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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.  This essay will focus on three perspectives of psychology, evolutionary, cognitive and biological.  The origins of each approach are 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.  Finally this essay will assess psychology’s current position as a science and attempt to offer an explanation to the question posed.  

The theory of evolution, (Charles Darwin 1859) posited how human beings adapted to their surroundings and provided the theories of natural selection and sexual selection.  “Evolutionary psychology assumes the human mind to be a discrete information processing machine” (Tooby and Cosmides 1997, as cited in Hampton, 2012).

This approach looks at the environment of evolutionary adaptation (EEA) and its influence on minds and behaviours as humans evolved (Pinel).  The key assumption of this perspective is that one will adapt to ensure the survival of ones genes (Eyseck).  It assumes that genetics determine the psychological attributes of a human being and is therefore highly deterministic.   The psychologist David Buss studied the evolution of mating and collated data in order 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).  Bowlby (1958) posited that within an evolutionary context, attachment can be understood.  The suggestion is that attachment is adaptive as it provides infants 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 deduced to a biological process (REF) making it physiologically deterministic (REF).  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 revised copy of the Diagnostic and Statistical Manual (DSM) in 1980 (REF).  He criticised Sigmund Freud’s theories in the early 1900s because of how little regard he gave to biology.  (REF).  Neuroscientist Oliver Sacks contributed to neuroscience and psychiatry, studying patients with a plethora of neurological disorders whilst illuminating the neurotypical brain and its capabilities in dealing with perception and memory (REF).

In 1959, Chomsky criticised B.F Skinner’s theory of language acquisition which he deduced to learned behaviour.  Chomsky claimed that a human being’s capacity is based upon genetics, and not determined by the input (REF).  The desire for greater knowledge on cognitive processes 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 (REF). 

The approach studies the mind and infers that 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 posited (2003) that 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 pivotal in the evolutionary perspective.  The ‘theory, theory’ of autism, is “the capacity one has to develop theories of another mind, and is phylogenetically novel” (REF).  Hampton (2010) cites “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”. 

Aaron Beck’s cognitive triad (1976) are the negative thoughts one experiences in terms of the self, the world and the future (REF).  Cognitive behavioural therapy seeks to identify those thoughts and replace with positive ones (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 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 predominantly uses drugs for treating mental illness today, and assumes the minds problems are caused my genetics.  With regards to ASD, depending on the severity of the behaviours, some can be managed with additional educational support or with the intervention of clinical psychologists (REF).  Evidence suggests “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)have successfully trialled Oxytocin on people with autism to improve their social skills.       

There are strengths and weakness across each of the three perspectives covered in this essay.  The evolutionary and biological approaches regard inherited genetics with paramount significance, with the evolutionary highlighting the influence of natural selection.  Another key strength is that behaviours can be cross-culturally compared.  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.  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 how it ignores social or cultural influences.  It is reductionist and mechanistic and individual differences are not considered.  

The biological approach uses medication to treat most disorders, which could be considered a strength.  It is deterministic and scientific.  However, the over-prescription of medications are a weakness of the approach.  It assumes that all behaviours can be deduced to a biological process and therefore assumes all individuals are the same.

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