psychopathology Flashcards

Question

what is systematic desensitisation?

Answer 1

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.

Answer 2

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

Answer 3

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.

Answer 4

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.

Answer 5

-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

Answer 6

-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

Answer 7

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.’

Answer 8

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.

Answer 9

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.

Answer 10

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.

Answer 11

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

Answer 12

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.

Answer 13

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.

Answer 14

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.

Answer 15

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.

Answer 16

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.

Answer 17

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.

Answer 18

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.

Answer 19

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.