Psychopathology

Question 1

What are the four definitions of abnormality?

Answer 1

The four definitions of abnormality are:

• Deviation from social norms
• Statistical Infrequency
• Failure to Function Adequately
• Deviation from Ideal Mental Health

Question 2

What is Deviation from Social Norms?

Answer 2

Deviation from Social Norms is a definition of abnormality.

This refers to the idea of deviating from the unwritten rules of how people ‘ought to behave’. People may be failing to meet generally accepted moral and ethical norms.

Question 3

What are 2 strengths and 3 weaknesses of Deviation from Social Norms as a definition of abnormality?

Answer 3

Strengths:
- Gives a clear distinction between what is normal and what is not normal
- Real life applications, such as in the diagnosis of antisocial personality disorder or schizophrenia

Weaknesses
- Cultural Relativism, as social norms are defined by our culture - behaviours may be normal in one culture and abnormal in another.
- Context Sensitivity, for example, it is normal to see someone naked on a beach but not in a classroom - there is a distinction between abnormality and normality.
- Time Sensitive, abnormality cannot be judged over large time periods, for example, homosexuality was not socially acceptable 50 years ago but it is now.

Question 4

What is Statisitical Infrequency?

Answer 4

Statistical Infrequency is a definition of abnormality.

This refers to the idea that abnormal behaviours are categorised as those that do not fit in the norm - when an individual has an uncommon characteristic, they are abnormal.

Question 5

What are 2 strengths and 2 weaknesses of Statistical Infrequency as a definition of abnormality?

Answer 5

Strengths:
- Real life applications: it allows for the measurement of the severity of different symptoms (for example with IQ)
- Objective: this definition of abnormality is based on fact, there is no bias as it is based on statistics.

Weaknesses:
- Unusual Characteristics can be Positive: just because a behaviour is uncommon doesn’t mean it requires treatment (such as above average intelligence).
- Subjectivity - the cutoff point for what is considered to be statistically rare is subjective, for example, defining abnormality as <70 IQ means that people with an IQ of 70 do not get support.

Question 6

What is Failure to Function Adequately?

What are the 5 ways Rosenham and Seligman (1989) propose you can identify this?

Answer 6

Failure to Function Adequately is a definition of abnormality.

Under this definition, someone is proposed as abnormal if they cannot cope in their daily lives.

Rosenham and Seligman (1989) stated that a person is failing to function adequately if they show:

• Maldaptive behaviour (behaviour that goes against long term interests, such as self-harm)
• Personal anguish (anxiety/distress)
• Observer discomfort (causes distress to those around them)
• Irrationality (unpredictable)
• Unconventionality (behaviour isn’t matched by society)

Question 7

What are 2 strengths and 2 weaknesses of Failure to Function Adequately as a definition of abnormality?

Answer 7

Strengths:
Patient’s Perspective - FFA attemps to include the thoughts and feelings of the person experiencing the issue, unlike other definitions.

Measurable through the GAF (General Assessment of Functioning) scale, allowing for the extent of the failure to function to be measurable. Therefore, the decision on whether a behaviour is abnormal or not can be made in an objective way.

Weaknesses:
- This definition only includes those who cannot cope - others, like psychopaths, can be seen as abnormal, however, they function in society fine in ways that benefit them.
- Clinician’s opinion - It is related to the persons’ personal and subjective experience, therefore judgement may be biased, and two observers may not agree on whether someone is managing.

Question 8

What is Deviation from Ideal Mental Health?

What are the 6 criteria for Ideal Mental Health?

Answer 8

Deviation from Ideal Mental Health is a definition of abnormality.

Jahoda (1958) states that normality is positive mental health, and therefore abnormality is a deviation from this ideal mental health.

She argues that to show ideal mental health, one must:
- show environmental mastery (the ability to adapt in new situations)
- show autonomy (independence)
- show resistance to stress
- show self-actualisation (motivation to reach their goals)
- have a positive attitude towards themselves
- have an accurate perception of reality.

Question 9

What are 2 strengths and 3 weaknesses of Deviation from Ideal Mental Health as a definition of abnormality?

Answer 9

Strengths
It is comprehensive - Covers a broad range of criteria for ideal mental health.

Achievement of Goals - Allows for goals to be set and focused on in order to achieve good mental health, allowing the individual to be aspirational.

Weaknesses:
All can’t be achieved - According to this criteria, everyone is abnormal to some degree.

Cultural relativism - some of these criteria are culturally relative, such as self-actualisation

Subjectivity - some of these criteria are difficult to measure. How do we know if someone has a high self esteem

Question 10

What are the 3 behavioural characteristics of phobias?

Answer 10

Panic - a reaction to the phobic stimulus. This may include crying, screaming or running away.

Avoidance - attempting to not come into contact with the phobic stimulus.

Endurance - an alternative to avoidance, where the individual suffers in the presence of the phobic stimulus, experiencing high levels of anxiety.

Question 11

What are the 3 emotional characteristics of phobias?

Answer 11

Anxiety - stopping someone from feeling relaxed or any positive emotion.

Fear - an immediate and unpleasant response when we think about or encounter our phobic stimulus.

Unreasonable emotional response - the emotional response experienced in relation to phobic material will go beyond what is reasonable.

Question 12

What are the 3 cognitive characteristics of phobias?

Answer 12

Selective attention - It is difficult to look away from the phobic stimulus if one can see it.

Irrational beliefs - an exaggerated belief in the harm the phobia can give to you.

Cognitive Distortions - the individual’s perception of the phobia may be distorted and therefore misrepresented compared to reality.

Question 13

What is the two-process model?

Answer 13

Howard Mowrer’s (1960) two-process model states that phobias are acquired through classical conditioning and maintained through operant conditioning.

Question 14

What is classical conditioning?

Answer 14

Classical Conditioning is a part of the two-process model. It is an explanation for how phobias are developed.

In Classical Conditioning, when a neutral stimulus is paired with an unconditioned stimulus, an unconditioned response is given. Eventually, this unconditioned response is associated with the neutral stimulus

Therefore, a phobia happens when the phobic stimulus is the conditioned stimulus which causes a fear response.

An example of classical conditioning is:
- Food would cause a dog to salivate
- A bell would trigger no response in a dog
- When food was shown alongside ringing a bell, the dog would salivate.
- Eventually, the bell ringing without food would cause a dog to salivate.

Question 15

What is operant conditioning?

Answer 15

Operant Conditioning is a part of the two-process model. It is an explanation for how phobias are maintained.

In Operant Conditioning, there are two types of rewards:
- Positive Reinforcement - a behaviour is carried out to receive a reward.
- Negative Reinforcement - a behaviour is carried out to avoid a negative consequence.
Both of these types encourage repetition of the behaviour.

When a phobic stimulus is avoided, fear and anxiety are also avoided, therefore, avoidance is an example of negative reinforcement.

Question 16

What research evidence is there to support classical conditioning?

What are 2 flaws with this study?

Answer 16

Watson and Raynor (1920) classically conditioned an 11-month old child known as Little Albert. They did this by pairing a white rat with a loud noise which scared him. Eventually, Albert begin to associate the fear of the loud noise with the white rat, even when it was on its own.

• This study is associated with ethical issues. Since Albert was a baby, he could not consent. Furthermore, the study came with the risk of long-term harm for Albert, and a phobia of rats was given to him despite this not being his natural experience.
• Little Albert is a single case study, so we cannot generalise - we cannot be certain that all people can develop a phobia the same way Little Albert did.

Question 17

How may the behavioural approach not provide a complete explanation of phobias?

Answer 17

Bounton (2007) highlights the fact that evolutionary factors could play a role in phobias, such as when a stimulus is avoided that could have caused pain or death to our ancestors.

Therefore, some psychologists conclude that some phobias may be a survival mechanism for our ancestors, known as biological preparedness.

In turn, this casts doubt on the two-process model, as it implies there is more to phobias than learning.

Question 18

What is systematic desensitisation?

What are the stages in systematic desensitisation?

Answer 18

Systematic Desensitisation is a behavioural approach to treating phobias developed by Joseph Wolfe. It is a form of counter-conditioning, where the therapist attempts to replace a fear response with a harmless response, as you cannot feal fear and relaxation at the same time.

The steps involved in systematic desensitisation are:

1. The therapist teaches the patient relaxation techniques
2. The client creates an anxiety hierarchy (list of situations involving the phobic stimulus) from least to most feared.
3. The client is exposed to each level, where they must relax in each stage.
4. Eventually, the association of the phobic stimulus with fear is made extinct and a new association with relaxation is formed.

Question 19

What are the 3 strengths and 2 weaknesses of Systematic Desensitisation?

Answer 19

Strengths:

• It is quick and requires less effort than other psychotherapies where the patient may need to play an active role.
• It works for some phobias - for example - Gilroy et al (2003) found that 43 patients with spider phobias who went through systematic desensitisation were significantly less afraid of spiders after 3 months and 33 months, suggesting that it works in the short and long term.
• It is ethical as the patients should feel comfortable, unlike flooding where the patients are ‘thrown into the deep end’.

Weaknesses:

• It only works for certain phobias - it may not work for some phobias such as social phobias.
• If the patient is not physically exposed to the phobia, they may not be able to imagine it well, in which case they must experience the phobia physically, however, this may be expensive for some phobias, such as heights.

Question 20

What is flooding?

Answer 20

Flooding is a behavioural approach to treating phobias.

Here, patients are exposed to the phobic stimulus at the highest level straight away. The client may panic, and the therapist must stop the client from escaping.

Eventually, the client will become exhausted of being in fear (as it requires energy), and calm down in the presence of the phobic stimulus.

Question 21

What is a strength and 2 weaknesses of flooding?

Answer 21

Strength:

• Flooding is cost effective and quicker than other treatments, which enables patients to be free from their symptoms sooner rather than later.

Weaknesses:

• It is less effective for certain types of phobias, such as social phobias, as these have a cognitive aspect to them, therefore, cognitive therapies would be more effective.
• Flooding can be highly traumatic for patients as it purposefully induces a high level of anxiety. Wolpe (1969) reported on a patient who was so anxious that she required hospitalisation.

Question 22

What are the 3 behavioural characteristics of depression?

Answer 22

• Decrease in activity level or agitation and difficulty to relax
• Disruption to sleep and eating behaviour
• Increase in aggression - either towards others or themselves (self harm)

Question 23

What are the 3 emotional characteristics of depression?

Answer 23

• Lowered mood
• Lowered self-esteem
• Anger

Question 24

What are the 3 cognitive characteristics of depression?

Answer 24

• Poor concentration
• Focusing on the negative
• Absolutist thinking (if a situation is slightly unfortunate they see it as an absolute disaster)

Question 25

What are the 3 behavioural characteristics of OCD?

Answer 25

• Compulsions: behaviours performed repeatedly to reduce anxiety, although anxiety levels are only reduced temporarily.
• Avoidance: take action to avoid being in the presence of situations that may trigger obsessions.
• Social impairment: inability to enjoy social activities.

Question 26

What are the 2 emotional characteristics of OCD?

Answer 26

• Anxiety: results from the obsessions
• Depression: result from being unable to control the anxiety-causing thoughts.

Question 27

What are the 3 cognitive characteristics of OCD?

Answer 27

• Obessions: intrusive, irrational and recurrent thoughts that tend to be unpleasant catastrophic thoughts about potential dangers.
• Hypervigilance: a state of constant alertness where the sufferer searches for the source of their obsessive thoughts
• Selective attention: more focus on the objects connected to the obsessions to the point where they cannot focus on other things.

Question 28

What is Beck’s negative triad theory for explaining depression?

Answer 28

Becks negative triad theory states that an individual with depression will have negative schemas about:
- Themselves (self-schemas - feeling inadequate or unworthy)
- The World (thinking people are hostile)
- The Future (thinking things will always turn out badly)
These negative thoughts lead to negative behaviours such as avoidance or social withdrawl.

The negative triad develops in childhood, but provides the framework for cognitive distortions in adulthood, which includes:

• Overgeneralisation (one negative experience results in an assumption that the same thing will always happen)
• Selective abstraction (mentally filtering out the positive and dwelling on the negative).

Question 29

What is Ellis’s ABC model for explaing depression?

Answer 29

Ellis’s ABC model demonstrates how people with depression may respond to negative events.

A - Activating event - An event which causes a reaction
B - Beliefs that are irrational which seek to explain why the event occured.
C - The feelings and behaviours that the beliefs cause.

Ellis also proposed the idea that those who are unable to accept that we do not live in a perfect world may have irrational beliefs. This is known as Musturbatory thinking.

Question 30

What are 2 strengths and 2 weaknesses of the cognitive approach to explaining depression?

Answer 30

Strengths:

• Research support: Grazioli and Terry found that women with negative thinking styles when pregnant were more likely to develop postpartum depression than those with positive thinking styles.
• Cognitive theories have lead to effective treatments with cognitive therapies: CBT had an effectiveness rate of 81%

Weaknesses:
- These explanations do not explain the link between depression and anger
- Assumes depressive thoughts are irrational, when depression may be a reasonable response to challenge.

Question 31

What is Beck’s CBT for treating depression?

Answer 31

CBT (cognitive behavioural therapy) is Beck’s cognitive approach to treating depression. The steps involved are:

• Identification of irrational thoughts from the negative triad (thought-catching)
• Treating the patient as the scientist, where they generate and test hypotheses about the validity of their own irrational thoughts
• Homework tasks, where they record negative thoughts and identify situations which may cause negative thinking.
• Behavioural activation, where they take part in activities they used to enjoy.

Here, the patients realise that their thoughts do not match reality, and therefore change their schemas, discarding their irrational thoughts.

Question 32

What is Ellis’s REBT for treating depression?

Answer 32

REBT (Rational emotive behavioural therapy) is Ellis’s cogntive approach to treating depression.

This is a development of his ABC model to ABCDE:

D - Dispute - The therapist confronts the client’s irrational beliefs using empirical arguments (challenging the client to give evidence for these beliefs) and logical arguments (showing that the beliefs don’t make sense)

E - Effect - reduction of irrational thoughts - restructuring Beliefs leading to better Consequences in the future.

The therapist may also include shame-attacking exercises, where the client performs a behaviour he fears doing in front of others to show that they are able to cope with other people’s dissaproval and unpleasant experiences.

Question 33

What are 2 strengths and 2 weaknesses of the cognitive approach to treating depression?

Answer 33

Strengths:
- March (2007) found that out CBT and drug therapies had an effectiveness rating of 86%, more than drug therapy or CBT alone.
- CBT gives the patients an active role, empowering them to take over their lives, in comparison to drugs where the patients take a passive role and may feel helpless.

Weaknesses:
- Cognitive therapies may be too focused on the present; clients may want to discusss events in their past.
- Some could argue that CBT implies that the client themselves is responsible for their depression, therefore victim blaming and clients feeling shame.

Question 34

What is meant by OCD?`

Answer 34

OCD, or Obsessive Compulsive Disorder, refers to constant intrusive thoughts that cause high anxiety levels (obsessions), which in turn causes a behavioural response to attempt to deal with the continuous invasive thought process (compulsions).

Question 35

What is the genetic explanation of OCD?

Answer 35

It is thought that a vulnerability to OCD is inherited from family.

Genetic analysis has revealed around 230 candidate genes found more frequently in people with OCD, which influence the functioning of neural systems within the brain. These include the:
- SERT gene (which affects serotonin reuptake)
- gene 9
- COMT gene
- 5HT1-beta gene

Therefore, OCD is polygenic, as a predisposition to OCD requires a range of genetic studies.

Question 36

What is the neural explanation of OCD?

Answer 36

Low serotonin levels are thought to cause obsessive thoughts.

Low serotonin levels could be due to it being removed too quickly from the synapse before it is able to transmit its signal to the postsynaptic cell.

In addition, OCD could be explained by the ‘worry circuit’, a set of brain structures which includes the oribtofrontal cortex and the basal ganglia. Communication between these structures appear hyperactive in people with OCD, therefore causing repeated obsessive thoughts. Compulsions may break this loop, but only temporarily.

Question 37

What research evidence is there to support the genetic explanation of OCD?

What is a flaw with this research?

Answer 37

• The biological explanation of OCD is supported by research into family studies, where it was found that the concordance rates of OCD between two non-identical twins are 31% and 68% between identical twins.
• One flaw with this study is that correlation does not equal causation here, as the concordance rates could also be explained by environmental influences, as twins likely grow up in the same household.

Question 38

What is a strength and weakness of the neural explanation of OCD

Answer 38

Strength:
- Neuroimaging studies using PET scanners have shown that hyperactivity in the orbitofrontal cortex can be seen in patients with OCD.

Weakness:
- We cannot be certain that hyperactivity in the orbitofrontal cortex were responsible for causing OCD or if it is a result of having OCD.

• Low levels of serotonin may have a role to play in OCD, but are not the sole cause, as a meta-analysis by Soomro found that SSRIs are more effective than placebos.

Question 39

What is the biological approach to treating OCD?

Answer 39

The biological approach to treating OCD includes drug therapies. The group of drugs used are known as SSRIs (selective serotonin reuptake inhibitors), which slows down the reuptake process of serotonin in the synapse. This decreases anxiety by normalising the activity of the worry circuit.

Examples of SSRIs include Fluoxetine and Prozac.

If SSRIs do not work, alternative treatments include:
- Benzodiapenes, which enhances a neurotransmitter known as GABA, which slows down the central nervous system and results in relaxation.
- SNRIs, which increases serotonin, but increases side effects as they have more side effects.

Question 40

What are 2 strengths and 2 weaknesses of the biological approach to treating OCD?

Answer 40

Strengths:
- Drug therapy is inexpensive and convenient for the patient, in comparison to other therapies which requires the patients to find time.
- Somooro conducted a meta-analysis and found that SSRIs significantly reduced the symptoms in OCD compared to placebos, suggesting drug therapy is effective in the long term.

Weaknesses:
- Drug therapies may have side effects, such as nausea, headache and insomnia.
- Goldacre argues that research on drug therapies are conducted by the pharmaceutical companies developing them, therefore leading them to avoid publishing negative results and skewing meta-analysises, therefore showing that drug therapies may not be as effective as they are claimed to be.