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AQA A Level Psychology > 4.1.4 - Psychopathology > Flashcards

4.1.4 - Psychopathology Flashcards

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1
Q

What are the 4 definitions of abnormality?

A
  • Statistical infrequency
  • Deviation from social norms
  • Failure to function adequately
  • Deviation from ideal mental health
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2
Q

What is statistical infrequency? example?

A

Occurs when an individual has a less common characteristic

Example: IQ
In any human characteristic, majority of scores are clustered around the mean. The further we go above or below that the fewer people there are attaining that score.
This is called a normal distributon - bell shaped curve
Average IQ 85-115 - lower than 70 = unusual/abnormal

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3
Q

Evaluation of statistical infrequency?

A

:) - Real life application - helps with doctors diagnosis
:( - Unusual characteristics can be positive - IQ scored over 130 just as unusual as below 70, but being intelligent isn’t undesirable. Statistical infrequency shouldn’t be used alone
:( - Not everyone benefits from a label - may have a negative effect on the way others view them and how they view themselves - people don’t need to be diagnosed as intellectually disabled

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4
Q

What is deviation from social norms? example?

A
  • Person behaving in a way that is different from how we expect them to behave
  • Usually noticeable

Example: Antisocial Personality Disorder (impulsive, aggressive, irresponsible)

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5
Q

Evaluation of deviation from social norms?

A

:) - Real life application - Can be used to diagose disorders and is used in clinical practice - shows it has value in psychiatry
:( - Not a sole explanation - Other factors to consider
:( - Cultural relativism - Social norms vary between cultures and generations
:( - Can lead to human rights abuses - can be used to maintain control over minority groups e.g. drapetomania in black slaves

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6
Q

What is failure to function adequately? Example?

A
  • An individual cannot cope with everyday life
  • They are unable to maintain basic standards of nutrition and hygiene
  • Unable to hold down a job or maintain relationships

Example: Rosenhan and Seligman suggested some signs to determine when someone is not coping:
- Not conforming to standard interpersonal rules
- Person experiences severe personal distress
- Behaviour becomes irrational or dangerous to themselves or others

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7
Q

Evaluation of failure to function adequately?

A

:) - Consider’s the patient’s POV - acknowledges experience of the individual
:) - Represents threshold for help - means treatment and services can be targeted to those who need them most
:( - Is it simply just a deviation from social norms? - hard to define between the two: not having a job may seem like failing to function for some people but not others
:( - Labelling and social control - “Failing to function” as a label could add to someone’s issues and lead to a self-fulfilling prophecy

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8
Q

What is deviation from ideal mental health?

A
  • Ignore what makes someone abnormal and instead think about what makes anyone “normal”
  • Once we have an idea of what ideal mental health looks like, we can see who deviates from this

Marie Jahoda (1958) suggested that the absence of mental illness is not a sufficient indicator of mental health

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9
Q

What is the criteria of good mental health according to Jahoda (1958)?

A
  • We have no symptoms of distress
  • We are rational and can perceive ourselves accurately
  • We self-actualise (reach our potential)
  • We can cope with stress
  • We have a realistic view of the world
  • We have good self-esteem and lack guilt
  • We are independent of other people
  • We can successfully work, love and enjoy our leisure
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10
Q

Evaluation of deviation from ideal mental health?

A

:) - Comprehensive - Covers a broad range of criteria for mental health
:( - Cultural relativism - Some of the ideas of Jahoda are specific to European and North American cultures e.g. collectivist cultures would see being independent as a negative thing. It is hard to apply to other cultures
:( - Sets unrealistically high standards for mental health - most people are probably seen as abnormal against this criteria

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11
Q

What is a phobia? (DSM-5 definition)

A

Excessive fear and anxiety is triggered by an object,place or situation

(Extent of fear is out of proportion to any real danger presented by the phobic stimulus)

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12
Q

Categories of phobias?

A

Specific phobia - Phobia of an object or situation
Social anxiety - Phobia of a social situation such as public speaking or using a public toilet
Agoraphobia - Phobia of being outside or in a public space

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13
Q

3 types of characteristics of phobias?

A
  1. Behavioural
    2 .Emotional
    3 .Cognitive
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14
Q

Behavioural characteristics of phobias?

A
  • Panic (crying, screaming, running away)
  • Avoidance (effort to avoid stimulus - can be hard in daily life)
  • Endurance (remains in presence of stimulus but experiences high levels of anxiety)
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15
Q

Emotional characteristics of phobias?

A

Anxiety
- unpleasant state of high arousal, prevents relaxing or positive emotion
- can be long term
- unreasonable
- very strong emotional response to something that poses little harm

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16
Q

Cognitive characteristics of phobias?

A
  • Selective attention to the phobic stimulus
  • Irrational belief
  • Cognitive distortions
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17
Q

What does Mowrer’s two-process model suggest about the formation of phobias?
(behaviourist approach)

A
  • Phobias are acquired using classical conditioning
  • Phobias continue because of operant conditioning
    e.g. Watson and Raynor’s Little Albert study
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18
Q

How are phobias maintained through operant conditioning?

A
  • When we avoid a phobic stimulus we escape the fear
  • Reinforced avoidance behaviour - phobia is maintained
  • This is negative reinforcement
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19
Q

Evaluation of the two-process model?

A

:) - Explanatory power - important implications for therapy: explains why patients need to be exposed to feared stimulus
:( - Not all avoidance is motivated by anxiety reduction - some avoidance behaviour may be motivated by positive feelings of safety (positive reinforcement)
:( - Incomplete - doesn’t take into account biological preparedness (phobias of things which may have been a danger in our evolutionary past)
:( - There are phobias that don’t follow trauma
:( - Ignores cognitive aspects e.g. selective attention, irrational beliefs

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20
Q

What are the 2 behaviourist treatments of phobias?

A

Systematic desensitisation
Flooding

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21
Q

What is systematic desensitisation?

A
  • Gradually reduces anxiety through classical conditioning
  • If sufferer can learn to relax in presence of phobic stimulus they will be cured

Involves:
- Counterconditioning - new response is learned (stimulus paired with relaxation instead of anxiety)
- Reciprocal Inhibition - impossible to be afraid and relaxed at the same time - one emotion prevents the other

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22
Q

What 3 processes are involved in systematic desensitiation?

A
  • Anxiety hierarchy
  • Relaxation
  • Exposure
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23
Q

Evaluation of systematic desensitisation?

A

:) Very effective - shown by Gilroy (2003)
:) - Suitable for a diverse range of patients - learning difficulties may make it hard to understand what is happening during flooding, and so SD is more appropriate
:) - Acceptable to patients - does not cause the trauma that flooding does and leads to lower refusal and attrition rates

:( - Time consuming as can take many sessions
:( - May not be appropriate for more generalised phobias (e.g.social phobia) where there is no obvious target behaviour so difficult to devise hierarchy
:( - Progress in therapy may not generalise outside of clinical setting - when the person must face their fear without support from therapist

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24
Q

What is flooding?

A

Exposes patients to stimulus without gradual build up
Immediate exposure

How does it work?
- stops phobic responses very quickly
- no avoidance - patient learns stimulus is harmless
- classical conditioning -extinction
- conditioned stimulus encountered without unconditioned stimulus
- conditioned stimulus no longer produces conditioned response

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25
Q

Ethical safeguards of flooding?

A
  • very unpleasant
  • need informed consent
  • usually given choice of SD or flooding
26
Q

Evaluation of flooding?

A

:) - Cost effective - highly effective and quicker than alternatives (makes it cheaper as it is a one-off)
:( - Less effective for some types of phobia e.g. social phobia
:( - Traumatic
:( - Symptom substitution- when one phobia disappears another may take it’s place

27
Q

What is depression?

A

All forms of depression are characterised by change in mood

DSM-5 definitions of depression:
Major depressive disorder - severe but often short-term depression
Persistent depressive disorder - long term or recurring depression
Disruptive mood dysregulation disorder - childhood temper tantrums
Premenstrual dysphoric disorder - disruption to mood prior to and/or during menstruation

28
Q

What are the 3 types of characteristics of depression?

A
  1. Behavioural
  2. Emotional
  3. Cognitive
29
Q

What are behavioural characteristics of depression?

A

Activity levels - reduced energy, making them lethargic - has a knock on effect (may drop out of work/education)

Disruption to sleep and eating - insomnia, particularly premature waking and/or increased need for sleep (hypersomnia)

Aggression or self-harm - irritable and can be verbally/physically aggressive , aggression can be directed towards self and could lead to self-harm or suicide attempts

30
Q

What are the emotional characteristics of depression?

A

Lowered mood - more pronounced than regular sadness, “empty”

Anger

Lowered self-esteem - self-loathing

31
Q

What are the cognitive characteristics of depression?

A

Poor concentration

Attending to and dwelling on the negative - bias towards recalling unhappy events rather than happy

Absolutist thinking - tend to think all good or all bad, “black and white thinking”

32
Q

What are the 2 cognitive explanations of depression?

A

Beck’s cognitive theory of depression
Ellis’s ABC model

33
Q

What is Beck’s cognitive theory of depression?

A

Beck (1967) suggests that a person’s cognition create a vulnerability
The model has 3 parts:

Faulty information processing - attend to negatives and ignore positives, everything is bad and there are no shades of grey

Faulty self schemas - (a package of information about ourselves) - can lead to negative self schema where we interpret information about ourselves in a negative way

The negative triad - there are 3 types of negative thinking: 1) Negative view of the world, 2) negative view of the future, 3) negative view of the self

34
Q

Evaluation of Beck (1967)?

A

:) - Good supporting evidence - Grazioli and Terry (2000), 65 pregnant woman assessed for cognitive vulnerability before and after birth. Those assessed as being high in cognitive vulnerability were more likely to have post-natal depression.
Also Clark and Beck’s (1999) meta analysis found there was solid support for all these factors.

:) - Practical application - CBT

:( - Does not explain all aspects of depression e.g. anger, hallucinations, strange beliefs (e.g. cotard syndrome - delusion they are zombies). This isn’t explained by Beck.

35
Q

What is Ellis’s (1981) ABC model?

A
  • Suggests that people with good mental health have rational thinking in ways that allow them to be happy and free of pain.
  • Suggests that people with poor mental health have irrational thinking and have thoughts that interfere with us being happy and free of pain.

The ABC model explains how irrational thoughts effect us:
A) Activating event - irrational thoughts triggered by external events, triggering irrational beliefs

B) Belief - e.g. musterbation, i-can’t-stand-it-itis, utopianism

C) Consequences - when activating event triggers irrational beliefs, there are emotional and behavioural consequences

36
Q

What is musterbation?

A

Belief we must always succeed or achieve perfection

37
Q

What is i-can’t-stand-it-itis?

A

The belief that it is a major disaster whenever something goes badly

38
Q

What is utopianism?

A

Belief that life is always meant to be fair

39
Q

Evaluation of Ellis (1981) ?

A

:( - A partial explanation - Supports reactive depression (depression following activating events), but some depression doesn’t have an obvious cause so the explanation only applies to some kinds of depression
:) - A practical explanation - led to successful therapy, CBT, support from Lipsky et al (1980) which suggests irrational beliefs had some role in depression
:( - Leaves out some aspects - doesn’t explain anger/delusions
:( - Ethical issues - it is effectively blaming the depressed person which is unfair

40
Q

What occurs in Cognitive Behavioural Therapy?

A
  • Clarify patient’s problems in an assessment
  • Identify goals for the therapy
  • Put together a plan
  • Identify where there might be irrational thoughts that need to be challenged
  • Change negative thoughts. Put more useful behaviours into place
41
Q

What are the 2 types of CBT?

A
  • Beck’s cognitive therapy
  • Ellis’s rational emotive behaviour therapy
42
Q

What is involved in Beck’s Cognitive Therapy?

A
  • Aims to identify negative thoughts about the world, future and self (negative triad)
  • Once identified these can be challenged
  • Also aims to test reality of beliefs. Set homework
  • ‘Patient as scientist’
  • Acts as counter-evidence against their irrational beliefs
43
Q

What is Rational Emotive Behaviour Therapy? (REBT)

A

ABCDE (ABC model + DE where D=Dispute E=Effect)

Identifies and disputes irrational thoughts
Argument with therapist to try and change irrational belief and break the link between negative life events and depression.

Different disputing methods:
- Empirical argument - disputing as to whether there is actual evidence to support the negative belief
- Logical argument - disputing whether the negative thought logically follows the facts

44
Q

What is behavioural activation?

A

A therapist might encourage depressed patient to be more active and engage in enjoyable activities.

45
Q

Evaluation of CBT?

A

:) - Effective - lots of supporting evidence e.g. March et al (2007) found that CBT is just as effective as medication and helpful alongside it

:( - May not work in severe cases - In some cases severity of depression means patients aren’t motivated to engage with CBT and they may not be able to pay attention to the session SO CBT cannot be sole treatment in some cases

:( - Success may be due to therapist/patient relationship - it may be the quality of the relationship between the therapist and the patient rather than the technique - supports the idea that simply having opportunity to talk to someone who will listen is what matters most

46
Q

What is OCD according to DSM-5?

A
  • Range of related disorders
  • Have repetitive behaviour accompanied by observed thinking in common
  • OCD = Obsessions and/or compulsions
  • Trichotillomania - Compulsive hair pulling
  • Hoarding disorder - Compulsive gathering of possessions, and inability to part with anything
  • Excoriation disorder - Compulsive skin pricking
47
Q

What is the OCD cycle?

A

Obsessive thought → Anxiety → Compulsive behaviour (to reduce anxiety) → Temporary relief

The cycle repeats

48
Q

3 types of characteristics for OCD?

A
  1. Behavioural
  2. Emotional
  3. Cognitive
49
Q

Behavioural characteristics of OCD?

A

Compulsions:
Two elements =
1. Compulsions are repetitive e.g. hand washing, tidying, counting, praying, crossing fingers
2. Compulsions reduce anxiety e.g. hand washing as a response
to fear of germs
About 10% only have compulsions and no obsessions

Avoidance
Attempt to reduce anxiety by avoiding stimulus that triggers it - can lead to people avoiding ordinary situations and interfering with a normal life

50
Q

Emotional characteristics of OCD?

A

Anxiety and distress - accompanies both compulsions and obsessions, urge to repeat a behaviour causes anxiety

Often accompanying depression - low mood and lack of enjoyment

Guilt and disgust - irrational guilt or disgust - could be at self, moral issues or external factors

51
Q

Cognitive characteristics of OCD?

A

Obsessive thoughts - thoughts that occur over and over and are always unpleasant - experienced by about 90% of OCD sufferers

Cognitive strategies to deal with obsessions - may help manage anxiety but may make sufferer appear abnormal and distract from everyday tasks e.g. praying

Insight into excessive anxiety - aware their obsessions and compulsions are irrational- Hypervigilant - constant alertness and attention focussed on potential hazards

52
Q

What are 2 biological explanations of OCD?

A
  • Genetic explanations
  • Neural explanations
53
Q

Genetic explanations of OCD?

A

Genes are involved in individual vulnerability to OCD

Diathesis-stress model: Certain genes leave some people more likely to suffer a mental disorder - some environmental stress is necessary to trigger it

Candidate genes: Genes that have been identified to create vulnerability for OCD - some of these are involved in regulating the development of the serotonin system

OCD is polygenic: Not caused by one single gene but several

Different types of OCD: Aetiologically Heterogeneous - one group of genes may cause OCD in one person but a different group of genes may cause OCD in another

54
Q

Evaluation of genetic explanation of OCD?

A

:) - There is good supporting evidence - e.g. Twin studies by Nestadt et al (2010) strongly suggest genetic influence

:( - Too many candidate genes - twin studies suggest genetic component but all genes involved have not been identified - each genetic variation only increases the risk of OCD by a fraction - this means the explanation provides little predictive value

:( - Environmental risk factors - can also trigger or increase risk of OCD, over half of OCD patients in Cromer et al (2007) had a traumatic event in their past showing OCD cannot be entirely genetic in it’s origin

:( - Twin studies flawed - identical twins may be more similar due to environment - difficult to generalise

55
Q

Neural explanations of OCD?

A

Genes associated with OCD are likely to affect levels of key neurotransmitters and structures in the brain

Serotonin is a neurotransmitter that is believed to be involved in regulating mood.
Low levels of this means that normal transmission of mood relevant information does not take place.
This affects mood and other mental processes.
Some cases of OCD may be explained by reduction in functioning of the serotonin system in the brain.

Some cases can be associated with impaired decision making.
May be associated with abnormal functioning of the lateral frontal lobes of the brain.
(Frontal lobes responsible for logical thinking and making decisions)
Evidence suggests the left parahippocampal gyrus functions abnormally in OCD and processes unpleasant emotions.

56
Q

Evaluation of neural explanation of OCD?

A

:) - Some supporting evidence - some antidepressents work purely on the serotonin system, they increase serotonin and this reduces OCD symptoms - suggests that serotonin is linked to OCD.

:( - Unclear what neural mechanisms are involved - research has showed other brain symptoms that may be involved sometimes - no system has been found that always plays a role in OCD.

:( - Cannot establish cause and effect- abnormalities in the brain could be as a result of OCD rather than a cause.

:( - Serotonin-OCD link may be co-morbidity (2 disorders together) with depression - many OCD sufferers become depressed, this depression probably involves disruption of the serotonin system, which poses a problem with the serotonin system being a basis for OCD.

57
Q

Example of biological treatments of OCD?

A

Drug treatments - aims to increase or decrease neurotransmitters in the brain or to increase/decrease their activity

58
Q

Example of drug treatment for OCD and how does it work?

A

SSRI’s (Selective Serotonin Reuptake Inhibitor) - antidepressant

  • They prevent the reabsorption and breakdown of serotonin
  • Increase levels of serotonin in the synapse
  • Continue to stimulate the post-synaptic neuron
  • Compensates for faulty serotonin system in OCD suffers
  • Takes 3-4 months of daily use to have impact
59
Q

How does synaptic transmission work normally?

A

e.g. Serotonin

Serotonin is released by neurons in the brain.
Released by presynaptic neurons and travels across a synapse.
Serotonin conveys the signal from the presynaptic neuron to the postsynaptic neuron.
Then it is reabsorbed by the presynaptic neuron where it can be broken down and re-used.

60
Q

How can SSRI’s be combined with other treatments?

A
  • Often used alongside CBT to treat OCD
  • Drugs reduce emotional symptoms (anxiety and depression)
  • Patients can then engage more with CBT
  • Some people respond better to different things - some just do CBT, some just do drugs, others do both
  • Occasionally other drugs are prescribed alongside SSRI’s
61
Q

Alternatives to SSRI’s?

A
  • Tricyclics e.g. clomipramine - have the same effect on serotonin system as SSRI’s but has more severe side effects
  • SNRIS (Serotonin-noradrenaline reuptake inhibition) - increase levels of both serotonin and nonadrenaline
62
Q

Evaluation of biological treatments of OCD?

A

:) - Effective - there is clear evidence of SSRI’s reducing severity of symptoms e.g. in Soomro et al (2009) symptoms declined in 70% of patients taking SSRI’s BUT not everyone :( .

:) - Cost effective and non disruptive - cheap compared to psychological treatments, non disruptive to patient’s lives.

:( - Side effects - indigestion, blurred vision and loss of sex drive.

:( - Unreliable evidence for drug treatments - some believe evidence is biased because research is supported by drug companies - publication bias = significant results published, anything else ignored.

:( - Some OCD follows trauma - believed to be biological in origin but it can have other causes such as response to traumatic life event.

AQA A Level Psychology (11 decks)

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