Psychopathology Flashcards

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1
Q

What is psychopathology

A
  • scientific study of mental disorders and abnormalities
  • in order to diagnose someone with a mental disorder we must first decide in what way their behaviour differs
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2
Q

What are the different abnormality definitions

A
  • deviation from social norms
  • failure to function adequately
  • deviation from ideal mental health
  • statistical infrequency
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3
Q

What is the deviation from social norms definition

A
  • any behaviour that does not follow accepted social patterns or social rules
  • such violation of these patterns or rules can be regarded as abnormal behaviour and would be classed as unacceptable
  • norms, values, and accepted ways to behave vary from one culture to the next and from one time period to the next
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4
Q

What does deviation from social norms consider

A
  • looks at impact of an individual’s behaviour upon others
  • behaviour displayed is examined in terms of how unstable the behaviour is for the individual and for society as a whole
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5
Q

What are social norms

A
  • rules in society governing behaviour
  • based on moral standards
  • can be either explicit or implicit
  • explicit => the law
  • implicit => codes of conduct
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6
Q

How can deviation from social norms be used

A
  • help to identify a person who might be suffering from a mental disorder
  • if a person is behaving in a strange way that deviates what is expected of them, then we could be concerned enough to think the person might be suffering from a mental disorder
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7
Q

What are negative evaluation points for deviation from social norms

A
  • odd/eccentric
  • context
  • temporal validity
  • benefits
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8
Q

How is odd/eccentric a negative evaluation point for deviation from social norms

A
  • definition does not always clearly indicate that a person has a psychological abnormality
  • therefore psychologists must be cautious when making judgements as individual may just be odd/eccentric
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9
Q

How is context a negative evaluation for deviation from social norms

A
  • context must be taken into account
  • e.g. wearing no clothes in high street would be odd and deviating from social norms but at a nudist beach would be considered acceptable
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10
Q

How is temporal validity a negative evaluation for deviation from social norms

A
  • social norms of a society can change over time
  • e.g. homosexuality was classed as a mental illness in the ICD until 1990 but is no longer considered an abnormality
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11
Q

How is benefits a negative evaluation for deviation from social norms

A
  • in some instances, it can be beneficial to break from social norms
  • e.g. the suffragettes broke many social norms but this led to women gaining the right to vote
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12
Q

What is the failure to function adequately definition

A
  • model of abnormality based on the fact that the person is unable to cope with day to day life
  • e.g. having a job or interacting with others well
  • due to individual experiencing psychological distress and discomfort
  • will impact their personal, social and occupational life
  • 7 criteria
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13
Q

What are the 7 criteria of the failure to function adequately definition

A
  • suffering => feeling sad, anxious or scared
  • unpredictability => unexpected behaviour characterised by loss of control
  • maladaptiveness => behaviour stopping individual from attaining life goals => socially and occupationally
  • observer discomfort => behaviour causing discomfort in others
  • vividness and unconventionality => behaviour not conforming to what is generally done in a certain situation
  • irrationality => illogical behaviours
  • violation of moral standard => behaviours violating society’s ethical standards
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14
Q

How is the criteria significant for failure to function adequately

A
  • more criteria displayed, the more abnormal the individual is
  • allows psychologists to see degree of abnormality
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15
Q

What are positive evaluation points for the failure to function adequately definition of abnormality

A
  • recognises patient’s perspective, e.g. personal distress
  • using GAF scale, psychologist can see degree of abnormality
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16
Q

What are negative evaluation points for the failure to function adequately definition of abnormality

A
  • Harold Shipmen
  • normality
  • Stephen Gough
  • measuring
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17
Q

How is Harold Shipman a negative evaluation for the failure to function adequately definition of abnormality

A
  • abnormality is not always accompanied by a failure to function
  • psychopaths can commit murders while appearing normal
  • Harold Shipman was a doctor who murdered 215 patients over 23 years
  • maintained outward appearance of a respectable member of his profession, and had a family, the whole time he was committing murders
  • no one was aware he was a serial killer
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18
Q

How is normality a negative evaluation for the failure to function adequately definition of abnormality

A
  • sometimes it is normal and psychologically healthy to suffer from person distress
  • e.g. when a loved one dies
  • it would be abnormal not to feel distress under these circumstances
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19
Q

How is Stephen Gough a negative evaluation for the failure to function adequately definition of abnormality

A
  • behaviour may cause distress to other people and be regarded as dysfunctional when person themself feels no distress
  • Stephen Gough has been imprisoned for breaching the peace as he insists on hiking naked
  • this makes others experience observer discomfort but he feels no distress
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20
Q

How is measuring a negative evaluation for the failure to function adequately definition of abnormality

A
  • can be difficult to measure and analyse criteria
  • needs to be operationalised
  • model is subjective and lacks being scientific and objective
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21
Q

What is the deviation from ideal mental health definition

A
  • stems from humanistic approach
  • behaviour is abnormal if it fails to meet prescribed criteria for psychological normality
  • devised by Jahoda (1958) under concept of ideal mental health
  • identified six characteristics that individuals should exhibit to be considered normal
  • absence of characteristics indicates abnormality
  • more criteria not met, more abnormal individual is
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22
Q

What is the criteria for deviation from ideal mental health

A
  • autonomy => being independent, self reliant and able to make personal decisions
  • perception of reality => perceiving world in non distorted fashion, having objective and realistic view
  • resistance to stress => effective coping strategies and being able to manage everyday anxiety provoking and stressful situations
  • integration => having self respect, high self esteem, confidence and positive self concept
  • environmental mastery => competent in all aspects of life and ability to meet demands of situations and flexibility to adapt to life changing circumstances
  • self actualisation => experience personal growth and development, reaching full potential and feeling fulfilled
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23
Q

What are positive evaluation points for the deviation from ideal mental health definition of abnormality

A
  • comprehensive, based on similar models for physical health
  • positive, holistic, focuses on optimal criteria which all should aim for
  • highlights areas individuals should work on
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24
Q

What are negative evaluation points for the deviation from ideal mental health definition of abnormality

A
  • demanding and unrealistic criteria => not many people reach self actualisation and most people do not meet all criteria at one given moment
  • most criteria is vague and difficult to measure => subjective (self actualisation)
  • cultural biased, collectivist cultures emphasise communal goals and regard autonomy as undesirable and these people would be seen as abnormal in individualistic cultures
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25
Q

What is the statistical infrequency definition to abnormality

A
  • abnormal behaviour is that which is statistically rare
  • instances of abnormality would lie at both extremes of a normal distribution
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26
Q

Using an example, explain how the statistical infrequency definition works

A
  • looking at IQ scores
  • average score is 100
  • scores that are significantly higher than 100 (130) or significantly lower than 100 (70) are statistically infrequent
  • 2.5% of the population has an above average IQ score and 2.5% has below average, showing infrequency
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27
Q

What are positive evaluation points for the statistical infrequency definition

A
  • judgements are based on objective, scientific and unbiased data which helps indicate abnormality and normality
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28
Q

What are negative evaluation points for the statistical infrequency definition

A
  • some behaviour can be statistically rare but also desirable such as someone who has above average IQ, they would be highly regarded instead of seen as someone who is abnormal
  • some disorders are not statistically rare, such as depression which affects 27% of elderly people
  • many rare behaviours or characteristics have no bearing on normality or abnormality, such as being left handed
  • there is a subjective cut off point, why is someone who has an IQ of 71 normal but someone with 70 abnormal
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29
Q

What are behavioural characteristics of phobias

A
  • avoidance => evade phobic object in presence
  • endurance => person may remain in presence of phobic object, frozen and unable to move
  • disruption of function => presence of phobic object may interfere with ability to function
  • panic => person may panic in presence of phobic object, crying, running, screaming, etc.
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30
Q

What are emotional characteristics of phobias

A
  • fear => persistent, excessive, unreasonable worry and distress may be felt in presence of phobic object
  • anxiety => person feels terror and might be uncertain and apprehensive when encountering phobic object
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31
Q

What are cognitive characteristics of phobias

A
  • irrational => person thinks in irrational manner and resist any rational arguments to counter
  • insight => person will know fear is excessive or unreasonable but still find it difficult not to fear
  • cognitive distortions => distorted perception of stimulus
  • selective attention => becoming fixated on phobic object
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32
Q

What are behavioural explanations of phobias

A
  • classical conditioning
  • operant conditioning
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33
Q

What is classical conditioning

A
  • learning through association
  • stimulus produces same response as another stimulus as they have been constantly presented at the same time
  • association built between stimuli
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34
Q

What is an example of a classical conditioning study

A
  • Little Albert by Watson and Raynor (1920)
  • presented Albert with rat, and he showed no fears
  • started striking metal bars behind Albert’s head each time he reached for rat
  • loud noise startled Albert, making him cry
  • both stimuli paired multiple times building association
  • started crying each time he saw rat
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35
Q

Explain how Little Albert was an example of classical conditioning

A
  • infants are born with certain reflex; stimulus of loud sound is unconditioned stimulus producing reflex of fear as unconditioned response
  • white rat is neutral stimulus producing no reflexes
  • over time, the white rat became associated with the unconditioned stimulus of a loud noise
  • white rat then became conditioned stimulus producing fear as conditioned response
  • conditioned response of fear then generalised to other objects or situations; Albert became scared of any white or fluffy objects
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36
Q

What is operant conditioning

A
  • learning through consequences of ones behaviour
  • positive reinforcement => behaviour adds something pleasant
  • negative reinforcement => behaviour removes something pleasant
  • punishment => behaviour adds something unpleasant
  • avoidance of phobic object reduces fear thus it being reinforced => negative reinfocement
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37
Q

What are positive evaluation points for behavioural explanations of phobias

A
  • supported by King (1998)
  • reviewed case studies and found children acquire phobias by encountering traumatic experiences with phobic object
38
Q

What are negative evaluation points for behavioural explanations of phobias

A
  • study on Little Albert was unreliable as they have not been repeated so cannot be generalised, study cannot be tested again due to ethical concerns
  • some people have traumatic experiences but do not develop phobia, e.g. car crash but still drive. People also build phobias without having traumatic experience, e.g. snakes
  • Menzies found only 2% of people with hydrophobia have had bad experience with water, 98% built phobia without classical conditioning so there must be other reasons
  • environmentally deterministic/reductionist, does not take into account biological factors such as genetic vulnerability and ignore free will
39
Q

What are behavioural treatments for phobias

A
  • systematic desensitisation (SD)
  • flooding
40
Q

What is SD

A
  • developed by Wolpe (1958) to reduce phobias using classical conditioning
  • person experience fear and anxiety as behaviour response to phobic object
  • SD replaces fear with relaxed response
  • impossible to experience two opposite emotions at same time => reciprocal inhibition
  • if patient can learn to stay calm they can be cured => counter conditioning
41
Q

What are the different stages of SD

A
  • anxiety hierarchy
  • relaxation training
  • gradual exposure
42
Q

What is anxiety hierarchy in SD

A
  • hierarchy of fear constructed by therapist and patient
  • situations involving phobic object ranked from least to most fearful
43
Q

What is relaxation training in SD

A
  • patients taught deep muscle relaxation, such as progressives muscular relaxation (PMR) and relaxation response
  • idea behind PMR is to contract muscles tightly, hold tension for a few seconds then consciously relax muscles even further
44
Q

What is gradual exposure in SD

A
  • patient introduced to phobic object and work way up anxiety hierarchy starting with least frightening
  • use relaxation techniques while exposed to phobic object
  • when comfortable, they move onto next stage
  • eventually, through repeated exposure and relaxation, phobia is eliminated
45
Q

What are positive evaluation points for SD

A
  • Jones (1924) => eradicated Little Peter’s phobia of white rabbit by presenting it closer each time his anxiety reduced
  • Klosko et al. (1990) => assessed various therapies for treatment of panic disorders and found 87% were panic free after SD, 50% after medication, 36% on placebo and 33% with no treatment
  • less traumatic therapy than compared to flooding, no ethical issues
46
Q

What are negative evaluation points for SD

A
  • behaviour treatments address symptoms of phobias
  • some believe that is only tip of iceberg and there are underlying causes
  • means symptoms return or symptom substitution occurs when abnormal behaviours replace ones removed
47
Q

What is flooding

A
  • direct exposure to phobic object
  • patient taught relaxation techniques but there is no gradual build up
  • can be for real or virtual
  • stops phobic responses quick as patient has no option for avoidance therefore sees object as harmless and extinction occurs
  • patient may achieve relaxation through exhausting themselves out
  • ethical even though there is psychological harm as there is informed consent
48
Q

What are cognitive characteristics of depression

A
  • negative schema => negative view of world, themselves and future => self fulfilling prophecy
  • poor concentration => difficulty paying/maintaining attention
49
Q

What are emotional characteristics of depression

A
  • low mood => ever present and overwhelming feeling of sadness/hopelessness and feeling empty
  • worthlessness => constant feelings of reduced worth, low levels of self esteem
  • anger => anger towards others or themselves
50
Q

What are positive evaluation points for flooding

A
  • Wolpe (1960) supports flooding to remove patient’s phobias of cases. Girl forced into car and driven around for 4 hours until hysteria was eradicated
  • Ost (1997) states flooding is effective at producing immediate improvements
  • cost effective compared to cognitive behaviour therapies
51
Q

What are negative evaluation points for flooding

A
  • highly traumatic experience and many patients may stop therapy => time and money wasted
  • less effective for some phobias as they may be more cognitive, social phobias better cured by cognitive therapies
52
Q

What are behavioural characteristics of depression

A
  • changes in activity levels => lethargy and withdrawal from activities previously enjoyable (anhedonia) / high levels of nervous energy, can neglect personal hygiene
  • disruption to sleep => insomnia (lack of sleep) or hypersomnia (excess sleep)
  • disruption to eating => increased/decreased weight
  • aggression => irritable causing aggression to others/self harm
53
Q

What are cognitive explanations of depression

A
  • underlying assumption of cognitive explanation is depression is result of disturbance in thinking
  • consequence of faulty and negative thinking about events
  • negative triad
  • ABC model
54
Q

What is the negative triad

A
  • Beck (1967) believed depressed people acquired negative schema during childhood so have tendency to adopt world in pessimistic view
  • schema is cognitive framework helping us organise and interpret information and make sense of new information
  • can be caused by parental/peer rejection and criticism from teachers
55
Q

What are negative schemas

A
  • activated when a person encounters a new situation, resembling original conditions in which schema was learned
  • lead to cognitive biases in thinking
56
Q

How do negative schemas works

A
  • negative schemas and cognitive biases maintain negative triad
  • irrational view of three elements in the persons belief system
57
Q

What are the elements in the negative triad

A
  • the self => there is nothing to like about me, I am boring
  • the world => nobody likes me, everyone would prefer someone else’s company
  • the future => I am always going to be on my own, nobody will ever love me
58
Q

What are positive evaluation points for the negative triad

A
  • Terry (2000)
  • assessed 65 pregnant women for cognitive vulnerability before and after birth
  • found women who had high cognitive vulnerability most likely to suffer post partum depression, supporting negative triad
59
Q

What are negative evaluation points for the negative triad

A
  • cause and effect not clear => does depression cause irrational thinking or the other way
  • does not explain how some symptoms of depression might develop => many patients are angry and Beck’s theory fails to account for this
60
Q

What is the ABC model

A
  • Ellis (1962) proposed depression caused by irrational beliefs
  • devised model to explain how irrational and negative beliefs are formed
61
Q

What are the stages of the ABC model

A
  • Activating Event => incident in someone’s life
  • Beliefs => thought after event, could be rational or irrational
  • Consequences => emotions caused by beliefs. Rational beliefs lead to healthy emotions whereas irrational beliefs lead to unhealthy emotions
62
Q

What are positive evaluation points for the ABC model

A
  • Bates (1999) found depressed patients who were given negative thought statements become more depressed supporting view that negative thinking leads to depression
63
Q

What are negative evaluation points for the ABC model

A
  • blames patient for depression
  • unclear whether depression causes negative thinking or negative thinking causes depression
  • Zhang (2005) found there is a gene related to depression making it 10x more likely, thus environmentally deterministic
64
Q

What are cognitive treatments for depression

A
  • aim of cognitive behaviour therapy is to change irrational thoughts and alleviate depression
  • Beck’s Cognitive Behavioural Therapy (CBT)
  • Rational Emotive Therapy (REBT)
65
Q

What is Beck’s CBT

A
  • identify irrational thoughts => thought catching
  • patient then berates hypothesis to test validity of irrational thoughts => patient as scientist
  • several strategies used to test hypothesis => patient may gather data and compare evidence, may do homework, may keep diary to record negative thinking situations to target
  • when patients report positive thoughts, they are praised by therapist => positive reinforcement
66
Q

What is the aim of Beck’s CBT

A
  • cognitive restructuring
  • learning to identify, dispute, and therefore change
67
Q

What is REBT

A
  • Ellis (1994) developed CBT for depression
  • therapist uses logical arguments to show patients’ self defeating beliefs are not logical
  • also uses empirical arguments to show self defeating beliefs are not consistent with reality
  • patients encouraged to engage in behavioural activation => becoming more active and taking part in pleasurable activities, many depressed patients do not engage in activities they use to enjoy
68
Q

What is the aim of REBT

A
  • challenging automatic negative thoughts and replacing them with rational beliefs
69
Q

What are positive evaluation points for CBT

A
  • March et al. (2007) => examined 327 adolescents and compared effectiveness of CBT. 81% of of anti-depressant group and 81% of CBT group significantly improved by 86% of combination group improved, showing combination is most effective
  • David (2008) => found CBT better than anti-depressants. Compared 170 patients with 14 weeks of CBT to patients with drug fluoxetine. 6 months later, found CBT patients less likely to relapse
70
Q

What are negative evaluation points for CBT

A
  • requires commitment and motivation, depression patients may not engage/join so CBT will be ineffective. Anti-depressants do not require same level of motivation so are more effective
  • suggests irrational thinking is primary cause for depression and ignores other factors, e.g. domestic violence or abuse victims who need to change circumstances and not thinking
  • relies on self reporting as thoughts cannot be objectively observed/measured => unreliable
71
Q

What are behavioural characteristics of OCD

A
  • compulsions => repetitive actions that could hinder person’s ability to perform everyday function, compulsive behaviour reduces anxiety created by obsessions, person feels like they must perform action or something bad will happen
  • avoidance => sufferers attempt to reduce anxiety by avoiding situations triggering OCD
72
Q

What are emotional characteristics of OCD

A
  • high anxiety => obsessions and compulsions are a source of anxiety, sufferers aware obsessions and compulsive behaviours are excessive causing embarrassment, also aware they cannot consciously control behaviour leading to distress
  • disgust => feelings of disgust may be directed against something external
73
Q

What are cognitive characteristics of OCD

A
  • obsessions => recurrent, instructive, irrational thoughts perceived as inappropriate. May be frightening/embarrassing and person may not share them. Uncontrollable and cause anxiety
  • awareness => sufferers understand compulsive behaviours and obsessive thoughts are irrational but cannot control/stop them
  • catastrophic thinking => scared something terrible will happen if compulsion not carried out
74
Q

What does the biological approach thinking about OCD

A
  • assumes OCD is caused by genetic and biochemical factors
75
Q

How does the SERT gene affect OCD

A
  • affects transportation of serotonin, causing low levels
  • low levels of serotonin linked to OCD (and depression)
76
Q

What is the genetic explanation behind OCD

A
  • classed as polygenic => many genes responsible for disorder (230) => candidate genes
77
Q

What are the two main genes that have a role in OCD

A
  • COMT gene
  • SERT gene
78
Q

How does the COMT gene affect OCD

A
  • gene regulates production of dopamine
  • high levels of dopamine associated with OCD
  • one variation of COMT gene results in higher levels of dopamine
  • this variation found more common in OCD patients
79
Q

What are positive evaluation points for the genetic explanation to OCD

A
  • Nestadt (2000) => found people who had first degree relatives with OCD were 5x more likely to get disorder
  • Billett (1998) -> found from meta analysis of 14 twin studies that OCD twice as concordant in MZ twins than DZ twins
80
Q

What are negative evaluation points for the genetic explanation to OCD

A
  • concordance rate for OCD in MZ twins is not 100% so OCD cannot be caused entirely by genetic factors
81
Q

What is the neural explanation for OCD

A
  • dopamine and serotonin are NTs affecting mood
  • abnormal levels of these are associated with abnormal transmissions of mood related information
  • OCD suffers have high levels of dopamine => linked to hyperactivity in basal ganglia in brain causing repetitive motor functions => compulsions
  • serotonin plays role in operating caudate nucleus’s in basal ganglia of brain => low levels cause caudate nucleus to fall function => obsessions
82
Q

What are positive evaluation points for neural explanations of OCD

A
  • anti depressant drugs increase serotonin levels in OCD leading to reduction in symptoms
83
Q

What are negative evaluation points for neural explanations of OCD

A
  • NTs may not necessarily cause OCD, instead low levels of serotonin and high levels of dopamine might be a symptom of OCD
  • no cause and effect, just relationship
84
Q

What are biological treatments for OCD

A
  • biological approach uses medication to increase/decrease levels of NTs or activity of them
  • selective serotonin re-uptake inhibitors (SSRIs)
  • benzodiazepines (BZ)
85
Q

How do SSRIs work

A
  • work on serotonin system in brain
  • serotonin released by presynaptic neurons and travels across synaptic cleft
  • chemically conveys signal from presynaptic neuron to postsynaptic neuron then reabsorbed (re-uptake) by presynaptic neuron, where it is broken down and reused
  • SSRIs prevent re absorption and breakdown of serotonin, increasing serotonin levels in synapse, where it continues to stimulate postsynaptic neuron => reduces anxiety
86
Q

What are positive evaluation points for SSRIs

A
  • Soomro (2009) => reviewed 17 studies comparing SSRIs to placebo for treating OCD, found all 17 studies showed SSRIs more effective than placebo , especially when combined with CBT
  • 70% of patients experienced decline in OCD symptoms when taking SSRIs, other 30% opt for psychological therapies or combination
87
Q

What are negative evaluation points for SSRIs

A
  • side effects => might mean OCD patient stops taking medication => temporary side effects
88
Q

How does BZ work in treating OCD

A
  • anti anxiety drug
  • slows down activity of CNS by encasing activity of GABA => has inhibitory effect on neurons
  • GABA reacts with GABA receptors on outside of neurons
  • when GABA locks into receptors, it opens channel increase flow of chloride ions to neuron
  • chloride ions make it harder for neuron to be stimulated by other NTs => slows down neural activity => more relaxed
89
Q

What are positive evaluation points for BZ

A
  • can begin to reduce anxiety levels and OCD symptoms in short period of time, especially compared to CBT, so patient experiences immediate relief
90
Q

What are negative evaluation points for BZ

A
  • if BZ used long-term, several side effects appear, Ashton (1997) found long term users of BZ become dependent on drug and withdrawal leads to high levels of anxiety and OCD symptoms
  • issue of tolerance, patients need larger doses in order to reduce symptoms as body becomes used to drug