2 - Models of Psychopathology Flashcards
List the five models of psychopathology
Biological; Psychodynamic; Humanistic; Behavioural; Cognitive
The Biomedical model investigates the degree that mental disorders are determined by genetics . It studies gene-environment interactions via which four methods?
Pedigree method (identifies proband, prevalence in family; Classical twin design (compares concordance rates for DZ and MZ twins); Adoption studies (compares concordance to biological vs. adopted relatives); Molecular genetics (candidate/wide genome associations)
What can we assume if MZ concordance rates are higher than DZ twins?
Contributions are due to genetics
What can we assume when MZ=DZ and both show high concordance rates, compared with low concordance rates?
If high concordance: contributions are due to shared environment; If low: non-shared environmental contributions
Compare Candidate gene studies with Genome wide association studies, and explain which candidate is the strongest predictor of AD
Candidate - observes whether one specific allele of a candidate gene is more frequently seen in people with the disorder than those without it; Genome wide - assesses common variations across the entire genome; ApoE-e4 is the strongest predictor (34% of people with AD have it)
The Biomedical model recognises what three contributing factors to the aetiology of mental disorders?
Biochemistry; Neuroanatomy; Endocrine system
Most drug therapies increase or decrease the activity of specific neurotransmitters, but the effects are very broad and don’t act in isolation. List four neurotransmitter systems involved in these therapies
Seretonin; Gamma Aminobutyric Acid (GABA); Noradrenaline; Dopamine
What does the Serotonin system regulate, and what is low activity associated with?
Behaviour, mood and thought processes; Aggression, suicide, impulsive overeating, hyper-sexual behaviour
Which drugs are known to primarily affect the serotonin system and reduce anxiety?
Tricyclic antidepressants; serotonin specific reuptake inhibitors (e.g. prozac)
What function does Gamma Aminobutyric Acid (GABA) serve, and which drugs make it easier for these molecules to attach to receptors of specialised neurons?
Inhibits a variety of behaviours and emotions; reduces overall arousal (has anxiolytic effects); Benzodiazepines (act at the level of neurotransmission)
Which glands secrete noradrenaline, and where are noradrenaline circuits located in the CNS?
Adrenal glands; circuits located in the hindbrain (controlling basic bodily functions, e.g. respiration; and fight or flight responses)
Which circuits do Dopamine circuits merge with, and what role does it serve?
Merges with Serotonin (influences many of the same behaviours); relays messages to control movements, mood and thought processes (damaged cells leads to Parkinson’s)
What is the hindbrain responsible for?
Bodily functions involved in sustaining life and regulation of sleep
What functions is the midbrain involved with?
Regulation of some motor activities (fighting and sex) and sleep
The forebrain is the site of what kind of functioning
Most sensory, emotional and cognitive functioning (includes the limbic system)
What can damage to the Reticular Activating System in the midbrain, and Orbitofrontal Cortex lead to?
RAS: disturbances in sexual behaviour, aggression and sleep; OFC: disinhibited behaviour
Which neural areas are involved in theory of mind?
Temporoparietal junction and dorsal lateral PFC
What areas are responsible for empathy?
Dorsal ACC and anterior insula
What areas are involved in social perception?
Posterior STS; fusiform face area and amygdala
Which regions control social behaviour?
VMPFC and OFC
What body organs make up the endocrine system?
Pineal, pituitary, parathyroid, thyroid and thymus glands, stomach, adrenal glands, pancreas, kidney, ovaries and testis
The endocrine organs produce hormones. What are the functions of these, and via what route are the messages transmitted?
They help regulate the body’s physiological processes, and coordinate internal bodily processes with external events; transmitted via the bloodstream (prolonged stress can cause dysfunction)
Where is the Hypothalamic-pituitary-adrenal-cortical (HYPAC) axis located, what does it control?
Where the hypothalamus and endocrine system interact; controls reactions to stress
The hypothalamus connects to which adjacent gland, and what may this gland, in turn, stimulate?
Pituitary gland (coordinator of the endocrine system); which may stimulate the cortical (outer layers) of adrenal glands to produce surges of adrenalin and cortisol
As well as electroconvulsive shock treatment, pharmacotherapy is used as a biological treatment (often discovered serendipitously, e.g. John Cade - lithium). But what problems can occur with prescription drugs?
Side effects (anti-depressant induced suicide, weight gain and mood swings, etc), and an over-reliance on them (2013-14 in US - drug with highest sales was an antipsychotic & 8th highest an antidepressant; 1/4 of children in US summer camps medicated for psychiatric disorders)
Peter Gøtzsche claims that drug companies don’t sell drugs, they sell lies, and that they’re the 3rd leading cause of death after heart disease and cancer. What does he suggest are the main reasons for these deaths?
“Dishonesty in research and marketing of drugs, permissive drug regulation, over-medicalisation, polypharmacy, and a lack of understanding about the harms of drugs”
According to WHO studies, what percentage of people in third world countries are on anti-psychotics compared to developed countries?
15%, compared to 60% in developed
Due to such complexities in the way systems interact, it’s too simplistic to conclude that one drug will influence a neurotransmitter imbalance, and many side-effects can occur. How is Cymbalta an example of this?
People coming off these antidepressants experience neuropathic pain sensations
According to Freud’s Psychodynamic model, what are the 5 overlapping stages of psychosexual development?
0-1.5: Oral; 1-3: Anal; 2-6: Phallic; 5-12: Latent; 11-20: Genital
Give some examples of fixations in Freud’s Oral period of development, and what impact they can have on adult personality
Forceful feeding, deprivation and early weening can lead to oral activities such as smoking, dependency and aggression
If toilet training in the Anal period was too harsh or too laxed, what, according to Freud could this lead to?
Obsessiveness, tidiness, meanness, untidiness, or generosity
In Freud’s Phallic phase of development, abnormal relationships to mother/father can lead to what in adult life?
Vanity, self-obsession, sexual anxiety, inadequacy, inferiority, or envy
Describe the 3 parts to our personality (often in conflict) according to the psychodynamic model
ID - motivated by biologically driven instincts; operates at unconscious level of pleasure and desire; Ego - motivated by the reality principle; uses defense mechanisms (e.g. repression, projection) to ward off unpleasant feelings; Superego - conscience and ego ideal (right vs. wrong)
What did neo-Freudians, Jung and Erickson, focus on in regards to how our personalities are formed?
Jung - de-emphasis of biological drives; collective unconscious and archetypes (memory traces of past generations and universal ideas); Erickson - formation of ego identity and psychosocial development; life-span approach (8 psychosocial stages of development)
What are the processes of Symptom Formation and Symptom Removal, according to the psychodynamic method?
Symptom Formation - traumatic childhood experiences > defense mechanisms > symptoms; Symptom Removal - free association > recovery of material > awareness and interpretation
List 5 ways in which the psychodynamic theory has contributed to the mental health domain
Impact of childhood experiences on later development; impact of the unconscious on behaviour; continuity of normality and abnormality; demystified mental illness; defense mechanisms
Describe 3 limitations of the psychodynamic theory
Resistance to empirical investigation; emphasises abnormality rather than psychological health; hasn’t contributed to prevention or early intervention methods
What does the Humanistic model emphasise?
An explicitly positive view of human nature (we’re born with the inclination to be friendly, cooperative and constructive, and are driven to self-actualise); and free will (we control, choose, and are responsible for our actions)
The Humanistic model originated in the 1940s by Carl Rogers, with a focus on what approach?
Client-centred therapy (based on acceptance, congruence and understanding)
How does the humanistic model explain abnormal behaviour?
It stems from the basic need to receive positive regard from significant others to accept our authentic selves unconditionally (if we believe we’re accepted only under certain conditions, we can’t accept ourselves unconditionally, leading to distress)
The Behavioural Model, founded by John Watson, led to the first wave of behavioural therapy in the 1940s. What did it focus on?
Behaviour which could be observed and measured; it rejected introspection, and emphasised learning as the key role in the development of behaviour
What are the 3 principle modes of learning?
Classical conditioning; Operant conditioning; Observational learning/modelling
According to Bandura, observational learning can be construed in conditioning terms but requires some extra assumptions. What are they?
The observer: must attend to the model and understand the connection between the model’s behaviour and the contingent reinforcement; must store what’s been learned in memory and recall the information; must be capable of performing the required behaviour (thus non-observable processes are necessary to explain modelling)
List 3 types of classical conditioning techniques used in behavioural treatments
Systematic desenstitisation; Aversion therapy; Exposure therapy (relearning connections)
List 4 types of operant conditioning techniques used in behavioural treatments
Positive reinforcement; Extinction; Token economies; Behavioural activation (re-engagement with rewards)
What techniques are used in modelling?
Social skills training (role plays)
What are the benefits of the behavioural model?
Theories and treatments can be tested in the lab; model is supported by lab research; many of the techniques remain useful
What are the disadvantages of the behavioural model?
No indisputable evidence that abnormal behaviour is due to improper conditioning; too simplistic; over-emphasis on learning and environmental determinants of behaviour; human cognition not accounted for
The cognitive revolution came about in the 1960s-70s, with CBT at its core in the 80s. What does this model consider abnormal behaviour to arise from?
Our beliefs about an event leads to consequences; it depends on how we interpret an even
Ellis identified 10 irrational beliefs that can lead to problems. Describe two of them
I must be loved, or at least liked, and approved by every significant person I meet; I must be completely competent, make no mistakes, and achieve in every possible way if I’m to be worthwhile
List 4 automatic negative thoughts according to Beck
Arbitrary inference (e.g. if someone didn’t smile back it means they don’t like you, rather than maybe they didn’t see you); Overgeneralising; Dichotomous thinking; Magnification or Minimalisation
What are the benefits of the cognitive model?
Amenable to empirical enquiry; complements behavioural strategies
What are the disadvantages of the cognitive model?
Precise role of cognitions in psychopathology is unspecified; narrowness of scope; no link between cognitive theory and cognitive science; lack of evidence that cognitive therapy adds to behavioural therapy; lack of evidence supporting hypothesised mediators of change in CBT
Which therapies arose in the third wave of behavioural therapy?
1990s: Dialectical behaviour therapy (DBT) and mindfulness based stress reduction; 2000s: Adaptations of mindfulness-based cognitive therapy (MBCT); 1999: Acceptance and commitment therapy (ACT - most widely used today)
What is ACT, and what is it based on?
A therapy approach that uses acceptance and mindfulness processes to produce greater psychological flexibility; Based on functional contextualism; relational frame theory; post-Skinnerian contextual theory of language and cognition
The ACT Theory of Change proposes that our psychological problems originate from thought and language. How so?
Language and cognition can trigger emotional pain and psychological discomfort, and associated behaviours; verbal regulation and rigid rules prevent us from moving in valued directions; hexaflex???
What is the goal of psychological flexibility?
Involves contact with the present moment and changing or persisting in behaviour in the service of chosen values
What 6 processes can lead to psychological rigidity?
Dominance of conceptualised past and feared future; Lack of values, clarity or contact; Inaction or disorganised activity; Attachment to conceptualised self (using labels); Fusion (buy into the thoughts, believing you ARE these things); Non-accepting/closed avoidance (fear of what might happen)
Psychological flexibility is established via six core ACT processes. Each of these areas is conceptualised as what?
A positive psychological skill, not merely as a method of avoiding psychopathology (idea of wellness/flourishing)
What is the Diathesis-Stress perspective on mental disorders?
Diathesis - predispositions we’re born with (genes, biological characteristics, psychological traits) interact with Stressors (environmental trauma, economic adversity, loss of loved ones, harsh family background) to determine our susceptibility to a disorder
According to the Biological paradigm, what are the causes of psychological disorders?
Inherited or acquired brain disorders involving imbalances in neurotransmitters or damage to brain structures
What does the Psychodynamic paradigm argue about the causes of psychological disorders?
Unconscious conflicts over impulses such as sex or aggression, originating in childhood
What caused psychological disorders according to the Humanistic model?
Lack of unconditional positive regard leads to self-deception and a distorted view of one’s experiences leads to psychological dysfunction
What does the Behavioural paradigm propose about the cause of psychological disorders?
Faulty learning
According to the Cognitive model, what causes psychological disorders?
Irrational or maladaptive thinking about one’s self, life events, and the world in general
What does the ACT propose as the primary source in psychopathology?
The way that language and cognition interact with direct contingencies to produce an inability to persist or change behaviour in the service of long-term valued ends. This psychological inflexibility emerges from weak or unhelpful contextual control over language processes
