Abnormality
the biological and psychodynamic approaches
The Biological approach
Four physical causes for mental disorders have been proposed and investigated: brain damage, infection, biochemistry and genetics.
Brain damage Abnormal behaviour can be a result of some form of damage to the brain. Once disease or brain damage has caused mental deterioration. There is little that can be done to stop it, or regenerate the damaged cells. E.g. Alzheimer disease, a type of dementia caused by malformation and loss of cells in a number of areas of the nervous system.
Excessive use of alcohol or other drugs can also damage the brain, and may result in hallucinations or other symptoms, such as loss of memory. (Korsakoff’s syndrome)
Infection
Flu has been linked to schizophrenia. Recent research suggests that 14% of schizophrenic cases may be linked to exposure to the flu virus in the womb during the first trimester. Brown et al 2004
Syphilis, an STI caused by a micro-organism, was identified in the 19th century as causing brain damage, resulting in symptoms of a mental disease known as general paresis.
Biochemistry
Neurotransmitters (chemicals that transmit nerve impulses from one nerve cell to another) are thought to be out of balance the nervous systems of individuals with certain mental disorders. E.g. schizophrenia has been associated with excess of activity in the neurotransmitter dopamine (known as dopamine hypothesis)
Depression has been associated with decreased availability of serotonin. The use of PET scans to provide images of the brain and measure the action of neurotransmitters has supported this association. Mann et all 1996
Evaluation of the biological approach
Treating abnormality
Biological therapies
Those psychologists who advocate the biological approach to abnormality assume that deviant behaviour and mental disorders are caused by biological abnormalities ad so are best treated by biological methods.
Aims of biological therapies
Biological treatments are interventions that aim to redress biological abnormalities such as biochemical imbalances. The treatments fall into 3 main categories: drug therapy, electro-convulsive therapy (ECT) and psychosurgery.
Drug treatment
Chemotherapy is the main therapy for mental disorders and is based on the assumption that chemical imbalance is at the root of the problem. Drugs for mental disorders include anti-anxiety drugs, anti-depressants and anti-psychotic drugs.
Anti-anxiety
Minor tranquilizers – valium. Calms by inhibiting the nervous system and causes muscles to relax. BZs (valium) work by enhancing the action of the chemical messenger (neurotransmitter) çknown as GABA, which acts to calm brain activity.
Anti-depressants
Moai’s, TCA’s and SSRI’s – these improve mood by increasing the availability of neurotransmitters such as serotonin, for example MOAI’s block the action f an enzyme that breaks down serotonin, so increasing its availability in the nervous system
Anti-psychotics
Major tranquilizers such as phenothiazines – these sedate and alleviate symptoms like hallucinations and delusions of the person suffering from psychotic disorders like schizophrenia they seem to or by blocking the D2 receptor for dopamine.
Evaluation of drugs treatments
Efficacy
“How good something is at doing something”
Drug treatment has been found to be effective in relieving the symptoms of mental disorders in many (but not all) people. For example, before the introduction of anti-psychotics, schizophrenia was seen as untreatable and patients were interned in institutions.
Despite the claims made for some modern drug treatments however, there are critics and the use of drugs remains controversial.
Fisher and Greenburg 1989 believe they have limited beneficial effects. Others, e.g. kirsch and Saperstein 1998, assert that beneficial effects are caused in large part by the placebo effect. They argue that therapy produces beneficial effects often because of the attention given and because the patient develops an expectation of success when treatment is offered.
In other words the patient’s condition improves owing to their belief that they are receiving appropriate treatment, in this case a beneficial drug, of course the placebo effect can play a part in the response to any type of therapy, not just drug treatment.
Side effects
Drugs may induce side effects which may in turn be considered worse than the original symptoms of the disorder. Some patients refuse to take anti-psychotics because of the unpleasant side effects, the worst of which include symptoms associated with Parkinson’s disease, such as stiffness and tremors.
Treating the symptoms
Psychologists have criticised psychiatry for focusing on the symptoms and assuming that relieving symptoms with drugs cures the problem. Unfortunately in many cases when drug treatment is stopped the symptoms recur, suggesting that drugs are not addressing the true cause of the problem or helping patients learn to cope with experiences in their lives that may have contributed to the disorder in the first place.
Ethical issues in use of drugs
There has been a good deal of criticism levelled at the use of drugs for psychological problems, particularly in mental institutions where patients had no choice. Were they being administered to alleviate suffering, or to sedate patient to make them more complaint with institutional regimes? More recently there has been greater emphasis on voluntary agreement and the right to refuse treatment.
Four physical causes for mental disorders have been proposed and investigated: brain damage, infection, biochemistry and genetics.
Brain damage Abnormal behaviour can be a result of some form of damage to the brain. Once disease or brain damage has caused mental deterioration. There is little that can be done to stop it, or regenerate the damaged cells. E.g. Alzheimer disease, a type of dementia caused by malformation and loss of cells in a number of areas of the nervous system.
Excessive use of alcohol or other drugs can also damage the brain, and may result in hallucinations or other symptoms, such as loss of memory. (Korsakoff’s syndrome)
Infection
Flu has been linked to schizophrenia. Recent research suggests that 14% of schizophrenic cases may be linked to exposure to the flu virus in the womb during the first trimester. Brown et al 2004
Syphilis, an STI caused by a micro-organism, was identified in the 19th century as causing brain damage, resulting in symptoms of a mental disease known as general paresis.
Biochemistry
Neurotransmitters (chemicals that transmit nerve impulses from one nerve cell to another) are thought to be out of balance the nervous systems of individuals with certain mental disorders. E.g. schizophrenia has been associated with excess of activity in the neurotransmitter dopamine (known as dopamine hypothesis)
Depression has been associated with decreased availability of serotonin. The use of PET scans to provide images of the brain and measure the action of neurotransmitters has supported this association. Mann et all 1996
Evaluation of the biological approach
Treating abnormality
Biological therapies
Those psychologists who advocate the biological approach to abnormality assume that deviant behaviour and mental disorders are caused by biological abnormalities ad so are best treated by biological methods.
Aims of biological therapies
Biological treatments are interventions that aim to redress biological abnormalities such as biochemical imbalances. The treatments fall into 3 main categories: drug therapy, electro-convulsive therapy (ECT) and psychosurgery.
Drug treatment
Chemotherapy is the main therapy for mental disorders and is based on the assumption that chemical imbalance is at the root of the problem. Drugs for mental disorders include anti-anxiety drugs, anti-depressants and anti-psychotic drugs.
Anti-anxiety
Minor tranquilizers – valium. Calms by inhibiting the nervous system and causes muscles to relax. BZs (valium) work by enhancing the action of the chemical messenger (neurotransmitter) çknown as GABA, which acts to calm brain activity.
Anti-depressants
Moai’s, TCA’s and SSRI’s – these improve mood by increasing the availability of neurotransmitters such as serotonin, for example MOAI’s block the action f an enzyme that breaks down serotonin, so increasing its availability in the nervous system
Anti-psychotics
Major tranquilizers such as phenothiazines – these sedate and alleviate symptoms like hallucinations and delusions of the person suffering from psychotic disorders like schizophrenia they seem to or by blocking the D2 receptor for dopamine.
Evaluation of drugs treatments
Efficacy
“How good something is at doing something”
Drug treatment has been found to be effective in relieving the symptoms of mental disorders in many (but not all) people. For example, before the introduction of anti-psychotics, schizophrenia was seen as untreatable and patients were interned in institutions.
Despite the claims made for some modern drug treatments however, there are critics and the use of drugs remains controversial.
Fisher and Greenburg 1989 believe they have limited beneficial effects. Others, e.g. kirsch and Saperstein 1998, assert that beneficial effects are caused in large part by the placebo effect. They argue that therapy produces beneficial effects often because of the attention given and because the patient develops an expectation of success when treatment is offered.
In other words the patient’s condition improves owing to their belief that they are receiving appropriate treatment, in this case a beneficial drug, of course the placebo effect can play a part in the response to any type of therapy, not just drug treatment.
Side effects
Drugs may induce side effects which may in turn be considered worse than the original symptoms of the disorder. Some patients refuse to take anti-psychotics because of the unpleasant side effects, the worst of which include symptoms associated with Parkinson’s disease, such as stiffness and tremors.
Treating the symptoms
Psychologists have criticised psychiatry for focusing on the symptoms and assuming that relieving symptoms with drugs cures the problem. Unfortunately in many cases when drug treatment is stopped the symptoms recur, suggesting that drugs are not addressing the true cause of the problem or helping patients learn to cope with experiences in their lives that may have contributed to the disorder in the first place.
Ethical issues in use of drugs
There has been a good deal of criticism levelled at the use of drugs for psychological problems, particularly in mental institutions where patients had no choice. Were they being administered to alleviate suffering, or to sedate patient to make them more complaint with institutional regimes? More recently there has been greater emphasis on voluntary agreement and the right to refuse treatment.