Psychopathology Flashcards
What are the 4 definitions of abnormality ?
(Definitions of Abnormality)
Statistical Infrequency
Deviation from social norms
Failure to function
Deviation from ideal mental health
What is statistical infrequency ?
(Definitions of Abnormality)
Abnormal Behaviour – a trait/behaviour/thinking which is numerically rare compared to the rest of the population
account desirable behaviour - normal undesirable behaviour
Evaluation - Statistical Infrequency - Limitation - Doesn’t distinguish between desirable and udesirable traits ?
(Definitions of Abnormality)
Point - Definition fails to account for behaviour wich is statistically rare but desirable such as high IQ
Further - Some statistically ‘‘normal’’ behaviour is still undesirable such as depression which still requires treatment
useful for normal/abnormal cases - people dont benefit from label
Evaluation - Statistical Infrequency - Strength - Real life application to intellectual disability disorder ?
(Definitions of Abnormality)
Point - This definition is used in the diagnosis of intellectual disability disorder showing that this definition of abnormality is useful in defining normal and abnormal characteristics
Counter - Some people dont benefit from a label. The label of a disability such as intellectual disability disorder could negatively impact the way patients are viewed by others and themselves
What is deviation from social norms ?
(Definitions of Abnormality)
Abnormal behaviour is behaviour which goes against unwritten rules/expectations of society
Norms are specific to time and culture – not many behaviours are considered universally abnormal
Social norms vary from place to place - Nymphomania
Evaluation - Deviation from social norms - Limitation - Culturally relative ?
(Definitions of Abnormality)
Point - Social norms vary from one generation to another and from one community to another, therefore someone may label another as being abnormal based on their own culture/norms
Further - Nymphomania was a historical example of deviating from social norms that no longer applies in society
Used to control groups - Drapetomania/slave disorder
Evaluation - Deviation from social norms - Limitation - Can lead to human rights abuses ?
(Definitions of Abnormality)
Point - Historically this definition has been used to control groups who deviate from the majority, such as homosexuality
Further - Drapetomania was a disorder that ‘caused slaves to flee captivity’, this disorder was designed to keep slaves in captivity and wasnt real
What is failure to function ?
(Definitions of Abnormality)
Defines abnormality as the inability to cope with everyday living
Not being able to maintain basic nutrition, hygiene, hold a job or maintain a relationship
Can be choice - people have free will
Evaluation - Failure to function - Limitation – Leads to Discrimination/Social Control ?
(Definitions of Abnormality)
Point - Hard to distinguish between failure to function and conscious decision to deviate from social norms
Further - people may choose to live off-grid or take part in high risk leisure activities, these people may just choose to do these things
acknowledges patient experience - patient may be unaware of themselve
Evaluation - Failure to function - Strength – Recognises the Patients Perspective ?
(Definitions of Abnormality)
Point - The definition is based on the subjective experience of patients and therefore acknowledges the experience of patients
Counter - someone else will still need to judge if a patient is distressed or distressing others while the individual might be content or unaware that they are not coping
What is the deviation from ideal mental health ?
(Definitions of Abnormality)
Instead considers what is normal
People are defined as abnormal if they do not meet Jahoda’s criteria:
No symptoms of distress
Rational thinking
Self-actualisation
Cope with Stress
Realistic view of the world
Good self-esteem and lack of guilt
Independent of other people
Can successfully work, love and enjoy our leisure
The more criteria you fail to meet the more abnormal you are
unrealistically high standard/sustainability - holistic
Evaluation - Deviation from ideal mental health - Limitation - Criteria is too demanding ?
(Definitions of Abnormality)
Point - The definition sets an unrealistically high standard. It is unlikely all criteria’s can be met or sustained for a long period of timemeaning everyone is abnormal
I&D - however it is a holistic approach with a criteria that covers most reasons why someone would seek help from mental health services
Based on western cukture - imposed etic
Evaluation - Deviation from ideal mental health - Limitation – Cultural Relativism ?
(Definitions of Abnormality)
Point - The criteria for ideal mental health are based on Western cultural norms. Factors are biased and desired in individualitic cultures but are not desirable in collectivist cultures
I&D - Deviation from ideal mental health may suffer from imposed etic, where western cultures impose their own cultural ideas of the ideal mental health to other cultures
How does the DSM-5 classify phobias ?
(Characteristics of Phobia)
Definition:
Excessive fear and anxiety triggered by an object, place or situation
Fear is out of proportion to any real danger
Classification:
Specific phobia – phobia of an object
Social phobia – phobia of social situation
Agoraphobia – Phobia of being outside
What are the three types of characteristics of phobia ?
(Characteristics of Phobia)
Behavioural characteristics – how the disorder affects behaviour
Emotional characteristics – how the disorder affects how we feel
Cognitive characteristics – how the disorder affects how we think
What are behavioural characteritics for phobias ?
(Characteristics of Phobia)
Panic – phobic stimulus causes crying, screaming, freezing
Avoidance – make an effort to prevent contact with the stimulus. Can affect everyday life
Endurance – remains with phobic stimulus but continues experiencing anxiety
What are the emotional characteristics for phobias ?
(Characteristics of Phobia)
Anxiety – unpleasant state of high arousal
Fear – immediate and unpleasant response when encountering or thinking of the phobic stimulus
Emotional responses are unreasonable - disproportionate to danger
What are the cognitive characteristics to phobias ?
(Characteristics of Phobia)
People with phobias process stimuli differently
Selective Attention - if they can see the stimulus, they cannot look away
Irrational beliefs – may hold irrational beliefs about the phobic stimulus
Cognitive distortions – perception of the stimulus is distorted
How do we acquire phobia through classical conditioning ?
(Behaviourist Explanation of Phobia)
We learn to associate something which we do not initially fear (neutral stimulus) with something that already triggers a fear response (unconditioned stimulus)
Watson and Rayner - Caused phobia in little Albert
Neutral stimulus (NS) – Albert was given a white rat which he played with
Unconditioned Stimulus (UCS) - After, whenever they presented the rat researchers made a loud, frightening noise by banging an iron bar close to his ear
Unconditioned Response (UCR) - this creates fear
NS (rat) became associated with the UCS (loud bang)
conditioned stimulus (CS) – rat becomes the conditioned stimulus that produced fear – conditioned response (CR)
This then generalised to similar objects
How do we maintain phobias through operant conditioning ?
(Behaviourist Explanation of Phobia)
People experience negative reinforcement
Individual avoids phobic stimulus
Results in a desirable consequence – escape fear
Reinforces the avoidance behaviour and phobia is maintained
Watson/Rayner Little Albert - idiographic approach
Evaluation - Strength - Research support ?
(Behaviourist Explanation of Phobia)
Point - Watson and Rayner demonstrated the process of classical conditioning in forming phobias in Little Albert by conditioning him to fear white rats
I&D - Due to the use of a case study this utilises the idiographic approach, so meaningful generalisations cannot be made
Systematic desensitisation uses classical conditioning - flooding/neg re
Evaluation - Strength - Application to theory ?
(Behaviourist Explanation of Phobia)
Point - The treatment of Systematic Desensitisation is very successful and uses the principles of classical conditioning to help people unlearn their fears
Further - the treatment of flooding uses the principles of operant conditioning to prevent people from avoiding their phobias and stopping negative reinforcment
Bounton other factors - Seligman biological prepardness
Evaluation - Limitation - Other Explanation for Phobia ?
(Behaviourist Explanation of Phobia)
Point - Behaviourist explanation does not account for all phobias. Bounton suggests evolutionary factors play a role in phobias
Further - Seligman says humans have evolved to have ‘biological preparedness’’ which is the innate predisposition to have certain fears to ensure our survival
What is systmatic desensitisation ?
(Behaviourist Treatment of Phobia)
Therapy aims to gradually reduce anxiety through classical conditioning
Uses counterconditioning – teach a new response to the phobic stimulus
Impossible to be scared and relaxed at the same time – called reciprocal inhibition – one emotion prevents the other
what are the three processes of systematic desensitasation ?
(Behaviourist Treatment of Phobia)
Anxiety heirachy - list of situations related to phobic stimulus that provoke anxiety arranged in order from least to most frightening
Relaxation - therapist teaches patient to relax as deeply as possible
Exposure - patient is exposed to phobic stimulus while in a relaxed state. Takes place across several sessions starting at the bottom of the anxiety hierarchy. When they can stay relaxed they move up a level
What is flooding ?
(Behaviourist Treatment of Phobia)
Flooding involves exposing the patient to the phobic stimulus without any gradual build up
How does flooding work ?
(Behaviourist Treatment of Phobia)
Operant Conditioning – Stops phobic responses very quickly as no option of avoidance behaviour the patient quickly learns the phobic stimulus is harmless
Classical Conditioning – process is called extinction – learned response is extinguished when conditioned stimulus is encountered without the unconditioned stimulus. The conditioned stimulus no longer produces the conditioned response
Ethical safeguards - Not unethical but is unpleasant so full consent is needed
Gilroy systematic desensitisation study - MGrath 75% treatment success
Evaluation - Strength - Research support for systematic desensitisation ?
(Behaviourist Treatment of Phobia)
Point - Gilroy et al gave one group of participants access to systematic desensitisation and another group only relaxation techniques with no exposure. At both 3 and 33 months those who had undergone systematic desensitisation were less fearful
Further - McGrath et al found that 75% of patients with phobias were succesfully treated with systematic desensitisation
Ourgrin flooding is effective and quicker - can be traumatic
Evaluation - Strength - Flooding is very cost effective ?
(Behaviourist Treatment of Phobia)
Point - Ougrin suggests flooding is just as effective as other treatments of phobia but quicker than alternatives
Counter - It is traumatic for patients, due to this often paitents are unwilling to see the treatment through until the end
Cannot cure complex phobias - Weschler claims useful for specific/agora
Evaluation - Limitation - Neither are effective for complex phobias ?
(Behaviourist Treatment of Phobia)
Point - Some complex phobias such as social phobias are caused by cognitive factors such as irrational thinking and not learnt. The cognitive approach uses cognitive behavioural therapy which is said to be more succesful for complex phobias.
Counter - Review by Wechsler et al concluded systematic desensitisation is effective for specific phobia, social phobia and agoraphobia
What is the DSM-5’s classification of depression ?
(Characteristics of Depression)
Definition – mental disorder characterised by low mood and low energy levels
Categories of depression:
Major Depressive Disorder – severe but often short-term Depression
Persistent Depressive Disorder – long-term or recurring Depression
Disruptive Mood Dysregulation Disorder – Childhood temper tantrums
What are the behavioural charcteristics for deppression ?
(Characteristics of Depression)
Reduced activity levels - Paitent withdraws from life aspects. When severe paitents cant leave bed. Opposite symptom psychomotor agitation, paitents cant relax
Disruption to sleep - Insomnia, premature wlaking, hypersomnia
Appetite behaviour - Eating levels may increase or decrease leading to weight change
Aggression or self harm - verbally or physically aggressive. Physical aggression aimed at self
What are the emotional characteristics of depression ?
(Characteristics of Depression)
Lowered mood - Feeling sad
Anger - directed at self or others
Lowered self-esteem - some describe hating themseleves
What are the cognitive characteristics of depression ?
(Characteristics of Depression)
Poor concentration - Cant stick to a task and find it hard to make decisions
Attending to and dwelling on the negative - pay more attention to negative aspects of a situation and ignore positives. May have bias to recalling unhappy events
Absolutist thinking - Tend to think situations are all good or all bad
What is Beck’s explanation for depression ?
(Cognitive Explanations of Depression)
They process information in a way which focuses on the negative aspects of a situation and ignores the positives
Depressed people have a negative schema
If you have a negative self schema you interpret all information about yourself negatively
What is the negative triad ?
(Cognitive Explanations of Depression)
Negative self schemas cause cognitive bias, which maintain the negative triad
What is Ellis’s explanation of depression ?
(Cognitive Explanations of Depression)
Irrational beliefs cause depression
Types of irrational beliefs:
Musturbation - belief that we must always suceed
Utopianism - life is always meant to be fair
I cant stand it itis - belief it is a major disaster everytime something goes wrong
What is Ellis’s ABC model for explaning depression ?
(Cognitive Explanations of Depression)
A - Activating event - event occurs
B - Beliefs - belief is shaped by interpretation of the event and can be rational or irrational
C - Consequences - rational beliefs lead to healthy consequence, irrational beliefs lewad to unhealthy consequence
Grazioli/Terry post-natal depression study - Clark/Beck strong support
Evaluation - Strength - Research support for Beck’s explanation ?
(Cognitive Explanations of Depression)
Point - Grazioli and Terry support the view that cognitive bias and negative schemas cause depression. Assessed 65 women for cognitive vunerability and found those assesed as more vunerable were more likely to suffer post-natal depression
Further - Clark and Beck reviewed research on this topic and concluded their was strong support for all these cognitive vunerability factors
Seratonin levels cause depression - Drug therapies and SSRI’s effective
Evaluation - Limitation - Alternative explanations for depression ?
(Cognitive Explanations of Depression)
Point - There is evidence to suggest that depression is caused by biological factors such as neurotransmitters. Researchers found lower levels of seratonin in patients with depression
Further - Drug therapies and SSRI’s which increase the level of seratonin are found to be effective in the treatment of depression which provides more support for the role of neurotransmitters in the dvelopment of depression
cognitive/rational emotive behaviour therapy - doesnt account social
Evaluation - Strength - Practical application to therapy ?
(Cognitive Explanations of Depression)
Point - Cognitive explanations for depression have been used to develop effective treatments for depression, cognitive behavioure therapy and rational emotive behaviour therapy which attempt to identify and challenge irrational thoughts
Counter - CBT has been criticised for its overemphasis on the role of cognitions as the cause of depression as the treatment doesnt take into account other factors such as social circumstances which could add to a persons depression
What is cognitive behavioural therapy ?
(Cognitive Treament of Depression)
CBT - most commonly used treatment for depression
- Set the end goal of what paitents want from therapy
- Begin with assesment where paitent and therapist classify problems
- Identify negative/irrational thoughts
- Challenge using Ellis rational emotive behavior therapy/Becks cognitive behaviour therapy
What is Becks cognitive behaviour therapy ?
(Cognitive Treament of Depression)
Aims to identify negative thoughts and challenge them
Identify negative thoughts about,world,self
Once thoughts are identified - They do this by testing if these thoughts are real
The therapists set homework to challenge negative thoughts
This is called ‘paitent as a scientist’ as they ‘test’ their reality
The therapist then uses evidence in future discussions when paitents make
What is the updated version of Ellis’s rational emotive behavioural therapy ?
(Cognitive Treament of Depression)
REBT extends the ABC model to the ABCDE model
D – Dispute
E – effect
Challenges irrational beliefs through dispute:
Logical dispute - therapists questions the logic of a persons thought
Empirical dispute - therapist seeks evidence for a persons thoughts
The intended effect is to change irrational beliefs
March CBT effective as Anti D - Cannot help severe cases
Evaluation - Strength - CBT is an effective treatment ?
(Cognitive Treament of Depression)
Point - March et al compared the effectiveness of CBT to anti-depressants, findings were that CBT was found to be just as effective as anti-depressants
Counter - CBT may not work for the most severe cases of depression as students cant motivate themselves to engage or pay attention to the session and may need to use anti-depressants first before commencing CBT
CBT Overemphasis on role cognition - Focus mind minimises circumstances
Evaluation - Limitation - Overemphasis on cognition ?
(Cognitive Treament of Depression)
Point - CBT has been criticised for its overmephasis on the role of cognition as the cause of depression. CBT does not account for other factors such as social circumstances
I&D - Ethical implications of CBT must be condidered as the risk of focusing on what is happening in the mind may minimise the importance of the circumstances of a paitent. Paitents suffering from abuse or poverty need to change their circumstances but may become demotivated to do so
CBT less suitable if rigid to change - Rosenweig therapist and paitent
Evaluation - Limitation - Individual differences ?
(Cognitive Treament of Depression)
Point - CBT seems to be less suitable for people with high levels of irrational beliefs that are ridgid and resistant to change. Also some people dont want the direct sort of advice CBT offers
Further - Rosenweig found CBT itself is not the reason people are succesful with therapy or not, and the key to succesful therapy is a positive relationship between therapist and paitent
What is the definition and classification of OCD ?
(Characteristics of OCD)
A condition characterised by obsessions and/or compulsive behaviour
Classification:
70% have both obsessions and compulsions
20% experience just obsessions
10% experience just compulsions
What is the cycle of OCD ?
(Characteristics of OCD)
What are the behavioural characteristics of OCD ?
(Characteristics of OCD)
Compulsions:
Compulsions are repetitive - sufferer feels forced to repeat behaviour
Compulsions redsuce anxiety - compulsive behaviour is carried out to reduce irrational anxiety that there obsession causes
Avoidance - Attempt to reduce anxiety by situations which create anxiety
What are the emotional characteristics of OCD ?
(Characteristics of OCD)
Anxiety and distress - strong anxiety accompanies obsessions and compulsions. Obsessive thoughts are unpleasant and axiety comes with these. The urge to repeat compulsions creates anxiety
Accompanying depression - OCD is accompanied by depression so low mood and lack of enjoyment
Guilt and disugust - irrational guilt over minor moral issues or disgust
What are the cognitive characteristics of OCD ?
(Characteristics of OCD)
Obsessive thoughts - 90% of sufferers have thoughts that occur over and over again, always unpleasant
Insight into excessive anxiety - sufferes aware that there compulsions are irrational
Cognitive strategies to deal with anxiety - all paitnets have coping strategeis to help manage anxiety
What is the genetic explanation ?
(Biological Explanation of OCD)
Suggests OCD can be inherited through specific genes
Tsylor suggests that OCD is polygenic and up to 230 genes could be involved
What are the two specific genes involved in the genetic explanation ?
(Biological Explanation of OCD)
SERT gene - effects transport of seratonin - a neurotransmitter involved in OCD
Variation causes lower levels of seratonin to be active within the brain - OCD paitents normally have this
COMT gene - effects production of dopamine
Variation causes higher levels of dopamine which is common in OCD paitents
What is the neural explanation ?
(Biological Explanation of OCD)
Seratonin - lower levels are associated with OCD
Pigott et al found antidepressants which increase the level of seratonin are effective for treating OCD
Dopamine - Higher levels are associated with OCD symptoms such as compulsive behaviour
How does the neural explanation of brain structure effect OCD ?
(Biological Explanation of OCD)
Lateral frontal lobe - responsible for logical thinking and decision making - found to function abnormally in OCD paitents
Parahippocampal Gyrus - associated with processing unpleasant emotions - functions abnormally in OCD paitents
Lewis OCD runs in families - Nestadt 5 times more likely if first degree
Evaluation - Strength - Genetic - Research support from family studies ?
(Biological Explanation of OCD)
Point - Lewis found that 37% of paitents with OCD had parents with the disorder and 21% had siblings with the disorder
Further - Nestadt et al found individuals with a first degree relative with OCD are up to five times more likely to develop the disorder over there lifetime than those who dont
AD’s purely seratonin reduce OCD - OCD caused by lack of seratonin /opp
Evaluation - Strength - Research support for neural ?
(Biological Explanation of OCD)
Point - Antidepressants that work purely on the serotonin system which increase the level of the neurotransmitter are effective in reducing OCD symptoms, suggesting seratonin is involved is OCD
Counter - Unclear whether lack of serotonin causes OCD or if having OCD causes serotonin to not go from one neuron to the next
Learning crucial development of OCD - Behavioural treatments successful
Evaluation - Limitation - Ignores other explanations ?
(Biological Explanation of OCD)
Point - Behaviourist Approach – two-process model - learning is crucial in developing OCD – classical conditioning causes patient to learn fear of the stimulus, stimulus is then associated with anxiety. Behaviour is maintained through operant conditioning
Further - behavioural treatments for OCD similar to systematic desensitisation have been successful. Findings show symptoms improved for 60-90% of individuals
How does drug therapy work ?
(Biological Treatments of OCD)
Aims to increase or decrease levels of neurotransmitters
How is diffusion different in OCD patients ?
(Biological Treatments of OCD)
Goes across cleft BUT doesn’t make it to postsynaptic receptor site and gets reabsorbed back into presynaptic neuron, gets broken down and reused
How does the anti-deppressant SSRI’s work ?
(Biological Treatments of OCD)
SSRI – Selective Serotonin Reuptake Inhibitor
SSRIs prevent the re-absorption and breakdown of serotonin so it increases its levels in the synapse to allow serotonin to go to the postsynaptic neuron
This compensates for what is wrong with serotonin system in OCD
Takes 3 to 4 months of daily use to have an effect on symptoms
How does combining SSRI’s with other treatments work ?
(Biological Treatments of OCD)
Drugs are combined with CBT
Drugs reduce emotional symptoms
This allows paitents to engage with CBT more effectively
What are the other types of anti-depressant’s ?
(Biological Treatments of OCD)
Tricyclics – older antidepressant – same effect on serotonin system SSRIs have. Has more severe sideffects and is only used when patients dont respond to SSRI’s
SNRIs – serotonin noradrenaline reuptake inhibitors – newer antidepressant – increases levels of serotonin and noradrenaline, is only used for those that dont respond to SSRI’s
Soomro SSRI comparison placebo - side effects
Evaluation - Strength - Effective at treating symptoms ?
(Biological Treatments of OCD)
Point - Soomro et al reviewed studies comparing SSRIs to placebos in treatment of OCD, all 17 studies showed significantly better results for SSRIs than for placebo conditions
Counter - some patients suffer side effects of SSRIs such as indigestion and blurred vision
Drug therapy is cheap - non-disruptive paitent life
Evaluation - Strength - Drugs are cost effective ?
(Biological Treatments of OCD)
Point - Drug treatments are cheap compared to psychological treatments, and are good value for public healthcare systems such as the NHS this means many docotrs may prefer to use drugs as treatment
Further - Drug therapies are non-disruptive to patients’ lives, drugs can be taken until symptoms decline without having to engage with the hard work of psychological therapy. CBT requires motivation to engage in the session
Evaluation - Limitation - Ignores causes of OCD and only treats symptoms ?
(Biological Treatments of OCD)
Point - OCD is not only caused by neurotransmitters, they can be caused by traumatic life experience. Drug treatments only treat the symptoms not all the possible causes. Once paitents stop taking the drug they are prone to relapse
Further - behavioural treatments for OCD similar to systematic desensitisation have been successful, symptoms improved for 60-90% of individuals, these would treat the causes not just symptoms
