Psychopathology Flashcards
1
Q
How many Definitions of Abnormality are there?
A
4
2
Q
What are ‘norms’?
A
Unwritten rules or expectations in society
3
Q
What is an Individualist Culture?
A
A culture that values individual needs and achievements
4
Q
What is a Collectivist Culture?
A
A culture that values family and togetherness
5
Q
What is ‘Abnormal’?
A
Someone who does not adhere to what society deems to be acceptable within the community
6
Q
What are the 4 Definitions of Abnormality?
A
Statistical Infrequency
Failure to Function Adequately
Deviation from Social Norms
Deviation from Ideal Mental Health
7
Q
What is Statistical Infrequency?
A
Any behaviour that is statistically rare - classified by being more than 2 standard deviations away from the norm
8
Q
What is Statistical Infrequency as a Definition of Abnormality?
A
When someone displays statistically rare behaviour or characteristics, they can be defined as abnormal
9
Q
What is an example of Statistical Infrequency?
A
IQ and Intellectual Disability Disorder (Mental Retardation)
- IQ has normal distribution and an average of 100
- Most people have an IQ between 85 and 115
- 2% of people have an IQ below 70
- These people are statistically rare, so are classed as abnormal
People with IQ above 115 can also be statistically rare, so classed as abnormal
10
Q
Evaluate Statistical Infrequency as a Definition of Abnormality
A
Good - Real World Application
- Can be used as a diagnostics tool
- It is objective and scientific
- It is appropriate for many mental illnesses
Bad - Not all abnormal behaviour is infrequent
- Depression is experienced by 10% of the population
- This means it is not technically statistically infrequent
- The behaviour is still abnormal
Bad - Not all infrequent behaviour is abnormal
- High IQ might be statistically rare
- It also might be desirable
- Therefore, it might be classed as abnormal although it is a positive trait
11
Q
What is Deviation from Social Norms?
A
Behaviour varying from what is seen as acceptable behaviour within a society
Social norms vary depending on culture and generation
Social norms separate socially desirable and undesirable behaviours
12
Q
What is Deviation from Social Norms as a Definition of Abnormality?
A
Someone who varies from what is seen as acceptable behaviour within a society is classed as abnormal
13
Q
What is an example of Deviation from Social Norms?
A
OCD
- Someone with OCD may have an obsession with germs
- They might wash their hands hundreds of times, when the social norm is to wash them once
- This action means they cannot live a normal life or fit in with societal explanations, so they would be labelled as abnormal
14
Q
Evaluate Deviation from Social Norms as a Definition of Abnormality
A
Bad - Social norms change depending on culture
- Social norms in individualist cultures might be different to those in collectivist cultures
- If we try and apply one set of norms everywhere so we can diagnose people as abnormal, there will be culture bias and imposed etics
- This suggests there is an element of situational relativism to this definition
Bad - Norms change over time and could lack temporal validity
- We cannot truly define anything as abnormal when current beliefs about what constitutes as abnormal may change
- Views on being gay have changed over time, and so who says what is abnormal now and whether it may stay abnormal over time?
Bad - Many individuals who break social norms are not seen as abnormal
- For example, people who cross-dress regularly break social norms, but they are seen as eccentric and cool, and they are popular rather than being seen as mentally ill
Good - Considers the social dimensions of a behaviour
- We understand that a behaviour might be normal in one situation but not in another
15
Q
What is Failure to Function Adequately?
A
When someone’s behaviour suggests they cannot cope with everyday life
16
Q
Who are the researchers in Definitions of Abnormality?
A
Rosenhan and Seligman
Jahoda
17
Q
What is Failure to Function Adequately as a Definition of Abnormality?
A
When someone’s behaviour suggests they cannot cope with everyday life, they are seen to be abnormal
They might be unable to maintain basic standards of nutrition, hygiene, a job or a relationship
Rosenhan and Seligman suggested there are signs to say when someone is not coping, and that the more of these someone shows, the more abnormal they are
18
Q
What did Rosenhan and Seligman do?
A
They created a list of signs someone is failing to function adequately
19
Q
What are Rosenhan and Seligman’s signs of Failure to Function Adequately?
A
Failure to conform to interpersonal rules (can’t maintain personal space)
Causes observer discomfort
Experiencing personal distress
Irrational or dangerous behaviours to themselves and others
20
Q
What is an example of Failure to Function Adequately?
A
Depression
- They might not do things they used to before (work, get out of bed, shower)
- Their interference with functioning might lead to personal distress
- They might cause observer discomfort due to worrying their friends and family
21
Q
Evaluate Failure to Function Adequately as a Definition of Abnormality
A
Good - Takes the patient’s experience into account and can be used for diagnosis
- It allows the assessment to be made from the patient’s point of view
- They are objectively judged through a criteria
- Priorities can be made from the number of symptoms to decide treatment
Bad - Abnormal behaviour is not always linked to dysfunction
- Harold Shipman
- He murdered 215 people but maintained a prestigious image as a Doctor
- He maintained his relationships and work showing no failure to function adequately
- Suggests there may be other factors
Bad - Dysfunction may not always be abnormal
- If someone is grieving or stressed they might display some of Rosenhan and Seligman’s signs
- They might not be abnormal, suggesting that there may be other factors that determine whether or not someone is abnormal
22
Q
What is Deviation from Ideal Mental Health?
A
Different mental health from mental health that is considered to be normal within a society.
23
Q
What is Deviation from Ideal Mental Health as a Definition of Abnormality?
A
It suggests that any deviation from normal mental health is abnormal. It uses Jahoda’s criteria for Ideal Mental Health to determine whether or not someones mental health is abnormal
24
Q
Who is the researcher for Deviation from Ideal Mental Health?
A
Jahoda
25
What did Jahoda do?
Created a criteria for Ideal Mental Health, so we can identify deviations
26
What does Jahoda's Criteria for Ideal Mental Health include?
We...
- Have no symptoms or distress
- Are rational and perceive ourselves accurately
- Self-actualise (can reach our full potential)
- Can cope with stress
- Have a realistic view of the world
- Have good self-esteem and lack guilt
- Are independent of others
- Can successfully work, love and enjoy our leisure
27
What is an example of Deviation from Ideal Mental Health?
Depression
- They have irrational self-perception
- They can not cope with stress
- They have an unrealistic view of the world
- They experience symptoms such as distress
Therefore they deviate from Ideal Mental Health
28
Evaluate Deviation from Ideal Mental Health as a Definition of Abnormality
Good - Takes a positive approach to mental problems
- It focuses on what is desirable rather than what is undesirable
Good - Standardised and comprehensive
- Jahoda's criteria covers most reasons we seek help
- It is a standardised list, meaning it can be used by everyone
Bad - Demanding
- The criteria are too demanding
- Most people do not meet all ideals everyday, so we should all be classified as abnormal
29
What approach is Phobias?
Behavioural
30
What are Phobias?
Excessive fear and anxiety that is triggered by an object, place or situation.
The extent of the fear is out of proportion to any real danger presented by the phobic stimulus.
31
What are 3 types of Phobias? (*)
Specific Phobias - phobias of an object or situation
Social Phobias - phobias of a social situation
Agoraphobia - phobia of being outside or in a public place
32
What are the 3 types of characteristics of phobias, depression and OCD?
Behavioural
Emotional
Cognitive
33
What are 2 Behavioural Characteristics of Phobias?
Panic
Avoidance
34
What does the Behavioural Characteristic of Phobias 'Panic' include?
Physical reactions such as screaming, running away or freezing
35
What does the Behavioural Characteristic of Phobias 'Avoidance' include?
Deliberately going out of their way to prevent coming into contact with the phobic stimulus
This can interfere with their daily life
36
What are 2 Emotional Characteristics of Phobias?
Anxiety and Fear
Unreasonable Emotional Response
37
What does the Emotional Characteristic of Phobias 'Anxiety and Fear' include?
They will experience an unpleasant state of high arousal that prevents them from relaxing or experiencing positive emotions, and an immediate unpleasant response when thinking about the phobic stimulus.
38
What does the Emotional Characteristic of Phobias 'Unreasonable Emotional Response' include?
Their emotional responses are wildly disproportionate to the danger posed by the phobic stimulus
39
What are 2 Cognitive Characteristics of Phobias?
Selective Attention
Irrational Beliefs
40
What does the Cognitive Characteristic of Phobias 'Selective Attention' include?
People will struggle to focus on anything else when the phobic stimulus is in sight
41
What does the Cognitive Characteristic of Phobias 'Irrational Beliefs' include?
People have beliefs about the stimulus that are not in keeping with reality
42
What are all the Characteristics of Phobias?
Behavioural:
- Panic
- Avoidance
Emotional:
- Anxiety and Fear
- Unreasonable Emotional Response
Cognitive:
- Irrational Beliefs
- Selective Attention
43
What is the Behavioural Approach to Explaining Phobias?
The 2 Process Model
44
What is the 2 Process Model?
The behavioural approach to explaining phobias
It suggests we learn Phobias through Classical Conditioning and maintain them through Operant Conditioning
45
What is the first process in the 2 process model?
What does it include/how does it work?
1) Acquiring Phobias
Classical Conditioning
It suggests we learn through association through classical conditioning
Mapping:
Phobic Stimulus = Neutral Stimulus --> No Response
Experience leading to Unconditional Response of Fear = Unconditional Stimulus
UCS --> UCR Fear
UCS + NS --> UCR of Fear
NS becomes a Conditioned Stimulus with a Conditioned Response of Fear
46
What case study can be used to support the 2 process model?
Little Albert
- Watson and Rayner
- Acquired a phobia of fur through association of animals and loud noises:
White Rat (NS) --> NR
Loud Noise (UCS) --> UCR of Fear
White Rat (NS) + Loud Noise (UCS) --> UCR of Fear
White Rat (CS) --> CR of Fear
They found his phobia then generalised to all furry objects
47
What is the second process in the 2 Process Model?
What does it include/how does it work?
2) Maintenance
Operant Conditioning (Negative Reinforcement)
Negative Reinforcement is used to maintain a phobia:
- a person avoids their phobic stimulus (avoidance behavioural characteristic)
- this will relieve their unpleasant anxiety
- the temporary removal of anxiety makes them likely to repeat the avoidance behaviour
- this means they will reinforce and maintain their phobia
48
What are the 2 processes in the 2 process model?
1) Acquisition through Classical Conditioning
2) Maintenance through Operant Conditioning (Negative Reinforcement)
49
Evaluate Explanations of Phobias
Good - Real World Application
- Knowing how association and negative reinforcement works in phobias helps us to tailor treatments to try and undo or combat their associations
Bad - Not all Bad Experiences lead to phobias
- Some people might not form phobias through a bad experience
- For example, someone might be badly injured competing in a sport but will return to that sport after their injury with no phobias
- This questions the validity of this explanation and suggests personality also factors in to the acquisition of Phobias
Bad - Not all Phobias are from Bad Experiences
- Some phobias are of things we have never experienced
- e.g. death, sharks, or snakes when you do not live near any snakes or sharks
Strength - Research Support
- Little Albert
- He demonstrated how frightening experiences can lead to the acquisition of Phobias
- This gives the 2 process model validity as it has been demonstrated in the real world
50
What are the Behavioural Approaches to Treating Phobias?
Flooding
Systematic Desensitisation
51
How many Behavioural Approaches are there to Treating Phobias?
2
52
What are the aims of the Behavioural treatments of Phobias?
They aim to counter-condition the phobia by associating the phobic stimulus with relaxation instead of fear
They also prevent the person from avoiding their phobic stimulus to prevent any more maintenance or reinforcement
53
What happens in Systematic Desensitisation?
There are 3 processes:
1) Anxiety Hierarchy
- the patient and therapist create a list of situations related to the phobic stimulus that would provoke anxiety
- they place them in order from least to most frightening
2) Relaxation Techniques
- the therapist teaches the client relaxation techniques so they can relax deeply and quickly to prevent fear
- these could include meditation, breathing exercises or even drugs such as Valium
3) Exposure
- the patient is exposed to the phobic stimulus while practicing the relaxation techniques
- they start from the bottom of the hierarchy and work their way up over several sessions until they can stay relaxed in situations high on the anxiety hierarchy
54
What are the 3 processes in Systematic Desensitisation?
1) Anxiety Hierarchy
2) Relaxation Techniques
3) Exposure
55
Evaluate Systematic Desensitisation as a Behavioural Approach to Treating Phobias
Good - Real World Application
- it has been proven effective in phobias where the phobic stimulus can be identified
- it is also versatile and suitable for different patients, such as those with learning difficulties
- the patients are in control and it is not complex
Good - Acceptable to patients
- the patients are likely to complete the treatment due to it being manageable and them being in control
- suggests it has good real world application (external validity)
Bad - Not cost effective
- the patients only move on when they are ready
- they can move back down again if they start to feel uncomfortable
- this could mean it takes a long time for each patient to complete their treatment, meaning there could be negative implications for the economy:
taking time off work (bad for company)
paying for the treatment (taxes)
long waiting list
- this potentially means it uses too many resources
Bad - Less suitable for Social Phobias
- it is difficult to complete with phobias that have never been experienced (death, shark bites), or with social phobias such as agoraphobia
56
What happens in Flooding?
The patient experiences immediate exposure to the phobic stimulus with no gradual build up
The senses are flooded with thoughts, images and experiences of the phobic stimulus, making it a very frightening and unavoidable situation
It stops phobic responses quickly as there is no option for avoidance behaviour
57
What is the key process in Flooding?
Extinction
58
What is Extinction in treatments of Phobias?
Learning that the stimulus is harmless as the phobic stimulus is encountered without the unconditioned stimulus (e.g. a dog is experienced without being bitten)
This then means the conditioned stimulus no longer produces the conditioned response of fear
59
Evaluate Flooding as a Behavioural Approach to Treating Phobias
Good - Cost Effective
- it has quick effects of extinguishing
- because it is quick it takes less time and money
Bad - Can be Traumatic for Patients
- flooding produces high levels of fear with no escape
- patients might not realise how much of the phobic stimulus will surround them, and it might worsen their phobias before it can solve it
- this matters because it might not be a successful treatment every time
Bad - High levels of Attrition
- due to it being a frightening experience, there is likely a high level of dropout
- less people will finish their treatment
- this matters because it could mean it is not as successful as Systematic Desensitisation, and there may still be implications for the economy if less people are treated but they are still taking up therapists' time
60
What Approach is used for Depression?
The Cognitive Approach
61
What are 3 Behavioural Characteristics of Depression?
Changes in Activity levels - lethargic/psychomotor agitation
Changes in Sleep levels - insomnia/hypersomnia
Aggression and Self Harm - can direct aggression inwards
62
What are 2 Emotional Characteristics of Depression?
Lowered Mood
Lowered Self Esteem
63
What are 3 Cognitive Characteristics of Depression?
Absolutist Thinking
Poor Concentration
Attention to/Dwelling on the Negatives
64
What are all the Characteristics of Depression?
Behavioural:
- Changes in Sleep Level (insomnia / hypersomnia)
- Changes in Activity Level (lethargic / psychomotor agitation)
- Aggression and Self Harm
Emotional:
- Lowered Mood
- Lowered Self Esteem
Cognitive:
- Poor Concentration
- Attention to / Dwelling on the negatives
- Absolutist thinking
65
What does the Emotional Characteristic of Depression 'Lowered Mood' include?
Sadness
Feeling worthless or empty
66
What does the Emotional Characteristic of Depression 'Lowered Self Esteem' include?
Not liking themselves
Self-Loathing
67
What does the Behavioural Characteristic of Depression 'Changes in Sleep' include?
Insomnia - reduced sleep
Hypersomnia - increased sleep
68
What does the Behavioural Characteristic of Depression 'Changes in Activity Levels' include?
Lethargic
- reduced energy levels
- may withdraw from work or social life
Psychomotor Agitation
- increased energy levels
- e.g. pacing
69
What does the Behavioural Characteristic of Depression 'Aggression and Self Harm' include?
Becoming verbally and Physically aggressive due to irritation
Can direct anger and aggression inwardly
70
What does the Cognitive Characteristic of Depression 'Absolutist Thinking' include?
Black and White thinking
Everything is either all good or all bad
71
What does the Cognitive Characteristic of Depression 'Poor Concentration' include?
Can't stick with a task
Find straightforward decisions difficult
72
What does the Cognitive Characteristic of Depression 'Attention to / Dwelling on the Negatives' include?
Paying more attention to negative events
Recalling more unhappy events
73
How many Cognitive Approaches are there to Explaining Depression?
2
74
What are the 2 Cognitive Approaches to Explaining Depression?
Beck's Negative Triad
Ellis' ABC Model
75
What did Beck do?
Suggested the Negative Triad as an explanation for Depression
He looked at why some people are more vulnerable to depression then others, and he found 3 parts of Cognitive Vulnerability (triad)
76
What are the 3 Cognitive Vulnerabilities in Beck's Negative Triad?
1) Faulty Information Processing
2) Negative Self-Schema
3) Negative View of the self, world, and future
77
What is Beck's Negative Triad to Explaining Depression?
1) Faulty Information Processing
- depressed people make fundamental errors in information processing
- they ignore the positives (focus and dwell on negatives)
- they see in black and white (absolutist thinking)
- they blow things out of proportion
2) Negative Self-Schema
- they have a bad package of ideas about themselves
- they see and interpret all information about themselves negatively
3) Negative Triad
- depressives have a negative view of the...
...self
...world
...future
78
What is included in Faulty Information Processing? (Beck's Negative Triad)
Fundamental Errors in Information Processing
Ignoring the positives
See in black and white
Blow things out of Proportion
79
What is included in Negative Self Schema? (Beck's Negative Triad)
Having a bad package of ideas about themselves
Seeing and interpreting all information about themselves negatively
80
What is included in Negative Triad? (Beck's Negative Triad)
Depressives have a negative view of the...
...Self
...World
...Future
81
Evaluate Beck's Negative Triad as a Cognitive Explanation of Depression
Good - Real World Application
- it has helped to create treatments
- Beck's CBT is based on Beck's Negative triad
- Good as it has external validity
Bad - Only a Partial Explanation
- there are more than just cognitive factors that contribute to depression
- it is a complex mental illness, so perhaps the explanation should be more comprehensive
82
What did Ellis do?
Suggested the ABC model as a Cognitive Explanation of Depression
- suggested poor mental health results from irrational thoughts that interfere wth us being happy and free from pain
- explained how they affect our behaviour and emotional state using the ABC model
83
What does ABC stand for in Ellis' ABC model?
Activating Event
Irrational Belief
Consequence
84
What is the full process of Ellis' ABC model?
An Activating event triggers...
An Irrational Belief which leads to...
An emotional or behavioural Consequence
85
What is an Example of the ABC process?
A negative event may trigger an irrational belief leading to Depression
86
What are 2 examples of Irrational Beliefs?
Utopianism
Musterbation
87
What is Utopianism?
An irrational belief where people believe life is always meant to be fair
88
What is Musterbation?
An irrational belief where people believe they must always achieve perfection or succeed
89
Evaluate Ellis' ABC Model as a Cognitive Explanation of Depression
Good - Real World Application
- Has led to Ellis' REBT which is a successful therapy
- Good external validity
Bad - only offers a partial explanation
- Endogenous Depression doesn't have an obvious cause
- there is no activating event
- perhaps it can only be used on certain types of depression
- limits external validity
Bad - Ethical Issues
- it places blame on the patients
- it says they have faulty thinking and irrational beliefs from an event they experienced
- this places unnecessary blame onto patients who are already suffering
90
How many Treatments for Depression are suggested by the Cognitive Approach?
2
91
What are the Treatments for Depression suggested by the Cognitive Approach?
Beck's Cognitive Behavioural Therapy
Ellis' REBT
92
What is the basis of Beck's CBT?
CBT is the most common psychological treatment for depression
It combines cognitive and behavioural elements:
Cognitive
- initial assessment to clarify problems and identify goals and irrational thoughts
- challenges faulty thinking
Behavioural
- Changes negative and irrational thoughts with effective behaviours
93
What is the aim of Beck's CBT?
To challenge the patient's Negative Triad and try to replace negative thinking with positive thinking
94
What is the Procedure of Beck's CBT?
Initial assessment of the client's condition:
- Therapist establishes a baseline to monitor improvement
- Client is asked how they perceive themselves, the future and the world
Techniques to combat irrational thoughts:
1) Reality Testing
- Therapist asks for the reality of the situation to challenge their thoughts
- e.g. 'tell me one time you have been successful' to challenge 'I'm always a failure'
2) Patient as Scientist
- Client is asked to record or gather evidence to combat their negative thoughts (homework)
- they try to replace the negative thinking with positive thinking to challenge them
95
What are 2 techniques in Beck's CBT used to challenge irrational thoughts?
Reality Testing
Patient as Scientist
96
Evaluate Beck's CBT as a Cognitive treatment of Depression
Good - Research Support suggests it is effective
March et al
- compared CBT to antidepressant drugs in 327 depressed adolescents for 36 weeks
- found 81% of the CBT group improved
- 81% of the antidepressant group improved
- suggests they are just as effective
HOWEVER
- 86% of CBT + antidepressant group improved
- suggests an interactionist approach would be even better
Bad - CBT won't work for everyone
- people with severe depression might not engage
- may be difficult for people with disabilities
- some people might not feel comfortable discussing their emotions
- again, perhaps an interactionist approach may be better as drugs could ease nerves and help patients open up during CBT
Bad - High relapse rate
- CBT deals with problems in the present, so it may be ineffective treatment for the actual cause of the depression in the past
- it doesn't change physiological issues
- over half of studied patients with depression relapsed within 1 year of stopping CBT
97
What does Ellis' REBT stand for?
Rational Emotive Behavioural Therapy
98
What does Ellis' REBT do?
It is a Cognitive Treatment for Depression
It extents the ABC model to the ABCDE model:
Dispute - challenges irrational beliefs
Effect - see a more beneficial effect on thoughts and behaviour
99
What are key concepts included in Ellis' REBT?
Dispute
Effect
Vigorous Arguments (x2):
1) Empirical Arguments
2) Logical Arguments
Behavioural Activation
100
What key technique is used in Ellis' REBT?
Vigorous arguments
They challenge the irrational beliefs and break the link between negative events and depression
101
What are the 2 types of Vigorous Argument in Ellis' REBT?
Empirical Arguments
Logical Arguments
102
What is Empirical Argument?
Disputing whether there is actual evidence to support negative beliefs
103
What is Logical Argument?
Disputing whether the negative thought logically follows on from the facts
104
What is Behavioural Activation?
Encouraging clients to engage in enjoyable activities and decrease their avoidance/isolation
105
Evaluate Ellis' REBT as a Cognitive Treatment of Depression
Bad - doesn't work for everyone
- again, some people might not want to discuss their thoughts
- it places blame on the patient, so they might not want to have their thoughts challenged again
Bad - Overemphasis on Cognition
- it focuses on the mind of the individual, which may minimise the circumstances or feelings of the individual
Good - Good implications for the economy
- treatment reduces the number of days off and improves productivity
Bad - Bad implications for the economy
- it costs time and money
- drugs are cheaper to produce and purchase, and are easier to administrate
106
What is OCD?
Obsessive Compulsive Disorder
- a mental illness characterised by obsessions or compulsions
107
What is the difference between Obsessions and Compulsions?
Obsessions are recurring thoughts (cognitive)
Compulsions are repetitive actions (behavioural)
108
What are 2 Behavioural Characteristics of OCD?
Compulsive Behaviour
Avoidance
109
What is included in the Behavioural Characteristic of OCD 'Compulsive Behaviour'?
Behaviours we feel we need to do
2 parts:
1) Repetitive - we feel compelled to repeat them
2) Reduce anxiety - they temporarily reduce the anxiety produced by obsessions (we keep doing them to reduce this anxiety --> negative reinforcement)
110
What is included in the Behavioural Characteristic of OCD 'Avoidance'?
Trying to reduce anxiety by keeping away from triggering situations
111
What are 3 Emotional Characteristics of OCD?
Guilt and Disgust
Depression
Anxiety and Distress
112
What is included in the Emotional Characteristic of OCD 'Guilt and Disgust'?
They may feel bad about their compulsive behaviour and they might direct it inward or outward
113
What is included in the Emotional Characteristic of OCD 'Anxiety and Distress'?
Obsessive thoughts can be unpleasant and frightening causing anxiety
Compulsions can also create anxiety
114
What is included in the Emotional Characteristic of OCD 'Depression'?
Depression often accompanies OCD as it is a 'comorbidity'
115
What are 3 Cognitive Characteristics of OCD?
Obsessive Thoughts
Excessive Thoughts
Hyper-vigilance
116
What is included in the Cognitive Characteristic of OCD 'Obsessive Thoughts'?
Unpleasant recurring thoughts that need to be acted on (through compulsions)
117
What is included in the Cognitive Characteristic of OCD 'Excessive Thoughts'?
Catastrophic thoughts that are often of the worst case scenario
118
What is included in the Cognitive Characteristic of OCD 'Hyper-vigilance'?
Maintaining constant alertness
Keeping attention focused on potential hazards
119
How many Biological Explanations of OCD are there?
2
120
What are the 2 Biological Explanations of OCD?
Genetic Explanations
Neural Explanations
121
What Approach is used in OCD?
The Biological Approach
122
What key concepts/researchers are included in the Genetic Explanation of OCD?
Lewis - genetic vulnerability
Diathesis Stress Model
Polygenic
Vulnerability from Candidate genes:
- COMT gene
- SERT gene
123
What did Lewis do?
Lewis researched his OCD patients and their families to test the genetic vulnerability of OCD
124
What did Lewis find?
37% of patients had parents with OCD
21% had siblings with OCD
- evidences genetic vulnerability for OCD but as it is low concordance, it also suggests there are other factors
125
How many people with OCD had parents with OCD? (Lewis)
37%
126
How many people with OCD had siblings with OCD? (Lewis)
21%
127
What is the Diathesis Stress Model?
It suggests that people gain a vulnerability towards OCD through their genetic inheritance
It also suggests that an Environmental Stressor is also needed to develop OCD
128
What is meant by 'OCD is Polygenic'?
OCD is caused by a combination of genetic variations that increase vulnerability, rather than just one gene
129
What are Candidate Genes?
Genes that create a vulnerability to certain mental illnesses
130
What are the 2 Candidate Genes for OCD?
COMT gene
SERT gene
131
How can the COMT gene increase likelihood of OCD?
It is involved in the production of an enzyme that regulates neurotransmitter Dopamine
An abnormal COMT gene causes low levels of the enzyme
This means there are higher levels of Dopamine
High levels of Dopamine increase the vulnerability to OCD
132
How can the SERT gene increase the likelihood of OCD?
It creates a protein that removes and re-cycles neurotransmitter Serotonin
An abnormal SERT gene produces too much of the protein
This means Serotonin levels decrease
Low levels of Serotonin increase the vulnerability to OCD
133
How does the COMT gene function abnormally in people with OCD?
It does not produce as much of the enzyme that regulates Dopamine, causing high levels of Dopamine
134
How does the SERT gene function abnormally in people with OCD?
It produces too much of the protein that removes and re-cycles Serotonin, causing low levels of Serotonin
135
Evaluate Genetic Explanations of OCD
Good - research support
- research was conducted on Twins with OCD
- MZ twins had a 68% concordance rate
- DZ twins had a 31% concordance rate
- this suggests there is a strong genetic influence on OCD
HOWEVER
Bad - there must be other factors
- MZ twins should have 100% concordance rate for genetic related issues
- this suggests there must also be environmental factors
- this supports the Diathesis Stress model more as it incorporates a gene and an environmental stressor
Bad - Biological Reductionism
- reduces the whole of OCD down to genes
- removes any other personal trauma or environmental influences on behaviour
Bad - too many genes involved
- OCD is polygenic
- there has not been research on every gene
- we cannot determine the precise cause of OCD genetically
136
What key concepts/researchers are in the Neural Explanation of OCD?
Neurotransmitters:
- Low Serotonin
- High Dopamine
Damaged or Abnormal Decision Making Systems:
- Abnormal Lateral frontal lobe
- Left Parahippocampal Gyrus
- Basal Ganglia
137
What is included in the Neural Explanation of OCD 'Low Serotonin'?
Serotonin regulates mood
Low levels of this might mean there is an abnormal transmission of mood-relevant information
This could affect moods and other processes, such as decision making processes
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What Decision Making Systems function abnormally in OCD?
Lateral Parts of the Frontal Lobe
Left Parahippocampal Gyrus
Basal Ganglia
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How does the Frontal Lobe function abnormally in OCD?
It is responsible for logical thinking and decision making
Some OCD patients have an abnormally functioning lateral part of the frontal lobe
this makes it difficult to think logically (obsessive thoughts)
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How does the Left Parahippocampal Gyrus function abnormally in OCD?
It is responsible for processing unpleasant emotions
It functions abnormally in OCD, making it harder to process emotions
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How does the Basal Ganglia function abnormally in OCD?
The Basal Ganglia has hypersensitivity in patients with OCD
This means there is a rise in repetitive motor behaviours in people with OCD
(Compulsive behaviour)
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Evaluate Neural Explanations of OCD
Bad - No unique neural system
- The link between low serotonin and OCD may not be unique to OCD
- There is a comorbidity between OCD and Depression, meaning low serotonin may be linked to depression instead
- This could mean there is low internal validity as the explanation may not explain OCD like it intended to
Bad - Correlation does not equal causation
- There is only a correlation between neural abnormality an OCD
- This means we cannot infer causation
Good - Real World Application
- Has helped drug therapies be developed by understanding which areas of the brain and which neurotransmitters are involved in OCD
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What is the Biological Approach to Treating OCD?
Drug Therapy
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What is the aim of Drug Therapy to treat OCD?
A chemical cause needs a chemical treatment
Aims to increase or decrease the levels of neurotransmitters in the brain to increase or decease their activity to bring them back to homeostasis
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What Drug is used to treat OCD?
SSRIs
Selective Serotonin Re-uptake Inhibitors
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What does SSRI stand for?
Selective
Serotonin
Re-uptake
Inhibitor
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How do SSRIs work?
They increase levels of Serotonin in the brain by preventing the re-absorption of Serotonin to the pre-synaptic neuron
By preventing the reabsorption, serotonin levels will increase in the synapse, and will continue to stimulate the post-synaptic neuron
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What can we combine SSRIs with?
CBT
The SSRIs may reduce the anxiety or depression so that patients can engage meaningfully to CBT
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What are some alternatives to SSRIs?
If treatment is not effective after 3-4 months, dosage can be increased or combined with:
1) Tricyclics - have the same effect on serotonin but more side effects
2) SNRIs (Serotonin Noradrenaline Re-uptake Inhibitors)- increase serotonin and noradrenaline
- noradrenaline is made from dopamine, and it increases and maintains blood pressure
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Why might patients want an alternative to SSRIs?
If they are ineffective
If there are too many side-effects
- every patient responds differently to drugs
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Evaluate the Biological Approach to Treating OCD
Bad - Drugs don't work for everyone
- there are bad side effects
- some are ineffective
- patients might have to keep trialing drugs for 3-4months to decide if they are right
- some OCD may be more trauma related so drugs won't work
Good - Cost effective
- cheap to produce
- cheap to purchase
- quick and easy to take
- good implications on the economy
Bad - Unreliable Evidence
- some drug companies do not publish all information or results surrounding the drug
- this means we cannot be sure exactly what could happen for each patient when they take them
- possibly riskier or less standardised than a psychological treatment
Good - Research support of effectiveness
- Research reviewed 17 studies comparing SSRIs to Placebos
- found symptoms were reduced by 70% in SSRI patients
- symptoms only reduced by 30% for placebo patients
- supports their use
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Draw a diagram of how SSRIs work:
use drawn copy to check
