psychopathology

Question 1

what are the four definitions of abnormality

Answer 1

statistical infrequency

deviation from social norms

Failure to function adequately

Deviation from ideal mental health

Question 2

what are the behavioral characteristics of phobias?

Answer 2

panic- may respond in panic when near the phobic stimulus e.g. crying, screaming, running away. Children e.g. freezing, having a tantrum
avoidance- e.g. not going to a theme part with a phobia of sick
endurance- alternative of avoidance, e.g. person with a fear of spiders may stay in the room of a spider to keep an eye on it

Question 3

what are the emotional characteristics of phobias?

Answer 3

anxiety-
-fears are anxiety disorders, makes it difficult to feel positive in the high arousal
fear-
-immediate unpleasant response to a phobic stimulus, more intense but shorter than anxiety
emotional response is unreasonable-
-anxiety and fear is much greater than average with the phobic stimulus e.g. with a tiny spider

Question 4

what are the cognitive characteristics of a phobia?

Answer 4

-selective attention to a phobic stimulus
-will concentrate on the phobic stimulus in order to be able to react quicker to it
irrational beliefs
-unfounded thoughts that cant be easily explained and don’t have any basis in reality e.g. if I blush people will think I’m weak’

Question 5

what are the behavioral characteristics of depression?

Answer 5

activity levels:
-lethargy
-withdrawal from work etc.
-or could lead to psychomotor agitation, struggling to relax
disruption to sleep and eating behavior:
-insomnia/hypersomnia, increased or decreased diet
Aggression or self harm:
-aggression against others or oneself

Question 6

what are the emotional characteristics of depression

Answer 6

lowered mood:
-worthless, empty
anger:
negative emotion is not just limited to sadness, towards self and others
low self esteem
-common in depression, can be so extreme that its addressed as self hate

Question 7

what are the cognitive characteristics of depression?

Answer 7

poor concentration
attending to dwell on the negative
-paying more attention to negative aspects ‘glass half empty’
absolutist thinking
-black and white thinking, when a situation is ‘unfortunate’ they see it as disastrous

Question 8

what are the behavioral characteristics of OCD?

Answer 8

compulsions are repetitive:
-compelled to repeat a behavior e.g. hand washing
compulsions reduce anxiety:
-compulsions are usually a method to reduce anxiety e.g. checking all doors are locked
avoidance:
-avoid anxiety triggers e.g. avoiding germs

Question 9

what are the emotional characteristics of OCD

Answer 9

anxiety and distress:
-powerful anxiety companies both obsessions and compulsions: cycle-> obsessive thought, anxiety, compulsive behavior, temporary relief
accompanying depression:
anxiety can be accompanied by low mood and lack of enjoyment in activities
guilt and disgust
-guilt for minor things and disgust for things like self or dirt

Question 10

what are the cognitive characteristics for OCD

Answer 10

obsessive thoughts
-90% of people with OCD
-e.g. uncertainty that the door is locked
cognitive coping strategies
-people also use this to deal with obsessions
-e.g. a religious person may respond to guilt by praying
insight into excessive anxiety:
-self aware that their anxiety and compulsions are not rational
-despite these insights they still have catastrophic thoughts that might result if thier anxiety was justified
-also hypervigilant, constant awareness of possible hazards

Question 11

Describe the classical conditioning stage of the two process model (behavioral approach to explaining phobias) (Mowrer)

Answer 11

classical conditioning- learning by association because two stimuli are paired together to then make a conditioned response
‘Little albert’: put in a room with a rat and wanted to play with it, however when he tried the researchers would make a loud noise by banging on an iron bar close to his ear. This would frighten him. this lead to him associating the unconditioned stimulus (loud noise) that gave him an unconditioned response (fear) with the neutral stimulus (rat) creating a conditioned stimulus and response. They tested albert by showing him furry objects such as a non white rabbit, a fur coat and a Santa beard. He displayed distress at the sight of all of these.

Question 12

Describe the operant conditioning stage of the two process model (behavioral approach to explaining phobias) (Mowrer)

Answer 12

-makes the phobias long lasting, maintaining it
-when our phobia is reinforced or punished
negative reinforcing and positive reinforcing both maintain a phobia. Negative example (avoidance, release of anxiety)

Question 13

what is systematic distension as a way of treating phobias?

Answer 13

behavioral therapy designed to gradually reduce phobic anxiety through the principle of classical conditioning, if it can lead to the person being relaxed in the phobic stimulus they will be cured. anew response to the phobic stimulus is learned (counter conditioning)
THREE PROCESSES-
the anxiety hierarchy list of phobic situations listed from least to most frightening
relaxation- therapist teaches the client to be as relaxed as possible, impossible to be arraign and relaxed at the same time. (reciprocal inhibition) e.g. breathing exercises, imagining relaxing situations, drugs such as Valium
exposure- while being relaxed this takes place. Anxiety hierarchy. until relaxed they move up until at the top and until they can stay relaxed in the high anxiety hierarchy

Question 14

what is flooding therapy?

Answer 14

• a person with a phobia is exposed to an extreme form of the phobic stimulus
• this is to learn that the phobic stimulus is harmless
• client may even feel relaxed as they become exhausted by their own response
• clients must have fully informed consent as it can be traumatic, they are usually given the choice of SD or flooding

Question 15

outline becks negative triad as an explanation for depression

Answer 15

-beck preposed that there are three kinds of negative thinking that contribute to becoming depressed:
Faulty information processing-people attend to the negative aspects and ignore the positive e.g. won £10 in lottery but ‘last week people won £15 (black and white thinking)
Negative self schema:
-schema- a packet of ideas and info developed through experience. Mental frame work for interpretation of sensory information. Self- schema is the information they have about themselves- people use schema to interpret the world so if someone has a negative self schema they will interpret the world in a negative way
the negative triad:
negative view of the world
negative view of the future
negative view of self

Question 16

Outline Ellis’ ABC model as an explanation for depression

Answer 16

Ellis proposed that depression occurs when an activating event (A) triggers an irrational belief (B) which in turn produces a consequence m (C)

• A- irrational thoughts are triggered by external events. E.g. failing a test might trigger irrational beliefs
• B- range of beliefs were identified. e.f. that we must always succeed or be perfect ‘mustibation’ belief that something is a major disaster if it doesn’t go smoothly
• C- emotional and behavioral consequences. E.G if someone fails if they believe they should always succeed it can trigger depression as the consequence

Question 17

outline cognitive behavior therapy as a treatment for depression

Answer 17

The client and the CB therapist work together to identify the clients problems. Jointly identify goals for the therapy and put together a plan to achieve them. E.g identifying where there might be negative or irrational thoughts that will benefit from challenge

Question 18

what is Becks cognitive therapy?

Answer 18

identify automatic thoughts about self, the future and the world (negative triad) once identified the thoughts must be challenged. As well as this, CT aims to help the clients test the reality with the negative beliefs. They might be set hw e.g record when they enjoyed an event. If the client says ‘no one is nice to me’ in future sessions then the therapist can produce this evidence to prove the clients statement incorrect.

Question 19

what is Ellis’s rational emotive behavioral therapy?

Answer 19

-extends the ABC model to a ABCDE model.
- D = dispute, E= effect.
-the aim of REBT is to identify and dispute (challenge) irrational thoughts.
-e.g. client might talk about how unlucky they are and therapist will identify this as an example of utopianism and challenge the thought.
-this would involve a vigorous argument
-aim: to change irrational beliefs and unlink negative events to depression
-different methods of disputing (arguing): empirical- disputing whether there is actual evidence to support the belief
logical- disputing whether negative thoughts logically follows from the facts

Question 20

describe behavioral activation as a way to treat depression

Answer 20

as people become depressed, they tend to avoid difficult situations by becoming isolated, which worsens/ maintains symptoms. aim: work with depressed individuals to slowly decrease their isolation and avoidance and increase engagement in activities. (improve mood)

Question 21

outline genetic explanations for OCD

Answer 21

-Lewis observed that 37% OCD patients had partners with OCD and 21% had siblings. this suggests OCD runs in families
-CANDIDATE GENES- researchers have identified genes that create vulnerability for OCD. Some are responsible for regulating the development of serotonin E.g 5HT1-D beta is responsible for carrying serotonin across synapses
-OCD is poly genetic: not caused by one gene but a combination of genetic variations that together increase vulnerability. Taylor found that approx up to 230 genes can be responsible. Genes studies have been linked with the role of dopamine and serotonin- both have a role in regulating mood.
different types of OCD:
- one group of genes may cause one OCD in one person but a different group many cause another person OCD. (aetiologically heterogeneous) there is also evidence to show different groups may be the result of particular genetic variations e.g hoarding disorder or religious obsession

Question 22

outline Neural explanations for OCD

Answer 22

Role of serotonin- If someone has low serotonin then normal transmission between neurons will not take place which can result in low mood. Some cases of OCD may be explained by a reduction in the function of the serotonin system in the brain.

Decision making systems:
-some cases of OCD, particularly hoarding disorder seem to be paired with impaired decision making. May be associated with abnormal functioning of the lateral of the frontal lobe. (responsible for decision making) there is also evidence that the parahippocampal gurus associated with producing unpleasant emotions functions abnormally in OCD

Question 23

outline drug therapy as a way to treat OCD (SSRI)

Answer 23

SSRIs
-antidepressant called selective serotonin reuptake inhibitors, serotonin is released by certain neurons in the brain (presynaptic neurons) and travel across a synapse.
neurotransmitter chemically coneys the signal from the presynaptic neuron where it is re absorbed, broken down and reused. SSRI’s increase levels of serotonin as it prevents the reabsorption and break down. increase levels of serotonin this stimulates the postsynaptic neuron. Dosage depends on what SSRI is prescribed e.g. fluoxetine 20mg unless not benefiting the person . takes four months of daily use to see much impact on symptoms

Question 24

combining SSRIs with other treatments

Answer 24

drugs can be used along side CBT. people can engage more effectively in CBT if symptoms like depression are reduced with drugs.

Question 25

alternatives to SSRIs

Answer 25

if SSRIs do not improve automatically within 4 months other drugs can be added or replace it.
Tricyclics - older antidepressant. e.g. clomipramine, works the same as an SSRI however has more severe side effects so is usually only reserved for people who do not respond to SSRIs
SNRI- increase serotonin and noradrenaline. like clomipramine, it is used as a reserve unless the client is not responding to SSRI’s

Question 26

describe statistical infrequency as a definition for abnormality

Answer 26

statistical infrequency- when an individual has a less common characteristic
-e.g. being depressed, having an IQ below 70 (intellectual disability disorder) where average is 100, most people range from 85 to 115

Question 27

describe deviation from social norms as a abnormality

Answer 27

-deviation from social norms
-varies in cultures
-behaviors that are different from the accepted standards of society
-e.g. antisocial personality disorder- impulsive, aggressive and irresponsible, social judgement that they do not fit into moral standards

Question 28

describe failure to function adequately as an abnormality

Answer 28

Failure to function adequately:
-when someone is unable to come with everyday commands
-experiences severe personal distress, no longer conforms to standard rules e.g. maintaining eye contact, irrational and dangerous behavior: e.g. Intellectual disability disorder- although it is a statistical frequency they must be failing to function adequately to be diagnosed

Question 29

describe deviation from ideal mental health as an abnormality:

Answer 29

Deviation from ideal mental health
-when someone doesn’t fit the standard criteria from ideal mental health ( no distress, rational, self actualize, cope with stress, realistic view of the world, good self esteem, lack guilt, independent and can successfully work and enjoy leisure )

Question 30

strength and limitation- statistical frequency

Answer 30

+usefulness: used in clinical practice- way to diagnose and assess severity of symptoms. E.g. Intellectual disability disorder=below 70 IQ. Beck depression inventory- a score of 30+ is diagnosed as severe depression. This shows it is useful in diagnostic and assessment process
-infrequent characteristics can be positive- e.g. above 130 IQ. Yet we would not think of them as abnormal. same with very low depression score. This means that although statistical infrequency serves purpose on diagnostic sections it is never good in defining basis of abnormality

Question 31

strength and limitation-deviation from social norms

Answer 31

+usefulness in clinical practice: e.g. key defining characteristic in APD is failure to conform to culturally acceptable behavior. Deviation from norms. Such norms also take place in the diagnosis of schizoptypal personality disorder, where the term strange is used to characterise the thinking behavior etc. This shows deviation from social norms criterion has value in psychiatry
-variability between social norms and different cultures and situations: Not everyone views stuff as abnormalities- E.g. hearing voices is the norm in some cultures but would be seen as an abnormality in UK. within cultures it can also be different, such as family life being different. This means it is difficult to judge deviation from social norms across different situations and cultures.

Question 32

strength and limitation: failure to function adequately

Answer 32

+failure to function criterion represents suitable threshold for people that need help. Many people will experience symptoms of a mental health disorder at some point of there life. But some people will face severe symptoms and fail to function adequately where people are then referred to help by others or professionals. This means that treatment an services an be targeted to those who need it the most.
-easy to label non standard lifestyle choices as abnormal. It can be hard to say someone is failing to function when they have simply chosen to deviate social norms. E.g. people who dont have a job or engage in unique spiritual practices can bee seen as failure to function to some people and therefore they could be unreasonably classed as irrational or danger to themselves. This means that people who make unusual choices are at risk of being labelled abnormal and their freedom of choice may be restricted

Question 33

strength and limit of deviation form ideal mental health

Answer 33

+highly comprehensive: The concept of ideal mental health includes a range of criteria distinguishing
-ideal mental health criteria is too harsh and would class lots of people as abnormal or mentally unwell

Question 34

what is behavioural activism (cog approach to treating depression)

Answer 34

goal is to work with depressed individuals and gradually decrease their avoidance and isolation and increase engagement in activities that have been showed to improve mood

Question 35

positives of two process model of explaining phobias

Answer 35

+RW application- exposure therapies: idea that people are avoidant of phobic stimulus and this maintains it- explains that its important that they are exposed. Once avoidance is prevented then the reinforcing factors such as release from anxiety allow it to cured as they do not occur. Shows value in treating.
+evidence in link between bad experiences and phobias: Little Albert study how frightening experiences with a stimulus can create fear of the stimulus. Other showed 73% with fear of dentistry had a bad experience. Compared to 21% of control group- low anxiety. This confirms theres an association between two that leads to the phobia

Question 36

limits of two process model:

Answer 36

-does not account to cog aspects: solely put on behavior and response to phobic stimulus and avoidance, but there are also irrational beliefs about the stimulus. TPM explains avoidance but not the cog irrational beliefs, so it TPM does not fully explain the symptoms of phobias.
-COUNTERPOINT TO studies showing link between experience and stimulus: Not all form due to a bad experience, e.g. snake phobias in countries were there are no snakes. This means the association between phobias and frightening experiences are not as strong as we expect if they provide a complete explanation

Question 37

two strengths of systematic desensitation

Answer 37

+evidence of effectiveness: study with 42 people who had it for spiders in 3 45 min sessions. At both 3 and 33 months they were less fearful than a control group treated by relaxation w/o phobia. Specialists have also recommended it. this suggests SD is likely to be helpful for people
+useful for people with learning disabilities. Some people with phobias have learning disabilities. SD alternatives may not be suitable. They often struggle with cog therapies that require complex thought. They also feel confused or stressed about flooding therapy. Therefore SD is the most effective therapy for these people.

Question 38

strengths and limits of flooding

Answer 38

+cost effective: clinically effective and not expensive. , and can work as little as one session apposed to 12 sessions in SD. This means more people can be treated at the same time with flooding as a side to SD etc.
-traumatic: highly unpleasant- study showed Ps and therapists rated it more stressful than SD. Raises ethical issues for psychologists as they knowingly are causing stress. However it is given permission with informed consent. Drop out levels for flooding is higher than Sd. This means over all therapists should not use this

Question 39

two strengths of Becks negative triad:

Answer 39

+supporting research: cognitive vulnerability definition, researcher concluded that the cog vulnerabilities were more common in depressed people and that they preceded the depression. This was confirmed in a more recent prospective study: tracked development of 473 adolescents regularly measuring cog vulnerability. Found that showing CV later predicted depression. This shows the association between the two.
+applications in screening and treatment: Researcher concluded that assessing cog vulnerability allows them to screen young people and see their risk for depression. and monitor those as high risk. Can also be applies to cognitive behaviour therapy. This works buy altering cognitions that make them vulnerable and making them more resistant to bad life events. This means an understanding of cog vulnerability is more useful than one aspect of clinical practice

Question 40

strength and limit of Ellis’s ABC model:

Answer 40

+RWA in treatment: the approach is called rational emotive behavioural therapy (REBT)- idea that arguing with the patient can alter their irrational beliefs. Some evidence supports the effectiveness of this in changing beliefs and treating depression. This means it has RW value.
-only explains reactive depression and not endogenous depression: some evidence may suggest life events trigger depression- reactive and our response seems to play part in our beliefs. However many cases of depression are not traceable to life events and it is not obvious at what leads to the depression. This is sometimes called endogenous depression. This means it is only a partial explanation

Question 41

strengths of CBT: (depression)

Answer 41

+large amount of evidence to support its effectiveness- e.g study compared CBT to antidepressant drugs and a combo of the two with 327 adolescents. After two weeks, 81% of drugs, 81% of CBT and 86% of both showed improvements. so it was just effective on its own and even more when combined. Also cost effective as it is around 12 sessions.
+COUNTER TO lack of effectiveness with severe clients + learning disabilities: there is now some more recent evidence that challenges this- A review concluded that CBT was as effective as drugs and behavioral therapies for severe depression. Another concluded that when used appropriately, CBT is as effective for people with learning disabilties. This means CBT may be suitable for a wider range of people than was once thought

Question 42

limits of CBT:(depression)

Answer 42

-lack of effectiveness in severe patients and those with learning disabilities. Some cases its so severe that clients cannot motivate themselves to engage in the therapy. Complex rational thinking involved can also be seen as unsuitable to people with learning difficulties. This suggests CBT is only suitable for a specific range of people
-high relapse rates: although it may be effective in tackling symptoms, there are concern over how long this lasts. Some recent studies have shown: 439 clients over 12 months- 42% relapsed within 6 months and 53% in a year. This means it must be repeated periodically

Question 43

strength and limit of the genetic explanation for explaining OCD:

Answer 43

+strong evidence base that suggests that people are vulnerable to OCD due to genetic makeup. E.g. twin studies: 68% of identical (MZ) twins shared OCD as opposed to 31% of DZ twins. Family studies also prove this: 4x more likely if you have a family member with OCD to develop it than someone without it. This suggest there may be some genetic influence on OCD development.
-also environmental risk factors: Although there is evidence to support genetics, there also see, to be environmental risk factors that play a part of risk increase in developing it. E.g. study found that over half of OCD clients in their sample had trauma event in their past. OCD was also more severe in those with one or more traumas. This means genetic vulnerability only provides a partial explanation for OCD.

Question 44

strength and limit of neural explanations for OCD:

Answer 44

+existence of some supporting evidence: antidepressants that work on just serotonin are effective in reducing OCD symptoms, suggesting serotonin may be responsible in explaining OCD. OCD symptoms form part of conditions that are known to be biological in origin such as parkinsons which causes muscle tremors and paralysis. If a biological disorder produces OCD symptoms we may assume biological processes underlie OCD. Suggests biological factors may be responsible for OCD.
-serotonin and OCD link may not be unique to OCD. Many people with OCD also experience clinical depression (co-morbidity= two disorders) And the depression may be the reason for the disruption of serotonin. Leaves us with problem when it comes to serotonin basis. This means it may not be relevant to OCD symptoms

Question 45

strengths of drug treatments for OCD:

Answer 45

+evidence of its effectiveness: clear evidence that SSRI’s reduce symptom severity and improve quality of life for people with OCD- e.g. study compared SSRIs to placebos, all 17 showed better outcomes for SSRIS than placebo. Typically symptoms reduce for around 70% of people taking SSRIs, for remaining 30% most can be helped by alt drugs or combos of drugs and therapies. This means drugs appear to be helpful.
+cost effective and not disruptive to lives: cheap compared to treatments as they can be made quickly and in big quantities in the time it takes to conduct one therapy session. Therefore good value to public health systems like NHS and represents good use of limited funds. NO time spent- not disruptive to lives and keep taking till symptoms go down. This means they are popular with many people

Question 46

limits of drug treatments for OCD:

Answer 46

-COUNTERPOINT TO goo evidence: even though there is evidence there is also evidence that they may not be the best treatments available: systematic review carries out concluded both cog and behavioral therapies were more effective than SSRIs in OCD treatment. Means they may not be optimum treatment for OCD
-can have potentially serious side effects: it doesn’t help some people. some people also get: indigestion, blurred vision, loss of sex drive. These are usually temporary however can be stressing for people and are long lasting for some. Those taking tricyclic: more common and more serious e.g. 1/10- experience weight gain. This means some people have a reduced quality of life as a result of taking drugs and may stop taking them all together deeming them ineffective