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“Are the psychological perspectives covered in the module equally valid and relevant in the treatment of mental health disorders today?”

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Mental health is a crisis spanning the length and breadth of all societies.  One in four people in the UK will experience a mental health problem in any given year (Mental Health Foundation 2015) and for some it is a lifelong journey with only 
short term fixes on offer.  With psychology entrenched in a hugely varied history of theoretical explanations one would expect a definitive ‘one size fits all’ remedy.   
Surely, with all that the human race is capable of, accurate diagnoses, and therefore appropriate treatments of mental health cannot be out of the question.  This essay will focus on three perspectives of psychology, evolutionary, cognitive and 
biological.  The origins of each approach will be explored, closely followed by an analysis of how each would apply its methodology to the treatment of autism 
spectrum disorder (ASD) and drawing on their limitations.  To summarise, the 
essay will assess psychology’s current position as a science and attempt to offer an explanation to the question posed.  

The theory of evolution, first formulated in Charles Darwin’s book “On the Origin of Species” in 1859 (REF 7) proposed that human beings adapted to their surroundings and provided two key theories – natural selection (Bussey, 2009) (battle to survive) and sexual selection (battle to reproduce) (REF).  Evolutionary psychology assumes that to make sense of ones self, one must journey back in time and explore ones natural history, as the human mind should be considered as “a discrete information processing machine” (Tooby and Cosmides 1997, as cited in Hampton, 2012).

This approach looks closely at the environment of evolutionary adaptation (EEA), and how it influenced minds and behaviours to evolve (Pinel), with the key assumption of this perspective being that one will adapt to ensure the survival of ones genes (Eyseck) with genetics determining the psychological and physical attributes of a human being.  It is therefore highly deterministic.   The psychologist David Buss carried out extensive research in the evolution of mating and sought to determine which physical attributes each sex looks for in a mate.  The study involved 37 cultures, and the data collected enabled him to hypothesise the evolutionary causes for the differences (REF).  Evolutionary psychology has its roots in other sub-disciplines of psychology for example, Bowlby (1958) posited that within an evolutionary context, attachment can be understood.  The suggestion is that attachment is adaptive as it provides the infant with increased chances of survival.  According to Bowlby infants seek close proximity with their caregiver universally when confronted with threat. (REF)

Evolutionary psychology intrinsically links itself to biological psychology, and therefore Charles Darwin.  The key assumption is that all behaviours can be explained by the bodies internal functions and the behaviour itself can be deduced to a biological process (REF), therefore it is physiologically deterministic.  A study in 2013 which analysed the genetic factors in mental disorders found shared genetic bases in Autism Spectrum Disorder, schizophrenia, Attention Deficit Hyperactivity Disorder, bipolar and recurrent major depressive disorder (REF).  Psychiatry is closely associated with this discipline of psychology. 

Originators of this perspective include John Harlow, who famously wrote about Phineas Gage and the impaling of the iron bar in 1848.  However, Emile Kraepelin regarded as the father of psychiatry, was the first to look at the connection between mental illness and the biology of the brain.  He was a founder of psychopharmacology and inspired the maverick psychiatrists who revised the Diagnostic and Statistical Manual (DSM) in 1980 (REF).  He criticised Sigmund Freud’s theories in the early 1900s because of the over-emphasis on sexual development and little or no regard for biology (REF). In recent times, neuroscientist Oliver Sacks contributed to neuroscience and psychiatry, studying patients with a plethora of neurological disorders whilst illuminating the neuro-typical brain and its capabilities in dealing with perception, memory and individuality (REF).

Biological psychology is closely aligned with the sub-discipline of cognitive psychology.  In 1959, Chomsky criticised B.F Skinner’s theory of language acquisition which was deduced to learned behaviour.  Chomsky claimed that a human being’s capacity (visual, mobility etc) is based upon genetics, and not determined by the input (REF).  The desire for greater knowledge on cognitive processes, such as thinking, language acquisition and attention grew and in 1967, Ulrich Neisser published Cognitive Psychology.  Neisser’s interests lied in memory and perception (REF) and was the first to suggest that a person’s internal processes could be measured and analysed (REF). 

The approach studies the mind and infers the internal processes, such as memory, thinking and perception affect behaviours (Eysenck 2010) and is mechanistic in nature.  It presupposes that the mind is akin to that of a computer, with input, storage and retrieval of information.  The cognitive perspective applies a nomothetic approach, preferring objective, controlled, scientific methods for investigating behaviour, likewise with behaviourist Albert Bandura’s social learning theory.

Autism Spectrum Disorder (ASD) is a “range of similar conditions including Asperger Syndrome, that affect a person’s social interaction, communication, interests and behaviour”.  Approximately 1 in every 100 people in the UK has ASD and is more prevalent in boys than girls (NHS UK 2016).  The disorder itself varies hugely from person to person which can prevent accurate diagnoses (REF).  Other clinical manifestations of ASD include anxiety, hyperactivity and depression but these are often overlooked due to the complexity of the disorder (REF).

Today the age-old evolutionary perspective provides a theoretical lens for the causes of defective human social and cognitive behaviour.  Baron-Cohen has provided theories for autism in evolutionary terms for many years.  He posited (2003) the ability to build a theory of mind appears between three and four years of age but those who suffer with autism appear “mind-blind” (unable to form theories of other minds).  Baron-Cohen (2004) postulated the lack of empathy observed in autism is at the heart of the evolutionary account.  Referred to as the ‘theory, theory’ of autism, it is the idea that the capacity one has to develop theories of another mind is phylogenetically novel.  Hampton (2010) cites that autism could be classed as a “phylogentic” disorder because autism is atavistic, to mean it occurs because of a very old habit from the distant past.

To the contrary, cognitive psychology has attempted to provide us with many explanations for the cause of autism, theory of mind is just one.  Aaron Beck’s cognitive triad (1976) encompasses the negative thoughts one experiences in terms of the self, the world and the future (REF).  Cognitive behavioural therapy helps to identify the distorted thoughts, re-evaluate and modify them, and replace with positive and more helpful thoughts (REF). Today, CBT is most commonly used in the treatment of depression and anxiety.  Examples of cognitive distortions are ‘magnification’ (magnify the negative) (REF) and ‘personalisation’ (the belief others are acting negatively towards you without good reason) (REF).  Furthermore CBT, which typically requires abstract thinking abilities has now been modified and rendered ASD-friendly.  Instead of a child verbally rating their anxiety, visual cues such as colour coded thermometers are displayed.  The study published in 2012, highlighted how CBT should be used to address social deficits in people with autism, as fundamentally it is these deficits which foster the feelings of anxiety (REF). 

The biological approach is by and large the expected option for treating mental illness today, and assumes the minds problems are caused my genetics.  According to the Oxford Textbook of Psychiatry (2012), “psychiatrists are required in two distinct capacities; firstly to collect clinical data, and secondly is the capacity for intuitive understanding of each patient as an individual”.  Assessment of ASD typically considers factors such as cognition, language, communication and social skills and co-morbidities (e.g epilepsy).  Depending on the severity of the behaviours, some can be managed with additional support in the form of special schooling, or by clinical psychologists (REF).  Evidence has suggested that short-term use of the antipsychotic drug, Risperidone can reduce aggression and self-injurious behaviours (REF).  Selective serotonin reuptake inhibitors (SSRIs) are also used to reduce compulsive and repetitive behaviours (REF).  The biological approach also attempts to find answers to clinical manifestations experienced in ASD, such as anxiety.  For instance, Stanford University (2014) are the first to successfully run trials which used Oxytocin (‘the love hormone’) as a way of improving the social skills in people with autism.      

There are strengths and weakness across each of the three perspectives covered in this essay.  The evolutionary and biological approaches stress the importance of our inherited genetics, with the evolutionary highlighting the influence natural selection plays in our genetic makeup.  Another key strength is that behaviours can be cross-culturally compared, and against other species.  However, it cannot explain individual differences which are paramount in the treatment and management of mental ill health.  

Cognitive psychology’s main strength is its scientific approach through its use of laboratory experiments.  Psychologists can test theories, such as attribution theory and use the findings to prove the validity.  Another strength is CBT.  However, some weaknesses include how the approach does not consider the nature/nuture debate and it ignores social or cultural influences.  It is reductionist and mechanistic and individual differences are not considered.  

The biological approach finds its main strength in the use of drugs in the treatment of mental illness.  It is deterministic and scientific, with measurable objectives.  However, dependency of drugs and the over-prescription of medications are all weaknesses of the approach.  It assumes that all behaviours can be deduced to a biological process and does not assume an individual to be unique.

Ultimately, one would assume that there is no ‘one size fits all’ in the treatment of mental health disorders.