psychopathology Flashcards
what is anxiety
a negative state of high arousal
what is cultural bias
the tendency to judge people in terms of one’s own cultural assumptions
what culture is the DSM
american western
what are the 4 definitions of abnormality
statistical deviation, deviation from social norms, failure to function adequately, deviation from ideal mental health
what is statistical deviation
when a persons behaviour is statistically rare
what is the real life example of statistical deviation
intellectual disability disorder-
average IQ is 100 most ranging from 85-115
only 2% of pop have an IQ of below 70 (statistically rare)
diagnosis of IDD
what is the evaluation of statistical deviation
easy to analyse but no detail or understanding of patient and experiences too simplistic
statistically common mental illnesses such as depression(1 in 6) doesn’t work
cut off point too fine sometimes people do not get help needed eg someone with IQ of 71 no help
what is deviation from social norms
when a persons behaviour deviates from the unwritten rules of a society
what is an example of deviation from social norms
homosexuality-
regarded as a mental illness until 1973
deviated from the norm of heterosexuality
what is the evaluation of deviation from social norms
social norms differ between cultures and they change over time and in places
some social groups have been discriminated against and suffered social exclusion
norms are context dependent
cultural bias
what is failure to function adequately
when someone is unable to cope with the demands of everyday life and this causes them suffering
what is the example of failure to function adequately
intellectual disability disorder
came after statistical deviation
they are paired / grouped
what is the evaluation for failure to function adequately
more of a well rounded diagnosis with both this and stat dev
neither on own are good
too subjective in nature- many factors do not take into account individual experiences- eg travelling- no home but not suffering
what is deviation from ideal mental health
abnormal if you don’t have perfect mental health and do not meet set of criteria
what is the criteria for “deviation from ideal mental health”
Marie Jahoda(1958)
• We have no symptoms or distress.
• We are rational and can perceive ourselves accurately.
•We self-actualise (reach our potential.
• 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 (autonomy)
•We can successfully work, love and enjoy our leisure
(envirommental
mastery)
what is the evaluation for deviation from the idea mental health
too unrealistic criteria - everyone copes with stress
don’t know when reached self actualisation
cultural bias
based on western ideal some cultures are collectivist eg china and rural japan so not independent
cant judge behaviour universally
what is depression
a mood disorder
what is ocd
an internal thought ( obsession) which causes anxiety
compulsion- repetitive and rigid behaviour to reduce the anxiety
how common is schizophrenia
1in 100
what are the DSM and ICD
diagnostic manuals
what are the behavioural symptoms of phobias
panic ( crying screaming running away )
avoidance
endurance ( alternative to avoidance)
what are the emotional symptoms of phobias
anxiety ( unpleasant state of high arousal )
fear ( immediate and unpleasant response)
what are the cognitive symptoms of phobias
selective attention to the phobic stimulus ( fixated)
irrational beliefs - unfounded thoughts
cognitive distortion (inaccurate and unrealistic perceptions)
what is a phobia
and irrational fear of an object or situation
what are the behavioural symptoms of depression
activity levels- reduced energy
disruption to sleep and eating ( reduced or incr)
aggression and self harm
what are the emotional symptoms of depression
lowered mood
anger- to self and others
lowered self esteem
what are the cognitive symptoms for depression
poor concentration- unable to stick with a task. hard to make decisions
attending to and dwelling on negative
absolutist thinking- “all good all bad situations “
what is depression
a mental disorder characterised by low mood and low energy levels
what are the behavioural symptoms of OCD
compulsions are repetitive
compulsions reduce anxiety
avoidance- keeping away from situations that trigger
what are the emotional symptoms of OCD
anxiety or distress
accompanying depression - low lack of enjoyment
guilt or disgust- over minor moral issues
what are the cognitive symptoms of OCD
obsessive thoughts- worries doors have unlocked- impulses to hurt someone
cognitive coping strategies- to deal with obsession
insight into excessive anxiety- aware of obsessions and compulsions are not rational
what is a phobia
an irrational fear of an object or situation
what is the model that explains phobias
the two process model
who came up with the two process model
Mowrer
what is the first stage of the two process model
acquisition
what is acquisition and what is it described using
classical conditioning
involves learning to associate something of which we initially have no fear for with something we fear
what is the example of acquisition
little albert
initially white rat didn’t bring and reaction
loud noise caused fear
rat paired with loud noise 6 times and then rat was feared
other similar animals also feared - stimulus generalisation
what is the second stage of the two process model
maintenance
what is maintenance and what is it explained by
explained by operant conditioning- shows why individuals continue to avoid feared stimulus
negative reinforcement - an individual avoids something unpleasant and outcome is positive experience ( avoid the phobic stimulus = escape anxiety)
avoidance is repeaded and phobia is maintained
what are the strengths of the two process model
it has good explanatory power( real world application)
can provide convincing explanations- eg people with a phobia have a traumatic experience with that phobia
allows us to understand how to treat the disorder( if learnt can be unlearnt)
what are the weaknesses for the two process model
ignores other factors
does not think about cognitive approach- irrational thinking so people may not get the right treatment ( no cognitive behaviour therapy)
does not think about biological prepareness- peopel are genetically preprogrammed and fear things due to evolutionary past
does not take into account diethesis stress model - both genetics and the interaction needs to be considered
what are the two behavioural treatments of phobias
flooding and systematic desensitisation
what is flooding
immediate exposure until no fear is present
gives patient no option to avoid
phobia is extinguished
( 1 session around 2-3 hours )
what is one strength of flooding
cost effective
takes less time
cures phobias more quickly and cost effective
what are two weaknesses of flooding
can be traumatic- elicits high anxiety
not unethical but high attrition rates as people drop out
waste of time and money
less effective for certain phobias
ones that have not been learnt can not be unlearnt
what is symptom substitution
although one phobia may be successfully removed, another may appear in its place
what is systematic desensitisation
method that aims to extinguish a phobia by eradicating an undesirable behaviour (fear) and replacing it with a more desirable one (relaxation) - counter-conditioning. works on principle of reciprocal inhibition - one person cannot feel fear and relaxation at the same time
what is the 3 step process of Systematic desensitisation
- hierarchy- order situations least to most scary
- relaxation- relaxation techniques or drugs (reciprocal inhibition)
- gradual exposure - step by step exposed to fear - have to be calm at stage to move into next
what are the two strengths for systematic desensitisation
evidence to support effectiveness- 75% of phobias were successful treated
favoured over flooding as less traumatic and low attrition rates - more appropriate for people with learning difficulties and anxiety disorders
what is one weakness of systematic desensitisation
it is not effective for treating all phobias - phobias not developed through personal experience ( evolutionary) can not be treated successfully with this method
what is depression
a mood disorder
what does the cognitive approach say about depression
that it is the result of faulty/ irrational thinking
it is the processing that is faulty not the situation
what are the two cognitive approach explanations
ellis’ abc model
becks negative triad
what is ellis’ ABC model explanation
that there are 3 parts to developing depression
A- activating event( environmental or situational)
B- belief - the irrational belief
C- the consequence which is unhealthy emotions/ depression
what is the most important part of the ABC model
the belief
what us musturbatory thinking
the belief that the individual must meet often perfectionist goals in order to achieve success or be happy - the source of irrational beliefs
what is an example of absolutist thinking
“i must do well or i am worthless”
what is becks negative triads explanation for depression
having a negative self schema- package of negative ideas of the self
this results in the negative triad - negative idea of the self, the world and the future
what are examples of a negative idea of the self, the world and the future
the self- “ i am worthless”
the world- “ no one loves me”
the future “ things will always be this way”
what is a strength of the explanations of depression
it has real life application - successfully applied in therapy
90% success rate after 27 sessions of cbt- suggests cognitive explanations
if cause is known easily treated
what are the two weaknesses of the cog approach to explaining depression
blames the client-
overlooks activation event
although gives client chance to change
other things need to be considered
does not take into account alternative explanations eg biological
reductionist
generic factors and neurotransmitters
studies found gene related to low levels of serotonin are 10x more common in depressed people
diathesis- stress model could be needed
what is the aim of CBT
to change the thought process in order to change the behaviour
what does CBT stand for
cognitive behavioural therapy
what is the subtype of CBT
R E BT - rational emotive behavioural therapy
who proposed the idea of REBT
ellis
what did ellis say about treating depression
extended ABC model to ABCDEF (REBT)
D- disputing/ challenging the thoughts - being trained to challenge your own thoughts
E- effects of disputing- this means new beliefs (rational) replace the old beliefs (irrational)
F- new feelings - leads to new positive feelings not depression
what are the three types of disputing
logical, empirical, pragmatic
what is logical disputing
asking yourself if the thought makes logical sense
what is empirical disputing
evidence based, reality tests thoughts - “where is the proof that this belief is accurate?”
what is pragmatic disputing
looking at the usefulness of the belief- how is this belief likely to help me ?
what is an important factor of empirical dispute
homework
who proposed the idea of homework
beck
what is homework
set homework such as to record when they enjoyed an event - provides evidence against irrational beliefs and enables beliefs to be tested against reality
reality testing
“client as scientist” client collects data themselves
what is another element of CBT
behavioural activation
what is behavioural activation
encouraging clients to be more active and engage in pleasurable activities
gradually decreases isolation and avoidance
what is one strength of CBT
research evidence to support the effectiveness
march et al- cbt, antidepressants, and both compared
327 depressed adolescents- after 36 weeks 81% of CBT, 81% of AD and 86% of both significantly improved
just as effective as AD and even better when paired
also cost effective so first choice for NHS
what are the weaknesses of CBT/ REBT
•more effective for some than others - lack of effectiveness for severe cases as depression = low motivation
also not suitable for those with learning disabilities
• high relapse rates- although effective at tackling symptoms , concerns at how long the benefits last- 439 patients everymonth for 12 months - 6 months in 42% relapsed, 12 months in 53% relapsed - needs to be repeated periodically
• alternative treatments- biological psychologists challenge cog basis of depression- think drug therapy is more effective
number of studies found low levels of serotonin implicated in depression as well as genetic factors
may be preferred course- ppts lacking motivation
what are obsessions and compulsions
obsession- a persistent thought or impulsive experience experience repeatedly- feels intrusive and causes anxiety
compulsion- a repetitive and rigid behaviour or mental act a person feels driven to perform to prevent or reduce anxiety
what are the genetic explanations of OCD ( no description)
SERT gene
COMT gene
OCD may be polygenic
what is the SERT gene explanation of OCD
a variation of this gene effects the transportation of serotonin- lower levels of it which is implicated in OCD and also links to depression
what are SERT GENES and COMT GENES examples of
candidate genes
what is the explanation of the COMT gene in OCD
supposed to regulate production of dopamine- variation results in higher production of dopamine - more common in patients with OCD
what is dopamine
pleasure neurotransmitter
what is serotonin
mood neurotransmitter
what is the explanation thag OCD may be polygenic
may be caused by a combination of genetic variations
Taylor found that up to 230 different genes may be involved
what is the neural explanation to OCD( no description)
the worry circuit
what is the explanation of the worry circuit in terms of OCD
the caudate nucleus normally surprises signals from the orbital frontal cortex and diffferentiates between major and minor worries
in OCD patients caudate nucleus is often damaged - meaning it fails to surpress minor worries - thalamus is alerted
too many worries
what are the strengths to explaining OCD
•research support for bio explanations from family studies- lewis examined OCD patients and 37% had parents with disorder, 21% had siblings with it
individuals with first degree relatives up to 5x more likely to develop it
provides evidence but does not rule out environmental factors playing role( families environments are all simulate so may be more about this than about genes)
•research support from twin studies - meta analysis ofc14 twin studies investigating genetic inheritance rate of OCD- monozygotic twins have double the risk of developing OCD compared to dizygotic if one had it - however for MZ twins still not 100% due to environmental factors so diathesis stress model may be more suitable
what are the weaknesses of the explanation of OCD
• issues with cause and effect relationships- while evidence to suggest certain neural systems do not function normally in patients suffering from OCD, there are other areas occasionally involved- no brain system constantly plays a role - difficult to ascertain if cause or effect of disroder
•there are alternative explanations such as behaviourist approach and the two process model - initial learning of stimulus could occur through classical conditioning + maintained through operant conditioning and negative reinforcement
this is supported by the success of behavioursl treatments where symptoms improves for 60-90% of adults
what is the biological treatment for OCD
drug therapy
what are the two drugs used to treat ocd
SSRIs ( antidepressant)
Benzodiazepines (anti- anxiety drug)
what does SSRI stand for
SELECTIVE SERATONIN REUPTAKE INHIBITORS
how do SSRIs work
(in presynaptic)
•stop uptake of serotonin back into pre synaptic (reabsorbtion) by blocking vesicles
•increases the level of serotonin available in synapse
• increases the concern of seritonin so can continue to stimulate post synaptic
•available as capsules or liquid
•3-4 months for it to have an impact
how do benzodiazepines work
•enhances the activity of neurotransmitter GABA
•GABA locks on to specific gaba receptor sites located in post synaptic membrane
•when locked onto these sites opens a channel which increases flow of chloride ions preventing other neurotransmitters from stimulating the post synaptic neuron.
•calming nature
what are the strengths of drug therapy - ocd treatment
•clear evidence of effectiveness of SSRIS in reducing symptoms - reviewed 17 studies comparing SSRI to placebo. all 17 showed significantly better outcomes- symptoms reduced for around 70% for remaining 30% can be helped by alternative drugs or combinations.
• drugs are cost effective and non disruptive- good value for NHS - passive and non disruptive- cheap compared to other psychological treatments because they can be mass manufactured in the time of one session of therapy. good use of limited funds
they also are not disruptive to peoples life as only have to take drugs so are a popular choice
what are the weaknesses of drug therapy - treatment for ocd
drugs can have side effects- some people see not benefit for SSRIS and also side effects such as indigestion, blurred vision, and loss of sex drive- some people feel they have a reduced quality of life so stop taking the drugs - ineffective
BZ known for being highly addictive and can increase aggression and have long term memory impairments
for short term use only
drugs treat the symptoms not the cause of ocd- once patient stops taking the drug prone to relapse- CBT may be more effective
