psychopathology Flashcards
What is the 4 definitions of abnormality?
Statistical infrequency
Deviation from social norms
Failure to function adequately
Deviation from ideal mental health
What is statistical infrequency? And an example?
This is when an individual has a less common characteristic that can be seen as abnormal
Eg IQ and intellectual disability order
- When individuals have an iq score of below 70 they are abnormal so recieve a diagnosis of intellectual disability disorder
What is Deviation from social norms? And an example?
This concerns behaviour that is differenent from the accepted standards behaviour in a community or society. We make a collective judgement about what is right
Eg Antisocial personality disorder
- impulsive, aggressive, ireesponsible
- absence of prosocial internal standards associated with failure to conform to lawful and culturally normative ethical behaviour
a03 - statistical frequency
STRENGTH : Real World Application
- used in diagnosis, clinical practice and as a way to assess severity of peoples symptoms
- eg iq of 70 means a disorder can be diagnosed
- They used the Becks depression inventory and score of 30+ indicates depression
- Useful in diagnosis and assessment
LIMITATION : infrequent characteristics can be positive/negative
- not think of someone with an abnormally high IQ as abnormal
- low depression on scale not seen as abnormal
- never sufficient
a03 deviation from social norms
STRENGTH : Real world application
- key characteristics eg recklessness and aggression can be used to define characteristics of antisocial behaviour
- such norms also play a role in schizotypal personality disorder where the term strange can also characterise the thinking, behaviour and appearance of people with the disorder
LIMITATION : Cultural and Situational relativism
- one cultural group may label someone from another group abnormal using their own standards
What is failure to function adequately? And examples?
Occurs when someone is unable to cope with the demands of day to day living eg nutrition and hygiene
EG Intellectual disability disorder
When is someone failing to function adequately?
Rosenham and Seligman
- When a person no longer conforms to standard interpersonal rules eg respecting personal space
- When a person experiences severe personal distress
- When a persons behaviour becomes irrational or dangerous to themselves or others
What is deviation from ideal mental health
Anyone who identifies from the ideals of being normal
What is Jahods criteria for ideal mental health (state 3)
- We have no symptoms or distress
- We are rational and percieve ourselves accurately
- We self actualise
- We can cope with stress
- We have a realistic view of the world
- We have good self esteem and lack guilt
- We are independent of other people
- We can successfully work love and enjoy our leisure
ao3 - failure to function adequately
STRENGTH - Threshold for professional help
- 25% of us experience symptoms of mental disorder to some degree
- when we cease to function adequately people seek or referred to professional help
- criterion provides a way to target treatment and services
LIMITATION - Lead to discrimination
- hard to distniguish between failure to function and conscious decision to deviate from social norms
- people may choose to live off grid
- abnornal and freedom of choice restricted
a03 - deviation from ideal mental health
STRENGTH - Approach being comprehensive
- range of criteria
- discussed meaningfully with a range of professionals
- checklist
LIMITATION
- culture bound
- variations in value placed on independence
- self actualisation not recognised
behavioral characteristics of phobias
Panic - Crying, Screaming, Running away from phobic stimulus
Avoidance - Prevent contact w phobic stimulus
Endurance - Remaining with stimulus and continuing to experience anxiety
Emotional Characteristics of phobias
Anxiety - unpleasant state of high arousal
Fear - immediare response
Emotional Response is Unreasonable - Disproportionate to threat prosed ( arachnaphobia with strong emotional response to a tiny spider)
Cognitive characteristics of phobias
Selective attention to phobic stimulus - hard to look away
Irrational beliefs
Cognitive distortions
behavioral characteristics of depression
Activity levels - lethargic
Distruption to sleep - insomnia & hypersomnia
Distruption to eating behaviour
Agression and self harm
emotional characteristics of depression
Lowered mood - people with depression describe themself as worthless
Anger - such emotions lead to aggression
Lowered self esteem - self loathing
cognitive characteristics of depression
Poor Concentration - cant stick with a task
Attention to negative - bias towards focusing on negative activities
Absolutist thinking - When a situation is unfortunate it is seen as an absolute disaster
What is the behavioral approach to explaining phobias
The two process model
What does the two process model consist of?
Classical conditioning where phobias are maintained
Operant conditioning where it is maintained
What is little albert and how does it explain phobias?
- When Little albert played with a white rat, a loud noise was made close to his hear the noise (UCS) caused a fear response (UCR)
- Rat (NS) did not create fear until the bang and the rat has been paired together several times
- Albert showed a fear response (CR) every time he came into contact with the rat (CS)
How does generalisation with phobias come about?
Little albery showed fear in response to other white furry objects
How are phobias maintained by operant conditioning
Negative reinforcement - an individual produces behaviour that avoids something unpleasant
When a person with a phobia escapes the anxiety they would have experienced reducing fear so phobia can be maintained
A03 - the behavioural approach to explaining phobias
STRENGTH - Real world application
- explains why people with phobias benefit from exposure therapies
-once avoidance behaviour is prevented it ceases to be reinforced by reduction of anxiety so it declines
- shows value of 2 process model as it can treat phobias
LIMITATION - unable to explain cognitive aspects of phobias
- behavioural explanations like 2 process model are geared towards explaining behaviour
- phobias also have a significant cognitive component eg people holding irrational beliefs
- 2 process model does not fully explain symptoms of phobias
STRENGTH - Evidence linking phobias to bad experiences
- john found 73% of dental phobics had experienced a trauma (involving dentistrsy)
- control group where people have low dental anxiety only 21% had a traumatic event
- association between stimulus (dentistry) and an unconditioned response (pain) does lead to phobia
COUNTERPOINT
- snake phobias occur where very few people have had bad experiences
What is the two behavioural approaches to treating phobias
Systematic Desensitisation
Flooding
What is systematic desensitisation
- This is based on classical conditioning where we reduce anxiety through counterconditioning
- Phobia is learned so that phobic stimulus (CS) produces fear (CR)
- CS paired with relaxation becoming the new CR
What is reciprocal inhibition - SD
Not possible to be afraid and relaxed at the same time so one emotion prevents the other
What is an anxiety hierarchy?
This is where fearful stimuli is arranged from least to most frightening
How do you work through the anxiety hierarchy
- Relaxation techniques such as deep breathing and meditation
- Each person is exposed to phobic stimulus in a relaxed state
When is treatment successful
The person can stay relaxed in high anxiety situations
What is the concept of flooding
To expose the person to the phobia without a gradual buildup
What is extinction - flooding
Without the option of avoidance behaviour the person quickly learns that the phobic object is harmless through exhaustion of fear response
Why does flooding require informed consent
It is a unpleasant process
ao3 - behavioural approach to treating phobias (SYSTEMATIC DESENSITISATION)
STRENGTH : Evidence for effectiveness
- gilroy et al followed up 42 people who had SD for spider phobias and at follow up SD were less fearful than a control group
- Wechlser concluded that SD us effective for specific phobia, social phobia and agoraphobia
STRENGTH : Usefulness for people with learning disabilities
- not distressing and doesnt require high level of rational thought, understanding or engagement
ao3 - behavioural approach to treating phobias (FLOODING)
STRENGTH - COST Effective
- work in as little as one session
- even with longer sessions it is more cost effective
LIMITATION - Traumatic
- ppts and therapists rated flooding as more stressful
- ethical concerns as higher attrition rates
What is the two explanations for the cognitive approach to treating depression
Beck Negative Triad
Ellis ABC model
What is a schema - negative triad (cognitive approach to treating depression)
- Package of ideas and information developed through experience
- Negative schema so all information interpreted the wrong way
What is the faulty information processing? - negative triad
(cognitive approach to treating depression)
- Some people are more prone to depression because of faulty information processing - black and white terms
What is the negative triad and examples ? (cognitive approach to treating depression)
- Negative view of the world : The world is a cold hard place
- Negative view of the future : There isnt much chance the economy will get any better
- Negative view of self : I am a failure —-> low self esteem
What is Ellis ABC model and its components (cognitive approach to treating depression)
A - Activating Event
- Depression arises from irrational thoughts
B - Beliefs
- Musterbation : Belief we must always succeed
- I-cant-stand-it-itis : Belief that it is a disaster when things do not go smoothly
- Utopianism : Belief the world must be always fair and just
C- Consequences
- When an activating event triggers irrational beliefs there are emotional and behavioural consequences
a03 - cognitive approach to treating depression (BECK NEGATIVE TRIAD)
STRENGTH : Supporting research
- Beck concluded cognitive vulnerabilities (faulty information processing) are more common in depressed people
- Cohen tracked 473 adolescents development and found early cognitive vulnerability predicted later depression
STRENGTH : Real world Application to screening for depression
- Assessing cognitive vulnerability in young people most at risk of developing depression means they can be monitored
- this understanding is applied in CBT to alter cognitions underlying depression so they are more resiliant
- Useful in clinical practice
A03 - cognitive approach to treating depression (abc model)
STRENGTH : Application in treating depression
- Applied the ABC to treat depression (REBT)
- REBT can change negative beliefs and relieve symptoms of depression
LIMITATION - Ellis model only explains reactive depression
- Reactive depression describes a form of depression which is triggered by negative activating events
- Not obvious what triggers depression
What is the cognitive approach to treating depression ( 6 point summary)
CBT
- Challenge irrational thoughts whilst also changing behaviour by CLIENT and THERAPIST working together
- Aim is to identify negative thoughts in the triad and allow them to be challenged by Client taking an active role
- Client is scientist by being set hw
- REBT extends ABC to ABCD(dispute beliefs) and E(effect)
- REBT identifies thoughts as Utopianism
—- empirical argument : disputing whether there is evidence to support belief
—– Logical argument : disputing whether negative thought follow from fact
- Behavioural action - decrease avoidance and increase engagement
A03 - cognitive approach to treating depression
STRENGTH : CBT has evidence for effectiveness
- march compared effects of CBR with antidepressant and a combo of the 2 in 327 depressed adolescents
- 81% of cbt group, 81% if antidepressants group and 86% of cbt and antidepressants significantly improved
- good case for making cbt the first choice of treatment in public health systems
LIMITATION - not suitable for diverse clients
- severely depressed clients may not be able to motivate themselves to engage with cognitive work of cbt or pay attention
- not suitable for learning difficulties
LIMITATION - high relapse rates
- relapse is common
- ali et al assessed depression for 12 months following a course of cbt
- 42% relapsed within six months of ending treatment and 53% within a year
- cbt needs to be repeated regularly
what are the two explanations for the biological approach in explaining OCD
Genetic Explanations
Neural explanations
What is the genetic explanations (the biological approach in explaining OCD)
- Candidate genes
eg 5HTI-D beta and implicated in transmission of serotonin across synapses
eg Dopamine implicated in ocd and may regulate mood - OCD is polygenic
- OCD is aetiologically heterogenous
Why is OCD polygenic ?
Not caused by one single gene but several genes involved
Why is OCD aetiologically heterogenous
One group of genes may cause OCD in one person but a different group of genes may cause the disorder in another
Evidence to show that different types of OCD may be the result of particular genetic variations
What is the neural explanations (the biological approach in explaining OCD)
- Neurotransmitters are responsible for relaying information from one neuron to another eg low levels of serotonin lowers mood
How does impaired frontal lobes have an effect?
- Some cases of ocd seem to be associated with impaired decision making
- Associated with abnormal functioning of the lateral frontal lobes of the brain
- Frontal lobes are responsible for logical thinking and making decisions
What area is associated with processing unpleasant emotions?
Left Parahippocampal gyrus
A03 the biological approach in explaining OCD ( GENETIC EXPLANATIONS)
STRENGTH : Evidence for genetic explanation of OCD
- nestadt found 68% of identical twins shared OCD as opposed to 31% of non identical
- Marini and Stebnicki found that a person with a family member with ocd is 4 times likely to develop as someone without
- genetically similar more likely to share
LIMITATION : Existence of environmental risk factors
- Factors that can trigger or increase the risk of ocd
- Cromer found over half the people with OCD experienced a traumatic eveny
A03 the biological approach in explaining OCD ( Neural EXPLANATIONS)
STRENGTH : Supporting evidence
- antidepressants that work on serotonin reduce ocd symptoms suggesting serotonin is involved in ocd
- ocd symptoms can form part of conditions such as parkinsons
- biological factors eg serotonin are involved in ocd
LIMITATION : No unique neural system
- people with ocd also experience depression which distrupts serotonin
- so serotonin not relevant to ocd symptoms
What is the biological approach to treating OCD?
Drug Therapy
What is SSRIS
Selective Serotonin Reuptake Inhibitors
- prevent reabsorbtion and breakdown of serotonin in the brain
- increases levels in the synapse thus serotonin continues to stimulate the post synaptic neuron
What is the typical dosage of SSRIS and the name of the medication?
Fluoxetine
- 20mg
- 3-4 months for impact
- dosage can be increased
What are the drugs used alongside and why
cbt
- the medication can reduce emotional symtoms so they can engage more effectively with CBT
What are the alternatives to SSRIS
TRICYCLICS
- eg clomipramine
- more severe
SNRIS
- second line of defence
- increase serotonin and noradrenaline
ao3 - biological approach to treating ocd
STRENGTH - effectiveness for drig therapy
- 17 studies showed better outcomes following SSRIS then placebos
- ocd symtoms reduced for around 70% of people taking ssris
COUNTERPOINT
- cbt might be more effective
STRENGTH - cost effective and non distruptive
- cheap and good value for nhs
- no time taken out of day
- preference
LIMTATION - side effects
- indigestion, blurred vision, loss of sex
-clomipramine has more common side effects and 1/10 experience weight loss
- quality of life is poor
- reduce effectiveness
