Psychopathology Flashcards
What is seen as abnormal
All societies have their standards of behaviour and attitudes
Deviating from these can be seen as abnormal
What are the problems of defining abnormality
Cultures vary so there isn’t one set of rules
Defining abnormality as deviation from social norms can be used to justify the removal of unwanted people from society e.g. opposing a political regime can be seen as abnormal
What is considered acceptable or abnormal can change over time e.g. homosexuality
How can abnormality be shown with a bell curve
People who behave averagely make up the middle of the bell curve
People who behave abnormally make up the tail ends of the curve
This shows that abnormality is the deviation from statistical norms
Negative evaluation: Problems with defining abnormality as deviation from statistical norms
Why can’t we define abnormality from just statistical norms
Doesn’t take into account desirability of behaviour, just its frequency
E.g. high IQ is abnormal, as is a low one, but a high IQ is desirable but a low one isn’t
No distinction between rare, slightly odd behaviour and rare, psychologically abnormal behaviour
No definite cut-off point where normal behaviour becomes abnormal behaviour
Some behaviours considered abnormal are quite common e.g. mild depression
What does failure to function adequately mean
You can’t function adequately if you can’t cope with the demands of day-to-day life
What is the criteria for failure to function adequately
Dysfunctional behaviour
Observer discomfort
Unpredictable behaviour
Irrational behaviour
Personal distress
If you tick more than one box then your behaviour is considered abnormal
Positive evaluation: strengths statistical infrequency
Why is statistical frequency good to show abnormality
Obvious and relatively quick way and easy way ti define abnormality
Real life application: relatively easy to determine abnormality using psychometric tests developed using statistical methods
Most patients with mental disorders will have their symptoms compared to the social norm
What are Jahoda’s six conditions associated with ideal mental health
Positive self attitude
Self actualisation ( realising your potential, being fulfilled )
Resistance to stress
Personal autonomy ( making your own decisions, being in control )
Accurate perception of reality
Adaptation to the environment
Negative evaluation of Jahoda’s six conditions
They’re subjective ( ideas of what is required will differ from person to person )
E.g. a violent offender may have a positive self-attitude and be resistant to stress - yet society wouldn’t consider them to have good mental health
Positive evaluations of Jahoda’s six conditions
Comprehensive - covers a broad range of criteria
This covers all aspects of mental health and makes us aware of all the different factors which can affect our mental health
What symptoms are associated with mental illness
Impairment of intellectual functions, such as memory or comprehension
Alterations to mood that lead to delusional appraisals of the past or future, or lack of any appraisal
Delusional beliefs, such as of persecution or jealousy
Disordered thinking - the person may be unable to appraise their situation or communicate with others
How do scientists classify mental disorders
DSM: Diagnostic and Statistical Manual of Mental Disorders
Used to classify disorders using defined diagnostic criteria
Includes a list of symptoms which are used to diagnose
What is a phobia
An example of an anxiety disorder
An extreme, irrational fear of a particular object or situation
The DSM classifies several types of phobia: specific phobias, agoraphobia, social phobia ( social anxiety disorder )
What are specific phobias
This is a fear of specific objects of situations
Subtypes of specific phobias
Animal type ( zoophobia, e.g. fear of spiders )
Environmental danger type ( e.g. fear of water )
Blood-injection-injury type ( fear of needles )
Situational type ( e.g. fear of enclosed spaces or heights )
Other ( any phobia not covered in categories above )
What is agoraphobia
Fear of open spaces, using public transport, being in an enclosed spaces, waiting in line or being in a crowd, or not being at home
Linked to a fear of not being able to escape or find help if your in an embarrassing situation
Involves the sufferer avoiding the situation in order to avoid distress
May develop as a result of other phobias, because the person’s afraid that they may come across the source of their fear if they leave the house
What is social anxiety disorder ( social phobia )
Fear of being in social situations
( e.g. eating in public or talking in front of a group of people )
It’s usually down to the possibility of being judged or being embarrassed
What are the cognitive symptoms of phobias
Irrational beliefs about the stimulus that causes fear
People often find it hard to concentrate because they’re preoccupied by anxious thoughts
What are the behavioural symptoms of phobias
Avoiding social situations because they cause anxiety
This happens especially if someone has social anxiety disorder (social phobia) or agoraphobia
Altering behaviour to avoid the feared object or situation, and trying to escape if it’s encountered
People are often generally restless and easily startled
What are the physical symptoms of phobias
Activation of the fight or flight response when the feared object or situation is encountered or thought about
This involves release of adrenaline, increased heart and breathing, and muscle tension
What are the emotional symptoms of phobias
Anxiety and a feeling of dread
How do behaviourists believe phobias are caused
Through classical and operant conditioning
How can phobias be caused by classical conditioning
In classical conditioning a natural reflex is produced in response to a previously neutral stimulus
Phobias can be created when a natural fear response becomes associated with a particular stimulus
Process of causing a phobia from classical conditioning
A certain stimulus, e.g. a loud noise ( UCS ) triggers a neutral reflex, e.g. fear ( UCR )
UCS repeatedly presented with another stimulus, e.g. a rat ( CS ) triggers fear ( UCR )
Over time, the rat presented by itself triggers fear ( CR )
How can phobias be generalised
Phobias can generalise to similar stimuli
E.g. Watson and Rayner conditioned a phobia in Little Albert of white rats which was generalised to fluffy white objects
How can operant conditioning play a part in phobias
Operant conditioning can be used to maintain phobias
How does Mowrer’s two process model explain how phobias are maintained
Explains how classical and operant conditioning can be used to maintain phobias
People develop phobias by classical conditioning - a CS is paired with an UCS to produce the CR
Once somebody has developed a phobia, it’s maintained through operant conditioning- people get anxious around the phobic stimulus and avoid it
This prevents anxiety and acts as negative reinforcement
How can operant conditioning explain how social phobia develop from a specific phobia
People are anxious that they’ll experience a panic attack in a social situation or an open place ( because of their specific phobia ), so they avoid these situations
Strengths of the behavioural explanation of phobias
Has been backed up with research: Barlow and Durante showed that 50% of people with a fear of driving had been in an accident so through classical conditioning the accident (UCS) turned driving into a CS
Behavioural therapies are very effective at treating phobias by getting the person to change their response to the stimulus
This suggest they treat the cause of the problem
Evidence that the behavioural explanation of phobias may be flawed
Facet found that only 7% of spider phobics recalled having a traumatic experience with a spider
This suggests that there could be other explanations, e.g. biological factors
How are mood disorders characterised
Characterised by strong emotions
These can influence a person’s ability to function normally
A mood disorder can affect a person’s perception, thinking and behaviour
What is major depression
Known as unipolar disorder
An episode of depression that can occur suddenly
Major depression can be reactive - caused by external factors e.g. death of a loved one
It can be endogenous - caused by internal factors e.g. neurological factors
What is manic depression
Bipolar disorder
Alternation between two mood extremes (mania and depression)
The change in mood often occurs in regular cycles of days or weeks
Episodes of mania involve over activity, rapid speech and feeling extremely happy or agitated
Episodes of depression involve regular depression symptoms
Physical/ behavioural symptoms of depression
Sleep disturbances - insomnia or hypersomnia
Change in appetite - may eat more or less and gain or lose weight
Pain - headaches, joint ache and muscle ache
Lack of activity - social withdrawal and loss of sex drive
Cognitive symptoms of depression
Experiencing persistent negative beliefs about themselves and their abilities
Suicidal thoughts
Slower thought processes - difficulty concentrating and making decisions
Emotional/ affective symptoms of depression
Extreme feelings of sadness, hopelessness and despair
Diurnal mood variation - changes in mood throughout the day e.g. feeling worse in the morning
Anhedonia - no longer enjoying activities that used to be pleasurable
How to be diagnosed with depression
According to DSM, a person must have at least 5 of the symptoms (from either behavioural, cognitive, emotional) every day for at least 2 weeks
How does the ABC model explain depression
Ellis’ ABC model:
Activating event (A) (e.g. a failed exam) begins disorder
Which then leads to a Belief (B) about why this happened
This belief may be rational (e.g. didn’t prepare enough) or irrational (e.g. too stupid to pass)
Belief leads to a Consequence (C)
Rational beliefs produce adaptive (appropriate) consequences (e.g. more revision)
Irrational beliefs produce maladaptive (bad and inappropriate) consequences (e.g. getting depressed)
How does Beck’s negative triad explain depression
Beck identified a ‘negative triad) of automatic thoughts linked to depression
These could be negative views about:
- Themselves (e.g. can’t succeed at anything)
- The world (e.g. must be successful to be a good person)
- The future (e.g. that nothing will change)
Negative evaluation for cognitive explanations for depression: does not explain all aspects of depression
The theory explains the basic symptoms of depression however it is a complex disorder with a range of symptoms, not all of which can be explained
This explanation also does not explain why some individuals experience anger associated with their depression or why some patients suffer hallucinations and delusions
What is systematic desensitisation
This is where counter conditioning is used so that the person learns to associate the phobic stimulus with relaxation rather than fear
How does systematic desensitisation work
The phobic person makes a fear hierarchy
This is a list of feared events, showing what they fear least (e.g. seeing a picture of a spider) through to their most feared event (e.g. holding a spider)
They are then taught relaxation techniques like deep breathing
The patient then imagines the anxiety-provoking situations, starting with the least stressful
They’re encouraged to use the relaxation techniques, and the process stops if they feel anxious
This whole process is repeated for each stage of the hierarchy, until they are calm through the most feared event
How is the feared event linked with relaxation
Relaxation and anxiety can’t happen at the same time, so when they become relaxed and calm, they’re no longer scared
This is repeated until the feared event is only linked with relaxation
What is flooding
Patient is exposed to the phobic stimulus straight away
No relaxation or gradual build up
Can be done in real life or patient can be asked to visualise it
Patient kept in this situation until the anxiety they feel at first has gone
Realise that nothing bad has happened to them in this time
Fear should be gone
Advantages of behavioural therapy
Very effective for treating specific phobias
Systematic desensitisation has been found to be the most effective for treating phobias
Works very quickly: anxiety can be reduced after just one session
Disadvantages of behavioural therapy
Ethical issues surrounding behavioural therapy - especially flooding, as it causes a lot of anxiety
If patients drop out of therapy before fear has gone, it can end up causing more anxiety than before
Behavioural therapy only treats the symptoms of the disorder
Other therapies try to tackle the cause of it e.g. CBT
Positive evaluation of behavioural therapy: it is suitable for a diverse range of people
Some people with anxiety disorders, also have learning disabilities
It can be difficult for people to understand other therapies such as flooding or CBT that require the ability to reflect on what you are thinking
How does Cognitive Behavioural Therapy work
Therapist and client identify the client’s faulty cognitions (thoughts and beliefs)
Therapists then tries to help the client see that the cognitions aren’t true
Together, they set goals to think in more positive or adaptive ways
Treatment mainly focuses on the present situation, although client may need to look back to past experiences
Therapists can encourages their clients to keeps a diary - can record though patterns, feelings and actions
Advantages of CBT
Empowers patients - it puts them in charge of their own treatment by teaching them self help strategies
Less ethical issues than other therapies like drug therapy
Patients who were withdrawn from CBT were less likely to relapse than patients withdrawn from drug therapy
CBT is particularly effective for people who put a lot of pressure on themselves and feel guilty about being inadequate
Disadvantages of CBT
Cognitive therapies may take a long time and be costly
May be more effective when combined with other approaches, e.g. drug therapy
CBT may only be effective if the therapist is experienced
Patients who therapists are still gaining experience may be better off with drugs
Person could begin to feel like he or she is to blame for their problems
Positive evaluation of CBT: How effective it is
CBT is effective in reducing symptoms of depression and in preventing relapse and there is a large body of evidence to support this
It is as effective as antidepressants for many types of depression
Negative evaluation of CBT: CBT may not work for the most severe cases
In some cases depression may be so severe that patients cannot motivate themselves to engage in the therapy
In these cases, it is possible to treat the patient with antidepressants 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
Positive evaluation for CBT: Success may be due to the therapist-patient relationship
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 talk to someone who will listen could be what matters most
Negative evaluation for CBT: Some patients may want to explore their past
CBT focuses on the ‘here and now’ however there may be links to childhood experiences and current depression and patients might want to talk about these experiences
They can find this ‘present-focus’ very frustrating
Negative evaluation for CBT: An over-emphasis on cognition
There is a risk that in focusing on what is happening in the mind of the individual may end up minimising the importance of the circumstances the individual is living in
Causes ethical issue for CBT: important for therapists to keep in mind that not all problems are in the mind.
How can OCD be split up
Obsessions and compulsions
These may be linked to eachother
E.g. excessive worrying about germs (obsession) may lead to excessive hand washing (compulsion)
What are the emotional aspects of OCD
OCD may feel depressed and/or other negative emotions
Guilt and disgust
What are the behavioural aspects of OCD
How a person acts (behaves) which typically leads to the carrying out of repetitive actions to reduce anxiety.
This often leads to avoidance of situations that trigger anxiety
What are the cognitive aspects of OCD
OCD sufferers are usually plagued with obsessive thoughts
They also tend to develop cognitive strategies
Anxiety
What are the statistics of OCD
Affects 2% of people around the world
Sufferers develop the disorder in their late teens or early 20s
Disorder occurs equally across men and women in all ethnic groups
How does the DSM classify obsessions
Persistent and reoccurring thoughts, images or impulses that are unwanted and cause distress to the person experiencing them
Person actively tried to ignore these but is unable to
Obsessions have not been caused by other physiological substances like drugs
How does the DSM describe compulsions
The person repeats physical behaviours or mental acts that relate to an obsession
Sometimes the person has rules that they must follow strictly
Compulsions are meant to reduce anxiety or prevent a feared situation - in reality they’re excessive or wouldn’t actually stop a dreaded situation
Only reduce anxiety for a short time
Compulsions have not been caused by other physiological substances like drugs
How to diagnose someone with OCD according to DSM
If obsessions or compulsions last at least 1 hour each day, this means a clinical case of OCD
Also if the obsessions or compulsions interfere with a person’s ability to hold down a job, maintain a relationship or take part in social activities
Common OCD behaviours
Checking: checking the lights are off
Contamination: fear of catching germs
Hoarding: keeping useless objects
Symmetry and orderliness: getting objects lined up perfectly
Evidence for genetic factors causing OCD
Meta analysis of twin studies:
Found that for identical twins, if one twin had OCD then 68% of the time both twins had it, compared to 31% for non identical
Another study found that 10% of people with an immediate relative (parent, offspring, sibling) with OCD also suffered
This is compared to around 2% of people in general population
Evidence against genetic factors causing OCD
No study has found a 100% concordance rate, so genetics can’t be the full cause of OCD
Possible that children imitate the behaviour of relatives with OCD
Concordance rates don’t prove that OCD is caused by genetics
May be that general anxiety is genetic and that going on to develop OCD has other contributing factors e.g. biochemical or psychological factors
How can genes be a cause of OCD
Candidate genes are involved in the development of OCD
E.g. SERT gene: involved in regulating serotonin, a neurotransmitter
Or COMT gene: regulates the production of dopamine
Dopamine effects motivation and drive
How can OCD be caused by neurological factors
PET scans show that abnormality in the basal ganglia within in the brain can be linked to OCD
Strengths of biological explanation of OCD
Has scientific basis in biology - evidence that low serotonin and damage to basal ganglia correlate with cases of OCD, though it doesn’t show a cause
Twins studies show genetics has some effect on the likelihood of OCD
Can be seen as ethical - people aren’t blamed for their disorders
Weaknesses of biological explanation of OCD
Doesn’t take into account the effect of environment, family, childhood experiences or social influences - psychologists taking other approaches consider these important
Biological therapies raise ethical concerns
Drugs can produce addiction and may only suppress symptoms not cure the disorder
How can OCD be treated using biological therapy
Involves drug therapy
Drugs increase levels of serotonin in the brain using selective serotonin reuptake inhibitors (SSRIs)
These are a type of antidepressants that increase availability of serotonin
What do SSRIs do
Prevent the reuptake of serotonin in the synaptic cleft (gap between two neurons)
This means there’s more serotonin available to the next neuron
Advantages of using SSRIs for OCD
Research has found SSRIs to be effective in treating OCD
Studies have found using other antidepressants that don’t affect serotonin levels is ineffective at reducing OCD symptoms
Disadvantages of using SSRIs for OCD
Up to 50% of patients with OCD don’t experience any improvement in their symptoms when taking SSRIs
Out of those that do improve, up to 90% relapse when they stop taking them
SSRIs have to be taken for several weeks before the patient notices an improvement in their symptoms
Side effects of the drugs include nausea, headaches and sometimes increased anxiety
This can cause people to stop taking the medication
Positive evaluation for how areas of the brain can cause OCD
Advances in technology allows scientists to see that OCD sufferers have excessive activity in the orbital frontal cortex
Cleaning and checking behaviours are “hard wired” in the thalamus
Negative evaluation for how areas of the brain can cause OCD
The compulsions may be explained by the structural abnormality of the basal ganglia but not necessarily the obsessional thoughts
There are inconsistencies found in the research as no system has been found that always plays a role in OCD
These neural changes could be as a result of suffering from the disorder, not necessarily the cause of it
What is dysfunctional behaviour
Dysfunctional behaviour - behaviour which goes against accepted standards of behaviour
What is observer discomfort
Observer discomfort - behaviour that causes other individuals to become uncomfortable
What is unpredictable behaviour
Unpredictable behaviour - impulsive behaviour that seems to be uncontrollable
What is irrational behaviour
Irrational behaviour - behaviour that’s unreasonable and illogical
What is personal distress
Personal distress - being affected by emotion to an excessive degree
What does the DSM do
Makes diagnosis concrete and descriptive
Classifications allow data to be collected about a disorder
Can help in the development of new treatments and medicine
However, has been criticised for stigmatising people and ignoring ‘uniqueness’ by putting them in artificial groups
