Psychopathology Flashcards
What is psychopathology?
Psychopathology - disease of the mind
4 definitions of abnormality:
4 definitions of abnormality:
-Satastical infrequency
-Deviation from social norms
-Failure to function normally
-Deviation from ideal mental health (marie jahoda 1958)
Abnormality - Statistical deivation
Statistical deviation: occurs when an individual has a less common characteristic than most of the population
Normal distribution on a graph
Normal distribution - a symmetrical spread of frequency data that forms a bell-shaped pattern. The mean, median and mode are all located at the highest peak
Strengths of the idea of statistical frequency
Stastical infrequency strengths:
-Has real life application in diagnosis of intellectual disability disorders - therefore useful when observing normal/abnormal characteristics
-Useful part of clinical assessment - assessments always include measurement of symptom severity in comparison to stastical norms
Limitations of statistical infrequency
Stastical infrequency limitations:
-Unusual characteristics can be positive (ie high IQ) - so they don’t require treatments - means statistical infrequency cannot be used alone to diagnose
-Doesn’t take desirability into account
-Not everyone who is ‘unusual’ would benefit from a level - eg someone with low IQ - labelling them as abnormal lead to low self esteem
Social norms
Social norms are accepted standards of behaviour within a society
Two types of social norms
Types of social norms:
-Implicit social norms
-Explicit social norms
Explicit social norms
Violating explicit rules means breaking the law eg drugs, arson
Implicit norms
Unspoken and conventional eg standing too close to someone
People who violate explicit rules
Violating explicit rules - criminal
People who violate implicit rules
Violating implicit rules - deviant
Characteristics that define the failure to function adequately
Characteristics that define the failure to function adequately:
-Suffering
-Maladiptiveness (maladaptive behaviour prevents individual from acheieving)
-Unconventionality
-Loss of control
-Irrational
-Observer discomfort (behaviour is governed by unspoken rules on how we should behave)
-Violation of moral standards
FFA
FFA - failure to function adequately
Diagnosing FFA
Diagnosing FFA requires an assessment criteria:
-DSM-V:: Set of guidelines: includes a global assesment of functional scale (GAF)
GAF (global assessment of functioning)
GAF - part of an assessment used to see wether someone has a mental disorder
Lower the scale : higher likelihood of a mental disorder
Strengths of using FFA
Strengths of FFA:
-Easy to judge fairly objectively because we can use a list eg GAF scale
-Attempts to include the subjective experience of the individual
Limitations of FFA
Limitations of FFA:
-Related to cultural ideas of how people should live their life
-Difficult to know if someone is really FFA or just deviating from social norms
-Person is judging their FFA - objectivity?
Strengths of the abornal definition ‘deviation from social norms’
Strengths of the abornal definition ‘deviation from social norms’
-Comprehensive - broad range of critera - helps people seek mental health services
-Social dimension to abnormality: alternative to idea of ‘being sick in the head’
Limitations of the abnormal definition ‘deviation from social norms’
Limitations of the abnormal definition ‘deviation from social norms’:
-Social norms vary with culture
-Unrealistic - people grow out of deviation
-Norms vary with time
Jahoda (1958) criteria for ideal mental health (PRAISE)
Jahoda’s criteria for ideal mental health (PRAISE)
Positive self attitude
Resistance to stress
Accurate perception of reality
Inidividual autonomy (ability to make own descisions about what is right)
Self actualisation (striving to fulfil your full potential)
Environmental master y (adapt to situations)
Jahoda (1958) criteria for ideal mental health (PRAISE)
Jahoda’s criteria for ideal mental health (PRAISE)
Positive self attitude
Resistance to stress
Accurate perception of reality
Inidividual autonomy (ability to make own descisions about what is right)
Self actualisation (striving to fulfil your full potential)
Environmental master y (adapt to situations)
Limitations of ‘deviation from ideal mental health’
Limitations of ‘deviation from ideal mental health’:
-Difficulty of meeting all criteria (PRAISE) - invalidates people’s mental health
-Cultural relativism: based on western idea of mental health
The 3 characteristics of phobias
3 types of phobias:
-Behaviour
-Emotional
-Cognitive
Behavioural characteristics - phobias
Behavioural characteristics of phobias:
-Panic
-Avoidance
-Endurance
Emotional characteristics- phobias
Emotional phobias:
-Anxiety
-Fear
-Emotional response is unreasonable: Disproportionate to the threat posed
Cognitive characteristics - phobias
Cognitive phobias:
-Selective attention to the phobic stimulus.
-Irrational beliefs
-Cognitive distortions
Definition of phobias
Phobias = anxiety disorders which interferes with daily living - instance of irrational fear that produced an avoidance
DSM-V
DSM-V is a criteria for diagnosing people with phobias:
-Persistent fears of object/situation
-Rapid anxiety response after phobic stimulus
-Excessive fear
-Phobic reactions interfere with individual’s life
Behavioural approach for how behaviours are learnt
Behaviour are learnt through:
-Classical conditioning (learning through association)
-Operant conditioning (learning through consequence)
Reinforcement and phobias
Positive and negative reinforcement increases likelihood of behaviours being repeated
Punishment and phobias
Positive and negative punishment decreases the likelihood of behaviours being repeated
Operant conditioning and phobias
Phobias are maintained through operant conditioning -
Mowrer’s two process model
Mowrer’s two process model:
Process 1- Development of phobias through classical conditioning = phobia develops through association of a neutral stimulus and a fear response
Process 2 - Maintenance of phobias through operant conditioning = Avoidance behaviours - escaping the stimulus to reduce anxiety = negative reinforcement (positive outcome of reduced anxiety from the removal of something negative)
Social learning theory and phobias
Social learning theory argues phobias are leant through the processes of observation and imitation - via role models
Generalisation and phobias
Generalisation in phobias is when people associate other objects/situations to their phobia due to similar characteristics
Counterconditioning
Counterconditioning: therapeutic technique where a client learns a new response to a stimulus that previously elicited an undesirable behaviour
-Two types: Aversive + Exposure
Aversive conditioning
Aversive conditioning: uses an unpleasant stimulus to stop an undesirable behaviour eg to eliminate addictive behaviours
Exposure therapy
Exposure therapy: therapist treats the phobia by presenting them with object/situation thats causing the problem
Flooding (exposure therapy)
Flooding: exposing the phobia to change the association (eg given relaxation techniques when in face with the fear)
Systematic desensitisation
Systematic desensitisation: tries to change individuals associations: individual makes a fear hierarchy, and they are given relaxation techniques for each fear
Limitations of flooding technique
Flooding at the early stage can be distressing
Limitation of systematic desensitisation
Limitation of systematic desensitisation: slow process
3 characteristics of depression
Characteristics of depression:
-Emotional: negative emotions - sadness, loss of interest and sometimes anger
-Behavioural - reduced or increased activity related to energy levels, sleep and/or eating
-Cognitive - irrational, negative thoughts and self-beliefs that are self-fulfilling
3 characteristics of OCD
3 characteristics of OCD:
-Emotional: anxiety and distress, and awareness that this is excessive, leading to shame
-Behavioural: compulsive behaviour to reduce obsessive thoughts, not connected in a realistic way
-Cognitive: recurrent, intrusive, uncontrollable thoughts (obsessions), more than everyday worries, cognitive coping strategies that have been created by the individual, self awareness of excessive anxiety
Ellis’ ABC model (1962) for explaining depression (using the cognitive approach)
ABC model (cognitive approach for explaining depression):
-Activating event leads to rational or irrational belief, which then leads to consequence
-Mustabatory thinking (eg wanting to be liked) - causes depression and dissapointment
Beck’s negative triad (1967) for explaining depression (using the cognitive approach)
Beck’s negative tried (1967) for explaining depression (using the cognitive approach):
-Negative schema = develops in childhood (eg parental rejection), leads to cognitive biases
-Negative triad = irrational and negative view of self, the world and the future
Ellis’ ABC model (1962) meaning
ABC model:
A = refers to an activating event
B = the belief, which may be rational or irrational
C = the consequence - rational beliefs lead to healthy emotions wheras irrational beliefs lead to unhealthy emotions
Mustabatory thinking
Mustabatory thinking - the source of irrational beliefs - thinking that certain ideas or assumptions must be true in order for an individual to be happy
Mustabatory thinking
Mustabatory thinking - the source of irrational beliefs - thinking that certain ideas or assumptions must be true in order for an individual to be happy
3 key elements of Beck’s negative triad (1967)
3 key elements of beck’s negative triad (1967):
-Negative view of the self
-Negative view of the world
-Negative view of the future
Positives of using the cognitive approach to explaining depression
Positives of the cognitive approach to explaining depression include:
-Support for the role of irrational thinking - negative thoughts lead to depression but does not cause it
-Practical applications in therapy - as it supprts the role of irrational thinking
Negative of the use of cognitive approach to explaining depression
Negative of the cognitive approach to explaining depression - blames the client and ignores situational factors - recovery may depend on recognizing environmental factors
How the cognitive approach is used to explain depression
The cognitive approach focuses on an individual’s negative thoughts, irrational beliefs and misinterpretation of events as being the cause of depression
Two main ‘schools of thought’ as to how faulty cognitions cause depression
2 main ‘schools of thought’ as to how faulty cognitions cause depression: Beck and Ellis
Basic assumptions of the two main schools of thought (Beck+Ellis) as to how faulty cognitions cause depression
Basic assumptions:
-The mind is like a computer
-Abnormality is due to irrational or faulty thought processes
Input > processing > output
Aaron Beck
Aaron Beck suggested there is a cognitive explanation as to why some people are more vulnerable to depression than other
Three parts suggested by Aaron beck to explain cognitive vulnerability
3 parts to cognitive vulnerability:
1- Faulty information processing
2- Negative self-schemas
3- The negative triad
Faulty information processing
Faulty information processing - Beck believed people who are depressed make fundamental eeors in logic
-Depressed people selectively attends to the negative aspects of a situation and ignore the positive aspects
-Blowing small problems out of proportion with black and white thinkings - ignoring middle ground
Negative self-schemas in explaining depression
Negative self-schemas:
Interprets all information about themselves in a negative way
Schema definition
Schemas are building blocks of knowledge - package of ideas and information that has developed with experience
Aim of the Weissman and Beck experiment (1978)
Weissman and Beck’s aim for their experiment = to investigate the thought processes of depressed people to establish if they make use of negative schemas
Weissman and Beck (1978) method
Weissman and Beck (1978) method:
Thought processes were measured using the Dysfunctional Attitude Scale (DAS) - parts filled out questionnaire (disagree/agree with statements
Results of Weissman and Beck (1978)
Results of Weissman and Beck (1978):
Depressed participants made more negative assessments than non-depressed people - when given some therapy to challenge and change their negative schemas there was an improvement in self-rating
Conlusion of Weissman and Beck (1978
Conlusion of Weissman and Beck (1978):
Depression involves the use of negative schemas
The negative triad (Beck’s model of depression 1979)
Negative triad - a cycle of negative thoughts as proposed by Beck
Negative view of self > Negative view of future > Negative view of the world
Albert Ellis
Ellis proposed good mental health is result of rational thinking
-Argued there are common irrational beliefs that underlie much depression and sufferes have based their lives on these beliefs ie being sucessful
Definition of irrational thoughts
Irrational thoughts - any thoughts that interfere with us being happy and free from pain
Ellis’ ABC model
Ellis ABC model:
(A) an Activating event causes
(B) an individuals Beliefs which results in
(C) a Consequence
Alternative explanations to explaining depression (other than cognitive)
Alternative explanations of depression:
-Biological approach - suggests genes and neurotransmitters can cause depression - evidence in drug therapies
-Diathesis-stress approach (suggests individuals with genetic vulnerability for depression more prone to effects of living in a negative environmental which leads to negative irrational thinking)
Evaluation of Beck’s theory for depression
Evaluation of Beck’s theory:
-Good supporting evidence
-Practical application in CBT
-Does not explain all aspects of depression
Evaluation of Ellis’ theory
Evaluation of Ellis’ theory:
-Only offers partial explanation (not all depressions arises as a result of an obvious cause)
-Practical explanation in CBT (challenging the irrational negative beliefs to relieve symptoms)
-Does not explain all aspects of depression (eg hallucinations or anger)
Trichotillomania
Trichotillomania - excessive hair pulling
Genetic explanations of OCD
Genetic explanations of OCD:
-Predisposition may be inherited
-OCD is polygenic (more than 1 specific gene has been identified in the onset of OCD)
-Candidate genes
Candidate genes
Candidate genes = the ones which, through research, have been implicated in the development of OCD
Dopamine
Dopamine - pleasure neurotransmitter - feelings of pleasure, addiction, movement and motivation - people repeat behaviours that lead to dopamine release
Serotonin
Serotonin = mood neurotransmitter = contributes to well-being and happiness; helps sleep cycle and digestive system regulation. Affected by exercise and light exposure
COMT gene
COMT gene = helps to reduce the action of dopamine - variation in the COMT gene decreases amount of COMT available therefore dopamine is not controlled - therefore there is too much dopamine (associated with OCD)
The SERT gene
SERT gene = affects the transport of serotonin, creating lower levels of this neurotransmitter. Low levels of serotonin have been implicated with OCD
Nestadt et al (2000)
Nestadt et al (2000):
-80 patients with OCD, 343 of their near relatives compared with control group without mental illness and their relatives
-Strong link with near family - 5x greater risk if had first degree relative
Diathesis-stress model
Diathesis-stress model = suggests that people gain a vulnerability towards OCD through genes but an environmental stressor is also required eg a stressful event such as grief
What is the frontal lobe of the brain responsible for?
The frontal lobe of the brain is responsible for thinking, memory, behaviour and movement
What is the parietal lobe of the brain responsible for?
The parietal lobe of the brain is responsible for language and touch
What is the temporal lobe responsible for?
The temporal lobe is responsible for hearing, learning and feelings
What is the occipital lobe responsible for?
Occipital lobe is responsible for sight
What is the brain stem responsible for?
The brain stem is responsible for breathing, heart rate and temperature
What is cerebellum responsible for?
Cerebellum is responsible for balance and coordination
What are the neural explanations for OCD?
Neural explanations of OCD refer to the genes associated with OCD being likely to affect the levels of key neurotransmitters as well as the structure of the brain:
-Serotonin - low levels
-Dopamine - high levels
What is the thalamus responsible for?
Thalamus is an area of the brain, functions include cleaning, checking and other safety behaviours
How does OFC (orbital frontal cortex) relate with the thalamus in reference to OCD?
-In OCD, the OFC and the thalamus are believed to be overactive
-Overactive thalamus results in an increased motivation to clean or check for safety
-Overactive thalamus causes an overactive OFC
-Overactive OFC = increased anxiety = increased planning to avoid anxiety
Function of the OFC (orbital frontal cortex)
The OFC is involved in decision making and worry about social and other behaviour
Main symptoms of OCD as declared by DSM
DSM describes main symptoms of OCD as being:
-Recurrent obsessions and compulsions
-Recognition by the individual that the obsessions and compulsions are excessive and/or unreasonable
-The person is distressed or impaired, and daily life is disrupted by the obsessions and compulsions
AO3 research evidence for the biological explanation of OCD
AO3 research evidence for the biological explanation of OCD
-Szechtman et al (1998): high dose of drugs that enhance dopamine induces movements resembling compulsive behaviors found in OCD patients (animal studies)
-Pigott et al (1992): antidepressant drugs that increase serotonin activity have been seen to reduce OCD symptoms
Drug therapy
Drug therapy - biological therapy for anxiety disorders - assumes there is a chemical imbalance - either increaeses or decreases neurotransmitter levels
SSRIs
SSRIs = selective serotonin reuptake inhibitors = treats OCD symptoms = increases a certain neurotransmitter by preventing the re-absorption of serotonin
Positive evaluation of drug therapy for OCD
Positive evaluation of drug therapy for OCD:
-Effective at tackling OCD symptoms
-Drugs are cost-effective and non-disruptive
Negative evaluation of drug therapy for OCD
Negative evaluation of drug therapy for OCD:
-Potential side effects
-Hard to come off, dosage has to be slowly decreased can take up to 6 months - risk of relapse
-Unreliable evidence for drug treatments - some drug companies don’t publish study results - therefore drug effectiveness is not completely trustworthy’
-Some cases of OCD follow trauma - not entirely biological
Cognitive bias definition
A cognitive bias is an error in how we process information about ourselves. They can lead us to focus on the negatives of experiences and block positive memories.
Strengths of CBT
Strengths of CBT:
Allows the client to take control – builds self-esteem.
Less reliance on drugs than other methods.
Does work for many people - Ellis (1957) claimed a 90% success rate for REBT, taking an average of 27 sessions to complete the treatment.
Limitations of CBT
Limitations of CBT:
Requires Individual motivation.
Relies on the competence of the therapist.
Works best combined with drugs.
Can be expensive and difficult to access (long waiting lists on NHS)
Evaluation of the cognitive approach for depression
Evaluation of the cognitive approach for depression:
Strengths = It has practical applications. CBT is a successful therapy which challenges irrational beliefs.
Limitations =
Some types of depression occur with no activating event - reactive depression.
Ignores biochemical explanations for depression.
Not all patients are able to engage with CBT or find it useful.
