Psychopathology Flashcards

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1
Q

discuss deviation from social norms as a definition of abnormality

A

behaviour that is unexpected or breaks the unwritten (or written) laws of society is defined as abnormal
e.g., anti-social personality behaviour: signs of it is impulsive, aggressive and irresponsible behaviour
. part of the DSM classification is ‘absence of prosocial behaviour’
. how far people deviate from social norms is mediated by the degree of severity and context. if an individual persistently6tf5 deviates from social norms, this may be evidence of psychological disturbance

-: does not allow for a global standard of abnormality since it is culturally relative
. different cultures have different norms so different things will be seen as abnormal
. for example, homosexuality is illegal or seen as abnormal in over 75 countries still
. when looking at mental illness, this means diagnosis is dependent on where you are.

-: can be easily abused
. this definition can be used to maintain a status quo that may not be ethical
. for example, historically in America, slaves who tried to flee captivity, therefore deviating from the social norms, were classed as abnormal and diagnosed with ‘drapetomania’

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2
Q

discuss failure to function adequately as a definition of abnormality

A

someone is abnormal when they can no longer cope with the demands of everyday life
e.g.,
bad hygiene
bad nutrition
cannot hold down a job
irrational or dangerous thoughts and behaviour
maladaptive behaviour

+ idiographic looks at patient’s experience more, takes into account that abnormality should have an effect on the individual, rather than statistical infrequency and deviation from social norms, that look at the patient relative the the whole population
-: is is possible to be abnormal but still function normally
e.g., people will psychopathy, Ted Bundy

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3
Q

discuss statistical infrequency as a definition for abnormality

A

abnormality is based on the number of times it is observed in the population
. rare or infrequent behaviour is abnormal
e.g., IQ: those will extremely lower/higher than average IQs will be abnormal
. those in the bottom 2% could be tested for a diagnosis of intellectual disability disorder.

-: more objective than others
. definition purely based on statistics and numbers, meaning there is no risk of observer bias when diagnosing people
e.g., with deviation form ideal mental health, it is hard to determine what an ‘accurate perception of reality’ looks like, meaning it could be more subjective
. the researcher has no input, especially if there is a cut off point for abnormality.
-: hard to decide the ‘cut off’ point for abnormality
. it is hard to decide at what percentage someone should be considered abnormal
e.g., for a happiness questionnaire, if it is decided that the bottom 10% are considered abnormally unhappy, this means that someone in the bottom 11% would not receive any diagnosis or treatment, even if they are abnormal
. this definition can be too rigid

+: infrequent behaviour can be positive

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4
Q

discuss ideal mental health as an explanation for abnormality

A

absence of good mental health constitutes as abnormal
Jahoda’s criteria for ideal mental health
. accurate perception of reality
. self actualisation
. cope with everyday stress
. self esteem
. independent
. accurate perception of self

-: unrealistic to be meeting all these standards all of the time
. e.g., if someone is grieving they may not be independent but that does not make them abnormal
-: culture bound
. it is an imposed etic to assume that achieving self actualisation is ‘normal’ behaviour as this is not a priority in collectivist cultures.

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5
Q

how does the behaviourist approach explain phobias? (AO1)

A
  • phobia: anxiety disorder classed by DSM
    . anxiety is an adaptive response to danger to ensure survival but people with anxiety disorders experience an anxiety disproportionate to stress level
    . there are emotional (anxiety), behavioural (freezing) and cognitive (irrational thoughts) aspects of a phobia
  • the behaviourist approach explains phobias as a response due to past experience
  • CC can be used to explain phobias shown by the little Albert experiment
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6
Q

what was the little Albert experiment? (AO3)

A
  • aimed to see hoe CC could be used to create a phobia in humans
  • 1case study on 11 month old albert
    . has previously played with animals like rats and rabbits and showed no signs of distress
    . after a while of playing with the rat with nothing happening, the experimenter would then bang a metal bar to scare Albert, and make this loud noise every time he went to play with the rat.
    UCS(noise) > UCR (fear) NS(rat)>nothing
    NS(rat)+UCS(noise) > UCR(fear)
    CS(rat) > UCR(fear) : Al had associated the rat with a loud bang
  • Al then got anxiety when seeing the rat and this anxiety response generalised to all objects similar to the rat (white and furry objects) - STIMULUS GENERALISATOIN
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7
Q

explain the 2 process model when using the behaviourist approach to explain phobias

A
  • phobia is acquired by CC and maintained by OC
  • depending on how a behavioural response to phobia is reinforces/ punished, behaviour is more/less likely to occur again
    e.g. in cases of negative reinforcement individual avoids the phobia (e.g. spider) which leads to a desirable consequence (reduced anxiety) so this behaviour is repeated.
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8
Q

AO3 on the behaviourist approach to explaining phobias

A

+ : SUPPORTING EVIDENCE FROM LITTLE ALBERT CASE STUDY- shows the influence of CC on acquiring phobias
- : IDIOGRAPHIC RESEARCH- we cannot use a single case to confirm validity of entire behaviourist explanation.
it is possible that the results of this experiment was an anomaly
Al was later found to have brain damage which could have affected the results of the experiment
. he is also a baby, so may be more irrational.
. results are not generalisable
LOW POPULATION VALIDITY

+ REAL LIFE APPLICATION- led to treatments
. 2 process model explains why patients must be exposed to their phobic stimulus in order to reverse the association of stimulus with fear- counterconditioning
. led to Systematic Desensitisation (patient associates phobic stimulus with relaxation instead of fear)
. EXTERNAL VALIDITY
- : SD DOES NOT TREAT MORE COMPLEX PHOBIAS, e.g., social phobias.
. 2 process model cannot explain all phobias especially ones with more cognitive symptoms like irrational thoughts (e.g., someone with social phobia of agoraphobia may think everyone will try kill me if I go outside)
. the 2PM does not necessarily explain this level of irrationality
. reduces validity of 2PM in explaining phobias.

  • PARTIAL EXPLANATION
    . claims all phobias are learnt but doesn’t account for the phobias the people are born with that have an underlying evolutionary function, like phobia of snakes or heights (biological preparedness)
    . undermines idea that all phobias are learned
    -: evidence of genetic phobias
    . Dias and Ressler, conditioned rats to fear the smell of peppermint, but found that this fear was present in even the rats’ grandchildren, who had not undergone any conditioning
    . supports presence of epigenetics, and suggests phobias are not completely formed from nurture.
    . interactionist approach?
    t= evidence supporting the innate nature of phobias
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9
Q

how does the behaviourist approach treat phobias?

A
  • systematic desensitisation- slow exposure to phobic stimulus while patient is in relaxed state
  • flooding: immediate + extreme exposure to phobia
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10
Q

what is the process of systematic desensitisation(SD) (AO1)

A
  1. anxiety hierarchy- made by patient and therapist
    . list of situations related to the phobia which cause anxiety, arrange from most to least anxiety inducing
  2. relaxation- therapist gets patient to relax as deeply as possible through e.g. meditation or drugs
    . they will be exposed to the phobic stimulus in this state due to the principle of reciprocal inhibition: cannot be relaxed and fearful at the same time
  3. exposure- patient is exposed to the phobic stimulus in this relaxed state so they begin to associate their phobia with calmness and relaxation
    this takes place over several sessions starting from the bottom of anxiety hierarchy to the top
    - treatment is successful when the patient is relaxed in situations high in the anxiety hierarchy
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11
Q

systematic desensitisation AO3

A

+ : EFFECTIVE- supporting research from Gilroy et al
. followed up 42 patients who has been treated for a spider phobia by 3, 45m sessions of SD
. anxiety levels after treatment were assessed
. the control group was treated by relaxation without the exposure
. SD group were less fearful.
. increased validity and the importance of exposure/counter conditioning
+ longitudinal study: . Gilroy followed up 3 months and 33 months after treatment and both times the SD group were less fearful
. shows long lasting effects of SD, making it more valid

+ : SUITS DIVERSE RANGE OF PATIENTS
. flooding and cognitive therapies are not suitable for all patients in need of treatment
. e.g. people with learning difficulties find it had to engage with cognitive therapy and may not understand flooding
. SD is most applicable to patients
- : Ohman said SD is not effective for more complex phobias which have an underlying survival component e.g. fear of heights, as situations on an anxiety hierarchy may be impractical to carry out, but also because it is harder to convince the patient that heights are harmless when in reality they can be dangerous
T = ALTHOUGH SD IS NOT IMPACTED BY CERTAIN DISPOSITIONAL FACTORS, IT IS NOT A SUITABLE TREATMENT FOR ALL KINDS OF PHOBIAS.

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12
Q

what is the process of flooding?

A
  • exposes patient to the phobic stimulus without the gradual build up made by the anxiety hierarchy
    e.g. phobia= spiders: the patients would have a spider crawl on them for a long time
    . one flooding session is linger than one SD sessions but less sessions are required for flooding
  • flooding quickly stops the phobic response (e.g. anxiety) as patients quickly realised that phobic stimulus is harmless
    . this process in CC would be called extinction: where the CR/learned response is undone when the CS(e.g. dog) is encountered without the UCS(e.g. being bitten)
  • ethical safeguards: flooding is an unpleasant experience so the therapist must have the patients fully informed consent to the procedure and must fully prepare the patient
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13
Q

flooding AO3

A

+ : COST EFFECTIVE
. is is at least as effective as other treatments in curing phobias
. Ougrin (2011) compared flooding to cognitive therapies, and found that flooding was highly effective (for those who completed the process) and quicker than alternatives
. this is a strength as patients are freed from the phobia quicker and it is cheaper so more accessible
. may be favourable for state healthcare like NHS
- : TRAUMATIC: this means that many patients are unwilling to complete the entire flooding process
. this is bad as it means that time and money/resources are wasted to prepare the patient only for them to back out
. inefficient and wasteful
T = ALTHOUGH FROM AN IDEALISTIC VIEW, FLOODING IS COST EFFECTIVE, IN REALITY, IT OFTEN WASTES RESOURCES.

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14
Q

what is depression

A

mental disorder characterised by low mood and low energy levels

behavioural aspects: aggression/self harm
. disruption to sleep and eating behaviour

emotional aspects:
lowered mood- lethargic and sad
anger
low self esteem

cognitive aspects reduced concentration
.dwelling on negative aspects

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15
Q

how does Beck use the cognitive approach to explain depression? (AO1)

A
  • cognitive approach explains depression as a result of negative perception and irrational thoughts
  • BECK: used CA to explain depression in 1967 with his 3 PART THEORY which explains why some people are more vulnerable to depression than others
  1. negative self schema: negative preconceptions of yourself (e.g. thinking you will be bad at something before trying it)
  2. negative triad: negative view of the WORLD(everyone is against me) FUTURE(I’m heading nowhere) and SELF(I’m worthless)
  3. faulty information processing: only focusing on the negative parts of a situation (e.g. winning 1m in the lottery but being sad that someone else won 10m)
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16
Q

AO3 for Beck’s explanation of depression

A

+ : SUPPORTING EVIDENCE
range of evidence supporting the fact that depression is caused by negative schema, triad, and faulty info. processing.
. Beck used DAS scale and found that people with depression made more negative assessment of self
. more (external) validity
- : PRACTICAL APPLICATION: Beck’s theory forms the basis of CBT
. all cognitive aspects of depression are identified and challenged including negative self schemas and triad
. this is a very successful therapy so it supports a cognitive cause of depression
T = EXTERNAL VALIDITY

17
Q

how does Ellis use the CA to explain depression?

A
  • Ellis developed Beck’s theory and made the ABC model which claims that poor mental health is causes by irrational thoughts (any thoughts which prevent us from being happy)
    A(activating event e.g. fail a test) triggers B(irrational belief e.g. think you are stupid) which produces C(consequence eg. depression)
18
Q

AO3 for Ellis’ explanation of depression

A
  • : PARTIAL EXPLANATION
    . although some cases of depression are caused by an activating event this type is called reactive depression
    . there are other types of depression which arise without an obvious triggering event
    . Ellis only explains one type of depression so it is a partial explanation- reductionist as it simplifies depression into a simple kind of stimulus-response process
    . bad because if it can’t explain all depression, it cannot treat all depression
  • : DOESN’T EXPLAIN ALL ASPECTS OF DEPRESSION
    . it explains why some people are more vulnerable to depression than other it doesn’t explain the anger that ca come with depression or why some people hallucinate
    . this is bad as it means that his explanation can’t leads to a treatment for these things
    T = ELLIS’ EXPL. IS UNLIKELY TO LEAD TO A TREATMENT FOR ALL TYPES OF DEPRESSION, BECAUSE IT DOESN’T CONSIDER ALL FACTORS.

-: alternative explanations: biological
. low serotonin
-: supported by the effectiveness of antidepressants in treating depression

19
Q

cognitive approach to treating depression (AO1)

A
  • cognitive behavioural therapy (CBT) is the main treatment
    . aims to treat depression through identifying and challenging patients’ negative and irrational thoughts about themselves and the world
    . treats depression based on cognitive and behavioural techniques
  • Beck introduced CBT in the 60s and Ellis developed CBT to form Rational Emotive Behavioural Therapy (REBT)
    . in REBT Ellis made a treatment called ABCDE which builds on the ABC model (identifies the cause of depression)
    . the D and E stand for Dispute(challenging irrational beliefs) and Effect( =effective new beliefs replace the old one)
20
Q

cognitive approach to treating depression AO1

A
  • CBT also uses behavioural activation where the therapist encourages the patients to be more active and engage in enjoyable activities that they used to do
    . provides more evidence for the irrational nature of their beliefs
  • in CBT therapist may also give the patients homework/ things to work on
    . they must put into practice what they have learnt in therapy which helps them see how their new rational way of thinking can be put into reality
21
Q

cognitive approach to treating depression AO3

A

+ : SUPPORTING EVIDENCE
. march et al compared the effects of CBT to effects of antidepressants and patients receiving both treatments
. 81% of CBT group significantly improved
. 81% of antidepressant group significantly improved
. 86% of both treatment group significantly improved
.increased external validity
+ furthermore
. shows that CBT is as effective as medication, without any possible side effects or risks of addiction
. this means that CBT can be considered as a first choice treatment, making it more valid

-: OTHER FACTORS?
. other factors could cause depression (e.g. genetics or NT imbalance) and in these cases CBT will not be beneficial as irrational thinking is not at the root of depression
. reduced the applicability of the treatment
-: CBT CANNOT BE APPLIED TO ALL PATIENTS
. CBT may not be appropriate for people with severe cases of depression or people with depression symptoms of low mood
. they may be too demotivated for CBT and cannot engage (in these cases drug therapy would be more effective)
. this is bad as it means that CBT is not applicable to all cases of depression (less valid).

  • : DOESN’T TAKE INTO ACCOUNT SOCIAL SITUATIONS
    . e.g. if bullying is the root of the problem, or Activating event, without this being fixed, the depression is unlikely to be cured even if the patient’s cognitive thinking is challenged
    +: however therapist may show the patient skills that allow them to deal with bullying, meaning they get less affected by it.
22
Q

what is OCD? (AO1)

A
  • OCD= obsessive thinking followed by repetitive behaviour
    . these obsessions can be thoughts/images/emotions followed by compulsions
  • there are behavioural (compulsions/actions which aim to reduce OCD) emotional (anxiety/guilt form feeling like a burden) and cognitive (obsessive/irrational thoughts) characteristics to OCD
  • there are 2 biological explanations to OCD, genetic and neural
23
Q

what is the genetic explanation of OCD? (AO1)

A
  • individuals have inherited specific genes from their parents which make them more likely to develop OCD
  • CANDIDATE GENE(CG): genes which make you vulnerable to OCD
    . many CGs are involved in regulating neurotransmitters(NTs)
    . e.g. SERT genes are involved in the transport of Serotonin- a variant of this gene can lead to low serotonin levels and many people with OCD have this SERT variant
  • OCD is POLYGENIC: there are 230+ genes involved in OCD which makes the disorder AETIOLOGICALLY HETEROGENOUS: the origin of OCD varies between peoples
24
Q

genetic explanation of OCD AO3

A

+ : SUPPORTING EVIDENCE showing that people are more susceptible to OCD due to genetics
. 68% of MZ twins share OCD but inly 31% of DZ twins share OCD (MZ twins share 100% of the same DNA)
. higher concordance rate between MZ twins suggests genetic cause
. MORE VALID
-: PARTIAL EXPLANATION
simplifies OCD to only being a result of inherited factors. if this was the case, there would be 100% concordance, this suggests that other factors must play apart, like neural expl.

  • : TOO MANY CANDIDATE GENES
    . there are too many genes that could make someone vulnerable to OCD so the disorder is aetiologically heterogenous
    . this is bad as it means that it is less likely to find a cure with high success rate due to its little predictive value
    T = ALTHOUGH THE EXPL. HAS SUPPORTING EVIDENCE, IT DOESN’T PROVIDE A HIGHLY EFFECTIVE TREATMENT.
25
Q

what is the neural explanation of OCD (AO1)

A
  • neural = abnormal brain structure and functioning causes OCD.
  • serotonin = neurotransmitter (NT)
    . low levels of serotonin are found in people with OCD
  • frontal lobe influences decision making and people with OCD are found to have different functioning of the lateral frontal lobe (may explain why they are compulsive)
  • parahippocampal gyrus is associated with unpleasant emotion and it functions abnormally in people with OCD
    . this may explain why people with OCD are more have more anxiety
26
Q

neural explanation for OCD (AO3)

A
  • : ISSUE OF CAUSE AND EFFECT
    . although there is a correlation between OCD and low serotonin levels, it is not a causal relationship
    . low serotonin is not proved to cause OCD and instead, low serotonin cause be a result OCD.
    T = IT IS NOT POSSIBLE TO DETERMINE A CAUSAL RELATIONSHIPBETWEEN LOW SEROTONIN AND OCD
    + : SUPPORTING EVIDENCE
    . antidepressants work on the serotonin system to increase its levels
    . these drugs are also effective at reducing OCD symptoms
    . supports the theory that NT imbalance leads to OCD, and not the other way round

-: BIOLOGICAL DETERMINISM
. presents OCD as a pre disposition, that the patient has not control over. negative impact on their mindset and will lead to less engagement with their condition
. this means that other treatments like CBT, which have been shown to be an effective treatment for OCD as it helps them come to terms with the irrational nature of their beliefs, will be less effective
-: ENTIRE NATURE ON THE NATURE/NURTURE DEBATE
. ignores the influence of environment
Cromer et al found that over half OCD patients has suffered a traumatic event in the past ,and OCD was more severe in patients with more than one trauma.
it is not accurate to assume OCD is purely biological, perhaps taking a diathesis stress model would be a more accurate explanation.

27
Q

explain the process of serotonin transmission (AO1)

A
  1. serotonin is released into presynaptic neuron
  2. travels across synapse and NT chemically send a signal from presynaptic neuron to post synaptic neuron
  3. then serotonin is reabsorbed by the presynaptic neuron, broken down, and reused
    - OCD DRUG TREATMENT TARGETS THE SEROTONIN REUPTAKE SYSTEM.
    (look at diagram in folder for diagram)
28
Q

how can the biological approach treat OCD? (AO1)

A
  • mainly treats OCD by fixing NT systems and imbalances
    . this is mainly done through drug therapy (chemical treatments influencing biological functioning)
  • OCD patients can be given antidepressants which are drugs which inhibit feelings of anxiety but take 3-4 months to become effective
  • low levels of serotonin are linked to OCD so OCD drug treatments target the serotonin reuptake system
  • SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRI): e.g. fluoxetine
    . inhibits the reabsorption of serotonin from the synaptic cleft back into the pre synaptic neuron this reabsorption happens too fast in people with OCD (their compulsions give them small anxiety release but then they have to do it again)
    . SSRIs make serotonin stay in the synaptic cleft for longer, so they are active in influencing the post synaptic neuron longer
29
Q

what is an alternative to SSRI? (AO1)

A
  • ALTERNATIVE TO SSRI (if SSRI are ineffective after 4 months): NON-SELECTIVE REUPTAKE DRUGS (SNRI)
    . e.g. tricyclics- same effect on sera. systems as SSRIs and influences the noradrenaline NT
    . intense side effects
30
Q

biological approach to treating OCD (AO3)

A

+ : SUPPORTING RESEARCH
. Greist et al looked at the effect of 4 drugs on reducing OCD vs. a placebo (ineffective) drug
. all 4 drugs were significantly more effective than the placebo with clomipramine being the most effective
. shows that this treatment can be applied to real life cases and increases external validity
- : PUBLICATION BIAS must be considered when looking at the effectiveness of drug therapy
. positive results are more likely to be published than negative ones
. this is because drug companies run most of the trials and they have a financial incentive (will make more profit if there is evidence showing that the drug is effective)
. this is bad as our view of the treatment is skewed
T = we cannot then make conclusive statements on the effects of drug therapy

-: SIDE EFFECTS
taking drugs can cause nausea/ insomnia
for clomipramine, the side effects are more severe, such as erection issues, tremors, weight gain, or increased aggression
patients are unlikely to continue treatment due to this.
calls into question to what extent the treatment is including their quality of life
-: ALTERNATIVES
CBT can also be used as a treatment for OCD
. encourages people to confront their obsessions, and realise the irrational nature of certain beliefs, which can lead to reduced anxiety and reduced chances of compulsive behaviour

+ : COST EFFECTIVE
. drug therapy is cheap compared to CBT and relatively easy to administer compared to CBT where trained therapists and appointments are required)
. drug therapy is more readily available which is good as it means it is more accessible
-: short term
Simpson(2004) saw that when drugs are taken away at the end of treatment, relapse (OCD symptoms return) in 45% of cases after 12 weeks compared to the 12% of relapse cases in 12 weeks after CBT
. bad as it shows that drugs aren’t a long term treatment and can cause other issues