4.1.4 Psychopathology💊 Flashcards
what are the four definitions of abnormality
statistical deviation
deviation from social norms
failure to function adequately
deviation from ideal mental health
define statistical deviation
An individual is classified as abnormal if they display a less common characteristic than most of the population
give an example of statistical deviation
intellectual disability disorder
only 2% of the population have an IQ score of below 70
limitations of statistical deviation
abnormality is sometimes desirable e.g higher IQ levels
cut off pointe are subjectively determined e.g based on self reports .
if somebody is happy and fulfilled there is no benefit in labelling them as abnormal may negatively effect them.
strengths of statistical deviation
it uses scores on well established standardised tests so it is more objective and scientific
it uses an objective point of two standard deviations to define abnormal behaviour
define deviation from social norms
an individual is classified as abnormal if they deviate from socially created norms of acceptable behaviour . Collect judgement from society about what is right , norms are subjective to culture.
give an example of deviation from social norms
antisocial personality disorder (APD)
they are agressive and lack prosocial internal standards
limitations of deviation from social norms
social norms vary over time e.g homosexuality was a mental disorder until 2000
norms are culturally relative
ethnocentric bias might effect perceptions of normality within a society that has ethnic minorities
strengths of deviation from social norms as a definition of abnormality
behaviour is seen within a context so it can be judged more holistically
define failure to function adequately as a definition of abnormality
an individual can be classified as abnormal when they can no longer cope with the demands of every day life
(Rosenhan and seigman personal dysfunction features - conformity , personal distress , irrational/dangerous behaviour to them self or others)
outline personal dysfunctional features (Rosenhan and seligman 1989) -
failure to function adequately
a person is failing to function when:
- they are no longer conforming to inter-personal rules e.g respecting personal space
- they experience personal distress
- irrotational or dangerous behaviour to themselves or others
give an example of failure to function adequately as a definition of abnormality
intellectual personality disorder requires more than just a low IQ
limitations of failure to function adequately as a definition of abnormality
difficult to say when somebody is failing to function when they are just deviating from social norms e.g people live alternative lifestyles , classifying them as abnormal could discriminate against some groups
some abnormal behaviour can be functional
strengths of failure to function as a definition of abnormality
the list is of behaviours that can be seen by the observer nor cognitive processes which can’t be seen
define deviation from ideal mental health as a definition of abnormality
an individual is classified as abnormal if they fail to meet the criteria of good mental health as proposed by Jahoda.
what is the criteria of ideal mental health as proposed by Jahoda
1) no symptoms of distress
2) we are rational - can perceive ourselves accurately
3) can cope with stress
4) realistic view of the world
5) independent of other people
6) can successfully work love and enjoy our leisure
limitations of deviation from ideal mental health as a definition of abnormality
sets unrealistically high standards for mental health - unobtainable for a lot of people how many does a person need to lack before being “abnormal”
definition is specific to western european and north american culture
subjective judgments are required to assess the functioning , what is a realistic view of the world ?
strengths of deviation from ideal mental health as a definition of abnormality
it has a holistic approach and looks at many variables
define phobias
phobias are an anxiety disorder , they are all characterised by excessive fear and anxiety and are triggered by an object , place or situation . The extent of fear is out of proportion to any real danger presented by the phobic stimulus
What are the three categories of phobias that are recognised by the DSM-5
specific phobia
social phobia
agoraphobia
what is a specific phobia
a phobia of an object such as an animal or insect
what is a social phobia
social situations e.g public speaking
what is agoraphobia
fear of being in an outdoor place
what are behavioural characteristics
ways in which people act
what are emotional characteristics
ways in which people feel
what are cognitive characteristics
refers to the process of thinking knowing and perceiving
what are behavioural characteristics of phobias
PANIC- (cry scream , run away , freeze , cling , tantrums)
Avoidance or stimulus
endurance (remain in the presence of it but experience high anxiety, only possible when avoidance is not possible)
what are emotional characteristics of phobias
anxiety (unpleasantly high state of arousal)
fear when in contact or thinking about phobic stimulus (immediate and unpleasant response)
unreasonable emotional response
what are the cognitive characteristics of phobias
irrational beliefs
cognitive distortions (e.g seeing the stimulus as alien ugly disgusting or agressive looking)
selective attention to phobic stimulus
what is the two process model in terms of being a behavioural explanation for phobias
the two process model is based on the behavioural approach to phobias , a phobia is acquired through classical conditioning and maintained through operant conditioning.
how are phobias acquired according to a the two process model , a behavioural explanation
acquisition of phobias is through classical conditioning
Learning to associate something of which we initially have no fear (neutral stimulus) with something that alrwady triggers fear (an unconditioned stimulus)
UCS- produced a fear response
UCS associated with NS
NS becomes a CS
CS produces a CR of fear when presented
e.g little albert study
how are phobias maintained according to the two process model , a behavioural explanation for phobias.
maintenance of phobias takes place through operant conditioning
operant conditioning takes place when our behaviour is reinforced or punished , Reinforcement increases the likelihood behaviour will continue , in negative reinforcement an unpleasant stimulus is removed or avoided which results in a desirable consequence.
- Mowrer suggested that whenever we avoid a phobic stimulus we successfully escape the fear and anxiety that we would have suffered if we remained there , this reduction in fear reinforces the avoidance of the behaviour so the phobia is maintained.
give a strength of the two process model of phobias
phobias are maintained through avoidance of thr phobic stimulus and negative reinforcement , we therefore know when treating the phobia we need to come into cons for with the stimulus rather than avoiding it. helps us develop treatments e.g flooding and systematic desensitisation
give another strength of two process model as an explanation for phobias
there is supporting evidence little albert study
limitation of two process model as an explanation of phobias
conditioning is not the only way feaes are acquired some phobias havw an evolutionary aspect - biological preparedness
what are the two behavioural treatments for phobias
systematic desensatisation (SD)
flooding
explain how systematic desensitisation works as a behavioural treatment for phobias
sysetmatic desensitisation works through reciprocal inhibition .
Anxiety hierarchy- list of situations ranked for how much anxiety they produce.
Relaxation- including imagery and breathing techniques or sometimes medication.
Exposure- gradual exposure to phobic stimulus whilst relaxed at each stage of the hierarchy.
works through classical conditioning if the sufferer can learn to relax in the presence of their phobic stimulus they will be cured.
define reciprocal inhibition
reciprocal inhibition is the idea you cant be physiologically scared and relaxed at the same time.
explain how flooding works as a behavioural treatment for phobias
flooding involves immediate exposure to the phobic stimulus.
flooding: works though extinction.
Exposes patients to a very frightening situation without a build-up.
Learned response is extinguished when CS is encountered without the UCS. It will then no longer produce the CR of fear.
Ethical safeguards- patients must give informed consent to and be prepared for flooding.
outline one strength of systematic desensitisation as a behavioural treatment for phobias
it can be a very effective treatment
Barlow et al found success rates of between 60-90% for specific types of phobias when individuals committed to the phobias and stuck to the regime.
positive because this therapy is effective at removing the symptoms of a disorder without the need for potentially damaging drugs (anti-anxiety drugs would be given within the Biological approach) which often cause many side effects (e.g. drowsiness, risk of addiction).
outline one limitation of systematic desensitisation as a behavioural treatment for phobias - ethical issues
it is more ethical than flooding but may still cause some distress .
clients are subjected to their most feared situations in techniques such causing some clients to experience very high levels of distress.
This is a weakness because clients may not stay in therapy and may actually leave the therapeutic situation in a worse state than when they began due to the potential for high levels of distress.
outline one strength of flooding as a behavioural treatment for phobias - cost effective
it is cheaper than systematic desensitisation , evidence suggested by craske et al found SD and flooding have similar effectiveness.
flooding requires less sessions so is cheaper and more favourable as iy is more cost effective.
outline one limitation of flooding as a behavioural treatment for phobias - susbsitution
)Removing symptoms of a phobia does not mean removal of the cause- symptom substitution can occur.
outline one limitation of flooding as a behavioural treatment for phobias - ethical issues
can be more traumatic than sd , not a gradual exposure its immediate , if the client cant stick to trhe regime the phobia may acc become worse.
outline behavioural characteristics of depression
shift in activity levels - e.g reduced activity and energy
legarthy/agitation
disruption to sleeping/eating patterns - increase / decrease
agression/self harm - many are irritable and anger can be self directed
outline cognitive characteristics of depression
absolutist thinking - blck and white
negative self belief
negative self concept
feelings of guilt
poor concentration
negative bias - tendency to focus on the negative
outline emotional characteristics of depression
LOWERED MOOD
feelings of sadness
anger towards self and others
feelings of hopelessness
what are the two theory / model that are cognitive explanations for depression
becks theory
ellis abc model
explain becks theory as cognitive explanation for depression
Faulty information processing: attending to the negative aspects of a situation.
Negative self-schemas develop through experience (mental framework for interpreting sensory information – about ourselves in this case)
Negative triad - a person develops dysfunctional views of oneself some from three types of thinking that occur automatically when depresssed these are ;
-negative view of the world, self and future.
explain Ellis ABC model as a cognitive explanation for depression.
ellis explanation from a cognitive approach sees irrational thinking as the root cause of maintaining a depressed state. He uses the ABC model to explain how irrational thoughts explain our behaviour and emotional state.
A- Activating event- a negative event triggers a response.
B-Beliefs- lead us to over-react to the activating event, e.g. that life should always be fair (e.g. utopianism or mustabation).
C-Consequences- depression results when we over-react to negative life events.
give three examples of irrational beliefs from ellis ABC model and define them
musterbation - the ability we must always succeed
utopianism- the belief that life is always made to be fair
i-cant-stand-it-itis - belief that it is a disaster whenevr something doesnt go smoothly
outline one strength of becks theory as a cognitiv explanation for depression- forms types of therapy
becks theory forms the basis of cognitive behavioural therapy CBT, components of the negative triad can be easily identified and challenged in CBT . THis is a strength because it translates well into successful therapy and shows it is benefitting peoples lives
outline one strength of becks theory as a cognitive e explanation for depression- supporting evidence
grazioli and terry assessed 65 pregnant women for cognitive vulnerability and depression before and after birth . they found women judged to have high cognitive vulnerability were most likely to suffer from post natal depression. these cognitions can be seen before depression develops , beck may be right about cognition causing depression in at least some cases.
outline one limitation of becks theory as a cognitive explanation for depression- cannot explain everything
depression is a complex disorder e.g some patients are deeply angry and becks theory cannot easily explain this extreme emotion
Can’t explain all aspects of depression- e.g. hallucinations or ‘Cotard syndrome’.- some depression patients suffer from delusions that they are zombies
becks theory cannot explain all casses of depression and just focuses on one aspect of the disorder
outline one limitation of ellis ABC model as a cognitive explanation for depression- partial explanation
some cases of depression follow activating events , psychologists call this reactive depression and see it as a different kind of depression that arises withoyt obvious causes. this means ellis explanation only applies to some kinds of depression.
what is the cognitive approach to treating depression
cognitive behavioural therapy CBT
explain how cognitive behavioural therapy works as treatment for depression
it starts with an assessment between patient and therapist to clarify patients problems and jointly identify goals.one of the central tasks is to identify where there may be irrational or negative thoughts.
it then uses becks CT and ellis REBT as the cognitive element
followed by behavioural activation
explain how becks cognitive therapy works as part of the cognitive element of treating depression
Aims to identify negative automatic thoughts (negative triad) and challenge them.
Patient as scientist- test the reality of their beliefs.
Patient is set homework to complete often to help them test beliefs.
explain how ellis rational emotive behaviour therapy REBT works as part of the cognitive element of treating depression
Aims to identify and challenge irrational beliefs through a therapeutic but vigarous argument it uses three disputing techniques- logical , empirical or pragmatic
logical - self defeating beliefs do not follow logically from the information available
empirical- self defeating beliefs that may not be consistent with reality
pragmatic -emphasises the lack of usefulness of self disputing techniques
Homework.
explain the behavioural activation element of cognitive behavioural therapy
the therapost may work to encourage a depressed person to be more active and engage in more enjoyable activities . this behavioural activation will provide more evidence for the irrational behaviour of their beliefs.
outline one strength of cognitive treatments for depression-supporting research
research to suggest CBT is just as effective as medication for treating depression. MArch et al conducted a study and found both CBT and anti-depressants were both 81% effective and a combination of both was 86%. shows it is just as effective as medication
outline one limitation of cognitive treatments for depression - overemphasisss cognitive factors
overemphasises the importance of cognitive factors in depression , it focuses too much on the mind a patient may end up minimising the importance if the circumstances they are living under. e.g a person suffereing abuse. this means if CBT is used innappropriately it can demotivate people to change their situation
outline one limitation of cognitive treatments for depression- Less effective in severe cases
CBT may be less effective in severe cases of depression. some might be so severe thet cant motivate themself to take part in hard cognitive work of CBT, mayb need to treat people with antidepressants first until they are more motivated. limitation as it cannot be used as a sole treatment for all cases of depression
define OCD
Obsessive compulsive disorder is characterised by either obsessions and/or compulsive behaviours. Most people with a diagnosis of OCD havw both obsessions and compulsions
outline the emotional characteristics of OCD
anxiety and distress - unpleasant overwhelming feelings
accompanying depression -
guilt and disgust - irrational guilt
outline the cognitive characteristics of OCD
obsessive thoughts - eg reoccurring thoughts , always unpleasant
cognitive strategies to deal with obsessions - to help manage anxiety
insight into excessive anxiety - they are aware their obsessions and compulsions are not rational . tend to be hyperviggilant
outline the behavioural characteristics of OCD
Compulsions :
- compulsions are repetitive - feel compelled to repeat a behaviour
- compulsions reduce anxiety - vast majority of compulsive behaviours are carried out to manage anxiety produced by obsessions
Avoidance :
- sufferers of OCD tend to try and manage their OCD by avoiding situations that trigger it
outline the genetic behavioural approach to explaining OCD
-Lewis found that 37% of OCD patients had parents with OCD and 21% had siblings with OCD- this shows genetic vulnerability is passed through generations
- candidate genes create vulnerability for OCD
e. g 5HT1-D beta - involved in regulating the development of the serotonin system . - Taylor found OCD is polygenic - up to 230 genetic variations
- aetiologically heterogeneous- one grouo do genes may cause OCD in one person but another group of genes may cause the disorder in another person .
- according to the diathesis-stress-model certain genes leave some people more likely to suffer a mental disorder but it is not certain , some environmental stress (experience)is necessary to trigger the condition
outline the neural behavioural approach to explaining OCD
low levels of serotonin are associated with OCD
- some forms of OCD have been associated with impaired decision making and difficulty processing unpleasant emotions -
abnormal functioning in lateral side frontal lobes
left parahippocampal gyrus may be malfunctioning - difficulty processing unpleasant emotions
outline one strength of the biological approach to explaining OCD - supporting study
nestadt found that 68% of identical twins shared OCD whereas 31% of non identical twins shared it
this strongly suggests genetic influence on OCD
outline one limitation of the biological approach to explaining OCD - predictive value - number of genes
psychologist have not been successful at understanding all or the genes involved in OCD .
there are several genes involved and waycg only increases the risk of OCD by a fraction
the genetic explanation is unlikely to be useful as it provides little predictive value - not useful for developing treatments
outline one strength of the biological approach to explaining OCD - antidepressants
antidepressants that work on the serotonin system eg SSRI , to increase level of serotonin are effective in reducing OCD symptoms
this shows that the serotonin system is involved in OCD
outline one limitation of the biological approach to explaining OCD - is it a result of OCD or a cause
suggesting that various neurotransmitters and structures of the brain do not function normally in patients with OCD is not the same as saying they cause OCD
these biological abnormalities could be as a result of OCD rather than a cause
outline one limitation of the biological approach to explaining OCD - diathesis stress model
the diathesis stress model shoes environmental factors can trigger or increase risk of developing OCD
Cromer found that over half the OCD patients had traumatic past events and OCD was more severe in those with more than one trauma .
this shows it cannot be entirely genetic in origin it might be better to focus on environmental causes because we can do something about them
outline biological treatments for OCD
biological explanations for OCD imply that biological treatments may be successful , most obviously through drug treatments that target abnormal neurotransmitter levels
people with OCD havw low serotonin levels
SSRI - are used
What does SSRI stand for
selective serotonin reuptake inhibitors
how do SSRIs work to biologically treat OCD
low levels of serotonin are associated with OCD
Neurotransmitters (serotonin) is released to the synapse to travel to the next neuron . the serotonin left begging can either be reabsorbed by the presynaptic neuron or be destroyed by enzymes
by preventing the re - absorption and breakdown of serotonin - SSRI effectively increase its levels in the synapse and continue to stimulate the postsynaptic neuron
how are SSRI’s used to treat OCD inc dosage
they are antidepressants that prevents the reabsorption ans breakdown of serotonin
the typical dose of fluoxetine is 20mg a day but this can be increased
drugs are capsules or liquids
it can take up to 3 - 4 Months for them to work- when a SSRI is not effective after this time the dose can be increased to 60mg a day fluoxetine or combined with other drugs
they can also be combined with CBT to reduce a patients emotional symptoms of OCD e.g depressed/anxious
outline two drug alternatives that may be used if SSRIS don’t work
tricyclics
- older type of antidepressant e.g clomipranine - has the same effect on the serotonin system as SSRIs but has more severe side effects so it is kept for patients who don’t respond to SSRIS
SNRIs -serotonin-nonadrenaline inhibitors . - different class of antidepressants, they increase levels of serotonin as well as another different neurotransmitter, nonadrenaline
outline one strength of the biological approach to treating OCD - supporting evidence
soomro et al reviewed studies comparing SSRI’s to placebo effects
concluded that all 17 studies showed SSRIS had significantly better results for the SSRIs than the placebo
effectiveness was greatest when SSRIs were combined with CBT.
typically symptoms decline for around 70% of patients taking SSRI
outline one strength of the biological approach to treating OCD - cost effective and non disruptive
drugs are cheap compared to psychological treatments , which is good value for public services (NHS) they are also non disruptive to patients lives , you could fake drugs until your symptoms decline and not engage with the hard work of psychological therapy
outline one limitation of the biological approach to treating OCD - side effects
SSRI can havw side effects such as ;
indigestion
blurred vision
loss of sex drive
although they are temporary they may put people off using them
clomipramine side effects are more common and more serious :
more than 1 in 10 parents suffer weight gain erection problems tremors disruption to blood pressure and heart rhythm
such factors reduce effectiveness because people stop taking the medication.
