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Daniella IB HL psych > abnormal > Flashcards

abnormal Flashcards

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1
Q

what is abnormal

A
  • statistical deviation from the norm
  • not following social norms criteria
  • rosenhaun and seligman’s criteria for abnormality
  • deviation from the norm
  • symptoms from a classification system, ICD DSM
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2
Q

rosenhaun and seligmans criteria for abnormality

A
  • maladaptiveness
    behavior which makes life more difficult
  • irrationality
    unable to communicate in a rational manner that is understood by others
  • suffering
    the behavior causes suffering
  • vividness / unconventionality
    the person experiences reality in a unconventional way
  • observer discomfort
    the behavior makes other people uncomfortable
  • unpredictability
    behavior is erratic and difficult to predict
  • violation of moral standards
    behavior violates accepted standards for right and wrong
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3
Q

difficulty defining abnormality
statistical deviation, social norms, MIS VOUV

A

statistical deviation
- simple, reliable, objective
- not all statistically unusually behaviour is undesirable

social norms
- simple and reliable
- social norms vary greatly depending on where you are

MIS VOUV
- more subjective
- not clear how many out of the list they have to be considered abnormal
- many items related to social norms and judgements which vary across time and place

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4
Q

medical model of abnormality

A
  • abnormal behaviour is a symptom of a mental disorder
  • mental disorders are due to biological abnormalities in the brain
  • no different to any other diseases
  • can be treated
  • normal behaviour is just the absence of any problems in your brain
  • psychological disorders have physiological causes that can be diagnosed on the basis of symptoms, and treated, and sometimes even cured
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5
Q

evaluation of the medical model

A
  • removes blame from patients
  • enables research into causes and more effective treatments
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6
Q

limitations of the medical model
thomas sasz

A
  • uncertain about what disorder is “real”
  • no way to objectively diagnose mental disorders aka blood tests
  • diagnosis can lead to stigmatization
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7
Q

ethics of mental health

A
  • stigmatization
  • labels
  • confirmation bias from other people with your “normal” behavior, different if you have a mental ilness
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8
Q

rosenhan (1973)
aim
fake patient

A
  • investigate whether abnormal behaviour can be detected and the ethical consequences of diagnosis
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9
Q

rosenhan (1973)
procedure
fake patient

A
  • 8 healthy adults checked themselves into mental hospitals
  • saying they (falsely) heard voices saying the words: empty, hollow and thud
  • after being admitted they acted normally and said that the voices had stopped
  • during any therapy sessions they told the truth about their lives
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10
Q

rosenhan (1973)
results
fake patient

A
  • all the pseudo patients were diagnosed with schizophrenia and forced to take psychiatric medication
  • kept for an average of 19 days, one person 52 days
  • no doctors or nurses suspected anything
  • when they were released they were diagnosed with schizophrenia in remission instead of being cured
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11
Q

rosenhan (1973)
conclusion
fake patient

A
  • once a person is diagnosed with a mental disorder, people dehumanize you, misinterpret your behaviour and forever label you as mentally ill
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12
Q

rosenhan (1973)
evaluation
fake patient

A
  • high ecological validity, real mental hospitals and doctors
  • ethical concerns as participants lied to doctors and hospital staff, used their resources
  • psychiatry relies on self report of symptoms and don’t expect people to fake symptoms
  • however after weeks of observation, suggests there is something wrong with psychiatry
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13
Q

langer and abelson (1974)
aim

A
  • investigate how stigma, labels and confirmation bias impacts perceptions of the mentally ill
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14
Q

langer and abelson (1974)
procedure

A
  • group 1, analytic psychologists who view mental illness as a consequence of internal conflict and childhood trauma
  • group 2, behavioural psychologists who focus on identifying and changing the negative pattern of behaviour in the present
  • participants watched a video of a man being interviewed about his feelings and experience and his past job
  • half the participants were told the man was a “job applicant” and the other half were told he was a “patient”
  • participants then rated the man for how “disturbed” or “well adjusted” he was
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15
Q

langer and abelson (1974)
results

A
  • behavioural rated the man pretty normal regardless of the label
  • analytic psychologists rated the man more disturbed when they were told he was a patient
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16
Q

langer and abelson (1974)
conclusion

A
  • labeled as mentally ill can cause psychologists to see evidence when there is none
  • analytical psychologists more likely to be influenced by labels as they see mental illness as an internal struggle whereas behavioural psychologists see it as behaviour cues
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17
Q

langer and abelson (1974)
evaluation

A
  • clear causal relationship between the label and how psychologists describe him
  • ecological validity is high because real psychologists were used
  • took place quite a while ago and analytic psychology is much less common
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18
Q

MDD

A

Major Depressive disorder

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19
Q

symptoms of MDD

A
  • feelings of sadness, guilt worthlessness
  • not enjoying activities
  • lack of initiative
  • self harm/suicide
  • negative thoughts
  • loss of energy
  • sleep changes
  • weight changes
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20
Q

prevalence facts

A
  • higher rates of MDD in lower socioeconomic groups and young adults
  • average of 4 depressive episodes across a person’s life
  • in western countries 15% of people will experience depression at some point
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21
Q

weisman et al
aim

A
  • investigate the prevalence of depression in different countries
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22
Q

weisman et al
procedure

A
  • 10 countries across the world from a range of cultures
  • participants randomly selected using phone registries
  • trained interviewer would call the people selected and interview them about their mental health history
  • 38,000 participants interviewed
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23
Q

weisman et al
findings

A
  • rates of depression varied greatly in different countries
  • 1.5% in Taiwan but 19% in Beirut
  • depression rate in Paris almost as high as Beirut even though Beirut just experienced 15 years of civil war
  • MDD in women 2-3x higher than in men
  • divorced much higher than married
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24
Q

weisman et al
conclusion

A
  • depression is a universal disorder
  • risk factors, women, divorce
  • some countries suffer more for unknown reasons
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25
Q

weisman et al
evaluation

A
  • large number of participants
  • strong random sampling method
  • results can be generalized to each country
  • multiple languages so translation may not be accurate
  • doesn’t explain why there are different rates of depression in different countries
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26
Q

why does prevalence vary

A

different rates of depression
- socioeconomic conditions
- rates of urbanization, more urban more depressed

how often depression is reported
- cultural stigma
- difference in diagnose, more likely/ less likely

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27
Q

serotonin hypothesis of MDD

A
  • the cause of depression is low levels of serotonin in the brain
  • makes it harder for signals to be passed on slowing down brain activity resulting in low energy, lack of enjoyment and sadness
  • treatment = selective serotonin reuptake inhibitors
  • allowing more serotonin to remain in the synapse
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28
Q

nurnberger and gershon (1982)
aim

A
  • the role of genetic factors in depression
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29
Q

nurnberger and gershon (1982)
procedure

A
  • meta analysis of 7 studies comparing the concordance rates for depression in identical (MZ) twins (100%) and fraternal (DZ) twins (50%)
  • twin studies assume twins have the same environment and if they have higher concordance it is due to genetics
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30
Q

nurnberger and gershon (1982)
results

A
  • depression for MZ twins was 65%
  • depression for DZ twins was 14%
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31
Q

nurnberger and gershon (1982)
conclusion

A
  • genetic factors play an important role in determining who will become depressed
  • although higher concordance rate for MZ twins it is still far below 100% showing environmental/ extraneous factors also play a role
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32
Q

nurnberger and gershon (1982)
evaluation

A
  • large amount of data from 7 studies
  • twin studies are reliable and well established
  • does not identify which specific genes can contribute towards depression
  • doesn’t explain which environmental factors impact depression
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33
Q

diathesis - stress model

A
  • both biology and the environment are important factors in depression
  • some people have genes that predispose them to depression (diathesis) but not all of those people will become depressed
  • stressful life events, combination of environment and genetic predisposition will increase risk of depression
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34
Q

caspi
aim

A
  • how genetic vulnerability and negative life experiences can interact to cause depression
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35
Q

caspi
procedure

A
  • genetic testing on 847 New Zealand men to determine what version of the serotonin transporter gene they carried
  • there is the short version and long version
  • long version is associated with higher levels of serotonin in the synapse
  • men completed a questionnaire about stressful life events and if they have ever suffered from depression
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36
Q

caspi
findings

A
  • few stressful life events had low rates of depression regardless of genes
  • participants with at least one short version of serotonin transporter gene who also had experienced 3 or more months of stressful life events had the highest rates of depression
  • participants with 2 long serotonin transporter genes had low rates of depression no matter how many stressful life events
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37
Q

caspi
conclusion

A
  • risk of depression is highest in people who have genetic predisposition (one or more short serotonin transporter gene) and multiple stressful life events
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38
Q

caspi
evaluation

A
  • strong support for the diathesis stress model of depression, biology and life experience leads to depression
  • large sample size, reliable
  • casual relationship between genetics and depression is not certain, could be other factors
  • supports the role of serotonin in depression
  • other factors that haven’t been explored
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39
Q

evaluation of serotonin hypothesis

A

pros
- SSRIs work by increasing serotonin and are effective in treating depression for many people
- Caspi suggests that different versions of serotonin transporter gene determine the risk of depression
cons
- increases serotonin right away but often takes people 3-4 weeks to feel better
- only effective in around 60% of people
- just because SSRIs are effective treatment doesn’t mean low serotonin causes depression
- can’t be sure how much of a role serotonin plays

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40
Q

cognitive theory of depression (beck)

A
  • depression is caused by cognitive distortions and illogical thinking processes
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41
Q

illogical thinking processes

A
  • selective attention
    only focusing on the negative aspects
  • magnification
    exaggerating the importance of negative life events
  • overgeneralization
    broad conclusions on the basis of a singular negative life event
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42
Q

illogical thinking processes leads to

A
  • negative thoughts about oneself, the world and the future
43
Q

evaluation of cognitive theory of depression

A

pros
- illogical thinking describes how most depressed people think about themselves, the world and their future
- possible to change negative thought patterns through therapy to treat depression
- evidence of cognitive behavioral therapy (CBT) effective depression treatment
cons
- unclear why people develop negative thoughts in the first place, could be biology
- unclear if negative thoughts and cognitive disorders cause depression or are a symptom

44
Q

alloy
aim

A
  • to determine if cognitive thinking styles can predict who will become depressed
45
Q

alloy
procedure

A
  • 347 american college freshman
  • questionnaire to determine their thinking style
  • style either “positive” or “negative”
  • participants followed for 6 years and rates of depression compared between each thinking style
46
Q

alloy
results

A
  • participants with a negative cognitive style were far more likely to become clinically depressed within the 6 years of the study
47
Q

alloy
conclusion

A
  • negative thoughts is associated with depression
  • cognitive style can predict who is likely to become depressed
  • participants had negative thoughts before they became depressed suggests that cognitive style may cause depression not a consequence of depression
48
Q

alloy
evaluation

A
  • supports beck’s cognitive theory of depression, negative thinking pattern can lead to depression
  • large sample size, increasing reliability
  • correlational, can’t be sure cognitive style causes depression
  • could be other differences such as biological, family support, social etc that could explain the findings
  • study only american college students which is not representative of the general population
  • depression in young people could be caused by other factors than other age groups
49
Q

haefell et al
aim

A
  • investigate if thinking style and risk for depression can be influenced by the people around you
50
Q

haefell et al
procedure

A
  • 103 college students that were randomly assigned a roommate during their first year
  • completed an online questionnaire to measure cognitive vulnerability and depressive symptoms 1, 3 and 6 months after arriving on campus
51
Q

haefell et al
findings

A
  • participants who were randomly assigned to a roomate with high cognitive vulnerability “caught” the negative thinking style and became more vulnerable themselves
  • students that developed increased cognitive vulnerability after 3 months had twice the level of depressive symptoms after 6 months compared to students who didn’t show an increase
52
Q

haefell et al
conclusion

A
  • cognitive style can be influenced by social environment
  • cognitive style is not a fixed trait
53
Q

haefell et al
evaluation

A
  • provides further support for beck’s cognitive theory of depression
  • highly applicable to real life treatment of mental illness, risk reduced by avoiding overly negative people
  • only american college students, more research on other cultural and age groups to test generalizability of results
54
Q

vulnerability model

A
  • some people are more at risk for developing mdd than others
55
Q

factors in the vulnerability model

A

decrease risk
- bonds with other people
- involvement with the community
increase risk
- unemployment
- social isolation
- three or more young children at home
- stressful life events

56
Q

brown and harris
aim

A
  • investigate the role of social factors and stressful life experiences in depression
57
Q

brown and harris
procedure

A
  • 458 south london women
  • asked questions about any episodes of depression in the past year and describe any difficult life events
58
Q

brown and harris
results

A
  • 8% had experienced an episode of depression in the last year
  • of the women who became depressed 90% experienced a stressful life event
  • 30% of women who did not become depressed also experienced stressful life events
  • lower class women with children 4x more likely than middle class women
59
Q

brown and harris
conclusion

A
  • social factors play a significant role in depression
  • lower class women with children are more at risk, financial problems and other stressful situations
60
Q

brown and harris
evaluation

A
  • provides support for the vulnerability model, stressful life events, socioeconomic status influence risk of depression
  • only south london women. unsure similar results in men or other regions
  • correlational study, no casual relationship between stressful life events and depressive episodes
  • could be having depression causes problems in relationships/at work creating additional stressful life events
  • many women experienced stressful life events did not become depressed, biological and cognitive factors to consider
61
Q

homes and rahe
aim

A
  • determine what events are most likely to lead to illness
62
Q

homes and rahe
procedure

A
  • medical records of 5000 patients were reviewed for correlations between stressful life events and illness
63
Q

homes and rahe
results

A
  • positive correlation between number of life events and subsequent illness
  • greater degree of life change = greater risk of illness
  • death of a spouse or child, divorce, imprisonment, death or close family member, personal injury, marriage, retirement
64
Q

homes and rahe
conclusion

A
  • major life changes can lead to stress and increase the risk of illness
65
Q

homes and rahe
evaluation

A
  • findings have been replicated in other countries, cross culturally valid
  • associations between life events and general illness not specifically depression
  • scale based on average correlation and will naturally vary between participants
66
Q

vulnerability model of mdd evaluation

A

pros
- considerable research
- consistent with diathesis stress model
cons
- correlational research, can’t tell what factors
- depression could cause negative life changes not negative life changes causing depression
- many people experience negative life events and do not become depressed, possibly cognitive factors matter more than the event itself

67
Q

SSRI’s

A

selective serotonin reuptake inhibitors

68
Q

how do SSRI’s work

A
  • blocking the reuptake of the neurotransmitter serotonin back into the presynaptic neuron
  • more serotonin remains in the synapse, changes in mood, activity levels and appetite
  • if depression is caused by low levels of serotonin in the synapse, most direct cure
69
Q

elkin
aim

A
  • compare effectiveness of different treatments for depression
70
Q

elkin
procedure

A
  • 280 depressed people
  • randomly assigned one of 4 groups
    antidepressant drug
    interpersonal therapy
    cognitive behavioral therapy (CBT)
    sugar pill (placebo)
  • double blind so neither clinician or patient knew if real antidepressant or placebo
71
Q

elkin
results

A
  • results on antidepressant showed fastest improvement
  • few weeks therapy also showed improvement
  • 50% of participants in each treatment group recovered
  • 29% on placebo recovered
72
Q

elkin
conclusion

A
  • antidepressants interpersonal therapy and CBT are equally effective
  • any treatment is better than no treatment (placebo)
73
Q

elkin
evaluation

A
  • large sample size, reliable
  • controlled experiment design, casual relationship between treatment type and outcome
  • double blind reduces researcher bias
  • can’t explain why nearly 50% of participants did not respond to treatment
74
Q

kirsch
aim

A
  • evaluate the effectiveness of SSRIs in treating depression
75
Q

kirsch
procedure

A
  • meta analysis of 47 clinical trials of SSRIs
76
Q

kirsch
findings

A
  • patients with mild to moderate depression small difference between SSRI’s and placebo
  • 75% of improvement seen with SSRIs also seen with the placebo
  • severe depression, larger difference between SSRIs and placebo
  • around half of studies failed to see a statistically significant difference between SSRIs and placebo
77
Q

kirsch
conclusion

A
  • SSRIs are not as effective as claimed, especially mild to moderate depression
  • side effects of SSRIs may not be worth it for patients with mild depression
78
Q

kirsch
evaluation

A
  • analyzed all data submitted to the FDA, no publication bias
  • not all studies may have been carefully carried out, drug companies rush studies to get approval
79
Q

evaluation of use of SSRIs

A

pros
- better at treating depression than a placebo
- cheap and easy to prescribe, not long expensive therapy
- SSRIs show faster improvement than therapy
cons
- doesn’t work for everyone
- many side effects
- patients who stop taking are at risk of becoming depressed again
- can alleviate symptoms but may not be treating the root cause

80
Q

CBT stands for

A
  • cognitive behavioural therapy
81
Q

components to CBT

A
  • cognitive restructuring
  • behavioral activation
82
Q

cognitive restructuring

A
  • helping patient become more aware of negative thoughts
  • identifying cognitive distortions such as overgeneralization and magnification
  • negative beliefs are then challenged
  • replace negative thoughts with positive rational thoughts
83
Q

behavioral action

A
  • planning enjoyable activities with others
  • overcoming obstacles (logical financial) to take part in activities
84
Q

riggs
aim

A
  • study the effectiveness of CBT on its own and in combination with SSRIs
85
Q

riggs
procedure

A
  • 126 teens either MDD or substance use
  • randomly selected CBT placebo or CBT and SSRI
  • double blind
86
Q

riggs
results

A
  • 67% of participants CBT and placebo very much or much improved
  • 76% of participants CBT and SSRI very much or much improved
87
Q

riggs
conclusion

A
  • CBT is effective treatment in teens suffering from MDD and substance abuse
  • CBT and SSRI is the most effective treatment option
88
Q

riggs
evaluation

A
  • experiment, casual relationship between treatment and results
  • double blind eliminated placebo effect and researcher bias
  • no control group, unethical to include one
  • only teensso not generalizable to other age groups
89
Q

CBT evaluation

A

pros
- considerable research (elkin, riggs), cbt is significantly more effective than a placebo and as effective as SSRIs without side effects
- combination of CBT and SSRIs best combination
- CBT doesn’t need years of therapy or childhood memories
- results orientated, focused and efficient
- develop lifelong cognitive skills, prevent future episodes
cons
- elkin suggests SSRIs are faster than CBT
- only effective is there is a good relationship between patient and therapist
- 10-12 hours of one on one therapy which can be expensive and not always covered by insurance

90
Q

cultural barriers to treatment

A
  • cognitive
  • affective
  • sociocultural
91
Q

`cultural barriers to treatment - cognitive

A
  • believe seeking professional psychological treatment is a weakness and unnecessary
  • mental hardships should be overcome by willpower or traditional practices
  • doubt the effectiveness
92
Q

`cultural barriers to treatment - affective

A
  • shame about seeking help
  • fear of being judged
  • embarrassment to the entire family
93
Q

`cultural barriers to treatment - sociocultural

A
  • reluctance to share personal or family problems with a stranger/ different culture
  • must be willing to share to be effective
94
Q

kinzie et al
aim

A
  • investigate cultural barriers to treatment for depression
95
Q

kinzie et al
procedure

A
  • blood tests 41 south east asian patients with depression
  • patients previously prescribed antidepressants
  • blood tests to measure compliance with treatment
96
Q

kinzie et al
results

A
  • no sign of medication usage in the blood of 61% of patients
  • only 6 patients had therapeutic levels of antidepressants in their blood
  • discussion about the benefits and side effects, compliance rates increased
97
Q

kinzie et al
conclusion

A
  • cognitive and affective barriers to treatment of patients from different cultures
  • shameful or doubt the efficacy
98
Q

kinzie et al
evaluation

A
  • blood tests, objective measures
  • small sample size (41) and only south east asians, generalizability
99
Q

indigenous therapy

A
  • alternative for non white patients
  • takes into account traditions, beliefs and cultural values
  • able to overcome cultural barriers
  • carried out by someone within the culture often in the language
  • incorporates beliefs they have
100
Q

zhang et al
aim

A
  • test the efficacy of chinese taoist cognitive psychotherapy (CTCP) for patients with generalized anxiety disorder (GAD)
101
Q

zhang et al
procedure

A
  • 124 patients with GAD randomly assigned CTCP or anxiety medication or both
  • assessed one month and six months after treatment
102
Q

zhang et al
results

A
  • patients on medication improved rapidly after one month but improvement was not sustained
  • CTCP not much improvement after one month but significant improvement after six months
  • both improvement at one and six months
103
Q

zhang et al
conclusion

A
  • medication short term CTCP is more effective long term for patients with GAD
104
Q

zhang et al
evaluation

A
  • support for indigenous therapy
  • well designed, cause and effect relationship between treatment and outcome
  • didn’t involve a comparison with CBT so unsure is CTCP is more effective

Daniella IB HL psych (12 decks)

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