Models of abnormality Abnormality is defined as a behaviour that deviates from the ideal social norm. One definition of abnormality is the failure to function adequately and are unable to meet their activities of daily living independently for example getting washed and dressed daily, being able to hold down a job and interacting with other people. It suggests that people should be able to achieve personal wellbeing and contribute to society.
Rosenhan and Seligman (1989) identified there as being seven characteristics of abnormality these being suffering, maladaptiveness, vividness and unconventionality of behaviour, unpredictability and loss of control, irrationality and incomprehensibility, observer discomfort and violation of moral and ideal standards. If there appeared to be only one or two of these seven it was not a concern unless all appear to be seen. It is important to remember that it depends on the context whether the activity is considered abnormal or not.
The limitations of this definition are that suffering is considered a part of life and is not always meant to be maladaptive. Some also say that some abnormal behaviour may be adaptive and functional to each individual. It is also seen that most people commit some maladaptive behaviour to themselves like drinking, smoking and truanting. Sue et al (1994) said that people seeking psychiatric help suffer from distress and discomfort because of the mental illness. Miller and Morley (1986) said distress is why people go to seek help.
One of the models of abnormality is the biological model this is also known as the medical model and assumes that abnormal behaviour is as a result of a physical problem. This should be treated medically by either medication or surgery. It is focused on the genetics, biochemistry, neuroanatomy and infections. However the biological model is still the most dominant model by psychiatrists. Barr et al (1990) linked schizophrenia to the mother having a virus when she was pregnant suggesting that the disorder may actually be a disease.
Although Day et al (1987) stated that stressful experiences cannot be ignored for the onset of depression or schizophrenia. There are also genetic factors saying that mental illnesses are inherited Masterson and Davis (1985) looked into families with schizophrenia and found out that they are 18 times more likely to develop the condition. Both schizophrenia and Bi-polar have been said to be genetic disorder. Sherrington et al (1988) also conducted a gene mapping study which is able o show the exact genes disorder are located there was evidence found to show that schizophrenia was found on chromosome 5, however other psychologists have found no evidence to support this. Barrettini (2000) also linked Bi-polar disorder to having the genes present on chromosomes 4, 6, 11, 12, 13, 15, 18 and 22. Biochemistry is also a considered factor by the biological model this focuses on the neurotransmitters e. g. dopamine, serotonin in which an excess can be linked to eating disorders, schizophrenia and depression. Depression has been found to be caused by a low level of serotonin.
Prozac an antidepressant is now used to treat depression by increasing the serotonin levels in the brain. As well as anxiety being associated with high levels of cortisol. The last part of the biological model was seen to be the neuroanatomy where if the brain cells were damaged it can lead to an abnormal behaviour. This is shown by the disease called Alzheimers where sufferers have vascular dementia and lose some of the cells within the brain. Some treatments for severe depression have included lobotomies this is a surgery that involves removing the section of brain tissue causing the illness.
There is also electric compulsive therapy this is used for severe depression and is a mood elevator to those patients. This model assumes no blame or responsibility of the illness to the sufferer. Most of the treatments are a cure for the illness or is able to manage the condition. There is lots of scientific evidence to suggest the neuroanatomy and biochemistry are to cause some mental health illnesses however mental illnesses should not be believed to be the same as physical illnesses.
A negative view of the model is that some patients will not help themselves to get better and there is a lack of responsibility for the persons own behaviour in this model. Also only focusing on the physical symptoms of the patient. Another negative view on the biological model is that giving drugs to the patient can have severe side effects whilst not all disorders are curable. It is also useful to remember the nature-nurture debate and whether we learn the behaviour or we already born with it.
Bulimia Nervosa is an eating disorder that was unknown until the 1970’s although in the 1980’s it was believed that Bulimia was more common than anorexia, Gordon (2001). It is said to be that Bulimia sufferers are more likely to be older and come from lower class background. The condition is 50% more likely to occur in females than males. Sufferers of this conditions bodyweight is normally within 10% of their normal weight however this fluctuates a lot. This condition has two types and is usually based on a binge purge cycle, that sufferers will use enemas, laxative, emetics to prevent them putting on weight after a binging session.
The second type is based on using excessive exercise to prevent gaining weight. The characteristics of Bulimia Nervosa are; the persons behaviour starts to have reoccurring episodes of binging that is uncontrollable then their behaviour turns to purging to stop the weight gain by using enemas, emetics and high dose laxatives, the cognitive issues of bulimia is the sufferer is influenced by their body shape and size. Fairburn et al (1999) studied that perfectionism and negative evaluation are both cognitive factors for developing Bulimia and they fail to realise how harmful the condition is.
Another cognitive characteristic was studied by Cooper and Taylor (1988) when they found a discrepancy between body size and their own estimation of what they weighed. The psychodynamic approach states that Bulimics cannot distinguish between hunger, body emotion or body needs and use food as a response. Within the genetics Kendler et al (1991) discovered that twins with bulimia found 23% were identical twins and 9% were non-identical twins suggesting a link between identical twins and the disease. Many bulimia sufferers are characterised as having high levels of arousal this is suggesting that perfectionism promotes stress levels.
The biological model sees Bulimia Nervosa as having genetic, biochemical and neuroanatomical components Kendler at al (1991) and Bulik et al (2000) both found evidence to suggest that Bulimia is a condition that is inherited. Where the genetic factors which may lead to the biochemistry and neuroanatomy. Lilenfield et al (2000) said that inherited factors may predispose some people to impulsivity therefor they develop Bulimia. The Biochemical factors are that serotonin has found to be a link to bulimia where decreased levels in the brain, Galla (1995) this shows as many people with bulimia unlike anorexia have an increased appetite at times.
Bulimia sufferers over eat and then feel guilty due to their desire to be thin. CCK is a hormone called cholecystokinin this has now been trialled in laboratories on animals which may them feel full up and stop eating. People with Bulimia have decreased levels of the hormone after eating, this explains why they can eat so much in one go. There has been one study conducted on 25 bulimia sufferers and 18 control participants they were asked to binge. The participants were able to eat 1,500 calories although the bulimia sufferers were able to intake 3,500 calories Kissileff et al (1996).
The neuroanatomy is the last biological model seen to be contributed to Bulimia is that if the hypothalamus is damaged which results in over eating because there is no feeling of being full. Serotonin helps to regulate the feeding centres in the hypothalamus. One treatment for bulimia is the use of psychotherapy and is the most researched method. Cognitive behavioural therapy is a time limited approach in which the patient usually has 16-20 sessions over 4-5 months to complete specific goals that they have set. This could be done as an inpatient or out patient.
Which helps the person to understand how they think and about how negative self talk and image can impact on their behaviour. The first part of the therapy is to focus on helping the patient break the pattern of unhealthy eating by breaking the binge purge cycle, this can be challenging to break. CBT will help them to monitor their eating habits and to avoid situations to want to make them binge. Also helping them cope with other stresses that are not involving food. The second part of CBT helps the bulimia sufferer to understand their belief about their self-image, body shape and dieting, this is done through all or nothing thinking.
The therapy tries to break the emotional connection with food, like turning to food when feeling low. Bipolar Disorder Bipolar disorder is a form of manic depression is a combination of depressed and manic states. Depressed states are characterised by having a persistent low mood and loss of interest in activities, changes in appetite, sleep patterns and recurrent thoughts of self harm. Manic states are characterised by persistent high moods, racing thoughts, talkativeness, and increased activities like shopping. Usually bipolar sufferers are in a mixed state.
The biological model sees inheritance in families of persons with bipolar disorder, first-degree relatives are more likely to have a mood disorder than the relatives of those who do not have bipolar disorder. Studies of twins show that if one twin has a mood disorder, an identical twin is about three times more likely to develop the disorder as well. Some studies suggest that a low or high levels of a specific neurotransmitter such as serotonin, norepinephrine or dopamine is the cause. Still other studies have found evidence that a change in the sensitivity of the receptors on nerve cells may be the problem.
Lithium carbonate is a frequent drug used for bipolar disorder to work as an anti-mania which the mechanism is understood, the side effects of this drug are that it can have an impact on the central nervous, cardiovascular and digestive systems. Another model that looks at bipolar disorder is the behavioural model, which was developed during the late 1950’s-1960’s. They base their theory on that most people learn through maladaptive learning and the best treatment is to re-educate them. Therapists believe that abnormal behaviour comes from conditioning, they believe that classical and operant conditioning can change.
It is important to focus on current problems Kendell and Hamman (1998). The treatments that are used are aversion therapy, cognitive behavioural therapy, systemetic desensitisation, classical and operant condition are also used. Token economies is a behavioural therapy based on rewards, this uses selective positive reinforcement Allyon and Azrin (1968). This can be used with patients who have been institutionalised and are given tokens for good behaviour to reward them these can be for smoking or watching telly.
Paul and Lentz (1977) did a study on long term schizophrenia patients in hopsital and found that patients developed better social skills. Their symptoms were reduced as well as reducing the drugs given to them. The problem with this method is that when the rewards are stopped the good behaviour is hard to continue. One problem may be that the rewards reduce a patients real motive to get better. The problems with taking medication is that it takes away the responsibility for the patients and gives it to the psychiatrists.
People often don’t like taking medication due to all the side effects so therapists are unsure if people are taking the tablets or not. Reference list Cardwell, M, Clark, L and Meldrum, C. (2003) “Psychology for AS level” (3rd Edition). Harper Collins: London Cardwell, M, Clark, L and Meldrum, C. (2008) “Psychology for AS for AQA” (4th Edition). Harper Collins: London Eysenck, M. (2005) “Psychology for AS level” (3rd Edition). Psychology press: East Sussex Gross, R (2010) “Psychology the science of mind and behaviour” (6th ed. ) Hodder Education www. bupa. co. uk/individuals/health-information/directory/b/bulimia
