Psychopathology

Question 1

What are the four definitions of abnormality?

Answer 1

-deviation from social norms
-Failure to function adequately
-Statistical infrequency
-Deviation from ideal mental health

Question 2

What is deviation from social norms?

Answer 2

-it is 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 therefore be unacceptable.
-an example would be wearing no clothes in public.
-deviation from social norms looks at the impact of an individual’s behaviour upon other people .
-deviation from social norms can be used to identify someone suffering from a mental disorder as when someone is behaving in a way that is not expected of them, we become concerned enough to think that the person is suffering.

Question 3

Strengths of deviation from social norms

Answer 3

1) it distinguishes between desirable and non desirable behaviour. This model aims to protect members of the public from the effects of abnormal behaviour and the damaging consequences it may have. For example, someone wearing no clothes in public would be damaging and disturbing to members of the public. Therefore, to highlight this behaviour as abnormal, we can aim to minimise this behaviour in order to protect people from its affects.

2) it is easy to identify someone when they do something that is not expected of them. For example (eg queue jumping or causing a scene in public). Therefore, people can quickly identify if someone is being abnormal and get them the help they need if they are suffering from a mental disorder.

Question 4

Weaknesses of deviation from social norms

Answer 4

1) one disadvantage of using devaition from social norms as a definition of abnormality is that the definition does not always clearly indicate that a person has a psychological abnormality. Therefore psychologists must be careful when using this definition to decide whether someone is abnormal or just odd. For example, people who streak might be quite odd however it does not mean they are mentally disturbed.

2) another disadvantage of this definition is that context must be taken into account. An example could be that wearing no clothes in the high street would be viewed as odd and deviating of social norms. However, wearing no clothes would be acceptable on a nudist beach. Therefore context must be considered when judinging whether a behaviour is deviant or not.

Question 5

What is failure to function adequately?

Answer 5

-this model of abnormality is based on the fact that the person is unable to cope with day to day life such as having a job because they are experiencing psychological distress and discomfort. This impacts their social, personal and occupational life.
-psychologists use the global assessment of functioning scale (GAF) to asses rates of social, occupational and psychological functioning.
-Rosenhan and Seligman created a model with 7 criteria that help define abnormality
-the higher the number of criteria someone has, the more abnormal they are.

Question 6

What are the 7 criteria by Rosenhan and Seligman ?

Answer 6

1) suffering
2) unpredictability and loss of control
3)maladaptiveness - means behaviour that prevents an individual from achieving their goals
4) observer discomfort
5) unconventionality- the way they behave is different to how others behave
6) irrationality - irrational behaviour
7) violation of moral and ideal standards -behaviour that violates social norms

Question 7

Strengths of failure to function adequately

Answer 7

1) an advantage of this model is that using the GAF scale means that psychologists can accurately assess the degree of abnormality and how well the patient is / is not coping with their daily life. If a patient appears to not be coping very well in their social / occupational life, then it could be concluded that they are not functioning adequately and are therefore abnormal.

2) This definition focuses on behaviours which can be observed in the individual for example not getting out of bed in the morning to go to work, allowing others to judge if the individual appears to have abnormal behaviours. Therefore, people can intervene and help the individual.

Question 8

Weaknesses of failure to function adequately

Answer 8

1) a disadvantage of failure to function adequately as a definition of abnormality is that abnormality is not always accompanied by dysfunction. Some people are abnormal yet appear to live a normal life and do not possess the 7 criteria by Rosenhan and Seligman. For example, Harold Shipman was a murderer yet appeared to function completely fine. On the other hand, someone may appear to not be functioning adequately, however they may just be having a bad day.

2) another disadvantage is that the 7 criteria used can be very difficult to measure and analyse. For instance how can we judge if somone is truly suffering or not. The model is very subjective and lacks being scientific and objective meaning psychologists need to be cautious when using this model. Also, some criteria may be appropriate in certain situations. For example, if a close relative passes away, it is totally normal to show signs of suffering.

Question 9

What is statistical infrequency?

Answer 9

• statistical infrequency occurs when an individual possesses a less common characteristic than most of the population. The behaviours displayed are statistically rare, for example being extremely intelligent with an iq score over 130.
  -the average IQ score is 100. Any scores significantly higher (130) or significantly lower (70) would be classed as statistically infrequent and therefore abnormal.
  -we can display the data gained from IQ scores in a normal distribution curve.
  -sometimes the distribution curves can be left -skewed (negative Skewness) so the tail of distribution is to the left.
  -sometimes the distribution curves can be right skewed (positive skewness) so the tail of distribution is to the right.

Question 10

Strengths of statistical infrequency

Answer 10

1) an advantage of statistical infrequency is that to have an IQ score over 130 is just as unusual or statistically infrequent as having an in score below 70. However, being very intelligent with an IQ score over 130 is not a negative bahviour but is actually quite positive and desirable . Just because something is infrequent does not mean someone is abnormal so statistical infrequency can be a good thing.

2) an advantage of statistical infrequency is that judgements are based on objective, scientific and unbiased data that can help indicate abnormailty and normality, for example the IQ scores. The requests can help identify whether someone needs psychological help and assistance eg an IQ score below 70 could indicate mental disability.

Question 11

Weaknesses of statistical infrequency

Answer 11

1) a disadvantage of statistical infrequency is that it involves labelling some people as abnormal and this is not beneficial. A person with a low iq of 70 might be labelled in a bad manner by other members of society , and this could lead to a negative view of themselves. It could affect self confidence and self esteem and lead to further problems.

2) statistical infrequency can be criticised because there seems to be a subjective cut off point between statistical infrequency and normality. We need to decide the dividing line between where normality ends and abnormailty starts and this is very subjective as someone with an iq score of 70 is classed as normal but someone with an iq score of 69 is abnormal.

Question 12

What is deviation from ideal mental health?

Answer 12

-This definition assesses mental health in the same way physical health is assessed
-Once it is established how individuals should look when they are psychologically healthy (ideal mental health), then those who deviate from this can be identified. Absence of signs of mental health used to judge abnormality.
-self actualisation means that humans should strive to reach their full potential. Normal people should strive to achieve their goals. Abnormal people fail to achieve their goals.
-Marie Jahoda (1958) suggested there are 6 characteristics an individual should display if they have an idea of mental health. The less u have, the more abnormal you are.

Question 13

What are Marie Jahoda’s 6 criteria (APPIES)

Answer 13

1) autonomy -the degree to which can individual is independant of social influence
2) perception of reality- having a real view of the world that is not distorted
3) personal growth - development and growth of an individual
4) integration -Resisting stress and being able to cope in stressful situations.
5) environmental mastery - Meeting the demands of the environment and situation you are in, and adapting to this.
6) self attitudes - high self esteem and a strong sense of identity.

Question 14

Strengths of deviation from ideal mental health

Answer 14

1) a strength of Marie jahodas model is that it can be viewed as being positive and productive. It focuses on criteria that we should all aim and strive for in order to be psychologically healthy. For example, self actualisation is a positive trait that every human should try to accomplish if possible.

2)another advantage is that it can highlight and target areas of dysfunction that the patient can work on and improve in their life. This can be very important when treating different types of disorders , for instance people who do not possess the criteria of “self attitudes” might be showing signs of depression. This can therefore highlight the area of dysfunction to both the patient and psychologist.

Question 15

Weaknesses of devaition from ideal mental health

Answer 15

1) deviation from ideal mental health can be viewed as problematic. The six criteria are based on abstract concepts and ideals and are difficult to define and measure. For instance, how much “environmental mastery” or “self attitudes” do we need to by judged as psychologically healthy. The model is not very objective or scientific.

2) another disadvantage of the model is that very few people can achieve all 6 criteria at any one time. Therefore many of us would be classed as abnormal; and we could argue that it would be “normal” to be abnormal. To sustain and meet all 6 criteria is deemed to be very difficult and an ideal that is very hard to meet.

Question 16

What are the Behavioural characteristics of phobias?

Answer 16

1) avoidance - when faced with the phobic object, the response is to avoid the object or situation. This can interfere with a person’s social and occupational life and cause distress.

2) endurance (freeze/faint) - when a person is stressed their bodily response is usually fight/flight. However when faced with the object, a person may freeze or faint instead.

3) disruption of functioning- anxiety and avoidance created by the phobia may be so extreme that it could interfere with a person’s ability to function socially or at work.

4) panic - the person may panic when in presence of the stimulus. They may show behavioural characteristics such as crying, screaming, vomiting, running away or freezing.

Question 17

What are the emotional characteristics of phobias?

Answer 17

1) fear- persistent and excessive fear might be felt in the presence of the stimulus. They might have feelings of terror and worry about death if they come into contact with their phobic object.

2) panic and anxiety - the person may be highly anxious and experience unpleasant negative feelings when faced with the phobic situation.

Question 18

What are the cognitive characteristics of phobias?

Answer 18

1) irrational- the person will think irrationally around the phobic object and will resist rational arguments to counter it. For example someone who is flying will not listen to the fact “flying is the safest form of transport”

2) insight - the person will know their fear is excessive and unreasonable but still find it difficult to not fear the object.

3) cognitive distortions - the person has a distorted perception of the stimulus for instance they may view snakes as alien and aggressive

4) selective attention- when a person encounters their phobic object, they place all their focus on it and ignore everything else around them.

Question 19

What is the two process model?

Answer 19

A) the phobia is learnt via classical conditioning or social learning
B) the phobia is maintained by operant conditioning

Question 20

What is classical conditioning + study?

Answer 20

1) this method of learning involves building up an association between two different stimuli so that learning takes place. This association can be generalised in other settings.
2) this was carried out by Watson and Rayner on 11 month old little Albert (1920).
3) little Albert was presented with animals such as white rats and rabbits.
4) he showed no fear and often touched them
5) however, whenever he reached for the white rat, a loud banging noise (unconditioned stimulus) was struck with a steel bar and hammer which made him cry.
6) they repeatedly did this whenever Albert reached for the white rat until classical conditioning and learning take place.
7) then we could see that when the white rat was presented again to Albert, he now had an emotional response. Therefore learning has taken place via classical conditioning and an association has been established.

Question 21

Strengths of classical conditioning

Answer 21

1) king (1998) supports the ideas proposed by classical conditioning. From reviewing the case studies, he has found that children acquire phobias by encountering traumatic experiences with the phobic object eg people who have been bitten by dogs, end up developing a phobia of dogs.

Question 22

Weaknesses of classical conditioning

Answer 22

1) the study on little Albert can be criticised because it was only conducted once and the findings have not been repeated (not very reliable). Therefore, it could be questioned whether the same results would be gained if this study was to be repeated when investigating whether phobias can be learnt via classical conditioning. This study cannot be repeated now due to ethical issues.

2) a disadvantage of classical conditioning is that some people do have traumatic experiences (eg being in a car crash) but do not develop a phobia (eg fear of driving) so classical conditioning does not always explain how phobias develop. The opposite is also true as some people have not had traumatic experiences with the phobic object eg snakes yet are still scared.

3) the psychologist Menzies criticises the behavioural model, especially the idea of classical conditioning. He studied people that had a phobia of water (hydrophobia) and he found that 2% of his sample had encountered a negative experience with water (due to classical conditioning). Therefore 98% of his sample had never had a negative experience with water, meaning they did not learn the phobia based on classical conditioning.

Question 23

What is the social learning theory/modelling

Answer 23

-this is based on observational learning whereby young children might observe a reaction that their parents or family have to a particular situation and the child will copy this behaviour . For instance is we watch someone get bitten by a dog and start screaming, then we might imitate this behaviour and become scared of dogs meaning we learnt a phobia via observational learning.

• the psychologist Minneka found that when one monkey in a cage showed a fear response to snakes, the other monkeys in the cage copied this behaviour and also showed a fear response. This example can be applied to humans.

Question 24

What is operant conditioning ?

Answer 24

Operant conditioning helps to explain how phobias are maintained.
-negative reinforcement - for instance is someone is scared of snakes , they will try to avoid snakes in order to reduce the risk that they will feel fear
-positive reinforcement - by avoiding snakes and not feeling fear, this is rewarding. Therefore the avoidance of snakes continue.

Question 25

Strengths of the two process model

Answer 25

1) Bandura supports the idea of social learning theory. A piece of research was conducted whereby a person acted as if they were in pain when a buzzer sounded and participants had to watch this reaction. The participants were then given the chance to hear the sound of the buzzer and then showed the same response (acted as if they were in pain) . Therefore social learning theory does seem to be an effective method when learning to be fearful of an object. 2)the two step process has received praise because it involves two clear steps that highlight how phobias are learned and how they are maintained. They are learnt by powerful classical conditioning or social learning and then maintained by operant conditioning . The process seems an accurate way in explaining how phobias can be learnt overall.

Question 26

Weaknesses of the two process model

Answer 26

1) the behavioural model/two process model is limited as it ignores other factors that could chase phobias. The model focuses on learning and the environment but would not take into account biological or evolutionary factors that could cause phobias. Some people may be more genetically vulnerable to develop phobias and the model ignores that. 2) social learning theory can be successful in explaining how learning a phobia can occur in animals and young children . However social learning theory is not very strong in explaining how adults can learn to have phobias. Therefore, the social learning theory is limited to young children and animals.

Question 27

What is systematic desensitisation?

Answer 27

SD is a behavioural therapy developed by wolpe (1958) to reduce phobias by using classical conditioning. Using classical conditioning, they replace the irrational fears and anxieties associated with phobic objects with calm relaxed responses instead. The central idea of SD is that it is impossible to experience two opposite emotions at the same time eg fear and relaxation; this is called reciprocal inhibition. Therefore if a patient can learn to remain relaxed around the phobic object, they can be cured. This is called counter conditioning .

Question 28

Process involved in systematic desensitisation

Answer 28

1) a hierarchy of fear is constructed by the therapist and patient. Situations involving the phobic object are ranked from least to most fearful. If a person has a fear of snakes, the therapists mights start by showing them a picture of a snake, then looking at a snake in a cage then eventually holding a snake. 2) patients are taught relaxation techniques such as deep breathing and progressive muscular relaxation. PMR is when the patient tenses a group of muscles, hold them in a state of extreme tension and then relaxes them. When doing the relaxation response, patients are asked to sit quietly and comfortably and close their eyes. While doing thus they are asked to close their eyes and sit. They then start by relaxing the muscles in their feet and work their way up. While doing this they are asked to breathe deeply and think of peaceful scenarios. 3) gradual exposure- the phobic object is introduced gradually and they work their way up the fear hierarchy starting with the least frightening stage. When they feel comfortable with the stage, they move onto the next. Patients are instructed to use relaxation techniques and eventually through repeated exposure, the phobia is eliminated. This process will take many therapy sessions.

Question 29

Strengths of Systematic desensitisation

Answer 29

1) Jones (1924) Support the use of SD to eradicate little Peter’s phobia. A white rabbit was presented to Peter at gradually closer distances and each time his anxiety levels lessened . Eventually he developed affection for the white rabbit which extended to all fluffy objects. 2) klosko et al (1990) supports the use of SD. He assessed various therapies for the treatment of panic disorders and found that 87% of patients were panic free after SD compared to 50% on medication and 36% receiving a placebo and 33% using nothing at all. Therefore SD is effective compared to other methods. 3) SD has the advantage of being less traumatic than other behavioural therapies such as flooding, where the patient is confronted with the phobic object directly. Therefore, SD has less ethical implications than other therapies and is less upsetting for the patient to endure.

Question 30

Weaknesses of systematic desensitisation

Answer 30

1) one disadvantage is that it is not always practical for individuals to be desensitised by confronting real life phobic situations eg for someone who is afraid of sharks, a fear hierarchy is difficult to construct. Therefore, SD might be very difficult to apply to real life situations and can question the effectiveness of the therapy. 2) some critics believe that symptoms are merely the tip of the iceberg and claim that underlying causes of the phobia will remain, and in the future the symptoms will return or symptom substitution will take place, when other abnormal behaviours replaced the ones that have been removed.

Question 31

What is flooding?

Answer 31

Flooding involves directly exposing the phobic patient to their feared object in an immmediate situation. Beforehand the patient is taught relaxation techniques such as deep breathing in order to stay calm. -flooding stops Phobic responses very quickly because the patient cannot avoid the object so they quickly learn their object is harmless and therefore extinction occurs. In some cases patients achieve relaxation as they become so exhausted by their own fear response. Flooding is ethical as even though it can cause a great deal of initial psychological harm, the patient would have to give their fully informed consent. Flooding therapy sessions usually last 2-3 hours, much longer than SD sessions.

Question 32

Strengths of flooding

Answer 32

1) flooding has the advantage of being cost effective, especially when compared to behavioural therapies with take months or years to rid the patient of their phobia. Flooding seems to be quicker and means it can rid patients of their symptoms as soon as possible, making the treatment cost and time effective. 2) Ost (1997) stated that flooding is an effective and rapid treatment that delivers immediate improvement for phobic patients. This is especially the case when a patient is encouraged to continue self directed exposure to feared objects outside of the therapy session. The results from flooding can be applied to everyday life outside of the therapy session.

Question 33

Weaknesses of flooding

Answer 33

1) a disadvantage of flooding is that it is less effective for curing some types of phobias such as a social phobia. This might be because social phobias have a more cognitive aspect that flooding cannot address well eg addressing negative thoughts about speaking publically. Social phobias may be cured better with cognitive therapies. 2) another disadvantage is that it is a highly traumatic experience and many patients might be unwilling to continue therapy to the end. Time ans money might be wasted preparing patients for flooding experience, and the patient may decide not to take part in the treatment and their phobia remains uncurled.

Question 34

What must you have to be diagnosed with depression?

Answer 34

-at least 5 symptoms must be present every day for 2 weeks -the five symptoms include sadness, or loss of interest and pleasure in normal activities -the person will show impairment in general functioning that has not been caused by other event (death of a loved one)

Question 35

What are the behaviourial characteristics of depression

Answer 35

1) shift in energy levels -some may have reduced amount of energy resulting in fatigue, lethargy and high levels of inactivity. Some may have Hugh levels of nervous energy 2)social impairment - reduced levels of social interactions 3) weight changes -significant increase /decrease in weight due to depression 4) poor personal hygiene - reduced incidence of washing/ wearing clean clothes 5) sleep pattern disturbance -some suffer from insomnia and some require large amounts of sleep 6) aggression and self harm - people with depression are often irritable and can become verbally aggressive. They may become physically aggressive in forms of self harm

Question 36

What are the emotional characteristics of depression?

Answer 36

1)loss of enthusiasm - lack of pleasure in regular day activities such as hobbies 2) constant depressed mood- overwhelming feelings of sadness and emptiness 3) worthlessness - reduced self esteem or inappropriate feelings of guilt 4) anger- may feel anger towards others or themselves which could result in self harm

Question 37

Cognitive triad by beck background info

Answer 37

-Beck believes that people become depressed because they have a negative outlook and develop negative schemes which dominate their thinking. -These schemes often develop during childhood whereby parents or adults have been overly critical of them. -These continue into adulthood ans cause depressive thoughts - examples of negative thinking are self blame and ineptness (expecting themselves to fail at everything)

Question 38

The cognitive triad stages

Answer 38

Stage 1 - negative thoughts about self - person may think they are worthless and helpless . They criticise themselves at every opportunity Stage 2 - negative thoughts about world - negative thoughts extend to wider world eg “I am useless at everything I do” Stage 3 - negative thoughts about the future - they think negatively about the future which causes self esteem eg “I will always be useless at everything I do” . These can lead to suicidal thoughts.

Question 39

Strengths of cognitive approach by beck

Answer 39

1) a strength is that it has become very influential within psychology during the last 30 years , especially since the theory has been based on sound experimental research that is objective and permits testing . Distorted and negative thoughts are common amongst patients with depression, and play a key development of the illness 2) there is a lot of supporting evidence to suggest that depression is caused by negative thinking as well as the cognitive thinking. Terry (2000) assessed 65 pregnant women for cognitive vulnerability and depression before and after birth. It was found that women with high cognitive vulnerability to think negatively were more likely to suffer post natal depression.

Question 40

Weaknesses of the cognitive triad by Beck

Answer 40

1) a limitation of the cognitive approach is that cause and effect is not clear. We cannot certainly say that irrational thoughts cause depression to develop or of depression causes patients to think in a negative and irrational way. Cause and effect needs to be investigated further so that psychologists can be sure that negative thinking causes depression to occur. 2) Beck’s theory can be criticised because it does not explain how some symptoms of depression may develop. Some depressed patients show symptoms of anger, hallucinations and bizzare beliefs (eg cotard syndrome where the patients believes they are a zombie). Beck’s theory fails to account for how these symptoms of depression to occur.

Question 41

What is Ellis’s ABC model

Answer 41

A = activating event - patients record events leading to negative thinking and this is triggered by an event in the environment such as exam failure. This event leads the, to have a negative effect on their mood and outlook. B= Beliefs - patients record their associated with the event. An example would be they think they are useless for failing the exam. Examples might be recording thoughts in a diary or journal. C= consequences - patients record their emotional response to their beliefs. Irrational beliefs can lead to negative emotions. For example, failing maths means that the patient feels demotivated and could lead to them dropping out of the course. Mustabatory thinking - Ellis identified that mustabatory thinking can cause irrational and negative thinking can be emotionally damaging. An individual who holds these beliefs are bound to be disappointed because the thoughts are too idealistic eg “I mist be loved by everyone”.

Question 42

Strengths of Ellis’s ABC model

Answer 42

1) there is research to support the ABC model of depression . Bates (1999) found that depressed patients who were given negative thought statements became more and more depressed supporting the view that negative thinking helps to cause depression. If psychologists know what causes depression, they can help provide effective treatments for curing depression . 2) the ABC model of depression is based on depression is based on sound scientific evidence that permits objective testing. This allows improvement of the model and a greater understanding for the causes of depression as a whole.

Question 43

Weaknesses of Ellis’s ABC model

Answer 43

1) a disadvantage of Ellis’s model is that it is not clear whether negative thinking actually causes depression. It could be that depression occurs first and then this causes the person to think in a negative or irrational way. Cause and effect needs to be established when looking at causes of depression. 2) a disadvantage if the ABC model is that it blames the client when looking at causes of depression. It gives the client some power to change the situation and improve their symptoms of depression, however it could mean that situational factors are overlooked eg family problems. Instead the psychologist would examine negative thoughts alone as a cause of depression .

Question 44

Cognitive behavioural therapy by Beck

Answer 44

- the central idea is Beck’s is to challenge and restructure negative ways of thinking so that they can be more positive and rational. - CBT can be used on individuals or small groups -It allows patients to have some control over their thinking - It focus on present experiences -the therapists needs to be highly trained - it is thought that positive thinking leads to positive behaviour - beck would use the cognitive triad as the basis of CBT -patients are encouraged to identify their negative thoughts “thoughts catching” -patients would be encouraged to challenge negative thoughts and test them out eg is it really true that you are useless at all subjects -reinforcement of positive thoughts are encouraged -patients would attend weekly sessions.

Question 45

Strengths of CBT by Beck

Answer 45

1) a strength of CBT is that it is very effective when the patient has mild depression as CBT stops the mild depression from getting worse. Therefore CBT is more applicable to clients who had mild depressive thoughts than severe symptoms. 2) an advantage of CBT is that it is widely respected and supported by vast symptoms of research as a therapy of depression. It is offered as a cost effective treatment for many disorders by the NHS, especially for depression. The treatment is quite economical compared to treatments such as the psychodynamic approach. 3) an advantage of CBT is that it can be used as a long term cure for depression. Once a patient has undergo CBT , it has lasting positive outcomes and there is high chance that the patient has actually been cured and they are less likely to suffer a relapse comapred to other treatments (such as medications).

Question 46

Weaknesses of CBT by Beck

Answer 46

1) the most popular treatment of depression is anti-depressant drugs. Drugs require less effort than CBT in general. However, Cujipers (2013) found that CBT can be very effective if is combined with drug therapy . Therefore maybe CBT used on its own to treat depression is not very effective and drugs should be used alongside it. 2)

Question 47

What is the rational emotive behaviourial therapy by Ellis

Answer 47

- REBT was developed by Ellis (1975) - the therapy involves making depressed patients think in a more rational and positive manner - the therapist aims to challenge depressed patients thinking and show how irrational their thoughts are - depressed patients are taught to practice positive thinking which can then have a positive impact on their behaviour -challenging negative thoughts by reinterpreting the ABC model in a more rational way eg the exam was difficult and that they are not useles for failing. - depressed clients are asked to complete homework between therapy sessions. -CBT encourages clients to be become more active and engage in pleasurable activities.

Question 48

CBT by Ellis (DEF)

Answer 48

1) disrupting irrational thoughts and behaviour . Logical disrupting occurs when self defeating beliefs do not follow logically from the information available eg “does thinking is this way make sense. Empirical disrupting is when self defeating beliefs are not consistent with reality eg “you think everyone hates you but there is no proof of this” 2) effects of disputing ans effective attitude to life- effective disputing can change self defeating beliefs into more rational beliefs. The patient can move away from irrational thinking eg “no one like me” to more rational interpretations eg “my friend has not replied to my text she is probably busy” 3) Feelings /emotions - patients begin to think in a more positive manner and begin to feel better. This can have a positive impact on their behaviour

Question 49

Strengths of REBT approach by Ellis

Answer 49

1) Flannaghan et al (1997) supports the use of REBT as an effective way to treat depressive stroke victims. This therefore suggests that REBT is a suitable treatment for specific groups of people with depression and can help the, become more positive over time in terms of their thoughts and behaviour. 2) there is research to support the use of CBT as a therapy for depression. David (2008) compared 170 depressive patients who had 14 weeks of REBT ans compared them to depressive patients who were treated with the drug fluoxetine. The outcomes found that REBT was a better long term treatment for depression than drug therapy .

Question 50

Weaknesses of REBT approach by Ellis

Answer 50

1) a disadvantage of REBT is that it is unclear if the distorted negative thinking is the cause of depression or merely a symtom. If it is only a symptom of depression then REBT is not tackling the root cause of the depression, and the depression might return in the future. This means that depression has not been cured properly. 2) a problem with REBT is that is is dependant on the depressed clients being articulate ans being able to talk about their thought processes coherently. Therefore REBT would not work for people with severe depression if they were unable to communicate properly , or who would feel uncomfortable taking about their feelings with a psychologist. In this case other treatments would be considered such as drug therapy

Question 51

Diagnosis of OCD

Answer 51

- ocd is an anxiety disorder - it is characterised by the DSM-V as a disorder whereby the patient shows repetitive behaviour and obsessive thinking

Question 52

Behavioural characteristics of OCD

Answer 52

1) compulsive behaviours - these behaviours are performed to reduce anxiety created by obsessions. They are repetitive such as hand washing or checking things. This could include mental acts such as praying or counting. Patients feel the need to carry out these actions otherwise something bad will happen. 2) hinder everyday functioning - having obsessive ideas creates a great deal of anxiety, this could lead to compulsions that can seriously hinder the ability to perform everyday functions eg washing hands repetitively can lead to being late to work. 3)social impairment - anxiety levels created by obsessions may become so high that the person may not be able to conduct meaningful interpersonal relationships. 4) repetitive - sufferers feel compelled to repeat behaviours over and over again as a response to their obsessive thoughts. 5) avoidance - sufferers may attempt to reduce anxiety by avoiding situations that might trigger their anxiety.

Question 53

Emotional characteristics of OCD

Answer 53

1) anxiety and distress - obsessions and compulsions are a source of anxiety. Sufferers are aware that their compulsive behaviour is excessive and this causes feelings of embarrassment and shame. 2) accompanying depression - anxiety may be accompanied by low mood and a lack of enjoyment of activities. 3) guilt and disgust - ocd sometimes involves irrational guilt over minor issues.

Question 54

Cognitive characteristics of OCD

Answer 54

1) obsessions - intrusive thoughts that are perceived as inappropriate or forbidden. Common obsessions are doubts, impulses and images. These thoughts are uncontrollable and cause anxiety . Obsessions are internal. 2) recognised as self generated - most sufferers understand that their obsessions are self invented and not inserted externally by others. 3) realisation of inappropriateness - most sufferers realise their compulsive behaviours are irrational but cannot control or stop them 4) attention bias - perception tends to be focused on anxiety generating stimuli. The sufferer pay more attention to the stimuli that creates anxiety.

Question 55

What 2 genes are linked to OCD?

Answer 55

The COMT gene The SERT gene

Question 56

What is the COMT gene?

Answer 56

-OCD has been classed as polygenic, so it is not caused by only one gene. Many genes may cause OCD and these are known as candidate genes. -the COMT gene regulate the production of the neurotransmitter dopamine where high levels are associated with ocd. -high levels of dopamine are responsible for motivation and aggression. - the COMT gene is more common in patients with ocd than those without the illness.

Question 57

What is the SERT gene?

Answer 57

- this gene affects the transportation of serotonin which results in low levels of serotonin resulting in depressive symptoms. - individuals have the SERT gene on chromosome 17. A mutation in this gene can cause ocd. -research conducted by Ozaki (2003) found evidence that 6 out of 7 family members who had ocd had a mutation in the SERT gene. The gene mutates and this causes low levels of serotonin to be produced.

Question 58

Positives of the genetic explanation of ocd

Answer 58

1) Nestadt (2000) supports the genetic explanation for ocd. He found that people who had a first degree relative who already had OCD were five times more likely to also get the illness. The supports the idea that OCD is transmitted genetically. 2) Billett (1998) supports the idea that OCD is transmitted genetically. He found from a meta-analysis of 14 twin studies that OCD is twice more likely to be concordant in identical monozygotic twins rather than dizygotic twins.

Question 59

Weaknesses of the genetics explanation of ocd.

Answer 59

1) a criticism of the genetics explanation is that the concordance rate for OCD is not 100%. Therefore, OCD cannot be caused entirely by genetic factors. The genetic explanation fails to take into account psychological and environmental factors that might contribute to the cause of OCD. 2) a criticism for the genetics explanation for ocd is that it is polygenic and one single gene is not responsible for causing the disorder. OCD has been genetically linked to other illnesses such as Tourette’s syndrome and autism. Therefore it seems that the genetic cause for OCD is very complex and might be related to other illness too. It could be that one specific gene is not responsible for ocd, but could be a predisposing factor.

Question 60

What was the research into genetics and ocd ?

Answer 60

-it was carried out by Beekman and Cath (2005) - a meta-analysis was conducted of twin studies and OCD -MZ twins were compared to DZ twins -OCD patients had been diagnosed with OCD using older criteria and studies that had patients diagnosed using the DSM criteria. -10,034 twin pairs were studied overall -in children, 45-65% of them inherited ocd via genetic influence -in adults, 27-47% of them inherited ocd via genetic influence - conclusion was that ocd is transmitted genetically and more apparent in children than adults.

Question 61

Strengths of Beekman and Cath’s research

Answer 61

1) there is a clear separation between environmental factors and genetic factors for causing OCD which helps psychologists give treatments for ocd as if they know the cause, they can know how to treat it. 2) they used a large sample size, which helps make results more reliable as similar results appeared throughout all the twins. 3) they did a meta-analysis which makes the findings more precise as it combines the results from different psychologists and different knowledge.

Question 62

Weaknesses of research by Beekman and cath

Answer 62

1) the research can be criticised because the majority of twin studies were not performed in controlled conditions. This means that the data is not very objective or scientific and therefore this might affect the validity and the reliability of the results gained from this research. This might question the idea that ocd is genetic. 2) the research can be criticised because gene mapping was not taken into consideration when looking at whether ocd is genetic. Gene mapping would look closely at the dna of the twins that ocd and compare this with twins that do not have OCD. a comparison needs to be made in order to make results more valid and robust.

Question 63

What are the two neural explanations of OCD ?

Answer 63

1) Neurotransmitters 2) neuroanatomy.

Question 64

How can neurotransmitters cause ocd?

Answer 64

Dopamine : -dopamine is a neurotransmitter that affects mood and might cause ocd and ocd sufferers have Hugh levels of dopamine. -the frontal lobes of the brain are linked to dopamine activity -research conducted on animals have found that high doses of drugs that enhance dopamine levels can induce movements that resemble repetitive behaviour, similar to ocd sufferers. -High dopamine levels have also been linked to over activity in the basal ganglia area of the brain Serotonin - serotonin is a neurotransmitter that affects mood and might cause ocd . Ocd sufferers have low levels of ocd and this causes depressive symptoms. -the frontal lobes of the brain are linked to serotonin activity. - Many ocd sufferers are depressed. -serotonin plays a role in operating the caudate nucleus and it seems low levels of serotonin cause the caudate nucleus to malfunction.

Question 65

Strengths of neurotransmitters as a neural explanation for ocd

Answer 65

1) there has a been a great deal of research support to state that neurotransmitters do cause ocd. Anti-depressant drugs will increase serotonin levels in OCD patients, and this has led to a reduction of ocd symptoms. Therefore there is good evidence to suggest that low level of serotonin could cause ocd 2) Menzies (2007) suggested research evidence that would support a genetic link to abnormal levels of neurotransmitters. Menzies studied MRI scans in OCD patients and their immediate family members and comaored them with healthy controls. It was found that ocd patients and their families had reduced grey matter in key regions of the brain and they had an unusual neuroanatomy.

Question 66

Weaknesses of neurotransmitters as a neural explanation for OCD

Answer 66

1) a disadvantage of the neural explanation is that neurotransmitters such as dopamine and serotonin might not cause ocd. Instead low levels of serotonin and high levels of dopamine might be the effect of ocd. Therefore we must be careful when looking at the cause and effect of neurotransmitters. 2) a problem with the neural explanation is that OCD is co morbid with depression. Therefore it is not clear whether low levels of serotonin cause ocd or depression or both. Therefore the link between low levels of serotonin causing ocd is not very clear and needs to be investigated further.

Question 67

Neuroanatomy explanation by Jenike and Rauch

Answer 67

-there might be a relationship between ocd being caused by some types of brain damage which might be caused by a virus. -the brain damage causes a problem in the short term memory which causes doubt in the person whether they performed an action or not, -this might result in repetitive behaviour

Question 68

Study on ocd patients with cleaning obsession

Answer 68

1) ocd patients were studied with PET scans. They were shown something dirty. Evidence found that the frontal lobes and ganglia were the most active parts of the brain. It seems the basal ganglia may be overactive. 2) the basal ganglia seems to malfunction in ocd sufferers. Basal ganglia controls voluntary motor movements so an overactive basal ganglia can lead to repetitive motor functions.

Question 69

Strengths of the neuroanatomy explanation of OCD

Answer 69

1) one strength of the neural explanation is that it uses PET scanning. We can see which parts of the brain are causing the damage and is very scientific. As we can trust machine readings, it is very objective and reliable. 2) another strength of this explanation is that the psychologist Rapoport (1990) found supporting evidence about neural causes of OCD. He reviewed an epidemic that occurred in Europe during 1916-1918 called “the great sleeping sickness”. There was a widespread of brain infections. He found that during the epidemic, there was a greater report of OCD cases. This shows how brain abnormality could cause ocd.

Question 70

Weaknesses of the neuroanatomy explanation of OCD

Answer 70

1) one problem with the neural explanation is cause and effect. We are not aware whether OCD causes brain damage or whether brain damage causes OCD. More research must be done. 2) a weakness of this research is that it is reductionist. It reduces the brain into simple components that could malfunction and cause ocd. The brain is much more complex and could involve multiple parts of the brain malfunctioning.

Question 71

What are SSRI drugs

Answer 71

-selective serotonin re-uptake inhibitors include Prozac. -low levels of serotonin are involved with ocd therefore drugs are given to increase serotonin levels to help regulate mood and reduce anxiety levels. -increasing serotonin via SSRI drugs help the orbital frontal cortex to function at normal levels - it helps regulate mood and improve memory to reduce compulsive behaviour. -SSRI is prescribed for 12-16 weeks -SNRI drugs are prescribed for Patients that cannot tolerate SSRI drugs.

Question 72

Positives to SSRI drugs

Answer 72

1) There is supporting evidence that SSRI’S are effective treatment for ocd. Soomro (2009) reviewed 17 studies that compared SSRI’S to placebo drugs for treating OCD and found in all 17, SSRIs were more effective, especially when SSRI’S were combined with CBT. 2) SSRI’s have the benefit of being relatively cheap and cost effective in comparison to psychological therapies, such as CBT, counselling or family therapy. Using SSRI’s drugs to treat ocd is more economical for NHS and compared to other treatments.

Question 73

Weaknesses of SSRI drugs

Answer 73

1) SSRI drugs can be criticised because they do not work for all ocd patients. For some patients SSRI drugs will not alleviate their ocd symptoms and they will have to take an alternative drug such as tricyclics instead 2) Koran (2007) has criticised the use of drugs and medication to help relive ocd symtoms. Koran sated that drug therapy might be common or popular treatment, but psychotherapies such as CBT should be tried first to reduce ocd symptoms. Drug therapy requires little effort and may be effective short term but does not provide a long term solution and patients may relapse within a few weeks.

Question 74

What are Benzodiazepines

Answer 74

-BZ drugs reduce anxiety and aim to control activities of neurotransmitters - examples include Valium and Xanax. - they reduce the activity in the central nervous system and reduce brain arousal. -aims to reduce blood pressure and heart rate - BZ aims to increase GABA (a neurotransmitter that makes a person less anxious as it reduces psychological activity in the body) -BZ drugs bind to GABA receptors site of the posts synaptic neuron which increases flow of chloride ions into the post synaptic neuron slowing down its activity and making the person more relaxed

Question 75

Benzodiazepines strengths

Answer 75

1) BZ drugs have the advantage that they work quickly and effectively to cure OCD symptoms compared to other psychological treatments (eg CBT). BZ drugs can begin to reduce anxiety levels and OCD symptoms in a short period of time so that patient will see some immediate benefits of relief. 2)BZ drugs have the strength that they can be used for short periods of time and they will produce hardly any real serious side effects unlike other drugs. Therefore side effects are kept to a minimum with BZ (in short term) which is good for the OCD patient.

Question 76

Benzodiazepines weaknesses.

Answer 76

1) however a problem with BZ drugs is that if they are used long term then several unwanted side effects can begin to appear. Examples include drowsiness, depression and unpredictable interactions with alcohol. Patients have a Hugh chance of being involved in accidents. Therefore they shouldn’t be used as a long term treatment. 2) Ashton (1997) found that BZ have weaknesses. Long term users of BZ become very dependent in the drug and a sudden withdrawal of the drug leads to a return of high levels of anxiety and OCD symptoms. There is also the problem of tolerance or drug escalation whereby patients need to take very large doses of the drug in order to reduce symptoms.