Introduction to Psychopathology Flashcards
Criteria for determining abnormality
- unusualness
- social deviance
- faulty perceptions or interpretations of reality
- significant personal distress
- maladaptive behavior
- dangerousness
Maladaptive behaviour
- cannot adapt to normal daily life.
- a threat to self and others
Define: mental disorder
- a clinically significant disturbance in cognition,emotion regulation or behaviour
- usually associated with significant distress or disability.
Demonic Possession
- symptoms of psychopathology result from being possessed by evil spirits.
- treated by exorcism
Trephination
boring a hole into the skull to release demons responsible for abnormal behaviour.
The Four Humors
Hippocrates believed that illnesses of the body and mind have natural causes. Galen proposed the links between temperament based on the four humours. Phlegm, Black bile, yellow bile, blood.
Phlegm
Phlegmatic: calm, unemotional, lethargic
Black bile
Melancholic: despondent, sleepless, irritable.
Blood
Sanguine: confident, optimistic
Yellow bile
Choleric: easily angered, bad tempered.
Philippe Pinel (1745-1826)
stopped harsh practices of asylums. Used talking, understanding and concern
Moral Treatment (Quaker Movement)
- abandoned medical practices.
- understanding, hope and moral responsibility
- occupational therapy
General paresis
psychological symptoms include personality changes, mood changes and dementia
(caused by syphilis)
Milieu therapy (1950s-1970s)
- supportive environment
- provides a sense of belonging, care and accountability
- vocational and recreational activities
- more likely to be discharged
- less likely to relapse.
Token Economy (1950s-1970s)
- based on operant conditioning
- rewarded with tokens for desirable behaviour
- promote social skills, independence and self-care
- patients discharged sooner
- use has declined since 1980s
- because people have a right to basic items previously used as reinforcers
- not always practical at maintaining positive behaviour after being discharged
Community Care
- enabling people to remain in their homes and be independent
- outpatient therapy
- daily living support
- day centres
- employment services
- peer support
The Biological Model - Genetics
Diathesis (inherited predisposition or vulnerability to developing a disorder) + stress (environmental) = psychological disorder
Frontal lobe in depression
decreased activation in prefrontal cortex - linked to goal attainment
Hippocampus in depression
fear related stimuli
deficits- dissociating affective responses from context - eg feel sad independent of context
Amygdala
fear response and emotional memory
- increased activation- prioritising threatening info and interpreting it negatively
Neurotransmitter used in mood disorders
serotonin and norepinephrine
Neurotransmitter used in anxiety disorders
norepinephrine and GABA
Neurotransmitter used in schizophrenia
dopamine
Neurotransmitter used in Alzheimer’s
acetylcholine
Critique of Biological model
- assumes something is ‘broken’ but the symptoms may be an extreme of normal behaviour
- the dysfunction is located within the individual
- ignores socio-economic and enviro factors
- cannot explain dysfunctional thoughts and beliefs
- stigmatising (self and other)
- person adopts a ‘sick role’
The purpose of classification
- creates a common language for research and data sharing
- understands the causes of psychopathology
- develop effective treatment and prevention strategies
- assess the effectiveness of treatments
- organise services and support
- medical aid
Problems with classification
- labels can be stigmatising
- encourages adoption of a ‘sick role’
- defines disorders as discrete entities (have it or you don’t)
- high rates of comorbidity
Axis 1
Clinical disorders
Axis 2
Personality Disorders and Mental Retardation
Axis 3
General Medical Conditions
Axis 4
Psychosocial and Environmental Problems
Axis 5
Global Assessment of Functioning (GAS) Score
DSM-5 Cultural Consideration Aims
- enhance the cross-cultural applicability of the DSM
- increase awareness of the challenges involved in using the DSM to evaluate people from diverse cultures
- acknowledges the cultural differences in symptom presentation, expression of distress, course and prevalence
- avoid misdiagnosis
The Cultural Formulation Interview
to increase the clinician’s understanding of the cultural context of illness experience
The Clinical Interview
- informal, unstructured or semi-structured conversation
- gain a broad insight into client and their problems
- assess the nature of symptoms
- info about history and current circumstances
- formulate treatment programme
Psychological tests
- most common form of assessment
- highly structured
- assess one or more specific characteristics
- rigid response requirements
- good reliability and validity
Minnesota Multiphasic Personality Inventory (MMPI-2)
- originally used to assess personality characteristics indicative of psychopathology
- 3 broad domains, emotion, thought and behaviour
- 10 clinical scales- depression, paranoia, social introversion
- 15 content scales -eg anxiety, anger
- good reliability and validity
Specific Trait Inventories
- measures functioning in one specific area eg. anxiety, depression, social skills, cognitive functioning
- also used as a research tool for understanding causes of psychopathology
- eg. Beck’s Depression Inventory
Projective Tests
- the person projects their unconscious desires and conflicts onto stimuli
- lower reliability and validity
- time consuming and needs expert training
Case Formulation
- use info to compile a psychological explanation of a client’s problem
- ABC approach (Antecedents, Beliefs, Consequences)
- developed with client
6 components of Case Formulation
- create a problem list
- identify underlying psychological mechanisms
- how do these mechanisms generate problems?
- identify kinds of precipitating events
- how do these precipitating events generate problems?
- devise a treatment plan
Biological Model- Genetics
diathesis (inherited predisposition to develop a disorder) + stress (environmental) = psychological disorder
Neurotransmitters for mood disorders
serotonin and norepinephrine
Neurotransmitters for anxiety disorders
norepinephrine and GABA
Neurotransmitters for schizophrenia
dopamine
Neurotransmitters for alzheimer’s
acetylcholine
Drug treatments for depression
- tricyclics eg trepeline
- SSRIs
- MAOIs
antidepressent drugs side effects
- nausea
- dry mouth
- drowsiness
- insomnia
- sweating
- decreased sexual response
Drug treatments for bipolar disorder
- controls mood swings
- lithium
- anti-epileptic agents
Drug treatments for anxiety
Anxiolytic drugs:
- benzodiazepines (valium)
- buspirone
- SNRIs
side effects of anxiety drugs
- drowisness
- light-headedness
- dry mouth
- depression
- insomnia
- confusion
- highly addictive
drug treatments for schizophrenia
- olanzapine, clozapine, quetiapine
- life long dosage
side effects of antipsychotic drugs
- blurred vision
- muscle spasms
- cardiac problems
- weight gain
Problems with drug treatments
- overprescribed
- not suitable for mild symptoms
- relapse rate high when medication stops
- does not address psychological, cognitive and social factors
Critique of Biological Model
- ignores socio-economic and enviro factors
- doesnt explain dysfunctional thoughts and beliefs
- stigmatising
- adoption of ‘sick role’
- assumes something is ‘broken’ but symptoms may be extreme form of ‘normal’ behaviour
Psychodynamic Perspective
- Sigmund Freud
- psychological disorders are rooted in unconscious conflicts stemming from early childhood experiences
- need to reveal these conflicts to reduce symtoms
Id
instinctual needs, pleasure principle
Ego
attempts to control the impulses of id
reality principle
Superego
develops out of the id and ego
societal values
Psychoanalysis aim
reveal unconscious conflicts causing symptoms of psychopathology
(free association, dream analysis, interpretation, transference, resistance)
The Behavioural Model
- the behaviour needs to change, it is not the symptom of an underlying cause
- dysfunctional and adaptive behaviours are learnt
- person can unlearn maladaptive behaviours and emotions
Classical Conditioning
Pavlov - learning association between 2 stimuli
Operant Conditioning
Skinner
learning a specific behaviour or response because it has rewarding or reinforcing consequences
Classical Conditioning Therapies- Exposure therapy
aim- to decrease the conditioned fear response associated with a specific cue
-If the feared object is repeatedly paired with absence of trauma or relaxation it will no longer elicit a fear response
Classical Conditioning Therapies- flooding, systematic desensitisation and aversion therapy
used to treat PTSD, phobias and OCD
Flooding
repeated exposure to highly distressing stimuli
Systematic Desensitisation
- overcome fears though gradual and systematic exposure
- thoughts or events paired with relaxation
Aversion Therapy
-conditions an aversion to a stimulus
-stimulus is paired with an aversive stimulus
-results in an aversive conditioned response
(eg alcohol)
Operant Conditioning Therapy Aims
- understand the factors reinforcing a person’s inappropriate behaviours
- use reinforcers or rewards to establish new/appropriate behaviours
- used to treat PTSD, OCD, phobias
Functional Analysis
- identify factors triggering the behaviour
- identify consequences of maintaining the behaviour
ABC
A-Antecedent
B-Behaviour
C-Consequence
The Cognitive Perspective
- Symptoms of psychopathology are caused by irrational beliefs and dysfunctional ways of thinking
- These beliefs and cognitions can also maintain symptoms
- Aim of therapy – identify, challenge and replace dysfunctional beliefs and thoughts
Rational Emotional Therapy (Ellis)
-irrational assumptions result in distress, anxiety and depression
-aim: to challenge irrational beliefs and replace them with more rational ones
ABCDEF approach
ABCDEF of Rational Emotional Therapy
Activating event Belief Consequences Disputing intervention Effective philosophy new Feelings
Mindfulness-Based Cognitive Therapy
Aim – to improve emotional well-being by increasing a person’s awareness of how their automatic cognitive and behavioural reactions can cause distress
Cognitive Therapy (Aaron Beck)
Aim of therapy:
- Help the person to become conscious of these beliefs
- Asking them to provide evidence for these beliefs
- Replace these beliefs with more rational cognitive schemas
- uses diaries, homework
Family Therapy (Salvador Minuchin)
- locus of pathology is in the context of the family, not the individual
- families that are overprotective, stifling independence, rigidity, poor problem solving
Family Therapy aim
- To understand the complex relationships that exist between family members
- To understand the function of the presenting symptoms
- To remould these relationships so that the family can function more effectively
- To improve communication between family members
- To resolve specific conflicts
The Humanistic Perspective
- consider the whole person not only their symptoms
- believe people are essentially good
- problems arise when obstacle prevent a person from realising their full potential
Carl Roger’s Personality Theory
-self-concept: the picture a person has of themselves and the values they attach to themselves
-ideal self: the self-concept a person would like to have.
-should be in harmony
-To understand the complex relationships that exist between family members
To understand the function of the presenting symptoms
To remould these relationships so that the family can function more effectively
To improve communication between family members
To resolve specific conflicts
Roger’s Client-Centred Therapy
- If people are unrestricted by fears and conflicts they will develop into happy, well-adjusted individuals
- Goal – to develop the client to a point where they are successful in experiencing and accepting themselves and are able to resolve their own conflicts and difficulties
- The therapist provides a supportive emotional climate
The Four Stages of DBT (Dialectical Behaviour Therapy) for BPD
- Address dangerous and impulsive behaviours
- Moderate extreme emotions
- Improve self-esteem and the person’s ability to deal with relationships
- Promote positive emotions such as happiness
Zen Philosophy
- Letting go of attachments to what you think reality should be like
- Finding a middle path through acceptance, self-validation and tolerance
- Focusing on the present moment, accepting reality as it is, without judgement
- Mindfulness
Distress Tolerance
- Designed to help people deal with overwhelming emotions, thoughts and situations
- Used to temporarily ride out an emotional storm:
1. Acceptance and validation
2. Distraction
3. Self-soothing
Interpersonal Effectiveness
-Objective effectiveness (DEAR MAN)
(Describe, Express, Assert, Reinforce, Mindfully, Appear confident, Negotiate)
-Relationship effectiveness
-Self-respect effectiveness
