Psychopathology Flashcards
Name the 3 ways that abnormality can be described.
Deviation from social norms/statistical norms and failure to function adequately
Why isn’t there one universal set of social ‘rules’?
As cultures vary
What is a problem with defining abnormality as deviation from social norms?
It can be used to justify the removal of ‘unwanted’ people from a society (people opposing a particular regime)
Name another problem with describing/categorising abnormality.
People can change over time.
Name 2 issues with defining abnormality through statistical norms.
Doesn’t take into account the desirability of behaviour and there’s no distinction between rare/sightly odd behaviours
Name 3 categories used in diagnosis of failure to function adequately.
Personal distress, irrational behaviour and dysfunctional behaviour
What are the 6 conditions that Jahoda associated with ideal mental health in 1958?
Positive self-attitude, self-actualisation, resistance to stress, personal autonomy, accurate perception of reality and adaptation to the environment
What are 2 issue with Jahoda’s 6 conditions?
Some such as a violent offender may have positive self-attitude and be resistant to stress, yet society wouldn’t consider them to be in good mental health and idea of ideal mental health changes across time and cultures
Name 2 symptoms that are associated with mental illness.
Disordered thinking and alterations to mood.
What is the DSM?
It is the diagnostic and statistical manual for mental disorders
What is the DSM used for?
Used to classify disorders using defined diagnostic criteria including a list of symptoms of each mental illness
What is good about the DSM?
It makes diagnosis concrete and descriptive
What are mood disorders?
Disorders characterised by strong emotions, which can influence a person’s ability to function normally
What is depression?
One of the most common mood disorders
What are the 2 types of depression?
Major and manic depression
What is major depression?
An episode of depression that can occur suddenly, it can be reactive /endogenous
What’s the difference between reactive and endogenous?
Reactive means external factors but endogenous means internal factors
What is manic depression also known as?
Biopolar disorder
What is manic depression?
Alterations between two mood extremes (mania and depression) changes in behaviour are usually in regular cycles
What are the behaviour symptoms of depression? (4)
Sleep disturbances, change in appetite, pain and lack of activity
What are the cognitive symptoms of depression? (3)
Persistent negative thoughts, suicidal thoughts and slower though processes
What are the emotional symptoms of depression? (3)
Extreme sadness, diurnal mood variation and anhedonia (reduced ability to feel pleasure)
What’s anhedonia?
When you no longer enjoy activities or hobbies that used to be pleasurable
What is a phobia?
It is an irrational fear of a particular object or situation
What are specific phobias and name 2 subtypes?
Fear of specific objects or situations. Subtypes: Animal types and blood-injection-injury
What is agoraphobia?
Fear of open spaces, using public transport or being in an enclosed space
What is social anxiety disorder?
The fear of being in social situations, usually down to the possibility of being judged
Name the cognitive characteristics of a phobia (2)
Irrational beliefs about the stimulus that causes fear, hard to concentrate due to anxious thoughts
Name the behavioural characteristic of a phobia
Avoiding social situations
Name the physical characteristics of a phobia
Activation of flight of fright response, increased heart rate and muscle tension
Name the emotional characteristics of a phobia
Anxiety and the feeling of dread
Name 3 of the diagnostic characteristics for phobias
Signifiant prolonged fear, anxiety response and phobia disrupts their lives
What are the 2 parts to OCD?
Obsessions and compulsions
What are obsessions?
They are the cognitive and internal aspect of OCD they are intrusive and persistent thoughts, images and impulse that can’t be ignored
What are compulsions?
They are the behavioural and external aspect of OCD which are physical or mental repetitive actions
What percentage of the world population suffer from OCD?
2%
What is an issue with compulsions for the suffers of OCD?
The action only reduces the anxiety caused by an obsession for a short time, meaning the obsessions starts all over again
What are the 3 ways the DSM diagnoses compulsions?
Them not being caused by drugs, they are meant to reduce anxiety and they repeat physical behaviours or mental acts
What are the 3 ways the DSM diagnoses obsessions?
Not caused by drugs, unable to ignore them and they have persistent reoccurring thoughts
Name the 4 types of OCD behaviours.
Checking, contaminating, hoarding nd symmetry/orderliness
In terms of OCD what’s meant by the behaviour of checking?
Includes checking that lights are turn off/you have your wallet
In terms of OCD what’s meant by the behaviour of contaminating?
This involves the fear of catching germs or going into restaurants etc…
In terms of OCD what’s meant by the behaviour of hoarding ?
Keeping useless or won out objects
In terms of OCD what’s meant by the behaviour of symmetry/orderliness?
Getting objects lined up such as having all the tins in your cupboard facing the same way
What does the cognitive approach assume? (depression)
That behaviours are controlled by thoughts and beliefs, so irrational thoughts an be seen as abnormal
Name the 2 models that explain how faulty cognitions can lead to depression.
Ellis’s ABC model and beck’s negative triad
When was the ‘ABC model’ proposed?
1962
What did Ellis’s ‘ABC model’claim?
That disorders begin with an activation event (A), leading to a belief (B) about why to happened. This may be rational or irrational. The belief leads to a consequence (C)
In the ‘ABC model’ what do irrational thoughts produces that’s different to rational thoughts?
Irrational thoughts produce adaptive (appropriate) consequences and rational thoughts produce maladaptive consequences (inappropriate)
What does Beck’s negative triad model show?
Beck identified a ‘negative triad’ of automatic thoughts of negative bias links to depression such as negative views about themselves, he world and the future
he said this can lead to avoidance social withdrawal and inaction
Suggest 2 strengths of using the cognitive explanation of depression.
Cognitive therapies often have more success when treating people with depression and the models offer a useful approach to depression as it considers the role of thoughts and beliefs
Suggest 2 weaknesses of using the cognitive explanation of depression.
Faulty cognitions may simply be the consequence of depression rather than its cause and the person may begin to feel as though they are to blame for their problems
What does cognitive behavioural therapy aim to identify and change?
Faulty cognitions
What happens during cognitive behavioural therapies?
The therapist and client identify the clients faulty cognitions, the therapist then tries to help them see they aren’t true and together create a set of goals to help them think in more positive way
What does CBT help the client do?
Focus on the present situations
Name an advantage of CBT
It empowers the patients and puts them in charge of their own treatment
Name 2 negatives of CBT
May take a long time and be costly but also could make the client feel as though they are to blame for their problems
What happens in classical conditioning and link it to phobias?
A natural reflex is produced in response to a previously neutral stimulus, phobias an be created when the natural fear response becomes associated with a stimulus
What happens in operant conditioning?
Learning through the consequences of actions
why is operant conditioning important to phobias?
Important in maintaining them
When was Mowrer’s two-process model proposed?
1947
What does Mowrer’s model suggest?
Explains how phobias are produced and maintained
Explain the two-process model.
People develop phobias by classical conditioning a CS is paired with an UCS to produce a CR. Once somebody has developed a phobia it is maintained through operant conditioning
Name a strength of the behavioural explanation of phobias.
Very effective at treating phobias by getting the person to change their response to a stimulus
Name a weakness of behavioural explanation of phobias.
Many times people can’t recall having a traumatic experience with their phobia suggesting there could be other explanations
How does systematic desensitisation work?
Works by using counter-conditioning so that the person learns to associate the phobic stimulus with relaxation rather than fear
What are the steps to systematic desensitisation?
First the phobic person makes a ‘fear hierarchy’, they are then taught relaxation techniques like deep breathing. The patient then imagines the anxiety-provoking situations starting with least to most stressful. The process stops if they feel anxious relaxation and anxiety can’t happen at the same time so when they become relaxed they are no longer scared
What is flooding?
It involves exposing the patient to the phobic stimulus straight away, without any relaxation or gradual build up. This can be done in real life or patients can be asked to visualise it they are kept in the situation until they no longer feel anxious
What are the advantages of behavioural therapys?
It is very effective for treating specific phobias and it works very quickly it was found by Ost et al that anxiety was reduced by 90% of patients in on session
What are the disadvantages of behavioural therapies? (Flooding/systematic desensitisation)
There are ethical issues especially surrounding flooding, it patients drop out before the therapy is finished then it can end up causing more anxiety these therapies only tackle the symptoms not the cause like others do
Name the 3 factors that can be used to explain OCD (biological)?
Genetic, biochemical and neurological
What is the evidence for genetic factors explaining OCD?
Billet et al did a meta-analysis of twin studies that had been carried out over a long period of time. They found for identical twins, if one had OCD then 68% of the time both twins had it compared to 31% for non-identical twins
What is the evidence against genetic factors explaining OCD?
No study found a 100% concordance rate, so genetics can’t be the full story in OCD, its possible that children imitate the obsessive actions of relatives
What is the evidence for biochemical factors explaining OCD?
Insel (1991) found that a class of drugs called SSIR’s, which increase levels of serotonin can reduce symptoms of OCD in 50 to 60% of cases
What is the evidence for neurological factors explaining OCD?
Mx et al (1995) found increased rates of OCD in people after head injuries that caused brain damage to the basal ganglia
What is the evidence against neurological factors explaining OCD?
Aylward et al (1996) didn’t find a significant difference in basal ganglia impairment between OCD patients and controls
Name a strength of the biological explanation of OCD
It has a scientific basis in biology, theres evidence that low serotonin and damage to the basal ganglia correlate with cases of OCD, twin studies have shown that genetics have at least some effect on the likelihood of getting OCD
Name a weakness of the biological explanation of OCD
It doesn’t take into account the effect of the environment, family or social influences and they raise ethical concerns (drugs might lead to addiction and may just supress symptoms rather than curing them
How do drug treatments work?
Increasing levels of serotonin in the brain using selective serotonin reuptake inhibitors. They are a type of antidepressant drug that increase the availability of serotonin
What are SSRI’s prevent?
The reuptake of serotonin in the synaptic cleft (gap between neurons) meaning theirs more serotonin available to the next neuron
What is the advantage of SSIR’s?
Several researchers have found SSIR’s to be effective in treating OCD, Thoren et al (1980) found that use of SSIR was significantly better at reducing obsessional thoughts than a placebo
What is the disadvantage of SSIR’s?
Up to 50% of patients with OCD don’t experience any improvement in their symptoms when taking SSIRs. Out of those that do improve, up to 90% have a relapse when they stop taking them
what does the cognitive approach say about depression
that its a result of irrational thoughts from maladaptive internal mental processes
whats a schema
mental frame work based on experiences schemas allow us to quickly process large amounts of sensory info and make automatic assumptions and responses
when was becks negative triad said to develop in people and what does it cause
develops in childhood and provides the frame work for persistent bias in adulthood leading to cognitive distortions perceiving the world inaccurately
what are 2 characteristics of cognitive distortions
overgeneralisation, one negative experience results in an assumption that the same thing will always happen
selective abstractions, mentally filtering out positive experienced and focusing on the negative
what did Ellis mean by mustabatory thinking
the consequence of not accepting that we don’t live in a perfect world
He said “there are three musts that hold us back: I must do well, you must treat me well and the world must be easy”
The fact that we fail to achieve unrealistic goals other people don’t behave the way we want them to, or an unexpected event happens and ruins our plans leading to disappointment
What was the study that provides evidence for cognitive approach to depression and explain it
Grazioli and Terry (2000) assessed the thinking styles of 65 women before and after giving birth (6 weeks after)
it was found that those women with negative thinking styles were the most likely to develop postpartum depression, especially in women with infants who identified as having difficult temperament
How does Grazioli and Terrys (2000) study provides evidence for cognitive approach to depression
supports the idea that faulty thinking leads to depression
but also that theres a diathesis-stress mechanism to becks theory, negative thinking is a vulnerability which can be triggered by adverse life experiences like motherhood
what is a negative evaluation of the models to do with cognitive approach to depression
Many people with depression also experience anger and people with bipolar depression experience manic phases, times when they feel extremely happy overly excited… these features of depression are hard to explain with theories like becks due to negative schemas as schemas are resistant to change
Explain Becks CBT (treatment for depression)
Patient is treated like a scientist: generates/tests hypotheses about the validity of their irrational thoughts when they realise their thoughts don’t match reality this will change their schemas and irrational thoughts can be discarded
Thought catching: identify irrational thoughts coming from, the negative triad of schema
Homework tasks: include keeping a sdiary used to record negative thoughts and identify situations that cause negative thinking
Behavioural activation: Taking part in activities that the sufferer used to enjoy
Explain Ellis’s REBT
rational emotive behaviour therapy
development of the ABC model adding D for dispute and E for effect
dispute: the therapist confronting the client’s irrational beliefs empirical arguments challenge the client to provide evidence for their irrational beliefs whilst logical arguments attempt to show that the beliefs dont make sense
effect: reduction of irrational thoughts (restructure beliefs) leading to better consequences in the future
Shame shaking exercises: The client preforms a behaviour they fear doing in front of others and this show the client they can act against their emotions and cope with an unpleasant exercise and survive other approval and that most people don’t care about our actions
Apart from serotonin re-uptake what else is seen as over active in people with OCD?
The “worry circuit” which is a set of brain structures including the orbitofrontal cortex the basal ganglia system as basal ganglia tends to filter out worries coming from OFC but if this area is over active then even small worry make it to the thalamus passed back to OFC forming a loop of recurring obsessive thoughts
Repetitive motor functions (compulsions) are an attempt to break this loop and give short term relief
What’s good about Jahodas definitions of idea mental health
It is a comprehensive definition
Covers a broad range of criteria for mental health
Probably covers most of the reasons why come one would seek help from mental health services
What are the strengths of the two process model
Good explanatory power- had important implications for treatment as it explained why patients need to be exposed to stimuli they fear
Negatives of two process model
It’s an alternative explanation for avoidance behavior- not all avoidance behavior could be due to anxiety
What are some evaluative points for Ellis ABC model
Practical application in CBT- suggest the theory is the basis of CBT
But doesn’t explain all aspects of depression-
What is some evaluative points for the biological approach to OCD
Too many candidate genes, genetic explanation unlikely to ever be useful because it provides little predictive value
Environmental risk factor
Not clear what neural mechanisms are involved
We shouldn’t assume the neural mech cause OCD
What can be an alternative to SSRIs
Tricyclics they are a type of antidepressants and have the same effect on serotonin systems as SSRIs
Clomipramine has more severe side effects and are generally kept for patients who don’t respond to SSRIs
Evaluations of SSRIs as drug treatments
Cost effective and non disruptive
Drugs have side effects
Some cases of OCD follow traumas
