Psychopathology

Question 1

What is statistical infrequency?

Answer 1

Describes behaviour as normal or not based on the number of times we observe it.
If the persons scores cluster around the average then they are considered ‘normal’ for that category.
On either side of the average people are attain the normal distribution therefore counting as abnormal. .

Question 2

Advantages of statistical infrequency?

Answer 2

• objective definition- once a way of collecting quantitative data has been decided, the data is based on real, unbiased data
• no value judgements are made- abnormal behaviour wouldn’t be seen as wrong or unacceptable but simply less frequent
• used in diagnosis, which helps people get help that they need.

Question 3

Disadvantages of statistical infrequency?

Answer 3

• not all rare behaviour is undesirable
  whilst it does suggest rare behaviour is undesirable (IDD), it cannot distinguish when a rare behaviour might be desirable to have.
  serious limitation to the concept of SI and means it would never be used alone to make a diagnosis.
• not all abnormal behaviour is rare
  in todays society depression is roughly found in 30% of the population. so, using this definition, depression would not be seen as abnormal.
  clearly then this definition is not that suitable in modern society as depression shouldn’t be considered normal.
• no benefit of being labelled abnormal
  could affect the way others view them and how they view themselves

Question 4

What is deviation from social forms?

Answer 4

Behaviour that is different from the accepted standards of behaviour in a community or society is considered abnormal. These are different in every culture and generation, there are very few behaviours universally considered abnormal.

Question 5

Weaknesses of deviation from social norms?

Answer 5

Not a sole explanation
- there are often many other factors in play when people are psychologically abnormal
Cultural relativism
- Different cultures have different perceptions of social norms. Even within cultures, some behaviour is acceptable in some situations but not others.
Can lead to human rights abuses
- There are several things in the past that were looked upon as socially abnormal and so they were punished for it such as Homosexuality and also race.

Question 6

What is failure to function adaquately?

Answer 6

When a person can no longer cope with the demands of every day life.
e.g unable to maintain basic standards of nutrition; can’t hold down a job or relationship.

Question 7

Strengths of failure to function adaquately?

Answer 7

Is applicable to mental illnesses
- EG depression or OCD where they may be unable to look after themselves or behave normally
- It is a sensible and realistic threshold for help. It can be said that most of us have a mental disorder to a degree, so servere cases are categorised by inability to cope.
- Thinks of the person’s experience not those around them.

Question 8

Weaknesses of failure to function adaquately?

Answer 8

• there are times when we all don’t meet the demands
  so we run the risk of mislabelling many as abnormal
• how do we know it is not just someone being alternative?
  there are many people who choose not to have a job - under the definition they would be abnormal.
  but they do not necessarily need help - it’s just their chosen way to live but if we treat these behaviours of ‘failures’ of adequate functioning, we risk limiting personal freedom and discriminating against minority groups

-Cultural relativism- lifestyles can be different from dominant cultures.W

Question 9

What is deviation from ideal mental health?

Answer 9

A picture/idea is created of what is psychologically healthy, and then those who do not match these ideals are abnormal.

Question 10

What is the ideal mental health?

Answer 10

-Self attitudes.
-Personal growth and the ability to self actualise.
-Ability to tolerate anxiety and stress.
-Independence.
-Accurate perception of reality.
-Can successfully work and love

Question 11

Strengths of deviation from ideal mental health?

Answer 11

• emphasises positive achievements and suggests a positive approach to mental problems- focussing on what is desirable not just undesirable
• identification of what is needed to achieve normality, allowing creation of personal goals to work towards and achieve
• allows professional comparison and discussion with a set criteria.

Question 12

Weaknesses of ideal mental health?

Answer 12

Cultural relativism
- Not all cultures work on the same basis as a western one. EG collective cultures would not think independence is something to be desired
Basically impossible to achieve
- No one can self actualise meaning that many people would be considered abnormal. Unrealistic standards.
- Subjective and hard to measure.

Question 13

Strengths of deviation from social norms?

Answer 13

-Distinguishes between desirable and undesirable.
-Helps in diagnosis. The DSM 5 symptoms are often surrounding failure to conform to socially acceptable behaviours.

Question 14

What is a phobia?

Answer 14

irrational fear of specific objects or situations

Question 15

What is the DSM-5 criteria for phobias?

Answer 15

Excessive anxiety or fear triggered by an object, situation or place, where the fear is out of proportion from the actual threat.

Question 16

What is a specific phobia?

Answer 16

fear of objects or specific situations or events

Question 17

What are social phobias?

Answer 17

severe anxiety or fear provoked by exposure to a social situation or a performance situation.

Question 18

What is agoraphobia?

Answer 18

extreme or irrational fear of crowded spaces or enclosed public places.

Question 19

What are the emotional characteristics of phobias?

Answer 19

Anxiety- the long term emotional response making it very difficult to relax and experience positive emotions.
Fear- the immediate and unpleasant response that is short term and more intense when we encounter or think about the stimulus.
These responses are unreasonable and out of proportion to the actual threat.

Question 20

What are the behavioural characteristics of phobias?

Answer 20

Panic- crying screaming or running away. Children may become clingy, have a tantrum or freeze.
Avoidance- Going to a lot of effort to not come into contact with the stimulus. This may make daily life very difficult.
Endurance- Staying in the presence of the stimulus instead of taking their eyes off of it.

Question 21

What are cognitive characteristics of phobias?

Answer 21

Selective attention- can be very difficult to look away from the stimulus. This is evolutionary good in dangerous situations because we can react quickly, but not good when the fear is irrational.
Irrational beliefs- Beliefs that cannot be talked out of. They can’t be explained and have no basis in reality.
Catastrophic beliefs- the worst case scenario involving the stimulus.
Cognitive distortion- Perceive things inaccurately and unrealistically.

Question 22

What is Mowrer’s two factor theory?

Answer 22

Phobias are acquired by classical conditioning and maintained by operant conditioning.

Question 23

How are phobias aqquired by classical conditioning?

Answer 23

We associate something we initially have no fear of (neutral stimulus) with an extreme fear response (UCR).L

Question 24

Little Albert Experiment?

Answer 24

Watson and Rayner.
-White rat was NS, the loud bang was UCS that produced the UCR.
-The rat was presented and the loud bang sounded at the same time.
-The rat was now the CS producing fear the CR.
-This fear was generalised to other furry objects like a fur coat and cotton balls.

Question 25

Why doesn't classical conditioning maintain phobias?

Answer 25

Responses acquired by classical conditioning weaken over time as the conditioned stimulus is no longer associated with the unconditioned stimulus.

Question 26

How does operant conditioning maintain phobias?

Answer 26

When the person avoids the phobic stimulus, they successfully avoid the fear and anxiety. This acts as negative reinforcement because avoiding a bad consequence. The behaviour of the phobia is likely to increase,

Question 27

Strengths of the two factor model?

Answer 27

-Credible explanation which explains the links between negative experiences and phobias. -Real life application for phobia treatments. If we can understand how they are acquired then we can treat them. Led to exposure therapies that try to reduce the negative reinforcement of the phobia. Therefore the theories have value.

Question 28

Limitations of two factor theory?

Answer 28

-Some people don't recall a traumatic event that triggered a phobia, so does not provide a complete explanation. -Diathesis stress model- suggests we have genetic vulnerability to mental disorders. So the traumatic event will trigger a phobia but only in the people with genetic vulnerability. -Biological preparedness- we are more likely to develop phobias to ancient fears that were dangerous in our past. Adapted to rapidly learn what life threatening stimuli were. This is not explained by the model. -Bandura looked at vicarious reinforcement of phobias. When a man acted in pain when a buzzer sounded, participants later on had a fear response to the buzzer. Not explained by model.Wh

Question 29

What is systematic desensitation?

Answer 29

a treatment for phobias in which the patient is exposed to progressively more anxiety-provoking stimuli and taught relaxation techniques.

Question 30

How does systematic desensitisation work?

Answer 30

1) Anxiety hierarchy- a list of situations involving the stimuli in order from least anxiety to most. 2) Relaxation- anxiety and relaxation cannot happen at the same time as one inhibits the other. This is called reciprocal inhibition. So clients are taught to relax as deeply as possible. 3) Exposure- move up the hierarchy, learning to relax at each level before moving. The phobia has been treated when the client can relax in the highest anxiety level.

Question 31

Strengths of systematic desensitisation?

Answer 31

- More ethical: involves gradual exposure and the client is fully involved in their therapy. More people choose treatment and carry on to the end, - Studies show it is successful: Capafons (1998) helped overcome fear of flying. Airlines offer courses to desensitise fear. -McGrath showed it was 75% effective. -Can be self administered and is cheaper/quicker than psychoanalysis therapies. -Not concerned with cognitive processes, so children and people with learning difficulties can access the treatment.

Question 32

Limitations of systematic desensitisation?

Answer 32

-Ohman suggested not as effective at treating phobias with an underlying evolutionary causes compared with ones of personal experience. -Requires a positive attitude. -Multiple sessions so more time consuming.

Question 33

What is flooding?

Answer 33

The immediate exposure to the most frightening situation involving the stimulus.

Question 34

How does flooding work?

Answer 34

Very quick learning through extinction - without the option of avoidance behaviour, the patient quickly learns that the phobic object is harmless through the exhaustion of their fear response. This is known as extiction. It is important to get fully informed consent.

Question 35

Strengths of flooding?

Answer 35

- It is cost/time effective. It is must faster and therefore cheaper than systematic desensitisation, this makes it better for patients and NHS. -More effective than cognitive behavioural therapy.

Question 36

Limitations of flooding?

Answer 36

- ethical issues- exposing patients to things they're afraid of (causing psychological harm) can also cause physical harm - high amounts of stress could cause a heart attack -not appropriate for children because of ethical reasons - not effective for all types of phobias (ie. social phobias) -Depends on the person who you are treating so can't be ued for everyone.

Question 37

What is depression?

Answer 37

A mental disorder characterised by low mood and low energy levels

Question 38

What is the DSM-5 criteria for depression?

Answer 38

Major depressive disorder- server but often short term. Persistent depressive disorder- long term or recurring depression. Disruptive mood disorder- child temper tantrums. Pre-menstrual dysphoric disorder- depressive period before or during menstruation.

Question 39

What are the behavioural characteristics of depression?

Answer 39

-Anxiety levels- causes some people to be lethargic. They withdraw from daily life which affects education, work and social life. Alternatively some may become agitated, and won't relax pr may even pace. -Disruption to sleep and eating. Some experience insomnia, premature waking or the need for more sleep. Appetite can increase or decrease. -Aggression or self harm. Often irritable and can be verbally/physically abusive towards others or themselves. Physical aggression towards the self in the form of cutting or suicide attempts.

Question 40

What are the emotional characteristics for depression?

Answer 40

Lowered moods- a constant feeling of worthlessness and emptiness. A more pronounced low mood than normal people feel. Anger- frequent anger directed to the self or others. Lowered self esteem- can lead to am extreme feeling of self loathing

Question 41

What are the cognitive characteristics of depression?

Answer 41

-Poor concentration- may struggle to do daily tasks and make decisions. This will affect their work. -Dwell on the negatives- ignore the positives and hyperfocus on negatives of a situation. May also have a bias towards recalling negative life events and not happy ones. -Absolutist thinking- are black and white thinkers. Situations are either all good or all bad. There is no grey area, just a right and wrong

Question 42

What was Beck's 1976 explanation for depression?

Answer 42

-People are more likely to develop depression due to cognitions. 1) Fault information processing. 2) Negative self schemas. 3) The negative triad.

Question 43

Faulty information processing?

Answer 43

-Pay special attention to the negative aspects of a situation and ignore the positives. -Tend to blow small things out of proportion. -Are absolutist thinkers.

Question 44

Negative self schemas?

Answer 44

Negative information we hold about ourselves based on negative past experiences that can lead to cognitive biases. All information we process about ourselves will be viewed negatively as a schema is a shortcut to process info.

Question 45

Negative triad?

Answer 45

Negative views of the self, the world, and the future that happen automatically. Contribute to becoming depressed.

Question 46

Strengths of Beck's explanation?

Answer 46

-Supported by research- Cohan et al (2019) followed 400 teenagers and found that cognitive vulnerability preceded depression, which shows their association. -Real world application in screening and treatment. Assessing cognitive vulnerability can help identify who is likely to develop depression. Also used in CBT, which tries to alter these flawed cognitions.

Question 47

Weaknesses of Beck's explanation?

Answer 47

- blames the client rather than the situation Beck suggests that the client is to blame for their disorder. this may cause the therapist to overlook important factors in the patients environment e.g. issues in the family etc. this might not be helpful when it comes to treating the patient. - Beck's explanation can't explain all aspects of depression depression is very complex - some have real anger issues, even hallucinations. Beck's model can only explain the feelings of low mood - not the other extreme symptoms. This makes it an incomplete explanation of the whole of depression.

Question 48

What was Ellis' 1962 explanation for depression?

Answer 48

-The ABC model. -Activating event. Belief. Consequence. -He believed a good mental health is the result of rational thinking. Irrational thinking leads to unhealthy emotions and behaviours.

Question 49

The ABC model to explain depression?

Answer 49

A-Depression is triggered by negative life events. B- Trigger irrational thoughts and beliefs. Mustabatory thinking= I MUST perform or I MUST do well. Utopian ism= the belief that life will/should be fair. C- The emotional consequence is depression.

Question 50

Strengths of Ellis' explanation?

Answer 50

v-Real world application in REBT. By vigorously arguing with someone you can alter their irrational beliefs. David et al (2018) showed this therapy was effective giving the explanation credit. -Bates et al found that patients had automatic negative thoughts when given negative situations.

Question 51

Weaknesses of Ellis' explanation?

Answer 51

-Sometimes the causes of a person's depression cannot be traced back to life events, which the model cannot explain. So only a partial explanation. -Blames the client. May empower them to change, but can overlook situational factors. -Not all irrational beliefs are actually irrational. This is called the sadder but wiser effect. Depressed people give more accurate predictions of disasters.

Question 52

What is CBT?

Answer 52

cognitive behavioural therapy -The most common treatment for depression. -Starts with an assessment- identify client's problems, the joint goals and the negative/irrational thoughts that need to be challenged. -They work together to challenge these thoughts and put more effective behaviours in place.

Question 53

Beck's cognitive therapy?

Answer 53

-Identifies the automatic negative thoughts about the self, future and world, then tests the reality of the beliefs. -Have homework tasks like recording positive events or when someone was nice to them. -The therapist then uses these things as evidence against the negative thoughts when they arise in future sessions.

Question 54

Ellis' REBT?

Answer 54

-Rational emotive behaviour therapy. -Adds to ABC model with D=dispute and E=effect. -Identifying and disputing irrational beliefs with a vigorous argument. This breaks the link between negative life events and depression consequence.

Question 55

What is the empirical argument?

Answer 55

disputing whether there is evidence to support the irrational belief

Question 56

What is the logical argument?

Answer 56

Disputing whether the negative thought logically follows from the facts

Question 57

What is behavioural activation?

Answer 57

Therapist encourages patient to engage in enjoyable activities or exercise to provide more evidence for irrational nature of beliefs. -Depressed tend to avoid uncomfortable situations, which isolates them and maintains their symptoms.

Question 58

Strengths of CBT?

Answer 58

-Ellis claimed a 90% success rate after 27 sessions of REBT. -John March et al (2007) compared CBT, antidepressants and a combination of both. After 35 weeks, combination was 86% effective and CBT alone was 81%, making it cost effective for the NHS. -Lewis and Lewis (2016) showed that it can be effective at treating severly depressed people, as well as antidepressants, so is accessible to a more wide range of people than once thought.

Question 59

Weaknesses of CBT?

Answer 59

-Drug therapies require less time and effort and can be self administered. -Not suitable for people with learning difficulties as people have to identify their own thoughts which is hard cognitive work. -Sufferers of severe depression cannot motivate themselves to take part, so will need antidepressants to put them in a better head space. Therefore can't be used as a sole treatment. -High relapse rates. Ali et al showed 42% of clients relapse within six months of treatment. So not long term solution. -Some people don't want to change their thought patterns, some want to find out where their symptoms originated from.

Question 60

What is OCD?

Answer 60

An anxiety disorder with which sufferers experience persistent intrusive thoughts, and carries out repetitive/compulsive behaviours in response to these thoughts.

Question 61

What is the DSM-5 criteria for OCD?

Answer 61

When repetitive behaviours are accompanied by obsessive thinking. -OCD. -Trichotillomania- obsessive hair pulling. -Hoarding disorder- compulsive gathering of possessions and the inability to part with anything. -Excoriation disorder- compulsive skin picking.

Question 62

What is the OCD cycle?

Answer 62

Obsessions -> anxiety -> compulsions -> relief -> obsessions

Question 63

What are the behavioural characteristics of OCD?

Answer 63

-Compulsions. Are repetitive- sufferers are compelled to repeat a behaviour. They are also an attempt to reduce anxiety as a response to the obsessions. 10% of sufferers have no obsessions just a general sense of anxiety. -Avoidance- attempt to reduce anxiety by avoiding the situations that trigger it. Interferes with ordinary life.

Question 64

What are the emotional characteristics of OCD?

Answer 64

-Anxiety and distress- powerful and unpleasant anxiety accompanying obsessions and compulsions. The thoughts are frightening so the anxiety is overwhelming and the urge to repeat behaviours also triggers anxiety. -Accompanying depressions- low mood and low enjoyment in activities as compulsions only bring temporary relief. -Guilt and disgust- directed towards external objects or the self.

Question 65

What are the cognitive characteristics of OCD?

Answer 65

-Obsessive thoughts- 90% of OCD sufferers have them as a major cognitive feature. Vary from person to person but always unpleasant. -Cognitive strategies to deal with obsessions - e.g. religious person tormented by obsessive guilt-> pray. Can make everyday life difficult and can seem abnormal to others. -Insight into excessive anxiety- sufferers are aware that obsessions and compulsions aren't rational. The thoughts are about the worst case scenarios if their anxieties were justified.

Question 66

What is the genetic explanation for OCD?

Answer 66

-genes are involved in vulnerability to OCD. they are passed on from one generation to the next. -Lewis (1936) found that of his OCD patients, 40% had parents with OCD and 20% had siblings with OCD.

Question 67

What is the diathesis stress model?

Answer 67

suggests that a person may be predisposed for a psychological disorder that remains unexpressed until triggered by a stressful event.

Question 68

OCD genetic characteristics?

Answer 68

-Taylor found that 230 genes could be responsible for significantly increasing vulnerability. Therefore OCD is polygenic. -Candidate genes that regulate serotonin levels. -Different groups of genes cause the variation in the types of OCD people experience. There is also evidence that specific genes cause specific types of the disorder.

Question 69

Strengths of the genetic explanation?

Answer 69

Research support- Twin studies of Gerald Nestadt et al (2010). Found that 61% of identical twins shared OCD opposed 31% of non identical twins. There must be some genetic influence.

Question 70

Limitations of the genetic explanation?

Answer 70

Strong evidence for environmental risk factors- Not entirely genetic origin. Kiara Cromer (2007) found that over half of OCD clients in their sample had experienced a traumatic event in their past. OCD was also more severe in people who had more than one trauma.

Question 71

What is the role of serotonin?

Answer 71

-Serotonin is a neurotransmitter that helps regulate mood. -The transmission of mood related information does not take place with low levels of serotonin and the person experiences low mood. -So OCD can be explained by low levels of serotonin and rational thinking cannot take place.

Question 72

What is the role of brain structure?

Answer 72

-Certain areas of the brain can function abnormally if you have OCD. -The lateral areas of the frontal lobe help decision making and logical thinking. Damage to these could be associated with the irrational obsessions. -The parahippocampal gyrus is associated with processing unpleasant emotions and there is evidence to suggest this functions abnormally in people with OCD.

Question 73

Strengths of the neural explanation?

Answer 73

+ practical applications drug treatments for OCD have been created based on the neural explanation. drugs for OCD are designed to increase serotonin. this strengthens the neural explanation - led to effective treatment + some supporting evidence there is evidence to support the role of some neural mechanisms in OCD. some antidepressants work purely on the serotonin system - increasing levels of this NT. such drugs are effective on reducing OCD symptoms and this suggests that the serotonin system is involved in OCD.

Question 74

Limitations of neural explanation?

Answer 74

The serotonin-OCD link is not unique to OCD. Many people with OCD have comorbidity for depression, which is also associated with low levels of serotonin. So is serotonin disrupted by OCD or just because they also are depressed.

Question 75

What is drug therapy for OCD?

Answer 75

Aims to increase the levels for serotonin, as low levels are associated with OCD.

Question 76

What are SSRIs?

Answer 76

-Selective serotonin reuptake inhibitors. -After serotonin travels across the synaptic cleft from the presynaptic neuron and binds to the postsynaptic neuron, it is reabsorbed by the presynaptic neuron to be broken down and reused. -SSRIs prevent this reabsorption which therefore increases the levels of serotonin continually stimulating the postsynaptic neuron. -Fluoxetine is an example with a daily dose. -Can take up to 4 months to see impact on symptoms.

Question 77

What are alternative drug therapies?

Answer 77

-If after 3 or 4 months there is no effect on symptoms, the dose can be increased or different drugs are tried. -Tricyclics- act on various serotonin systems in the body including re-uptake. Have more serious side effects. -SNRIs- serotonin nor-adrenaline re-uptake inhibitors. Increases serotonin if SSRIs don't work.

Question 78

What is drug therapy combined with to treat OCD?

Answer 78

-CBT. -The drugs reduce emotional symptoms such as anxiety and distress meaning the patient is more cooperative in CBT, so it is more likely to be effective.

Question 79

Strengths of drug therapies?

Answer 79

-Evidence for effectiveness- Soomro et al (2009) reviewed 17 studies that compared SSRIs to placebos. All 17 showed symptoms improved by 70% for SSRIs. Therefore drug therapy effectively reduces symptoms and improves quality of life. -Cost effective and non disruptive- Cheap compared to psychological treatments as many thousands of tablets can be manufactured at a time. Therefore it is efficient to implement into public health systems like the NHS. It is also non disruptive in people's lives, they only have to remember to take a tablet.

Question 80

Limitations of drug therapies?

Answer 80

-Side effects- low sex drive, indigestion and blurred vision. Usually temporary but can be distressing and therefore reduces quality of life. -Biassed evidence- research into the effectiveness of drug therapy is usually sponsored by the drug companies. Often accused of bias as they may selectively publish positive outcomes. There is a lack of independent studies. -Skapinakis et al (2016)- reviewed the outcomes of studies and concluded that CBT was more effective than drug therapy for treating OCD. Therefore drugs may not be the most effective treatment.