Psychopathology Flashcards
1
Q
What is psychopathology
A
- scientific study of mental disorders and abnormalities
- in order to diagnose someone with a mental disorder we must first decide in what way their behaviour differs
2
Q
What are the different abnormality definitions
A
- deviation from social norms
- failure to function adequately
- deviation from ideal mental health
- statistical infrequency
3
Q
What is the deviation from social norms definition
A
- any behaviour that does not follow accepted social patterns or social rules
- such violation of these patterns or rules can be regarded as abnormal behaviour and would be classed as unacceptable
- norms, values, and accepted ways to behave vary from one culture to the next and from one time period to the next
4
Q
What does deviation from social norms consider
A
- looks at impact of an individual’s behaviour upon others
- behaviour displayed is examined in terms of how unstable the behaviour is for the individual and for society as a whole
5
Q
What are social norms
A
- rules in society governing behaviour
- based on moral standards
- can be either explicit or implicit
- explicit => the law
- implicit => codes of conduct
6
Q
How can deviation from social norms be used
A
- help to identify a person who might be suffering from a mental disorder
- if a person is behaving in a strange way that deviates what is expected of them, then we could be concerned enough to think the person might be suffering from a mental disorder
7
Q
What are negative evaluation points for deviation from social norms
A
- odd/eccentric
- context
- temporal validity
- benefits
8
Q
How is odd/eccentric a negative evaluation point for deviation from social norms
A
- definition does not always clearly indicate that a person has a psychological abnormality
- therefore psychologists must be cautious when making judgements as individual may just be odd/eccentric
9
Q
How is context a negative evaluation for deviation from social norms
A
- context must be taken into account
- e.g. wearing no clothes in high street would be odd and deviating from social norms but at a nudist beach would be considered acceptable
10
Q
How is temporal validity a negative evaluation for deviation from social norms
A
- social norms of a society can change over time
- e.g. homosexuality was classed as a mental illness in the ICD until 1990 but is no longer considered an abnormality
11
Q
How is benefits a negative evaluation for deviation from social norms
A
- in some instances, it can be beneficial to break from social norms
- e.g. the suffragettes broke many social norms but this led to women gaining the right to vote
12
Q
What is the failure to function adequately definition
A
- model of abnormality based on the fact that the person is unable to cope with day to day life
- e.g. having a job or interacting with others well
- due to individual experiencing psychological distress and discomfort
- will impact their personal, social and occupational life
- 7 criteria
13
Q
What are the 7 criteria of the failure to function adequately definition
A
- suffering => feeling sad, anxious or scared
- unpredictability => unexpected behaviour characterised by loss of control
- maladaptiveness => behaviour stopping individual from attaining life goals => socially and occupationally
- observer discomfort => behaviour causing discomfort in others
- vividness and unconventionality => behaviour not conforming to what is generally done in a certain situation
- irrationality => illogical behaviours
- violation of moral standard => behaviours violating society’s ethical standards
14
Q
How is the criteria significant for failure to function adequately
A
- more criteria displayed, the more abnormal the individual is
- allows psychologists to see degree of abnormality
15
Q
What are positive evaluation points for the failure to function adequately definition of abnormality
A
- recognises patient’s perspective, e.g. personal distress
- using GAF scale, psychologist can see degree of abnormality
16
Q
What are negative evaluation points for the failure to function adequately definition of abnormality
A
- Harold Shipmen
- normality
- Stephen Gough
- measuring
17
Q
How is Harold Shipman a negative evaluation for the failure to function adequately definition of abnormality
A
- abnormality is not always accompanied by a failure to function
- psychopaths can commit murders while appearing normal
- Harold Shipman was a doctor who murdered 215 patients over 23 years
- maintained outward appearance of a respectable member of his profession, and had a family, the whole time he was committing murders
- no one was aware he was a serial killer
18
Q
How is normality a negative evaluation for the failure to function adequately definition of abnormality
A
- sometimes it is normal and psychologically healthy to suffer from person distress
- e.g. when a loved one dies
- it would be abnormal not to feel distress under these circumstances
19
Q
How is Stephen Gough a negative evaluation for the failure to function adequately definition of abnormality
A
- behaviour may cause distress to other people and be regarded as dysfunctional when person themself feels no distress
- Stephen Gough has been imprisoned for breaching the peace as he insists on hiking naked
- this makes others experience observer discomfort but he feels no distress
20
Q
How is measuring a negative evaluation for the failure to function adequately definition of abnormality
A
- can be difficult to measure and analyse criteria
- needs to be operationalised
- model is subjective and lacks being scientific and objective
21
Q
What is the deviation from ideal mental health definition
A
- stems from humanistic approach
- behaviour is abnormal if it fails to meet prescribed criteria for psychological normality
- devised by Jahoda (1958) under concept of ideal mental health
- identified six characteristics that individuals should exhibit to be considered normal
- absence of characteristics indicates abnormality
- more criteria not met, more abnormal individual is
22
Q
What is the criteria for deviation from ideal mental health
A
- autonomy => being independent, self reliant and able to make personal decisions
- perception of reality => perceiving world in non distorted fashion, having objective and realistic view
- resistance to stress => effective coping strategies and being able to manage everyday anxiety provoking and stressful situations
- integration => having self respect, high self esteem, confidence and positive self concept
- environmental mastery => competent in all aspects of life and ability to meet demands of situations and flexibility to adapt to life changing circumstances
- self actualisation => experience personal growth and development, reaching full potential and feeling fulfilled
23
Q
What are positive evaluation points for the deviation from ideal mental health definition of abnormality
A
- comprehensive, based on similar models for physical health
- positive, holistic, focuses on optimal criteria which all should aim for
- highlights areas individuals should work on
24
Q
What are negative evaluation points for the deviation from ideal mental health definition of abnormality
A
- demanding and unrealistic criteria => not many people reach self actualisation and most people do not meet all criteria at one given moment
- most criteria is vague and difficult to measure => subjective (self actualisation)
- cultural biased, collectivist cultures emphasise communal goals and regard autonomy as undesirable and these people would be seen as abnormal in individualistic cultures
25
Q
What is the statistical infrequency definition to abnormality
A
- abnormal behaviour is that which is statistically rare
- instances of abnormality would lie at both extremes of a normal distribution
26
Q
Using an example, explain how the statistical infrequency definition works
A
- looking at IQ scores
- average score is 100
- scores that are significantly higher than 100 (130) or significantly lower than 100 (70) are statistically infrequent
- 2.5% of the population has an above average IQ score and 2.5% has below average, showing infrequency
27
Q
What are positive evaluation points for the statistical infrequency definition
A
- judgements are based on objective, scientific and unbiased data which helps indicate abnormality and normality
28
Q
What are negative evaluation points for the statistical infrequency definition
A
- some behaviour can be statistically rare but also desirable such as someone who has above average IQ, they would be highly regarded instead of seen as someone who is abnormal
- some disorders are not statistically rare, such as depression which affects 27% of elderly people
- many rare behaviours or characteristics have no bearing on normality or abnormality, such as being left handed
- there is a subjective cut off point, why is someone who has an IQ of 71 normal but someone with 70 abnormal
29
Q
What are behavioural characteristics of phobias
A
- avoidance => evade phobic object in presence
- endurance => person may remain in presence of phobic object, frozen and unable to move
- disruption of function => presence of phobic object may interfere with ability to function
- panic => person may panic in presence of phobic object, crying, running, screaming, etc.
30
Q
What are emotional characteristics of phobias
A
- fear => persistent, excessive, unreasonable worry and distress may be felt in presence of phobic object
- anxiety => person feels terror and might be uncertain and apprehensive when encountering phobic object
31
Q
What are cognitive characteristics of phobias
A
- irrational => person thinks in irrational manner and resist any rational arguments to counter
- insight => person will know fear is excessive or unreasonable but still find it difficult not to fear
- cognitive distortions => distorted perception of stimulus
- selective attention => becoming fixated on phobic object
32
Q
What are behavioural explanations of phobias
A
- classical conditioning
- operant conditioning
33
Q
What is classical conditioning
A
- learning through association
- stimulus produces same response as another stimulus as they have been constantly presented at the same time
- association built between stimuli
34
Q
What is an example of a classical conditioning study
A
- Little Albert by Watson and Raynor (1920)
- presented Albert with rat, and he showed no fears
- started striking metal bars behind Albert’s head each time he reached for rat
- loud noise startled Albert, making him cry
- both stimuli paired multiple times building association
- started crying each time he saw rat
35
Q
Explain how Little Albert was an example of classical conditioning
A
- infants are born with certain reflex; stimulus of loud sound is unconditioned stimulus producing reflex of fear as unconditioned response
- white rat is neutral stimulus producing no reflexes
- over time, the white rat became associated with the unconditioned stimulus of a loud noise
- white rat then became conditioned stimulus producing fear as conditioned response
- conditioned response of fear then generalised to other objects or situations; Albert became scared of any white or fluffy objects
36
Q
What is operant conditioning
A
- learning through consequences of ones behaviour
- positive reinforcement => behaviour adds something pleasant
- negative reinforcement => behaviour removes something pleasant
- punishment => behaviour adds something unpleasant
- avoidance of phobic object reduces fear thus it being reinforced => negative reinfocement
37
Q
What are positive evaluation points for behavioural explanations of phobias
A
- supported by King (1998)
- reviewed case studies and found children acquire phobias by encountering traumatic experiences with phobic object
38
Q
What are negative evaluation points for behavioural explanations of phobias
A
- study on Little Albert was unreliable as they have not been repeated so cannot be generalised, study cannot be tested again due to ethical concerns
- some people have traumatic experiences but do not develop phobia, e.g. car crash but still drive. People also build phobias without having traumatic experience, e.g. snakes
- Menzies found only 2% of people with hydrophobia have had bad experience with water, 98% built phobia without classical conditioning so there must be other reasons
- environmentally deterministic/reductionist, does not take into account biological factors such as genetic vulnerability and ignore free will
39
Q
What are behavioural treatments for phobias
A
- systematic desensitisation (SD)
- flooding
40
Q
What is SD
A
- developed by Wolpe (1958) to reduce phobias using classical conditioning
- person experience fear and anxiety as behaviour response to phobic object
- SD replaces fear with relaxed response
- impossible to experience two opposite emotions at same time => reciprocal inhibition
- if patient can learn to stay calm they can be cured => counter conditioning
41
Q
What are the different stages of SD
A
- anxiety hierarchy
- relaxation training
- gradual exposure
42
Q
What is anxiety hierarchy in SD
A
- hierarchy of fear constructed by therapist and patient
- situations involving phobic object ranked from least to most fearful
43
Q
What is relaxation training in SD
A
- patients taught deep muscle relaxation, such as progressives muscular relaxation (PMR) and relaxation response
- idea behind PMR is to contract muscles tightly, hold tension for a few seconds then consciously relax muscles even further
44
Q
What is gradual exposure in SD
A
- patient introduced to phobic object and work way up anxiety hierarchy starting with least frightening
- use relaxation techniques while exposed to phobic object
- when comfortable, they move onto next stage
- eventually, through repeated exposure and relaxation, phobia is eliminated
45
Q
What are positive evaluation points for SD
A
- Jones (1924) => eradicated Little Peter’s phobia of white rabbit by presenting it closer each time his anxiety reduced
- Klosko et al. (1990) => assessed various therapies for treatment of panic disorders and found 87% were panic free after SD, 50% after medication, 36% on placebo and 33% with no treatment
- less traumatic therapy than compared to flooding, no ethical issues
46
Q
What are negative evaluation points for SD
A
- behaviour treatments address symptoms of phobias
- some believe that is only tip of iceberg and there are underlying causes
- means symptoms return or symptom substitution occurs when abnormal behaviours replace ones removed
47
Q
What is flooding
A
- direct exposure to phobic object
- patient taught relaxation techniques but there is no gradual build up
- can be for real or virtual
- stops phobic responses quick as patient has no option for avoidance therefore sees object as harmless and extinction occurs
- patient may achieve relaxation through exhausting themselves out
- ethical even though there is psychological harm as there is informed consent
48
Q
What are cognitive characteristics of depression
A
- negative schema => negative view of world, themselves and future => self fulfilling prophecy
- poor concentration => difficulty paying/maintaining attention
49
Q
What are emotional characteristics of depression
A
- low mood => ever present and overwhelming feeling of sadness/hopelessness and feeling empty
- worthlessness => constant feelings of reduced worth, low levels of self esteem
- anger => anger towards others or themselves
50
Q
What are positive evaluation points for flooding
A
- Wolpe (1960) supports flooding to remove patient’s phobias of cases. Girl forced into car and driven around for 4 hours until hysteria was eradicated
- Ost (1997) states flooding is effective at producing immediate improvements
- cost effective compared to cognitive behaviour therapies
51
Q
What are negative evaluation points for flooding
A
- highly traumatic experience and many patients may stop therapy => time and money wasted
- less effective for some phobias as they may be more cognitive, social phobias better cured by cognitive therapies
52
Q
What are behavioural characteristics of depression
A
- changes in activity levels => lethargy and withdrawal from activities previously enjoyable (anhedonia) / high levels of nervous energy, can neglect personal hygiene
- disruption to sleep => insomnia (lack of sleep) or hypersomnia (excess sleep)
- disruption to eating => increased/decreased weight
- aggression => irritable causing aggression to others/self harm
53
Q
What are cognitive explanations of depression
A
- underlying assumption of cognitive explanation is depression is result of disturbance in thinking
- consequence of faulty and negative thinking about events
- negative triad
- ABC model
54
Q
What is the negative triad
A
- Beck (1967) believed depressed people acquired negative schema during childhood so have tendency to adopt world in pessimistic view
- schema is cognitive framework helping us organise and interpret information and make sense of new information
- can be caused by parental/peer rejection and criticism from teachers
55
Q
What are negative schemas
A
- activated when a person encounters a new situation, resembling original conditions in which schema was learned
- lead to cognitive biases in thinking
56
Q
How do negative schemas works
A
- negative schemas and cognitive biases maintain negative triad
- irrational view of three elements in the persons belief system
57
Q
What are the elements in the negative triad
A
- the self => there is nothing to like about me, I am boring
- the world => nobody likes me, everyone would prefer someone else’s company
- the future => I am always going to be on my own, nobody will ever love me
58
Q
What are positive evaluation points for the negative triad
A
- Terry (2000)
- assessed 65 pregnant women for cognitive vulnerability before and after birth
- found women who had high cognitive vulnerability most likely to suffer post partum depression, supporting negative triad
59
Q
What are negative evaluation points for the negative triad
A
- cause and effect not clear => does depression cause irrational thinking or the other way
- does not explain how some symptoms of depression might develop => many patients are angry and Beck’s theory fails to account for this
60
Q
What is the ABC model
A
- Ellis (1962) proposed depression caused by irrational beliefs
- devised model to explain how irrational and negative beliefs are formed
61
Q
What are the stages of the ABC model
A
- Activating Event => incident in someone’s life
- Beliefs => thought after event, could be rational or irrational
- Consequences => emotions caused by beliefs. Rational beliefs lead to healthy emotions whereas irrational beliefs lead to unhealthy emotions
62
Q
What are positive evaluation points for the ABC model
A
- Bates (1999) found depressed patients who were given negative thought statements become more depressed supporting view that negative thinking leads to depression
63
Q
What are negative evaluation points for the ABC model
A
- blames patient for depression
- unclear whether depression causes negative thinking or negative thinking causes depression
- Zhang (2005) found there is a gene related to depression making it 10x more likely, thus environmentally deterministic
64
Q
What are cognitive treatments for depression
A
- aim of cognitive behaviour therapy is to change irrational thoughts and alleviate depression
- Beck’s Cognitive Behavioural Therapy (CBT)
- Rational Emotive Therapy (REBT)
65
Q
What is Beck’s CBT
A
- identify irrational thoughts => thought catching
- patient then berates hypothesis to test validity of irrational thoughts => patient as scientist
- several strategies used to test hypothesis => patient may gather data and compare evidence, may do homework, may keep diary to record negative thinking situations to target
- when patients report positive thoughts, they are praised by therapist => positive reinforcement
66
Q
What is the aim of Beck’s CBT
A
- cognitive restructuring
- learning to identify, dispute, and therefore change
67
Q
What is REBT
A
- Ellis (1994) developed CBT for depression
- therapist uses logical arguments to show patients’ self defeating beliefs are not logical
- also uses empirical arguments to show self defeating beliefs are not consistent with reality
- patients encouraged to engage in behavioural activation => becoming more active and taking part in pleasurable activities, many depressed patients do not engage in activities they use to enjoy
68
Q
What is the aim of REBT
A
- challenging automatic negative thoughts and replacing them with rational beliefs
69
Q
What are positive evaluation points for CBT
A
- March et al. (2007) => examined 327 adolescents and compared effectiveness of CBT. 81% of of anti-depressant group and 81% of CBT group significantly improved by 86% of combination group improved, showing combination is most effective
- David (2008) => found CBT better than anti-depressants. Compared 170 patients with 14 weeks of CBT to patients with drug fluoxetine. 6 months later, found CBT patients less likely to relapse
70
Q
What are negative evaluation points for CBT
A
- requires commitment and motivation, depression patients may not engage/join so CBT will be ineffective. Anti-depressants do not require same level of motivation so are more effective
- suggests irrational thinking is primary cause for depression and ignores other factors, e.g. domestic violence or abuse victims who need to change circumstances and not thinking
- relies on self reporting as thoughts cannot be objectively observed/measured => unreliable
71
Q
What are behavioural characteristics of OCD
A
- compulsions => repetitive actions that could hinder person’s ability to perform everyday function, compulsive behaviour reduces anxiety created by obsessions, person feels like they must perform action or something bad will happen
- avoidance => sufferers attempt to reduce anxiety by avoiding situations triggering OCD
72
Q
What are emotional characteristics of OCD
A
- high anxiety => obsessions and compulsions are a source of anxiety, sufferers aware obsessions and compulsive behaviours are excessive causing embarrassment, also aware they cannot consciously control behaviour leading to distress
- disgust => feelings of disgust may be directed against something external
73
Q
What are cognitive characteristics of OCD
A
- obsessions => recurrent, instructive, irrational thoughts perceived as inappropriate. May be frightening/embarrassing and person may not share them. Uncontrollable and cause anxiety
- awareness => sufferers understand compulsive behaviours and obsessive thoughts are irrational but cannot control/stop them
- catastrophic thinking => scared something terrible will happen if compulsion not carried out
74
Q
What does the biological approach thinking about OCD
A
- assumes OCD is caused by genetic and biochemical factors
75
Q
How does the SERT gene affect OCD
A
- affects transportation of serotonin, causing low levels
- low levels of serotonin linked to OCD (and depression)
76
Q
What is the genetic explanation behind OCD
A
- classed as polygenic => many genes responsible for disorder (230) => candidate genes
77
Q
What are the two main genes that have a role in OCD
A
- COMT gene
- SERT gene
78
Q
How does the COMT gene affect OCD
A
- gene regulates production of dopamine
- high levels of dopamine associated with OCD
- one variation of COMT gene results in higher levels of dopamine
- this variation found more common in OCD patients
79
Q
What are positive evaluation points for the genetic explanation to OCD
A
- Nestadt (2000) => found people who had first degree relatives with OCD were 5x more likely to get disorder
- Billett (1998) -> found from meta analysis of 14 twin studies that OCD twice as concordant in MZ twins than DZ twins
80
Q
What are negative evaluation points for the genetic explanation to OCD
A
- concordance rate for OCD in MZ twins is not 100% so OCD cannot be caused entirely by genetic factors
81
Q
What is the neural explanation for OCD
A
- dopamine and serotonin are NTs affecting mood
- abnormal levels of these are associated with abnormal transmissions of mood related information
- OCD suffers have high levels of dopamine => linked to hyperactivity in basal ganglia in brain causing repetitive motor functions => compulsions
- serotonin plays role in operating caudate nucleus’s in basal ganglia of brain => low levels cause caudate nucleus to fall function => obsessions
82
Q
What are positive evaluation points for neural explanations of OCD
A
- anti depressant drugs increase serotonin levels in OCD leading to reduction in symptoms
83
Q
What are negative evaluation points for neural explanations of OCD
A
- NTs may not necessarily cause OCD, instead low levels of serotonin and high levels of dopamine might be a symptom of OCD
- no cause and effect, just relationship
84
Q
What are biological treatments for OCD
A
- biological approach uses medication to increase/decrease levels of NTs or activity of them
- selective serotonin re-uptake inhibitors (SSRIs)
- benzodiazepines (BZ)
85
Q
How do SSRIs work
A
- work on serotonin system in brain
- serotonin released by presynaptic neurons and travels across synaptic cleft
- chemically conveys signal from presynaptic neuron to postsynaptic neuron then reabsorbed (re-uptake) by presynaptic neuron, where it is broken down and reused
- SSRIs prevent re absorption and breakdown of serotonin, increasing serotonin levels in synapse, where it continues to stimulate postsynaptic neuron => reduces anxiety
86
Q
What are positive evaluation points for SSRIs
A
- Soomro (2009) => reviewed 17 studies comparing SSRIs to placebo for treating OCD, found all 17 studies showed SSRIs more effective than placebo , especially when combined with CBT
- 70% of patients experienced decline in OCD symptoms when taking SSRIs, other 30% opt for psychological therapies or combination
87
Q
What are negative evaluation points for SSRIs
A
- side effects => might mean OCD patient stops taking medication => temporary side effects
88
Q
How does BZ work in treating OCD
A
- anti anxiety drug
- slows down activity of CNS by encasing activity of GABA => has inhibitory effect on neurons
- GABA reacts with GABA receptors on outside of neurons
- when GABA locks into receptors, it opens channel increase flow of chloride ions to neuron
- chloride ions make it harder for neuron to be stimulated by other NTs => slows down neural activity => more relaxed
89
Q
What are positive evaluation points for BZ
A
- can begin to reduce anxiety levels and OCD symptoms in short period of time, especially compared to CBT, so patient experiences immediate relief
90
Q
What are negative evaluation points for BZ
A
- if BZ used long-term, several side effects appear, Ashton (1997) found long term users of BZ become dependent on drug and withdrawal leads to high levels of anxiety and OCD symptoms
- issue of tolerance, patients need larger doses in order to reduce symptoms as body becomes used to drug
