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
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

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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.

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(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.

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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

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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.

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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.

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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.

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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.

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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

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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
 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.

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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.

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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)

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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.

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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
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
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
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
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
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
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.

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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
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
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
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.

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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.

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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

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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.

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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.

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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.

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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.

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