Psychopathology Flashcards

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1
Q

What are the definitions of abnormality

A

• Deviation from social norms

• Failure to function adequately

• Deviation from ideal mental health

• Statistical infrequencies

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2
Q

Define deviation from social norms

A

Behaviour that defies the unwritten rules of society

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3
Q

What are the limitations of deviations from social norms as a definition of abnormality

A

• Deviating from social norms can be beneficial to society (the suffragettes broke social norms leading to women gaining the right to vote)

• Social norms of a society can change overtime (homosexuality was classified as a mental illness in the international classification of diseases (ICD) until 1990

• Deviation from social norms does not always correlate with mental health issues. Eccentric people are not abnormal but do deviate from social norms (naturists break social norms by being naked but they do not necessarily have mental health problems)

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4
Q

Define failure to function adequately

A

• Abnormal behaviour causes an inability to cope with everyday life

• Behaviour disrupts their ability to work/conduct satisfying interpersonal relationships

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5
Q

List the seven features of someone that fails to function adequately and who made them

A

• Personal distress - feeling anxious, sad, worried

• Maladaptive Behaviour - behaviour that stops one to achieve goals

• Unpredictability - unexpected behaviours (losing control)

• Irrationality - behaviour that cannot be explained logically

• Observer discomfort - behaviour that causes discomfort in others

• Violation of moral standards - behaviour that violates ethics

• Unconventionality - behaviour that does not conform to norms

• Rosenhan and Seligman (1989)

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6
Q

What are the limitations of failure to function adequately as a definition of abnormality

A

• abnormality does not always cause dysfunction. Harold Shipman murdered 215 patients over 23 years, nobody knew of his psychopathic nature

• Regular people suffer from personal distress during their lifetimes (when a loved one dies)

• Behaviour can cause distress to others and make them feel observer discomfort, but the individual may not feel any personal distress (Stephen Gough, naked hiker)

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7
Q

List the six characteristics of ideal mental health and who made them

A

• Positive attitude towards oneself - Self-respect, self-confidence, positive self-concept

• Self-Actualisation - experience personal growth, reach full potential

• Autonomy - be independent, self-reliant

• Resistance to Stress - effective coping strategies to manage anxiety, stress

• Accurate Perception of Reality - perceiving the world realistically (no hallucinations/delusions)

• Environmental Mastery - being competent in all aspects of life, adapting to any circumstance

• Jahoda (1958)

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8
Q

What are the limitations of deviation from ideal mental health as a definition of abnormality

A

• Criteria is very demanding and unrealistic

• many criteria are vague (personal growth) and near impossible to define

• criteria are subject to cultural relativism
-Collectivist cultures (India, Japan) emphasise communal goals over autonomy
-Individualistic cultures (Germany, USA) emphasise autonomy

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9
Q

Statistical Infrequency

A

• Abnormal behaviour is defined as behaviour that is statistically rare

• Lies at both extremes of a normal distribution

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10
Q

What are the limitations of statistical frequency as a definition of abnormality

A

• Behaviour that is statistically rare can be desirable - high IQ

• Psychological disorders are not necessarily statistically rare - depression affects 27% of elderly (NIMH, 2001)

• Rare behaviours can be neither abnormal nor normal - left handedness

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11
Q

What are the characteristics of phobias

A

• Panic - you know what panic means
• Avoidance - running away (interferes with everyday life)
• Endurance - freezing up when in presence of phobic object

• Fear - unreasonable worry and distress
• Anxiety - unsure of what will happen and apprehensive

• Irrational Beliefs - resist rational arguments, have thoughts that’s not logical
• Selective Attention - become fixated on the phobic object

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12
Q

How are phobias initiated and how’re they maintained

A

Classical conditioning

Operant conditioning

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13
Q

Define classical and operant condition

A

• Classical conditioning - learning through association

• Operant conditioning - learning through consequences

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14
Q

‘Little Albert’ method (classical conditioning)

A

Watson and Raynor (1920)
• hit metal bar to make noise every time he played with white fluffy rat
• loud noise startled him causing him to cry
•every time he saw anything white or fluffy he cried

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15
Q

Talk about ‘Little Albert’ (stimuli + responses)

A

• Loud noise - unconditioned stimulus
• Fear/crying - unconditioned response

• white rat - neutral stimulus
Became associated with unconditioned stimulus

• white rat - conditioned stimulus
• fear/crying - conditioned response
Conditioned response then generalised to other objects

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16
Q

Talk about operant conditioning (flow chart)

A

• reinforcement - increase behaviour
• punishment - decrease behaviour

• positive reinforcement - add good thing
• negative reinforcement- remove bad thing

• positive punishment - add bad thing
• negative punishment - remove good thing

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17
Q

What are the advantages of deviation from ideal mental health as a definition of abnormality

A

• The criteria is comprehensive and based on similar models for physical health

• This is a positive and holistic approach to diagnosis

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18
Q

Strengths of the Two-Process Model

A

• Doesn’t label people with stigma of mentally ill, instead wrongly learned responses which can change

• King(1998) saw in case studies phobias develop from trauma (classical conditioning)

19
Q

Weaknesses of Two-Process Model

A

• People develop phobias WITHOUT traumatic experiences
• People have traumatic experienced and DONT develop phobias
• doesn’t account for biological factors to phobias

20
Q

What’re the two treatments for phobias

A

• Systematic Desensitisation
• Flooding

21
Q

Stages of systematic desensitisation

A

• Anxiety Hierarchy - ranking of fearful situations, made by therapist & patient

• Relaxation Techniques - patients are taught deep muscle relaxation techniques
- progressive muscular relaxation, PMR. (Tense group of muscles for a few seconds, fully contracted, and then relax).
- Patients are told to sit quietly and comfortably close their eyes. Working from feet to top of body.

• Gradual Exposure - patient is introduced to phobic object and work up anxiety’s hierarchy.
- Use their relaxation techniques when exposed to phobic object.
Once comfortable, progress hierarchy until phobia is eliminated

22
Q

Evaluation of Systematic Desensitisation

A

• Jones(1924) supports SD. When a white rabbit was presented to Little Peter at gradually closer distances, his anxiety lessened until he was affectionate (of rabbit) (+)

• Klosko et al. (1990) supports SD. He assessed various therapies for panic disorders
- 87% of patients were panic free after SD.
- Compared to 50% on meds
- 36% on placebo
- 33% on nothing (+)

• Behavioural treatments address Symptoms of phobias. Some critics claim underlying causes will remain. In the future symptoms can return or symptom substitution will occur (abnormal behaviours replace the removed ones) (-)

23
Q

Flooding

A

• Directly exposing patient to phobic object.
- Patients would be taught relaxation techniques beforehand.
- No Anxiety Hierarchy.
- Flooding stops phobic responses quickly, due to no option for avoidance. phobic object is deemed harmless, extinction occurs.

• Patient may achieve relaxation from being exhausted by fear responses.

• Patients are required to give fully informed consent to be ethical because of initial psychological harm.

• Patients have options of SD or flooding. Sessions last 2-3 hours (longer than SD sessions)

24
Q

Evaluation of Flooding

A

• Wolpe(1960) supports flooding to remove a patient’s phobia of being in cars. Girl was forced into a car and driven around for 4 hours until her hysteria was eradicated. (+)

•Weakness is that it it highly traumatic and patients would not wish to continue to its end. Time and money would be wasted for prep and phobias go uncured. Also cannot be used on children (-)

25
Q

9 Characteristics of Depression

A

• Activity - lethargy, neglect hygiene, anhedonia (not enjoy things anymore)
• Sleep - insomnia or hypersomnia
• Eating - significant increase or decrease
• Aggression - irritable verbally or physically, self harm

• Low Mood - overwhelming sadness, emptiness
• Worthlessness - low self esteem, inappropriate guilt
• Anger - at others or at self. Retaliating to feeling hurt

• Negative Schema - negative world view
• Poor Concentration - poor memory, slower thought processes, difficulty making decisions

26
Q

What is the negative triad

A

• Depression is caused by negative thinking

• Depressed people have negative schema
• negative schema leads to cognitive biases
• cognitive biases lead to overgeneralisations

Negative triad:
• The Self - hate self
• The World - hate world
• The Future - hate future

27
Q

What is the ABC model

A

• Depression is caused by irrational beliefs

• A - Activating event - incident occurs
• B - Beliefs - either rational or irrational
• C - Consequences - result of B (unhealthy emotions stems from irrational beliefs, depression)

28
Q

Evaluation of negative triad

A

• Terry(2005) tested 65 pregnant women. Those with high cognitive vulnerability were more likely to suffer with post-natal depression (+)

• Cause and effect isn’t clear. Chicken vs the egg which came first (-)

• Doesn’t explain some symptoms. Anger, manic periods in BPD. (-)

29
Q

Evaluation of ABC model

A

• Bates(1999) found giving patients negative thoughts made them more depressed

• Still blames the patient for depression

30
Q

What’s Cognitive Behavioural Therapy

A

• Identify irrational belief (thought-catching)
• Test hypothesis based on irrational belief
- Keeping a diary to record real world events. Homework assignments to identify truths.

• Patients report positive thoughts, therapist praises them (positive reinforcement)

• Cognitive restructuring - learning to identify, dispute, therefore change irrational thoughts

31
Q

What’s Rational Emotive Behavioural Therapy

A
  • Ellis(1994)
    • challenge automatic negative thoughts to replace with rational beliefs

• therapist uses logical arguments to dispute patient
• therapist uses empirical arguments to defeat beliefs inconsistent with reality

• patients engage in behavioural activation (being active and doing things they enjoy more)

32
Q

Strengths of CBT

A

• March et al(2007) found CBT was as effective as antidepressants.
- 327 adolescents
- in 36 weeks
- 81% antidepressants
- 81% CBT group improved
- 86% BOTH improved

• David(2008) found CBT was better long term than antidepressants.
- 170 patients on CBT
- 14 weeks of CBT
- compared to patients using drug fluoxetine
- 6 months later CBT patients were less likely to relapse

33
Q

Weaknesses of CBT

A

• Requires commitment and motivation
- Bad for patients with severe depression
- Because wouldn’t engage or even attend
- Antidepressants would work better

• Assumes root cause is irrational thought
- ignores other factors (eg domestic violence)

• Relies on patients self-reporting thoughts
- May be unreliable

34
Q

What are the characteristics of OCD

A

• Compulsions - repetitive actions to reduce anxiety stemming from obsessions
• Avoidance - attempt to reduce anxiety by avoiding situations that may trigger it

• Anxiety - stems from awareness of behaviour being excessive and know they can’t control themselves, feeling shame
• Disgust - either at self or at external sources

• Obsessions - recurrent intrusive irrational thoughts which cause anxiety
• Awareness of Irrationality - sufferers understand their behaviour and thoughts are inappropriate but they still can’t control it
• Catastrophic Thinking - worried that if they do not carry out compulsion, something bad will happen (irrational)

35
Q

What’re two biological explanations of OCD + assumptions

A

• Genetic explanation

• Neural explanation

• caused by genetic and biochemical factors

36
Q

What is the genetic explanation of OCD

A

• OCD is classed as polygenic (many candidate genes responsible for causing)

• COMT gene - regulates dopamine production. High dopamine associated w/ OCD.
- Variation of COMT gene that produces higher levels of dopamine is common with OCD patients

• SERT gene - affects transportation of serotonin. Causing lower levels. Low serotonin is linked to OCD

37
Q

What is the neural explanation of OCD

A

• abnormal levels of neurotransmitters are associated with OCD (dopamine+serotonin)

• high dopamine levels are linked to hyperactivity in the basal ganglia area in the brain (causes compulsions)

• low levels of serotonin in the caudate nucleus in the basal ganglia cause the caudate nucleus to malfunction (causes obsessions)

38
Q

Evaluation of genetic explanation OCD

A

• Nestadt(2000) found that people with a first degree relative with OCD were five times more likely to have OCD (+)

• Billett(1998) found from a meta-analysis of 14 twin studies that OCD is twice more likely to be concordant in identical monozygotic twins rather than dizygotic (non identical) (+)

• Concordance rate in identical twins is not 100%. Thus fails to account psychological and environmental factors (-)

• Contradicts with behavioural approach. Two process model suggests that OCD is learnt via classical conditioning and reinforced through operant conditioning. OCD is often treated with behavioural therapies such as exposure (similar to SD) (-)

39
Q

Evaluation of neural explanation of OCD

A

• Antidepressants increase serotonin levels, has shown reduction in OCD symptoms (+)

• Ciccerone(2000) found giving patients low doses of drug Risperidone to lower dopamine caused symptoms of OCD to alleviate (+)

• Neurotransmitters may not necessarily cause OCD but rather just a symptom (low serotonin, high dopamine) (-)

• OCD is co morbid with depression. It is unclear if low serotonin causes OCD or depression or both. Link is unclear (-)

40
Q

What is the biological treatment for OCD

A

•Uses medication to increase/decrease neurotransmitter levels
- general purpose to decrease heart rate, anxiety, lowarousal, blood pressure

41
Q

What is selective serotonin re-uptake inhibitors

A

• Serotonin release by presynaptic neurons.
-Travel across synaptic cleft.

• Chemically convey signal from presynpatic neuron to postsynaptic neuron
-reabsorbed (re-uptake) by presynaptic neuron
-broken down and reused

•SSRIs prevent reabsorption & breakdown of serotonin.
-increase levels in synapse
-continues to stimulate postsynaptic neuron
-reduces anxiety

42
Q

What is benzodiazepines

A

•anti-anxiety drugs (Valium, diazepam)

•slow activity of CNS by enhancing neurotransmitter GABA (has inhibitory effects on neurons)

•GABA reacts with GABA receptors outside neurons
-GABA locks into these receptors
-opens channel to increase chloride ion flow into neuron

• chloride ions make it harder for neuron to be stimulated by other neurotransmitters (slows down neural activity, makes person relaxed)

43
Q

Evaluation of selective serotonin re-uptake inhibitors

A

•Soomro(2009) reviewed 17 studies comparing SSRIs with placebos.
-all 17 studies showed SSRIs were more effective. especially when combined with CBT (+)

•70% of patients that take SSRIs see a decline in symptoms. 30% opt for psychological therapies or a combo of both (+)

•Severe side effects meaning they may stop taking it making it ineffective.
-Symptoms include indigestion, blurred vision, loss of sex drive (-)

44
Q

Evaluation of benzodiazepines

A

•reduce anxiety levels and OCD symptoms quickly, compared to CBT where patient doesn’t experience immediate relief (+)

•if used long-term then side effects appear
-side effects include drowsiness, depression, unpredictable interactions with alcohol (-)

• Ashton(1997) found long-term users to become dependent and experience high levels of anxiety + symptoms with withdrawal.
-patients need progressively larger doses to reduce symptoms because tolerance (body gets used to drug) (-)