Psychopathology Flashcards

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1
Q

Definitions of Abnormality- Statistical Infrequency- AO1

A
  • When an individual has a less common characteristic
  • IQ and intellectual disability disorder
    Average IQ=100
    2% people score below 70
    Abnormal / statistical infrequency / IDD
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2
Q

Definitions of Abnormality- Statistical Infrequency- AO3

A
  • Real world application +
    Used in clinical practice- formal diagnosis and assessing severity of symptoms
    Intellectual disability disorder=IQ below 70
    Assessment tool=Beck depression inventory- score of 30+=severe depression
  • Unusual characteristics can be positive -
    IQ above 130
    Wouldn’t think high IQ=abnormal
    Don’t think low depression score on BDI abnormal
    Unusual does not mean abnormal
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3
Q

Definitions of Abnormality- Deviation from Social Norms- AO1

A
  • Behaviour that is different from the accepted standards of behaviour in a community/society
  • Norms are specific to the culture we live in- few behaviours are universally abnormal
    Homosexuality considered abnormal in our past and still abnormal in some societies today
  • Antisocial personality disorder
    Impulsive, aggressive, irresponsible
    DSM-5=absence of prosocial internal standards
    Psychopaths abnormal because don’t conform to moral standards
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4
Q

Definitions of Abnormality- Deviation from Social Norms- AO3

A
  • Real world application +
    Used in clinical practice
    Antisocial personality disorder=failure to conform to culturally normal ethical behaviour=deviations from social norms
    Criteria had value in psychiatry
  • Cultural and situational relativism -
    May label someone as abnormal based on own standards rather than other persons
    Hearing voices=norm in some cultures (ancestors) but abnormal in UK
    Even within one culture, social norms vary in situations
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5
Q

Definitions of Abnormality- Failure to Function Adequately- AO1

A
  • When someone is unable to cope with ordinary demands of day-to-day living
  • Rosenhan+Seligman- not coping when: don’t conform to interpersonal rules / experiences severe distress / irrational or dangerous
  • Intellectual disability disorder
    Having a low IQ=statistical infrequency but must be failing to function adequately to get a diagnosis
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6
Q

Definitions of Abnormality- Failure to Function Adequately- AO3

A
  • Represents a threshold for help +
    Most have symptoms of metal disorder as some point
    Mind- 25% people experience mental health problem in any given year
    When cease to function adequately=seek professional help
    Treatment/services targeted to those who need it most
  • Discrimination and social control -
    Hard to say when someone failing to function adequately
    High-risk leisure activities could be irrational/dangerous but that doesn’t make the person failing to function
    Unusual choices=risk of being labelled
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7
Q

Definitions of Abnormality- Deviation from Ideal Mental Health- AO1

A
  • When someone does not meet a set of criteria for good mental health
  • Jahoda’s criteria:
    No distress / self-actualise / copes with stress / good self esteem etc.
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8
Q

Definitions of Abnormality- Deviation from Ideal Mental Health- AO3

A
  • A comprehensive definition +
    Jahoda’s concept=range of criteria distinguishing mental health from illness
    Mental health=discussed meaningfully with professionals who might take different views
    Can assess ourselves and others well
  • May be culture-bound -
    Jahoda’s criteria westernised
    Self-actualisation=self-indulgent in most of world
    Europe even has variation in value placed on independence
    Success in life different in cultures
    Difficult to apply concept cross-culturally
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9
Q

Phobias- DSM-5 Categories of Phobia

A
  • An irrational fear of an object or situation
  • Specific phobia
    Phobia of an object or a situation
  • Social phobia
    Phobia of a social situation
  • Agoraphobia
    Phobia of being outside or in a public place
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10
Q

Phobias- Behavioural Characteristics (APE)

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  • Ways in which people act
  • Avoidance
    Effort to prevent coming into contact with phobic stimulus
  • Panic
    Panic in response to phobic stimulus
  • Endurance
    Choosing to remain in the presence of the phobic stimulus (keeping an eye on it)
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11
Q

Phobias- Emotional Characteristics (FEAr)

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  • Related to a persons feelings or mood
  • Fear
    The immediate and extremely unpleasant response when encountering a phobic stimulus
  • Emotional response unreasonable
    Fear much greater and disproportionate to any other threat posed
  • Anxiety
    An unpleasant state of high arousal, preventing relaxation and positive emotion
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12
Q

Phobias- Cognitive Characteristics (SAIBCD)

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  • Refers to the process of thinking, reasoning, remembering, believing
  • Selective attention
    If they can see the phobic stimulus, it is hard to look away from it- can react quickly to any threat
  • Irrational beliefs
    Holding unfounded thoughts in relation to the phobic stimulus
  • Cognitive distortions
    A person with a phobia may have inaccurate and unrealistic perceptions
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13
Q

Depression- DSM-5 Categories of Depression

A
  • Characterised by changes to mood
  • Major depressive disorder
    Severe but often short-term depression
  • Persistent depressive disorder
    Long-term depression
  • Disruptive mood dysregulation disorder
    Childhood temper tantrums
  • Premenstrual dysphoric disorder
    Disruption to mood prior to and/or during menstruation
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14
Q

Depression- Behavioural Characteristics (AAD)

A
  • Ways in which people act
  • Activity levels
    Reduced levels of energy- lethargy
    Knock on effect withdrawal from work, social life
    Psychomotor agitation- struggle to relax and will pace up and down
  • Aggression and self-harm
    Irritable, verbally/physically aggressive
    Knock on effects aspects of personal life
    Physical aggression directed against the self
  • Disruption to sleep/eating behaviour
    Insomnia=reduced sleep
    Hypersomnia=increased need for sleep
    Appetite may increase/decrease=weight loss/gain
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15
Q

Depression- Emotional Characteristics (ALL)

A
  • Related to a persons feelings or mood
  • Anger
    Directed at self or others
    Emotions can lead to aggressive/self-harming behaviour
  • Lowered mood
    Feeling sad
    Mostly worthless and empty
  • Lowered self-esteem
    Liking themselves less than usual
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16
Q

Depression- Cognitive Characteristics (AAP)

A
  • Refers to the process of knowing
  • Absolutist thinking
    Black and white thinking
  • Attending to/dwelling on the negative
    Pay more attention to negative and ignoring positive
    Bias toward recalling unhappy event
  • Poor concentration
    Unable to stick with a task
    Hard to make straightforward decisions
17
Q

OCD- DSM-5 Categories of OCD

A
  • Range of related disorders- repetitive behaviour accompanied by obsessive thinking
  • OCD
    Obsessions and/or compulsions
  • Trichotillomania
    Compulsive hair-pulling
  • Hoarding disorder
    Compulsive gathering of possessions and inability to part with anything
  • Excoriation disorder
    Compulsive skin picking
18
Q

OCD- Behavioural Characteristics (ACC)

A
  • Ways in which people act
  • Avoidance
    Avoiding situations that trigger anxiety
  • Compulsions are repetitive
    Compelled to repeat a behaviour
  • Compulsions reduce anxiety
    Compulsive behaviours performed in attempt to manage anxiety produced by obsessions
19
Q

OCD- Emotional Characteristics (AAG)

A
  • Related to a persons feeling or mood
  • Anxiety and distress
    Obsessive thoughts are unpleasant and frightening and the anxiety can be overwhelming
  • Accompanying depression
    Anxiety can be accompanied by low mood and lack of enjoyment
  • Guilt and disgust
    Irrational guilt or disgust directed against something external
20
Q

OCD- Cognitive Characteristics (ICO)

A
  • Refers to the process of knowing
  • Insight into excessive anxiety
    Aware that obsessions and compulsions not rational
    Hyper-vigilant
  • Cognitive coping strategies
    To deal with obsessions
    Help manage anxiety but may appear abnormal to others
  • Obsessive thoughts
    Thoughts that recur over and over again and are always unpleasant
21
Q

Behavioural Approach Explaining Phobias- AO1

A
  • Two-process model=explanation for onset and persistence disorders- CC and OC
  • Acquisition by CC=association
    UCS -> UCR
    UCS + NS -> UCR
    CS -> CR
    Watson+Rayner=Little Albert / white rat / loud noise / fear that generalised to similar objects
  • Maintenance by OC=consequences
    Mowrer=NR avoiding phobic stimulus=desirable so behaviour repeated
    Avoiding=escaping fear and anxiety, reinforcing behaviour so phobia mantined
22
Q

Behavioural Approach Explaining Phobias- AO3

A
  • Real-world application +
    Phobias maintained by avoiding phobic stimulus
    Once avoidance prevented=no reinforcement and anxiety decreases too
    Identifies means of treating phobias
  • Cognitive aspects -
    Phobias not simply avoidance responses- significant cognitive component
    Irrational beliefs
    Does not offer adequate explanation of phobic cognitions
  • Phobias and trauma +
    Little Albert
    Jongh=73% fear of dental treatment=traumatic experience with dentistry
    Control group of low dental anxiety=21% experienced trauma
23
Q

Behavioural Approach Treating Phobias- Systematic Desensitisation- AO1

A
  • Behavioural therapy utilising classical conditioning
    Counterconditioning=phobic stimulus paired with relaxation instead of anxiety
  • Anxiety hierarchy=list of situations least to most anxiety
  • Relaxation- reciprocal inhibition=cannot be afraid and relaxed at same time
    Breathing exercises / mental imagery
  • Gradual exposure to phobic stimulus- only move up hierarchy when completely relaxed
24
Q

Behavioural Approach Treating Phobias- Systematic Desensitisation- AO3

A
  • Evidence of effectiveness +
    Gilroy=42 people SD for arachnophobia
    SD group less fearful than control
    Wechsler=SD effective for specific phobia, social phobia and agoraphobia
  • People with learning disabilities +
    Alternatives to SD not suitable
    Struggle with cognitive therapies as require complex rational thought
    Confused and distressed by trauma of flooding
25
Q

Behavioural Approach Treating Phobias- Flooding- AO1

A
  • Immediate exposure to phobic stimulus / long sessions but small number of them
  • Without avoidance option=learn phobic stimulus is harmless
    Extinction=learned response extinguished when CS encountered with UCS- CS no longer produces CR (fear)
    Achieve relaxation as exhausted by own fear response
  • Important to give informed consent as traumatic so need to be fully prepared- given choice of SD or flooding
26
Q

Behavioural Approach Treating Phobias- Flooding- AO3

A
  • Cost effective +
    Therapy=cost-effective if clinically effective (tackles symptoms) and inexpensive
    Can work in as little as one session, whereas SD takes a lot more
  • Traumatic -
    Promotes tremendous anxiety
    Schumacher=flooding rated as significantly more stressful than SD
    Ethical issue of psych harm although not issue if informed consent
    Attrition (dropout) rates higher than SD
27
Q

Cognitive Approach Explaining Depression- Beck’s Negative Triad- AO1

A
  • Faulty information processing=attend to negative aspects of situation and ignore positives
    Black and white thinking
  • Negative self-schema=mental framework of beliefs and expectations derived from experience linked to the self
    Interpret info about themselves in a negative way
  • Negative triad
    =Negative view of the world- no hope anywhere
    =Negative view of the future- reduce hopefulness and enhance depression
    =Negative view of the self- enhancing depressive feelings as confirming existing emotions of low self-esteem
28
Q

Cognitive Approach Explaining Depression- Beck’s Negative Triad- AO3

A
  • Research support +
    Cognitive vulnerability=ways of thinking that predispose depression
    Clark+Beck=cognitive vulnerabilities more common in depressed people and they preceded depression
    Cohen=cognitive vulnerability predicted later depression
  • Real-world application +
    Cohen=assessing cognitive vulnerability allows screening of young people to identify most risk of depression
    Applied in CBT=altering cognitions that make vulnerable to depression- more resilient to negative life events
29
Q

Cognitive Approach Explaining Depression- Ellis’ ABC Model- AO1

A
  • Good mental health=result of rational thinking- allow people to be happy and free from pain
    Poor mental health=result of irrational thoughts- interfere with us being happy and free from pain
  • A=Activating event
    Depressed when experience negative events that trigger irrational beliefs
  • B=Beliefs
    Musturbation- belief must always achieve/perfection
    I-can’t-stand-it-itis- major disaster when something goes wrong
    Utopianism- life is always meant to be fair
  • C=Consequences
    Emotional and behavioural
30
Q

Cognitive Approach Explaining Depression- Ellis’s ABC Model- AO3

A
  • Real-world application +
    Rational emotive behaviour therapy=arguing with depressed person so as to alter irrational beliefs
    David=support REBT changing negative beliefs and relieving depression symptoms
  • Reactive and endogenous depression -
    Depression triggered by activating event=reactive
    Many depression cases not traceable to life events and not obvious what leads to depression=endogenous
    Ellis’s model only explains reactive depression
31
Q

Cognitive Approach Treating Depression- AO1

A
  • Cognitive behaviour therapy
    Cognitive element=client and therapist clarify client’s problems / where irrational thoughts that will benefit from challenge
    Behaviour element=change irrational thoughts and put more effective behaviours in place
  • Beck’s cognitive therapy=identify negative triad and challenge them
    Client as scientist=investigating reality of beliefs in way scientist would
    Therapist uses client’s finings to disprove their beliefs
  • Ellis’s REBT=ABCDE model- D=Dispute and E=Effect
    Identify and dispute irrational thoughts
    Vigorous argument=challenge irrational belief and break link between negative events and depression
    Empirical argument- evidence to support negative belief
    Logical argument- negative thought logically follows from facts
  • Behavioural activation=gradually decrease avoidance and isolation / increase engagement in activities that improve mood
32
Q

Cognitive Approach Treating Depression- AO3

A
  • Evidence for effectiveness +
    March=compared CBT to antidepressants and combo of both
    36 weeks=81% CBT, 81% antidepressants, 86% both=significantly improved
    CBT just as effective alone and more so when in combo
    CBT cost effective as 6-12 sessions
  • Suitability for diverse clients -
    Depression so severe that no motivation to engage with CBT
    Complex rational thinking in CBT=unsuitable for learning disability clients
    Sturmey=any form psychotherapy unsuitable for learning disabilities
  • Relapse rates -
    Concerns over how long the CBT benefits last
    Recent studies suggest long-term outcomes not as good as assumed
    Ali=depression 439 clients every month 12 months following course CBT
    42% relapsed within 6 months and 53% within a year
33
Q

Biological Approach Explaining OCD- Genetic- AO1

A
  • Genes=individual vulnerability to OCD
    Lewis=37% parents with OCD, 21% siblings with OCD
    Diathesis-stress model=certain genes more likely develop mental disorder but not certain- environmental stress necessary to trigger condition
  • Candidate genes=specific genes cause OCD
    5HT1-D=transport of serotonin across synapses
  • Polygenic genes=combination of genes increase genetic vulnerability
    Taylor=230 different genes involved in OCD- associated with serotonin and dopamine=role in regulating mood
  • Different types of OCD
    One group genes cause OCD in one person but different group genes cause OCD in another
    Aetiologically heterogenous=origins of OCD vary from one person to another
    Different types OCD result of particular genetic variations
34
Q

Biological Approach Explaining OCD- Genetic- AO3

A
  • Research support +
    Some people vulnerable to OCD as a result of genetic makeup
    Nestadt=68% MZ shared OCD, 31% DZ twins
    Family studies=family member with OCD 4x likely develop it as someone without
  • Environmental risk factors -
    Not entirely genetic in origin and environmental factors increase risk developing OCD
    Cromer=over 1/2 OCD clients= traumatic event
    OCD more severe in those with more traumas
35
Q

Biological Approach Explaining OCD- Neural- AO1

A
  • Role of serotonin
    Helps to regulate mood
    Low serotonin=mood-relevant info doesn’t take place=low moods
    Some cases OCD=reduction functioning serotonin system
  • Decision-making systems
    Some cases OCD=impaired decision-making
    Abnormal functioning lateral frontal lobes (logical thinking and making decisions)
    Left parahippocampal gyrus=unpleasant emotions=functions abnormally in OCD
36
Q

Biological Approach Explaining OCD- Neural- AO3

A
  • Research support +
    Antidepressants work on serotonin=reduce symptoms OCD suggests serotonin involved in OCD
    OCD symptoms form part of conditions known to be biological- Parkinson’s
    If bio disorder produces OCD, assume bio processes underline it
  • No unique neural system -
    People OCD also clinical depression
    Two disorders=co-morbidity
    Depression probably involves disruption to action of serotonin
    Serotonin possible basis OCD but could be that serotonin activity disrupted as depressed as well
37
Q

Biological Approach Treating OCD- AO1

A
  • Drug therapy=increase/decrease neurotransmitters to increase/decrease activity
  • SSRI’s=selective serotonin reputake inhibitor via synaptic transmission
    Preventing reabsorption and breakdown=increase serotonin in synapse=stimulate postsynaptic neuron
    Dosage and advice vary to which SSRI prescribed- 3/4 months daily=impact
  • Combining SSRI’s with treatments
    Drugs and CBT- drugs reduce emotional symptoms=engage more effectively CBT
  • Alternatives to SSRI’s
    Tricyclics=same effect SSRI’s more severe side effects- reserve for those don’t respond SSRI’s
    SNRI’s=serotonin noradrenaline reuptake inhibitor (increase serotonin and noradrenaline)- different class antidepressants and reserve for those don’t respond SSRI’s
38
Q

Biological Approach Treating OCD- AO3

A
  • Evidence of effectiveness +
    SSRI’s reduce symptom severity and improve QoL for OCD
    Soomro=compare SSRI’s to placebos
    All studies=better outcomes SSRI’s
    Symptoms reduce 70% people taking SSRI’s
    Remaining 30%=alternative drugs/combinations/therapies
  • Cost-effective and non-disruptive +
    Cheap compared to psych treatments as thousands tablets manufactured in time one session
    Drugs=good value for health systems
    Non-disruptive to peoples lives
  • Serious side effects -
    Indigestion/blurred vision/loss sex drive
    Usually temporary, quite distressing and minority are long lasting
    Tricyclic=more common and serious
    Reduced QoL and some stop taking them so cease to be effective