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psychopathology Flashcards
define deviation from social norms
any behaviour which breaks the unwritten rules of society
evaluate deviation from social norms as a definition for abnormality
-it lack cultural bias/ what is considered normal changes over time/ it ignores context and is subjective
+it is easy to distinguish normal from abnormal
define statistical infrequency
statistical uncommon or rare behaviours
evaluate statistical infrequency
-it lacks cultural bias/ some behaviours are desirable ie: high IQ some are undesirable ie: depression/ labelling causes distress
+ its an objective measure and has real-life application
define deviation from ideal mental health
Jahoda’s 6 criteria need to be met to be “normal” (self-actualisation, integration, autonomy, reality.
evaluate deviation from ideal mental health
-too unrealistic/ there is cultural bias
+can be used as something to aspire to
define failure to function adequately
unable to cope with the demands of daily life
evaluate failure to function adequately
-difficult to define / ignores context
+real life application
define OCD
you have obsessive thoughts that cause anxiety that are relived through compulsive behaviours
define phobias
persistent fear of a thing or situation that is irrational
define depression
constant state of low mood and loss of interest in pleasure
cognitive characteristics of depression
diminished ability to concentrate and a tendency to focus on negative thoughts.
emotional characteristics of depression
depressed mood, feelings of worthlessness and lack of interest or pleasure in all activities
behavioural characteristics of depression
loss of energy, sleep disturbance and changes in appetite
behavioural characteristics of OCD
compulsive behaviours are repetitive and used to reduce anxiety
emotional characteristics of OCD
anxiety, depression
cognitive characteristics of OCD
repeated thoughts, some OCD sufferers come up with cognitive strategies to deal with their obsessions and some experience selective attention to the anxiety generating stimuli
cognitive characteristics of phobias
Selective attention to the phobic stimulus, Irrational beliefs, Resistance to rational arguments
emotional characteristics of phobias
Anxiety-unable to relax or feel positive emotions(long term)
Fear-immediate response when presented with the phobic stimulus
Most emotional responses are unreasonable and disproportionate to the actual danger presented by the phobic stimulus
behavioural characteristics of phobias
Panic-crying,screaming,running away,freezing,fainting. Avoidance-avoid coming into contact with the phobic stimulus .Endurance-the person remains in presence of the phobic stimulus but experiences high levels of anxiety
Two process model concept:
we acquire phobia through classical conditioning and maintain them through operant conditioning
classical conditioning for phobia
UCS -> UCR
NS -> UCR
NS + UCS -> UCR
CS-> CR
Operant conditioning for phobia
phobias can be negatively reinforced. This is where a behaviour is strengthened, because an unpleasant consequence is removed. For example, if a person with a phobia of dogs sees a dog whilst out walking, they might try to avoid the dog by crossing over the road. This avoidance reduces the person’s feelings of anxiety and negatively reinforces their behaviour, making the person more likely to repeat this behaviour (avoidance) in the future.
Evaluation of two process model
-This explanation is useful for developing therapies, as it explains that in order to overcome the fear, the person must be exposed to the phobic stimulus.
-Some phobias don’t follow a traumatic experience, for example a person may have a fear of snakes without ever having encountered a snake. This suggests some phobias have not been acquired through learning, weakening this explanation
-We may be pre-disposed to some phobias, such as snakes or spiders, which would have given human ancestors a survival advantage. This means the capacity for certain phobias is ‘hard-wired’, and therefore not learnt. Phobias of guns and cars, which are far more dangerous to most human today, are very rare, perhaps because these things were not present in humans’ evolutionary past. This weakens the behavioural explanation.
what is systematic desensitisation?
Systematic desensitization is a behavioral technique whereby a person is gradually exposed to an anxiety-producing object, event, or place while being engaged in some type of relaxation at the same time in order to reduce the symptoms of anxiety.
what are the three processes involved in systematic desensitisation?
1) the anxiety hierarchy: is put together with the therapist and patient in order of the most-least anxiety provoking
2)relaxation: the therapist teaches the patient methods of relaxation such as breathing methods
3)exposure: finally the patient us exposed to the phobic stimulus while in a relaxed state
what is flooding?
Flooding therapy is an intensive type of exposure therapy in which you must face your fear at a maximum level of intensity for an extended amount of time. There’s no avoiding the situation and no attempt on the therapist’s part to reduce your anxiety or fear.
in terms of classical conditioning how does flooding work?
extinction- a learned response is extinguished when the conditioned stimulus is encountered without the unconditioned stimulus.
resulting in the conditioned stimulus no longer producing the conditioned response.
evaluation of systematic desensitisation:
-effective. Gilroy et al (2003) followed 42 patients that underwent systematic desensitisation therapy at both 3 and 33 months
-it is suitable for a wide range of patients
-it is acceptable to patients - preferred by most patients as it doesn’t involve as high levels of trauma
evaluation of flooding:
-it is cost effective as patients are free of their symptoms as soon as possible making the treatment cheaper
-it is less effective for some types of phobias more complex phobias like social phobias can not be treated as effectively via flooding
-highly traumatic
becks cognitive theory of depression:
Beck developed a cognitive explanation of depression which has three components: a) cognitive bias; b) negative self-schemas; c) the negative triad.
a) Cognitive Bias
Beck found that depressed people are more likely to focus on the negative aspects of a situation, while ignoring the positives. They are prone to distorting and misinterpreting information, a process known as cognitive bias.
Beck detailed numerous cognitive biases, two of which include: over-generalisations and catastrophising. For example, a depressed person may make over-generalisations, where they make a sweeping conclusion based on a single incident, for example: ‘I’ve failed one end of unit test and therefore I’m going to fail ALL of my AS exams!’ Alternatively, a depressed person may experience catastrophising, where they exaggerate a minor setback and believe that it’s a complete disaster, for example: ‘I’ve failed one end of unit test and therefore I am never going to study at University or get a good job!’
b) Negative self-schemas
A schema is a ‘package’ of knowledge, which stores information and ideas about our self and the world around us. These schemas are developed during childhood and according to Beck, depressed people possess negative self-schemas, which may come from negative experiences, for example criticism, from parents, peers or even teachers.
A person with a negative self-schema is likely to interpret information about themselves in a negative way, which could lead to cognitive biases, such as those outlined above.
c) The negative triad
Beck claimed that cognitive biases and negative self-schemas maintain the negative triad, a negative and irrational view of ourselves, our future and the world around us. For sufferers of depression, these thoughts occur automatically and are symptomatic of depressed people.
The negative triad (pictured below) demonstrates these three components, including:
The self – ‘nobody loves me.’
The world – ‘the world is an unfair place.’
The future – ‘I will always be a failure.’
ellis abc model of depression
Ellis took a different approach from Beck (cognitive triad) to explaining depression and started by explaining what is required for ‘good’ mental health. According to Ellis, good mental health is the result of rational thinking which allows people to be happy and pain free, whereas depression is the result of irrational thinking, which prevents us from being happy and pain free.
Ellis proposed the A-B-C three stage model, to explain how irrational thoughts could lead to depression.
A: Activating Event
An event occurs, for example, you pass a friend in the corridor at school and he/she ignores you, despite the fact you said ‘hello’.
B: Beliefs
Your belief is your interpretation of the event, which can either be rational or irrational.
A rational interpretation of the event might be that your friend is very busy and possibly stressed, and he/she simply didn’t see or hear you.
An irrational interpretation of the event might be that you think your friend dislikes you and never wants to talk to you again.
C: Consequences
According to Ellis, rational beliefs lead to healthy emotional outcomes (for example, I will talk to my friend later and see if he/she is okay), whereas irrational beliefs lead to unhealthy emotional outcomes, including depression (for example, I will ignore my friend and delete their mobile number, as they clearly don’t want to talk to me).
The above example illustrates how an activating event – a friend not greeting you in the corridor – can be rationally or irrationally interpreted. Irrational thinking or interpretations lead to unhealthy outcomes, for example depression, whereas rational and logical thoughts lead to good mental health and happiness.
evaluate ellis abc model
One strength of the cognitive explanation for depression is its application to therapy. The cognitive ideas have been used to develop effective treatments for depression, including Cognitive Behavioural Therapy (CBT) and Rational Emotive Behaviour Therapy (REBT), which was developed from Elliss ABC model. These therapies attempt to identify and challenge negative, irrational thoughts and have been successfully used to treat people with depression, providing further support to the cognitive explanation of depression.
However, one weakness of the cognitive approach is that it does not explain the origins of irrational thoughts and most of the research in this area is correlational. Therefore, we are unable to determine if negative, irrational thoughts cause depression, or whether a person’s depression leads to a negative mindset. Therefore, it is possible that other factors, for example genes and neurotransmitters, are the cause of depression and one of the side effects of depression are negative, irrational thoughts.
evaluate becks cognitive theory of depression
It has good supporting evidence ; In 2000 Grazioli and Terry assessed 65 women of their cognitive vulnerability, and found that women they deemed to be more vulnerable were more likely to suffer with postnatal depression. This showed that cognitions can be seen before depression emerges, which supports Becks theory
It has a practical application ; The basis of CBT is Becks theory. The components of the negative triad can be easily identified and challenged. This is a positive as it shows it can be translated into a form of treatmnet.
It does not explain all aspects of depression ; Patients will often experience multiple emotions with depression, from anger to sadness. Becks theory does not take into account those extreme emotions. Sufferers may get hallucinations, or bizarre beliefs caused by other delusions like Cotard Syndrome. Therefore, Becks theory cannot explain all cases of depression, only focusing on one aspect of it.
treatment of depression: cognitive behavioural therapy
Cognitive Behavioural Therapy (CBT) involves both cognitive and behavioural elements.
The cognitive element aims to identify irrational and negative thoughts, which lead to depression. The aim is to replace these negative thoughts with more positive ones.
The behavioural element of CBT encourages patients to test their beliefs through behavioural experiments and homework.
There are various components to CBT, including:
Initial assessment
Goal setting
Identifying negative/irrational thoughts and challenging these:
Either using Beck’s Cognitive Therapy or Ellis’s REBT
Homework
treating depression: elis’s Rational Emotive Behaviour Therapy (REBT)
Ellis developed his ABC model to include D (dispute) and E (effect or effective). Like Beck, the main idea is to challenge irrational thoughts, however, with Ellis’s theory this is achieved through ‘dispute’ (argument).
The therapist will dispute the patient’s irrational beliefs, to replace their irrational beliefs with effective beliefs and attitudes. There are different types of dispute which can be used, including: logical dispute – where the therapist questions the logic of a person’s thoughts, for example: ‘does the way you think about that situation make any sense?’ Or empirical dispute – where the therapists seeks evidence for a person’s thoughts, for example: ‘where is the evidence that your beliefs are true?’
Following a session, the therapist may set their patient homework. The idea is that the patient identifies their own irrational beliefs and then proves them wrong. As a result, their beliefs begin to change. For example, someone who is anxious in social situations may be set a homework assignment to meet a friend for a drink.
treating depression:Beck’s Cognitive Therapy
Beck’s Cognitive Therapy
If a therapist is using Beck’s cognitive therapy, they will help the patient to identify negative thoughts in relation to themselves, their world and their future, using Beck’s negative triad.
The patient and therapist will then work together to challenge these irrational thoughts, by discussing evidence for and against them.
The patient will be encourage to test the validity of their negative thoughts and may be set homework, to challenge and test their negative thoughts.
evaluation of treatments of depression:
One strength of cognitive behaviour therapy comes from research evidence which demonstrates its effectiveness in treating depression.
Research by March et al. (2007) found that CBT was as effective as antidepressants, in treating depression. The researchers examined 327 adolescents with a diagnosis of depression and looked at the effectiveness of CBT, antidepressants and a combination of CBT plus antidepressants. After 36 weeks, 81% of the antidepressant group and 81% of the CBT group had significantly improved, demonstrating the effectiveness of CBT in treating depression. However, 86% of the CBT plus antidepressant group had significantly improved, suggesting that a combination of both treatments may be more effective.
One issue with CBT is that it requires motivation. Patients with severe depression may not engage with CBT, or even attend the sessions and therefore this treatment will be ineffective in treating these patients. Alternate treatments, for example antidepressants, do not require the same level of motivation and maybe more effective in these cases. This poses a problem for CBT, as CBT cannot be used as the sole treatment for severely depressed patients.
Furthermore, cognitive behavioural therapy has been criticised for its overemphasis on the role of cognitions. Some psychologists have criticised CBT, as it suggests that a person’s irrational thinking is the primary cause of their depression and CBT does not take into account other factors. CBT therefore ignores other factors or circumstances that might contribute to a person’s depression. For example, a patient who is suffering from domestic violence or abuse, does not need to change their negative/irrational beliefs, but in fact needs to change their circumstances. Therefore, CBT would be ineffective in treating these patients until their circumstances have changed.
explanations of OCD: genetic
Genes may create a vulnerability (risk of developing) to OCD. There is evidence that OCD runs in families. Lewis (1936) found that 37% of patients with OCD had parents with the disorder. The diathesis-stress model suggests that, along with this vulnerability, the environment may trigger OCD. There are many candidate genes involved in OCD (for example, those involved in the serotonin and dopamine systems), and it is polygenic: several genes are involved (perhaps up to 230). OCD is aetiologically heterogeneous, meaning different combinations of genes cause different types of OCD in different people.
explanations of OCD:genetic evaluation
Supporting evidence from Nestadt et al (2010) showed that 68% of identical twins were both diagnosed with OCD, compared to 31% of non-identical twins, suggesting there is a genetic basis.
There are too many candidate genes for OCD- potentially hundreds. This means that finding a definitive genetic cause is very unlikely, reducing the usefulness of this explanation.
There is evidence from Cromer et al (2007) that the environment is very influential- OCD was more severe in patients who had experienced traumatic events in their lives, and even more severe where patients had experience more than one event. This suggests the environment is more important than biology in developing OCD.
explanations of OCD: neural
Low levels of serotonin (a neurotransmitter) leads to impaired transmission of mood-relevant information, leading to a lowered mood. Low levels of serotonin are also linked to obsessive thoughts. Abnormal frontal lobe functioning leads to impaired decision-making, leading to symptoms of OCD. Abnormal functioning of the left parahippocampal gyrus leads to more processing of unpleasant emotions, which is a feature of OCD.
explanations of OCD: neural evaluation
Supporting evidence from antidepressant studies shows that increasing serotonin levels reduces OCD symptoms, suggesting serotonin has a role in the development of OCD
There is a lack of understanding what neural mechanisms are involved, making this an incomplete explanation.
The cause-effect relationship not known- it could be that changed in the brain are a result of OCD, rather than causing it in the first place. This weakens the neural explanation.
treatment of OCD: drug therapy
SRIs (selective serotonin reuptake inhibitors) are the most commonly prescribed drugs for OCD. These work by blocking the transporter mechanism that re-absorbs serotonin into the presynaptic cell after it has fired. As a result, more serotonin is left in the synapse to be absorbed by the post synaptic cells. Dosages vary with the patient, and it takes 3-4 months for benefits to show. An example of an SSRI is Fluoxetine. Often SSRIs will be combined with CBT.
Other drugs include tricyclics, for example Clomipramine, which work in the same way as SSRIs but have more side effects. SNRIs work on noradrenaline as well as serotonin, and may also be used. These other drugs will be prescribed where a patient is not responding well to SSRIs.
