Need To Know Psychopathology Flashcards
Ellis abc model
- assumes depression is due to irrational thinking
- Not events that cause depression but the way we think about them
A - activating event is interpreted by the individual using
his beliefs- (B) this leads to consequences (C)
Becks negative triad
- believed depressed people feel depressed because they have a negative view (schemas) of world
- negative schemas lead cognitive biases which in turn lead to depression
- 3 key elements in a persons belief system (triad):
- negative view of the self
- negative view of the world
- Negative view of the future
Symptoms from the dsm
1- depressed mood most of day, nearly every day, by self report
2 - disinterest or displeasure all/ almost all, activités most of day
3- significant weight loss/weight gain eg change of more than 5% of body weight in month
4- insomnia/Hypersomnia nearly every day
5- agitation or retardation nearly every day
6- fatigue/loss of energy nearly every day
7- feelings of worthlessness or excessive/ inappropriate guilt which may be delusional nearly every day
8- diminished ability to think/ concentrate/ indecisiveness nearly every day
9- recurrent thoughts of suicidal ideation without a specific plan or a suicide attempt or a specific plan for committing suicide.
Mood disorder
-psychological disorder characterised by disturbances in mood
Types of mood disorders
- Bipolar
- depressive
Definitions of Abnormality
- Statistical Infrequency
- Deviation from Social Norms
- Deviation from ideal mental health
- failure to function adequately
Definitions of Abnormality-
Statistical Infrequency A01 with example
- person’s trait, thinking or behavior is classified as abnormal if it is rare or statistically unusual.
- E.g. individual who has an IQ below or above average level of IQ in society is abnormal.
Definitions of Abnormality Deviation from Social Norms
AO1
- suggests we define mental illness by looking at absence of signs of physical health
- person’s thinking or behavior is classified as abnormal if it violates rules about what’s expected or acceptable behavior in a particular social group.
- behaviour may be incomprehensible to others or make others feel threatened or uncomfortable
Definitions of Abnormality Deviation from Ideal Mental Health
AO1 of the 6 criteria PRAAMS jahoda
- Positive self-concept
- Resistance to stress
- Autonomy
- Accurate perception of reality
- Mastery of environment
- Self actualisation
Definitions of Abnormality Failure to Function Adequately
AO1 with example
- refers to abnormality that prevent person from carrying out a range of behaviors that society expects from them like:
- getting out of bed each day, holding down a job,etc.
- eg schizophrenia -person can have disturbing hallucinations which can lead to bizarre behaviour; experience distress and can be irrational and unpredictable around other people
Biological Approach to OCD - Characteristics of OCD Cognitive, emotional and behavioural
- Cognitive characteristics
- obsessive thoughts (obsessions)
- Emotional characteristics
- anxiety and distress caused by obsessions, which consist of persistent thoughts
- Behavioural characteristics
- compulsions (e.g. excessive hand washing).
Genetic Explanations of ocd COMT and SERT
- SERT gene is Serotonin transporter
- mutation causes increase in transporter proteins at neuron’s membrane
- increase in reuptake of serotonin into neuron which decreases level of serotonin in synapse.
- COMT gene regulates function of dopamine
- causes decrease in COMT activity and therefore a higher level of dopamine.
Neural mechanisms
- regions of brain structures like neurons and neurotransmitters
- involved in sending messages through nervous system
Neural Explanations of OCD PFC (pre frontal cortex)
- PFC involved in decision making and regulation of primitive aspects of our behavior
- over active PFC, causing exaggerated control of primal impulses
- if you have OCD, your PFC is over activated which means obsessions and compulsions continue
an imbalance of serotonin and dopamine in patients with ocd
- Reduced serotonin and excessive dopamine may cause OCD.
- OCD patients have low levels of serotonin
- Dopamine is abnormally high in individuals with OCD.
- High levels of dopamine thought to influence concentration
- explains why OCD individuals experience an inability to stop focussing on obsessive thoughts and repetitive behaviors.
Outline how SD might be used to treat a phobia
- relaxation training
- anxiety hierarchy
- gradual exposure to anxiety hierarchy
Outline how flooding might be used to treat a phobia
- immediate/direct/ full exposure
- prevention of avoidance
- until they are calm/anxiety has receded/ fear is extinguished
Why is SD more effective to treat phobias than flooding
- SD allows people to make progress in small steps in own time scale so client in control
- SD generally has low attrition rates/high completion rates because gradual process of therapy allows respite- relaxation is pleasant
- SD may be more successful for certain individuals eg children, people with health conditions
- SD less traumatic leading to more people completing treatment and suitable for wider range of clients
Definitions of Abnormality Failure to Function Adequately rosenhan and seligman seven features of abnormality
- suffering
- maladaptiveness
- vividness and unconventionality
- unpredictablity and loss of control
- irrationally/ incomprehensibility
- causes observer discomfort
- violates moral/social standards
Definitions of Abnormality Failure to Function Adequately evaluation strength
- attempts to include subjective experience of individual
- may not be an entirely satisfactory approach because it’s difficult to assess distress
- definition acknowledges the experience of the patient is others
Definitions of Abnormality Failure to Function Adequately evaluation
Weakness
- someone has to judge whether a patient is distressed or distressing
- some patients say they’re distressed but may be judged as not suffering
Definitions of Abnormality Deviation from Ideal Mental Health example
- depression illustrates definition
- sufferers generally have low self esteem ie a negative struggle to make decisions
- ie not autonomous and experience high levels of stress concerning their low mood condition
Definitions of Abnormality Deviation from Ideal Mental Health evaluation strength
- comprehensive definition
- covers broad range of criteria for mental health
- probably covers most reasons someone would seek help from mental health services or be referred for help
Definitions of Abnormality Deviation from Ideal Mental Health evaluation weakness
- unrealistically high standard for mental health
- accused of having over demanding criteria very few people attain
- all jahodas criteria for mental health probably none of us achieve all of them at the same time or keep them up for very long
Definitions of Abnormality-
Statistical Infrequency evaluation strength - real life application
- real life application in diagnosis of intellectual disability disorder
- place for statistical deviation in thinking about what are normal and abnormal behaviours and characteristics statistical deviation is
- useful part of clinical assessment
Definitions of Abnormality-
Statistical Infrequency weakness
Not everyone unusual benefits from a label
- if someone is living happy fulfilled life there’s no benefit to them being labelled as abnormal regardless of how unusual they are
- someone with low iq but who wasn’t distressed, quite capable of working etc would simply not need a diagnosis of intellectual disability
- If person was ‘labelled’ as abnormal might have negative effect on way others view them and way they view selves
Definitions of Abnormality Deviation from Social Norms example
- antisocial personality disorder or psychopathy
- person is impulsive and often agressive, pleasing only themselves
- one symptom is absence of pro social internal standards and failure to conform to lawful or culturally ethical behaviour
Definitions of Abnormality Deviation from Social Norms evaluation strength not a sole explanation
- real life application in diagnosis of antisocial personality disorder
- place for deviation from social norms in thinking about what is normal and abnormal
- deviation from social norms is never sole reason for defining abnormality
Definitions of Abnormality Deviation from Social Norms evaluation weakness cultural relativism
- problem is social norms vary tremendously from one generation to another and from one community to another
- creates problems for people from one culture living within another culture group
Behavioural characteristics of ocd compulsions- two elements
1 compulsions are repetitive :
- typically sufferers of ocd feel compelled to repeat a behaviour
- common example is hand washing.
2 compulsions reduce anxiety :
- around 10% of sufferers of ocd show compulsive behaviour alone
- have no obsessions just general sense of irrational anxiety but for vast majority compulsive behaviours are performed in an attempt to manage anxiety produced by obsessions
Behavioural characteristics of ocd
Avoidance
- behaviour of ocd sufferers may also be characterised by their avoidance as they attempt to reduce anxiety by keeping away from situations that trigger it
- Sufferers of ocd tend to try to manage their ocd by avoiding situations that triggers anxiety
Emotional characteristics of ocd
Anxiety and distress
- ocd is regarded as particularly unpleasant emotional experience because of powerful anxiety that accompanies both obsessions and compulsions
- Obsessive thoughts are unpleasant and frightening and anxiety that goes with these can be overwhelming
- urge to repeat a behaviour creates anxiety.
Emotional characteristics of ocd
Accompanying depression
- ocd often accompanied by depression
- anxiety can be accompanied by low mood and lack of enjoyment in activities
- Compulsive behaviour tends to bring some relief from anxiety but this is temporary
Emotional characteristics of ocd
Guilt and disgust
- ocd sometimes involves other things such as irrational guilt
- for example over minor moral issues or disgust which may be directed against something external like dirt or at self
Cognitive characteristics of ocd
Obsessive thoughts
- around 90% of ocd sufferers major cognitive feature of condition is obsessive thoughts ie thoughts that recur over and over again.
- vary considerably from person to person but are always unpleasant
- Example of recurring thoughts are worries of being contaminated by dirt and germs or certainty a door has been left unlocked and intruders will enter
Cognitive strategies to deal with obsessions
- people respond by adopting cognitive coping strategies
- for example a religious person tormented by obsessive guilt may respond by praying or meditating
- may help manage anxiety but can make person appear abnormal to others and can distract them from everyday tasks
Cognitive characteristics of ocd
Insight into excessive anxiety
- people suffering from ocd are aware that their obsessions and compulsions aren’t rational
- Ocd sufferers experience catastrophic thoughts about worst case scenarios that might result if their anxieties were justified
- tend to be hyper vigilant ie they maintain constant alertness and keep attention focused on potential hazards
Phobia definition
- persistent anxiety disorder which interferes with daily living
- instance of irrational fear which causes people to avoid it
Two process model of phobia acquisition mowrer suggests what
- phobias are acquired as a result of classical conditionin
- maintained by opérant conditioning
Behavioural treatments of phobias aim to
- 1 reduce phobic anxiety though principle of classical conditioning
- whereby new response to phobic stimulus is paired with relaxation instead of anxiety- counterconditioning
2 reduce phobic anxiety through principle of opérant conditioning
-whereby there’s no option for avoidance behaviour
Sd définition + reciprocal inhibition
- aims to teach patient to learn a more appropriate association
- designed to reduce an unwanted response such as anxiety to a stimulus
- reciprocal inhibition is process of inhibiting anxiety by substituting a competing response
Sd evaluation
- effective
- techniques have proven most effective with specific phobias when a particular phobic object/ situation can be identified
- less effective with agoraphobic and social phobias
- suitable for diverse range of patients
- simple process that patient controls it’s often most suitable form of treatment
Sd evaluation gilroy et al
- followed up on 42 patients who underwent sd for spider phobia.
- were less fearful than a control group who only used relaxation at 3 and 33 months
Sd evaluation may only treat symptoms rather than underlying cause
- may only treat symptoms rather than underlying cause and so will resurface in another form (symptom substitution)
Sd evaluation more useful for children
- more useful for children and péople with learning difficulties
- due to difficult thinking and reflection required during flooding or cognitive therapies
Sd évaluation more suited to phobias as a result of personal experience
- more suited to phobias as a result of personal experience rather than evolutionary, survival based ones eg fear of dark
Flooding definition
- involves overwhelming individuals senses with item or situation that causes anxiety so person realises that no harm will occur
- no relaxation techniques or step by step build up
- individual is exposed repeatedly and in intensive way with phobia
- individual has senses flooded with thoughts images and actual experiences of object of phobia
How does flooding work
- flooding stops phobic résponses very quickly
- without option for avoidance behaviour, patient quickly learn that phobic stimulus is harmless
- process is called extinction
- a learned response is extinguished when conditioned stimulus is encountered with unconditioned stimulus
- result is conditioned stimulus no longer produces conditioned response
Ethics of flooding
- flooding isn’t unethical
- patients give informed consent so know exactly what’s involved
- unpleasant experience and patient has to be properly prepared
- patient would normally be given choice of sd or flooding
Flooding evaluation
- cost effective
- fast method and treatment it makes treatment cheaper than alternatives
- treatment is traumatic for patients
- flooding produces high levels of fear and can be very traumatic and many patients refuse to start or complete treatment
- less effective for some types of phobias
- like social phobias because social phobias have cognitive aspects an individual doesn’t simply experience an anxiety response but thinks unpleasant thoughts about social situation
Dépression
-mood disorder where individual feels sad and or lacks interest in their usual activities
Ocd
- anxiety disorder where anxiety arises from both obsessions and compulsions
- Compulsions are a response to obsessions and person believes the compulsions will reduce anxiety
ABC model définition
- cognitive approach to understanding mental disorder focusing on effect of irrational beliefs in emotions
Negative triad definition
- cognitive approach to understanding depression
- focusing on how negative expectations about self world and future lead to depression
Irrational thoughts
- rational thinking is flexible and realistic where beliefs are based on facts and logic
- irrational thinking is rigid and unrealistic and lacks internal consistency
Behavioural
- ways in which people act
Emotional
- ways in which people feel
Cognitive
- ways in which people process information including perception attention and thinking
A compulsion
- behaviour ie it’s something you do
An obsession
- a cognition ie it takes place in the mind
Dsm ( diagnostic and statistical manual of mental disorders)
- list of mental disorders
- used to diagnose mental disorders
- for each disorder a list of clinical characteristics is given
Thé cognitive approach to explaining depression
Évaluation
Support for the role of irritational thinking
- view that depression is linked to irrational thinking
- supported research by hammen and krantz
- found depressed participants made more errors in logic when asked to interpret written material than did non depressed participants
- bates et al found depressed participants who were given negative automatic thought statements became more and more depressed
- research supports view negative thinking leads to depression
- negative thinking may also be a consequence of depression
Thé cognitive approach to explaining depression
Évaluation
Blames the client rather than situational factors
- cognitive approach suggests client who’s responsible for disorder
- gives client the power to change way things are
- may lead to client or therapist to overlook situational factors life events or family problems which may have contributed to mental disorder
- strength- therefore lies in its focus on clients mind and recovery but others aspects of clients life may also need to be considered
Thé cognitive approach to explaining depression
Évaluation
Practical applications in therapy
- effectiveness of CBT supports usefulness of cognitive approach
- CBT ie consistently found to be best treatment for depression especially when used in conjunction with drug treatments eg cuijpers et al
- if dépression is alleviated by challenging irrational thinking then suggests such thoughts has a role in depression in first place
Thé cognitive approach to explaining depression
Évaluation
Alternative explanations
Biology
- depression can be explained biologically in genetic factors and neurotransmitters
- studies found low levels of neurotransmitter sérotonin in depressed people
- gene related to low levels of serotonin is 10x more common in depressed more common is depressed people
- Research shows drug therapies which raise serotonin levels are successful in treatment of depression.
- means neurotransmitters also play role in causing depression and diathesis stress model could be better approach to take
Thé cognitive approach to explaining depression
Évaluation
Issues and debates
- link to nature- nurture debate
- diathesis stress is model of interaction between nature and nurture
Emotional characteristics of depression
- sadness and or loss of interests and pleasure in activities a person is normally interested in
- takes pleasure from other feelings include
- despair
- low self esteem
- lack of control
- inward or outward directed anger
Behavioural characteristics of depression
- difficulties in concentrating
- decreased or increased activity patterns
- excessive sleep or insomnia
- increased or decreased appetite
