psychopathology Flashcards
four definitions of abnormalities:
- statistical infrequency
- deviation from social norms
- failure to function adequately
- deviation from ideal mental health
statistical infrequency and eval
displaying UNCOMMON characteristics
deviation from common statistics
normal distribution in standard deviation graphs
eg 68% have IQ between 85-115
only 2% have below 70 - this is an abnormality
+ real life application - intellectual disability disorder diagnosed using statistical deviation and looking at IQ
- not all statistical deviations are bad eg IQ over 130 and we don’t consider them to be psychopathologies
deviation from social norms and eval
going against what society deems acceptable
- explicit and implicit norms eg laws or just social practice
- antisocial personality disorder “absence of prosocial internal standards associated with failure to conform to lawful and culturally normative ethical behaviour”
+ real life application used to diagnose APD
- norms vary over time
- culture and situation dependent
- can lead to human rights abuses, controlling minority groups
failure to function adequately and eval
people unable to cope with demands of everyday life: not conforming to interpersonal rules, personal distress, irrational or dangerous behaviour
- eg OCD, unable to have healthy eating habits due to fearing germs
- context - base jumpers take part in sports with high mortality rate
- cultural relativism
+ threshold for help, treatment can be targeted to those who most need it
deviation from ideal mental health and eval
focuses on defining ideal mental health - Jahoda 1958
- positive attitudes towards yourself
- self-actualisation
- cope with stress
- personal autonomy
- accurate perception of reality
- characteristics are culturally biased, individualist culture
- very few people have an ‘ideal’ mental state, so should we all be abnormal? defeats the purpose
- how far do we need to deviate before we are classed as abnormal?
behaviourist explanation for phobias: two process theory
acquisition from a traumatic experience (classical conditioning)
maintained because avoidance response is learnt (operant conditioning)
negative reinforcement: avoiding unpleasant situation
evaluation two process theory
- many people have phobias of things they have never had fearful encounters with so can’t have been conditioned
- evolutionary explanation of phobias - scared of dangerous things to us (people scared of snakes because they WERE dangerous to us, not many scared of cars which are dangerous NOW)
+ real world application - exposure in therapy
characteristics of phobias - behavioural
panic
avoidance - negatively reinforced
characteristics of phobias - emotional
anxiety and fear (unreasonable)
characteristics of phobias - cognitive
selective attention - focuses on phobic stimulus
irrational beliefs
cognitive distortion
characteristics of depression - behavioural
reduced activity lessons
sleep changes
eating changes
aggression
characteristics of depression - emotional
low mood
low self esteem
anger
characteristics of depression - cognitive
poor concentration
negative thoughts
absolutist thinking
characteristics of OCD - behavioural
compulsions (repetitive and intrusive thoughts that reduce anxiety by acting on them, -vely reinforced)
avoidance behaviour (-vely reinforced)
characteristics of OCD - emotional
guilt and disgust - thoughts of irritation
anxiety
characteristics of OCD - cognitive
acknowledgement of irrationality and excessive
obsessive thoughts
develop cognitive strategies to deal with obsessions
behavioural therapies - systematic desensitisation
uses counter conditioning
- fear response is replaced with alternative and harmless response
1. anxiety hierarchy - patients asked to list situations from least=>most fearful
2. patients taught relaxation techniques
3. exposure - occurs across many sessions
visualise least fearful situ along with performing relaxing technique, once comfortable they move up until can cope with most fearful situ
systematic desensitisation study
Gilroy et al 2003
42 patients treated for arachnophobia with SD
compared to control group treated with relaxation techniques
3 months and 33 months later the experimental group showed less fear
+ almost 3 years later is still effective, more worthwhile and useful
behavioural therapies - flooding
removes association between stimulus and response
- patients are exposed to feared object/situation until the fear response disappears
- high levels of fear and anxiety cannot be sustained
patient learns stimulus is harmless (extinction - learned response (fear) is extinguished)
conditioned stimulus no longer produces conditioned response
evaluating flooding
- ethical issues, flooding is unpleasant whereas SD is more gradual
+ cost, one session so often cheaper than SD - suitability for different phobias
cognitive approach to depression: Ellis’ ABC model
A - activating event
B - the belief (rational/irrational)
C - consequence (healthy/unhealthy)
Ellis’ ABC - what affects our beliefs
musturbation: thinking certain ideas MUST be true to be happy
i can’t stand it itis: feeling overwhelmed if something goes wrong, believing it’s a disaster
utopianism: believing the world should always be fair
cognitive approach to depression: Becks negative triad
- faulty info processing (only seeing negatives, maximising small problems, minimising success)
- negative self-schemas (we interpret everything about ourselves as negative)
we experience 3 types of faulty, negative thoughts
self - i am not good/clever
world - everyone thinks i’m stupid
future - i won’t succeed in anything
evaluating cognitive approach to depression: Cohen et al
473 adolescents - longitudinal study over 3 years (+ gives proper overview over time, better understanding, more worthwhile) (- lacks pop validity, hormones which may affect depression are different in adults and teens)
self report and interviews with adolescent and CG, measuring cognitive vulnerability and depressive episodes
- found cognitive vulnerability was a good predictor of later depression, allows psychologists to screen people and target help to those most at risk
general evaluation for cognitive approach to depression
- ABC only applies to depression following an activating event - not all depression has a trigger
- blames client for the thoughts (determinism/free will)
+ practical application - CBT - does not explain cause of the faulty cognitions
CBT (cognitive behavioural therapy) aim
identify problem (negative/irrational thoughts) and change them and put more effective behaviours in place
identify => challenge => gain insight
type of CBT - rational emotive behavioural therapy (don’t need to know name)
extension of ABC model (DE = dispute and effect)
identify and dispute irrational thoughts (could relate to utopianism, musturbation)
vigorous argument
empirical argument (based on evidence) or logical argument
type of CBT - becks cognitive theory
challenges negative schemas => client keeps a diary of thoughts and anxieties
client+therapist go through the diary to identify negative automatic thoughts
therapist challenges these cognitions by thinking realistically (reality testing)
- client encouraged to test faulty beliefs (write good things to refer back to in future)
type of CBT - behavioural activation
therapy also encourages people to participate in activities
reduces avoidance and isolation
therapist reinforced activities that improve mood
evaluating CBT - march et al 2007
327 adolescents (pop validity - hormones different) with depression
effect of antidepressants and CBT over 36 weeks (longitudinal, reliable and valid, long lasting)
% that had massively improved
- antidepressants 81%
- CBT 81%
- both 86%
CBT just as effective as drug treatment
evaluating CBT
+ attempts to address cause of depression (changing cognitions) so more worthwhile, long lasting, more impact
- needs dedication and motivation, more difficult to commit to than drugs
- overemphasis on cognition, may ignore situational factors
biological approach to explaining OCD - genetics
genes passed from parents, so if they have an abnormality it can be passed to us
likelihood of having OCD is greatly increased by sharing genes with someone with it (parents 37%, siblings 21%)
some genes make you more vulnerable (candidate gene) but not a certainty (diathesis-stress model)
SERT gene: mutation of the gene causes lower levels of serotonin
COMT gene: variation causes higher levels of dopamine
OCD seems to be polygenic - 230 different genes may be involved in OCD (different groups of genes cause different types of OCD)
evaluating genetic explanation for OCD
+ allows complexities, doesn’t reduce it
+ Nestadt et al 2010 - MZ twins 68% DZ 31%
> MZ concordance rates are not 100% so it cannot be completely down to genetics
> environmental influences, MZ twins share a more similar environment than DZ twins
> large amount of data, better pop validity, more generalisable
- makes diagnosis harder
biological approach to explaining OCD - neural
caused by changes in brain chemicals and brain structure
serotonin: neurotransmitter to regulate our mood, low levels of it can affect our mood + impulse control
- may be related to having a mutated SERT gene
brain structure: abnormal functioning of frontal lobe (decision making and logical thinking) may cause OCD
- orbitofrontal cortex converts sensory info into thoughts and actions - can send worry signals
- PET scans shown OCD has increased activity of the OFC when symptoms are active
evaluating neural explanation for OCD
+ drugs that increase serotonin activity reduce OCD symptoms
> only 70% of the time though, so may not be the full cause
- low levels of serotonin may just be due to comorbidity with depression and not related to OCD at all
- reductionist - ignores cognitions and learning (two process model may explain ocd)
drug treatment for OCD (low serotonin) what is SSRI
selective serotonin reuptake inhibitors
takes 3-4 months of daily dosage to impact
eg fluoxetine (Prozac)
how do SSRIs work
after serotonin targets receptor sites it is reabsorbed by the presynpatic neuron
SSRIs block reabsorption, increasing conc of serotonin at receptor site
if SSRIs don’t work what is used
SNRIs (noradrenaline)
tricyclics - similar but worse side effects
eg clomipramine
drug therapy study Soomro et al 2008
reviewed 17 studies looking at SSRIs and OCD
SSRIs are more effective than placebos in reducing symptoms of OCD, reduced for approx 70%
- only 70% response
- side effects like headaches, weight gain, nausea - people less likely to continue taking the drug so it’s less effective
- treats the symptoms not the cause, relapses?
+ little time and effort, also discreet (preferable to some) - preferable to costly and time consuming (CBT)
