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A Level Psychology > 4.2 - Depression , phobias, OCD and Abnormality > Flashcards

4.2 - Depression , phobias, OCD and Abnormality Flashcards

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1
Q

What type of disorder is depression?

A

A mood disorder

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2
Q

What are the two types of depression?

A

• major depressive disorder - an episode of depression that can occur suddenly
- can be reactive , caused by external factors eg. The death of a loved one
- can be endogenous , caused by internal factors eg. Neurological factors

• manic depression - alternation between two mood extremes ( mania and depression)
- change in mood often occurs in regular cycles of days or weeks
- episodes of mania involve overactivity , rapid speech and feeling extremely happy or agitated

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3
Q

What are the cognitive characteristics of depression?

A
  • Irrational and negative self beliefs
  • suicidal thoughts
  • slower thought processes - difficulty concentrating and making decisions
  • poor levels of concentration and unable to make decisions
  • ‘black and white ‘ thinking as see most situations as all bad
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4
Q

What are the emotional characteristics of depression?

A

Negative emotions eg.
- Sadness
- anger
- diurnal mood variation = changes in mood throughout the day
- anhedonia = no longer enjoying activities or hobbies that used to be pleasurable

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5
Q

What are behavioural characteristics of depression?

A
  • Increased or decreased levels of activity
  • sleep disturbances , insomnia ( being unable to sleep ) or hypersomnia ( sleeping a lot more than usual )
  • change in appetite
  • pain eg. Headaches , joint ache and muscle ache
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6
Q

What is the cognitive approach assumption?

A

That behaviours are controlled by thoughts and beliefs

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7
Q

What is depression?

A

A mental disorder characterised by low mood and energy levels

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8
Q

What are the 4 types of depression?

A

• major depressive disorder - severe but often short- term
• persistent depressive disorder - long term or recurring
• Disruptive mood dysregulation disorder - childhood temper tantrums
• premenstrual dysphoric disorder

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9
Q

Why did beck create becks cognitive theory (1967)?

A

Suggest that people are more vulnerable to depression due to cognitions

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10
Q

What are the 3 things that make up beck’s cognitive theory?

A

• faulty information processing
• negative self- schema
• negative triad

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11
Q

What is faulty information processing?

A

• focuses on the negative aspects
• ignoring the positive
• blowing small problems out of proportion
• thinking in black and white

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12
Q

What is a negative self-schema?

A

View self in a negative way

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13
Q

What is the negative triad?

A

Automatic dysfunctional view of self
negative view of the :
• the world
• the future
• of yourself

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14
Q

What is Ellis’s ABC model (1962) ?

A

• the model claims that disorders begin with an activating event ( A ) - eg. A failed exam
• leading to a belief ( B ) about why this happened
• this may be rational ( eg. I didn’t prepare well enough)
• or irrational ( eg. I’m too stupid to pass exams )
• the belief leads to a consequence ( C )
• rational beliefs produce appropriate consequences - eg. More revision
• irrational beliefs produce maladaptive ( bad and inappropriate) consequences ( eg. Getting depressed )

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15
Q

What does therefore ABC stand for?

A

A - activating event
B - Belief
C - consequence

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16
Q

What are the strengths of the cognitive explanation of depression?

A

• useful approach to depression as it considers the role of thoughts and beliefs
• Hollon and Kendall (1980) developed the Automatic thoughts questionnaire ( ATQ)
to measure the negative thinking associated with depression
• Harrell and Ryon (1983) used the ATQ to compare negative thinking in 114 depressed and non depressed participants
- the depressed participants scored a significantly higher ( more negative thinking) than the other groups , supporting a correlation between negative thinking and depression

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17
Q

What are the weaknesses for the cognitive explanation of depression?

A

• faulty cognitions may simply be the consequence of depression rather than its cause
- for eg. Depression may be caused by a chemical inbalance in the brain which causes people to think very negatively
• the person could begin to feel like themselves are to blame for their problems

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18
Q

What is a strength of beck’s cognitive theory based on supporting evidence?

A

• Grazioli & Terry (2000) assessed 65 pregnant women and found that those who had high cognitive vulnerability were more likely to suffer post- natal depression
• Clark & Beck ( 1999) reviewed research and found support as cognitions can be seen before which may have caused depression

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19
Q

What does CBT Stand for ?

A

Cognitive behaviour therapy

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20
Q

What is CBT ?

A
  • CBT aims to identify and change the patients faulty cognitions
  • the idea is that patients learn how to notice negative thoughts when they have them and test how accurate they are
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21
Q

What are the 3 key assumptions of the cognitive approach?

A
  • individuals who suffer from mental disorders have distorted and irrational thinking - which may cause maladaptive behaviour
  • it is the way you think about the problem rather than the problem itself which causes the mental disorder
  • individuals can overcome mental disorders by learning to use more appropriate cognitions - if people think in more positive ways, they can be helped to feel better
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22
Q

What did Albert Ellis propose in 1962?

A

That good mental health is the result of rational thinking

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23
Q

What is the evaluation of Ellis’ theory?

A
  • only offers a partial explanation
  • some depression does occur as a result of an activating event
  • however not all depression arises as a result of an obvious cause
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24
Q

What is a strength of beck’s cognitive theory based on CBT ?

A

Forms basis of cognitive behavioural therapy so triad can be identified and challenged and is successful

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25
Q

What is a weakness of beck’s cognitive theory based on?

A
  • Does not explain all aspects of depression such as aggression, hallucinations or bizarre beliefs
  • eg. Cotard syndrome - the delusion that they were zombies ( Jarrett 2013 )
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26
Q

What are 2 strengths of Ellis’ ABC model?

A

1) explains reactive depression - ( depression following activation events )
2) practical use in CBT as led to successful therapy changing irrational beliefs so must have a role

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27
Q

What are the 4 steps of CBT ?

A

1) assessment where client and patient clarify problems
2) identify goals and plan
3) identify irrational or negative thoughts that benefit from a challenge
4) change thoughts by putting effective behaviour’s in place using Becks , REBT or both

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28
Q

What are the 5 steps of Becks cognitive theory ?

A

1) identify automatic thoughts in the negative triad
2) challenge these thoughts
3) help test reality of negative beliefs
4) homework to investigate truths of negative beliefs
5) introduce evidence to prove statements incorrect

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29
Q

What does REBT stand for?

A

Rational emotive behavioural therapy

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30
Q

What are the steps of REBT ?

A

1) identify and dispute irrational thoughts/ beliefs
2) challenge though argument to break links between negative life events and depression

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31
Q

What are the 2 argument types?

A

Empirical - disputing whether there is evidence to support the belief

Logical - disputing whether negative beliefs follow facts

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32
Q

What is behavioural activation?

A

Therapist might encourage to be more active and engage in enjoyable activities to provide more evidence against irrational beliefs

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33
Q

What is a strength of CBT by march et al. (2007) ?

A

-Compared CBT effectiveness to antidepressants in 327 adolescents
- after 36 weeks, 81% of the CBT group , 81% of the antidepressant group and 86% who took both improved
- Shows CBT is as effective as drugs and should be NHS first choice

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34
Q

What is a weakness of CBT in terms of extreme cases?

A

Clients may not be motivated or able to concentrate on hard cognitive work so antidepressants may be used to help them be more alert so not always the sole treatment

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35
Q

What is a weakness of CBT in terms of therapist - patient relationship by Rosenzwig (1936) ?

A
  • suggested that differences in psychotherapy treatments might be small as the quality of therapist- patient relationship may determine success not the technique
  • comparative reviews eg. Luborsky et al. 2002 finds small differences, supporting the view that talking matters most
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36
Q

What is the effectiveness of CBT ?

A

Pros:
- Smith and Glass did a meta- analysis of therapies and found that out of 10 different therapies, CBT had the second highest success rate

Cons :
- the effectiveness of the therapy depends on the quality and competence on the therapist
- research shows that as much as 15% of the variance in outcome is due to the therapists competence

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37
Q

What is the appropriateness of CBT ?

A

Pros :
- there are no side effects to CBT and there is less chance of relapse compared to drug therapy- thus appropriate for lots of different types of clients

Cons :
- CBT requires lots of commitment and motivation from the client
- not appropriate for those who want a quick fix

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38
Q

What is musturbation?

A

The belief that it is a disaster when something doesn’t run smoothly

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39
Q

Define Utopianism

A

The belief that life must always be fair

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40
Q

What are the advantages of CBT ?

A
  • empowers patients = puts them in charge of their own treatment by teaching them self- help strategies = fewer ethical issues than with other therapies like drug therapy
  • DeRubeis et al (2005) compared CBT and drug therapy as depression treatment’s in a placebo controlled trial , both treatments are more effective than the placebo after 8 weeks , generally the 2 therapies were similarly effective but CBT may have been less effective than drug therapy in cases where therapists lacked experience
  • Hollon et al. (2005) = compared participants from a alDeRubeisbstudy after they were withdrawn from treatment ( CBT and drug treatment) with participants who continued drug treatment
    Participants withdrawn from CBT were significantly less likely than patients withdrawn from drug treatment to have relapsed after one year and no more likely to have relapsed than patients who continued drug treatment
  • Brandsma et al (1978) found that CBT is particularly effective for people who put a lot of pressure on themselves and feel guilty about being inadequate
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41
Q

What are the disadvantages of CBT ?

A
  • may take long and be costly
  • as Derubeis et al. (2005) found CBT may only be effective if the therapist is experienced
  • the person could begin to feel like he or she is to r for their problems
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42
Q

What is abnormality?

A

A deviation from social Norms

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43
Q

Define Statistical infrequency ?

A

Behaviour that doesn’t fit into the normal range ( numerically rare or unusual ) is seen as abnormal

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44
Q

What is deviation from social norms?

A
  • concerns behaviour that is different from the accepted standards of behaviour in a community or society
  • Norms are specific to the culture we live in
  • A person with antisocial personality disorder is impulsive, aggressive and irresponsible
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45
Q

What are some limitations of defining abnormality ?

A
  • Deviation from social norms is that it can be used to justify the removal of ‘unwanted’ people from society for eg. People opposing a particular political regime could be said to be abnormal
  • What is considered acceptable or abnormal can change over time for eg. As recently 1974 homosexuality was as classified in the Diagnostic and statistical Manual of Mental disorders (DSM) as a disorder —> but the diagnosis was dropped because it was found that homosexuality wasn’t as infrequent as previously thought and that homosexuals don’t differ from heterosexuals in terms of psychological well- being
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46
Q

What is a example of Statistical infrequency?

A

IQ

  • less than 70 ( bottom 2.5%) classed as mental illness
  • Numerically rare - liable to o receive a diagnosis or intellectual disability = ABNORMAL
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47
Q

SI classes mental illnesses as statistically rare , what are the statistics ?

A
  • 1 in 4 people = mental illness —> relatively common
  • thus a lot of people wouldn’t be diagnosed
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48
Q

What are the issues of defining abnormality simply in terms of Statistical infrequency?

A
  • doesn’t take account of the desirability of behaviour - just its frequency for eg. A very high IQ is abnormal likewise a very low one but having a high IQ is desirable whilst having a low IQ is undesirable
  • no distinction between rare , slightly odd behaviour and rare, psychologically abnormal behaviour
  • no definite cut- off point where normal behaviour becomes abnormal behaviour
  • some behaviours that are considered psychologically abnormal are quite common eg. Mild depression
  • Hassett and White (1989) argue that you cannot use statistical infrequency to define abnormality because of this —> using this statistical infrequency idea , some disorders would not be classed as anything unusual
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49
Q

Define Dysfunctional behaviour

A

Behaviour which goes against the accepted standards of behaviour

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50
Q

Define Observer discomfort

A

Behaviour that causes other individuals to become uncomfortable

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51
Q

Define Unpredictable behaviour

A

Impulsive behaviour that seems to be uncontrollable

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52
Q

Define irrational behaviour

A

Behaviour that’s unreasonable and illogical

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53
Q

Define personal distress

A

Being affected by emotion to an excessive degree

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54
Q

What is failure to function adequately?

A

When a person can no longer cope with the demands of every day life
Eg. Unable to maintain basic standards of nutrition and hygiene

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55
Q

What does Rosenhan and Seligman suggest?

A

They suggest that personal dysfunction has 7 features, the more the person has the more they are classed as abnormal

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56
Q

How is the individuals ability to cope with everyday life assessed?

A

The global Assessment or functioning scale ( GAF ) which rates their level of social, occupational and psychological functioning

57
Q

What are the 6 conditions that Jahoda (1958) associated with the ideal mental health?

A

1) positive self-attitude
2) self actualisation ( realising your potential being fulfilled )
3) resistance to stress
4) personal automany ( making your own decisions, being in control)
5) Accurate perception of reality
6) adaptation to the environment

58
Q

Explain how the ideal of mental health varies across time and between cultures?

A
  • what’s considered mentally healthy at one time wouldn’t necessarily be at another
  • for eg. In some cultures It is considered abnormal for women to enjoy sex - they may be forced to have their clitoris surgically removed to prevent their enjoyment
  • in Victorian times - women who enjoyed sex were deemed abnormal and hence Freud coined the term ‘ NYMPHOMANIA’ there’s still influence from this today - there are still DOUBLE STANDARDS about male and female sexual activity
59
Q

What are 4 symptoms which are associated with mental illness?

A

1) impairment or intellectual functions such as memory and comprehension
2) Alterations to mood that lead to delusional appraisals of the past or future or lack of any appraisal
3) Delusional beliefs - eg. Persecution or jealousy
4) Disordered thinking - the person may be unable to appraise their situation or communicate with others

60
Q

What are the strengths of F2FA ?

A
  • assess the degree of abnormality as the GAF is scored on a continuous scale it allows clinicians to see the degree to which individuals are abnormal
  • It provides a practical checklist individuals Can use to assess their level of abnormality
61
Q

What are the limitations or F2FA ?

A
  • abnormality is not always accompanied by dysfunction - psychopaths people with dangerous personality disorders can cause great harm but appear normal
  • there are times I’m peoples lives when it’s normal to suffer distress like loved ones passing
  • Grieving is psychologically healthy to overcome loss - F2FA doesn’t consider this
62
Q

What is an example of a limitation or F2FA ?

A
  • Harold shipman an English doctor who murdered at least 215 patients over a 23 year period seemed to be a respectable doctor
  • he was abnormal but didn’t display features or dysfunction
63
Q

How to do psychologists try to classify mental disorders?

A
  • DSM is the American psychiatric associations diagnostic and statistical manual of mental disorders
  • DSM is used to classify disorders using defined diagnostic criteria - includes a list of symptoms which can be used as a tool for diagnosis
  • The DSM makes diagnosis concrete and descriptive
  • Classifications allow data to be collected about a disorder - helps in the development of new treatments and medication
  • this type of classification has been criticised for stigmatising people and ignoring their ‘uniqueness’ by putting them in artificial groups
64
Q

What are the strengths of the definition ( DFIMH ) ?

A
  • it’s a positive definition which emphasises positive achievements rather than failures
    - the definition allows targeting of which areas to focus on when treating abnormalities
65
Q

What are the limitations of the definition ( DFIMH ) ?

A
  • has over-demanding criteria - most people do not meet all ideals
  • fewer people experience personal growth all the time
  • it has subjective criteria many of the criteria are vague and difficult to measure
66
Q

What are the issues surrounding self actualisation ?

A

-Difficult to measure and is different to different people
- mental illness rely more on subjective opinion thus LACK RELIABILITY - may be misdiagnosed

67
Q

Define cultural relativism

A

The view that behaviour cannot be judges unless it’s viewed in the context of culture in which originates

68
Q

What are the 7 characteristics that Rosenham & seligman (1989) suggested that would not enable someone to function adequately?

A

1) suffering
2) maladaptivness ( being a danger to self )
3) vividness when unconventionally ( standing out )
4) unpredictability and loss of control
5) irrationality & incompressibility
6) causes the observer discomfort
7) violate moral/social standards

69
Q

Define deviation from ideal mental health

A

rather than defining what is abnormal we define what is normal/ ideal and anything that deviates from this is regarded as abnormal - this requires us to decide on the characteristics we consider necessary to mental health

70
Q

What does OCD stand for?

A

Obsessive compulsive disorder

71
Q

What are OCD symptoms?

A

behavioural : compulsions - often repetitive and relieves anxiety temporarily for the sufferer eg. Checking or cleaning

Emotional : Anxiety/ distress, accompanying depression eg. Disgust/guilt (irrational)

Cognitive : obsessive thoughts, cognitive coping strategies, insight into excessive anxiety

72
Q

What is the criteria that must be followed for the DSM to classify it as obsessions?

A
  • persistent and reoccurring thoughts, images or impulses that are unwanted and cause distress to the person experiencing them for eg. Imagining that you’ve left the door unlocked and burglars are rampaging through your house
  • the person actively tries to ignore the thoughts, images or impulses but is unable to
  • the obsessions have not been caused by other physiological substances, such as drugs
73
Q

Define OCD

A

An anxiety disorder that is characterised by experiencing persistent and intrusive thoughts which occur as obsessions, compulsions or both

74
Q

What are obsessions?

A

Cognitive internal intrusive thoughts eg. There are germs everywhere and they can harm me

75
Q

What are compulsions ?

A

Behavioural external repetitive behaviours eg. I need to wash my hands each time I touch something to avoid the germs and getting ill

76
Q

Define Excoriation

A

Compulsive skin pulling

77
Q

Define Trichotillomania

A

Compulsive hair pulling

78
Q

What criteria does the DSM refer to in order to diagnose compulsions?

A

1 ) person repeats physical behaviour or mental acts that relate to an obsession
For eg. The person may have rules that they must follow strictly - a rule that you must check the door is locked ten times before you can leave home

2) compulsions are meant to reduce anxiety or prevent a feared situation - in reality they’re excessive or wouldn’t actually stop a dreaded situation

3) the compulsions have not been caused by other psychological substances such as drugs

79
Q

What does the DSM state in regards to OCD ?

A
  • If the obsessions or Compulsions last at least one hour each day this is an indication of a clinical case or OCD
  • if the obsessions and compulsions interfere with a persons ability to maintain a relationship, hold down a job or take part in social activities
80
Q

State 4 types of OCD behaviours

A

1) CHECKING - includes checking that the lights are off or that you have a purse or wallet

2) CONTAMINATION - involves a fear of catching germs by say going to a restaurant, touching door handles , shaking hands or using public toilets

3) HOARDING - keeping useless or worn out objects such as old newspaper or junk mail

4) SYMMETRY AND ORDERLINESS - getting objects lined up just right - such as having wok the tins in your food cupboard facing exactly the same way

81
Q

What did researchers identify about the involvement of certain genes in OCD?

A

Researchers identified that genes may create a vulnerability to OCD

82
Q

What did Lewis (1936) discover ?

A
  • 37% of OCD patients had a parent with OCD
    - 21% had a sibling with OCD
    = suggests a genetic proponent to OCD
83
Q

What does it mean when OCD is referred to as polygenic ?

A

OCD is not caused by one single gene but a combination of genetic variations that together cause significantly increase vulnerability

84
Q

What did Taylor (2013) discover ?

A
  • up to 230 genes may be involved in OCD
  • genes may affect dopamine and serotonin actions
    = lacks predictive value and practical applications
85
Q

What did Tukel et al. (2013) suggest ?

A
  • suggested a variation of the COMT gene may contribute to OCD as it is more common in patients who suffer from OCD than in those who don’t
  • this variation produces higher levels of dopamine and lower activity of the COMT gene
86
Q

Evaluations - what are the strengths of genetic explanations ?

A
  • Nestadt et al. (2010) reviewed evidence that 68% of identical twins will both have OCD compared to 31% of non-identical twins
  • Marini et al. (2012) found a person with a family member diagnosed with OCD is around 4 times as likely to develop it as someone without
  • this is a significant link to show that genetics play an important role in the development of OCD and that nature is shown to play a larger role here
  • Grootheest et al. (2005) - found their genetic link was stronger in children that were sufferers of OCD
87
Q

What are the limitations of genetic evaluations?

A
  • ignores environmental factors - these twins also share the same environment which could trigger OCD
  • evidence to suggest that identical twins are treated ‘more similar ‘ in terms of their environment (eg. Expectations , style of dress, extracurricular activities) that non-identical twins who are treated more as individuals
  • Pato et al. (2001) noted that although there does seem to be a genetic link between OCD sufferers - there is not enough understanding about the actual genetic mechanisms causing OCD
  • Grootheest et al. (2005) - found that the genetic link was stronger in children that were sufferers of OCD , than when the OCD originated in adulthood showing the probability of different causes
88
Q

What are 4 neural explanations ?

A

1) Serotonin - ( known to play a role in regulating mood ) - if a person has low levels of serotonin the person can have low moods and other mental processes are often affected

2) the reduction or serotonin can explain some cases of OCD

3) Dopamine levels are thought to be abnormally high in people who suffer from OCD

4) Abnormal brain circuits

89
Q

What does the orbital frontal cortex do ?

A

sends signals to the thalamus about things that are worrying you , this area of the brain is over reactive in people who suffer from OCD

90
Q

What does the Thalamus do ?

A

The Thalamus ( part of brain that instructs is the person to do a certain activity or behaviour ) in OCD sufferers this would be the OCD behaviour

91
Q

What does the Caudate nucleus do ?

A

the Caudate nucleus ( part of the brain that in non- OCD suffers ) surprises the messages from the OFC + Normalises the worry —> In OCD sufferers this part of the brain is not completing this job and allows the OFC to make the sufferer worry - could be due to damage or overstimulation

92
Q

What are the strengths of neural connections ?

A

Antidepressants eg. SSRIs - used to control levels of serotonin are seen to be effective in reducing OCD symptoms —> support the idea of an imbalanced neural network

93
Q

What are the limitations of neural connections?

A
  • environmental triggers play a large role in triggering OCD
  • one study found over half the participants had suffered a traumatic event and this led to their OCD
  • not all OCD sufferers respond positively ti antidepressants —> shows It is not the neural network causing OCD in those patients
94
Q

What does serotonin affect ?

A
  • sleep
  • memory
  • emotions
  • appetite
  • sexual behaviour
95
Q

What does a lack of serotonin result to ?

A

Loss of inhibition

96
Q

State further Evidence for Neurological factors

A
  • Max et al. (1995) found increased rates or OCD in people after head injuries that caused brain damage to the basal ganglia
  • surgery that disconnects the basal ganglia can reduce symptoms for severe OCD cases
  • Wise & Rapport found that OCD in cases of Huntingtons, Parkinson’s and Tourette’s = all involve the basal ganglia - implicates the basal ganglia in OCD
97
Q

State further evidence against Neurological factors

A

Aylward et al. (1996) didn’t find significant difference in basal ganglia impairment between OCD patients and controls

Basal ganglia damage hasn’t been found in 100% of people with CD

98
Q

State evidence for the biochemical factors

A
  • Insel (1991) found that a class of drugs called SSRIs which increase levels of serotonin can reduce symptoms of OCD in 50% to 60% of cases
  • Zohar et al. (1996) also found that SSRIs alleviated symptoms in 60% of patients with OCD
99
Q

State evidence against the biochemical factors

A
  • SSRIs appear to offer some relief to sufferers of OCD - but this is not true in 100% of cases there must be more to understanding OCD
  • the link with serotonin is correlational so it doesn’t show cause and effect
    It may be decreased serotonin levels are a symptom of OCD rather than a cause of it
100
Q

What are the strengths of the biological explanation of OCD ?

A
  • has a scientific basis in biology - there’s evidence that low serotonin and damage to the basal ganglia correlate with cases of OCD
  • Twin studies have shown that genetics have at least some effect on the likelihood of developing OCD
  • It can be seen as ethical - people aren’t blamed for their disorders - they just have an illness
101
Q

What are the weaknesses of the biological explanation of OCD ?

A
  • doesn’t take into account the effect of the environment, family , childhood experiences or social influences
  • Biological therapies raise ethical concerns - drugs can produce addiction and may only suppress symptoms rather than cure the disorder
102
Q

What does SSRIs stand for ?

A

Selective serotonin reuptake inhibitors

103
Q

How do SSRIs work?

A
  • work solely on the neurotransmitter serotonin which is associated with OCD
  • they inhibit the re-uptake / absorption of serotonin which happens too fast in people with OCD
  • by preventing the reabsorption of and breakdown of serotonin SSRIs effectively increase levels of serotonin in the synapse which results in the neurotransmitter remaining active in influencing the post-synaptic neuron
  • the average time for SSRIs to take effect is 4 months before they impact on symptoms
104
Q

What are some SSRIs examples ?

A

Fluoxetine
Sertraline
Paroxetine

105
Q

What are some alternatives drugs ?

A
  • SNRIs - work similarly- increases levels of serotonin - also increase another neurotransmitter called noradrenaline
  • Tricyclics - reserved for those that SSRIs do not work for - it is an older antidepressant no has more severe side effects than SSRIs
106
Q

What are some side effects of SSRIs ?

A
  • indigestion
  • blurred vision
  • Clomipramins can cause Impotence, tiredness and weight gain
  • cause distress to patient and worsen their condition = may not be able to work = drain on the economy
107
Q

What are the strengths of Biological treatments of OCD ?

A
  • Drug therapy is cost effective - cheaper- preferred by health services that have a budget they must adhere to
  • drug therapy is non- disruptive to peoples lives - don’t need to put time aside to attend therapy
  • Greist et al. (1995) conducted a meta analysis - they reviewed placebo controlled trials of the effects of 4 drugs on OCD - they found all 4 drugs were significantly more effective than the placebo
  • NICE ( national institute for health and care excellence ) - recommends treatments for illnesses in the UK - states that a mix of therapies and drugs work best
108
Q

What are some limitations on the biological treatments for OCD ?

A
  • serious side effects
  • high relapse rates once patients stop taking the drug
  • Simpson (2004) found that 45% of cases in 12 weeks relapsed - compared to only 12% of patients who had CBT - suggests that drug therapy does not treat OCD
  • publication bias - positive results are more likely to be published than not - according to Goldacre (2013) as drug companies sponsor the drug trials - selectively publish positive outcomes for the drugs their sponsors are selling
109
Q

What is meant by Slow effectors ?

A
  • SSRIs work rapidly on serotonin levels in the brain but take several months to exhibit an effect on the symptoms of the patient
  • some patients do not experience relief from taking SSRIs
  • the cause of OCD may not solely originate in serotonin levels = suggests a behavioural component
110
Q

Define Phobia

A

An extreme , irrational fear where the perceived fear usually outweighs the actual threat

111
Q

Define specific phobias

A

-This is a fear of specific objects or situations
-There are 5 subtypes

1) animal type - zoophobia
2) Environmental dangers
3) Blood injection injury
4) situational
5) ‘other’

112
Q

What is agoraphobia ?

A
  • fear of open spaces , using public transport , being in an enclosed space , waiting in line or being in a crowd
  • specifically linked to the fear of not being able to escape or find help if an embarrassing situation arises
  • often involves the sufferer avoiding the situation in order to avoid distress
  • may develop as a result of other phobias because the sufferers afraid they’ll come across the source of their fear if they leave the house
113
Q

What is social anxiety disorder?

A

Fear of being in social situations - usually down to the possibility of being judged or being embarrassed

114
Q

What are the 3 phobia symptoms ?

A

1) behavioural
2) emotional
3) cognitive

115
Q

What are the cognitive symptoms of phobias?

A
  • irrational beliefs about the stimulus that causes fear
    - people find it hard to concentrate because they’re preoccupied by anxious thoughts
  • selective attention - when the person is near the phobia cannot focus on anything else
  • cognitive distortions - the persons perception of the phobia can be distorted
116
Q

What are the behavioural symptoms of phobias ?

A
  • PANIC in response to the phobia stimulus could result in = crying or screaming
  • AVOIDANCE , avoid the phobic stimulus which can make daily life complicated
  • ENDURANCE - opposite behaviour to avoidance , individual chooses to remain in the presence of the phobia but continues to suffer and experience high levels of anxiety
117
Q

What are the emotional characteristics of phobias ?

A
  • Emotional response - being unreasonable and irrational the emotional response felt by the sufferer is disproportionate to the danger they are facing
  • Anxiety - unpleasant state of high arousal and this state stops the person fro, being able to relax or feel any other emotion
  • Fear - the persons immediate emotion when coming into contact with the phobia is fear
118
Q

What does the behaviourist approach explain in regards to phobias ?

A
  • explains all Behaviour as something that is both observable and learned
  • focuses on explaining the behaviours created by the phobia and does not explain the cognitive or emotional features of phobias
119
Q

What is the two process model ?

A
  • an explanation for the onset and persistence of disorders that create anxiety
  • Mowrer (1960) suggests phobias are first learnt by association ( classical conditioning) and then maintained via reinforcement ( operant conditioning )
120
Q

Explain the acquisition of the phobia by classical conditioning

A
  • phonic objects are at first a neutral stimulus ( NS) when do not produce a phobic response
  • if then presented with an unconditional stimulus ( UCS) that produces an unconditioned response ( UCR)
  • then the NS will become associated with the UCS and then the fear will occur whenever the NS is there
  • the NS becomes a conditioned stimulus ( CS) and the UCR becomes the conditioned response ( CR)
121
Q

Explain the maintenance of phobias by operant conditioning

A
  • If a person avoids the phobic object or situation then anxiety is greatly reduced which is rewarding for the sufferer
  • operant conditioning happens when behaviour is reinforced by avoiding something unpleasant and being rewarded through not experiencing anxiety - reinforcing the avoidant behaviour
  • MOWRER - suggests this is what happens when we void the phobic stimulus - we reduce the fear and this reduction in fear reinforces the avoidance behaviour and so the phobia is maintained
122
Q

Example of acquisition of a phobia : little Albert (1920)
Explain the little Albert case study…

A
  • Josh Watson & Rosalie parks (1920) wanted to study the development of phobias and conducted a laboratory study experiment where they used a 9 month old baby called Little Albert
  • at the start of the study - Albert showed no unusual anxiety or worries about different objects
  • Albert tried to play with a white rat when presented with it at the beginning
  • Watson and Rayner wanted to give Albert a phobia so thus when the white rat was presented , they made a loud scary noise by banging an iron bar close to alberts ear
  • the noise UCS created a fear response
  • when the rat ( NS) and the UCS were put together they became associated and Both then created a fear response
  • Albert started to display fear when he saw the rat (NS)
  • the rat then became the CS that produces the CR and the phobia had started
123
Q

What did Watson and Rayner thus show ?

A

That the conditioned stimulus could be generalised to similar objects

  • when they shower Albert other fluffy objects such as farther Christmas’ s beard made from cotton wool , a non - white rabbit , fur coat = Albert showed distress
  • his phobia had become generalised
  • important to note that today this experiment would not take place due to the ETHICAL guidelines and the psychological harm he was put under
124
Q

What are the strengths of the behavioural explanations of phobias ?

A
  • real world application - it explains using two distinctive elements how phobias are both created and maintained
  • Barlow and Durand (1995) showed that in case of individuals with a severe fear of driving 50% or them had actually been involved in a road accident
  • through classical conditioning the road accident ( an UCS ) has turned driving into a CS for those now with the phobia
  • Behavioural therapies are very effective at treating phobias by getting the person to change their response to the stimulus
125
Q

What are the limitations of the behavioural explanation of phobias ?

A
  • Davey (1992) found that only 7% of spider phonics recalled having a traumatic experience with a spider
  • suggests that there could be other explanations eg. Biological factors
  • not all phobias appear following a bad experience and the phobia of snakes is evidenced in many people who have no experience of them which does not support the two process model
126
Q

What did Seligman suggest ?

A
  • we have evolutionary phobias
  • fearing potentially dangerous things in the environment would be beneficial to our ancestors in survival eg. Fearing snakes
  • we are biologically ready to react to threatening stimuli
  • conditioning processes mean we’re more likely to develop phobias or these stimuli
  • behaviourist explanation is too simplistic
127
Q

What did ohman et al. Investigate?

A
  • presented PS with fear related stimuli ( eg. Pictures of spiders ) and fear irrelevant ( eg. Picture of flowers ) alongside electric shocks
  • measured anxiety levels when exposed only to images
  • fewer shocks were needed to condition the anxiety response for fear relevant images
  • learned responses to fear irrelevant stimuli extinguished but not to for fear relevant stimuli
  • supports biological preparedness
  • suggests phobias may be resistant to cures
128
Q

What did DiNardo suggest?

A
  • 60% of people with a fear of dogs can relate it to a fearful event in their past
  • supports the two process model and phobia acquisition
  • but the same proportion of PS in the control group ( no phobia ) had experienced a fearful event with dogs
  • individual differences In phobia development
  • behavioural explanation is not a full explanation
129
Q

What is flooding ?

A
  • phobia treatment
  • phobic person is placed in a situation where they are forced to face the phobia
  • situation lasts until phobic response disappears
  • as the physical response reduces , the anxiety reduces then the session ends
130
Q

What is systematic desensitisation?

A

Main behaviourist therapy to treat phobias and it is designed to slowly reduce the anxiety caused by the phobia using classical conditioning

131
Q

What are the 3 processes involved in systematic desensitisation?

A

1) anxiety hierarchy
2) relaxation
3) exposure

132
Q

What is anxiety hierarchy?

A

The patient and therapist work together to construct an anxiety hierarchy which is a list of situations that involve the phobic stimulus from least to most frightening

133
Q

What is relaxation in systematic desensitisation?

A
  • it is impossible to be afraid and relaxed at the same time and so the therapist teaches the patient relaxation techniques
  • could be a form of breathing exercises or using imagining techniques - where the patient imagines themselves in a relaxing environment
  • could also include medication if needed to help the patient relax such as Valium
134
Q

What is exposure in the systematic desensitisation?

A
  • whilst in a relaxed state the patient is exposed to the phobic stimulus starting at the bottom of the hierarchy
  • likely to take several sessions between the patient and the therapist
  • once the patient is comfortable and relaxed in the lower levels of the hierarchy then they move up the scale
  • aim of the treatment is to allow the patient to be successful and move up to the top of the hierarchy whilst remaining relaxed
135
Q

What are the strengths of systematic desensitisation?

A
  • Gilroy et al. (2003) followed a group of 42 patients who had SD as a treatment for a phobia of spiders - over 3 45 minute sessions and she found that at both 3 and 33 months they were less fearful and more in co tell if their phobia compared to the control group who had no sessions
  • successful with patients who have a vivid Imagination and can imagine their phobia
  • fast treatment & requires less effort than most other psychotherapies
  • technological advances = dangerous situations can be lessened as the patients can also be treated with Virtual reality
  • successful those with learning disabilities
  • does not require a huge cognitive load and means the patients are less confused
136
Q

What are the limitations of systematic desensitisation?

A
  • less effective do evolutionary therapies
  • doesn’t treat the cause of the phobia only the behaviour it causes
  • may leave the patient vulnerable to other phobias developing as the real reason behind the fear has yet to be uncovered
  • virtual reality is less effective than using real stimulus
  • cannot apply what they have learnt to actual everyday situations
137
Q

Explain the process of flooding

A
  • patient will be flooded with immediate exposure to their phobia
  • for eg. A patient afraid of spiders will be placed in a room with lots of spiders at once
  • flooding stops the phobic responses quickly
  • due to the fact that the patient cannot avoid the phobia in the flooding situation and thus their irrational behaviour of avoidance is stopped and the patient realises the phobic stimulus is harmless
  • thus the phobic response stops and the learned response is extinguished in classical conditioning this process is called - EXTINCTION
  • counter conditioning happens and the patient learns to relax around the phobic stimulus instead of the anxiety they faced before
138
Q

What are the strengths of flooding ?

A
  • cost effective
  • Much fewer sessions are require as sessions are longer than SD
  • higher rates of success than any other behavioural treatment
  • works very well with simple phobias
139
Q

What are the limitations of flooding ?

A
  • very traumatic for the patient and an unpleasant experience for them
  • if the patient panics and the treatment is not completed, it may leave them with an even worse phobia
  • SCHUMACHER et al. (2015) found both patients and therapists rated flooding as significantly more stressful than SD
  • less effective with more complex phobias
  • not suitable for individuals who are not in good health due to the extreme levels of stress and anxiety caused during the session —> could cause heart attacks

A Level Psychology (20 decks)

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