Psychopatholgy

Question 1

Definition of abnormality

Answer 1

Statistical infrequency
we can define what is normal by mean, median, and mode then by using this typical value in the data we can see what is not normal

Deviation from social norms
Norms are created by a group of people and thus social
there are standards of acceptable behaviours that are set by the social group anyone who behaves differently is classed as abnormal

Failure to function adequately
functioning refers to going about daily life such as eating regularly when you fail to do this then it can cause distress and suffering for the individual and others
- in some cases the person does not feel distress but others around them are distressed for example schizophrenic people
- understanding and communicating
- getting around
- self care
- getting along with people
- life activities
- participation in society
it is rated on a scale of 1 to 5 then scored out of 180

Deviation from ideal mental health
Maire Jahoda (1958) said that we should judge mental health like we do physical illness and look at the absence signs of mental health
self attitudes person growth
personal growth and self actualisation
integrations - being able to cope in stressful situations
autonomy - being independent and self regulation
having an accurate perception of reality
mastery of the environment

Question 2

Describe mental disorders

Answer 2

Phobias
Emotional characteristics
primary emotional characteristics is unreasonable and excessive fear, this is allied by anticipation of a specific object and out of proportion to the actual danger based

Behavioural characteristics

• avoidance - interferes with the daily routine and causes the personal distress this distinguishes phobias from every day fears
• freeze or faint, person plays dead

Cognitive characteristics
their irrational behaviour and their resistance to rational arguments
the person recongises that there fear is excessive or unreasonable this distinguishes between a phobia and mental illnesses - they could be schizophrenic if they cannot realise their excessive behaviour

Depression
Emotional characterstics
sadness
loss of interest and pleasure
sadness is most common description, they feel empty lonely and have low self-esteem
feel despair and lack of control, have anger and this is directed towards one self or others they want to hurt or retaliate

Behavioural characteristics
reduce of increase their activity level, 
they want to sleep more or less
increasingly agitated and restless
don't want to eat  

Cognitive characteristics
associated with negative self hate as well as guilt and worthlessness
negative view of the world and expect things to turn badly
negative thoughts can be fulfilling for believing they will fail out of a test and actually fail
negative thoughts are irrational

OCD
Emotional characteristics
obsessions and compulsions are a source of anxiety and distress, the people are aware that there behaviour is excessive and are shamed and embarrassed

Behavioural characteristics
the compulsive behaviours reduce anxiety and patients feel that they must perform the action otherwise some thing dreadful will happen, even though the events are not connected in a realistic way

Cognitive characteristics
obsessions are recurrent and some thoughts are embarrassing so they don’t want to share
common thoughts include ideas or impulses
impulses are not excessive and are worries of everyday problems at some point person recognises that obsession is unreasonable

Question 3

The behavioural approach to explaining phobias

Answer 3

Little Albert
John B Watson along with Rosalie Raynerin 1920 conducted the study with little Albert
- wanted to show that an emotional response could be learned via classical conditioning, 11th month old could called Albert showed fear furry objects these were the neutral stimuli
- every time albert reached for the furry objects a loud noise was played behind his head
- this was repeated and scared him
- this conditioned him

The Two-Process Model
Orval Riopart Maurer 1947 - proposed the two process model to explain how phobias are learned
- 1st stage would be classical conditioning while the 2nd stage is operant

classical conditioning - a phobia is acquired through association between neutral stimuli and the response being learned
the UCS Is the noise and the UCR is the fear, in the case of little Albert the furry object (NS) is being paired with the UCS transferred the properties and made it to a CS which produces a CR

operant conditioning
classical conditioning does not explain why the individual continue to feel fearful or why they avoided the feared object, the avoidance of the phobic stimulus this reducing the fear thus reinforcing - negative reinforcement as the individual is escaping an unpleasant situation therefore is why they avoid

Social Learning
phobias may be acquired through modelling the behaviours of others for example persons is afraid of spiders and gets attention then the other person sees there reaction and mimics this to get attention which is rewarding

Question 4

The behavioural approach to treating phobias

Answer 4

Flooding

• one long session this could last between 1-3 hours this is because a person adrenaline being released and therefore there fear response has a time limit
• patient experiences fear at the same time as trying to relax - the session continues until the patient is fully relaxed
• can be conducted in vivo (actual exposure) or virtual reality
  1. patient is taught relaxation techniques
  2. patient masters the feared situation that caused them to seek help in the first place

Systematic Desensitisation (SD)

• counterconditioning - this is when the patient is taught a new association that runs counter to the original association - relaxation instead of fear
• relaxation - relaxation techniques are taught to the patient - focus on their breathing and take deep breaths and use progressive muscle relaxation
• desensitisation hierarchy - gradually introduce the person to the feared situation - at each stage the patient has to fully relax before they can progress to the next stage.
  1. patient is taught how to relax their muscles completely as anxiety is not compatible with relaxation
  2. therapist and patient together construct a desensitisation hierarchy - each one causing more anxiety than the previous
  3. patient gradually works there way through the hierarchy completely relaxing in the previous stage before moving on to the next
  4. once patient has mastered one step they move on to the next
  5. patient eventually masters the feared situation

Question 5

The cognitive approach to explaining depression

Answer 5

Ellis’ ABC model
- A - refers to the activating event
- B - the belief which may be rational or irrational
- C - the consequence that the rational or irrational beliefs lead to - rational - happy, irrational - unhealthy emotions
for example ….
- A - get fired
- B - rational - I was sacked as it was overstaffed, irrational - I was sacked as they always had it in for me
- C - rational - acceptance, irrational - depression

Masturbatory thinking
- source of irrational thinking, it involves thinking that certain ideas must be true for an individual to be happy
- I must be approved of or accepted by people I find important
- I must do well or I am worthless
- The world must give me happiness or I will die
other irrational symptoms include
- others must treat me fairly and give me what I need
- people must live to my expectations or its terrible

Beck’s Negative Triad
Negative Schema
- depressed people usually develop a negative schema during childhood
- they have a negative view of the world
- caused by parental and peer rejection or criticisms by teachers
- lead to systematic cognitive biases in thinking and are activated every time a new situation is encountered

The negative triad
- these are pessimistic and irrational view of the three key elements
- Negative schemas and cognitive biases maintain a negative bias
- The self
- The world
- The future
for example ….
The self - “ I am just plain undesirable and there is nothing to like about me”
The World - “ I can understand why people don’t like me, they would prefer other peoples company even my boyfriend left me”
The future - “I am always going to be on my own, there is nothing that is going to change this”

Question 6

The cognitive approach to treating depression

Answer 6

Aim of CBT

• Ellis created this
• To turn irrational thoughts to rational thoughts
• renamed his therapy rational emotive therapy (RET) because the therapy focused on resolving emotional problems
• later he changed it to rational emotional behaviour therapy (REBT) because it also resolves behavioural problems

Challenging irrational thoughts
D - disputing the rational and irrational thoughts
E - the effects of disputing and effective attitude to life
F - the new feelings and emotions that are produced
- logic disputing - self - defeating beliefs do not follow logically from the information available (does thinking this way make sense)
- Empirical disputing - self-defeating beliefs that may no be consistent with reality (where is the proof that this belief is accurate)
- Pragmatic disputing - emphasises the lack of usefulness of self-defeating beliefs (how is this belief likely to help me)
- challenges self-defeating beliefs into more rational beliefs
- client can move from catastrophizing to more rational interpretations
- makes the client feel better

Homework
Clients are often asked to complete assignments after sessions and between sessions - might include asking someone out on a date or asking friends to tell them what they really think of them - puts reality to the test and puts rational beliefs into practise

Behavioural activation

• Makes depressed clients become more active
• being active leads to rewards this replaces the depression - characteristic of many depressed people is that they no longer take part in the things that they enjoy

Unconditional positive regard

• Ellis 1994 - important factor is convincing that there client is of worth as a human being
• if feel worthless they will be less willing to consider changing their beliefs and behaviour - however if they feel respect and appreciation regardless of what the client does this will facilitate a change in beliefs and attitudes

Question 7

The biological approach to explaining OCD

Answer 7

Genetic explanations
The COMT gene
- Regulates the production of the neurotransmitter dopamine that is involved in OCD
- one form of the COMT gene has been found to be more common in OCD patients than people without the disorder
- Tukel et al 2013 - this produces lower activity of the COMT gene and higher levels of dopamine

The SERT gene

• effects the transport of the neurotransmitter serotonin creates lower levels of the neurotransmitter
• these lower levels are involved in OCD
• Ozaki et al 2003 - found a mutation of this gene in two unrelated families where 6 of the 7 members had OCD

Diathesis-stress

• the idea of a simple link between one gene and OCD is unlikely
• the SERT gene are implicated in a number of other disorders such as depression and PTSD
• suggests that each individual gene creates a vulnerability for OCD as well as other conditions such as depression - other factors affect what mental illness could develop

Neural explanations
Abnormal levels of neurotransmitters
- Dopamine levels are though to be abnormally high in people with OCD - based on animal studies
- Szechtman et al 1998 - high doses of drugs that enhance levels of dopamine induce stereotyped movements resembling the compulsive behaviours in OCD patients
- lower levels of serotonin are associated with OCD
- Pigott et al 1990 - this conclusion is to based on the fact that antidepressant drugs that increase serotonin activity have been shown to reduce OCD symptoms
- Jenicke 1992 whereas antidepressants that have less effect on serotonin do not reduce OCD symptoms

Abnormal brain circuits

• areas in the frontal lobes of the brain are thought to be abnormal in people with OCD
• The caudate nucleus normally suppresses signals from the orbitofrontal cortex (OFC) then the OFC sends signals to the thalamus about worrying things
• when the Caudate is damaged it fails to suppress minor worries and the thalamus is alerted and sends signals back to the OFC this is a worry circuit
• supported by PET scans of OCD patients when symptoms are activated
• serotonin and dopamine are linked to these regions of the frontal lobes
• Comer 1998 - reported that serotonin play a key role in the operation of OFC and caudate nucleus therefore abnormal levels will cause these to not function
• Sukel 2007 - dopamine is also linked to this system - main neurotransmitter of the basal ganglia therefore high levels of dopamine could cause over reaction

Question 8

The biological approach to treating OCD

Answer 8

Drug therpay
Anitdepressants: SSRIs
- Most commonly used drugs for OCD are antidepressants, this is because low levels of serotonin are associated with OCD therefore drugs increase the serotonin level
- Low levels of serotonin may be a factor which cause the worry circuit therefore increasing the levels of serotonin will normalise the worry circuit
- They also reduce the anxiety associated with OCD
- SSRIs are currently the preferred drugs for treating anxiety disorders – Choy and Schneier 2008 as it regulates mood and anxiety
- Serotonin is released into a synapse from one nerve and targets receptor cells on the receiving neuron at receptor sites, afterwards it is re-absorbed by the initial neuron and send the message – in order to increase the serotonin levels the re-absorption is stopped

Antidepressants: tricyclics

• The Tricyclic Clomipramine was the first antidepressant to be used for OCD and today is primarily used in the treatment of OCD rather than depression
• They block the transported mechanisms that re-absorbs both serotonin and noradrenaline into the pre-synaptic cell after it has fired therefore more of the neurotransmitters are left in the synapse this prolongs there activity and eases the transmission of the next impulse
• They have the advantage of targeting more than one neurotransmitter
• Greater side effects in comparison to SSRIs so are only used when SSRIs are not effective

Anit-anxiety drugs

• Benzodiazepines (BZs) are commonly used to reduce anxiety, manufactured under various trade names
• Slow down the activity of the central nervous system by enhancing the activity of the neurotransmitter GABA (gamma-aminobutyric acid) a neurotransmitter when released that has a quietening effect on many of neurons in the brain
• It does this by reacting with special sites called GABA receptors on the outside of receiving neurons, when GABA locks into these receptors it opens a channel that increases the flow of chloride ions into the neuron
• Chloride ions make it harder for the neuron to be stimulated by other neurotransmitters, this slows down activity making the person feel more relaxed

other drugs

• Research found that D-Cycloserine has an effect on reducing anxiety and thus may be an effective treatment for OCD, its more effective when used in conjuction with psychotherapy
• It is also an antibiotic used to treat TB, and enhances transmission of GABA reducing anxiety