The psychological approaches and examples are outlined and evaluated. The treatments and therapies for each approach are given and also evaluated. Based on the Third Edition for Psychology AS 'The Complete Companion Student Book' by Mike Cardwell and Cara Flanagan for AQA 'A'

1. Abnormality AQAJasmine Barrett

2. Deviation from social norms
• Social norms are implicit and
explicit rules that society has
about what is acceptable
behaviour
• Rules are based on a set of moral
standards, and sometimes to
deviate from social norms may
mean breaking the law
• Implicit rules agreed upon as a
matter of convention
• Showing inappropriate emotion
such as laughing at a funeral may
indicate mental illness such as
schizophrenia
• Deviation from social norms can
be vital in getting people with
disorders help, people with
depression find it hard to
motivate themselves to find help,
therefore depend on others to
find them help.
EVAL:
Eccentric or abnormal?
Deviation from social norms doesn’t always indicate mental illness, some
behaviours are merely eccentric such as dressing as a giant rabbit to run a
marathon. Only particular kinds of abnormal behaviour are regarded as
pathological.
The role of context:
Behaviour is context specific, if you take behaviour out of a scenario it may
seem abnormal however in the original setting you would contextualise the
scene are regard it as socially acceptable. Such as shouting and leaping up
and down may be considered quite abnormal out of context, but in a setting
such as a football match, it would be seen as normal.
Cultural issues:
Social norms vary, what is abnormal in one behaviour is acceptable in
another, and therefore this can’t be generalised to countries across the
world, as this is based on Western ideologies, talking to a ‘ghost’ is seen as
‘strange’ in the west, but in some African cultures following bereavement, it
is believed you can stay in contact with a loved one for a brief while.

3. Failure to function adequately
• People with psych disorders
often experience much
distress and may have a
general inability to cope with
everyday activities as a
consequence.
• This is so common doctors are
required to take it into account
when diagnosing an individual
and have diagnostic manuals
when trying to identify a
particular illness. (GAF scale is
used to gather an idea of
score, and how well the
individual copes with general
life)
• If behaviour is regarded as
strange but it doesn’t harm
anyway, and it isn’t
dysfunctional then
intervention isn’t needed.
EVAL:
Not the whole picture:
This definition is more of a way of determining the extent of a person’s
problems and what likelihood that they need professional help. People’s
behaviour is only regarded as abnormal if it interferes with daily life their
might be cases where this is not evident in some individuals.
Exceptions to the rule:
A student acting out or uncharacteristically because of an exam wouldn’t be
regarded as abnormal. Furthermore sociopaths who can act violently and
aggressively, who are regarded as abnormal don’t tend to experience
suffering or any general dysfunction.

4. Deviation from ideal mental health:
1. Positive attitudes towards the self: Having positive self
concept and sense of identity; self-respect, self-
confidence, self-reliance and self-acceptance. They view
themselves realistically and objectively.
2. Self-actualisation: Constantly striving to fulfil one’s
potential, mental health problems occur when we fail
to reach true potential.
3. Resistance to stress: ability to tolerate anxiety without
disintegration, mentally healthy people develop good
coping strategies.
4. Personal autonomy: reliance on own inner resources
and remain relatively stable even after hard knocks and
frustrations, not dependent upon others.
5. Accurate perception of reality: seeing oneself and the
world in realistic terms, rather than over positively or
pessimistically. If someone continually distorts reality
then they are indeed not living in the real world.
6. Adapting to and mastering the environment: being
competent in all areas of life, work, personal
relationships and leisure activities. Involves being
flexible rather than rigid being able to adjust to change.
EVAL:
Difficulty of self-actualising:
It is difficult to achieve full potential, the environment or a failure
within self may result in difficulty to achieve. Most people might
be regarded as unhealthy with this approach.
Benefits to stress:
Some work better in stressful conditions, many actors feel they
act better when anxious.
Cultural issues:
Based on western ideas of self-fulfilment. Seeking to fulfil
potential may be prime life goal in some cultures but not in
others.
Regarded as abnormal in some cultures to pursue own individual
goals, not regarded as abnormal to out yourself above others in
some cultures.
Jahoda identified 6 major criteria for optimal living, promoting health and wellbeing, anyone who lacked these
qualities would be vulnerable to mental disorder.

5. Biological approach
• Sees mental disorders to be caused by abnormal physiological processes and physical structure of
the brain
• This approach suggests deviant behaviour is caused arises from biological abnormalities and so it
can be treated by biological intervention
Brain Damage Infection Biochemistry Genes
• Abnormality occurs of the
brain is damaged in some
way
• Once a disease has caused
mental deterioration little can
be done to stop it
• Alzheimer's = loss +
malformation of cells
• Excessive use of alcohol +
drugs can damage brain and
cause hallucinations and
other symptoms of mental
disorders
• Korsakoff’s syndrome =
impairment of memory
caused by alcohol abuse
• Infection can give rise to
mental illness
• Flu has been linked to
schizophrenia – 14% of cases
linked to exposure to flu in
womb during first trimester
• Syphilis caused by micro-
organism, can cause brain
damage, resulting in
symptoms of mental illness
• Neurotransmitters: psych
disorders can come about as
a result of unbalance of NTs
in the nervous system
• Schizophrenia = link to
excess activity of dopamine
• Depression = decreased
serotonin availability
• Hormones: origin of some
mental disorders
• Depression = high cortisol
• Reasons why these chemical
changes take place is unclear
– could be infections, stress
or genetic defect
• Some people are genetically
at risk of developing a mental
disorder
• Only sufficient evidence for
schizophrenia + bipolar
depression
• First degree relative = 10%
chance
• To investigate researchers
carry out adoption, family
and twin studies
• These studies are hard to
interpret because similarities
might be result of shared
environment rather than
biology

6. Biological approach evaluation
Relinquish responsibility Research Reductionist
• Criticism
• People are encouraged to become
passive patients
• They hand over responsibility for
their health and so they don’t feel
responsibility for their recovery
• Strength
• Huge amount of research
• McGuffin –Depression, 109 twin
pairs, 46% accordance in MZ twins,
20% in DZ twins
• Findings can be inconclusive and
hard to interpret; in family and twin
studies it can be hard to distinguish
effects of genetics from shared
environment
• Cause and effect hard to establish;
for example a rise in dopamine
levels may be a consequence rather
than a cause of schizophrenia
• Criticism
• Breaking abnormality down to the
most fundamental level
• It is much more likely that
psychological disorders are the
result of interaction by many
factors, such as learned patterns of
behaviour, ways of thinking,
emotional experiences and
biological factors

7. Biological therapies - drugs
• Anti-anxiety drugs: minor tranquilisers BZs
such as Valium, calming effect, inhibit
nervous system + calm muscles. BZs
enhance activity of GABA which calm brain
activity.
• Anti-depressant drugs: MAOIs, TCAs, SSRIs,
improve mood by increasing availability of
neurotransmitters such as serotonin.
MAOIs block enzyme which breaks down
serotonin, making more of it available.
• Anti-psychotic drugs: major tranquilisers
such as phenothiazines, sedate and
alleviate symptoms of person suffering
from psychotic disorders. Work by blocking
D2 receptor for dopamine.
EVAL:
Efficacy:
Effective in reducing symptoms of mental disorders in
many people. Before phenothiazines, schizophrenia
was seen as untreatable. Could be beneficial effects
are caused by placebo effect.
Side effects:
Worse than original symptoms. Phenothiazines –
Parkinson's link, stiffness and tremors.
Treating symptoms:
Focusing on and relieving symptoms, drugs do not
address true cause of the problems or help patients to
cope with experiences in their lives.
Ethical issues:
In mental institutions patients seem to have no choice,
are they being used to sedate patients so they cause
less trouble? More recently there has been more
emphasis on voluntary agreement.

8. Biological therapies - ECT
• Lies on a bed, lose clothes, receives
anaesthetic and muscle relaxant. Passes a
current 70-130 volts through the brain for
approximately half a second, fixing
electrodes to patient’s temples.
• Non-dominant hemisphere to reduce
memory loss
• Current induces convulsions that last for
approximately one minute, once they come
round from anaesthetic they remember
nothing about the procedure.
• Mainly used to treat people with severe
depression, treatments are typically given
2 or 3 times a week for 3 or 4 weeks.
EVAL:
Efficacy:
Quick treatment compared to drugs or therapies,
effective short-term treatment for depression – 60-
70% of patients showing improvement (Sackheim)
however approximately 60% of patients regress again
within a year.
Mode of action:
Not exactly clear how ECT works.
Side effects:
Opinions are still divided regarding severity of
cognitive and emotional impairments following
treatment.
Ethical issues:
History of abuse, as means of controlling or punishing
people in mental hospitals. ECT is prohibited of the
patient is capable of making decisions and refuses
treatment, unless immediately necessary to save a life
or prevent serious deterioration.

9. Biological therapies - psychosurgery
• Brain surgery to treat psych disorders.
Most invasive form of therapy, involves
removal of brain tissue and it has
irreversible effects.
• Pre-frontal lobotomy developed in 1930s
as cure for schizophrenia.
• Offered as a last resort.
EVAL:
Controversial treatment:
1960s – used on thousands in attempt to reduce
mental hospital numbers in absence of other
treatments.
A last resort:
Although rarely performed, some procedures are
carried out to alleviate symptoms of sever anxiety or
OCD have been beneficial.

10. Psychodynamic approach
• Views abnormal behaviour to be caused by unconscious, underlying psychological forces
• All behaviour, normal and abnormal, is learned – derived from unconscious forces not physical origin
• Psyche consists of 3 interrelated structures:
Id – unconscious, insatiable instincts that we’re born with, the id is pleasure orientated and completely selfish
Ego - conscious and rational part of personality, arbitrates between id and super ego
Superego – last part of personality to develop, morality driven (concerned with right or wrong), develops
through socialisation when people learn moral standards and expectations of their culture
Psychological disturbances in adulthood are caused by unresolved, unconscious conflicts and experiences
which date back to child hood:
Unresolved conflicts – ego may be unable to balance competing demands of id and superego; Freud suggested this
takes place at an unconscious level and that we’re unaware of their influence, although this conflict can occur at
anytime, it is usually marked in childhood because ego is not fully developed. If conflicts arising within the stages of
psychosexual development are not satisfactorily resolved problems may arise later on.
Early experiences – immature ego is not developed fully enough to deal with external events such as maternal
absences, parental shortcomings or sibling competition. Traumatic or confusing events in childhood are then pushed in
to the unconscious, Freud called this repression. Distressing feelings round traumatic times do not disappear, they find
expression in dreams and irrational behaviour, which may eventually erupt into psychological disorders such as
depression.

11. Freud’s stages of psychosexual development
Oral Stage – (0 - 18 months) Pleasure gained from eating and sucking – weaning is
the most important developmental achievement.
Anal Stage – (18 – 36 months) Pleasure gained from expelling or retaining faeces.
Bowel and bladder control are important
achievements.
Phallic stage - (3 - 6 years) Most vital stage – child becomes aware of gender,
focus is on genitals. Oedipus complex occurs for boys
and Electra complex for girls, where the child
develops a rivalry with the same-sex parent for the
affection of the opposite-sex parent. At this stage
boys experience castration anxiety and girls
experience penis envy. This complex is resolved when
the boy, represses desire for the mother and
identifies with the father, or when the girl sublimates
penis envy into the desire to have a baby.
Latency stage – (6 years to puberty) Focus is on social rather than psychosexual
development; calm before the storm of adolescence.
Genital stage – (puberty to maturity) If conflicts in earlier stages are resolved, then the
greatest pleasure comes from mature heterosexual
relationships.

12. Little Hans – phobia – Freud 1909
• 5 year old boy, fear of horses.
• Freud’s analysis based on letters from father.
• At 3 years, Hans showed lively interest in his “widdler”, he invited his
mother to touch it. He was told it was “piggish” and was warned that his
penis would be cut off if he continued touching it.
• According to Freud Hans showed strong sexual urges towards his mother
and these were repressed through fear of castration.
• 6 months late Hans saw horse-drawn van tip over and was thereafter
scared to go outside in fear of being bitten by a horse.
• Initial fear of castration by father transposed to horses (symbol of father)
Muzzle: moustache Blinkers: spectacles
• Freud told Hans’ father to continue to be loving toward his son, to talk
through his phobia with him until it disappeared and Hans identified with
his father.

13. Ego Defence Mechanisms
Repression Prevents unacceptable desires from
becoming conscious, making events
unconscious so you are not even aware of
them. They remain in the unconscious
where they influence behaviour in ways we
are unaware of – may cause emotional
probs.
No recollection of events
Projection People’s own unacceptable faults /wishes
are attributed on to someone else. In the
extreme this can lead to paranoia
Accusing someone of doing something or
acting a certain way when it’s actually you
Denial Refusal to believe events or admit they are
experiencing certain emotions
An alcoholic could deny they are dependant
on alcohol
Regression Responding to anxiety by behaving in a
childish way, adults may resort to stamping
and kicking, which they may have found
effective as children.
An older child going through a traumatic
experience such as bed wetting may revert
back to thumb-sucking/bedwetting
Displacement Diverting emotions on to someone else
because the emotions cannot be expressed
to the person concerned.
A child who feels angry towards parents
may resort to bullying. A student who fails
an exam may blame the teacher.
Sublimation Diverting emotions onto something else
(rather than someone) socially acceptable
displacement, encouraged in society.
Playing a vigorous sport as an expression of
aggressive drives.
Essentially ways of protecting the go from distress, allowing person to cope with
life. Satisfies id without upsetting superego, normal expression of anxiety.

14. Evaluation of psychodynamic model:
• Untestable: proved difficult to test scientifically but has inspired empirical
research – can’t be falsified.
• Retrospective data: People with psych problems may recollect having
experienced emotional trauma, however info is collected during interviews
and is retrospective, gathered years after the event. This can be considered
unreliable.
• Current experiences: The psychodynamic model underestimates
importance of current difficulties experienced by a client, other factors
such as a break up or loss of job may contribute to emotional problems –
reductionist.
• Ethical issues: Suggests people are not responsible for own psych issues
but parents are partially responsible for a child’s issues. This may prove to
be a heavy burden for parents who feel they have ‘tried their best.’

15. Psychodynamic treatments – psychoanalysis
Aims: bring repressed impulses and traumatic memories into awareness, assist the person in finding insight
into conflicts and anxieties, cure neurotic symptoms.
Methods:
Dream analysis: unconscious is revealed in dreams, Freud believed
that repressed memories and impulses often appear in dreams in a
symbolic form.
Free association: clients are encouraged to let thoughts wander and
say whatever comes to their thought without editing or censorship,
this is the thought that uncensored thought may reveal underlying
conflicts and uncomfortable wishes. The analyst then pieces
together patterns of association and offers an interpretation of the
behaviour. The analyst makes these patterns aware to the client.
Successful free association leads to catharsis – pathological effect is
removed when the client is made aware of the memories/urges
behind them.
Transference: Client projects onto the analyst the characteristics
which are unconsciously associated with parents or other important
people, repressed feelings are directed towards the analyst, this
helps to reveal repressed feelings gradually alleviating symptoms.
Evaluation:
Expense: time-consuming and expensive,
taking place over a number of years. Only
available to those who can afford it.
Does it work?: Eysenck – waste of time.
Bergin (reanalysis of Eysenck’s data) 83%
improvement compared to those on waiting
list.
Ethical issues: power lies with analyst,
therapist may abuse power.
Behaviourists criticism: Better to concentrate
on changing the problem rather than diving
into past experiences from childhood.

16. Behavioural approach to psychopathology
Focuses on behaviour of an individual to explain psychological problems. Suggests that
behaviour is learned through experience. Explains emergence of specific behaviours,
maladaptive or dysfunctional such as phobias through classical and operant conditioning,
and social learning.
STUDIES:
Classical conditioning: Little Albert – 11 months old,
tested on fears and found only thing afraid on was loud
noises. They introduced him to a white rat, no fear at
first, and every time he reached out to touch it
scientists made a loud noise, hammer + iron bar. Albert
became afraid of the rat, because it was associated
with the loud noise, he also became afraid of things
that resembled the white rat, but he was withdrawn
before the fear could be extinguished.
Social learning: Mineka et al, phobia can be developed
through observation. Young monkeys raised by parents
who had fear of snakes did not automatically have the
fear themselves. When monkeys observed parents
showing fearful reactions to snakes they also acquired
the persistent fear.
Classical conditioning: “stimulus-response associations”, the
environment (stimulus) results in a physiological reaction
(response), Freud – Little Hans – noisy accident w/ horses,
associated horses with being afraid.
Operant conditioning: Behaviour is influenced by the
consequences of our actions i.e. rewarded for good/punished for
bad. If childhood aggression is rewarded it is likely it will be
repeated, the more attention we receive for actions the more
likely it will be repeated.
Social Learning: Behaviour is learned through imitation –
observation. Phobias can be learned through observing eg.
Spiders/snakes – Mineka et al.

17. Evaluation of behavioural approach:
• Focuses on functioning: Provided behaviour presents no problems
then there is no reason for it to be regarded as abnormal.
• Underlying causes: Psychodynamic approach claims that the BA only
focuses on symptoms not causes, symptoms may only be the tip of
the iceberg. If you treat the symptoms without identifying the cause
then they underlying issue may only manifest itself in other way –
symptom substitution.
• Reductionist: Seeks to explain complex behaviours in a very simple
way, it ignored the role of biology emotion or thinking. It may be
interaction of many factors.

18. Behavioural therapies – systematic desensitisation
• Relaxation – teaching how to relax w/
muscle relaxation techniques.
• Hierarchy of anxiety – Individual imagines
graded series of anxiety provoking
situations, starting with the least to the
most.
• Reciprocal inhibition: 2 incompatible
emotional states ant exist at the same time,
when fully relaxed client moves through
hierarchy until tolerant of all situations
• Complete treatment: treatment ends when
client is desensitised – able to work through
hierarchy without anxiety.
EVAL:
Research support:
Evidence does exist to show that ability to tolerate imagined stressful
situations leads to reduced real-life anxiety.
Alternatives to imagination:
Not everyone able to imagine stressful situations, some therapists
use photographs to go straight into in vivo procedure, evidence
suggests this is longer-lasting and more effective
Quicker alternatives:
SD is time consuming, flooding can be used instead, client is exposed
to feared object, without gradation, escape from feared object is
prevented. Too traumatic for some.
Symptom substitution:
Phobia is symptom of underlying condition, another phobia will just
emerge and take its placed once removed – little evidence.
We should be able to change maladaptive behaviour into adaptive behaviour same way we learn it. Systematic
desensitisation uses reverse conditioning to replace a maladaptive response with healthier response, incompatible with
bad response.

19. Behavioural therapies – aversion therapy
• Aims to rid individual of undesirable habit
by pairing the habit with unpleasant
consequences.
• It deals with addictions – alcoholic drinks
laced with emetic, after a few pairing of the
drink with the nausea the person will want
to avoid the taste or smell or alcohol.
EVALUATION:
Research support:
Evidence does exist to show that nausea paired with alcohol is
effective but there are doubts on maintenance after discontinuation
over time.
Ethical issues:
Clients can’t anticipate what will happen during course of therapy,
many psychologists are unhappy about inflicting pain or discomfort
even when people have asked for it.
Behavioural therapies – behaviour modification
• Aims to anti-social/maladaptive behaviour
by reinforcing appropriate behaviour and
ignoring inappropriate – mainly in prisons,
schools or mental hospitals.
• Token economy – tokens are given when
desirable behaviour is shown – encourages
self-care and social skills – people with
learning disabilities.
EVALUATION:
Research support:
Isaacs et al. 40 year old with schizophrenia – not spoken in 19 years. Gum
used as reinforcement, 19 weeks later – spontaneous “gum please.”
Institutional bias:
Risk that what is considered desirable is being influenced by institution
rather than for the needs/wellbeing of the individual.
Token learning:
People who’s behaviour has been shaped by reinforcement might not
behave the same way when reinforcement is withdrawn – dependence on
token economy regime.

20. Cognitive approach to psychopathology
Stresses role of cognitive problems such as irrational thinking in abnormal functioning. The rationale behind
the cognitive model is that the thinking processes that occur between a stimulus and response are responsible
for the feeling that forms part of the response.
IRRATIONAL THINKING – ELLIS 1962
Emotional problems can be attributed directly to
distortions in our thinking processes, These
distortions take the form of negative thoughts
and irrational beliefs/illogical errors. These
maladaptive thoughts take place without full
awareness – automatically.
We all experience irrational thoughts but
psychological problems occur only if people
engage in faulty thinking to the extent that it
becomes maladaptive for them and others
around them.
Thinking rationally = behaving rationally = happy,
competent, effective.
Thinking irrationally = psychological disturbances,
accustomed to disturbed thoughts.
Irrational ways of thinking:
Polarised thinking: seeing everything in black or white
Overgeneralisation: sweeping generalisation from a single event
Tyranny of ‘should’, ‘ought’ and ‘must’: “I must be loved by
everyone”
Catastrophising: making a mountain out of a mole hill.
THE COGNITIVE TRIAD AND ERRORS IN LOGIC (BECK
1967)
Why people become depressed:
Errors in logic:
The tendency to draw illogical conclusions when
evaluating yourself. This is overgeneralisation. Negative
thoughts can lead to negative feelings which can result in
depression.
Cognitive triad:
Three interacting components which can lead to
impairments in perception, memory and problem solving,
the person can become obsessed with negative thoughts.
Negative views
about the world
Negative views
about oneself
Negative views
about the future

21. Evaluation of cognitive approach:
• Research support: Many people suffering w/ mental disorders to
exhibit thought patterns associated with maladaptive functioning
(Gustafson)
• Reductionist (Irrational thinking – cause or effect?) Does not attempt
to examine origins of irrational thinking nor does the treatment
address these origins. It may be that irrational thinking is a
consequence rather than cause of depression and other mental
disorders.
• Individual is responsible: Suggests everyone should be self-
sufficient. Places responsibility firmly with the individual, rather than
social environment. Consequently attention may be drawn away from
the need to improve social conditions that have significant effect on
quality of life.

22. Cognitive approach therapies – Cognitive Behavioural therapy
• Cognitive element: encouragement of client to become
aware of beliefs that contribute to their
anxiety/depression/dysfunction. ABC model can be used to
help client understand where their thoughts are leading
them.
• Behavioural element: decide together how client’s beliefs
can be reality tested, either as homework or role-play.
Clients will come to recognise consequences of negative
thinking, targets are set in order for positive thoughts to be
incorporated into thinking.
• Examples of CBT:
• REBT – rational-emotive behaviour therapy using ABC –
ultimate aim to have clients incorporate thinking into way of
life.
• SIT – stress management training
• Beck’s cognitive therapy – training clients to monitor
situations where negative assumptions are made and
encourages challenge of distorted thoughts.
EVAL:
Applications:
Very popular, very widely used, short-term and economic.
Appeal of CBT:
Appeals if insight therapies are too threatening. Educates client into
self-help strategies, fostering independence and subsequently
positive thoughts.
CBT in treating depression:
At least as effective as drugs.
Ethics:
Equal relationship between therapist + client, unlike psychotherapy,
fosters independence and means there is equal power.
Aims to encourage people to examine beliefs and expectations underlying their unhappiness and replace irrational
thought with a more adaptive way of thinking. Client and therapist work together to set goals for clients, in order to
make sure more realistic, rational beliefs are corporated into their way of thinking.