Psychopathology Flashcards
treating phobias
define the aims of systematic desensitisation
aim to teach patient to learn a more appropriate association to reduce unwanted response
reciprocal inhibition- inhibiting anxiety by substituting a competing response(relaxation)
evaluation of systematic desensitisation
EFFECTIVE
works with specific phobias then a particular phobic object/situation can be identified
BUT less effective with acrophobia and social phobia
evaluation of systematic desensitisation SUITABLE FOR A DIVERSE RANGE OF PARTICIPANTS
simple process that patient controls
evaluation of systematic desensitisation
ACCEPTABLE TO PATIENT
choice between SD and Flooding, more patients choose SD as it does not create the same degree of trauma
treating phobias
define flooding
involves overwhelming an individual senses with the item or situation that causes anxiety= realises that not harm will occur
*no relaxation technique is set up
individual is exposed repeatedly and in an intensive way
treating phobias aimed results of flooding
indivusal learns phobic stimulus is harmless = extinction
conditioned stimulus (dog) is encountered without the unconditioned stimulus (being bitten) = conditioned stimulus no longer produced the conditioned response (fear)
evaluation of flooding
COST EFFECTIVE
quick effect that flooding does = treatment is cheaper than alternatives
evaluation of flooding
LESS EFFECTIVE FOR SOME PHOBIAS
like social phobias because they have cognitive aspects - individuals does not simply experienced an anxiety response but thinks unpleasant things
evaluation of flooding
TRAUMATIC
produces high levels of fear and this can be very traumatic = patients may refuse to start or continue treatment
DSM-5 categories of OCD
OCD
trichotillomania - hair pulling
hoarding disorder
Excoriation disorder- skin picking
all repetitive behavior accompanied by obsessive thinking
behavior signs and symptoms of OCD
compulsions are repetitive- feel compelled to repeat behaviour
compulsions reduce anxiety- behavior are performed in attempt to manage anxiety produced by obsesssions
avoidance- attempt to reduce anxiety by keeping away from triggering situations
cognitive signs and symptoms of OCD
obsessives thoughts- 90% of suffers have obsessives thoughts . are always unpleasant
cognitive strategies to deal with obsessions- adapt coping strategies to help manage anxiety but may seem abnormal to others
insight into excessive anxiety- aware thoughts are irrational but have “worst case” scenario thinking = anxiety. tend to be very hyper-vigilant
emotional signs and symptoms of OCD
anxiety and distress- unpleasant emotional experience due to anxiety (obsessions + compulsion)
thoughts can be frightening and overwhelming
accompanying depression- anxiety accompanied with low moods and lack of enjoyment
guilt and disgust
obsessive compulsive disorder
persistent thoughts, ideas or impulses that are experiences repeatedly, feels intrusive and cause anxiety
repetitive and rigid behavior tor mental act that person acts on to reduce anxiety
the cycle of OCD
obsessive thought -> anxiety-> compulsive behavior -> temporary relief-> obsessive thought ….
biological explanations for OCD
GENETICS
candidate genes have been implicated in the development of OCD
eg : SERT gene, regulates serotonin (facilitates message transfer across synapses) low levels in OCD
COMT gene, regulates the production of dopamine (drive and motivation) high in OCD
biological explanations for OCD
GENETICS counter
not everyone in a family gets OCD so there must be an additional factor
diathesis stress model- people gain a vulnerability towards OCD by genes but an environmental stressor is also required (stressful event)
OCD is thought to be polygenic- development is not determined by a single gene but a few = there is little predictive power from this explanation
evaluation of genetic explanations
GENETIC
(OCD)
evidence suggest that there is a genetic component to the disorder.
Pauls et al ; there is a higher percentage of OCD suffers in relatives of patients with OCD than in control group without OCD
BUT
the results of family studies could also be explained by environmental influences, relatives may have observed and imitated the behavior (SLT)
evaluation of genetic explanation
CANDIDATE GENES
candidate genes are ones which through research has been implicated with the development of OCD
BUT
there are too many genes involves and psychologists have not be successful in identifying all the genes involved
evaluation of genetic explanations
ENVIRONMENTAL FACTORS
OCD
individuals may gain a vulnerability towards OCD through genes that are then triggered by an environmental stressor
BUT
Cromer found that OCD was more sever in those with more than one trauma , therefore it may be more productive to focus on environmental cause it seems that not all OCD is entirely genetic in origin
neural explanation of OCD
genes associated with OCD are likely to affect the levels of key neurotransmitters as well as structures of the brain
- abnormal levels of certain neurotransmitters
- certain brain circuits may be abnormal
neural explanation of OCD
role of serotinin
regulates mood
low levels of serotonin = normal transmission of mood relevant information does not take place and mood are affected
OCD can be explained by a reduction in the functioning of the serotonin system in the brain
neural explanation of OCD
neuroimaging
enabled researchers to study the brain in detail and identify normal brain patterns= comparisons with abnormal brain patterns
basal ganglia
responsible for innate psychomotor functions
hypersensitivity of the basal ganglia = rise to the repetitive motor behaviors seen in OCD
orbitofrontal cortex and the thalamus
(thalamus- cleaning, checking and safety behaviors)
(OFC decision making and worrying)- overactive in OCD
= increased motivation to clean or check for safety = overactive OFC = increased anxiety and increased planning to avoid anxiety
evaluation of neural explanations for OCD
role of neurotransmitters
allows medication to be developed
BUT
drugs are not completely effective
decreased OCD symptom but does not mean that it causes it in the first place
evaluation of neural explanation for OCD
advances in technology have allowed investigation in specific areas of the brain more accurately , OCD suffers have more activity in orbital frontal cortex
BUT
not necessarily the cause of it
DSM-5 categories of depression
MAJOR DEPRESSIVE DISORDER - sever but short term depression
PERSISTENT DEPRESSUIVE DISORDER- long term/ recurring depression, including sustained depression
DISRUPTIVE MOOD DYREGULATION DISORDER - childhood temper tantrums
PERMENSTURAL DYSPHORIC DISORDER- disruption to mood prior to and/or during mensturation
behavioral characteristics of depression
behavior changes and reduced energy levels
- activity levels
- disruption to sleep and eating behaviors
-aggression and self harm
(too much sleep “hypersomnia” & too little sleep; “insomnia”)
cognitive characteristics of depression
tend to focus on the negative aspects of a situation
- poor concentration
-dwelling on negative
-absolutist thinking
emotional characteristics of depression
describe themselves as “worthless” and “empty”
-lowered mood
-anger
-lowered self esteem
Becks approach to explaining depression
suggest that there is a cognitive explanation to why some people are more vulnerable to depression than others
- faulty information processing
-negative self schemas
- the negative triad
becks approach to explaining depression
define faulty information processing
people who are depressed make fundamental errors in logic
they tend to selectively attend to the negative aspects of a situation and ignore the positive aspects
think in terms of black and white and worry over small problems
becks approach to explaining depression
negative self schemas
ideas we have about our selves, developed with experience
= interpret all the information about themselves in a negative way
(childhood events)
becks approach to explaining depression
the negative schemas STUDY
aim: to investigate the thought process of depressed people to establish if they have negative schemas
method: thought processes were measured using Dysfunctional Attitude Scale. participants were asked to fill in a questionnaire, agree or disagree
result: depressed participants made more negative assessments
= depression involves the use of negative schemas
becks approach to explaining depression
the negative triad
built on the idea of maladaptive responses and suggests that people with depression are trapped in a cycle of negative thoughts
tend to view things in a pessimistic way - the triad of impairments
- negative view of themselves
- negative view of the future
- negative view of the world
= automatic negative thoughts
Ellis explanation for depression
proposed that good mental health is due to rational thinking
rational thinking: reasonable, logical, realistic
irrational thinking: self defeating, illogical, inaccurate
ABC model:
Activating event
Belief
Consequence
evaluation of Becks explanation
APPILCATION
cognitive explanation has formed the basis of cognitive behavioral therapy. all cognitive aspects of depression can be challenged in CBT= therapist can challenge patients views and promote rational thinking
evaluation of Becks explanation
limited explanation
explains the basic symptoms of depression but complex disorder has a range of symptoms
such as hallucinations and delusions
evaluation of Ellis explanation
partial explanation
some depression does occur as a reuslt of an activating event but not all depression occurs due to obvious cause
evaluation of Ellis explanation
application
explanation has led to succesful therapy.
irrational negative beliefs are challenged = reduce depressive symptoms
therefore suggests that irrational thinking has some role in depression
evaluation of Ellis explanation
limited explanation
does not explain why some individuals experience anger associated with their depression/ suffer from hallucinations
alternative explanation to depression
BIOLOGICAL APPROACH
genes and neurotransmitters may cause depression
- drug therapies help patients reduce symptoms by altering levels of neurotransmitters
diathesis stress model- genetic vulnerability to depression that is activated by the environment which leads to irrational thinking
definitions of abnormality
deviation from social norms
failure to function adequately
statical infrequency
deviation from ideal mental health
define deviation from social norms
each society has norms which are seen as acceptable
behaviour that deviates from the norms are seen as abnormal
making a collective judgement as a society about what is right
eg: anti social personality disorder
+ allows consideration of social dimensions of behaviour, behaviour is abnormal dependent on situation
- norms change overtime= cannot define abnormality
define statistical infrequency
behaviours that are statically rare are seen as abnormal
(outside normal distribution of 5%)
Eg : IQ
+ appropriate for mental illnesses where statistical criteria is available
- not all infrequent behaviours are
abnormal (depression 10% = suggests it is not abnormal
define failure to function adequately
behaviour is abnormal when it causes distress leading to dysfunction and cannot cope with everyday life
Rosenhan and Seligman
- no longer conforms to standard interpersonal rules (eg, making eye contact or respecting another personal space)
- personal distress
-irrational or dangerous to themselves/ others
- violates moral standards
eg: schizophrenia
+ take into account experiences of the patient = assessment made from the point of view of the person experiencing it
- abnormality is not always accompanied by dysfunction
define deviation from ideal mental health
Jahoda’s criteria for good mental health:
- positive attitude towards self
-self actualisation
-resistance to stress
-autonomy
-accurate perception of reality
-mastery of environment
eg: depression
+positive approach to mental problems focus on what is desirable. giving aims
- accused of having over demanding criteria - difficult to meet all 6 characteristics
DSM-5 categories of phobias
- specific phobia: phobia of an object, or a situation
- social anxiety (social phobia): phobias of a social situation such as public speaking
-Agoraphobia: phobia of being outside or in a public space
behavioural characteristics of phobias
panic: panic in response ot the presence of the phobic stimulus. (crying, screaming or running away)
avoidance: make effort to avoid coming in contact with the phobic stimulus. make it hard to go about daily life
endurance: alternative to avoidance. suffers remains in the presence of the phobic stimulus but continues to experience high levels pf anxiety
emotional characteristics of phobias
anxiety: unpleasant state of high arousal. prevents the sufferer relaxing and experience positive emotion. fear is the immediate and extremely unpleasant response
emotional responses are unreasonable: disproportionate to the danger the stimulus poses.
cognitive characteristics of phobias
how information is processed
selective attention to the phobic stimulus: hard to look away when there is a phobic stimulus near even when causing anxiety. not useful when the fear is irrational because there is no dangerous threat
irrational beliefs: causes unreasonable rinses of anxiety towards the phobic stimulus due to incorrect perception as to what the danger posed actually is
cognitive distortion: perception of the phobic stimulus may be distorted. therefore it may appear grossly distorted or irrational
behavioural approach to explaining phobias
TWO PROCESS MODEL
based on the behavioural approach
phobias are acquired by classical conditioning and continued due to operant conditioning
classical conditioning
learning to associate something we have no fear of (neutral stimulus) with something that spreading triggers a fear repsonse (unconditioned stimulus)
NS-> no fear
UCS-> fear (UCR)
NS + UCS->UCR
CS-> CR
classical conditioning
little Albert
created a phobia of rats in a 9 month baby
the conditioning then generalised to similar objects
two process model
classical conditioning
little Albert
created a phobia of rats in a 9 month baby
two process model
operant conditioning
changing behaviour because of a reward or punishment
once fear is established the individual then avoids the object or situation that produces fear
= reduces anxiety
+ strengthens fear because makes it more likely that this object/situation will be avoided in the future
reinforces avoidance behaviour
evaluation of the two process model
good explanatory power
explains how phobias can be maintained over time- helps in therapy because it explains why patients need to be exposed to the feared stimulus
patient is prevented from avoiding stimulus= no longer reinforced
evaluation of the two process model
alternative explanation for avoidance behaviour
not all avoidance behaviour is result of anxiety reduction
eg; complex phobias like agoraphobia can be motivated by a positive by a positive feeling of safety
theory only suggests avoidance is motivated by anxiety reduction
evaluation of the two process model
incomplete explanation of phobias
evolutionary factors have some rile in phobias but isn’t mentioned in the theory
easily acquire phobias from source of danger in past (dark, snakes)
biological preparedness- innate predisposition to acquire some fears
processes involved in SD
anxiety hierarchy- is put together by patient and therapist. list of situations related to the phobic stimulus in order from least to most frightening.
relaxation: teaches the patient to relax as deeply as possible. breathing exercise or mental imagery techniques
exposure: when in a relaxed state they are exposed to the phobic stimulus starting at the bottom of the heirarchy
what is drug therapy to treat OCD
used for biological therapy for anxiety
assumes that there is a chemcial imbalance in the brain
commonly uses SSRI
combining SSRIs with other treatment for OCD
drug used alongside CBT
drug reduces emotional symptoms such as anxiety or depression
= engage in CBT to treat behavioral and cognitive symptoms
alternative to SSRIs for treating OCD
not effective after 3 - 4months = dose increased or combined with another drug
tricyclics= same effect on serotonin system as SSRI’s. only used for patients that don’t respond to SSRI’s
SNRIS= (serotonin noradrenaline reuptake inhibitors) second choice of drug to SSRI’s for patients that don’t respond. increase serotonin and noradrenaline
evaluation of drug therapy
COST
cheap in comparison to psychological treatments + are non disruptive to patients lives.
evalution of drug therapy
UNRELIABLE EVIDENCE
drug companies sponsor research they may decide to suppress any results that do not support the drug they are marketing.
drug companies do not publish all their results. therefore data on the effectiveness of drugs may not be trustworthy
evaluation of drug therapy
OCD TRAUMA
OCD is believed to be biological in origin it can also have different causes. OCD with no family history can be triggered by a life event and therefore treated differently from those with family history and no trauma . drugs may not be appropriate
