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  1. 1. GCE – AQA PSYCHOLOGY A – AS Award 1181 UNIT 2 – PSYA2 – 1 hour 30 minutes Biological Psychology, Social Psychology and Individual Differences UNIT 1 - Contents BIOLOGICAL PSYCHOLOGY – STRESS Stress as a Bodily Response 1. The body’s response to stress (a) The Fight or Flight Response 03 (b) Selye’s General Adaptation Syndrome – GAS 04 2. The pituitary-adrenal system and the sympathomedullary pathway 04 - 05 3. Stress-related illness and the immune system 05 - 06 Stress in Everyday Life 1. Life Changes and Daily Hassles 07 2. Workplace Stress 08 3. Personality factors, including Type A behaviour 09 4. Emotion-focused and Problem-focused Approaches 10 - 11 5. Physiological Methods of Stress Management, drugs and biofeedback 11 6. Psychological Methods of Stress Management, Hardiness Training and Stress Inoculation 12 7. The Role of Control in Coping with Stress 13 SOCIAL PSYCHOLOGY – SOCIAL INFLUENCE 1. What is meant by the terms ‘obedience’ and ‘conformity’? 14 2. Explain the terms ‘social norms’ and ‘normative social influence’. 14 3. Public compliance and private acceptance. 15 4. Why do people conform? 15 5. A study of majority influence (Asch, 1951) 16 6. A study of obedience to authority (Milgram, 1963) 17 - 19 7. A study of obedience to authority (Hofling, 1966) 19 8. Outline 3 psychological factors that may lead people to obey. 20
  2. 2. Social influence in everyday life 1. How can people resist pressures to conform and pressures to obey? 21 2. Conformist, anti-conformist, or independent? 21 - 22 3. What are the main ethical principles in social research? 23 - 24 4. Would research into social influence as carried out by Hofling, 24 - 25 Milgram and Zimbardo be ethically acceptable today? 5. What are the implications for social change of research 25 - 27 into social influence? 6. A study of minority influence (Moscovici, 1969) 27 INDIVIDUAL DIFFERENCES – PSYCHOPATHOLOGY (Abnormality) Defining and explaining psychological abnormality 1. Definitions of Abnormality Deviation from Social Norms 28 Failure to Function Adequately 28 Deviation from Ideal Mental Health 29 Statistical Infrequency 29 2. Key Features of the Biological Approach to Abnormality 30 3. Key Features of the Psychodynamic Approach to Abnormality 31 4. Key Features of the Behavioural Approach to Abnormality 32 - 33 5. Key Features of the Cognitive Approach to Abnormality 33 - 34 Treating Abnormality 1. Biological Therapies Drugs – Chemotherapy 34 - 35 ECT – Electroconvulsive Therapy 35 - 36 Psychotherapy 36 2. Psychological Therapies Psychoanalysis 37 Systematic De-sensitisation 38 Cognitive Behavioural Therapy 39 2
  3. 3. BIOLOGICAL PSYCHOLOGY – STRESS Stress as a bodily response  The body’s response to stress, including the pituitary-adrenal system and the sympathomedullary pathway in outline  Stress-related illness and the immune system 1. The body’s response to stress (a) The Fight or Flight Response When people feel in danger or under threat, they go into a state of arousal. Stress provokes the fight-or-flight response; either we prepare to flee from the danger or we are attracted to a suitable target. Walter Cannon (1914) argues that this was an adaptive, evolutionary response in our early ancestors when faced with predators or with animals to hunt down. During the alarm stage, several predictable physiological changes happen automatically. For example, our heart rate increases, we breathe more deeply, our pupils dilate, and the liver releases more glucose to provide bursts of energy. After the emergency is over, our physiological systems return to their normal level of functioning. Human beings, then and now, respond to stressors in much the same way. a) The heart beat speeds up to pump more blood around the body. b) Breathing deepens to increase the intake of oxygen. c) Sugar/glucose levels rise (liver production) to provide additional energy. d) Saliva and mucus dry up to widen the air passages to increase oxygen intake. e) People may go pale as blood is diverted from the skin to the muscles. f) Pupils dilate to admit more light and provide better vision. 3
  4. 4. (b) Selye’s General Adaptation Syndrome (GAS) Hans Selye (1956) defined stress as the non-specific response of the body to any demand made upon it. This response reflects the General Adaptation Syndrome (GAS), the body’s defence against stress. The body responds in the same way to any stressor, whether it’s environmental (e.g. extreme temperature, or electric shock) or arises from within the body itself. The GAS comprises three stages: ALARM reaction, RESISTANCE and EXHAUSTION. By the last stage, the body’s resources are becoming depleted, and psycho-physiological disorders develop. These include cardiovascular disorders such as high blood pressure/BP (hypertension), coronary artery disease (CAD), and coronary heart disease (CHD). Friedman & Rosenman (1974) found evidence for the role of individual differences in men’s ways of dealing with stressful situations. They concluded that men who displayed Type A behaviour (TAB) were far more likely to develop CHD than other men. In summary, Hans Selye suggested that: a) ALL stressors produce the same range of physiological responses, for example, the heart rate accelerates and glucose levels rise. b) Under stress, a person may go through the stages of ALARM – RESISTANCE – EXHAUSTION if the stress is not relieved. The alarm stage is also known as the fight-or-flight mode. c) Persistent stress may produce psychosomatic illnesses such as hypertension, cardiac disease, migraine, asthma, gastric ulcers, and eczema. 2. The pituitary-adrenal system and the sympathomedullary pathway Most psychologists regard the hypothalamus as the starting point for the stress response. The hypothalamus initiates a hormonal response known as the hypothalamic-pituitary- adrenal axis. Situations and events that we perceive as threatening or anxiety inducing activate a ‘primitive’ area of the brain known as the hypothalamus which then stimulates the release of a hormone known as corticotrophin-releasing factor (CRF). CRF targets a tiny gland called the pituitary gland. The pituitary gland is often called the ‘master gland’ because it secretes a wide range of hormones that influence bodily functions and behaviour. The pituitary gland is divided into two parts, the anterior (front) and posterior (back). In response to CRF the anterior pituitary gland begins to release a hormone known as adrenocorticotropic hormone (ACTH). ACHT travels in the blood to its target organ, the adrenal glands. 4
  5. 5. Like the pituitary gland, the adrenal glands are made up of two parts: the adrenal cortex (the outer part), and the adrenal medulla (the centre or inner part). When an individual is aroused, the sympathetic division of the autonomic nervous system (ANS) speeds up bodily activity. This involves increasing heart rate and stimulating certain glands, including the adrenal medulla to secrete the hormones adrenaline and noradrenaline which further increase arousal. Together, this response is described as the flight or fight response, the immediate arousal response to a stressor. This is likely to be an evolutionary response developed in our earliest ancestors to give them a better chance of survival when faced with threat and danger. Even today when human beings feel aggressive and fearful there are large increases of adrenaline and noradrenaline in our systems. 3. Stress-related illness and the immune system The immune system is a collection of billions of cells that travel through the bloodstream. They move in and out of tissues and organs, defending the body against foreign bodies (antigens), such as bacteria, viruses and cancerous cells. The main types of immune cells are white blood cells (leucocytes). When we’re stressed, the immune system’s ability to fight off antigens is reduced. That is why we are more susceptible to infections. This was demonstrated by Glaser’s study of medical students facing important examinations, and in Schliefer’s study of men whose wives had died from breast cancer. Riley’s study of mice stressed out by being placed on rotating turntables also helps to 5
  6. 6. demonstrate that different stressors, including exams, death of a spouse, caring for relatives with Alzheimer’s disease, are all involved in reduced immune function. Glaser (1986) assessed 40 medical students 6 weeks before they took important examinations. He asked the students to complete a questionnaire and also took blood samples. He then medically assessed the students again during the actual period of examination by taking and analysing more blood samples. During the examination period, Glaser noted high levels of adrenaline and noradrenaline, the ‘stress hormones’, in the students’ blood. We know there is a direct link between these hormones and the Immune System. Glaser observed that there was a significant reduction of T cells during the examination period. The reduction of T cells is one method we use to assess whether or not the Immune System is being suppressed. A few weeks after the examinations were over, the students T cell count had returned to normal. Glaser concluded that the medical students had been under significant stress during their examinations. This helps to conform that that different stressors, including exams, death of a spouse, caring for relatives with Alzheimer’s disease, are all involved in reduced immune function. 6
  7. 7. Stress in everyday life  Life changes and daily hassles  Workplace stress  Personality factors, including Type A behaviour  Distinction between emotion-focused and problem-focused approaches to coping with stress  Psychological and physiological methods of stress management, including Cognitive Behavioural Therapy and drugs 1. Life Changes and Daily Hassles Life events include changes that happen to most people, such as leaving school, marriage, having children, and much less common ones, such as imprisonment, and being fired at work. Holmes & Rahe (1967) constructed an instrument for measuring stress. They defined stress as the amount of change a person has to deal with during a particular period of time. Their Social Readjustment Rating Scale (SRRS) comprises 43 life events, each given a life change unit (LCU) score. They found that the higher someone’s overall LCU score (how many life events they’d experienced during the previous year, the more likely they were to show symptoms of both physical and psychological illness. The greater the stress, the more serious the illness. They claimed that stress actually makes us ill. Holmes & Rahe’s SSRS was the first attempt to measure stress objectively and to examine its relationship to illness. It assumes that any change is stressful. But the list of life events is largely negative, especially those with the highest LCU scores (such as the death of a spouse). So, the SSRS may be confusing ‘change’ with ‘undesirability’, things that we don’t want to happen. Some of the life events can refer to positive or negative change, and there’s no reference to the problems of old age, or natural, or man-made disasters. In addition, only those life events that can be classified as out of a person’s control are correlated with later illness, and the life events don’t include everyday hassles such as traffic jams, bad weather and financial worries. Later research has shown that daily hassles may be a more powerful predictor of both physical and psychological symptoms rather than the SRRS’s life events. Instead of life events causing illness, they could be early signs that an illness is already developing. Finally, in describing life events, participants are often asked to recall both their illnesses and the stressful events that occurred during the preceding year. Retrospective studies like this can sometimes produce unreliable data. 7
  8. 8. 2. Workplace Stress Social isolation. In some work situations, workers are isolated from each other for long periods of time. This often happens on production lines where machines control the work operations. Workers have few opportunities to communicate socially with each other. Social isolation is related to various indicators of stress, for example, high levels of adrenaline and noradrenaline. Work should be organised so that workers have regular opportunities for social contact with each other. Work overload. One way of identifying work overload is in terms of the number of hours worked per week. A number of studies suggest a link between long hours, stress and ill health. For example, a study of workers under the age of 45 in light industry found that those who worked more than 48 hours per week were twice as likely to develop coronary heart disease than those who worked 40 hours or less (Breslow & Buell, 1960). The amount of work done by workers should be regularly checked and adjusted to ensure mental and physical health. Other stressors in the workplace may include: 1. Working conditions (environmental stressors such as noise, temperature, over- crowding, risk & danger). 2. Roles at work (e.g. role conflict, role ambiguity, levels of responsibility) 3. Relationships at work (e.g. with immediate line manager) 4. Career development (job security, redundancy, retirement) 5. Organisational (e.g. the feeling of involvement & belonging) It is important to remember that is the perception of work overload by a worker rather than simply the number of hours worked. In this sense, work overload is a perception held by a worker that he is required to work too long/hard. Something only becomes a stressor when the individual perceives it as such. Therefore, every individual is making transactions with the environment around him throughout his life. 8
  9. 9. 3. Personality factors, including Type A behaviour Psychologists investigating stress have focussed on two personality types: Type A and Type B. Characteristics of Type A include an overriding need to achieve, a highly competitive nature and a tendency to show anger and hostility. In contrast, Type B individuals tend to be more relaxed and are far less hostile and aggressive. Research has shown that Type A individuals respond more actively to stressors; they are more easily “wound up”, tend to overreact, and are often at “boiling point”. This may cause excessive wear and tear of their bodies, especially the cardio-vascular system. The Type A personality has been associated with hypertension, chronic high blood pressure. Chronic hypertension puts strains on both the heart and the arteries. Friedman & Rosenman (1974) found evidence for the role of individual differences in men’s ways of dealing with stressful situations. They concluded that men who displayed Type A behaviour (TAB) were far more likely to develop CHD than other men. Coronary heart disease (CHD) is the biggest single cause of death in modern industrialised societies. In Britain, almost 50% of all deaths result from CHD. Around half of these deaths may be related to stress, and stress may be related to individual personality types. Friedman & Rosenman (1974) assessed the personality types of 3500 healthy middle- aged men as part of a 12 year longitudinal study. Participants were asked questions relating to impatience, competitiveness, motivation for success, frustration at goals being hindered, and their feelings towards being under pressure. High scorers were described as ‘Type A’ personalities while low scorers were described as ‘Type B’ personalities. More than twice as many of the Type A personalities went on to develop cardiovascular disorders than did Type B personalities. They concluded that men who displayed Type A behaviour (TAB) were far more likely to develop CHD than other men. Further research revealed that angina sufferers tended to be Type A personalities who were impatient with other people and susceptible to feeling pressure at work. Those with heart failure tended to comprise Type A personalities who rushed through life with hasty personal habits and over-loaded schedules. 9
  10. 10. 4. Emotion-focused and Problem-focused Approaches to Coping with Stress David has unexpectedly been made redundant. David sits down and considers the options open to him and their likely outcomes. He decides on his priorities and acts directly to deal with the stressful situation. David has adopted a problem-focused approach to coping with stress. Jon has unexpectedly been made redundant. He feels angry and frustrated, and he vents those feelings. He then tries to keep up his hopes about the future, and he works hard to control his emotions. Jon has adopted an emotion-focused approach to coping with stress. Individuals cope with stressful situations in different ways. Endler and Parker (1990) devised the Multi-dimensional Coping Inventory to describe three major coping strategies:  Task-oriented or problem-focused strategy: obtain information about the stressful situation – consider alternative courses of action and their likely outcome – decide on priorities – put plan into action.  Emotion-oriented or emotion-focused strategy: remain hopeful – try to control emotions – vent feelings of anger and frustration as safety valve, especially when it is difficult to see the way ahead.  Avoidance-oriented strategy: bury head in the sand – deny or minimise the seriousness of the situation – consciously suppress stressful thoughts – replace negative thinking by self-protective thoughts. Which kind of coping strategy is best at reducing stress? The answer depends on the nature of the stressful situation. Generally-speaking, problem-focused strategies work best when the individual has the resources and means to resolve the situation. In contrast, emotion-focused strategy may be preferable, at least on a temporary basis, when the individual lacks the means to resolve the situation. However, you may not be surprised to learn that individuals with the Type A behaviour pattern, including an overriding need to achieve, often rush to the problem-focused approach even when it is not appropriate. Avoidance approaches are rarely effective because stressful situations rarely resolve themselves; avoidance is best left to ostriches. To be fair, avoidance strategies can be useful at times. For example, if you are in hospital it’s best not to dwell on all the things that might go wrong; most of them won’t; and lying there worrying about what might happen is simply going to increase the stress, not reduce it. Most people, as we might expect, use a combination of emotion-focused and problem- focused strategies to deal with stressful situations. Fontenot and Brannon (1991) discovered that individuals in the work place tend to use the problem-focused approach in 10
  11. 11. relation to a job-related crisis but they used emotion-focused coping when the situation involved relationships with the colleagues around them. 5. Physiological Methods of Stress Management, drugs and biofeedback Stress is often accompanied by feelings of anxiety and depression, and drugs in particular are very effective in helping people cope with these moods. For example, the most commonly prescribed drugs are the benzodiazepines. These are minor tranquillisers such as Librium and Valium. These drugs reduce the activity in the part of the brain that controls emotions. This helps to reduce feelings of anxiety. Anti-depressant drugs such as Prozac and Tofranil can help the individual cope with the stressors that produce their depression. Beta-blockers block the action of noradrenaline on the Autonomic Nervous System. They can reduce many of the physical symptoms of anxiety, such as a racing heartbeat. Beta- blockers slow the heart and reduce the strength of contractions, which helps reduce blood pressure. This helps the individual feel calm and relaxed as well as protecting the heart from damage. Although drugs may be very useful in the short-term by helping the individual to cope, they have severe limitations. They tackle the symptoms but not the causes of the stress. People can become psychologically and physically addicted to drugs. There are usually undesirable side-effects, and in some cases they may even increase the anxiety and deepen the depression after prolonged use. Biofeedback has the advantage of no undesirable side-effects. It does not invade the body the way that drugs so, and the individual feels more in control of his treatment. Biofeedback provides the individual with information, visual or acoustic, about bodily processes such as heart rate and blood pressure. People can learn to exercise control of their processes, and by doing so they can reduce the feelings of stress. It is probably this feeling of being in control that reduces stress. The effects of biofeedback are probably short term rather than long term. It is often used along side learning relaxation techniques; learning to relax may be more beneficial than biofeedback itself. 11
  12. 12. 6. Psychological Methods of Stress Management, Hardiness Training and Stress Inoculation Stress management programmes such as Hardiness Training and Stress Inoculation are designed to train individuals in skills that help them cope with stressful situations. Just as we can strengthen our muscles by physical exercise, so, it is suggested, we can develop coping strategies that we can use with stress. Suzanna Kobasa and other psychologists have developed hardiness training programmes. These programmes encourage participants to learn three main strategies: (1) to recognise and identify the reality and the symptoms of their stress; (2) to consider how they coped with similar stressful events in the past, and to employ similar coping strategies; and (3) to take on a fresh challenge in their lives and experience success again. Stress Inoculation Training (SIT) was developed by Donald Meichenbaum and his colleagues. This is a cognitive-behavioural approach to stress management that involves training the individual to recognise stress symptoms (cognitive recognition) and then learn certain skills (behavioural) to reduce the stress. Meichenbaum believes that people sometimes find things stressful because they think about them in self-defeating ways. He believes that SIT’s ‘power of positive thinking’ approach can successfully change people’s behaviour. Some behaviourists suggest that focusing on internal thoughts is unscientific, but it has proved successful, especially in reducing exam nerves and the anxiety associated with severe pain. Stress Management programmes have several strengths. Most importantly, they try to equip the individual with skills he can use in a variety of stressful situations; these are transferable skills. SIT in particular has proved effective in the long term as long as the individual keeps on practising the coping skills. These programmes combine both cognitive and behavioural approaches that usually produce the most lasting changes. In addition, unlike physical approaches to stress management, such as drugs, they are not invasive, they cannot cause dependency, and they do not have undesirable side-effects. On the other hand, stress management programmes require time, money and commitment. They seem to be relevant for the affluent few rather than the stressed-out many. 12
  13. 13. 7. The Role of Control in Coping with Stress Kobasa (1979) examined business executives in danger of losing their jobs. Some of became stressed while others did not. She attempted to identify what enabled some businessmen to be ‘hardy’. She found that hardy executives who copes with stress saw stressors as challenges to be met head on, and didn’t try to avoid them or ignore them. Training in ‘hardiness’ can be provided to help people become more hardy in this way, and Kobasa’s findings suggest that assertiveness training may be useful for reducing stress. The more out of control we feel, the greater our levels of stress are likely to be. For example, a study of male passengers on a commuter train (Lundberg, 1976) indicated that stress levels increased the more crowded the train became, even though all of the passengers managed to get a seat. Stress was measured by the amount of adrenaline in urine samples. Those who joined the train first had lower levels of adrenaline even though they had longer journeys to the city. Those who joined the trainer later had higher levels of adrenaline. What made the difference was the wide choice of seats available to the first passengers – they felt more in control because they had a greater choice of seats. Unpredictable events often make us feel out of control and produce high levels of stress. If a stressful event comes ‘out of the blue’ – for example, our aeroplane loses altitude very suddenly – we have less time to prepare coping strategies which can reduce stress. Research shows that the sudden and unexpected death of a loved child is often more stressful than when the death of the child follows a long illness. (Hazzard, 1992). Unpredictability, uncertainty, and lack of control are a feature of many jobs associated with high levels of stress. These include fire-fighters, ambulance drivers and paramedics, and doctors and nurses. Workers in these occupations are often unable to predict what they will be doing, what demands will be placed on them, and where they will be from one hour to the next. In addition, they are often in situations where they feel that what is happening is beyond their control. Natural disasters such as earthquakes and volcanoes, and unnatural disasters such as the destruction of the Twin Towers in New York often leave people feeling as if they have no control over their lives. For a long time, they may feel vulnerable and stressed, they may become anxious and depressed, until they adapt and return to normal. Laboratory experiments with both animals and humans have confirmed that stress levels rise when individuals feel they have lost control. In experiments with humans, participants show less arousal and report lower levels of stress as long as they know the shocks are coming. It is the unpredictable and unpredicted negative events of human experience which cause us the greatest stress. 13
  14. 14. SOCIAL PSYCHOLOGY – SOCIAL INFLUENCE Social influence  Types of conformity, including internalisation and compliance  Explanations of why people conform, including informational social influence and normative social influence  Obedience, including Milgram’s work and explanations of why people obey. 1. What is meant by the terms ‘obedience’ and ‘conformity’? In Psychology, conformity has two meanings. Firstly, it means that the individual is acting in terms of the accepted behaviour of a social group. For example, most Sixth Formers will behave like the majority of the Sixth Formers around them to keep their approval and acceptance. Secondly, conformity means a change in the behaviour of a minority to fit the behaviour of the majority. For example, in a jury room two jurors who believe the accused is not guilty may change their opinion to guilty simply to confirm with the opinion of the 10 in the majority. Obedience occurs when a person changes his behaviour because he has been given a direct command, instruction or order by another person who he believes has authority over him. For example, a student may obey the instructions of a teacher only because he sees the teacher as having authority over him. 2. Explain the terms ‘social norms’ and ‘normative social influence’. Every society and social groups has its own accepted ways of behaving. Social norms are the accepted standards of behaviour of social groups. These groups range from friendship and work groups to nation states. These norms define the behaviour for every social group – for example, students, teachers, workers, yobs, partygoers, gays, neighbours, lesbians, patients, drinkers in a pub, and so on. Normative social influence means being influenced by others to conform to their behaviour (social/group norms) because of a desire to gain their approval and acceptance. For example, you join the Sea Cadets – you spend the first few sessions doing what others around you do because you wish to be accepted in their group. In other words, you conform to the social norms of the group you wish to belong to. 14
  15. 15. 3. Explain the difference between public compliance and private acceptance. Public compliance means conforming to the behaviour of others despite privately disagreeing with their behaviour. For example, you join in some verbal teasing even though you know it’s wrong and you don’t feel comfortable about it, but you don’t wish to fall out with the group. Private acceptance means conforming to the behaviour of others because you come to the conclusion that their behaviour is the right thing to do, and you are comfortable 4. Why do people conform? Within any culture, normative and informational influences will play an important role in determining levels of conformity. People have a need to feel they belong to a group and will often accept the norms of the group in order to belong; for example, teenagers are notoriously conformist because they don’t wish to appear out-of-step with their peer group. On other occasions, people will conform simply in order to “get it right”; they may be unsure or lacking in confidence, and they will look to the group for information about what to do and how to behave. Conformity will also depend to some extent on cultural factors. People living in so- called Collectivist cultures such as China and Japan will conform more readily than those in Individualist cultures such as the UK and the USA where individual success are values are regarded more highly than the group success of collectivist cultures. Group size is also important in determining whether or not a person will conform. Research suggests that as the size of the group increases, so conformity will increase, above all, if opposition to the individual is unanimous. For example, in the jury situation, a person outnumbered 11-1 will find it much harder to resist the majority than a split of 10-2. Therefore, people will often conform in order to preserve group unanimity. To some extent, conformity can be explained by individual temperament and personality. These personality characteristics can be very influential. People with low self-esteem, a need for approval, feelings of insecurity or anxiety will usually conform more readily than other people. However, the behaviour of the same individuals will vary on different occasions and in different situations. 15
  16. 16. 5. Describe the aims and procedures and findings and conclusions of one study of conformity (majority influence). Then give two criticisms of the investigation. (SOLOMON ASCH) Aims: Solomon Asch (1951) AIMED to investigate how far an individual would conform to the responses of the majority even when the majority was clearly wrong. Procedures: Asch tested 123 American male college students who worked in groups between seven and nine in size. In each group one naïve participant was subjected to pressure when the stooges gave what was clearly the wrong answer. Members of the group were asked to estimate the length of a line in comparison with three others lines. The participants called out the answers one after the other with the naïve calling out last or second last. The stooges called out the wrong answer deliberately 12 times out of 18 trials. Which line is similar to line X? If others tell you it is A, you might not trust your own judgement. Findings: Conformity was measured by the number of times the naïve participants gave the same wrong answers as the stooges on the critical trials. Overall, there was a conformity rate of 32%. In other words, the naïve participants conformed to the wrong answers about a third of the critical trials. Conclusions: Asch concluded that the majority can have a significant influence on an individual by subjecting him/her to group pressure. Criticisms + The task was unambiguous. The answers were clearly right or wrong. Therefore, conformity could be measured in an objective way. - Participants were stressed. Some participants reported getting quite stressed when the stooges gave the wrong answer on critical trials. This could be considered unethical. Also, the naïve participants were clearly deceived about what was really going on. 16
  17. 17. 6. Describe the procedures and findings of one study that has explored obedience to authority. Milgram’s (1963) ‘Shocking Obedience Study’ Stanley Milgram claimed that in the right situation, ordinary people will obey orders from those in authority, even if obedience goes against their deeply held moral beliefs. He devised an experiment in which the participants were asked to administer electric shocks of increasing severity to confederates working with Milgram. Aims Milgram set out to test the ‘Germans are different’ hypothesis. This claimed that (a) the Germans are a highly obedient nation; and (b) Hitler couldn’t have put his plans to exterminate the Jews into practice unless the German population had co-operated. Milgram’s experiment was meant to be a pilot study. He was going to carry out the ‘real’ experiment in Germany. Procedures Participants volunteered for a study of memory and learning. This took place at the Yale University psychology department. When they arrived, they were met by the experimenter wearing a grey lab coat. They were introduced to a Mr. Wallace who was a stooge pretending to be another participant. The experimenter told the naïve participant and ‘Mr. Wallace’ that the experiment was about the effects of punishment on learning. One of them would be the ‘teacher’ and the other would be the ‘learner’. Things were always rigged in such a way that Mr. Wallace was always the learner, and the naïve participant the teacher. The experimenter explained that the punishment was to take the form of electric shocks. All three then went into an adjoining room. There, the experimenter strapped Mr Wallace into a chair with his arms attached to electrodes. The teacher was to deliver the shocks via shock generator. This was situated in another room. 17
  18. 18. The generator had a number of switches. Each switch was clearly marked with a voltage level, starting at 15 volts and a verbal description (‘slight shock’). Each switch gave a shock 15 volts higher than the one before. The last switch gave 450 volts. The teacher was instructed to deliver a shock each time Mr Wallace made a mistake on a paired-associate word task. Mr Wallace indicated his answer by switching on one of four lights located above the shock generator. With each successive mistake, the teacher had to give the next highest shock (that is, 15 volts higher than the one before). At 300 volts, Mr Wallace kicked against the wall that adjoined the two rooms. After 315 volts, he stopped kicking and also stopped responding to the teacher’s questions. The teacher was instructed to keep on shocking if Mr Wallace stopped answering. Whenever a participant tried to pull out of the experiment, the experiment would give them a ‘verbal prod’ instructing them to continue. After 4 verbal prods, participants were permitted to stop shocking Mr Wallace. Findings Obedience rate was defined as the percentage of participants who kept on giving shocks right up to 450 volts. Obedience rate was 65%. Many teacher-participants showed signs of extreme distress, such as twitching or giggling nervously, digging their nails into their flesh, and verbally attacking the experimenter. Conclusions The ‘Germans are different’ hypothesis was clearly false. Milgram’s participants were 40 ‘ordinary’ Americans living in a fairly typical small town. Their high level of obedience shows that we all intend to obey people we regard as authority figures in particular situations. If we had lived in Nazi Germany, we might well have acted just as obediently. Criticisms o Unethical: Milgram’s exposed his participants to high levels of distress, which is ethically unacceptable. 18
  19. 19. o However, it was the first attempt to study obedience experimentally, that is, under controlled conditions. o It did provide crucial information about an aspect of human behaviour. It is difficult to think of an experiment to explore obedience that doesn’t involve some risk to the participants. 7. Describe the procedures and findings of one study in social influence that has explored obedience to authority. Then consider the ecological and the experimental validity of this study. (Hofling’s nurses) In a naturalistic study of obedience, Hofling et al (1966) studied 22 nurses working in various U.S. hospitals. A stooge ‘Dr Smith of the psychiatric department’ instructed them by telephone to give his patient Mr. ‘Jones’ 20 mg of a drug called Astrofen. Dr Smith was in a desperate hurry. And said he’d sign the drug authorisation form later when he came to see Mr. Jones. Astrofen was actually a dummy drug (a harmless sugar pill) invented just for the experiment. The label on the box clearly stated that the maximum daily dose was 10 mg, so, if the nurse obeyed Dr Smith’s instructions, she’d be giving twice the maximum dose. Also, hospital rules required that doctors sign the authorisation form before any drug was given. Another rule demanded that nurses should be absolutely sure that ‘Dr Smith’ was a genuine doctor. 21 out of the 22 nurses complied without hesitation. A control group of 22 nurses were asked what they would have done in that situation. 21 said that they wouldn’t have given the drug without written authorisation, especially as it exceeded the maximum daily dose. Hofling concluded that the greater power and authority of doctors seem to influence nurses’ behaviour more than those rules do. Also what people actually do do in a particular situation may be very different from what they say they would do. Although this experiment is ethically very disturbing since the nurses were tricked into illegal actions, it does have high experimental validity and high ecological validity. It is experimentally valid because the experimental situation is entirely believable. It was a field study that took place in an actual real-life setting. The participants had little or no cause to suspect they were taking part in a psychology experiment. They fully believed they were acting on genuine instructions from a genuine doctor. The experiment is also ecologically valid because it has genuine real-world significance. It supports Milgram’s emphasis on the importance of authority in obedience. There is little doubt that the nurses believed they were carrying out the instructions of their ‘managers’ and that they had little or no right to dispute a doctor’s instructions – even though they would be having been acting illegally and risking their jobs and, perhaps, freedom in this case. 19
  20. 20. 8. Outline 3 psychological factors that may lead people to obey. o People are more likely to obey when they accept the power and status of the person seen to be in authority. For example, we are more likely to obey a headteacher rather than a caretaker, regardless of what each is like as an individual person. o People are more likely to obey if they see themselves acting as AGENTS OF A SUPERIOR AUTHORITY – this is called being in an agentic state. We give up personal responsibility for our actions (the autonomous state) and transfer the responsibility onto the authority figure – “I was only following orders.) o Authority figures often possess highly visible symbols of their power and status – the judge’s robes and wig; the policeman’s uniform; the general’s gold 5 stars. These make it much more difficult to disobey them. For example, the guards’ uniforms in Zimbardo empowered them, while the prisoners’ dress disempowered them. 20
  21. 21. Social influence in everyday life  Explanations of independent behaviour, including how people resist pressures to conform and pressures to obey authority.  The influence of individual differences on independent behaviour, including locus of control  Implications for social change of research into social influence 1. How can people resist pressures to conform and pressures to obey?  People may use their cognitive abilities to resist obedience and conformity. If people are reminded of their rights and responsibilities in situations, obedience to repugnant orders decreases. People always have the ability to ask “Why?” though they don’t always use it.  Group solidarity often helps people resist repugnant instructions. For example, when Milgram gave a participant a supporter (a co teacher) who refused to follow the instructions, rates of obedience were drastically reduced. In other words, it is not so easy to “pick a person off” as long as he has support from at least one other person.  Anything that increases our sense of personal responsibility will also increase our resistance to obedience. In Milgram, when the experimenter said, “You have no other choice, you must go on”, many participants stopped obeying. The word ‘choice’ brought home to them that they did have a choice and that they were responsible. 2. Conformist, Anti-conformist, or Independent? The influence of individual differences on independent behaviour, including locus of control. Do you consider yourself to be conformist, anti-conformist or independent when it comes to deciding your behaviour, values and attitudes? Of course most individuals are a combination of all three but psychology is interested why individuals are more one thing than the other. During the Korean War (1950 – 1953), around 3600 American soldiers were captured and imprisoned in China. They were subjected to constant pressure to conform to the Communist beliefs of their captors. Most prisoners resisted the pressure, and afterwards the resisters could be broadly divided into two groups: anti-conformists and independents. (Schein, 1956) 21
  22. 22. The anti-conformists turned out to be individuals who had a long history of reluctance to conform to any kind of authority. Most of these soldiers had difficulty in conforming to the instructions of their American officers; they certainly were not about to conform to the instructions of their Chinese captors. The independents, on the other hand, refused to conform, because they felt it would be wrong to collaborate with the enemy. They believed in the standards they were fighting for and would not conform to ideas they believed were wrong or immoral. Deeply held beliefs often motivate individuals to resist pressure to conform or obey wrongful authority. In addition, these individuals are inclined to take responsibility for their own actions. Milgram (‘Shocking Obedience Study’, 1963) reported that individuals who refused to give the highest levels of shock usually did so on the grounds that such behaviour went against their fundamental beliefs. From his experiments, Solomon Asch (1951) reported that independent individuals had high levels of self-confidence about their own abilities and were able to resist mental pressure from the majority. High levels of self esteem have been confirmed as an important element in maintaining independence in the face of external pressures. Crutchfield (1954) studied a group of businessmen and military officers aiming to identify those characteristics that contributed to individualism or anti-conformity. Among the personality traits he identified were: strong egos, leadership ability, intellectual effectiveness, no feelings of inferiority, no strict belief that authority is always right, nor any feeling that they themselves had to be in control all the time. Of course, the ability to behave independently often depends to some extent on the situation an individual finds himself in. We can think of these as situational factors. For example, it is easier to refuse to conform or obey if you have an ally (Asch, Milgram). You may need to weigh the costs of not going along with the group – can you cope with being the outsider? Do you feel competent in your own ability to remain independent? Perrin and Spencer (1980) carried out conformity tests involving mathematics, engineering and science students as participants. They found conformity on only one trial out of 396. Presumably these participants were accustomed to make judgements and had the skills, confidence and experience to maintain their judgements even in the face of fierce pressure to conform to the judgements of others. 22
  23. 23. 3. What are the main ethical principles in social research? Codes of Conduct and Ethical Principles have been published by the British Psychological Society which must be followed by psychologists in all research, practice and teaching. The Main Ethical Concepts are:  Voluntary Participation  Informed Consent  Deception should be avoided  De-briefing should be provided  Physical and Mental Harm should be avoided  Confidentiality should be maintained  Professional Conduct at all times Voluntary Participation means that participants in research should take part on a voluntary basis. No attempt should be made to coerce them into participating or to remain in the study. This includes the right to withdraw at any stage even if the participant has received payment for taking part. Furthermore, participants have the right to request that results are retracted, and if necessary, destroyed. Informed Consent means that participants should be informed about the aims, procedures and expected outcomes of the research, and that they should freely consent to participating in the project. Psychologists recognise that there are some situations in which informed consent cannot be obtained. These include children, or people who have cognitive or psychological difficulties, and who may not fully understand what they are being told. Deception should be avoided. It is not ethical to deceive participants about the aims and procedures of any research projects. Misleading participants about the true nature of the study or withholding important information from them is unacceptable, if it is likely to cause distress once they have been debriefed. For example, Milgram recruited participants for his electric shock experiment by a deceptive newspaper advertisement, and misinformed them that the experiment was designed to investigate whether punishment improves learning. Such deception is no longer permissible. De-briefing means that participants should have the opportunity to discuss what happened during the research and be informed of the outcomes of the research. Counselling should also be provided if appropriate and necessary. Physical and Mental Harm should be avoided. Research psychologists have a duty to protect participants from possible psychological harm caused by the nature of the research. Participants should be subject to no greater stress than that which they could be reasonably expected to encounter in their everyday lives. For example, many of the 23
  24. 24. participants in the Milgram and Zimbardo experiments were visibly upset, and some even had to leave the experiments. Serious risk of psychological harm is no longer permissible in research projects. 4. Would research into social influence as carried out by Hofling, Milgram and Zimbardo be ethically acceptable today? Although participation in the Milgram and Zimbardo experiments was voluntary, almost the entire Milgram experiment was an exercise in deception. Milgram used a deceptive newspaper advertisement to recruit his volunteers for a “study of memory” rather than for an obedience experiment. They were then told that the experiment was designed to investigate whether punishment improves learning. The participants continued to be deceived throughout the experiment, which would certainly not meet the criterion of Informed Consent. On the other hand, we must remember that ‘informed’ consent was impossible because of the nature of this particular experiment. In the Stanford Prison Experiment, students were recruited to play the roles or prisoners and guards in a mock prison. These participants were not deceived about the nature of the experiment, and clearly gave their informed consent. In addition, Zimbardo tried to reduce the possibility of mental harm; on the basis of interviews, psychological tests and physical examinations, those chosen to participate were judged to be mentally and physically healthy. In the Milgram experiment, however, so such tests and examinations were carried out on participants. Both Zimbardo and Milgram exposed their participants to the risk of physical and mental harm. Perhaps Milgram was more reckless because Zimbardo’s participants knew they were role-playing. In Milgram, many of the participants were visibly distressed. Signs of tension included trembling, stuttering, laughing nervously, biting lips and digging fingernails into palms of hands. Three participants had uncontrollable seizures, and many pleaded to be allowed to stop the experiment. Participants interviewed after the experiment gave every indication that their distress was real. In Zimbardo, too, there is no doubt that the prisoners suffered during the experiment. After all, the aim of the experiment was to simulate the social relationships and psychology of prison life – power, control, oppression, humiliation and powerlessness. And it did. The guards’ behaviour became increasingly negative, hostile, insulting and dehumanising. Five of the prisoners had to be released because of extreme emotional depression; others developed psychosomatic illnesses. The experiment was planned to last for two weeks, but was terminated after six days because, in Zimbardo's own words, “We had to close down our mock prison because what we saw was frightening.” To his credit, Zimbardo ensured that debriefing sessions were held with participants on a one-to-one basis, and this was followed by regular questionnaire to assess their 24
  25. 25. psychological health. Zimbardo claimed that no long-lasting psychological damage was done to any of the participants. He also claimed the findings were valuable and provided a lesson about what can happen in real society. Critics argue that what happened during the experiment should have been anticipated, and, however valuable the findings, the end does not justify the means. Similar criticisms are made about Milgram’s experiments, and, by extension, of all research that risks embarrassment, humiliation, damage to self-esteem and to the psychological health of the participants. 5. What are the implications for social change of research into social influence? Faced with a decision, most people tend to go along with the majority, but although majority influence is very powerful there are other forms of social influence. Solomon Asch (1951, 1956) demonstrated that in a situation where the correct answer was obvious, a significant number of individuals (37%) would agree with an incorrect answer when they were subjected to social pressure. However, Asch’s work on conformity was carried out in the United States in the early 1950s, a period in American history where people were particularly conformist. The era of individualism, ‘doing your own thing’, did not take hold until the 1960s. When Perrin and Spencer (1980) repeated Asch’s study in England in the late 1970s, they found very little evidence of conformity. They concluded that Asch’s results were very much influenced by the time and culture in which they had taken place. Perrin and Spencer’s (1980) findings may also have been influenced because their participants were engineering students who were trained in the importance of accurate measurement. Smith and Bond (1993) summarised the findings from 20 cross-cultural studies of conformity using Asch’s 1951 design. They wished to investigate if levels of conformity were similar across different cultures. Asch (1951) reported that students gave the wrong answer on 37% of the conformity trials. Smith and Bond (1993) reported the average figure was about 30% for studies carried out in several parts of the world. The highest figure was 58% wrong answers for Indian teachers in Fiji; the lowest was 14% among Belgian students. Smith and Bond (1993) concluded: “Levels of conformity in general had steadily declined since Asch’s studies in the early 1950s.” It is reasonable to assume that levels of conformity through majority influence vary with time and culture. Hogg and Vaughan (1995) have pointed out that we are often influenced by people who are not present at the time we make a decision. They define social influence as the process whereby attitudes, perceptions and behaviours are influenced by the real or implied presence of other people. They point out that two or more people who share a common definition and evaluation of themselves will behave in accordance with that definition. For example, if I define myself as a political Conservative much of my behaviour, including the way I vote, will be influenced by that definition. I will then 25
  26. 26. think, behave and vote in much the same way that all other Conservatives do. “That’s what/who I am, so that’s the way I must behave.” The majority does not always get its own way. Considerable research, including Moscovici et al. (1969), has investigated the conditions under which minority influence will prevail. Minority influence occurs when a minority of members in a group “rejects the established norm of the majority of group members and induces the majority to move to the position of the minority.” (Turner, 1991). For example, if there is a jury split of 8- 4, but the 4 in the minority eventually get the majority to agree with their verdict, then minority influence has prevailed. a) The majority will sometimes yield (give way) to the minority IF the minority can show that there is an alternative, coherent point of view. For example, if two Sixth Formers were able to show that Scotland was an attractive alternative to Spain for an end-of-year holiday, the Sixth Form majority might yield and agree to go to Scotland. b) The majority may also yield if the minority demonstrates certainty, consistency and confidence in their point of view. The minority mustn’t waver from their point of view. In this case, the majority may be impressed by the commitment of the minority and accept their proposal. Therefore, the Sixth Formers must keep on repeating consistently that Scotland is a better alternative than Spain. c) The minority must try to shake the confidence of the majority and produce doubt and uncertainty into their thinking. d) The minority must suggest, hint at and imply that harmony within the group will be restored as soon as the majority yields and shifts towards the minority point of view. The ‘anything for an easy life’ strategy. When we compare majority and minority influence, research suggests that the majority tends to maintain the status quo, keeping things the way they are, while the minority tends to bring about change and innovation. We have also seen how a number of individuals resist influence, either majority or minority, and remain independent or anti-conformist. This provides further evidenced that there are various kinds of social influence, including personality traits and the situation in which an individual finds himself. Of course, an individual may have such a powerful influence upon a group that he/she becomes the leader of the group and becomes a key influence in the group’s attitudes, values and behaviour. In his contingency model of leadership Fiedler (1964, 1967) attempted to analyse how a leader can control group members. He concluded there are three factors. First, the leader must win and maintain the loyalty and confidence of the group. Second, the leader must clarify the structure of the tasks facing the group. Third, 26
  27. 27. the leader must control the rewards and sanctions available to the group; in other words, the power of reward and punishment must be controlled by the leader. Hogg and Vaughan (1995) have suggested that Fiedler’s (1964, 1967) model needs to take into account processes within the group that may support or undermine the control and influence exercised by the leader. 6. Describe the aims and procedures and findings and conclusions of one study of MINORITY INFLUENCE. Then give two criticisms of this study. Aims: Moscovici aimed to investigate under what conditions the minority could influence the majority to change its responses even the responses are clearly wrong. Moscovici et al. (1969), in his Green Colour Slide Experiment (GCSE), predicted that a minority could influence a majority if it consistently called a green slide blue. Procedures: Moscovici used group of 6 participants. Four of them (the majority) were naïve; two of them were stooges working with the researcher. During 36 trials a slide that was clearly blue was presented on a screen. On 24 of the trials, the stooges called out that the blue screen was green. The number of times that naïve participants agreed with their calls was noted. Findings: Moscovici found that 32% of the naïve participants gave the green response at least once. Conclusion: Moscovici concluded that the minority can influence the majority as long as the minority are consistent in their responses. He also observed that minority influence takes time to take effect while majority influence is usually immediate. Criticisms (AO1/AO2) o Ethical issues. Naïve participants couldn’t give their informed consent. As with any study involving stooges, participants were deceived as to the true purpose of the experiment. o Artificiality. As with Asch’s experiments, the experimental task was very artificial. So, the experiment may lack ecological validity. 27
  28. 28. INDIVIDUAL DIFFERENCES – PSYCHOPATHOLOGY (Abnormality) Defining and explaining psychological abnormality  Definitions of abnormality, including deviation from social norms, failure to function adequately and deviation from ideal mental health, and limitations associated with these definitions of psychological abnormality.  Key features of the biological approach to psychopathology  Key features of psychological approaches to psychopathology, including the psychodynamic, behavioural and cognitive approaches 1. DEFINITIONS OF ABNORMALITY Deviation from Social Norms Social norms are the approved and expected ways of behaving in a particular society. In terms of social norms, abnormal behaviour can be seen as behaviour that deviates from or violates social norms. In other words, what is seen as socially unacceptable is regarded as abnormal. The main difficulty with this definition is that social norms vary as times change. For example, a few years ago it was not acceptable for men or boys in the UK to wear ear- rings. Fashion has changed and males wearing ear-rings is now socially acceptable. A more serious example is homosexuality; today being ‘gay’ is acceptable but in the past it was included under sexual and identity disorders. Failure to Function Adequately A failure to function adequately means that a person is unable to live a normal life, unable to experience the normal range of emotions, or engage in the normal range of behaviour. In other words, the person is not able to cope with life on a day-to-day basis. For example, a person may become so depressed that he is prepared to label his own behaviour as ‘abnormal’, and then wish to seek treatment to help him cope. One advantage of this definition is that we don’t have to label a person as ‘mentally abnormal’, which still carries a stigma in many societies. We can focus on treating the behaviour that is hindering the person from leading an adequately normal life, and offer treatment to encourage more adaptive behaviour. One limitation of this definition is that apparently abnormal behaviour may actually be helpful, function and adaptive for the individual. For example, a person who has the obsessive-compulsive disorder of hand-washing may find that the behaviour makes him cheerful, happy and better able to cope with his day. 28
  29. 29. Deviation from Ideal Mental Health This definition of mental abnormality suggests that there are a number of desirable or ideal characteristics that we need to enjoy ideal mental health. These include the ability to cope with stress, being in control of our environment, and having a grip on reality. If any of these are missing, this may be a sign of mental abnormality. One advantage of the Ideal Mental Health definition is that it emphasizes positive achievements rather than failure and distress. It gives individuals targets to aim at, which will increase their mental health. It is practically impossible for any individual to achieve all of the ideal characteristics all of the time. For example, a person might not be the ‘master of his environment’ but be happy with his situation. The absence of this criterion of ideal mental health hardly indicates he is suffering from a mental disorder. Again, there is the difficulty of cultural relativism, i.e. characteristics will vary between cultures. For example, women in the West might not regard women in Asia and Africa as having strong sense of personal identities, which would not be the way these women saw themselves. The very concepts of normality and abnormality depend on the norms and values of the society in question. Statistical Infrequency The ‘statistical infrequency’ definition of abnormality refers to behaviour that is statistically or numerically infrequent in a given population. Specific characteristics can be measured and plotted on a ‘normal’ distribution curve. Anybody who deviates from the average is classified as ‘abnormal’. However, this definition fails to distinguish between desirable and undesirable behaviour. Statistically speaking, many very gifted individuals could be classified as ‘abnormal’ using this definition. The use of the term ‘abnormal’ in this context would not be appropriate. One advantage of this definition is that no value judgments are made. The assessment is objective. We measure and quantify the behaviour to determine whether or not it is statistically infrequent or not. For example, homosexuality – which was defined as a mental illness in early versions of the DSM (Diagnostic and Statistical Manual of mental Disorders) – would not be judged as ‘wrong’ or ‘unacceptable’, merely less statistically frequent in most populations than heterosexuality. 29
  30. 30. 2. KEY FEATURES OF THE BIOLOGICAL APPROACH TO PSYCHOPATHOLOGY (Abnormality) Assumption 1: The Biological or Medical Model of abnormality assumes that mental abnormality has physiological causes. These abnormalities may be caused by chemical malfunctions in the brain or by genetic disorders. For example, too much dopamine in the brain is linked with the mental illness called schizophrenia. It is also clear that the eating disorder called anorexia nervosa has a genetic component. Assumption 2: The Medical Model also assumes that mental disorders can be treated in ways similar to physical disorders. In other words, we can cure the patient by using medical treatments. Treatments include medication (drugs), ECT and psychosurgery. Advantage 1: The main advantage of the Medical Model is that it is scientific. The results of treatment can be measured and manipulated until we have a satisfactory outcome. For example, we can vary the dosage of Prozac until the depressed patient is able to function adequately. Advantage 2: A second advantage is that the patient is not labelled as mentally ill. Unfortunately, the label of mental illness still carries a stigma in our society. It is reassuring to most people to learn that their behaviour has an organic/medical cause that can be corrected by medical treatment. Limitation 1: The main limitation of the Medical Model is that it may be useful in dealing with the symptoms of mental illness but it may not be effective in resolving the underlying causes. Mental illness may have multiple causes, including cognitive and behavioural causes. The MM does not take these into consideration. It is always dangerous to reduce a complex phenomenon to a single explanation (reductionism). Limitation 2: A second limitation is that medical intervention may have undesirable side effects. Very few drugs can be used without negative side effects. For example, prolonged use of Prozac is associated with suicidal thoughts. Drugs may also encourage addiction and dependency similar to nicotine addiction. In addition, techniques such as ECT and psychosurgery are invasive, unpredictable and often irreversible. 30
  31. 31. 3. KEY FEATURES OF THE PSYCHODYNAMIC APPROACH TO PSYCHOPATHOLOGY (Abnormality) Assumption 1: The Psychodynamic Model assumes that experiences in our earlier years can affect our emotions, attitudes and behaviour in later years without us being aware that it is happening. Freud suggested that abnormal behaviour is caused by unresolved conflicts in the Unconscious. These conflicts create anxiety, and we use defence mechanisms such as repression and denial to protect our Ego against this anxiety. However, if defence mechanisms are over-used, they can lead to disturbed abnormal behaviour. Assumption 2: The Psychodynamic Model assumes that if repressed memories can be recovered from the Unconscious through psychotherapy, and if the patient experiences the emotional pain of these repressed memories, the conflicts will be resolved and the patient will be cured. Modern psychoanalysis suggests patients must also come to understand these memories cognitively. Strength 1: One strength of the Psychodynamic Model is that it reminds us that experiences in childhood can affect us throughout our lives. It accepts that everybody can suffer mental conflicts and neuroses through no fault of their own. Strength 2: The model also suggests there is no need for medical intervention such as drugs, ECT or psychotherapy, and that the patient, with the help of a psychoanalyst, can find a cure through his own resources. Weakness 1: The main limitation of the Psychodynamic Model is that it cannot be scientifically observed or tested. There is no way of demonstrating if the Unconscious actually exists. There is no way of verifying if a repressed memory is a real or false memory unless independent evidence is available. In other words, most of the theory must be taken on faith. Weakness 2: Any evidence recovered from a patient must be analysed and interpreted by a therapist. This leaves open the possibility of serious misinterpretation or bias because two therapists may interpret the same evidence in entirely different ways. Psychoanalysis is time-consuming and expensive. It may not even work: in a comprehensive view of 7000 cases, Eysenck (1952) claimed that psychodynamic therapy does more harm than good. 31
  32. 32. 4. KEY FEATURES OF THE BEHAVIOURAL APPROACH TO PSYCHOPATHOLOGY (Abnormality) Assumption 1: The Behavioural Model of Abnormality assumes that all behaviour is learned through experience. All behaviour, including abnormal behaviour, is learned through the processes of classical and/or operant conditioning. Classical conditioning involves learning through association. Operant conditioning involves learning through rewards (positive and negative reinforcement) and punishment. Assumption 2: The BM assumes that what has been learned/acquired can be unlearned through the processes of conditioning, classical or operant. Undesirable or maladaptive behaviour can be replaced by desirable or adaptive behaviour. For example, we can use behavioural therapies such as Desensitization and token economies. Advantage 1: Behavioural approaches, especially when combined with cognitive approaches, have proved very effective in treating clients with phobias and other neurotic disorders, such as obsessive-compulsive disorders. They are less successful with more serious disorders such as schizophrenia and psychosis. Advantage 2: There is also the advantage that therapy can focus directly on the client’s maladaptive behaviour. There is no need to refer to the client’s previous history or to his medical history. Behaviourists believe that changing the behaviour from maladaptive to adaptive is sufficient for a ‘cure’. 32
  33. 33. Limitation 1: One limitation of the BM is that only behaviour is considered. The thoughts and feelings of cognition are not taken into consideration. However, a human being is much more than a bundle of behaviours, and thinking and feelings need to be considered. Behavioural therapy may change the behaviour without resolving the underlying causes of that behaviour. Limitation 2: The BM ignores possible medical causes of abnormal behaviour. For example, we know that there is a genetic element in anorexia, that the lack of glucose can deepen depression, and that excessive dopamine is linked with several mental disorders. It is likely that the Behavioural Model takes too narrow a focus of what constitutes human psychology. Humans are more than rats in Skinner boxes. 5. KEY FEATURES OF THE COGNITIVE APPROACH TO PSYCHOPATHOLOGY (Abnormality) Assumption 1: The Cognitive Model of Abnormality assumes that how we think influences how we feel and how we behave. The ways in which we process information (cognition) directly affect the ways we behave. The Cognitive Model suggests that disordered thinking can cause disordered or abnormal behaviour. Disordered thinking includes irrational assumptions and negative views about the self, the world and the future. Assumption 2: The Cognitive Model assumes that cognitive disorders have been learned and, therefore, they can be unlearned. Thoughts can be monitored, evaluated and altered. Individuals can learn to challenge their irrational cognitions and self-defeating thoughts. So the model assumes cognitive change will lead to behavioural change. Strength 1: A major strength of the Cognitive Model is that it concentrates in current thought processes. It does not depend on the past history of the client, for example, recovering repressed memories from the Unconscious. This is an advantage because details about a person’s past are often unclear, irrelevant, misleading and misremembered. Strength 2: A second strength is that Cognitive Therapies, especially when used together with Behavioural Therapy, have a good success rate in helping clients. It is a popular and much-used approach. It also empowers the individual to take responsibility for his own thinking processes by monitoring, evaluating and altering self-defeating thought processes. Weakness 1: Like all other approaches, psychological and medical, the Cognitive Model rarely supplies the complete solution to abnormal behaviour by itself. There may be medical and environmental influences affecting a person’s behaviour. Focussing only on a person’s cognition may be too narrow an approach. 33
  34. 34. Weakness 2: The Cognitive Model sometimes places the blame for any disorder unfairly on the individual – “It’s your disordered thinking, so you are at fault”. For example, a person suffering from depression may be living in awful circumstances where depression is a perfectly valid and rationale response to the situation. It will hardly be surprising if he perceives the world and his future as a negative and grim. Treating abnormality  Biological therapies, including drugs and ECT  Psychological therapies, including psychoanalysis, systematic de-sensitisation, and Cognitive Behavioural Therapy 1. BIOLOGICAL THERAPIES DRUGS - CHEMOTHERAPY About 25% of all drugs prescribed by the National Health Service are for mental health problems. Psychotherapeutic drugs modify the working of the brain and affect mood and behaviour. Patients suffering from mental disorders are often prescribed more than one drug. Drugs work by entering the bloodstream in order to reach the brain where they affect the transmission of chemicals in the nervous system. These chemicals are called neurotransmitters and they have a variety of effects on behaviour. The main neurotransmitters are dopamine, serotonin, acetylcholine, noradrenaline and GABA. Basically, drugs work by either increasing or decreasing the availability of these neurotransmitters and hence modifying their effects on behaviour. The five major drug types are: the anti-psychotics (major tranquillisers), the anti-anxiety drugs (minor tranquillisers), the anti-depressants, the anti-manics (mood-stabilising drugs), and the stimulant drugs. All of these groups have varying levels of effectiveness, from short-term to long-term, but most have negative, undesirable side-effects. It is also fair to say that while chemotherapy is often effective at tackling the symptoms of mental disorders, they may not reach the underlying causes of the disorder, and when the chemotherapy is discontinued the disorder returns. For example, the benzodiazepines, which are the most commonly used minor tranquillisers, are effective in controlling anxiety in the short term, become less effective, and they can even produce the symptoms they are intended to reduce, the so-called ‘rebound effect’. Benzodiazepines are also highly addictive. 34
  35. 35. On the other hand, the anti-depressant drugs often cure the mental disorder. Depression is thought to occur because not enough serotonin and noradrenaline are being produced in the brain. By boosting the levels of these neurotransmitters, the majority of patients can remain free from depression for long periods of their lives. Unlike the benzodiazepines, anti-depressant drugs are not addictive though they may cause negative side-effects such as nausea, diarrhoea and headaches. The major tranquillisers, the anti-psychotics, work by lowering dopamine activity in the brain. These drugs are used to treat dopamine disorders, the manic phase of manic depression, and other psychotic symptoms. They can help relieve voice-hearing, hallucinations, delusions and feelings of paranoia. Although they do not cure the illness, the reduction of psychotic symptoms can significantly improve many patients’ lives. ECT – ELECTROCONVULSIVE THERAPY In the 1930s two Italian doctors, Ugo Cerletti and Lucio Bini, observed that patients suffering from epilepsy often experienced positive changes in their mood after the convulsions caused by an epileptic seizure had subsided. They proposed that severely depressed patients might also experience similar positive changes in mood following artificially stimulated convulsions. They developed a method of provoking convulsions by passing a moderate electrical current through a patient’s head, by positioning an electrode on either side of the head. In the early years it was not uncommon for convulsing patients to experience serious injuries. Sometimes the electrical shock would jerk the patient off the bed, causing injuries such as broken bones. In some cases the convulsion might cause the patient to bite his tongue off. The modern procedure is much safer. Patients are totally sedated with muscle relaxants and anaesthesia. The electrical current is kept to a minimum. Electrodes are attached either to one side of the head (unilateral) or to both sides (bilateral). A typical course of treatment involves about six sessions, with two or three treatments each week. ECT is usually used to treat severe depression when a patient has failed to respond to chemotherapy. Studies show that about 50-70% of patients not responding to drugs benefit from ECT. In addition, ECT typically reduces depression more rapidly than anti- depressant drugs. This can saves lives in cases where the patient is at risk of committing suicide. On the negative side, ECT can have a number of undesirable side-effects. There can be damage to general memory, which lasts several months. There can be short-term memory loss lasting 24-36 hours after treatment. The patient may also suffer impaired speech but this is much less common if ECT is applied only to the right side of the brain (the speech centre is usually located in the left-side of the brain). On the positive side, MRI scans of 35
  36. 36. the brain have shown there is no damage or change to brain structures following ECT; this is not surprising as many epileptics suffer convulsions over a number of years with no damage to the brain. Ethical concerns are often raised over the use of electroconvulsive therapy. Changing an individual’s behaviour through ECT, or drugs, can be regarded as highly invasive because it takes responsibility for treatment away from the patient. In addition, there is little understanding of why ECT is so effective though the effects are probably due to the increased levels of the neurotransmitters noradrenaline and serotonin. On the other hand, it can be argued that a patient, if fully informed about the risks involved in the therapy, has the right to choose a treatment that can bring relief to such a debilitating condition as severe depression. PSYCHOSURGERY Psychosurgery involves the deliberate destruction of brain tissue in an attempt to alleviate mental illnesses such as clinical depression. The destruction of brain tissue has a long history going back to trepanning (drilling a hole through the skull) and lobotomy (crude destruction of tissue). In modern medicine, psychosurgery is used to treat severe depression, and anorexia which is threatening the life of the patient. The aim in psychosurgery is to interrupt the brain circuits that control our emotional responses. This is done by making tiny lesions/cuts in the brain tissue to destroy some of the nerve cells. Psychosurgery is now possible without cutting through the skull. Radiosurgery is used to concentrate radiation (the so-called gamma knife) into a single, tiny point of brain tissue in the emotional centres of the brain. This tissue is destroyed while the surrounding healthy tissue is spared damage. There are issues involving undesirable-effects and the irreversible nature of psychosurgery. Since the procedure involves the destruction of brain tissue, the results of any operation are irreversible. This has raised ethical doubts in the minds of many people who believe no one has the right to destroy part of another person, even if this is in the name of a cure. However, others believe it is a patient’s right to be able to give their informed consent to such a last-resort operation. It is difficult to evaluate the effectiveness of psychosurgery when so few operations are carried out, and the criteria for success cannot be agreed upon. Although Cobb (1993) reported a 75% success rate, the Mental Health Charity MIND (2002) believes that there should be a “rigorous review to determine whether any continued use if justified.” Psychosurgery is seen very much as a treatment of last resort. 36
  37. 37. 2. PSYCHOLOGICAL THERAPIES PSYCHOANALYSIS The psychodynamic approach assumes that experiences in our earliest years can affect our emotions, attitudes and behaviour in later years without us being aware that it is happening. The therapy called Free Association or the Talking Cure is based on the psychodynamic model of abnormality. Psychotherapy places great significance on childhood experiences, such as the psychosexual stages, and on repressed impulses and unresolved conflicts in the unconscious. The aim of psychotherapy is to bring repressed material into conscious awareness – ‘to make the unconscious conscious’. During therapy sessions the patient is encouraged to relax on a couch and talk about whatever comes into his mind. The therapist listens and offers no judgment about anything the patient says. It is hoped the patient will relax his internal censor and released repressed material from the unconscious. The therapist then helps the patient interpret the material and gain insight into the origins of the conflict. During the therapy the patient may also transfer his unconscious feelings and emotions onto the therapist. The psychotherapist helps the patient deal with the emotions and memories recovered from the unconscious. This cathartic emotional experience is called abreaction, and a patient experiencing abreaction will be ‘cured’ of his disorder. In modern psychoanalysis, the therapist will help the patient come to a cognitive understanding of his experiences in childhood. Psychotherapy has been criticized because there is no way we can scientifically test the methods of free association and dream analysis. The results of these methods depend on speculation and interpretation by the therapist. This means two therapists could interpret the same material and come to opposite conclusions. In addition, psychotherapy is often time-consuming and expensive. The Talking Cure has had some success with mental problems such as anxiety, hysteria and OCD, but some psychologists argue it is being able to talk about difficulties that produce the improvement, making the therapy essentially cognitive rather than psychodynamic. 37
  38. 38. SYSTEMATIC DE-SENSITISATION According to classical conditioning theory, a phobia is an automatic reflex acquired as a response to a non-dangerous stimulus. For example, Little Albert (Watson & Rayner, 1920) acquired his fear of rats when he ‘learned’ to associate the sight of a white rat with the fright of a hammer crashing down on a steel bar just behind his head. After only seven trials, Albert became frightened and backed away from the white rat every time he saw it. Behaviour therapy could have been used to counter Albert’s conditioning by exposing him to the phobic stimulus (the white rat) while pairing the sight of the white rat with something pleasant (sweets, hugs, cuddles) until the fear response was reduced and extinguished. During the therapy known as Systematic Desensitisation (SD), the patient is trained to substitute a relaxation response for the fear response in the presence of the phobic stimulus. Since this is unlikely to occur naturally, behaviour therapy can help by exposing phobics to their fears in a safe and controlled setting. Systematic Desensitisation was devised and developed by Wolpe (1958) as a therapy to help clients overcome their phobias, i.e. an irrational fear of something that is not genuinely dangerous – for example, Little Miss Muffett and her fear of spiders. Systematic Desensitisation involves three steps:  First, the patient is trained to relax completely. This may be with the help of relaxation techniques, deep muscle relaxation, or tranquillisers.  Second, the patient draws up a list of his most frightening scenarios, from least frightening to most frightening. This is called his fear hierarchy.  Third, the patient will progress through the scenarios, beginning with the least frightening, learned to stay as relaxed as he can. Sometimes the patient will be asked to imagine these frightening situations, but the therapy is said to be more effective if the situation is real. For example, we might ask Miss Muffett to touch a dead spider rather than imagine touching it. Simple or specific phobias are quite effectively treated with behaviour therapy. Wolpe (1988) claims that “80 to 90 per cent of patients are either apparently cured or much improved after an average of twenty-five to thirty sessions.” SD is not so successful with more serious disorders, such as schizophrenia. 38
  39. 39. COGNITIVE BEHAVIOURAL THERAPY Cognitive Behavioural Therapy is based on the idea that our thoughts influence our feelings and our feelings in turn influence our behaviour. In other words, how we think about a situation, influences how we feel about a situation, and this affects how we behave and react in any given situation. CBT assumes that it not external things such as people, situations and events that control our behaviour, but how we think, and then how we feel about them. CBT encourages clients to monitor and challenge their negative thoughts, irrational assumptions and disordered thinking about a situation, and then to change their behaviour in response to this fresh, rational thinking. CBT also teaches the client coping skills and new ways of reacting to situations rather than meeting them with the same old negative thought patterns. According to Albert Ellis (REBT), when we think rationally, we behave rationally, and as a consequence, we are happy, competent and effective. CBT is a joint-enterprise between therapist and client. The therapist seeks to discover what the client wants out of life, the client’s goals, and then tries to help the client achieve these goals, often by clarifying the behaviour required, the options available, and the possible routes to achieving these goals. The client’s role is to be frank about his worries and concerns, to reflect on what he is learning during therapy, and to put these lessons into action. One of the main skills the client must learn during CBT is self- counselling; therefore, CBT therapists focus on rational self-counselling skills. These are aimed at encouraging the client to take responsibility for his own life, now and in the future. Relaxation techniques may also be taught. Cognitive Behavioural Therapy is briefer than many other forms of therapy, for example psychotherapy that can take years. In fact, the average number of sessions a client will receive is 16 sessions. CBT is often time-limited; at the start of the therapy, client and therapist agree when the formal therapy will end. This is possible because the CBT therapist offers ‘instruction’ to the client, and also sets regular ‘homework’ assignments that must be completed on time. For example, the therapist will set reading assignments and encourage his clients to practise the skills and techniques studied during the therapy sessions. CBT can be used alone or in conjunction with medication. CBT has proved effective with many conditions, including depressive disorders, panic disorders, agoraphobia, generalised anxiety disorder, post-traumatic stress disorder, bulimia, and chronic fatigue. 39