Psychopathology Flashcards
What are the four ways to define abnormality
Statistical infrequency
Deviation from social norms
Failure to function adequately
Deviation from ideal mental health
What is statistical infrequency, with example
Defining abnormality in terms of number of times it has been observed.
Behaviour that is rarely seen is abnormal.
e.g, average IQ is between 85 and 115. 2% of people score below 70. This 2% would be seen as intellectually abnormal, and be diagnosed with intellectual disability disorder.
What is a strength of statistical infrequency
RWA
Useful in diagnosing things like depression (using BDI) and intellectual disability disorder.
What are two negatives of statistical infrequency
Abnormal does not always mean negative
IQ scores above 130 are just as rare as below 70, but this is not regarded as undesirable or requiring treatment.
Social stigma
Abnormality through not fitting with the majority could lead to social consequences for the patient.
This means labelling someone as abnormal just because they are statistically unusual
What is deviation from social norms
When a person behaves in a way that is different from how they’re expected to behave.
What is an example of deviating from social norms
Laughing at a funeral
What is a strength of deviation from social norms
Flexibility
It is flexible dependent on situation and age.
A social norm is to wear full clothing whilst out, but a bikini is acceptable on a beach.
What is a limitation of deviation from social norms
Cultural relativity
Norms vary across cultures.
Hearing voices is acceptable in some cultures, but in the Western world, this is seen as abnormality.
This means it is difficult to judge deviation from social norms across different contexts.
What is failure to function
An inability to deal with demands of everyday life.
What is an example of failure to function
Not being able to maintain basic hygiene or nutrition.
What are 2 advantages of failure to function
Behaviour is easily observable
Failure to function adequately can be seen by others around the individual because they may not get out of bed on a morning.
This means that problems can be picked up by others and they can help intervene.
Consideration of how the individual feels
This definition is focused on the individual and how they are managing in everyday life from their perspective.
If someone feels as though they are struggling they will be deemed abnormal and get help.
What is a limitation of failure to function adequately
Failure to function may not be a sign of abnormality
In some cases, failure to function is a normal response, for example in bereavement.
It is unfair to give someone a label for reacting normally to difficult circumstances
What is ideal mental health
A criteria that a person should have to be in a state of ‘ideal mental health’
Who theorised ideal mental health
Jahoda (1958)
What is the criteria for ideal mental health
Positive attitude towards self
Self-actualisation
Autonomy
Resistance to stress
Environmental mastery
Accurate perception of reality
What are 2 strengths of ideal mental health
Comprehensive
Includes a range of criteria for mental health, covering most reasons why someone may need help.
This gives professionals the opportunity to have meaningful discussions with patients on their mental health.
Clear goals
Gives a clear checklist for patients to try to reach in order to have an ideal mental health.
This can help treatment and recovery plans for those with mental disorders
What are 2 limitations of ideal mental health
Cultural relativity
Differing value placed on different criteria across different countries.
e.g, in Germany, there is high value placed on independence, while low value placed in Italy.
This means it is difficult to generalise ideal mental health to all people.
Unrealistic standards
Very few people will tick all of Jahoda’s criteria, and almost nobody will maintain them for long.
This makes majority of the population abnormal, which is paradoxical as then that would be normal.
What is a phobia
A type of anxiety disorder.
An strong, irrational fear of something.
What are the three types of reaction a person can have to a phobia
Behavioural
Cognitive
Emotional
What happens with behavioural response to a phobia
Panic - crying/screaming
Avoidance - considerable effort to avoid contact with phobic stimulus.
Endurance - alternative to avoidance, involves remaining with phobic stimulus and continuing to experience anxiety
What are some emotional responses to a phobia
Anxiety - unpleasant state of high arousal
Fear - immediate response when phobic stimulus is thought of
Unreasonable emotional response - disproportionate reaction to the stimulus, e.g an arachnophobic having strong emotional response to very small spider.
What are cognitive responses to a phobia
Selective attention to phobic stimulus - hard to look away from it
Irrational beliefs
Cognitive distortions - e.g, a fear of belly buttons as they are ‘ugly’
What is depression
Depression is a mood disorder, where the suffering experiences low mood and low energy levels.
What are behavioural characteristics of depression
Decreased activity levels
Disruption to sleep and eating levels
Aggression and self harm
What are emotional characteristics of depression
Lowered mood
Anger
Lowered self-esteem
What is OCD
An anxiety disorder and is characterised by experiencing persistent and intrusive thoughts which occur as obsessions, compulsions or sometimes both.
What are behavioural characteristics of OCD
Repetitive compulsions
Compulsions reduce anxiety
Avoidance of anxiety triggering situations
What are emotional characteristics of OCD
Anxiety and distress
Depression
Guilt and disgust
What are cognitive characteristics of OCD
Obsessive thoughts
Cognitive coping strategies, like meditation
Poor concentration
Focus on negatives
Absolutist thinking
What does behaviourist explanation for phobias believe
That phobias are learned through classical conditioning and maintained by operant conditioning (Mowrer 1960)
What is the two process model
Classical and operant conditioning working together to learn and affirm a phobia
What is a research support for behavioural explanation for phobias
Watson and Rayner (1920) ‘Little Albert’ study
What was Watson and Rayners study called
‘Little Albert’ study
What was the process of Watson and Rayners study
Whenever Albert played with a white rat, a loud noise was made close to his ear (UCS), creating a fear response (UCR).
Rat (NS) did not create a fear response until the noise and rat were paired together several times.
Albert showed a fear response (CS) every time he came into contact with the rat (now a CS)
Albert also had generalised fear to other white furry objects
How does operant conditioning maintain phobias
Avoiding situations with the stimulus negatively reinforces the phobia, e.g a person scared of lifts takes the stairs, which relieves anxiety.
What are 2 strengths of the two-process model/behavioural approach to explaining phobias
RWA
Idea that phobias are maintained by avoidance helps to explain why exposure therapies work, as it removes the negative conditioning used to maintain phobias.
Evidence linking phobias to bad experiences
De Jognh et al (2006) found 73% of dental phobics had experienced a trauma to do with dentistry.
This suggests that NS of dentistry with the UCS of pain lead to the phobia.
What are 2 limitations of the behavioural approach to explain phobias
Unable to explain cognitive aspects of phobias
Behavioural explanation is geared towards explaining behaviour, such as avoidance, while ignoring the significant cognitive components like irrational beliefs.
Not all phobias are learnt
Many people have a phobia of snakes in places where very very few people have any experiences with snakes, e.g UK. Additionally, not all frightening experiences lead to phobias.
This means behavioural explanation cannot explain all phobias.
What are the two behavioural approaches to treating phobias
Systematic desensitisation (SD)
Flooding
What is systematic desensitisation based on
Classical conditioning
What does systematic desensitisation therapy aim to do
Gradually reduce anxiety through counterconditioning
What is the process of systematic desensitisation
Therapist and client design an anxiety hierarchy.
Client is taught relaxation techniques like deep breathing.
Works through the anxiety hierarchy with the following process for each step.
Phobia is learned and becomes the conditioned stimulus (CS)
The patient has the CS paired with relaxation, and this feeling becomes the new CR.
Relies on reciprocal inhibition.
What is reciprocal inhibition
The idea that it is not possible to be afraid and relaxed at the same time, so one emotion prevents the other.
What is the anxiety hierarchy
Fearful stimuli arranged in order from least to most frightening, e.g a small spider up to a tarantula
What is flooding
Exposing a person with a phobia to the phobic object with no gradual build up.
What is an example of flooding
Person with arachnophobia having a tarantula crawl over their hand until they can relax fully.
What is a strength of systematic desensitisation (SD)
Evidence of effectiveness
Gilroy et al (2003)
Followed 42 people who went through SD for arachnophobia. On follow up, those that had SD were less fearful than a control group.
What is a limitation of systematic desensitisation
Time consuming
Takes a long time to complete all stages, from anxiety hierarchy, breathing techniques and working up the hierarchy.
This then means the therapy is more expensive, making it less accessible to lower income patients.
What is a strength of flooding
Cost effective and quick
Flooding can work in just 1-3 hours, meaning patients do not need to pay as much or donate as much time in comparison to other treatments like SD.
What is a limitation of flooding
Can be traumatic
Schumacher et al (2015) found that both participants and therapists rated flooding as more stressful than SD.
Thus, there can be ethical concerns about willingly causing stress (which can be offset with informed consent). This suggests that therapist may avoid using this treatment.
What does the cognitive approach believe to explain depression
Depression is due to irrational thoughts from maladaptive internal mental processes
What did Beck (1957) theorise
Negative triads
What does Beck believe causes depression
That some people were more prone to depression because of faulty information processing.
Negative self schema, which interprets all information about themselves in a bad way.
What are the three negative schemas of the negative triad
The self - feeling inadequate or unworthy
The world - thinking people are always hostile
The future - ‘things will always turn out badly’
What is Beck’s negative triad and when is it developed
Three schemas with an automatic negative bias
Developed in childhood to give persistent biases in adulthood, leading to cognitive distortions
What are 2 cognitive distortions in depression
Overgeneralisation - the belief that one negative experience causes assumption that same thing will always happen
Selective abstraction - mentally filtering out positive experiences and focusing on the negative. e.g, posting on social media and getting lots of positive attention, but focusing on the one negative comment.
Who theorised the ABC model
Ellis
What does ABC stand for in ABC model
Activating event - can be anything that happens to someone
Belief - people without depression have rational beliefs about A, depressed people have irrational beliefs about A.
Consequence - rational beliefs lead to positive consequences, irrational leads to negative
What is an example of a rational ABC model
A - Break up
B - Weren’t right for each other, want different things, etc
C - Look for new healthy relationship
What is an example of an irrational ABC model
A - Break up
B - Fundamentally unlovable, never be able to find someone
C - Avoid relationships altogether, or get into a new unhealthy one
What is mustabatory thinking
Irrational thinking where person does not accept we don’t live in a perfect world.
What are the three musts in mustabatory thinking
I must do well
You must treat me well
The world must be easy
What is a research support of Becks model
Clark and Beck (1999)
Concluded negative vulnerabilities like negative schema are more common in depressed people.
Shows there is an association between cognitive vulnerability and depression
What is a second strength of Becks model (not research support)
RWA
Screening for depression by assessing cognitive vulnerability
Understanding this cognitive vulnerability can allow those with high risk of depression to be monitored, and can be applied to CBT to alter these cognitions.
What is a strength of Ellis’ model
RWA in REBT therapy
Rational emotive behaviour therapy can change negative beliefs and relieve symptoms of depression.
What are two limitations of Ellis’ model
Only explains reactive depression
In many cases, depression has no obvious triggers, which is endogenous depression.
Places blame on patient
Can further depression as patient may feel responsible for their own condition
What is reactive depression
A form of depression triggered by activating events.
What is endogenous depression
Depression with no clear root trigger
What is CBT
Cognitive behaviour therapy
Most common psychological treatment for depression
Cognitive - challenge irrational thoughts
Behaviour - change behaviour so it is more effective
What is the process of CBT
Challenge negative thoughts
Client encouraged to test reality of irrational beliefs through ‘homework’
Taught mindful meditation to combat depression
What is REBT
Ellis’ therapy
Rational emotive behaviour therapy
Extends ABC model to ‘ABCDE’ model by adding dispute and effect
What is the two parts to REBT therapy
Challenge irrational thoughts:
- Empirical argument; disputing evidence to support the irrational belief
- Logical argument; disputing whether negative thought actually follows the facts
Behavioural activation:
When individuals are depressed they tend to avoid difficult situations.
Behavioural activation helps to gradually reduce avoidance and isolation, and increase engagement in activities to improve mood
What is a strength of CBT
March et al (2007)
Evidence of effectiveness
Compared CBT against antidepressants and a combination of CBT and antidepressants against a control group.
After 36 weeks, 81% of CBT group, 81% of antidepressant group and 86% of combination group were significantly improved.
This makes CBT a good choice for first treatment of depression
What is 2 limitations of CBT
High relapse rates
Ali et al (2017)
Assessed depression for one year following a CBT course
42% relapsed in 6 months and 53% relapsed within a year.
This means CBT may not be a permanent fix
Time and money
CBT requires patient to give up at least an hour a week for the duration of the course, and pay usually a large sum of money (unless NHS treatment is taken).
This means it may not be possible for everybody.
What is the two biological explanations for OCD
Genetic explanation
Neural explanation
What is the genetic explanation for OCD
Believing that OCD is inherited from our parents through ‘candidate genes’ that may cause the illness
What are the two candidate genes for OCD
COMT gene
SERT gene
What is the COMT gene
Associated with production and regulation of dopamine.
What is different about COMT gene in OCD sufferers
Overactive, producing higher levels of dopamine.
What is the SERT gene
Associated with transport of serotonin
What is different about SERT gene in OCD patients
Causes lower levels of serotonin
What is the neural explanation for OCD
Focus on neurotransmitters and brain structures
What neurotransmitters are implicated in OCD
Abnormal levels of dopamine and serotonin
What is serotonins function
To regulate mood
What levels are dopamine/serotonin at to influence OCD
Serotonin - very low
Dopamine - very high
How can brain structures influence OCD
Damaged or faulty frontal lobes
What is frontal lobe responsible for
Decision making and logical thinking
What is a strength of genetic explanation for OCD
Twin studies
Nestadt et al (2010)
Found concordance rates of 68% in identical twins (MZ) and 31% in non identical twins (DZ)
This means people who are genetically similar are more likely to share OCD, supporting idea of genetic vulnerability.
What is a limitation of genetic explanation for OCD
Does not account for environmental risk factors
Cromer et al (2007) found over 50% of OCD sufferers experienced a traumatic event.
This means genetic vulnerability only offers a partial explanation for OCD.
What is a strength of neural explanation
Antidepressant research
Antidepressants that are based on serotonin (SSRIs) reduce OCD symptoms. This suggests that neurochemical factors, specifically serotonin, is a factor in OCD
What is a limitation of neural explanation
Correlation and causality
While we can see that brain structures and neurochemical levels are altered in patients with OCD, we cannot know if these changes are due to OCD, or were the cause of it.
What does SSRI stand for
Selective serotonin reuptake inhibitors
What do SSRIs do
Prevent reabsorption and breakdown of serotonin in the brain.
This increases its levels in the synapse and so serotonin continues to stimulate.
This compensates for the decrease of serotonin causing OCD
What are drug treatments (SSRIs) usually combined with when treating OCD
CBT
What are alternatives to SSRIs
Tricyclics
SNRIs
What are two strengths of drug therapy
Effectiveness
Soomro et al (2009)
Reviewed 17 studies of SSRIs for treatment of OCD. All 17 studies showed better outcomes following SSRIs than placebos.
Typically symptoms were reduced by around 70%.
This shows drugs are highly effective and can be used widely
Low money and time
In general cheaper than psychological treatments, meaning it is good value for the NHS and patients. SSRIs also do not disrupt patients lives as they don’t require time and energy like therapy.
This means both doctors and patients may prefer drug therapy.
What is a limitation of drug therapy
Side effects
A minority of people experience no benefit from SSRIs, and have side effects like indigestion and blurred vision, though these are usually temporary.
This means that it can reduce quality of life, reducing patients will to carry on with the treatment.
