psychopathology

Question 1

deviation from social norms

Answer 1

deviating from the norms of society - not necessarily negative or mentally abnormal
social deviation = negative deviation from social norms
context - different behaviors expected on different situations
norms change over time

AO3
- szoszy 1974 - mental illness is a way of excluding undesirable people from socity - definition supports it
- ethnocentric bias - cochrane 1977 - black people more commonly diagnosed with SZ in britan - based off of majority culture leading to under/over representation of minority in diagnostic statistics
+ useful for helping individual
+ social dimension to abnormality - helps general pop understand
+ adaptive to situational norms

Question 2

failure to function adequately

Answer 2

lacking the ability to maintain basic responsibilities in society
rosenham and seligman 1989 - global assessment of functionality scale - 0-90 90 being normal functioning, 0 being high concern
personal distress
maladaptive behaviors
irrationality
observer discomfort
unconventionality
violation of moral standards
unpredictability
AO3
- dependent on individuals context
- symptoms may not be obvious so over looked
szosz 1974
- distress is normal in everyday life
- does not account for people being rewarded for abnormal behavior
+ assesses degree of abnormality not black and white
+ adaptive to person - if they are coping with symptoms rather than if they have symptoms
+ takes into account outside opinions

Question 3

deviation from ideal mental health

Answer 3

judges mental health like physical health - any variation from the ideal leads to an abnormal classification
jahoda 1907 - 2001 - study to find a set of normal characteristics found:
positive attitude to oneself
self actualization
autonomy
resisting stress
accurate perception of reality
environmental mastery
all characteristics must be met to be considered normal

AO3
- normal not to have all at one time
- not scale - checklist - black and white
- not widely used
- unhelpful for treatment - mental != physical health
- idealistic not realistic
- ethnocentric - set of defined characteristics based off of white western behaviors
- does not consider eccentricity or self destructive behaviors
- desirable traits change over time
+ focuses on positives
+ checklist allows targeted treatment
+ huistic

Question 4

deviation from statistical norm

Answer 4

any behavior that is +/- 2 SD of the mean ability
AO3
- classifies talent as abnormal
- classes non-issues as abnormal - left handedness
- under reporting of mental disorders can lead to over treatment - cohen 1988 - mental illness in India seen as curse - lead to under reporting
- kesut et al 1994 - 48% of Americans suffer from mental illness at some point - makes metal illness the norm
+ objective - statistical unbiased
+ no judgment - removes stigma
+ easy to use to get help
+ gives overview of abnormality between cultures

Question 5

Diagnostic and Statistical manual

Answer 5

published by american psychiatric association - currently on 5th iteration, released in 2013 - classifies disorders into 3 groups - depressive, anxiety and obsessive compulsive disorders

Question 6

phobias

Answer 6

irrational fear of an object or situation - three categories:
specific - fear of an object/situation
social anxiety - fear of social situations
specific - fear of object/situation
agoraphobia - fear of open spaces

Question 7

characteristics of phobias

Answer 7

behavioral:

• escape
• fight or flight response
• avoidance
• endurance
• in children only - freezing, clinging and tantrums

emotional:

• anxiety
• fear

cognitive response:

• selective attention - focuses on stimuli - stroop test
• becker et al 2001 - P’s took longer to speak phobia v general anxiety words

Question 8

behavioral explanation of phobias

Answer 8

mowres two process model 1960 - classical conditioning causes a phobia to be learned, operant conditioning maintains the phobia
AO3:
- diathesis stress model - normal amount of fear in every day life
- diande et al 1985 - not all traumatic event lead to phobia - evidence against classical conditioning being the sole factor in learning a phobia
+ P’s often able to identify specific event starting phobia - supports classical conditioning
- biological preparedness - phobias biological response to dangers like cliffs and snakes
- ignores cognitive factors - behaviorist therapy’s ignore maladaptive cognitive processes leading to fear
- avoidance not anxiety reaction but safety
+ basis for effective therapies

Question 9

systematic desensitization for phobias

Answer 9

gradually re-associating symptoms with classical conditioning
holpe 1958 - defined process of systematic desensitization
anxiety ranking - ranking the different anxiety levels produced by different exposure to a phobic stimuli
relaxation techniques - P works with psychologist to learn techniques to stunt anxiety response
exposure - works up ranking, only move up a stage when no anxiety is produced at the current stage
treatment is considered complete when no anxiety is produced at highest level of exposure

AO3
+ Gilroy et al 2003 - 42P’s with specific phobias in 3 45 min sessions - more effective after 3 months and 33 months than control group (relaxation techniques only)
+ gloved approach suitable for wider range of P’s - children, p’s with further mental health conditions and complex phobias
+ less traumatic - lower rates of attrition
- symptom substitution - extinguish one set of symptom but replaces it with another - does not treat root of problem
- less effective than other options (flooding)

Question 10

flooding for phobias

Answer 10

intimidate exposure to phobic stimuli for an extended period of time - in confined space with stimuli with no coping methods
AO3:
+ effective - ougrin 2011
+ quick and cheap - one session
- less effective for complex phobias, children and people with further mental health conditions
- higher rates of attrition
- symptom substitution

Question 11

Obsessive Compulsive Disorder

Answer 11

a range of related disorders with repetitive obsessive thinking
OCD cycle - Obsessive thoughts –> anxiety –> compulsion –> temp relief –> obsessive thoughts etc
10% show only compulsions no obsessions
behaviors are recognized as abnormal by P

Question 12

characteristics of OCD

Answer 12

behavioral:
avoidance of stimuli
behavioral compulsions

emotional
anxiety/distress
guilt/disgust
accompanying depression

cognitive
obsessive thoughts
cognitive compulsions

Question 13

genetic explanation of OCD

Answer 13

lewis 1936 - 50 OCD P’s 37% had parents with OCD and 21% with siblings - genetic predisposition to OCD
AO3
- polygenic - more than 1 candidate gene (~230) - unuseful for treatment - could be silver bullet - could be a result of lots of related disorders under 1 banner
+ twin studies - mesult et al - 68% MZ 301% DZ
- environmental risk factor - cromer et al 2007 - 50% of OCD P’s had traumatic events - symptoms more sever in P’s with more than one traumatic event

Question 14

neuralanatomical explanation of OCD

Answer 14

OFC circuit = Orbital cortex sends worry signal to thalamus -> forwarded to amygdala which triggers anxiety response
caudate nuculeas responsible for suppressing signals between thalamus and amygdala - prevents constant state of arousal - damage or lack of activity in basal ganglia and over activity in OFC circuit OCD
AO3:
+ PET scans of OCD P’s show increased activity in OFC and decreased activity around basal ganglia (location of caudate nuculeas)
+ max et al 1994 - disconnected basal ganglia in rats - OCD symptoms reduced
+ menzines et al 2007 - used fMRI’s to find reduced grey mater in OCD P’s and immediate family members in OFC
+ saxena and raunch 2000 - PET and fMRI’s showed correlation between increased OFC activity and OCD

Question 15

serotonin explanation of OCD

Answer 15

piyatt 1990 - low levels of serotonin in OCD p’s - serotonin increasing drugs decreased OCD symptoms

AO3
comer 2008 - serotonin key neurotransmitter in OFC
hu 2006 - serotonin levels lower in OCD P’s than control
- Baxter 2007 - chicken or egg - cause or effect
- not all OCD P’s respnd well to SSRI’s

Question 16

dopamine explanation of OCD

Answer 16

abnormaly high levels of dopamin in OCD P’s
AO3
+ szeltman et al 1998 - increased dopamine in rats - lead to typical OCD like symptoms
- animal studies - not generalize - stereotypical symptoms != clinical symptoms
+ sickle 2007 - Dopamine linked to OFC - main neurotransmitter in basal ganglia - suggest over activity linked to OCD

Question 17

Drug therapy for OCD

Answer 17

inhibits serotonin reuptake in pre synaptic neuron - increase chances of post synaptic neuron firing
often used alongside CBT - treats both cause and symptoms at same time
if not working - increase dosage, change type, tryciclics - same effect as SSRI but more side effects, Serotonin-noradrenalin reuptake inhibitors - increases Serotonin through noradrenaline
AO3
+ cheap and quick
+ non disruptive to routine
- life long - only effective when taking them
- side effects
- tolerance builds up over time
+ soomro et al 2009 - SSRI ‘s more effective than placebo but most effective (70%) when combined with cognitive therapy
- drug companies sponsor studies - compromises findings

Question 18

psychosurgery for OCD

Answer 18

using radio frequencys to destroy brain tissue in cortio-stratical circuit (OFC, thalamus and basal ganglia) - richter et al 2004 - 30% of P's had 35% reduction of symptoms - but some sever side effects - mallett et al 2008 - deep brain stimulation effective as therapy
AO3:
- side effects
- low success rate (30%)
- only used after long term drug resistance for 10 years
\+ last resort for sever OCD
\+ increases quality of life
\+ often works where drugs don't