Exam Flashcards
Habituation
Normalise to anxiety
Exposure response prevention therapy
OCD maintained through avoidance learning exposure hierarchy by doing what will make you feel even worse while vocalizing and embracing thoughts
Key question
Are mental health drugs being over prescribed in the UK
Agree with key question
-dt beneficial as less time ndcost consuming
-those who have biological cause
-pots team shows better than placebo
Disagree of key question
-drugs have side effects
-drugs only work if taken
-disorder may be due to social factors
-pots show therapy better than DT
Rosenhan aim
Test reliability of mental health diagnosis to see if could be told between sane insane
Sample rosenhan
8 patients in 12 hospitals in the us in 5 states by just faking one symptom
Procedure of rosenhan
Clinical interviews and reportedearig voices and wen admitted behaved normally and request to be discharged
Took notepad and pen to record what they heard and saw in covert
Dispose meds given and friendly and polite
Rosenhan 2
Agree to second study but aware seeking for 3 months an given liver type scale to assess patient on10 point for whether ill or pseudo patient
Results of rosenhan
All took with 11 sz and 1 manic depressed
Average of 19 days before released
Staff abuseto patients and other disposal of meds 15 a day
Depersonalization
Results of rosenhan 2
Sent no pseudo in so all patients real
Out 139/ 41 rated as pseudo
Conclusion of rosenhan
Diagnosis tools like dsm and icd unreliable
Posiives of rosenhan
ecological validity but field experiment
-application
Generalizability as different types of hospitals used
Negatives of rosenhan
unrepresentative
-unethical
Reliability
Cross cultural
the systematic comparisons of different cultures that aim t understand to understand variations of human behavior as it is influenced by cultural context
-outsider
Examin of cross culture
gottesman40 European countries
-issues of representation
-validity
-littlewood and lipsedge - country affects
-defining abnormality
Family intervention therapy
improvin communication, solving family issues wiht practical and emotional support and aims to treat distressin 4 Ds
Predictive validity
Try to predict future behaviors of people with mhds but it isnt Sam was physical and should help recover or if symptoms will continue
Construct validity
Mental health disorders can overlap it isn’t a fixed construct as mental health diagnosis not just one symptom
Aetiological validity
For each mhd has the same cause of diagnosis so occurs in same way
OCD
Obsessive compulsive disorder is where you have reoccurring thoughts and behaviors that cannot be controlled
Obsessions
Unwanted ideas, thoughts and images
Compulsions
Recurring behaviors r actions
Dsm - 5 of ocd
thoughts and actions must occur for 1 hour and 2 weeks
- attempt to neutralize thought with action
- -disturbance not explained better by another disorder
Common ocd
cleansing ocd
-order ocd
-contamination ocd
Roominations
Bad thoughts on a cycle
Strengths family intervention therapy
relapse rates in nccmh found 26% unlike standard of 50%
Negatives family intervention
Time consuming and costly
-DT and FI have been shown more effective
How does family intervention therapy work
Takes place in the home for. 3-12 on the period wiht sessions every 2-4 weeks following the NICE schedule
Supporting evidence of FI therapy
Phtaraoh -reviews 53 studies to investigate effectiveness of FI and meds increased compliance and not allbenefitted wiht therapy of standard care
Mowrer
Believed ocd can be explained by classical conditioning and reinforcement
Classical conditioning of ocd explanation
Connection made between object (CS)and fear (CR)
The NS then becomes paired wiht the experience and anxiety is produced
The anxiety that is caused has been discovered to be avoided by avoiding the stimulus and developing strategies (compulsions)
reinforcement in ocd
Behavior of avoidance is negatively reinforced in that it continues in order to reduce anxiety
OCD contmaination example
UCS- being ill UCR- anxious
NS- food
CS-food CR- anxiety
Stimulus generalization
Anything could be contaminated- anxiety that is created can be associated y anything similar to the original cause
Problems with Behavioural approach in ocd
Doesn’t explain lack of serotonin in biological
If just learnt then drugs wouldn’t have an effect
Very environmental
Founded on research on animals
Tracy OCD
Student Ps given checklist of ocd symptoms and categorized wit either ocd or not
Those identified as ocd type more likely to be conditioned on eye blink task where earned to blink to sound of bell - much easier with ocd type to be conditioned
Problems with biological ocd
cause and effect as only scan after ocd
-twins share environment
-twin study registry has publication bias and only published if results found
Family and two studies in ocd
Genetic factors as ocd levels in population is 1-2% and the likelihood increases the closer their genetic relationship wit someone already wiht ocd
OCD abnormalities
polygenetic
-abnormality on HSert gene in recent studies
Supporting evidence of FI therapy
Phtaraoh -reviews 53 studies to investigate effectiveness of FI and meds increased compliance and not allbenefitted wiht therapy of standard care
Mowrer
Believed ocd can be explained by classical conditioning and reinforcement
Classical conditioning of ocd explanation
Connection made between object (CS)and fear (CR)
The NS then becomes paired wiht the experience and anxiety is produced
The anxiety that is caused has been discovered to be avoided by avoiding the stimulus and developing strategies (compulsions)
HSERT ROLE IN OCD
Codes proteins tat transport serotonin - abnormality makes transporter to acttooquickly and take serotonin before transmitted its message to next neuron
-not enough left at synapse
Bio-chemical theory in ocd
Argues ocd sufferers have over activity in orbi frontal contex - responsible for decision making, converting sensory info and alerting worries in environment - likely inherited
What is obrifrontla
Worry circuit - respond with alarm when not necessary
Carey ad Gottesman results
Found identical twins had concordance of 87%of obsessive
DZ twins only 47%
What does Carey and gottesman find
Genetic factors moderately important
Grootheest
Review of twin studies on ocd -reported higher concordance for MZ then DZ
Dsm
Diagnostic and statistical manual of mhd to provide criteria of diagnosing disorders -American
Why was dsm developed
Developed for census of mhd using descriptions and classifications eg neuroses
Issues witht dsm
Holistic- cant determine the whole picture
Multi axial system
Consists of 5 axes where each diagnosis has 5levels and therefore relate to different aspects soundersands all
Axis 1-
Considers development and learning of mhd
Axis 2
Underlying personality conditions
Axis 3
Medical and physical conditions
Axi 4
Physiological and environmental factor of mhd
Axi 5
Assessment of global functioning
Subjectivity and objectivity fo diagnosis points
IQ high despite abnormality
-culture abnormality
-interpretation of statistics
-not abnormal if its 50%
-behavior changes over time
IQ high despite abnormality
Some statistical deviations sociallly desired so shouldn’t over or under include
Interpretation of statistics
2 standard deviation away from mean
-is 2.2 inclusive enough and what is behavior puts you in bottom or top
It’s not abnormality if 50%
Can’t rely on some mhd as some stistically rare eg depression is frequent behavior
Behavior changes
Eg homosexuality, moral sanity
- white men use diagnosis to control aswhen deviating form social norms you become vulnerable to manipulation so is used as a tool against less powerful
Drapetomania
Slaves irrational desire to escape
ICD 10
Used to monitor global mortality and morbidity statistics
-each disorder has a code starting with F and are listed with 11 sections in chapter 5
Example of ICD10
Sz,sizatydand and delusional disorders are all grouped
Positives of ICD 10
Each section has left over codes for later added disorders codes used for indexing medical records
International classification of disorders
How is ICD 10 used
Selects key words from interview that relate to symptoms and look upon index
Differences between dsm and icd
Dsm- greater need to satisfy avoidance or emotional numbing symptoms - most widely used research - holistics
Icd- more widely used clinically and certain events can classify -clinical -easier to do as quicker for locating
