beats died within 3-4 years, compared to just 18% who had not Conclusions: STRENGTH • stress can be fatal for people with existing coronary heart disease • psychological stress can dramatically increase the risk of death in people with poor coronary artery circulation Stress-related illness: Cardiovascular and Psychiatric Disorders AO2 Individual Differences • research suggests that the sympathetic branch of the ANS in some individuals is more reactive than in others LIMITATION • some people respond to stress with greater increases in blood pressure and heart rate than others, which would lead to more damage to the cardiovascular system in hyper responsive individuals The diathesis-stress model • proposes that in order for a person to a develop a psychiatric disorder, they must possess a biological vulnerability to that disorder (diathesis) • this is determined by genetic or early biological factors STRENGTH • stress can have an impact on that vulnerability, either triggering the onset of the disorder or worsening it’s course • if a person is incapable of adapting to stressful situations, psychiatric symptoms will develop or worsen A casual link? (between stress + depression) • although the relationship between stress and depression has been demonstrated by some researchers, others claim the effects are small, accounting for less than 10% LIMITATION • it is frequently not possible to assess whether stressful events in the period before diagnosis of a disorder have caused the disorder or have been a consequence of the person’s deteriorating state
  20. 20. Positive + Negative events: • research using the SRRS appears to suggest that any life-changing event has the potential to damage health due to the significant readjustment it entails • however some critics now suggest it is the quality of the event that is crucial, with ‘undesired, unscheduled and uncontrolled’ changes being the most harmful Individual Differences: • what are relatively minor stressors for some, (child leaving home or very busy Christmas), would be major stressors for other people LIMITATION  the SRRS ignores the fact that life changes will have different significance/effects for different people Rahe et al (1970): SRRS and the US Navy • correlation study • 2500+ men given form of SRRS to complete just before they set sail on duty • had to indicate all of the events that they had experienced over previous 6 months Findings/Conclusions • higher LCU scores linked to higher incidence of illness over next 7 months  Stress involved in the changes that life events bring is linked to an increased risk of illness Life Changes SRRS Scale (Holmes and Rahe, 1967) Used to rank events from most to least stressful Life events = events in a person’s life such as divorce or death that require a significant adjustment in various aspects of a person’s life How does it measure this using ‘life change units’ (LCU’s)? People scored life events on how stressful they are The higher the number of LCUs, the more stressful it was • Death of spouse = 100 LCUs • Pregnancy = 40 LCUs • Christmas = 12 LCUs Michael and Ben-Zur (2007): Life changes and life satisfaction in divorced and widowed women • studied 130 men + women – half had been recently divorced, other half recently widowed • looked at levels of life satisfaction Findings/Conclusions • widowed group= high life satis’ before death of spouse than after • divorced individuals = higher levels of life satisfaction after separation than before (+ lower stress)  Could be due to dating or living with new partner, or turned life change into a positive experience Heikkinen & Lonnquist (1995): Real-world applications (suicide) • examined possible causes during last 3 months preceding suicide among 219 suicide victims in Finland • Differences in life events were found across age groups STRENGTH • younger victims = financial troubles, loss, unemployment = most common • physical illness appeared to be the most important stressor in elderly suicides, particularly men DeLongis et al (1988):Life changes + Daily hassles • studied stress in 75 married couples • gave participants life events questionnaire + a hassles & uplifts scale Found no relationship between life events + health, but found positive correlation of +.59 between hassles and next-day health problems such as flu + headaches LIMITATION Lazarus (1990): • it is the minor daily hassles in life that are the more significant source of stress for most people, rather than life changes as they are quite rare in lives of most people
  21. 21. Flett et al (1995): Daily hassles vs. Life changes • 320 students (160M, 160F) read a scenario describing a male or female individual who had experienced major life event/daily hassles • then rated amount of support (emotional + practical) the person would receive and would seek from others Findings/Conclusions • individuals who had suffered major life events were rated higher in both seeking and receiving support from significant others  Suggests that the greater the negative influence of daily hassles on psychological adjustment may be due to the reduced amount of support received from others Bouteyre et al (2007): Daily hassles and uni students -Studied relationship between daily hassles + mental health of students during transition from school – uni • 1st year psych students at French uni completed Hassles part of HSUP and the Beck Depression Inventory. Measured any symptoms of depression that are caused by the hassles of transition Findings/Conclusions • 41% suffered from depressive symptoms • positive correlation between scores on the hassles scale and the incidence of depressive symptoms • transition to uni frequently fraught with daily hassles  can be considered a significant risk factor of depressionDaily Hassles AO1 Gervais (2005): Daily uplifts and nurses • asked nurses to keep diaries for a month, recording all their daily hassles + uplifts while at work • also asked to rate their own performance over the same period Findings/Conclusions • at end of month, daily hassles were found to increase job strain + decrease job performance • Nurses felt some uplifts they experienced counteracted the negative effects of their daily hassles (compliment from patient/praise from superior) • uplifts also improved their job performance The Hassles and Uplifts Scale (HSUP) Daily hassles = minor events that arise in the course of a normal day Daily uplifts = more positive experiences that we have every day What does the scale aim to measure? -respondents’ attitudes towards daily situations - instead of focusing on the more highly stressful life events, the HSUP provides a way of evaluating both the positive and negative events that occur in a person’s daily life -Hassles = issues arising in family, disagreements - Uplifts = smile from someone in street, email from long lost friend
  22. 22. Daily Hassles AO2 Gulian et al (1990): Real-world applications – daily hassles and road rage • found that participants who reported a difficult day at work subsequently reported higher levels of stress on their commute home STRENGTH because... • when unresolved hassles are carried forward into the driving situation, events are more likely to be interpreted as stressful by the driver. Miller et al (1992): Individual differences – gender differences in what constitutes as a ‘hassle’ LIMITATION • pets appear to serve different roles for male + female owners.  For females, pets = uplifts (e.g. leisure)  For males, pets = hassles (e.g. Time, money) The Accumulation Effect: • an accumulation (build up) of minor daily stressors creates persistent irritations, frustrations and overloads which then result in more serious stress reactions such as anxiety and depressions STRENGTH because... • daily hassles provide a more significant source of stress for most people than major life events What does research tell us? • most research on daily hassles is correlation We cannot draw casual conclusions about the relationship between daily hassles and well-being HOWEVER  Correlations indicate that daily hassles in our lives can potentially effect our health and well- being
  23. 23. Johansson et al (1978): Swedish sawmill workers + repetitive tasks -Looked at effects of performing repetitive jobs that require continuous attention and some responsibility • compared 2 groups of workers 1. Sawyers (high risk group) – repetitive, intense, skilled work 2. cleaners (low risk) – less repetitive, more flexible  High risk = higher illness rates, more adrenaline in urine  also = higher levels of stress hormones on work days than rest days Lazarus (1995): the impact of workplace stressors • Lazarus’ transactional approach emphasises that the degree to which a workplace stressor is perceived as stressful depends largely on the person’s perceived ability to cope LIMITATION because... • high job demands and role ambiguity may be perceived as stressful to one person, but not to another – particularly those high in hardiness Ritvanen et al (2007): Real world applications • investigated whether aerobic fitness could reduce the physiological stress responses teachers experienced during work hours • 26 male+female teachers participated in study which involved exercise tests, measurement of physiological responses (e.g. Blood pressure) as well as measurement of perceived stress STRENGTH/LIMITATION because... • teachers with the highest levels of aerobic fitness had lower levels of heart rate, muscle tension and perceived stress • study suggests that improving aerobic fitness may therefore reduce the negative effects of work stress in teachers Workplace Stress Research into workload and control Research into control What did Marmot et al find 5 years after their study? -Men + women who had initially reported low levels of job control were more likely to have developed heart diseased than those who reported high levels of job control What did they conclude about the importance of control in the workplace? -Critical factor in determining the onset of heart disease was the level of control – regardless of the grade of the job - other factors, such as workload or the degree of social support received at work did not appear to be associated with the risk of heart disease Marmot et al (1997): Workload and illness -Investigated the job-strain model of workplace stress (says the workplace creates stress + illness in 2 ways: high workload, low control • Studied 7372 civil servants in London, asking to complete questionnaire on workload, job control + amount of social support, then assessed/checked for signs of cardiovascular disease • suggested higher-grade employees = high workload + low-grade employees = low job control (so both likely to experience high stress) Findings/Conclusions (5 years later) • no link between high workload and stress related illness in civil servant • also found direct link between relative status of the civil servants and their levels of stress-related illness • the lower they were in the hierarchy = more likely to suffer stress related illness (low grade had less social support) Schaubroek et al (2001): individual differences; the role of control LIMITATION of Marmot because... • some workers respond differently to lack of control – they are less stressed by having no control or responsibility Kivimaki et al (2006): Research support on the harmful effects of work stress • carried out meta-analysis of 14 studies looking at relative risk of coronary heart disease in association with work stress • involved over 83,000 employees across Europe, Japan + the US STRENGTH because... • employees with high levels of job strain = 50% more likely to develop CHD
  24. 24. Kobasa (1979): Business executives and illness • assessed 800 American business executives’ stress using the SRRS Findings/Conclusions  approx 150 were classed as high-stress according to the SRRS score  some had low illness records and some had high – suggests something else was modifying the effects of stress because individuals experiencing the same stress levels had different illness records Behaviour Characteristics How does this affect stress-related illness? Type A • competitiveness and achievement striving (ambitious) • impatient • hostile + aggressive • characteristics lead to raised BP and raised levels of stress hormones which are linked to illness and the development of CHD Type B • non-competitive • relaxed • easy-going • behaviours are believed to decrease an individuals risk of stress- related illness Personality Factors and Stress AO1 Type A and Type B behaviour The Hardy personality Control: see themselves as being in control of their lives, rather than being controlled by external factors beyond their control Commitment: very involved in what they do and show a high level of commitment Challenge: see life challenges as problems to be overcome rather than as threats or stressors. Friedman and Rosenman: The Western Collaborative Group Study – CHD associated with Type A • 3000 men aged 39-59 in California were examined for signs of CHD (to exclude already ill individuals) and their personalities assessed by interviews • questions about how they responded to everyday pressures • interview conducted in a provocative manner to try and elicit type A behaviour Findings/Conclusions • after 8½ years, twice as many type A participants had died of cardiovascular problems • over 12% of type A has experienced heart attacks, compared to 6% type B’s • type A also had higher blood pressure + cholesterol • also more likely to smoke and have family history of CHD Maddi et al (1987): Telephone company employees and hardiness • studied employees of a US company that over the course of a year was dramatically reducing the size of it’s workforce Findings/Conclusions • two-thirds of employees suffered stress-related health problems over this period but the remaining third thrived • thriving showed more evidence of hardiness
  25. 25. Personality Factors and Stress AO2 Type A behaviour The Hardy personality Riska (2002): Individual Differences) Myrtek (2011): Type A/CHD link • carried out a meta-analysis of 35 studies on the link between type A and CHD • found an association between CHD and a component of type A personality – hostility LIMITATION because... • other than the link between hostility and CHD, there was no evidence of an association between type A personality and CHD Real-world applications • In the 1990s Gulf War, the higher the hardiness level, the greater the ability of soldiers to experience combat-related stress without negative health consequences such as PTSD or depression STRENGHT because... • concept of hardiness used to explain why some soldier remain healthy under war-related stress • hardiness training has now become more widespread throughout the military Negative affectivity • some critics argue that characteristics of the hardy personality can be explained by the concept of negative affectivity High NA individuals are more likely to report distress and dissatisfaction, dwell more on their failures and focus on negative aspects of everything STRENGHT/LIMITATION because... • NA and hardiness correlate quite well, which suggests that ‘hardy individuals’ are simply those who are low on NA
  26. 26. Effectiveness: Michenbaum compared SIT with systematic de- sensitisation on patients. both helped deal with phobias but SIT was better as it helped clients deal with a second non-treated phobia. SIT can help future and current stressful situations. Psychological methods of stress management STRESS INOCULATION THERAPY HARDINESS TRAINING AO1 AO1 Meichenbaum (1985) BRIEF SUMMARY: a form of cognitive behavioural therapy which trains people to cope with anxiety and stressful situations more effectively by learning skills to ‘inoculate’ themselves against the damaging effects of future stressors. THREE MAIN PHASES: 1. CONCEPTUALISATION PHASE: The therapist and client establish a relationship, and the client is educated about the nature and impact of stress.  the client is taught to view perceived threats as problems to be solved which enables the client to think differently about their problem. 2. SKILLS AQUISITION PHASE (AND REHEARSAL): Coping skills are taught and practised, then gradually rehearsed in real life. Skills include: positive thinking, relaxation, social skills, methods of attention diversion, using social support systems and time management.  Clients may also be taught to use coping self-statements – “relax, you’re in control”. 3. APPLICATION PHASE (AND FOLLOW-THROUGH): Clients are given opportunities to apply the newly learned coping skills in different situations that become increasingly stressful.  Various techniques used: imagery (imagining how to deal with stressful situations), modelling (watching someone else cope with stressors and then imitating this behaviour), and role playing (acting out scenes involving stressors) AO2 BRIEF EXPLANATION: the aim of hardiness training is to increase self- confidence and sense of control so that individuals can more successfully navigate change in their lives. HOW IT IS TAUGHT: 1. FOCUSING: The client is taught to be able to identify the sources of stress and recognise the biological signs of stress such as muscle tension and increased heart rate. 2. RELIVING STRESS ENCOUNTERS: The client relives a stressful encounter and is helped to analyse such situations and what their response is to them.  This enables them to have an insight into their current coping methods and they may be more effective than first thought 3. SELF-IMPROVEMENT: The insights gained by the client can be used to learn new techniques of how to deal with stress  The client is taught to focus on seeing stressors as challenges that they are able to take control of, rather than problems they must give in to. AO2 Does it work?  Hardiness training at Utah Valley State College has helped students stay in and graduate from school by helping them master the stresses they encounter while working to develop themselves professionally and personally. Practical Application in Sport: Fletcher (2005)  found that HT has been effectively used by UK Olympic swimmers to ensure they are able to control the stressful daily aspects of their lives that might otherwise interfere with their training. Problems with hardiness training: It cannot be seen as a rapid solution to stress management as it first has to address basic aspects of personality and learned habits of coping that are difficult to modify.  Requires a lot of time, effort, motivation and money. Unnecessarily complex: The effectiveness of SIT may be due to certain elements of training rather than the whole.  it may be equally effective to just learn to talk more positively and relax more. Preparation for future stressors:  It doesn't just deal with current stressors, it enables clients to cope with future problems. (the focus on phase 2 provides long lasting effectiveness.
  27. 27. Side Effects •Side effects of BZ’s include increased aggressiveness and cognitive side effects (including impairment of memory, especially the ability to store acquired knowledge in long-term memory LIMITATION because... • most people who take BZ’s experience no side effects, although some studies have linked them with an increased risk of developmental diabetes Addiction LIMITATION because... • patients taking even low doses of BZ’s show marked withdrawal symptoms when they stop taking them Ease of use • the therapy requires little effort from the user whereas... SIT requires a lot of time, effort and motivation from the client to be effective STRENGTH because... much easier than the time and effort needed to use psychological methods How do BZ’s aim to treat anxiety and stress? - by slowing down the activity of the central nervous system What is GABA? - a neurotransmitter that is the body’s natural form of anxiety relief - about 40% of neurons in the brain respond to GABA How does GABA reduce anxiety? - when GABA locks onto GABA receptors it opens a channel which increases the flow of chloride ions into the neuron. Chloride ions make it harder for the neuron to be stimulated by other neurotransmitters, thus slowing down it’s activity and making the person feel more relaxed. How do BZ’s enhance GABA? -By binding to special sites on the GABA receptor and boosting the actions of GABA - this allows more chloride ions to enter the neuron, making it even more resistant to excitation. As a result, the brains output of excitatory neurotransmitters is reduced, and the person feels calmer How do BZ’s and serotonin reduce anxiety? -Serotonin is a neurotransmitter that has an arousing effect in the brain - BZ’s reduce any increased serotonin activity, which then reduces anxiety Biological Methods of Stress Management: Drug Therapies Benzodiazepines (BZ’s) Beta-blockers (BB’s) What is sympathetic arousal? • stress leads to the arousal of the sympathetic nervous system which causes raised BP, increased HR etc • these symptoms can lead to cardiovascular disorders and also reduce the effectiveness of the immune system How do BB’s work? • reduce activity of adrenaline and noradrenalin which are part of the sympathomedullary response to stress • BB’s bind to beta-receptors on the cells of the heart and other parts of the body that are usually stimulated during arousal What do BB’s achieve? • by blocking these receptors, BB’s cause the reverse effect of stress hormones, causing the heart to beat more slowly with less force • blood vessels do not contract so easily which results in a fall in blood pressure and therefore less stress on the heart – person feels calmer and less anxious Lockwood (1989): Real-world Applications • studied over 2000 musicians in major US symphony orchestras • found that 27% reported taking beta-blockers • said they felt better about their performance after taking BB’s STRENGTH because... • Beta-blockers significantly reduce the symptoms of anxiety
  28. 28. Criticism(1) Key points: LIMITATION why... Deviance is related to context and degree • social deviance cant offer complete definition of abnormality as its related to context AND degree e.g. Bikini on beach = normal, bikini in class/formal event = abnormal • there is not a clear line between what is an abnormal deviation and what is harmless eccentricity Cultural relativism • social norms defined by the culture • disorders defined/diagnosed in different ways in different places by different places by different groups • diagnosis may be different for the same person in two different cultures Criticism(2) Key points: LIMITATION why... Who judges? • other people judge behaviours as abnormal as they feel uncomfortable • e.g. schizophrenics • the individual may be unaware that they are not coping Adaptive or maladaptive? • some ‘dysfunctional’ behaviour can be adaptive and function for the individual • e.g. People make a living out of cross-dressing (transvestitism in list of mental disorders and regarded as abnormal) • the behaviour is not actually abnormal for the individual Criticism(3) Key points: LIMITATION why... Cultural relativism • most of the criteria are culture- bound  The criteria of self-acualisation is relevant to individualist cultures but not collectivist cultures • cannot be generalised to other cultures Is mental health the same as physical health? • physical illness = physical causes e.g. Virus • some mental illnesses = physical causes (brain injury) but many do not • it is unlikely that we could diagnose mental & physical abnormality in the same way Definitions Abnormality = psychological condition/behaviour that departs from the norm or is harmful and distressing to the individual or those around them. 1. Deviation from Social Norms What are ‘social norms’? - Standards of behaviour that are accepted/expected by the majority e.g. Politeness, ways of dressing How is abnormality defined? - the problem with this is that the majority of behaviour that deviates from social norms are unlikely to represent mental illness 2. Failure to Function Adequately e.g. Depression; can be coped with as long as you still go to work, eat meals etc. As soon as depression interferes, the individual may label their own behaviour as abnormal How is abnormality defined? - from an individuals point of view abnormality can be judged in terms of not being able to cope (failing to cope) 3. Deviation from Ideal Mental Health (Jahoda, 1958) 1. Self attitudes – having high self-esteem and a strong sense of identity 2. Personal growth & self-actualisation – the extent to which an individual develops their full capabilities 3. Integration – such as being able to cope with stressful situations 4. Autonomy – being independent and self-regulating 5. Accurate perception of reality 6. Mastery of the environment – including the ability to love, function at work and in interpersonal relations, adjust to new situations and solve problems
  29. 29. Cause and effect • schizophrenia is commonly associated with an excess of the brain neurotransmitter dopamine • some studies of schizophrenic patients have shown reduced levels of dopamine in some brain tissues LIMITATION because...  available evidence does not support a simple cause + effect link between mental illness such as schizophrenia and altered brain chemistry The Biological Approach How does the biological approach explain mental disorders? - they have physical causes Why are mental disorders seen as similar to physical disorders? - they are illnesses Physical factors that cause abnormality Genetic Inheritance – abnormalities in brain anatomy or chemistry are sometimes the result of genetic inheritance How does this cause abnormality? • passed from parent to child • many of the genes responsible for abnormal behaviours are the product of evolutionary adaptations in our ancestors What evidence supports this? • Twins (identical) – when one twin has a disorder, the other has it as well. Genes and abnormal biochemistry/neuro-anatomy How does this cause abnormality? • genes determine the levels of hormones and neurotransmitters in the brain • high levels of serotonin are associated with anxiety, whereas low levels have been found in depressed individuals What evidence supports this? • research has shown that schizophrenics have enlarged spaces (ventricles) in their brains, indicating shrinkage of brain tissue around these spaces. Viral Infection How does this cause abnormality? • some disorders may be related to exposure in the womb What evidence supports this? • Torrey (2001) – mothers with strain or influenza during pregnancy had children with schizophrenia Cultural similarities Key Points: • suggests many disorders have a biological origin • evolutionary view argues mental disorders are an exaggerated version of a trait from ancestors • therefore assumes most humans would have the same adaptation STRENGTH because... • Research supports this  depression is currently the most common mental disorder with around 120m sufferers worldwide Inconclusive evidence (Gottesman and Shields, 1976) • reviewed results of 5 studies of twins looking for concordance rates of schizophrenia • genetically identical twins concordance rate = 50% • if schizophrenia was entirely the product of genetic inheritance it would be 100% LIMITATION because... • no evidence that mental disorders are purely caused by inheritance • concordance rates never 100% • disorder only develops if individual is exposed to stressful life conditions
  30. 30. Case Studies: • offer an in depth data insight into behaviour LIMITATION because... • difficult to generalise from individual cases as each has unique characteristics Abstract concepts: • the id, ego and superego are difficult to define and research •Actions motivated by them operate primarily at an unconscious level, so there is no way to know for certain that they are occurring LIMITATION because... • psychodynamic explanations have received limited empirical support  So psychodynamic theorists have had to rely largely on evidence from individual case studiesThe Psychodynamic Approach Freud’s theory of personality: Personality structures Id: • the irrational, primitive part of personality • present at birth • demands immediate satisfaction • ruled by the pleasure principle (innate drive to seek immediate satisfaction) Ego: • the conscious, rational part of personality • develops by the end of the infants first year as the child interacts with the constraints of reality Superego: • embodies our conscience and sense of right & wrong • develops between the ages of 3 and 6 Defence mechanisms (ego defences) Repression: defence mechanism to reduce anxiety (putting unpleasant thoughts in the unconscious)  Regression: behaving like a child (reverting to an earlier stage Cause Problem? How this causes mental disorder: Unresolved conflict • conflicts between the id, ego + superego create anxiety • these defences can be the cause of disturbed behaviour if they are overused Early experiences • in childhood the ego is not developed enough to deal with traumas so they are repressed • e.g. Childs loss of parent – later deaths in life can lead to re-experience. Unexpressed anger about loss directed inwards towards self, causing depression Unconscious motivations • ego defences, such as repression + regression exert pressure through unconsciously motivated behaviour • this frequently leads to distress, as person does not understand why they are acting out in that particular way • underlying problem cant be controlled until brought into conscious awareness Mental disorders Problems with research: Lack of research evidence: • theory is difficult to prove or disprove •Could indicate that the person is behaving this way as a consequence of their defence mechanism LIMITATION because... • theory is not rejected if results do not support it Other research – Sexism: • Freud’s work = sexist (theory was sexually unbalanced) (perhaps due to Victorian times) LIMITATION – cannot be applied to female participants
  31. 31. Animal studies (BA uses evidence from animals) • the same basic laws of learning apply to human and non-human animals STRENGTH because...  it is reasonable to conduct research on non-human animals, such as rats and pigeons, and make generalisations to human behaviour Behaviours = the responses a person makes to their environment External events are important because: They are more observable Abnormal behaviour and learning theory Learning Theory How can this explain phobias? Classical conditioning Learning occurs through association • the feared object was associated with fear or anxiety sometime in the past Operant conditioning Learning occurs through reinforcement • if a response is punished, this decreases the probability that it will be repeated • psychological disorder is produced when a maladaptive behaviour is rewarded Social learning theory (vicarious conditioning) Behaviours are learned by seeing others rewarded and punished • when researchers report that some disorders run in families, it is difficult to separate the effects of genetics from the effects of social learning (behaviours are observed and imitated) Learning environments Learning environment = the idea that the area around us and social areas will reinforce behaviours How can learning environments reinforce abnormal behaviours? Avoidant behaviour lowers anxiety and depressive behaviours may cause help from others The Behavioural Approach A limited view (behavioural explanations are reductionist) • behaviourist explanations tend to ignore the role of cognition in the onset and treatment of abnormality LIMITATION because... • behaviourist explanations of mental disorders offer an extremely limited view of the factors that might cause abnormal behaviours Counter evidence (can causes of behaviours be identified?) • theories of the acquisition would have a problem explaining why people are unable to identify an incident in their past LIMITATION because... • lends itself to scientific validation Behavioural therapies are effective • systematic desensitisation STRENGTH – allows phobias to be treated
  32. 32. Consequence rather than cause (which comes first, thinking or mental disorder?) • not clear which comes first • people with maladaptive cognitive processes are at greater risk of developing mental disorders • LIMITATION because •  faulty thinking is a vulnerability factor for abnormality ABC Explanation/Example A (activating event) • e.g. The sight of a large dog B (belief) • may be rational or irrational e.g. ‘the dog is harmless’ = rational OR ‘the dog will attack me’ = irrational C (consequence) • rational beliefs lead to healthy emotions e.g. Amusement or indifference • irrational beliefs lead to unhealthy emotions e.g. Fear or panic The Cognitive Approach Cognitions = thinking, expectations and attitudes that direct behaviour  how people perceive, reason and judge the world around them Why does faulty/disordered thinking cause abnormal behaviour? It prevents the individual from behaving adaptively The ABC model (Ellis, 1962) The importance of the individual Why is the cognitive approach unique? • it is the only explanation that thinks we are in control of our thoughts so we control our own behaviour How is the individual in control of abnormal behaviour? • an individual’s behaviour is caused by forces outside of their control – physiological, genetic, unconscious or environmental factors • the cognitive model portrays the individual as being the cause of their own behaviour because the individual controls their thoughts. Blames the patient (situational and environmental factors are overlooked): • it is the patient who is responsible – the disorder is simply in the patients mind and recovery lies in changing that, rather than the individuals environment LIMITATION because... • may overlook situational factors e.g. Not considering how life events or family problems may have contributed to the mental disorder e.g. Aviatophobia Fear or flying – caused by plane crash ideas (activating event) A B B CC Event rational irrational calm panic Irrational beliefs may be realistic (accurate) • Alloy+Abrahmson (1979) • depressive realists tend to see things for what they are • not all irrational beliefs are irrational LIMITATION because... • depressed people gave more accurate estimates of the likelihood of a disaster than ‘normal controls, and called this the ‘sadder but wiser’ effect
  33. 33. Placebo effects (effectiveness of drugs may be due to psychological effect as well as chemical effect): Kirsch et al (2002) - 38 studies of antidepressants  found patients who received placebos fared almost as well as those getting real drugs LIMITATION because… HOWEVER Mulrow et al (2002) – compared use of tricylics and placebos in 28 studies and found a success rate of 35% for placebos and 60% for tricyclics Ease of use: (chemotherapy)  requires little effort from the user  considerably less than for therapies such as psychoanalysis STRENGTH because…  many clinicans advocate a mixture of chemotherapy and some form of psychotherapy Treatment What does the drug target? How is the disorder treated? Antipsychotic drugs: -Conventional antipsychotics - Atypical antipsychotics (e.g. clozapine) • used to combat the positive symptoms of schizophrenia e.g. chlorpromazine • temporarily occupy dopamine receptors then rapidly dissociating to allow normal dopamine transmission • block the action of the neurotransmitter dopamine in the brain by binding to dopamine receptors • may explain by why such atypical antipsychotics have lower levels of side effects • Anti- depressant drugs • reduce the rate of re- absorption of neurotransmitters or by blocking the enzyme which breaks them down  Both increase the amount of neurotransmitters available to excite neighbouring cells • most common = SSRIs’s Block the transporter mechanism that re-absorbs serotonin into the presynaptic cell after it has fired  more serotonin is left in the synapse, prolonging it’s activity, and making transmission of the next impulse easier Drug Treatments Biological therapies: Drugs & ECT Why does ECT work? • ECT alters the way the chemical messengers (neurotransmitters) are acting in the brain and helps bring about recovery • Abrams (1997) has concluded after studying ECT for 50 years, we are no closer to understanding why it works Electroconvulsive therapy (ECT) Electrode placed above temple of non-dominant side of brain. Second in middle of forehead (unilateral ECT) OR placed above each temple (bilateral ECT) Patient injected with short-acting barbiturate so unconscious before electric shock administered. Given nerve-blocking agent to prevent muscles contracting + causing fractures. Patient is also given oxygen to help them breathe Small electric current (0-6amps) that lasts about ½ second is passed through the brain. Current produces a seizure lasting up to a minute, affecting the entire brain ECT usually given 3 times a week. Patient requires between 3-15 treatments Drug Treatments ECT ECT can save lives:  Supporters of ECT claim it is an effective treatment, particularly for severe depression STRENGTH because…  it can be life saving, particularly when depression is so severe it can lead to suicide Side Effects:  impaired memory, cardiovascular changes, headaches  psychological effects may be evident as well LIMITATION because…  DOH report (1999) found 30% of people receiving ECT in last 2yrs reported it has resulted in permanent fear and anxiety
  34. 34. Psychological Therapies: Psychoanalysis AO1 Repression and the unconscious Psychoanalysis is based on: the idea that individuals are unaware of the many factors that cause their behaviour, emotions and general mental health How does the therapist attempt to deal with the patients repressed memories? Therapist attempts to trace unconscious thoughts to their originals and then help the patient deal with them Psychoanalysis techniques Technique What is patient/ therapist required to do? How does this deal with abnormal behaviour Free association Patient – express thoughts exactly as they occur, even if they seem irrelevant Therapist – helps interpret the thoughts for the patient, who corrects, rejects and adds further thoughts and feelings • reveals areas of conflict and brings memories into consciousness that have been repressed Therapist interpretation Patient – may initially be resistant to therapist interpretations. May also display transference towards therapist Therapist – listen carefully, looking for cues and drawing tentative conclusions of the possible causes of the problem • better understanding of repressed memory Working through •Patients meet with therapist 4 or 5 times a week •Patient + therapist examine same issues repeatedly, sometimes for years in an attempt to gain a better understanding of the causes of their neurotic behaviour • allows the patient to understand the influence of their past on their current condition and gives them a chance to make positive changes in their life
  35. 35. Psychological Therapies: Psychoanalysis AO2 Bergin (1971): Effectiveness analysed data from 10,000 patient histories and estimated 80% benefitted from psychoanalysis compared to 65% from electric therapies  the longer and more intensive the treatment, the better the results STRENGTH because…  this is modest supports for psychoanalysis  as psychoanalysis tends to be both lengthy and intensive, it would be expected to produce better results Tschuschke et al (2007): Length of treatment  carried out one of the largest studies investigating long-term psychodynamic treatment STRENGTH because… more than 450 patients were included in the study, which showed that the longer psychotherapeutic treatments took, the better outcomes were Ethical Issues  painful memories are brought into the conscious mind  forced termination – where the therapist must break off from a therapeutic relationship before a client is ready for it LIMITATION because…  forced termination may leave clients feeling deprived from happiness and provoke a range of negative reactions Repressed memories may be false  critics claim some therapists are not helping patients recover repressed memories, but planting false memories ‘of sexual abuse’ or alien abduction LIMITATION because…  All psychoanalysis assumes is that a patient can reliably recall earlier memories that have been repressed, but there is little evidence to support this  this claim would challenge the belief that uncovering repressed memories during therapy is the key to recovery
  36. 36. Effectiveness (SD is successful)  research has found that SD is successful for a range of anxiety disorders Stage in therapy What is patient/therapist required to do? 1 • patient taught how to relax their muscles completely (A relaxed state is incompatible with anxiety). 2 •Therapist and patient together construct a de- sensitisation hierarchy – a series of imagined scenes, each one causing a little more anxiety than the previous ones. 3 •Patient gradually works his/her way through de- sensitisation hierarchy, visualising each anxiety- evoking event while engaging in the competing relaxation response. 4 •Once the patient has mastered one step in the hierarchy (They can remain relaxed while imagining it), they are ready to move onto the next. 5 •Patient eventually masters the feared situation that caused them to seek help in the first place. How does systematic-desensitisation aim to gradually reduce anxiety? Process of gradually introducing an individual to an object or event that they feel anxious about Why is relaxation important in this process? You learn to associate the phobia with relaxation instead of fear Psychological Therapies: Systematic De-Sensitisation Use of systematic de-sensitisation – how is imagining feared situations combined with confronting real stimuli? -When individuals are able to conquer their imagined feared situations, they may be encouraged to confront the real stimuli - Although de-sensitisation to imagined stimuli can be effective by itself, behaviour therapists often follow it up with direct exposure to the actual situation that causes the person their anxiety Appropriateness (SD is suited to treating anxiety disorders):  behavioural therapies may be the only treatment possible for certain groups of people e.g. individuals with severe learning difficulties STRENGTH because…  quick and require less effort for the patients  successful outcomes can be achieved relatively quickly Reduced effectiveness for some phobias (SD does not treat ‘survival’ phobias as effectively) LIMITATION because…  SD may not be as effective in treating anxieties that have underlying evolutionary survival components e.g. fear of the dark/heights/dangerous animals, than phobias acquired from personal experiences The problem of symptom substitution  SD may appear to resolve a problem, but eliminating or suppressing symptoms may result in other symptoms appearing LIMITATION HOWEVER  Langevin claims there is no evidence to support this objection
  37. 37. REBT and computers (REBT can be used in software programs – Yoichi et al, 2002):  developed computer program for computer-assisted counselling based on REBT 50 minute sessions adds instruction in the ABC model, as well as homework (clients think about advantages and disadvantages of each irrational belief) STRENGTH because…  Yoichi et al’s research found a significant decrease in anxiety among clients using this program Rational Emotive Behavioural Therapy (REBT) Based on the idea that many problems are actually the result of irrational thinking Aims to reduce anxiety by targeting irrational beliefs ABC Rational Irrational A (activating event) Negative event Negative event B (belief) Rational belief Irrational belief C (consequence) Healthy emotion Unhealthy emotion How REBT uses the ABC model to convert irrational into rational beliefs Psychological Therapies: CBT 1. Logical disputing 2. Empirical disputing 3. Pragmatic disputing Self-defeating beliefs do not follow logically from the information available e.g. does thinking this way make sense Self-defeating beliefs may not be consistent with reality e.g. where is the proof that this belief is accurate Emphasises the lack of usefulness of self-defeating beliefs e.g. how is this belief likely to help me? How REBT disputes/challenges irrational beliefs Appropriateness (REBT can also be used in non-clinical participants):  clinical populations – people suffering from mental disorders or phobias  non-clinical populations – people who might suffer from lack of assertiveness or examination anxiety STRENGTH because…  it is not only useful for clinical populations but it is also useful for non-clinical populations Irrational environments (REBT cannot change negative environments):  REBT fails to address that the irrational environments in which clients exist, continue beyond the therapeutic situation e.g. marriages with bullying or jobs with overly critical bosses LIMITATION because…  as a result, these environments continue to produce + reinforce irrational thoughts and maladaptive behaviours LIMITATION  people who claimed to be following REBT principles were not putting their revised beliefs into action OR people simply don’t want sort of advice that REBT practitioners tend to give