4. Psychopathology Flashcards
What is cultural relativism?
The view that behaviour cannot be judged properly unless it is viewed in the context of the culture in which it originates
What is Deviation from social norms?
Abnormal behaviour is seen as a deviation from unstated rules about how on ‘ought’ to behave. Anything that violates these rules is considered abnormal
What is DSM?
(Diagnostic and Statistical Manual of Mental Disorders) A list of disorders that is used to diagnose mental disorders. For each disorder a list of clinical characteristics is given - ie the symptoms
What is Statistical infrequency?
Abnormality is defined as those behaviours that are extremely rare ie any behavior that id found found in very few people is regarded as abnormal
What is psychopathology?
Psychopathology is the scientific study of psychological disorders (‘pathology’ is the study of disease)
Why is diagnosing psychological disorders more difficult than diagnosing physical disorders?
Physical has certain symptoms - it is difficult to diagnose if someone is ‘ill’ - in what way does their behaviour differ from what is normal
How is abnormality determined using statistics?
By the presence of several of the characteristics
The most obvious way being in terms of statistical infrequency
What are descriptive statistics?
The mean, median and mode
What are descriptive statistics used for?
To represent the typical value in any set of data
How do we define aspects of what is normal?
By referring to typical values
What can statistics inform us about?
I.e. average shoe size for 10 year olds
How can we gain an idea of what is abnormal using statistics?
By defining what is most common or normal which then gives an idea of what is not common/abnormal
What do we consider statistical norms?
The distribution of data and how the curve fits, if it has a normal distribution we consider it normal vice versa
What are social norms?
These are norms created by a group of people and thus are ‘social’
Why are social norms formed?
As there are standards of acceptable behaviour in any society which are set by the social group and adhered to by the social group
What is deviation from social norms?
Anyone who behaves differently (deviates) from the socially created norms is classed abnormal
Give an example of a social norm and why it is good
Politeness
Politeness means good relationships form, people who behave rudely are considered to be behaving in a socially deviant way
What are the two types of ways social norms can be enforced?
- Implicit rules (i.e. not laughing at a funeral)
- Laws (e.g. causing disorder in public is against the law)
Give an example of social norms changing
In the past homosexuality was classified as abnormal and was regarded as a mental disorder - this judgment was based on social deviation
Give 3 evaluation points for statistical infrequency
- Some abnormal behaviours are desirable
- The cut-off point is subjective
- Statistical infrequency is sometimes appropriate
Give 3 evaluation points for deviation from social norms
- Susceptible to abuse
- Deviance is related to context and degree
- There are some strengths
What are the 4 definitions of abnormality?
- Statistical infrequency
- Deviation from social norms
- Failure to function adequately
- Deviation from ideal mental health
What is deviation from ideal mental health?
Abnormality is defined in terms of mental health, behaviours that are associated with competence & happiness
Ideal mental health would include a positive attitude towards the self, resistance to stress and accurate perception of reality
What is failure to function adequately?
People are judged on their ability to go about daily life
If they can’t do this and are also experiencing distress then it is considered a sign of abnormality
Who was Marie Jahoda?
She came up with deviation from ideal mental health
(1907-2001) Born in Vienna, Austria, to a Jewish family & fled to the US at the start of WW2. She later worked at the university of Sussex & developed the first department of social psychology in Britain
What is being unable to cope with everyday living as a definition of abnormality?
Failure to function adequately
What is coping with everyday life considered?
- Eating regularly
- Washing clothes
- Getting up for a job or some form of activity
- Being able to communicate with others
What does not functioning adequately cause?
It causes distress for the individual
What is considered abnormal based on statistical infrequency?
An individual who is outside the normal (two standard deviations away from the mean)
What is depression?
A mood disorder where an individual feels sad/lacks interest in their usual activities
Further characteristics:
- Irrational negative thoughts
- Raised or lowered activity levels
- Difficulties with concentration, sleeping & eating
What is obsessive-compulsive disorder (OCD)?
An anxiety disorder where anxiety arises from both obsessions and compulsions
Compulsions are a response to obessions & the person believes the compulsions will reduce anxiety
What are phobias?
A group of mental disorders characterised by high levels of anxiety in response to a particular stuimulus/group of stimuli
The anxiety interferes with normal living
What group of disorders do phobias come over?
Phobic disorders are included in ‘anxiety disorders’
It’s a group of mental disorders that share the primary symptom of extreme anxiety
What is the primary symptom of phobias?
Extreme anxiety
How do phobias affect someone’s actions?
They are instances of irrational fears that produce a conscious avoidance of the feared object/situation
What is agoraphobia?
Fear of being trapped in public place where escape is difficult
What is social phobia?
Anxiety related to social situations such as talking to a group of people
What are specific phobias?
Fears about specific objects such as spiders or snakes, or specific situations such as heights or the dark
What are the emotional characteristics of phobias?
Primary characteristic: marked & persistent - likely to be unreasonable
Coupled with fear are feelings of panic & anxiety
These emotions are cued by the specific object or situation & are out of proportion
What are the behavioural characteristics of phobias?
Avoidance, freezing or fainting
The fight, flight or freeze response
Why do people freeze when they have a phobia of something?
It is an adaptive response because a predator may think the prey is dead
What is avoidance (in terms of phobias)?
When a person with a phobia is faced with the object/situation that creates fear the immediate response is to avoid it
How does avoidance affect people with phobias?
Avoidance in the feared situation interferes significantly with the persons routine, occupation, social activities or relationships
There is also marked distress
How are phobias distinguished from normal everyday fears?
There is marked distress and they interfere with normal day to day living unlike everyday fears
What is classical conditioning?
Learning through association
A neutral stimulus is consistently paired with an unconditioned stimulus so that it eventually takes on the properties of this stimulus & is able to produce a conditioned response
What is operant conditioning?
Learning through reinforcement/punishment
If a behaviour is followed by a desirable consequence then that behaviour is more likely to occur again in the future
What is the two process model?
A theory that explains two processes that lead to the development of phobias
They begin through classical conditioning & are maintained through operant conditioning
What is flooding?
A form of behavioural therapy used to treat phobias & other anxiety disorders
Client is exposed to (or imagines) an extreme form of the threatening situation under relaxed conditions until the anxiety reaction is extinguished
What is systematic desensitisation?
A form of behavioural therapy used to treat phobias & other anxiety disorders
Client is gradually exposed to (or imagines) the threatening situation under relaxed conditions until the anxiety is extinguished
What is the ABC model?
A cognitive approach to understanding mental disorder
Focuses on the effect of irrational beliefs on emotions
What is the negative triad model?
A cognitive approach to understanding depression
Focusses on how negative expectations (schema) about self, world abs future lead to depression
What is a schema?
A cognitive framework that helps organise & interpret info in the brain
A schema helps an individual to make sense of new info
What is cognitive behavioural therapy (CBT)?
A combo of cognitive therapy & behavioural therapy
What is cognitive therapy?
A way of changing maladaptive thoughts & beliefs
What is behavioural therapy?
A way of changing behaviour in response to these thoughts & beliefs
What are irrational thoughts?
Rational thinking is flexible & realistic - where beliefs are based in fact & logic
Irrational thinking is rigid & unrealistic and lacks internal consistency
What is concordance rate?
Measure of genetic similarity
e.g. 100 twin pairs, one twin of each pair has a phobic disorder - the no. their other twin also shows the illness determines the concordance rate (if 40 have phobic disorder, concordance rate is 40%)
What is dopamine?
One of the key neurotransmitters in the brain, with effects on motivation and ‘drive’
What is a gene?
A part of a chromosome of an organism that carries info in the form of DNA
What is a neurotransmitter?
Chemical substances that play an important part in the workings of the nervous system by transmitting nerve impulses across a synapse
What is GABA?
Gamma-aminobutyric acid
A neurotransmitter that regulates excitement in the nervous system - acting as a natural form of anxiety reducer
What is noradrenaline?
A neurotransmitter found mainly in areas of the brain that are involved in governing autonomic nervous system activity
e.g. blood pressure or HR
What is serotonin?
A neurotransmitter implicated in many different behaviours & physiological processes, including aggression, eating behaviour, sleep & depression
What are the 3 main groups of drugs to treat OCD?
- SSRIs (antidepressants)
- Tricyclics (antidepressants)
- Benzodiazepines (anti-anxiety drugs)
What is the biological approach to treating OCD?
Drug therapy e.g. SSRIs
What are the most commonly used drugs to treat OCD?
SSRIs - also commonly used for depression
What are low levels of serotonin associated with?
Depression and OCD
How do SSRIs help OCD?
They increase levels of serotonin which regulates mood & anxiety
What does SSRI stand for?
Selective serotonin re-uptake inhibitors
What are the two neurotansmitters that can cause OCD?
- Dopamine when levels are too high
- Serotonin when levels are too low
What are the 3 types of drugs used/perscribed for OCD?
SSRIs
Tricyclics
Benzodiazepines
What does SSRI stand for?
Selective Serotonin Reuptake Inhibitors
What are the most commonly used drugs to treat OCD and depression?
SSRIs
Give 3 examples of SSRIs
- Fluoxetine (e.g. Prozac)
- Sertraline (e.g. Zoloft)
- Citalopram (e.g. Celexa)
How do SSRIs work?
They block the reuptake of serotonin from synapses while allowing other processes to continue
Leads to a “build-up” in synapses as it cannot be removed
Why do some people not have enough serotonin - leading to OCD?
The patient removes serotonin too quickly or they don’t produce enough
How do Tricyclics compare to SSRIs?
They are commonly used for OCD but are more powerful than SSRIs so are rarely prescribed first
Give two examples of Tricyclics
- Amitriptyline (e.g. Elavil)
- Clomipramine (e.g. Anafranil)
How do Tricyclics work?
They block reuptake of serotonin and noradrenaline
Works as both NT are in the same chemical family
Causes them to build up in synapses, increasing their effects
How does increased serotonin on OCD patients help them (relating to Tricyclics?
Gives them better impulse control
How does increased noradrenaline in OCD patients help them (relating to Tricyclics)?
Helps patients feel “awake” & motivated (helps with often-comorbid depression)
How are charges in neurons changed in summation?
They are changed by ion exchange (making the neurons +ive or -ive)
What is summation?
At the end of synaptic transmission there are inhibitory/excitatory signals that cuase the cell to fire (complete the action) if enough build up
What are the most common ions that change the charge in neurons during summation?
Cl- (negative)
K+ (positive)
Na+ (positive)
What is depolarisation?
Excitatory neurotransmitters allow Na+ to enter the neuron
What are the stages of a cell being reset after summation?
- Excitatory NTs allow Na+ to enter the neuron (depolarisation)
- Neuron becomes +ive inside the membrane (EPSP ->AP)
- This opens channel to let K+ ions out
- Outside of cell becomes more +ive
- Cell is “reset” (hyperpolarised)
What are BZs used for?
Are used for a range of anxiety disorers; including panic disorder, addiction withdrawl & OCD
Give 3 examples of BZs
Alazopram (e.g. Xanax)
Diazepam (e.g. Valium)
Lorazepram (e.g. Ativan)
How do BZs work?
They mimick GABA
What is the process of BZs mimicking GABA?
- Bind to receptors with chloride channels, casing them to open; GABA normally does this
- -ive chloride ions (Cl-) flood intothe postsynaptic cell
- Created IPSP (hyperpolarisation), reducing neuron activity; addressing impulsivity & anxiety
What does GABA do?
Causes IPSP (hyperpolarisation) by opening channels that let negatively-charged ions through the membrane
What is GABA?
An inhibatory neurotransmitter
What is OCD classed as?
An anxiety disorder characterised by obsessive thinking & repetitive behaviours
What are obsessions?
Internal componenets as they are intrusive thoughts (something you think)
What are compulsions?
External components as they are repetivite behaviours (something you do) - these reduce anxiety
How does the biological apprach explain OCD?
It sees abnormal conditions such as OCD, as being similar to physical illness caused by abnormal biological processes
What are the two main biological explanations for OCD?
- Neural explanations
- Genetic explantions
What are neural explanations (biological approach)?
The occurrence of OCD through abnormal functioning of neural (brain) mechanisms & neurotransmitters
What are genetic explanations (biological approach)?
Hereditary influences through genetic transmission from parent to offspring
What are the two genes in the biological approach to explaining OCD?
COMT and SERT (5-HTT)
What does the COMT gene produce and how does this affect OCD patients ?
An enzyme that degrades dopamine
People with OCD can’t degrade dopamine properly
Do people with OCD have the COMT gene?
No - they have a low activity variant of this gene
How does the COMT gene cause OCD?
COMT degrades dopamine and people with OCD have a low activity version of this gene
Therefore dopamine levels build up in the synapse and are very high
What does the SERT gene produce?
A protien that transports serotonin back to the presynaptic neuron (reuptake)
Do OCD patients have the SERT gene?
No - they have a high activity variant of this gene
What happens if serotonin is removed too quickly?
It results in lower levels recieved & a shoerte duration of serotonin’s effects
How does the SERT gene affect OCD patients?
The SERT gene in OCD patients is a high activity variant
It removes serotonin too quickly & results in a shorter duration of serotonins effects
What is the genetic explanation fo OCD?
There are genes that are thoguth to contribute to OCD as they impact neurotransmitter levels
What are the two neurotransmitters involved in OCD?
Dopamine and Serotonin
How do serotonin levels affect OCD?
Lower levels of serotonin in the brain are also associated with OCD
How do dopamine levels affect OCD?
Abnormally high dopamine levels are found in people with OCD
What sort of neurotransmitter is dopamine?
An excitatory neurotransmitter
What sort of neurotransmitter is serotonin?
An inhibatory neurotransmitter
What does dopamine control?
- Reward
- Movement
- Memory
- Waking up
What does serotonin control?
- Appetite
- Control of behavioural impulses
- Mood
Where is serotonin released to?
It is released into emotional, memory & muscle-control areas
What is serotonin’s main behavioural function?
Imoulse control
Where is dopamine released into?
Emotional, executive & memory areas
What is dopamine’s main function?
Habit forming
What are the 3 abnormal brain circuits in OCD?
- OFC
- Thalamus
- Caudate nucleus
What is the OFC (relating to OCD)?
Sends signal to the thalamus about things that are worrying
What is the Thalamus (relating to OCD)?
Leads to impulse to act & then to stop activity when the impulse lessens
What is the Caudate nucleus (relating to OCD)?
Normally suppresses signals from the OFC
If damaged, it fails to do this & so the thalamus is alerted about minor worry signals
It sends signals back to the OFC acting as a worry circuit
Which part of the brain must be damaged for a worry cicuit to occur?
The Caudate nucleus (surppresses worry signals) is damaged
OFC and Thalamus form a worry loop
What is the COMT OCD process?
COMT - activity low ->
Dopamine - levels high ->
Caudate nucleus - overactive ->
Hypervigilance - anxiety ->
Obsessive thoughts
What is the SERT OCD process?
SERT - activity high ->
Serotoning - levels low ->
Obritofrontal cortex - underactive ->
Impulsiveness ->
Compulsive behaviour
What is diathsis-stress?
The idea of a simple link between one gene & a complex disorder like OCD is unlikely
What does diathesis-stress suggest?
Each individual gene only creates a vulverability (diathesis) for OCD along with other conditions
Other factors (stressors) affect what condition develops or indeed whether mental illness develops
What is humanism?
Modern secular belief system that treats human experience as the ultimate source of meaning
What sort of approach does humanist healthcare use?
A “person centred appraoch” - the patient’s subjective feelings are what matters
How does humanism account for cultural relativism?
By considering individuals’ happiness above fixed diagnostic tools
Who proposed deviation from ideal mental health?
Jahoda (1958)
What does Jahoda look at specifically in her deviation from ideal mental health?
Her definition looks at the positives rather than the negatives - the idea of mental health rather than mental illness
What did Jahoda beleive her 6 major criteria for ideal mental health promoted?
She believed they promoted psychological health & well-being, enabling an individual to feel happy (free of distress) & behave competently
What did Jahoda think would happen to a person who lacked any of her 6 criteria?
They vould be vulnerable to mental disorder & therefore abnormal
The more characteristics they fail to meet & the further they are from realising them, the more abnormal they are
What were the 6 major criteria that Jahoda promoted in her theory?
- Self-attitudes
- Self-actualisation
- Integration
- Autonomy
- Accurate perception of reality
- Mastery of the environment
Define Self-attitudes (Jahoda’s 6 categories)
Having high self-esteem & a strong sense of identity, high self-respect & a +ive self concept
Define Self-actualisation (Jahoda’s 6 categories)
The extent to which an individual develops their full capabilities
i.e. fulfilling their potential
Define Integration (Jahoda’s 6 categories)
Being able to cope with stressful situations
Define Autonomy (Jahoda’s 6 categories)
Being independent & self-reliant and able to make personal decisions
Define having an accurate perception of reality (Jahoda’s 6 categories)
Perceiving the world in a non-distorted fashion
Having an objective & realistic view of the world
Define Mastery of the environment (Jahoda’s 6 categories)
Being competent in all aspects of life - being able to meet the demands of any situation
e.g. ability to love, function at work etc
What is depression generally characterised by?
Low mood & low energy levels
What is the cognitive approach to explaning depression?
Cognitive scientists are most concerned w how irrational thinking (cognitions) leads to depression
What are the two major cognitive approaches to exaplaining depression?
- Ellis’ ABC model (1962)
- Beck’s negative triad (1967)
What does Ellis believe irrational beliefs are due to in his ABC model?
Mustabatory thinking
What is mustabatory thinking?
These are cognitions containing fixed terms
e.g. I NEED a partner or I am unlovable, I MUST receive +ive feedback or I am worthless
What is Ellis’s ABC model in a rational thinker?
A = Activating event B = rational Belief C = Concequence
What is Ellis’s ABC model in an irrational thinker (someone who has depression)?
A = Activating event B = irrational Belief C = Concequence
What are the two cognitive processes predicted by Beck’s negative triad?
- Ruminating
- Catastrophising
Define ruminating
Repetitive circular thinking with each thought feeding the next
Define catastrophising
Irrationally -ive view and/or perception of situations
What are the key aspects of Beck’s negative triad?
- Perception of self
- Perception of future
- Perception of world
(arranged in a tringle which -ive shcema in the middle)
Sorry max I can’t put in pictures bc I don’t have pro I’m poor lol :) just imagine it
What does the -ive core schema in Beck’s triad lead to?
It leads to negative cognitive biases
How do negative cognitive biases affect us (Becks triad)?
-ive cognitive biases affet our perception, causing irrational perception of events
What are the limitations of the cognitive approach to explaining depression?
- Biological = genes (5-HT) & Amygdala
- Behavioural = Learned helplessness
- Humanist (counselling) = low self-esteem & poor self-belief
How had Beck’s theory helped CBT?
It formed the basisof CBT - all cognitive elementsof depression can be identified & challanged in CBT
Modern CBT has a 75% sucess rate for depression
How had Ellis’ theory helped CBT?
His theory led to sucessful CBT, his idea that by challanging the negative, irrational beliefs a person can reduce their depression
Is supported by research
What are cognitions?
They are theoretical constructs, so we can’t directly interact with them
What is CBT?
Cognitive behavioural therapy
Is a talking therapy that aims to identify irrational core beliefs & uses practical activities to challange & change them
How can we challange cognitions?
We can use behavioural training to help challenege & modify cognitions indirectly
The process is collaborative - we need the patient’s engagement
How does CBT help patients?
Assists patients to identify irrational thoughts & change them
