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psychopathology Flashcards

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1
Q

What are the 4 definitions of abnormality?

A
  1. Deviation from social norms
  2. Failure to function adequately
  3. Statistical infrequency
  4. Deviation from ideal mental health
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2
Q

how far from the norm does something have to be from the norm?

A

2 standard deviations away

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3
Q

what is statistical infrequency?

A

Occurs when an individual has a less common characteristic, for example being more depressed or less intelligent than most of the population.

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4
Q

what are some evaluation for statistical infrequency?

A
  • can be used to measure normal/ expected development in children
  • uses data from established and standardised tests such as IQ assessments
  • some rare behaviours are desirable
  • it does not account for cultural differences.
  • t it could lead to misdiagnosis, if abnormal behaviour is not rare.
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5
Q

What is deviation from social norms?

A

Concerns behaviour that is different from the accepted standards of behaviour in a community or society

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6
Q

what are some examples of deviation from social norms?

A
  • laughing in a funeral
  • dressing in a certain way
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7
Q

what are the factors that affect deviation from social norms?

A
  • time
  • context
  • culture
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8
Q

what are the evaluation points for deviation from social norms?

A
  • dependant on the situation
  • culturally specific
  • keeps society in order
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9
Q

What is failure to function adequately?

A

When a person can no longer cope with the demands of every day life.

e.g unable to maintain basic standards of nutrition; can’t hold down a job or relationship.

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10
Q

who came up with the indicators for when a person can not function adequately?

A

Rosenhan and Seligman

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11
Q

what are the indicators for when a person can not function adequately?

A
  • unpredictability
  • maladaptive behaviours
  • personal stress
  • irrationality
  • observer discomfort
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12
Q

what is the global assessment of functional scale?

A

a scale in which lower scores indicate more severe symptoms

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13
Q

what are some evaluation points for failure to function adequately?

A
  • it cannot explain those people who do not experience personal distress but are clearly suffering from an abnormality
  • people have different definitions of abnormality (subjective)
  • people can embrace their abnormalities
  • it recognises its own subjectivity
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14
Q

What is deviation from ideal mental health?

A

Failure to present all of jahoda’s 6 criteria for ideal mental health:

  • Positive attitude towards the self
  • Self-actualisation
  • Autonomy
  • Resistance to stress
  • Environmental mastery
  • Accurate perception of reality
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15
Q

what are the evaluations of deviation from ideal mental health?

A
  • considered unrealistic
  • autonomy is culturally biased
  • it looks as mental and physical health similarly
  • a positive approach
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16
Q

what is person autonomy?

A

Personal autonomy is the idea that a person can be self reliant, independent and not have to depend on others to manage. For a person to have personal autonomy, they have to be able to be able to look after themselves.

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17
Q

what are the emotional factors for depression?

A

a formal diagnosis requires the presence of at least 5 symptoms and must include either sadness, loss of interest and pleasure in daily activities
intense sadness, numbness, loss, worthlessness, low self esteem, anger, irritability are the most common symptoms

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18
Q

what are the cognitive factors for depression?

A

the negative emotions related to depression are a consequence of negative thoughts such as guilt and a sense of worthlessness
people will often have a negative view of the world and think very pessimistically
they have negative expectations about their lives and relationships and even though these things are irrational they believe them to be true

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19
Q

what are the behavioural factors for depression?

A

people may experience changes in sleep patterns ( reduced sleep or insomnia) or ( increased need for sleep or hypersomnia)
changes in appetite ( too much eating) or (loss of appetite)

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20
Q

are women or men more likely to have phobias?

A

women are twice as likely

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21
Q

what are the behavioural factors for phobias?

A
  • panic - panic in response to the presence of the stimulus eg crying, screaming or running away
  • avoidance- going at great lengths to avoid coming into contact with the stimulus
  • endurance- unavoidable circumstances where the person has to face the phobia
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22
Q

what are the cognitive factors for phobias?

A
  • paying more attention to the phobia - difficult to look away from phobias
  • irrational fears- false beliefs about the phobia
  • distortions- perceptions of the phobia may be distorted
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23
Q

what are the emotional factors for phobias?

A
  • anxiety and fear around the phobia
  • unreasonable emotional responses
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24
Q

what is the two process model?

A
  • The behavioural approach emphasises the role of learning the acquisition of behaviour
  • Orval Hobart Mowrer (1947) proposed the two - process model to explain how phobias are learnt.
  • The first stage is classical conditioning and the behaviour is maintained through operant conditioning
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25
Q

what is classical conditioning?

A
  • phobias are acquired through association- for example Little Albert made an association between a neutral stimulus, the white rat and a loud noise, an unconditioned stimulus to produce a conditioned fear response
  • this fear can then be generalised to other similar objects
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26
Q

what is operant conditioning?

A
  • behaviour is reinforced through rewards or punishment
    reinforcement tends to increase the frequency of behaviour
  • this is true of both negative and positive reinforcement
    negative reinforcement: an individual avoids a situation which is unpleasant
  • such a behaviour results in a desirable consequence, avoiding the feared stimulus, therefore the behaviour is repeated
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27
Q

Tomarken et al ( 1989) - presenting images of phobic stimulus

A

presented a series of snake and neutral images (e.g trees) to phobic and nonphobic participants. The phobics tended to overestimate the number of snake images presented.

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28
Q

Mowrer - negative reinforcement

A

suggests that whenever we avoid a phobic stimulus we successfully escape the fear and anxiety that we would have suffered. This reduction in fear reinforces the avoidance behaviour and so the phobia is maintained

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29
Q

what is systematic desensitisation?

A
  • it is designed to gradually reduce anxiety through the principle of classical conditioning
    the patient can learn to relax in the presence of a phobic stimulus
    a new response can be learned around the phobic stimulus ( counterconditioning)
    it is impossible to feel relaxed and afraid at the same time, therefore one emotion prevents the other ( reciprocal inhibition )
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30
Q

what is the first stage of systematic desensitisation?

A

anxiety hierarchy

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31
Q

what is the second stage of systematic desensitisation?

A
  • relaxation
  • therapists teach patients to relax as deeply as possible
  • could involve different breathing techniques or mental imagery
    meditation or drugs such as valium may be used
32
Q

what is the third stage of systematic desensitization?

A
  • exposure
  • patient is exposed to phobic stimulus while in relaxed state
    takes place over several sessions, starting at the bottom of the list
    treatment is successful when the patient goes through all the stages
33
Q

what is flooding and how does it work?

A
  • involves exposing patients to phobic stimulus but without the gradual build up
  • Sometimes only one long session is enough to cure a patient
  • stops phobic responses very quickly
    May be because, without the option of avoidance behaviour, the patient quickly learns that the phobic stimulus is harmless
  • In classical conditioning terms this process is called extinction
  • A learned response is extinguished when the conditioned stimulus is encountered without the unconditioned stimulus
  • The conditioned stimulus no longer produces the conditioned response (fear)
  • In some cases, patients may achieve relaxation in the presence of the phobic stimulus simply by becoming exhausted with their own fear response!
34
Q

is flooding unethical?

A

-flooding is not unethical but it is seen as unpleasant so it is important to gain informed consent beforehand.

35
Q

evaluation for systematic desensitisation - high amounts of evidence

A

one strength of systematic desensitisation is the fact that there is high amounts of evidence for its effectiveness
Lisa Groley et al (2003) followed 42 people with arachnophobia and performed SD
within 33 months, the group was less fearful

36
Q

evaluation for systematic desensitisation - help those with learning difficulties

A

a further strength of SD is that is can help those with learning difficulties and phobias
people with learning difficulties often have trouble with cognitive therapies as they require complex thought
they may also find flooding overwhelming

37
Q

evaluation for flooding -cost effective

A

one strength of flooding is that it is highly cost effective
flooding can work in one session and there is no need to pay out for multiple sessions
this means it can reach more people

38
Q

evaluation for flooding - highly unpleasant

A

one limitation is that it is highly unpleasant
Sarah Schumacher et al ( 2015 ) found that participants who experienced flooding showed a lot more emotional stress than SD
the traumatic nature means that there are a lot more dropouts than SD

39
Q

what does the cognitive approach to depression believe?

A
  • there are a number of cognitive explanations that believe that the disorder is the result of the disturbance of thinking
    they focus on an individual’s negative thoughts, irrational beliefs, and misinterpreted events as being the cause of depression
  • it is down to distorted and irrational thinking which may cause maladaptive behaviour
  • it is the way you think about the problem rather than the problem itself which causes the mental disorder
40
Q

what is beck’s theory of depression?

A

Aaron Beck (1967) suggested an approach to explaining why some people are more vulnerable to depression than others
in particular, it is a person’s cognitions that create this vulnerability

41
Q

what are the three parts of cognitive vulnerability?

A
  • faulty information processing:
  • negative self-schemas:
  • the negative triad:
42
Q

what is faulty information processing?

A

depressed people pay selective attention to aspects of their environments that confirm what they already know and do so even when evidence to the contrary is right in front of them. There are two main cognitive biases that are involved including over-generalisations and catastrophizing. They may blow small problems out of proportion and think in black and white.

43
Q

what is negative self- schemas?

A

negative information we hold about ourselves based on negative past experiences that can lead to cognitive biases. These schemas are developed during childhood. depressed people possess negative self-schemas, which may come from negative experiences, for example criticism

44
Q

Weissman and Beck (1978) - study on negative schemas

A

aim was to investigate the thought processes of depressed people to establish if they make use of negative schemas
thought processes were measured using the dysfunctional attitude scale ( DAS ). Participants were asked to fill in a questionnaire by ticking whether they agreed or disagreed with a set of statements. eg “people will hate me if i make mistakes”
-concluded that depressed participants made more negative assumptions’
when given therapy, there was improvement in self ratings
concluded depression involves the use of negative schemas

45
Q

what is the negative triad?

A

a theory proposed by Beck that refers to thoughts about self, world, and future. In all three instances, depressed individuals tend to have negative views of these.

46
Q

what is Ellis’s ABC model?

A

Albert Ellis (1962) proposed that good mental health is the result of rational thinking defined as “ways that allow people to be happy and free of pain”
conditions such as depression and anxiety result from irrational thoughts defined as not unrealistic but “ any thoughts that interfere with us being happy of free of pain”
He used the model to explain how irrational thought affect behaviour and emotional state

47
Q

what happens in the A component of the ABC model? (activating event)

A

focus on situations in which irrational thoughts are triggered by an external stimuli
we get depressed when we experience negative events and these trigger irrational beliefs

48
Q

what happens in the B component of the ABC model? (belief)

A

the belief that we must always succeed is called “musturbation”
“I- can’t- stand - it - itis” is the belief that it is a major disaster whenever something does not go smoothly
utopianism is the belief that life is always meant to be fair

49
Q

what happens in the C component of the ABC model? (consequence)

A

when an activating event triggers irrational beliefs there are emotional and behavioural consequences
e.g if you fail at something when you believe you must always achieve, it can trigger depression

50
Q

Evaluation for Beck’s theory :

A
  • it has good supporting evidence
    (much of the research has supported that depression is associated with faulty information processing, negative self schemas and the triad of impairments )
  • it has practical application to CBT
    (The cognitive explanation forms the basis of CBT. All cognitive aspects of depression can be challenged by CBT)
  • there is supporting research
    (in a study done by Joseph Cohen et al (2019) they tracked the development of 473 adolescents and how their cognitive vulnerability predicated depression)
51
Q

Evaluation for Ellis’s theory:

A
  • It only offers a partial explanation
    ( some depression does not occur due to an obvious cause)
  • It has practical application in CBT
    ( has led to successful therapy. Irrational negative beliefs are challenged and this can help to reduce depressive symptoms)
  • It does not explain all aspects of depression
    ( this explanation does not explain why some individuals experience things like anger or hallucinations or delusions)
  • it only explains reactive depression and not endogenous depression
    ( there are many cases to show that depression is not always down to reacting to a life event and it’s not always obvious what causes a person’s depression)
52
Q

overall evaluation points for cognitive explanations:

A
  • there is support for the role of irrational thinking
    ( Hammen and Kranz (1976) found that depressed participants made more errors in logic when asked to interpret written material than non depressed participants)
  • there is trouble distinguishing what is the cause
    (do negative thoughts cause depression? or does depression cause negative thoughts)
    -blames the client rather than situational factors
    (although this gives a client power to change, it can lead to overlooking situational factors that affect a person)
  • irrational thoughts may be realistic
    ( there are some people who theorised that people with depression see the world realistically and that their realistic thoughts are diminished and seen as irrational by people with rose tinted glasses)
53
Q

Ellis’s rational behaviour therapy - counteracting ABC model

A

extended to ABCDE model
D = dispute (challenging the thoughts)
E = effect ( see a more beneficial effect on thought and behaviour)
therefore the central technique of REBT is to identify and dispute the patient’s irrational thoughts

Ellis argues that irrational thoughts are the main cause to all types of emotional distress and behaviour disorders
REBT is based on the premise that whenver we become upset, it is not the event taking place that upsets us; it is the belief we hold that make us anxious, depressed etc
Ellis believed that irrational beliefs make impossible demands on the individual, leading to anxiety, failure and psychological difficulty
REBT challenges the client to prove these statements then replace them with realistic ones (empirical disputing/ logical disputing)

54
Q

Newark et al (1973) - discovering if those with psychological problems had irrational attitudes

A

aim: to discover if people with psychological problems had irrational attitudes

method: two groups of participant were asked if they agreed with the following statements that are identified as irrational:

it is essential that one be loved or approved of by virtually everyone in the community
one must be perfectly competent, adequate and achieving in order to consider oneself worthwhile
One group consisted of people who had been diagnosed with anxiety. The other group had no psychological problems and were “normal”

results: 65% of the anxious participants agreed with the first statement, compared to 2% of non anxious participants . 80% of anxious participants agreed, compared to 25% of non anxious participants

conclusions: people with emotional problems think in irrational ways

55
Q

CBT is effective at treating depression

A

CBT is effective in reducing symptoms of depression and in preventing relapse and there is a large body of evidence to support this

( March et al, 2007)
March et al
found that CBT was as effective as antidepressants, in treating depression.
The researchers examined 327 adolescents with a diagnosis of depression and looked at the effectiveness of CBT, antidepressants and a combination of CBT plus antidepressants.
After 36 weeks, 81% of the antidepressant group and 81% of the CBT group had significantly improved, demonstrating the effectiveness of CBT in treating depression.
However, 86% of the CBT plus antidepressant group had significantly improved, suggesting that a combination of both treatments may be more effective.

it is the most effective psychological treatment for moderate depression
it is effective as antidepressants for many types of depression ( fava et al, 1994)

56
Q

fava et al - determining the effectiveness of treatment

A

to determine the effectiveness of this treatment modality in addressing the symptoms of major depressive illness.
The subjects were 40 patients with major depressive disorder who were successfully treated with antidepressant drugs.
They were then randomly assigned to either cognitive behavioural treatment or clinical management of residual symptoms. In both subgroups, antidepressant drugs were tapered and discontinued.

Results: The group that received cognitive behavioural treatment had a significantly lower level of residual symptoms after drug discontinuation in comparison with the clinical management group. Cognitive behavioural treatment also resulted in a lower rate of relapse (15%) at a 2-year follow-up than did clinical management (35%), although this difference did not reach statistical significance. Most of the residual symptoms were found to have occurred also in the prodromal phase of illness

57
Q

cases where patients are not motivated

A
  • in some cases depression may be so severe that patients cannot motivate themselves to engage in therapy
  • in these cases , it is possible to treat the patient with anti depressants and then CBT can commence at a later date
    This is therefore a limitation as it means that CBT cannot be used as the sole treatment in all cases

55% drugs alone
52% CBT alone
85% when used together

58
Q

therapist- patient relationship

A
  • success may be due to the therapist- patient depression
  • research has shown that there is little difference between CBT and other forms of psychotherapy
  • it may be the quality of the therapist- patient relationship that makes the difference to the success of the treatment rather than the treatment itself
    -simply having the opportunity to take to someone who will listen could be what matters most
59
Q

CBT focuses on the here and now

A
  • Some patients may want to explore their past
  • CBT focuses on the “here and now” however there may be linked to childhood experiences and current depression and patients might want to talk about these experiences
  • they can find the “present focus” very frustrating
60
Q

what is OCD?

A
  • classed as an anxiety disorder
  • characterised by either obsessions ( recurrent intrusive thoughts - cognitive ) and/ or compulsions ( repetitive behaviour that must be completed in order to stop the obsessions - behavioural )
  • most people have both obsessions and compulsions
61
Q

what are the behavioural effects of OCD?

A
  • Compulsions are repetitive and typically sufferers feel compelled to repeat behaviour. A common example is hand washing.
  • Around 10% of people with OCD show compulsive behaviour alone; they have no obsessions, just irrational anxiety. However, for the vast majority, compulsion are done to manage the anxiety produced by the obsession
62
Q

what are the emotional effects of OCD?

A
  • Anxiety and distress is the most common.
  • OCD is often accompanying depression so anxiety can be accompanied by depressive symptoms
  • Guilt and disgust is also very common
63
Q

what are the cognitive effects of OCD?

A
  • obsessive thought. for 90% of people with OCD these obsessive thoughts are the majority of the problem
  • the compulsions are a temporary solution
64
Q

what are the components of the OCD cycle?

A
  • obsessions
  • anxiety
  • compulsions
  • relief
65
Q

what is the genetic explanation for OCD?

A
  • COMT regulates the production of the neurotransmitter dopamine that has been implicated in OCD.
  • according to Tukel et al, 2013 that this form of the COMT gene produces lower activity of the gene and higher levels of dopamine.
  • the SERT gene is thought to affect the transport of serotonin creating lower levels of the neurotransmitter. These changed levels of serotonin are also implicated in OCD.
66
Q

what is the neural explanation for OCD?

A
  • suggest that abnormal levels of neurotransmitters, in particular serotonin and dopamine, are implicated in OCD.
  • suggest that particular regions of the brain, in particular the basal ganglia and orbitofrontal cortex, are implicated in OCD.
  • lower levels of serotonin and higher levels of dopamine are associated with OCD
67
Q

Max et al. (1994) - ocd and brain structure

A

found that when the basal ganglia is disconnected from the frontal cortex during surgery, OCD-like symptoms are reduced

68
Q

what have PET scans found about the orbitofrontal cortex?

A
  • PET scans have found higher activity in the orbitofrontal cortex in patients with OCD.
  • One suggestion is that the heightened activity in the orbitofrontal cortex increases the conversion of sensory information to actions (behaviours) which results in compulsions. The increased activity also prevents patients from stopping their behaviours.
69
Q

strength of the biological explanation (family studies)

A

Lewis (1936) examined patients with OCD and found that 37% of the patients with OCD had parents with the disorder and 21% had siblings who suffered. Research from family studies, like Lewis, provide support for a genetic explanation to OCD, although it does not rule out other (environmental) factors playing a role.

70
Q

strength of the biological explanation - research into anti depressants

A
  • Support for the neural explanations of OCD comes from research examining biological treatments including anti-depressants.
  • Anti-depressants typically work by increasing levels of the neurotransmitter serotonin. These drugs are effective in reducing the symptoms of OCD and provide support for a neural explanation of OCD.
71
Q

counter argument to twin studies

A

no twin study has found a concordance rate of 100% in identical twins, which means that biological factors are not the only factor contributing to OCD and there must be environmental factors that also contribute to this disorder.

72
Q

weakness of biological explanation - reductionist

A

it ignores other factors and is reductionist.
- For example, the biological approach does not take into account cognitions (thinking) and learning.
- Some psychologists suggest that OCD may be learnt through classical conditioning and maintained through operant conditioning stimulus (for example, dirt) is associated with anxiety and this association is then maintained through operant conditioning, where a person avoids dirt and continually washes their hands.
- This hand washing reduces their anxiety and negatively reinforces their compulsions.

73
Q

how do SSRI’s work?

A

When serotonin is released from the pre-synaptic cell into the synapse, it travels to the receptor sites on the post-synaptic neuron. Serotonin which is not absorbed into the post-synaptic neuron is reabsorbed into the sending cell (the pre-synaptic neuron). SSRIs increase the level of serotonin available in the synapse by preventing it from being reabsorbed into the sending cell. This increases level of serotonin in the synapse and results in more serotonin being received by the receiving cell (post-synaptic neuron).

74
Q

how do anti anxiety drugs work?

A

GABA tells neurons in the brain to ‘slow down’ and ‘stop firing’ and around 40% of the neurons in the brain respond to GABA. This means that BZs have a general quietening influence on the brain and consequently reduce anxiety, which is experienced as a result of the obsessive thoughts.

75
Q

strengths of biological treatments - research support

A
  • One strength of biological treatments for OCD comes from research support which uses randomised drug trials. These trials compare the effectiveness of SSRIs and placebos (a ‘drug’ with no pharmacological value).

Soomro et al. (2008) conducted a review of the research examining the effectiveness of SSRIs and found that SSRIs were more effective than placebos in the treatment of OCD, in 17 different trials. This supports the use of biological treatments, especially SSRIs, for OCD.

76
Q

weaknesses of biological treatments - side effects

A

one weakness of drug treatments for OCD is the possible side effects of drugs like SSRIs and BZs. Although evidence suggests that SSRIs are effective in treating OCD, some patients experience mild side effects like indigestion, while other might experience more serious side effects like hallucinations, erection problems and raised blood pressure. BZs are renowned for being highly addictive and can also cause increased aggression and long-term memory impairments. As a result, BZs are usually only prescribed for short-term treatment. Consequently, these side effect diminish the effectiveness of drug treatments, as patients will often stop taking medication if they experience these side effects.

psychology (11 decks)

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