psychopathology Flashcards
What are polygenic conditons?
There are many genes that contribute to the condition
What is the DSM5 definition?
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OCD is recognised as a disorder of obsessive behaviour,of which there are several:
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3 examples of OCD?
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Trichotillomania – Compulsive hair pulling.
Hoarding Disorder - Compulsion to keep all possession regardless of worth.
Excoriation Disorder – Compulsive skin picking.
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Def OCD?
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Obsessive Compulsive Disorder (OCD) – People experience on a consistent basis both Obsessive and Compulsive Behaviours
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What are the behavioural characteristics?(OCD)
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Compulsions – these are broken down 2 sub types:
Compulsions are Repetitive – the need to repeat even minor actions a set amount of times, this often includes washing, tidying and ordering items.
Compulsions are need to be acted on to Reduce Anxiety – 90% of OCD suffer will need to do things in order to reduce the anxiety that they are feeling. I.e. They must wash their hands regularly in a set way 3 times in order to prevent them being contaminated by germs which would kill them.
Avoidance – OCD sufferer will seek to avoid or reduce their anxiety in by avoiding situations that would trigger their obsessions.
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What are the emotional characteristics? (OCD)
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Anxiety and Distress – Powerful and unpleasant emotions are frequently experienced, ie fear and anxiety around not doing something they feel a compulsion to.
Accompanying Depression – frequently depression will be present as well. Escape from this can often be achieved, if briefly by engaging in compulsions.
Guilt and disgust – frequently targets at themselves or at others.
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What are the cognitive characteristics? (OCD)
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Obsessive Thoughts. – 90% of OCD suffers experience thoughts which they cant shake or stop which cause them significant distress.
Cognitive Strategies – The person develops methods to deal with the thoughts however to others around them they may make them seem odd.
Insight to the Excessive Nature of Their Anxiety – simply put they can know that their actions are irrational and unusual but this does not mean they can stop them.
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What is systematic desensatisation?
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SD is a behavioural therapy designed to gradually reduce phobic anxiety through classical conditioning.
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What are the stages of this therapy?
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- The Anxiety Heirarchy - is put together by patient and the therapist. They create a list of situations related to the phobic stimulus that would frighten them.
- Relaxation - The therapist teaches the patient to relax as deeply as possible then patients are introduced to their stated scenarios and asked to imagine a sense of of calm in these settings.
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Exposure - The patient is exposed to phobic stimulus while in a relaxed state over several sessions until patients are able to stay calm in high anxiety scenarios.
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How is this an effective treatment?
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It is effective - Systematic desensatisation is effective in the treatment of specific phobias.For example Gilroy et al (2003) followed up with 42 patients who had been treated for anachraphobia in 3 45 minute sessions on SD. Their phobias were assessed through questionaires. The control group was just relaxed instead of being exposed to the stimulus. At 3 months and 33 months later SD was more effective than the control group. Therefore this is a support due to SD being successful at decreasing the level of fear in patients over an extended period of time.
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How can the range of patients support this?
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Suitable for a range of patients - Alternative theories such as flooding/cognitive therapies are not well suited to all patients. Therefore it is more effective for a majority no matter their curcumstances.
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How are the patients more likely to choose this?
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It is acceptable to patients -Most patients will choose this method especially over flooding. This is due to the lack of trauma taking place in order to get rid of the phobia. It can been seen in the low refusal rates and low drop out rates - therefore this demonstrates validity.
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What is flooding?
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This involves exposing patients to phobic stimulus but without a gradual build up. These sessions are usually longer that SD, often around 2-3 hours). Sometimes one session of this can cure the phobia comepletely.
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How does flooding work?
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This stops phobic reactions quickly. In CC this is called extinction where the faulty conditioned response is removed. The condition stimulus (dog) is experienced without the unconditioned stimulus (being bitten). This however can be dangerous because people can have heart attacks, panic attacks or have no PTSD. So patients now have to give their explicit consent.
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How does cost support this?
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It is cost effective - It is just as effective as other treatments for specific phobias and is also quick which lowers the cost of the therapy. Patients are therefore freed from the burden of their phobias without adding a financial one.
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How is its effectiveness an issue?
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It is less effective for some types of phobias - More complex phobias are not as easy to treat with this method, for example social phobias.
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How can trauma be an issue?
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The Treatment is Traumatic for Patients - Flooding is highly traumatic because it creates high levels of stress and anxiety patients are often unwilling to continue or take part in the treatment initially. This is a limitation of flooding because time and money is sometimes wasted preparing patients who eventually refuse the treatment.
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What is the definition+use for Statistical Infrequencies/Deviations?
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- Under this definition a persons actions are classified as abnormal if it is statistically unusual.
- It is necessary to be clear how rare this trait or behaviour is before it is classed as abnormal.
- If we use this definition we would have to class those who are not normal as abnormal and we should be looking for the normal behaviour initially.
- This definition does not distinguish between the positives and negatives that can be found in these abnormalities. Abnormality because of this now has a negative stigma. It also classes rare characteristics as abnormal despite them just being very rarely occuring.
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What is a Strength of this definition? ( statistical infrequency )
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Strengths - It makes it easy to find and diagnose these mental illnesses to give them help. There is therefore room for statistical infrequency as part of the clinical assesment.
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How can unusual characteristics be positive? (stat)
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IQ scores over 130 are just as unusual as those below 70. Howver one is a severely dehabilitating position while the other is just statistically rare, rather than a cause for concern. Her statists fail to define what we class as ‘normal’ effectively. This seriously limits this explanation as it shows that not all statistically infrequent occurences need treatment and should never be the sole definiton used to form a diagnosis.
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How can satatistically infrequent abnormalities have no use?
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Some people live with what would be defined as ‘abnormalities’ through this defininition might be more negatiely impacted by being labeled than going without. Someone with a high IQ recieves no benefit to having an abnormal diagnosis. Therefore the diagnosis of everyone under the definition of statistical infrequency may lead to more harm than good, producing negative views of themselves through an insufficient definition.
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What is the defnition of Deviation from social norms?
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- Here what is classified as abnormal is if it violates the unsaid rules about what is expected and correct in a certain social group.
- Behaviour can been seen as incomprehensible or threatening to others.
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What is the criticism for abuse? (Deviation)
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Can be abused by, for example being used agains gay rights or those of different political views. This leads to minorities being targetted and classsified as abnormal due to their failure to conform to the social or societal norms. Therefore we need to be careful when classifying ‘abnormality’ through this lense as it may have detrimental effects fro the individuals in the minorty.
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What is the criticism for cultural relativism? (deviation)
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A final criticism is how cultural relativism is also relevent as the cultures may see different parts of their own society as natural. For example in Africa it would be acceptible to carry a weapon whereas in the UK this would not be acceptible. This demonstrates how this definition is limited to its use in different cultures and therefore is suffering from cultural relativism.
Weakness implies that they are failing and so become classed under a limited view of mental health. In Caribbeasn comminities we see that those who are classed with schizophenia are often classed by those are white doctors from a middle/upper class background. This means that a limited powerful group are being given power over the medicalisation of mental health. Therefore we need to be careful when giving this power to any particular group.
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What is the criticism for context? (deviation)
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A further criticism is the level of or the context of the situation and the degree of the deviation has to come into account. For example laughing at a funeral would be considered abnormal in that context. This shows we must always consider the violation in a relative light depending on the situation. Therefore this is not as effective as it first seems.
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What is the definition + characteristics of Fialure to Function Adequately? (R&S)
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- If they are unable to cope with the demands of everyday life and perform necessary behaviours that allow themselves to thrive.
Rosenhan & Selgman (1989) - Characteristics of Mental Health
- suffering (Seriously?)
- maladaptiveness (Mrs)
- vividness & unconventiallity (Utah)
- unpredictability &loss of control (Loves Cradling)
- Irrationality/Incomprehensability (Irate [and..])
- Causes observer discomfort (Disabled)
- violates moral/social standards (Murder Statistics)
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How can a lack of subjective opinions support this defninition? (failure)
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A strenght of this is that it does not seek to only use subjective opnions of the patient’s state. Although distress can be difficult to measure , at leaste here we see a diefinition that acknowledges the patient’s experience of the abnormality. Therefore it is a useful definiton to use when assessing useful criteria that can assess abnormality.
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Adaptiveness or Maladaptiveness? (failure)
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Furthermore is this adaptiveness or maladaptiveness? For example a drag queeen takes on the persona of a different identity to do their work and yet they normally have a totally seperate personality - which would usually be classed as abnormal. This shows that sometimes somehting can be adaptive incertian situations and not in others. Therefore context is key when using this definiton as it may lead to missdiagnosis.
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How is subjectiveness a problem? (failure)
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When we have to decide whether someone is either distressed or distressing there is a certain element of external, subjective assessment. Patients may say they are distressed but be judged to be not suffering. There are methods such as the GAFS that seek to lower the level of subjectivity so someone is rationally diagnosed. Therefore we have to realise that a psychiatrist still has the right to diagnose with their expertise over that of a patient.
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What is the definition + characteristics of Deviation from the Ideal Mental Health?
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- Anything that does not fall under this catagorie of promoting positive menthal health, is deemed abnormal.
- Here we need to decide what is necessary for mental health.
Jahoda
- Positive view of oneself
- Capability for growth and development
- Autonomy and independence
- Accurate perception of reality
- Positive friendships and relationships
- Environmental mastey of every day situations
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How si it a positive and pragmatic definition? (ideal)
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Strength - Provides a set pf behaviours that should be present and to aim towards.
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What is the problem with cultural relativism here? (ideal)
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Finally cultural relativism suggests that through this definition we should be treated as an individual and yeet in any societies we see the needs of the group being put first. In china we see a collecrivist culture which values the group and codependence as essential. This shows that these criteria fail to recognise cultural relativism therefore providing us a theory that should only be applied to individualist cultures.
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How is the list of criteria not realisitic? (ideal)
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There are such a large amount of criteria on this list that it is not realistic to expect us to meet these all at once. For example if you were fired from your job due to incompetency. In this scenario you cannot possibly be having a positive view of ones self and be capable of growth and development simultaneously. Therefore the definition is not accurate as it tries to cover too many aspects and this means it generates internal conflicts.
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Should we jsut use physical markers? (ideal)
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This definition assumes that the mental conditions are plainly physical and treat them similarely to physical issues. This leads to generic treatments that do not specify to the patient which due to the nature of mental health is not appropriate. Therefore we should seek to note overmedecalization mental health issues by medical establishments.
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What are drug treatments?
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Drugs are careful constructed chemical compounds which are used by people as they have effects which are deemed useful. However there are nearly always other, undesired effects too. These are labelled “side effects as they are not intended effects but they are in truth just effects we don’t want.
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Whare are SSRIs and how do they treat OCD?
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The most common form of drug treatment is to prescribe a specific type of anti depressant called Selective Serotonin Reuptake Inhibitors ( SSRI). These work to cause a build up of serotonin between the pre and the post synaptic neurons.
It does this by preventing the enzymes from breaking down the serotonin. It also prevents the serotonin form being reabsorbed (taken back in) as quickly. Over the period of 3-4 months, these SSRI’s lead to a build up of serotonin, which seem to lead to an elevation of the OCD suffered condition. The normal daily dose is of 20mg in capsules or liquid form.
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How is treatment a support for SSRIs?
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Is effective in treating OCD, Sansone & Sansone (2011) – 70% of OCD suffered show significant improvement in OCD symptoms compared to a placebo treatment.
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How are side effects limiting?
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Side effects often cause people to stop taking them. (eg. headaches, amnesia, taste perversion and delusions). If people stop taking the medecation it will no longer be effective. Therefore this treatment is not effective due to these circumstances.
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How can the delays be a criticism?
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A further criticism of SSRIs is the long delays make people give up on them before they kick in where they will stop taking the pills before the become effective. With OCD patients it can take 3 to 4 months and with the slightest slip they can be forced to start over. Therefore these treatments are not as effective as they seem at first glance.
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SSRIs are not a cure, how is this a problem?
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Another criticism is that the drug treatment is not a cure. Althought the patients are taking this drug (SSRIs), if they were to stop at any point they would return to their premedicated state unlike such treatments as CBT. Therefore it is not an effective long-term solution and patients may only use these as stop gaps so that they can then engage in effective therapy.
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Draw out application of operant conditioning
