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Psychopathology Flashcards

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1
Q

What does the DSM 5 stand for?

A

Diagnostic and Statistical Manual

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2
Q

What are the 4 ways to define an abnormality?

A

Statistical infrequency
Deviation from social norms
Failure to function adequately
Deviation from ideal mental health

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3
Q

What is Statistical infrequency?

A

Members of the population that fall outside the standard deviation, on the normal distribution curve.

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4
Q

What is considered statistically infrequent?

A
  • /+2 SD of the mean

2. 1% (on each side of the curve)

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5
Q

What % of the population will be within the 1 SD of the mean?

A

68%

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6
Q

What % of the population will be within the 2 SD of the mean?

A

95%

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7
Q

What are the limitations of statistical infrequency?

A

Both ends of the curve should be considered abnormal, but isn’t,
8-10% of the UK have depression,
Behaviour doesn’t have to be rare to be abnormal.

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8
Q

What is the strength of statistical infrequency?

A

In clinical diagnosing it is useful to know frequency of behaviour. Diagnosis will always require other features than just unusualness.

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9
Q

What is deviation from social norms?

A

Behaviour that goes against unwritten expectations and rules in a society/culture.

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10
Q

What are examples of past things that were considered against social norms?

A

Inter-racial marriage
Children being born to single mothers
Men having long hair
(These were looked down just in society not a clinical diagnosis)

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11
Q

What are the limitations of deviation from social norms?

A

Things that professionals call abnormal may not be considered abnormal in the future. E.g. homosexuality was a mental disorder in the DSM until 1973.
Varies across culture.
Can be used to support discrimination. E.g. Drapetomania is a ‘mental illness’ that caused black slaves to run away in 1851.

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12
Q

What is a strength of deviation from social norms?

A

Has ideas about desired behaviour. So can be used to refer to what is socially acceptable.
E.g. can be used to diagnose Antisocial personality disorder (this is where a person is manipulative, deceitful and reckless, and will not care for other people’s feelings.)

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13
Q

What is failure to function adequately?

A

This is where someone is unable to cope with the daily demands of everyday life.

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14
Q

What are the 4 criteria of failure to function adequately?

A

Person cannot cope with the demands of everyday life
Behaviour is maladaptive/irrational or dangerous
Behaviour causes distress to the person
Behaviour causes distress to others

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15
Q

What are the strengths of failure to function adequately?

A
  • Takes into account the feelings of the person and the affects of those around them
  • Used in the DSM for disorders such as OCD, anxiety and depression
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16
Q

What are the limitations of failure to function adequately?

A
  • It is subjective judgement made by the psychiatrist as there is no objective test
  • Others distress could be due to social norms being broken
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17
Q

What is deviation from ideal mental health?

A 
When someone does not meet the criteria for good-mental health.
Criteria:
Good self-esteem
Self-actualisation
Ability to cope with stress
Realistic view of the world
Independence from other people
Environmental mastery
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18
Q

What are specific phobias?

A

Phobias of objects - most commonly animals, events (flying), situations (enclosed places).

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19
Q

What are social phobias?

A

Phobias of social situations, public speaking, parties, meeting new people.

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20
Q

What is agoraphobia?

A

Fear of public places and leaving safety of home.

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21
Q

What are the emotional characteristics of phobias?

A

Anxiety

Emotional responses are unreasonable - reaction is disproportionate to the danger posed

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22
Q

What are the behavioural characteristics of phobias?

A

Panic
Avoidance
Endurance

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23
Q

What are the cognitive characteristics of phobias?

A

Selective attention to the phobic stimulus
Irrational beliefs
Cognitive distortions

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24
Q

What are the strengths to the two-process model?

classical and operant conditioning

A

Can account for unusual phobias

Has applications for therapy - can be deconditioned

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25
Q

What are the limitations of the two-process model?

classical and operant conditioning

A
  • It cannot account for why some phobias of some common objects/situations are rare (cars) but phobias of uncommon objects/situations are common.
  • Some people develop a phobia with no previous awareness of a traumatic, triggering event.
  • The model ignores cognitions which may be an important part of the phobia.
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26
Q

What are the two behavioural methods used in the treatment of phobias?

A

Systematic desensitisation

Flooding

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27
Q

What are the 4 steps used in systematic desensitisation?

A

Relaxation (patient learns techniques)
Anxiety hierarchy (least frightening to most frightening)
Exposure (to phobic stimulus whilst practising relaxation techniques)
Success (when the patient can stay relaxed in situations high on the anxiety hierarchy)

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28
Q

What is the name for when the phobic stimulus is paired with a response of relaxation instead of anxiety?

A

Counterconditioning

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29
Q

What are the strengths of systematic desensitisation?

A

It is effective
It is suitable for a diverse range of patients - including children and people with learning disabilities
It is acceptable to patients because the steps are gradual

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30
Q

What is flooding?

A

Overwhelming the individual’s sense with the item or situation that causes anxiety so that the person realises that no harm will occur. It doesn’t give the option of avoidance and so the patient quickly learns that the phobic stimulus is harmless.

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31
Q

Why is flooding not unethical?

A

Patients give their consent so they know exactly what’s involved. Flooding is not suitable for those who cannot consent.

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32
Q

What are the strengths of flooding?

A

It is cost effective - cheaper and quicker than SD

33
Q

What are the limitations of flooding?

A

It is less effective for some types of phobias - social phobias have cognitive aspects which are not involved in flooding.
The treatment is traumatic for patients - produces high levels of fear.

34
Q

What are the characteristics of depression?

A

Emotional: Lowered mood, anger and lowered self-esteem.
Behavioural: Low activity levels, disruption to sleep and eating behaviour, aggression and self-harm.
Cognitive: Poor concentration, dwelling on the negative, absolutist thinking.

35
Q

What is the DSM criteria for depression?

A

A - 5/9 symptoms for 2 weeks; at least one symptom must be 1 or 2.
1 - Depressed mood
2- Loss of interest
3 - Weight loss or gain
4 - Insomnia or hypersomnia
5 - Agitation or retardation
6 - Fatigue or loss of energy
7 - Feelings of worthlessness/inappropriate guilt
8 - Inability to concentrate/indecisiveness
9 - Thoughts of death or suicidal thoughts

B - Failure to function adequately/clinically significant distress

36
Q

What are the cognitive mechanisms in depression?

A 
Ideas of worthlessness
Thoughts of guilt
Diminished ability to think/concentrate
Indecisiveness
Recurrent thoughts of death
Suicide plan

How people assess the same situation varies because they have different cognitions.

37
Q

Who are the two main theorists in the cognitive approach to depression?

A

Beck - automatic negative thoughts

Ellis - Irrational beliefs

38
Q

What are the 3 explanations that Beck suggest cause some people to be more vulnerable to depression than others?

A

Faulty information processing
Negative schemas
The negative triad

39
Q

What is faulty information processing?

A 
Believed that depressed people process information in a faulty way. They tend to selectively attend to the negative aspects of a situation and ignore the positive aspects.
They also make certain attributions:
internal - external
global - specific
stable - unstable
40
Q

What are negative schemas?

A

A negative package of information that we have about ourselves. They interrupt all information about themselves in a negative way.

41
Q

What is the negative triad?

A

Depressed people have automatic negative thoughts about themselves, the world and the future and are trapped in these.

42
Q

What are the strengths of Beck’s theory?

A

Good supporting evidence: A group of teenagers were studied and those who were identified as cognitively vulnerable were more likely to become depressed later. Also, women were studied before and after giving birth, and those who had high cognitive vulnerability were more likely to experience post-natal depression.

Practical application in CBT: All cognitive aspects of depression can be challenged in CBT, reducing someone’s vulnerability to depression. It is a useful theory.

43
Q

What is the weakness of Beck’s theory?

A

It does not explain all aspects of depression. The theory explains the cognitive symptoms of depression, but not all symptoms such as extreme anger. Therefore, it is an incomplete explanation.

44
Q

What are the common irrational beliefs that Ellis believed underlined depression?

A

Musturbation - ‘i must’, sets very high standards for self.
‘I-can’t-stand-it-itis’ (catastrophising) small set backs seen as a major destruction.
Utopianism - belief the world and life are fair.

45
Q

What is Ellis’ ABC theory?

A

A - Activating events
B - Beliefs about A
C - Consequences - your emotional and behavioural responses to your belief

46
Q

What is a strength of Ellis’ theory?

A

It has practical application in CBT. Research shows that when irrational beliefs are challenged this can reduce depressive symptoms, suggesting that irrational beliefs had some role in the depression.

47
Q

What are the weakness of Ellis’ theory?

A
  • It does not explain all aspects of depression.
  • It does not explain why some individuals experience anger associated with their depression. Therefore it is an incomplete explanation.
  • It can’t explain all depression. Some depression does not occur as a result of an activating event. It is a limited explanation because not all depression arises as a result of an obvious cause.
48
Q

What is the biological explanation of depression?

A

Suggests genes and neurotransmitters may cause depression. Anti-depressant drug treatments work - the medication alters the levels of specific neurotransmitters and reduces the symptoms which suggest neurotransmitters play an important role.

49
Q

What is CBT?

A

Cognitive behaviour therapy.
It challenges irrational and negative thoughts.
It is a way of talking about how think about yourself, the world and other people and how this affects emotions and behaviours.
Behavioural activation - encouraging patients to engage in those activities they are avoiding.

50
Q

What are the steps to CBT?

A

Assessment
Identifying goals
Treatment (homework and monitoring)
Treatment complete

51
Q

What does Ellis add to the ABC model for CBT?

A

D - Disputations to challenge irrational beliefs

E - Effect on beliefs and consequences

52
Q

What are the strengths of CBT?

A 
Research support that CBT is effective
March et al
- 81% of adolescents improved with CBT
- 81% improved with medication
- 86% improved with both
Keller et al
- 52% of adults with chronic depression improved with CBT
- 55% improved with medication
- 85% improved with both
53
Q

What are the limitations of CBT?

A

It may not work for severe cases.
People with severe depression may lack any motivation to engage with therapy. CBT may not always be suitable as a first line treatment.

Success may be due to the therapist-patient relationship which is not unique to CBT.

Some patients may want to explore their past. CBT doesn’t focus on childhood experience.

CBT may over-emphasise importance of cognition in depression.

54
Q

What is thought catching?

A

When a person becomes aware of their negative and irrational thoughts so they can stop them leading to unhelpful emotional and behavioural consequences.

55
Q

What is OCD?

A

Obsessive Compulsive Disorder is characterised by the presence of obsessions and/or compulsions.

56
Q

What are obsessions?

A

Recurrent and persistent thoughts, urges or images that are intrusive or unwanted. They make the person feel anxious.

57
Q

What are compulsions?

A

Repetitive behaviours or mental acts an individual feels driven to perform, to reduce their anxiety.

58
Q

What is the cycle of OCD?

A

Obsessive thoughts/images/urges
Anxiety
Compulsive behaviour or mental act
Relief

59
Q

What are the emotional characteristics of OCD?

A

Anxiety and distress
Accompanying depression
Guilt and disgust

60
Q

What are the behavioural characteristics of OCD?

A

Compulsions

Avoidance

61
Q

What are the cognitive characteristics of OCD?

A

Obsessions
Cognitive coping strategies
Insight

62
Q

What are the two biological explanations of OCD?

A

Genetics

Neural explanations

63
Q

What studies support genetics as a biological explanation of OCD?

A 
Lewis - 1936
- Studied patients with OCD
- 37% had parents with OCD
- 21% had siblings with OCD
In conclusion, there is a genetic basis to the disorder.

Nestadt - 2010
- Twin study studying MZ and DZ twins
- MZ had 68% concordance rate
- DZ had 31% concordance rate
In conclusion, there is a genetic basis to OCD because MZ twins who share more DNA have a much higher concordance rate than DZ twins.
However, it is also evidence that there is an environmental influence on development on OCD because if it was purely genetic, MZ concordance rate would be 100%.

64
Q

What is the strength and weakness of family and twin studies?

A

Strength - There is evidence to suggest that there is a genetic component to OCD. Twin studies are one of the best sources of evidence.
Weakness - Family studies could also be used as evidence of environmental and genetic factors.

65
Q

What is the strength and weaknesses of candidate genes?

A

Strength - research has implicated a number of candidate genes in the development of OCD.
Weakness - There are many genes involved and there may be more yet to be identified.
Weakness - each genetic variation only increases the risk of OCD by small fraction so it lacks predictability.

66
Q

What is the strength and weakness of the interaction of genes and environmental factors?

A

Strength - Research supports that individuals may have a genetic vulnerability towards OCD that is triggered by an environmental stressor.
Weakness - Cromer found that over half of the OCD patients in their sample had a traumatic event in the past. This means that environment is very important in explaining OCD. It may be better to focus on environmental rather than biological explanation as we may be able to change the environment.

67
Q

What does the basal ganglia control?

A

Repetitive movement

68
Q

What does the orbitofrontal cortex control?

A

Worry

69
Q

What does the thalamus control?

A

Safety behaviours

70
Q

What evidence is there that serotonin plays a role in OCD?

A

Low levels are associated with OCD because SSRI medications, which increase the activity of serotonin at the synapses of the brain, are effective at improving OCD symptoms in many cases.

71
Q

How does SSRI work?

A

Selective serotonin reuptake inhibitor targets serotonin and blocks the reuptake channel so serotonin remains in the cleft for longer, and can continue to deliver its message at the receptor sites. It amplifies the serotonin message so that many people taking SSRI uptain some relief from taking it.
They are effective for 70% of patients.

72
Q

What are the strengths of brain function as a neural explanation?

A

Advance technology has allowed accurate investigation - OCD sufferers do seem to have hyperactivity in parts of the brain.
We know cleaning and checking behaviours are hard wired in the thalamus where there is hyperactivity.

73
Q

What are the weaknesses of brain function as a neural explanation?

A

Repetitive acts may be explained by the abnormality of the basal ganglia but this doesn’t explain obsessional thoughts.
No area has been found that always plays a role in OCD.
Neural changes could be as a result of suffering from the disorder not necessarily the cause of it.

74
Q

What is the strength of the role of neurotransmitters as a neural explanation?

A

It allows medication to be developed which helps many sufferers.

75
Q

What are the weaknesses of the role of neurotransmitters as a neural explanation?

A

Drugs are not completely effective so neurotransmitters are not the only cause of OCD.
Just because administering SSRIs decrease OCD symptoms it does not mean that this was the cause in the first place.

76
Q

What other drugs are used in treatment of OCD other than SSRIs?

A

Trycyclics - also alter amount of serotonin at the synapses in the brain but have more side effects and are fatal if overdosed - not recommended for patients also experiencing depression.
Antipsychotic medication - have unpleasant side effects and are used when other treatments do not work.

77
Q

What are the strengths of drug therapy as a treatment of OCD?

A

Is effective - study reviewed 17 studies of SSRI and placebo trials. All showed better symptoms than those having a placebo.
Cost effective and non-disruptive.

78
Q

What are the limitations of drug therapy as a treatment of OCD?

A

Side-effects: weight gain, dry mouth, sexual dysfunction and loss of memory.
Coming off a drug is a slow process with risk of relapse.
Unreliable evidence for drug treatments - many drug companies do not publish all of their results and may be suppressing unfavourable evidence.
Some cases of OCD follow trauma - may be not purely biological.

Psychology (17 decks)

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