Psychodynamics Flashcards
what are the definitions for abnormality
statistical infrequency, deviation from ideal mental health, deviation from social norms, failure to function adequately
definitions for abnormality - statistical infrequency (example)
intellectual disability disorder
individuals with a low IQ (2% below 70) in infrequent
definitions for abnormality - statistical infrequency (definition)
anyone who falls outside normal distribution (statistically rare) should be seen as abnormal
definitions for abnormality - statistical infrequency (strengths)
appropriate for multiple mental illnesses where statistical criteria available, allowing for objective assessment of level of disability
definitions for abnormality - statistical infrequency (weaknesses)
not all infrequent behaviours are abnormal e.g. high IQ is desirable
not all abnormal behaviours are infrequent - some frequent behaviours are abnormal e.g. 10% of the population have depression
definitions for abnormality - deviation from social norms (definition)
any behaviour deviating from social norms seen as abnormal
those who don’t adhere to social norms at that time period
definitions for abnormality - deviation from social norms (example)
psychopathy
fail to conform to lawful/culturally moral behaviour
definitions for abnormality - deviation from social norms (strengths)
allows consideration of social dimensions of a behaviour e.g. behaviour may be acceptable in one situation but not in another
definitions for abnormality - deviation from social norms (weaknesses)
people regularly break social norms but seen as ‘eccentric’ instead
norms change over time e.g. homosexuality seen as mental illness till 1990 - can’t truly define act as abnormal as society changes so must our behavioural beliefs
definitions for abnormality - deviation from ideal mental health (definition)
Marie Jahoda identified 6 characteristics of what it is to be normal - any absence of these = abnormality
e.g. resisting-stress, autonomy, self-actualisation
definitions for abnormality - deviation from ideal mental health (example)
depression as people have low self-esteem, stressed and struggle to make decisions
definitions for abnormality - deviation from ideal mental health (strengths)
takes a positive approach to mental problems by focusing on what is desirable
definitions for abnormality - deviation from ideal mental health (weaknesses)
over-demanding criteria
Jahoda argued mental health can be considered physical but diagnosing it is more subjective
definitions for abnormality - failure to function adequately (definition)
too assess degree of dysfunction Rosenhan & Seligman came up with 7 features of abnormality e.g. distress, unpredictability
behaviours suggesting they can’t cope with everyday life
definitions for abnormality - failure to function adequately (example)
Schizophrenia - experience distress, irrationality and unpredictability around people
definitions for abnormality - failure to function adequately (strengths)
allows assessment of abnormality - more symptoms shown = more abnormal)
definitions for abnormality - failure to function adequately (weaknesses)
abnormality not always accompanied by dysfunction
problem over deciding who has right to define behaviours as dysfunctional
phobia
anxiety disorder
excessive / persistent fear or a situation / object
Social Phobia
social anxiety disorder
fear of social situation through thought they may be judged / embarrised
Agrophobia
irrational fear of being in places where escape if difficult
e.g. crowded spaces, leaving home
Specific Phobias
phobia of specific object
Phobia - emotional characteristics
anxiety / panic
excessive / unreasonable fear to stimulus
Phobia - behavioural characteristics
freezing / fainting
avoidances interfering with life
Phobia - cognitive characteristics
irrational thinking
resistant to logical thinking
awareness of own irrationality
The Behaviourist Explanation for Phobias:
Little Albert
white rate = neutral stimulus and elicits neutral response
bang unconditioned it naturally produces fear
bang & rat paired
rat becomes conditioned stimulus which elicits conditioned response (fear)
Behaviourist Approach to Treating Phobias: Flooding
- Relaxation (taught e.g. breathing exercises, visualisation, progressive muscle relaxation)
- Flooding/Intense Exposure (introduced to phobic stimulus at its worst whilst using relaxation techniques called reciprocal inhibition) (2-3 hour sessions gives fear response chance to pass) (once calm, neural experience with phobic stimulus so unlearns association) (involve vitro (imagined) or vivo (contact)
Behaviourist Approach to Treating Phobias: Systematic Desensitisation
- Relaxation
- Desensitisation Hierarchy/Gradual Exposure (gradually introduced to phobic stimulus whilst using relaxation techniques) (hierarchy series of agreed progressive steps) (usually vitro then move onto vivo) (several shorten sessions online or self-administered)
Evaluation of the behaviourist treatment to phobias: Flooding
+ similar effectiveness to alternate therapies
+ Choy et al: some evidence better than SD
- very intense not appropriate for everyone
- risk exposure backfire + make worse
- unethical: traumatic - risk people won’t turn up because of intensity wasting resources
- difficult and unethical to run alone/online
Evaluation of the behaviourist treatment to phobias: Systematic Desensitisation
+ McGrath et al: 75% success rate
+ Choy et al: vivo more effective
+ works in long-run (Gilroy et al: patients less afraid of spiders than control group at 3-year follow-up after 45’ session)
- not appropriate for all phobias (ancient fears best treated by flooding)
+ allows patient buy-in since they agree on steps - their pace so little distress or drop-outs
+ self-administered & done online - cheap & widens access to those who can’t access conventional therapy
Obsessive Compulsive Disorder
anxiety disorder
obsessions: reoccurring + persistent thoughts
compulsions: repetitive behaviours
behavioural: compulsions
cognitive: obsessions
emotional: anxiety, disgust, shame
Genetic Explanation to OCD
genetic basis: heritable
investigated through family (fam rates of OCD to calculate risk), twin (look at twin with OCD to calculate concordance rates), gene (study DNA sequences to identify which variant (mutation) of particular gene
Evidence for the Genetic Explanation of OCD
Nestadt et al: those with first degree relatives have 5x risk - meta-analysis: MZ concordance rate 68% vs DZ 31%
specific genes discovered: COMT (controls production of COMT regulates dopamine (COMT mutation -> high dopamine -> OCD)) SERT gene (regulates serotonin transport (SERT mutation -> low serotonin -> OCD))
OCD treatment: Selective Serotonin Reuptake Inhibitors (SSRIs)
OCD = low serotonin levels
tries to increase serotonin - CNSSRIs inhibit reuptake of serotonin - restores normal functioning of the OFC + caudate nucleus - relieves anxiety + obsessions
OCD treatment: tricyclic antidepressants
inhibit reuptake of serotonin + noradrenaline TMT they remain in synapse increasing levels of serotonin + noradrenaline
more effective than SSRI but greater side effects e.g. insomnia, headache, upset stomach, loss of appetite
OCD treatment: anti-anxiety drugs (benzodiazepines)
BZ alter GABA receptor function, GABA action enhanced
GABA has calming effect TMT BZ slow down neural signals + relax nervous system
work by increased chloride channel efficiency, enabling greater influx of chloride ions (negative) which decrease membrane potential + prevent firing
side effects: drowsiness, depression, vision problems
evaluate strengths for drug therapy
evidence for effectiveness (show SSRI reduce symptom + improve QOL) (Soomro et al: reviewed 17 studies comparing SSRI to placebos - all showed sig better outcomes for SSRI) (symptoms reduce 70%) WEAKNESS (Skapinakis et al: systematic review of outcome + concluded both cog + beha therapies more effective in treatment)
cost-effective and non-disruptive (cheap compared to psychological treatments bc thousands of tablets/liquid doses can be manufactured in time it takes to conduct 1 session of psychological therapy - good value for public health systems (NHS)) (non-disruptive to lives)
evaluate weaknesses for drug therapy
serious side effects (indigestion, blurred, loss sex drive) (those taking ticyclic clomipramine side-effects more common e.g. more than 1 in 10 people experience erectional problems + weight gain)
cognitive explanation for depression
have schemas (about themselves or other people) that would affect how we process the world
cognitive explanation for depression: Ellis’s ABC model
American psychologist who founded REBT (form of therapy)
if we react rationally, experience health emotions e.g. acceptance
if we react irrationally, experience unhealthy emotions e.g. hopelessness, worthlessness
Ellis proposed activating events interpreted with irrational belief, causes unhealthy consequence of depression - faulty belief: maladaptive thinking
cognitive explanation for depression: Beck’s Cognitive Triad
-tive schemas acquired (often in childhood from rejection) provide -tive framework for viewing events pessimistically
these become biases: overgeneralisation, magnification, selective perception, absolutist think
evaluate cognitive approach to depression
strengths:
+ supported by research (Hammen & Krantz: depressed people make logical errors in thinking tasks reinforcing cognitive bias of behaviour)
+ real world application (CBT)
weaknesses:
- ignores other approaches (genetics has evidence)
- correlation between -tive thoughts + depression but no causation
alternative approaches to cognitive explanation for depression
Lewinsohn: operant conditioning - depression caused by removal of +tive reinforcement - reduction in activity + moods tends to cause others to express sympathy + give attention, -tively reinforcing depressed behaviour
monamine hypothesis of depression argues it results from low levels of serotonin
role of genetic factors: genes that influence activity of serotonin have been linked to depression (Zhang et al) - most researchers believe only creates vulnerability for depression - Caspi et al: depression only emerge if vulnerable individual experiences significant life stress
cognitive approach to treating depression: CBT
identify -> challenge -> replace
identify dysfunctional thoughts -> challenge them -> test reality of irrational beliefs
set homework to record when enjoy event or someone nice to them, ‘patient as scientist’ investigation reality of -tive beliefs
behavioural activation (therapist encourages patient more active + engage enjoyable activities - provide more evidence for irrational nature of beliefs)
rationale: maladaptive thinking explains depression, psyc treat by working with patients to change thinking called ‘cognitive restructuring’ change way people interpret + process things by identifying, challenge, replacing - effortful + long-term solution
research support for CBT: cognitive approach to treating depression
Ellis: 90% success rate for Rational Emotive Behavioural Therapy (REBT) - 27 sessions - not always effective
REBT & CBT done well in outcome of depression - Cuijpers et al: 75 studies CBT superior to no treatment
cognitive approach to treating depression: CBT - individual differences (weaknesses)
less suitable for people high level irrational beliefs that are resistant to change (Elkin et al)
less suitable in situations high levels stress in individual reflect realistic stressors that therapy can’t resolve (Simons et al)
