Psychopathology Flashcards
What are the four definitions of abnormality?
Statistical deviation/infrequency
Deviation from social norms
Failure to function adequately
Deviation from ideal mental health
What is statistical deviation/infrequency?
A person’s trait/thinking/behaviour is abnormal if it’s numerically (statistically) rare/uncommon/anomalous
Mathematical method for defining abnormality
Abnormality should be based on infrequency - if rare, abnormal
What s
Limitation of statistical infrequency - cultural bias
IQ
Different around the world
Varies in every culture
What is deviation from social norms?
Each culture, country and social group have own social norms
Can easily detect those who deviate from social norms
What are social norms?
Unwritten rules of beliefs, attitudes and behaviours that are considered acceptable
Provide us with expected idea of how to behave and function to provide order and predictability in society
Strength of deviation from social norms - practical application
Antisocial personality disorder (sociopath)
Show disregard for normal social behaviour
Lack guilt or regret
Limitation of deviation from social norms - cultural bias
Hearing voices
Seen has a higher power (charman)
Psychics and medians (hear voices)
What is failure to function adequately?
A person is considered abnormal if they are unable to cope with demands of everyday life or experience personal distress
Unable to perform behaviours necessary for day-to-day living
What are the characteristics defining a failure to function adequately?
Suffering
Maladaptiveness (danger to self)
Vividness and unconventionality (stands out)
Unpredictability and a loss of control
Irrationality/incomprehensibility
Causes observer discomfort
Violates moral/social standards
Strength of failure to function adequately - practical application
Phobias
Cannot cope with different things
Agoraphobia - open spaces
Limitation of failure to function adequately - cultural bias
“hold down a job”
In other countries not everyone should hold down a job
Women aren’t always expected to have a job
What is deviation from ideal mental health?
Rational
Realistic
Actualise - set yourself a goal and stick to it
Independent
No distress
Stress-free
Self-esteem
Successful
Adaptiveness
Who created the criteria for deviation from ideal mental health?
Jahoda
Strength of deviation from ideal mental health - practical application
OCD and phobias and depression
Irrational thoughts
Limitation of deviation from ideal mental health - cultural bias
Stress
- if not stressed, abnormal
- or bad
Success
- changes in every culture
What is cultural relativism?
View that behaviour cannot be judged properly unless it’s viewed in the context of the culture which it originates
Limitation of definitions of abnormality - socially sensitive
Stigma behind mental health
Words we use aren’t great - negative
May stop people from seeking support
Limitation of definitions of abnormality - not sole explanation
Rosenhan’s study - don’t work on their own
Placed pseudo patients into a hospital
Found that doctors and nurses were unable to stop the “fake” patients
What are the behavioural characteristics of phobias?
Panic - sweating, trembling, nausea
Endurance - continuing to experience more severe panic
Avoidance - avoiding anything surrounding phobia
What are the emotional characteristics of phobias?
Anxiety
Unreasonable - describes the significantly high anxiety
What are the cognitive characteristics of phobias?
Selective attention - only pay attention to that phobia stimulus
Irrational beliefs - brain thinks irrationally to make the panic make sense
Cognitive distortions - distorting memories to make them feel worse
What is the two process model of phobias?
Classical conditioning - negative experience starts phobia
Operant conditioning - maintains phobia
What is classical conditioning in relation to phobias?
UCS (fear stimulus) –> UCR (anxiety)
NS (neutral stimulus) –> NR (no response)
UCS + NS –> UCR
CS (neutral is now fear stimulus) –> CR (anxiety)
How is a phobia maintained by operant conditioning?
Negative reinforcement
Maintains a learnt avoidance of phobia by removal (moving away from phobia) of the negative emotions and feelings will reinforce the behaviour
Allows individual to learn that avoiding situations will reduce negative situations
Strength of behavioural explanation of phobias - research evidence
Little Albert - Watson and Raynor
Conditioned after 6 negative experiences to fear rats/fluffy things
Affected his entire life
Limitation of behavioural explanation of phobias - incomplete explanation
Seligman 1971
Biological preparedness
Innate predisposition to acquire certain fears
Limitation of behavioural explanation of phobias - phobias don’t follow a trauma
Not all phobias are created due to bad experiences
Lots of people fear snakes but have never seen one (Sue et al)
Some people do have a bad experience with a stimulus but don’t create a phobia
Someone who is bitten by a dog doesn’t always lead to a phobia (DiNardio)
What are the behavioural treatments of phobias?
Systematic desensitisation (SD)
Flooding
What is SD?
Teach patients RELAXATION TECHNIQUES
Create an ANXIETY HIERACHY: situations that are least to most fearful with the phobia included
GRADUALLY EXPOSE patient to the anxiety hierarchy, using relaxation techniques at each stage
What is counter-conditioning?
Phobic stimulus (conditioned stimulus) paired with relaxation so it becomes and conditioned response
What is reciprocal inhibition?
Not possible to be afraid and relaxed at the same time so one emotion prevents the other
What is an anxiety hierarchy?
Fearful stimuli arranged in order from least to most frightening
What are some examples of relaxation techniques?
Deep breathing
Meditation
Mental imagery techniques
Counting
What is gradual exposure?
Patient works through the anxiety hierarchy
At each level, patient exposed to phobic stimulus in a relaxed state
Strength of SD - Gilroy et al
Followed up 42 people who had SD for spider phobia
SD less fearful than control group
Limitation of SD - practicality
Takes longer than other treatments and more expensive
If patients severely suffering, might want quick treatment
Strength of SD - research support
McGrath
75% of patients reported well to SD
Most successful part of treatments seems to be contact with feared stimulus
In vino treatment better than in vitro
Limitation of SD - economy
Due to SD taking several sessions, leads to higher cost for NHS
Means longer waiting times, meaning patients may not be able to return to work as quickly also negatively impacting the economy
What is flooding?
Exposing patient with phobia to phobic object without a gradual build up (immediate exposure)
Without option of avoidance behaviour, person quickly learns phobic object is harmless through exhaustion of their fear response
What is extinction?
Patient not allowed to avoid their fear so learn it isn’t as bad as their anxiety lets them believe it is
Limitation of flooding - ethical concerns
Participants and therapists rated flooding as more stressful
Ethical concerns about knowingly causing stress
Traumatic nature leads to higher attrition rates than SD
Strength of behavioural treatments of phobias - effectiveness
Craske - flooding and SD were effective therapies
Choy - especially reducing physical symptoms
Limitation of behavioural treatments of phobias - alternative therapies
Anti-anxiety medication
Cheaper
More passive
What are the behavioural characteristics of depression?
Lethargic - lack of energy
Aggression
Disruption to sleeping and eating - hypersomnia (sleeping lots), insomnia (sleeping too little), eating too much, eating too little
What are the emotional characteristics of depression?
Self-esteem - low
Anger/aggression
Mood - low
What are the cognitive characteristics of depression?
Concentration - lack of
Absolute thinking
Negative
What type of psychologists were Ellis and Beck?
Cognitive psychologists
Who believed that people suffering from depression had faulty information processing?
Ellis and Beck
What is faulty information processing?
Interpret things badly
Who believed that people suffering from depression created negative schemas?
Ellis and Beck
What does creating negative schemas mean?
A schema is a “package” of ideas and information developed through experience
Only remembers or focuses on negative experiences
What is Beck’s cognitive triad of depression?
Negative views for the self (“I am a failure”)
Negative views of the future (“It’s never going to get better”)
Negative views of the world (“The world is a cold, dark place”)
Strength of Beck’s explanation - supporting evidence
Grazdi and Terry
65 pregnant women tested for cognitive vulnerability and depression before and after birth
Found that women who were rated high in cognitive vulnerability were more likely to suffer from post-natal depression
Limitation of Beck’s explanation - reductionism
Doesn’t explain all aspects
Some depressive patients experience Cottard syndrome where they have delusions that they are zombies/dead/ghosts
What is Ellis’ ABC model of depression?
Activating events - negative or significant, stressful events
Beliefs - irrational beliefs
Consequences - negative emotional and behavioural
Strength of Ellis’ explanation - research evidence
Irrational thinking
Alloy and Abraham
People with depression are more accurate in their estimations of disasters
People with depression are realists
Strength of cognitive explanations of depression - practical application
Ellis - REBT
Beck - CBT
What are the cognitive treatments of depression?
CBT
REBT
What does REBT stand for?
Rational Emotional Behaviour Therapy
What is REBT?
Action-orientated psychotherapy
Teaches individuals to identify, challenge and replace their irrational thoughts and beliefs with healthier thoughts that promote emotional well-being and goal achievements
Highly directive, persuasive and confrontational
What are the types of arguments used in REBT?
Empirical
Logical
What is a empirical argument?
Disputing where there is evidence to support the irrational belief
What is a logical argument?
Disputing whether the negative thought actually follows the facts
What does REBT believe about a therapist-client relationship?
Therapist is teacher so no need for warm, personal relationship with client
What do the different methods of REBT depend on?
Personality of the patient
Strength of REBT - research support
Ellis found that an average patient took 27 sessions of therapy
From these patients, 90% success rate (reduction or elimination of symptoms)
Counterpoint REBT - research support
Researcher bias/investigator effects
What does CBT stand for?
Cognitive Behavioural Therapy
What is CBT?
Talking therapy
Idea that the client identifies their own unhelpful beliefs and then proves them wrong so, as a result, their beliefs begin to change
Client discovers misconceptions by themselves
What are some examples of behavioural activation?
Homework
Journal writing
Patient-as-scientist
What does patient-as-scientist mean?
Patient creates their own activity to challenge their own belief
What does CBT believe about a therapist-client relationship?
Stresses quality of the therapeutic relationship
What do the different methods of CBT depend on?
Particular disorder
Strength of CBT - effective treatment
Better with drugs
March et al
Compared effects of CBT with antidepressants and combination of two in 327 adolescents
After 32 weeks
CBT = 81%
Antidepressants = 81%
CBT and antidepressants = 86%
AO3 CBT - comparison with drug treatment
CBT
+ long-term impact
- expensive (economy)
- doesn’t work if lethargic
Drug treatment
- symptoms can come back
+ cheap (economy)
+ take no effort (low effort)
- side effects
Limitation of CBT - suitability
CBT less suitable for people with high levels of irrational beliefs that are rigid and resistant to change
May find situation too stressful and not be able to resolve their issues in therapy
What does OCD stand for?
Obsessive-Compulsive Disorder
What are the behavioural characteristics of OCD?
Compulsions
Avoidance - avoid situations triggering anxiety
Repetitive action
Reduce anxiety
What are the emotional characteristics of OCD?
Depression - low mood, lack of enjoyment and limiting
Anxiety and distress - worst-case scenario being repeated
Guilt - intrusive and obsessive thoughts are negative about people
What are the cognitive characteristics of OCD?
Obsessive thoughts - how frequent it is, leading to compulsion
Intrusive thoughts - negative contents, can be one-off
Insight - awareness that what they do is irrational
What are monozygotic twins?
Identical twins
One egg and one sperm
100% DNA similarity
What are dizygotic twins?
Non-identical twins
Two eggs and two sperm
50% DNA similarity
What are candidate genes of OCD?
Increase the vulnerability of having OCD
Believed to interfere with serotonin in the brain causing symptoms
What is the genetic explanation of OCD?
37% of OCD patients had parents with OCD
21% of OCD patients had siblings with OCD
OCD is polygenic which means there are multiple candidate genes which could affect likelihood of suffering with OCD, potentially 230 genes involved
Could be due to there being lots of different types of OCD
Strength of genetic explanation of OCD - research support
Nestadt et al
Reviewed twin studies and heritability of OCD
MZ twins showed 68% inheritability
DZ twins showed 31% inheritability
Limitation of genetic explanation of OCD - nature vs nurture
Cromer research
Genes not whole explanation
Nature = OCD purely caused by genetic factors
Nurture = there is an environmental element which causes OCD
Diathesis-stress model = genes give you a vulnerability of getting OCD but you need an environmental trigger to suffer from the symptoms
What does serotonin do?
Makes you calm
What is the neural explanation of OCD?
Some psychologists believe OCD sufferers have reduced serotonin levels
Reduction of serotonin leads to impaired mental functions (COGNITIVE CHARACTERISTICS) and mood regulation (EMOTIONAL CHARACTERISTICS)
How is the decision making system affected in individuals with OCD?
Frontal lobe (responsible for logical thinking and decision making) is impaired
Left parahippocampal gyrus (in charge of emotions - NEGATIVE EMOTIONS) is abnormally structured
Strength of neural explanation of OCD - practical application
Therapy on serotonin
Using anti-depressants which work on serotonin levels have caused improvement in OCD symptoms
Limitation of neural explanation of OCD - cause and effect
Cannot establish whether it is brain areas/neurotransmitters which cause OCD or whether OCD symptoms cause the changes
Lacks validity - as OCD could be caused by other primary factors
Scientists would need to study people’s brains before they suffer with OCD symptoms to understand if the brain is the cause
What are SSRIs?
Drug therapy
To have “normal” serotonin levels, all of your receptor sits have to be hit
For OCD patients because they have low serotonin, not all sites are hit
SO SSRI BLOCKS THE REUPTAKE SO THEY HAVE TO KEEP HITTING THE RECEPTOR SITES
What is a tricyclic?
Antidepressant drug
Same effect as SSRIs but side effects and be more severe
What is SNRI?
Increase serotonin and noradrenaline
Limitation of drug treatments of OCD - side effects
Indigestion, blurred vision, loss of sex drive
Patients may not continue drug treatment
Strength of drug therapy for OCD - research support
Soomro et al
Reviewed 17 studies of SSRI
Either given SSRI or placebo
70% improved
Other 30% were helped with alternative drugs or combination of drugs and psychological therapies
AO3 drug therapies of OCD - practicality
+ very cheap
+ very little effort
- CBT gives more long-term results
