Psychopathology

Question 1

Definitions of abnormality (1)

Answer 1

Statistical infrequency & Deviation from social norms

Question 2

Statistical infrequency

Answer 2

-Numbers
-Normal distribution, mean is at highest peak
-Above or below is abnormal
-e.g IQ average is 100
-68% have a normal distribution score of 85-115
-2% have a score below 70
-Individuals below 70 are abnormal and liable to be diagnosed with Intellectual Disability Disorder (IDD)

Question 3

Devitation from social norms

Answer 3

-Norms are specific to the culture we live in
-Few behaviours considered universally abnormal, where they breach social norms
-e.g Homosexuality no longer abnormal in the UK but maintains in other cultures, even illegal
-e.g Antisocial persionality disorder (psychopathy)
-They are impulsive,aggresssive and irresponsible
-According to DSM-5 the important symptom of Antisocial personality disorder is an ‘absence of prosocial internal standards associated with failure to conform to lawful and c ulturally normative ethical behaviour’
-We make the social judgement that psychopaths are abnormal because they dont conform to or mroal standars
-Psychopathic behaviour would be considered abnormal is a very wide range of cultures

Question 4

Definitions of abnormality (2)

Answer 4

Failure to function adequately & Deviation from ideal mental health

Question 5

Failure to function adequately

Answer 5

-e.g unable to maintain basic standards of nutrition and hygiene
-e.g No longer functioning adequately if they cannot keep a job or maintain friendships
-Rosenhan & Seligman’s sings that someone is failing to function adequately:
-Person no llonger conforms to standard interpersonal rules e.g maintaining eye contact and repecting personal space
-Severe distress
-Person’s behaviour is irrational or dangerous to themselves or others
-e.g Intellectual Disability Disorder
-Diagnosis not based only on low IQ but also failing to function adequately

Question 6

Deviation from ideal mental health

Answer 6

Jahoda’s criteria for good mental health:
-We have no symtoms or distress
-We are rational and can percieve ourselevs accurately
-We self Actualise (strive to reach our potential)
-We can cope with stress
-We have a realistic view of the world
-We have good self esteem and lack guilt
-We are indpendent of other people
-We can successfully work, love and enjoy our leisure
-There is some overlap between deviation from mental health and failure to function adequately e.g Not being able to keep a job :Failure to cope with pressures of work/deviation from the ideal of successfuly working

Question 7

Phobia

Answer 7

An irrational fear of an object or situation

Question 8

DSM-5 Catergories of phobia

Answer 8

-Specific phobia
-Social anxiety (social phobia
-Agoraphobia - phobia of being outside

Question 9

Specific phobia

Answer 9

-Phobia of an object e.g animal or body part,
-Or a situation e.g flying or injection

Question 10

Social phobia (social anxiety)

Answer 10

-Phobia of a social situation such as public speaking or using public toilet

Question 11

Agoraphobia

Answer 11

-Phobia of being outside or in a public place

Question 12

Behavioural characteristics of phobias

Answer 12

1. Panic
2. Avoidance
3. Endurance e.g remaining in room with spider and keeping eye on it than leaving

Question 13

Emotional characteristics of phobias

Answer 13

1. Anxiety
2. Fear
3. Emotional response is unreasonable

Question 14

Cognitive characteristics of phobias

Answer 14

1. Selective attention to the phobic stimulus
2. Irrational beliefs
3. Cognitive disortions

Question 15

Phobia examples

Answer 15

Arachnophobia : Spiders
Mycophobia : Mushrooms
Pogonophobia : Beards

Question 16

DSM -5 Categories of depression

Answer 16

1)Major depressive disorder : Severe but short term depression
2) Persistent depressive disorder : Long term or recurring deprssion, including sustained major depression and what used to be callled dysthmia
3) Disrupted mood dysregulation disorder : Childhood tempter tantrums
4) Premenstrual dysphoric disorder : Disruption to mood prior and or during mestruation

Question 17

Behavioural characteristics of depression

Answer 17

1) Activity levels
-Reduced levels of energy, effecting withdraw from social life or even getting out of bed
-Some cases leads to oppositve effect of psychomotor agitation, stuggling to relax e.g pacing a room
2) Disruption to sleep and eating behaviouer
-e.g insomnia or hypersomnia
-Appetite may increase or decrease, weight loss or weight gain
3) Aggression and self harm
-Often irritable and verbally or physically aggressive
-Verbal aggression by ending a relationship or quitting a job
-Phsyical agression e.g cutting or suicide attempts

Question 18

Emotional characteristics of depression

Answer 18

1) Lowered mood
e.g sad , worthless and empty
2) Anger
-can lead to aggressive or self harming behaviour
3) Lowered self esteem
-How much we like outselves
-They hate themselves

Question 19

Cognitive charcteristics of depression

Answer 19

1) Poor Concentration
2) Dwelling on the negative
3) Absolutist thinking

Question 20

DSM 5 categories of OCD

Answer 20

• OCD - characterised either by obsessions (recurring thoughts ,images) and/or compulsions (repetitive behaviours such as handwashing)
  Most people with OCD have both obsessions and complsions
  -Trichotillomania - compulsive hair pulling
  -Hoarding disorder - Compulsive gathering of possessions and inability to part with anything regardless of value
  -Excoriation disorder - Compulsive skin picking

Question 21

Behavioural characteristics of OCD

Answer 21

1) Complusions are repetitive
2) Complusions reduce anxiety
-Only 10% of OCDs show only compulsive behaviour, no obsessions jsut a general sense of irrational anxiety
-Majority perform compulsive behaviours to manage anxety produced by obsessions
e.g Compulsive handwashing in respnose to an obsessive fear of germs
3) Avoidance
-Attempt to reduce anxiety by keeping away from situations that trigger it
-e.g Avoiding contact with germs to avoid compulsive washing
-This avoidance can lead people to avoid ordinary situations e.g emptying rubbish bins, interfering regular life

Question 22

Emotional characteristics of OCD

Answer 22

1) Anxiety and distress
Anxiety accompanies both obsessions and emotions
The urge to repeat a behaviour (compulsion) creates anxiety
2) Accompanying depression
-Compulsive behaviour brings some relief from anxiety but this is temporary
3) Guilt and disgust
-to external or self

Question 23

Cognitive characteristics of OCD

Answer 23

1) Obsessive thoughts
90% of OCDs major cognitive feature is obsessive thoughts e.g worry of contamination of dirt and germs or impulses to hurt someone
2) Cognitive coping strategies
-Adopting cognitive stategies to deal with obsessions
-e.g religious person who is tormented with guilt may pray
-Can manage anxiety but make the person appear abnormal to others and can distract them from everyday tasks
3) Inisight into excessive anxiety
-OCDs must be aware that their obsessions and compulsions are not rational
-If they thought it was reality it would be a different mental disorder
-But they may experience thoughts about the worst case scenarios that might result if their anxieties were justified
-Tend to be hypervigilant i.e maintain contant alertness and keep focus on potential hazards

Question 24

What approach explains phobias

Answer 24

Behavioural

Question 25

What is the Behavioural approach to explaining phobias

Answer 25

2 process model : The role of learning in the acquisition of behaviour
-Explains behavioural aspects of phobia: Panic avoidance and endurance
-Mowerer proposed the 2 process model: Acquisition by classical aconditioning and contunuation due to operat conditioning

Question 26

Acquisition by classical conditioning

Answer 26

-Neutral stimulus of something we have no fear of is associated with something that triggers a fear response called Unconditioned stimulus
-Watson and Rayner did the Little Albert experiment
-White rat with no fear intially, but presented with a loud frightning noise by banging an iron bar close to Albert’s ear.
-Noise is an Unconditioned stimulus which creates an unconditioned response of fear
-When a rat (NS) and UCS are encountered together , the NS is associated with UCS and now both produce rear response
-Albert displayd fear when he saw a rat (NS) which is now a conditioned stimulus that produces a conditioned response
-This conditioning is then generalised to similar objects
-They tested Albert by showing him other furry obkects such as a non white tabbit, fur coat .
-Albert displayed distress at the sight of all these

Question 27

Maintainence by operant conditioning

Answer 27

-Responses acquired by classical conditioning tend to decline overtime
-Phobias long lasting duration is explained by Mowrer with operant conditioning
-Operant conditioning takes place when behaviour is reinforced or punished
-Reinforcment leads to increase frequency of behaviour
-Uses negative nad positive reinforcment
-Negative reinforcment: Person avoids an unpleasant situation. Such behaviour results in a desirable consequence meaning behvaiour will be repeated
-Wheneever we avoid a phobic stimulus we successfuly escape the fear and and anxiety that would have remained there
-This reduction in fear reinforces the avoidance behaviour and so the phobia is maintained

Question 28

Behavioural approaches to treating phobias

Answer 28

-Systematic desensitisation
-Flooding

Question 29

Systematic desensitisation

Answer 29

-Behavioural therapy designed to reduce phobic anxiety through the principle of classical conditioning
-If person can learn to relac in precense of the phobic stimulus they will be cured
-Counterconditioning: Phobic stimulus is paired with relaxation istead of anxiety
3 Processes :
1. Anxiety Hierarchy
-Put together by client and therapist
-List of situations related to the phobic stimulus that provoke anxiety arranged from most to least frightening
e.g Arachnophobia may identify a picture of a spider low and holding a tarantula at the top
2.Relaxation
-Therapist teaches client to relax as deeply as possibble
-Not possible to be afraid and relaxed at same time so one emmotion prevents the other : Reciprocal inhibition
-e.g breathing excercises or learn mental imginery techniques (e/g picturing themselves lying on a beach ), or meditation
-Or drugs using Valium for relaxation
3. Exposure
-Exposed to stimulus in a relaxed state over several sessions, going up once they stay relaxed inthe lower levels
-Treatment is successful when client can stay relaxed in situations high on the anxiety hierarchy

Question 30

Flooding

Answer 30

-Exposing phobic stimulus without build up
-e.g arachnopobia will have a large spider crawl over them for an extended peiod
-Flooding sessions are longer than systematic desenstisation sessions, one period lastin 2-3 hours
-Sometimes only 1 session is enough to cure
-Works because without avoidance behaviour, client quickly learns that phobic stimulus is harmless
-In classical conditioning terms this is called extinction
-A learned response is extinguished when the conditioned stimulus e.g dog is encountered without hthe unconditioned stimulus e.g being bitten
-The result is that the conditioned stimulus no longer produces consitioned response e.g fear
-In some cases client may achieve relaxation in precense of phobic stimulus because they ar exhausted by their own fear response
-Flooding is not unethical but it is unpleasant so clients must give informed consent
-Normally given choice of systematic desenstitation or flooding

Question 31

Cognitive approaches to explaining depression

Answer 31

Becks negative triad and Eliss’s ABC model

Question 32

Beck’s ngeative triad

Answer 32

-Person’s congitions that makes someone more vulnerable to depression
3 Parts of cognitive vulnerability :
-Faulty information processing
Black and white thinking
Irrationally focus on negative aspects of a situation and ignore postives e.g winning 1 million but focusing that someone won 10 million last week
-Negative self shema
Package of ideas developed trhough experience
Mental frame work
Self schma is the information people have about themselves
People use schema to interpret the world so if a person has negative self schema they interpret the infromation about themselves in a negative way
-Negative triad
Dysfunctional thinking about themselves because of 3 types of negative thinking that occur atomatically, regardless of the reality of the time
When a person is depressed, negative thoughts on the world, future and oneself are uppermost
a) Negative view of the world (creates impression there is no hope anywhere e.g the world is evil
b)Negative view of the future e.g there isnt much chance the econmy will get better .Reduces hope and ehances depression
c) Negative view of the self e.g I am a failure
Enhances existing depreeive feelings because they confirm the existing emotions of low self esteem

Question 33

Ellis’ ABC model

Answer 33

-Elis said rational thinking makes good mental heath, thinking in ways tjat allow people to be happy and free pain
-Depression results from irrational thoughts, defined not illogical or unrealistic but interfere with happiness and free from pain
ABC model explains how irrational thoughts affect our behaviour and emotional state
A: Activating event
-Irrational thoughts triggered by external events
-When we experience negative events they trigger irrational beliefs
e.g failing an importnat test or ending a relationship
B: Beliefs
-Range of irrational beliefs
-Belief we must always succeed = musterbation
-Belief that it is a distaster when something doesnt go smoothly = I-cant-stand-it=itis
C: Consequences
-When activating event triggers iirational beliefs there are emotional and behavioural consequences
-e.g if person believes they must always succed and fails then this can trigger depression

Question 34

Cognitive approaches to trating depression

Answer 34

Cognitive behaviour therapy and Rational Emotive Behaviour Therapy

Question 35

Beck’s Cognitive behaviour therapy

Answer 35

-Begins with an assessment where the client and therapist work together to carlify the client’s problems
Cognitive element:
-Jointly identify goals for the therapy and make a plan to achieve them
-One of the central tasks is to identify where there may be irrational thoughts that will benefit from challenge
Behaviour element: CBT then involves working to change negative and irrational thoughts and finally put more effective behaviours into place
-Application of Becks congnitive theory and aims to identify automatic thoughts about the world, self and future (negative triad)
-Once identified, thoughts must be challenged - a central compnent of the therapy
-As well as challnging thoughts directly, it aims to help clients test the reality of their negative beliefs
-May be set homework like recording when they enjoyed an event or when people were nice to them
-Reffered to as ‘client as scientist’ where they investigate the reality of their negative beliefs like a scientist
-If in future sessions the client says no one is nice to them or there is no point going to events, therapist can then produce this evidence and prove the client’s statments are incorrect

Question 36

Eliss’ Rational Emotive Behaviour Therapy

Answer 36

-REBT extends the ABC Model o ABCDE Model
-D = Dispute and E= Effect
-Central technique of REBT is to identify and dispute irrational thoughts
-e.g Client may talk about how unlucky they are or how unfair things seem
-REBT therapist would identify these as examples of utopianism and challenge it as an irrational belief
-This would involve a vigorous argument aimed to chnage the irrational belief and so break the link between negative life events and depression
-Argument is the main part of REBT
-Elis found different ways of disputing e.g Empirical argument= involves disputing whether there is actual evidence to support the negative belief
-Logical argument= disputive whether the negative thought logically follows from the facts
-Behavioural activation is working with depressed individuls to decrease their avoidance and isolation and increase engagement in activties shown to improve mood e.g excercising, going out for dinner
-Therapist reinforces such activity due to depressed individuals tending to avoid difficult difficult situations and become isolated

Question 37

The biological approach to explaining OCD

Answer 37

Genetic explanations & Neural explanations

Question 38

Genetic explanations for OCD

Answer 38

-Genes are involved in individual vulnerability to OCD
-Lewis observed that of his OCD patients, 37% had parents had OCD and 21% had siblings with OCD
-Suggests OCD runs in families, but genetic vulnerability is passed not the certainty
-According to the diathesis stress model certain genes leave some people more likely to develop a mental disorder but not certain
-Some environmental stress is necessary to trigger the condition
-Candidate genes create vulnerability for OCD
-e.g 5HT1-D beta is implicated in the transport of serotonin across synapses
-OCD is polygenic meaning not caused by one single gene but a combination of genetic variations that significantly increase vulnerability
-Taylor analysed findings of previous studies and found that 230 different genes may be involved in OCD
-Genes associated may be those associated with the action of dopamine aswell as serotonin, both neurotransmitters believed to have a role in regulating mood
-OCD is Aetiologically heterogeneous meaning different groups of genes may cause ocd in different people
-Aetiology= origins
-Heterogenous= vary from one person to another
-There is evidence to suggest that different types of OCD may be the result of particular genetic variations such as hoarding disorder and religious obsession

Question 39

Neural explanations for OCD

Answer 39

-Genes associated with OCD are likely to affect the levels of key neurotransmitters as well as structures of the brain
The role of serotonin
-Neurotransmitter serotonin believed to help regulate mood
-Neurotransmitters are responsible for relaying information from one neuron to another
-If person has low levels of serotonin then normal transmission of mood relevant information does not take place and a person may experience low moods (and other mental processes may be affected)
-Some cases of OCD may be explained by a reduction in the functioning of the serotonin system
Decision making systems
-Some cases of OCD particularly hoarding disorder seems to be associated with impaired decision making
-This may be associated with abnormal functioning of the lateral frontal lobes of the brain
-Frontal lobes in front part of brain are responsible for logical thinking and making decisions
-Also evidence that an area called the left parahrippovampalgyrus, associated with processing unpleasant emotions, functions abnormally in OCD

Question 40

Biological aproach to treating OCD

Answer 40

Drug therapy

Question 41

Drug therapy for OCD

Answer 41

Aims to increas or decrease levels of neurotransmitters to increase/ decrease activity
-Typically for serontonin in OCD
SSRIS
-They reduce a person’s emotional symptoms

Question 42

SSRIS for OCD

Answer 42

-An anti depressant dryg called Selective Serontonin Reuptake Inhibitor
-SSRIS work on serontonin system in the brain
-Serontonin is released by certain neurons in the brain
-It is released by presynaptic neurons and travel across a synapse
-Serontonin neurotransmitter chemically covneys the signal from he presynaptic neuron to the postsynaptic neuron and is rebsorbed by the presynnaptic neuron where it is broken down and reused
-By preventing reabsorption and breakdown, SSRIs increase levels of serontonin in the synapse and thus continue to stimulate the postsynaptic neuron
-This compensates for wharever is wrong with the serontonin system in OCD
-Dosage and advice vary according to which SSRI is prescribed
-Fluoextine (brand name Prozac)’s typical daisy does is 20mg though this may increase if it is not benefitting the person
- Available as capsules or liquid
-Takes 3-4 motnhs of daily use for SSRIs to have impact of symptoms
-If not effective after 3-4 months, the dose can be increased up to 60 mg a day (Specifically Fluoxetine)

Question 43

Combining SSRIS with other treatments

Answer 43

-Drugs like SSRIS are often used with Cognitive behaviour therapy CBT to treat OCD
-The drugs reduce a person’s emotional symptoms, such as feeling anxiousor depressed
-Means people with OCD can angage more effectively with the CBT
-In practice some people respond best to CBT and others do with using drugs like Fluextine
-Occassionally other drugs are prescribed alonsdie SSRIS

Question 44

Alternatives to SSRIs

Answer 44

-When SSRI is not effective after 3-4 months thhe dose can be increased e.g up to 60mg for Fluectine or combined with other drugs
-People respond differently to different drugs and alternatives work well for some people and not at all for tohers
1)Tricyclics : An older type of antdepresant e.g Clomipramine
-Acts on various sytems including serontonin system where it has the same effect as SSRIS
-Clomipramine has more serious severe effeects that SSRIS so generally kept in reserve for people who do not respond to SSRIS
2) SNRIs (Serontonin-non adrenline reuptake inhibitors) have been used more recently to treat OCD
-They are a different class of antidepressant drugs and like clomipramine, kept in reserve for those who dont respond to SSRIS
-SNRIs increase levels of another neurotansmitter, noradrenaline as well as serontonin