Psychopathology

Question 1

Statistical deviation/infrequency

Answer 1

Abnormality is defined as those behaviours that are extremely rare i.e any behaviour that is found
Example: the average IQ is set at 100 and only 2% have a score below 70 which allows for a diagnosis of intellectual disability disorder

Question 2

Strengths - statistical deviation/infrequency

Answer 2

Real-life application:
Most assessments of patients with mental disorders includes some sort of measurement of how severe their symptoms are compared to statistical norms thus statistical frequency is a useful part of clinical assessment e.g. the diagnosis of intellectual disability disorder as only 2% have an IQ score below 70

Question 3

Limitations - statistical deviation/infrequency

Answer 3

Unusual characteristics can be positive:
IQ scres over 130 are just as unusual as those below 70 but super-intelligence is not an undesirable characteristic that needs treatment so just because a minority display certain behaviours does not make the behaviour abnormal

Not everyone benefits from a label:
There is no benefit to someone being labelled as abnormal regardless of how abnormal they are if they are living a happy life so if someone with a low IQ was capable of working, they do not need a label that will have a negative effect on the way others view them/how view they view themselves

Question 4

Deviation from social norms

Answer 4

Behaviour that is different from accepted/expected standards of behaviour in society
Example: antisocial personality disorder (psychopathy) is impulsive, aggressive and irresponsible - a psychopath does not conform to the moral standards of society

Question 5

Strengths - deviation from social norms

Answer 5

Not a sole explanation:
can distinguish between desirable and undesirable e.g. Highly aggressive people are equally unusual as highly non-aggressive people however we tend to regard high levels of aggression (but not low levels) as abnormal because its a less desirable trait thus social norms work better than statistical infrequency because we are clearly not simply looking at how unusual the behaviour is but also at its social unacceptability.

Question 6

Limitations - deviation from social norms:

Answer 6

Cultural relativism:
Social norms vary from one community to another e.g. hearing voices is socially acceptable in some cultures but would be a sign of mental abnormality in the UK which creates problems for people from one culture living within another culture group

Question 7

Failure to function adequately

Answer 7

When someone can no longer cope with demands of everyday life or face distresses whilst completing everyday tasks i.e hygeine standards

Question 8

Rosenhan and Seligman

Answer 8

Rosenhan and Seligman proposed signs to determine when someone is not coping: facing severe distress, dangerous behaviour to themselves or others and not conforming to interpersonal rules i.e. maintaining eye contact/respecting personal space

Question 9

Strengths - Failure to function adequately

Answer 9

Measurable: The The Global Assessment of Functioning Scale (GAF) based on Rosenhan and Seligman’s sections allows for the extent of the failure to function to be measured in a relatively objective way

Question 10

Limitations - Failure to function adequately

Answer 10

Inadequate measure: imposed etic
Those with alternative lifestyles can be seem failing to function adequately e.g. thos who practice extreme sports could be accused or behaved in a maladaptive way whilst those with religious/supernatural beliefs could be seen as irrational which could limit personal freedom and discrimination against minority groups

Question 11

Deviation from ideal mental health

Answer 11

When someone does not meet the set criteria for good mental health
Jahoda’s criteria for good mental health:
Self-actualisation (being able to realise true potential and achieve full potential/ideal self),
Cope with stress
Autonomy (independence from other people)
Rational/accurate perception of oneself
Good self esteem and lack of guilt
No symptoms of distress

Question 12

Limitations - Deviation from ideal mental health

Answer 12

It sets an unrealistically high standard for mental health:
Very few attain all Jahoda’s criteria for mental health and probably none/a very small minority achieve all of them

Cultural relativism:
Some ideas of Jahoda’s classification are culture-bound (specific to western societies) e.g. the emphasis on personal achievement in self-actualisation would be considered self-indulgent in collectivist cultures. Similarly some see autonomy as a bad thing

Question 13

Strengths - Deviation from ideal mental health

Answer 13

Achievement of goals: This idea allows for clear goals to be set and focused upon to achieve ideal mental health, and, in Jahoda’s opinion, to achieve normality.

Question 14

The two-process model

Answer 14

Mowrer: phobias are acquired (learned in the first place) by classical conditioning and then maintained because of operant conditioning

Question 15

Acquisition by classical conditioning

Answer 15

Classical conditioning involves learning to associate something we initially have no fear (neutral stimulus) with something that triggers a fear response (unconditioned stimulus)

Question 16

Watson and Rayner

Answer 16

Created a phobia in 9-month-old baby called ‘Little Albert’

White rat - Neutral Stimulus (NS)
Albert showed no anxiety at the start and played with the white rat

Loud frightening noise by banging an iron bar - Unconditioned Stimulus (UCS) 
Unconditioned response (UCR) of fear 

White rat + loud, frightening noise - Neutral Stimulus (Rat) becomes associated with Unconditioned Stimulus (loud noise) to produce a Conditioned Response (CR)

Question 17

Maintenance by operant conditioning

Answer 17

Operant conditioning takes place when our behaviour is reinforced (rewarded) or punished which tends to increase the frequency of behaviour

An individual avoids a situation that is unpleasant (negative reinforcement)
Mowrer suggested that whenever we avoid a phobic stimulus we successfully escape the fear/anxiety that we would suffered if we had remained there. This reduction of fear reinforces the avoidance behaviour so the phobia is maintained

Question 18

Strength - behavioural approach to explaining phobias

Answer 18

lead to treatments
explained how phobias could be maintained over time which has important implications for therapy because it explains why patients needed to be exposed to the feared stimulus. Once a patient is prevented from practicing avoidance behaviour, it ceases to be reinforced so it declines. - allows for treatment

Question 19

evolutionary phobias

Answer 19

Bounton points out that evolutionary factors have an important role in phobias but the two-process model fails to mention this e.g. the fear of the dark/snakes is adaptive, Seilgman called this biological preparedness (the innate predisposition to acquire certan fears). This shows there is more to acquiring phobias than simple conditioning

Limitation - behavioural approach to explaining phobias

Question 20

Psychodynamic theory of phobias

Answer 20

Phobias that don’t follow a trauma:
Some people develop a phobia without being aware of having a related bad experience. It is possible that sometimes a phobia can be the result of a displaced anxiety on to something easier to deal with e.g. fear of zombies may for example be a displaced fear of death following the death of a loved-one. These alternative explanations for phobias suggest perhaps not all phobias result from classical conditioning

Limitation - behavioural approach to explaining phobias

Question 21

Alternative explanation for avoidance behaviour:

Answer 21

The two-process model suggests avoidance is motivated by anxiety reduction. Avoidance by patients with agoraphobia is motivated by a positive feeling of safety which comes from not leaving their home.

Limitation - behavioural approach to explaining phobias

Question 22

Systematic desensitisation

Answer 22

behavioural therapy designed to reduce anxiety to a stimulus. It is a step-by-step approach where the patient works out a hierarchy of fear from the least frightening to the most frightening situation. The patient then works through the hierarchy learning to use relaxation techniques in the presence of the feared object.

Question 23

Gilroy et al

Answer 23

found that patients with arachnophobia who were treated with systematic desensitisation were less fearful than those in a control group who were only taught using relaxation techniques. This shows that systematic desensitisation is a more successful long-term treatment for phobias.

Strength - systematic desensitisation

Question 24

Strengths - systematic desensitisation

Answer 24

It is suitable for a diverse range of patients: patients who are suffers of anxiety disorders/have learning difficulties may have difficulty understanding the processes of flooding/cognitive therapies and for these patients systematic desensitisation is probably the most appropriate treatment

It is acceptable to patients: patients who were given the choice between systematic desensitisation and flooding choose prefer systematic desensitisation because it does cause the same degree of trauma and include relaxation procedures that are pleasant

+ Gilroy

Question 25

Limitations - systematic desensitisation

Answer 25

Systematic desensitisation does not help treat the patients who have evolutionary phobias of phobias which have not developed through a personal experience.

Question 26

Flooding

Answer 26

A technique where a person, instead of taking steps towards the object of fear, goes straight to their most feared situation, which is usually contact with the object. Flooding works better for specific phobias than social and agoraphobias because these complex phobias are caused by irrational thinking instead of an unpleasant experience

Question 27

Strength - flooding

Answer 27

It is cost effective - studies comparing flooding to cognitive therapies have found flooding is highly effective and quicker than alternative which is a strength because patients are free of symptoms as soon as possible which also makes treatments cheaper

Question 28

Limitations - flooding (suitability)

Answer 28

It requires a patient to be in good physical health because it is highly traumatic. As flooding can cause a lot of distress it also means that it is not a suitable treatment for children and those of not good physical health.

It is less effective for some phobias - flooding appears to be less effect for treating complex phobias such as social phobia which have cognitive aspects and might be better treated by cognitive therapies that tackle irrational thinking (CBT)

Question 29

Limitations - flooding (treatment)

Answer 29

Flooding as a treatment raises major ethical issues as during flooding treatment, a therapist takes control and may have to go against the patient’s wishes and this can cause major distress for the patient which may cause the patient to be in a worse state than when they began.

The treatment is traumatic for patients: it is highly experience so patients are often unwilling to see it through to the end which is a limitation because time and money are sometimes wasted preparing patients only to have them refuse to start/complete treatment

Question 30

Symptom substitution - Phobias

Answer 30

Symptom substitution: A common criticism for both treatments of phobias is based on the Freudian theory that if one phobia is treated, another may appear in its place e.g phobia of snakes replaced by a phobia of trains

All symptoms of mental illness are simply a reflection of an underlying unconscious conflict.

Question 31

Genetic explanation to OCD - Lewis

Answer 31

Genes are involved in individual vulnerability to OCD

Lewis Observed that out of his OCD patients - 37% had parents with OCD and 21% had siblings with OCD which suggests OCD runs in families but its probably genetic vulnerability instead the certainty of OCD that is passed on

Question 32

Taylor

Answer 32

Taylor analysed findings of previous studies and found
that up to 230 different genes may be involved in OCD
Genes in relation to OCD also include those associated with the action of dopamine/serotonin regulation

Question 33

Methods of investigating the influence of genes:

Answer 33

Involves looking for a high concordance rate of the disorder between relatives

twin studies- MZ v DZ twins
family studies- 1st generation relatives
adoption studies- adopted child and biological parents

Question 34

Nestadt et al

Answer 34

Reviewed previous twin studies and found 68% of identical twins shared OCD as opposed to 31% of non-identical twuns which strongly suggests a genetic influence on OCD. This validates and increases our confidence in the genetic hypothesis for OCD

Strength - biological approach to explaining phobias

Question 35

Cromer et al

Answer 35

Cromer et al found that over half the OCD patients in their sample had a traumatic event occur in their past and OCD was more severe with those who had more than one trauma. This suggests OCD cannot be entirely genetic in orgin in all case. This affects the validity of the genetic hypothesis as it is likely that a shared environment acts as a confounding variable

If this is the case then cases of OCD where there is no family history of OCD, but there is a relevant life event, should be treated differently from those where there is a family history and no trauma.

Limitation - biological approach to explaining phobias + drug therapy

Question 36

Biological approach to explaining phobias - difference in explanations

Answer 36

Genetic explanations:
Genes create a vulnerability to OCD

Neural explanations:
Genes associated with OCD are likely to affect the levels of key neurotransmitters (in particular serotonin and dopamine, are implicated in OCD) as well structures of the brain

Question 37

The role of serotonin - neural explanation phobias

Answer 37

Neurotransmitter responsible for regulation of mood, emotion, motivation

Serotonin has been linked with preventing the repetition of tasks, consequently people who have low levels of serotonin have been more likely to have OCD

Question 38

Decision making system - neural explanation phobias

Answer 38

Some cases OCD (in particular hoarding disorder) are associated with abnormal functioning in the frontal lobes of the brain which is responsible for logical thinking and decision making

Question 39

supporting evidence - neural explanation phobias

Answer 39

Antidepressants work purely on the serotonin system and increase levels of this neurotransmitter. Such drugs are effective in reducing OCD symptoms and suggests that the serotonin system in involved in OCD

strength

Question 40

Limitations - neural explanation phobias

Answer 40

We should not assume the neural mechanisms cause OCD:
Biological abnormalities in various neurotransmitters/structures of the brain could be a result of OCD rather than its cause. The neural explanation is correlational and not causal.

The serotonin-OCD link may be simply co-morbidity with depression
People who suffer OCD become depressed. This depression involves disruption to the serotonin system which questions whether low levels of serotonin actually are a basis for OCD. It could be that serotonin system is disrupted in OCD patients because they are depressed. However, the fact that antidepressants that don’t work on the serotonin system have no effect on OCD suggests that serotonin is directly involved in OCD and not just in accompanying depression.

Question 41

Drug therapy

Answer 41

Aims to increase/decrease levels of neurotransmitters (or their activity) in the brain

Question 42

SSRIs

Answer 42

Used to tackle the symptoms of OCD
Antidepressant drug called selective serotonin reuptake inhibitor (SSRI)

Works by preventing the re-absorption and breakdown of serotonin at the presynaptic neuron which increases the level of serotonin in the synapse (thus continuing to stimulate the postsynaptic neuron)

Question 43

Combining SSRIs with other treatments

Answer 43

Drugs are often used alongside cognitive behaviour therapy (CBT) to treat OCD
The drugs reduce a patient’s emotional symptoms i.e feeling anxious/depressed which means the patient can engage effectively with the CBT

Question 44

Alternatives to SSRIS

Answer 44

Tricyclics : (an older type of antidepressent) have the same effect as SSRIs but has more severe side-effects so it kept in reserve for patients who dont respond to SSRIs

SNRIs (serotonin-noradenaline reuptake inhibitors): like Tricyclics are a second line of defence for patients to treat OCD (for patients that dont respond to SSRIs) - increase serotonin + another transmitter noradrenaline

Question 45

Soomoro et al

Answer 45

Reviewed studies comparing SSRIs to placebos in the treatment of OCD and concluded all 17 studies showed significantly better results for SSRIs than placebo conditions

strength - drug therapy

Question 46

Strengths of drug therapy

Answer 46

Drugs are cost effective and non-disruptive:
Cheap compared to psychological treatments, using drugs to treat OCD is therefore a good value for public health services such as the National Health Service. Also non-disruptive as patients can simply take them until their symptoms decline and not engage with the hard work of psychological therapy

Soomoro et al

Question 47

Side effects of drug therapy

Answer 47

Some patients also suffer side effects such as indigestion, blurred vision and loss of sex drive.

Such factors reduce the effectives because people stop taking the medication

Question 48

Goldacre

Answer 48

Believes that evidence favouring drug treatments is biased because the research is sponsored by drug companies who do not report all the evidence and supress any results that do not support the drug they are marketing. Currently many drug companies do not publish all of their results and may indeed be supressing evidence. This suggests that the data on the effectiveness of drugs may not be trustworthy.

Limitation - drug therapy