psychopathology Flashcards

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1
Q

how can statistical frequency show abnormality

A
  • implies that a disorder is abnormal if the frequency is more than two standard deviations away from the mean incidence rate
  • people who behave “abnormally” will deviate away from the centre
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2
Q

evaluation of statistical frequency as a definition of abnormality

A

+ objective and based on data
+ good measure for psychological disorders
- infrequency does not mean abnormality and may be desirable (high IQ)
- abnormality may not be infrequent (anxiety and depression)
- some psychological disorders are difficult to measure objectively
- rely on arbitrary cut off points which may not apply to everyone
- only those that seek help will be included in data
- cultural bias- may be more frequent in other cultures like auditory hallucinations

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3
Q

define social norms

A

an unwritten rule of society which sets guidelines for behaviour

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4
Q

how can deviation from social norms show abnormality

A

behaviours which violate these moral standards are seen as abnormal

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5
Q

evaluation of deviation from social norms strengths

A

+ distinguish between desirable and undesirable behaviours
+ social dimensions can help abnormal individual and wider society by helping them

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6
Q

evaluation of deviation from social norms weaknesses

A
  • beliefs about abnormality and social norms of morally acceptable behaviour change over time- homosexuality was classified as a mental disorder until 1972 so lacks temporal validity
  • definition is subjective , basing our assumptions on prevailing social norms
  • judgements are related to context of behaviour- hard to know difference between abnormal deviation or harmless eccentricity
  • cultural relativism and cultural bias- behaviours in western countries may be different to ethnic minorities, like hearing voice or hallucinations may be “normal” in african and asian cultures
  • can be used to justify the removal and discrimination about certain people in society
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7
Q

jahoda’s criteria for deviation from ideal mental health

A
  • positive attitudes towards the self
  • personal growth and self actualisation
  • resistance to stress
  • personal autonomy- independent
  • accurate perception of reality
  • mastery of environment- ability to love, function in different places, adapt
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8
Q

evaluation of deviation from ideal mental health strengths

A

+ focuses on what is positive and functional
+ allows for goal setting h- permits the identification of what is needed to achieve normality
+ holistic view and approaches the whole of the human being

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9
Q

evaluation of deviation from ideal mental health weaknesses

A
  • over demanding criteria- meeting all 6 would be difficult
  • subjective criteria- vague and difficult to measure
  • cultural variation- in some countries personal autonomy or self actualisation is uncommon like in collectivist cultures
  • the degree to which people meet the criteria may vary overtime
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10
Q

how can inability to function adequately show abnormality

A
  • unable to navigate everyday life or behave in a necessary way
  • cause distress and suffering to the individual, as well as people around them
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11
Q

rosenham and seligman criteria for dysfunctional behaviour

A
  • personal distress
  • observer discomfort
  • irrational behaviour
  • unpredictable
  • dysfunctional
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12
Q

DSM assessment rating for functioning adequately

A
  • understanding and communicating
  • getting around
  • self care
  • getting along with other people
  • life activities
  • participation in society
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13
Q

evaluation of ability to function adequately strengths

A
  • assess degree of abnormality with WHODAS
  • focuses on observable behaviour so has empirical evidence
  • practical methods for assessment
  • personal perspective which helps to recognise personal experience
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14
Q

evaluation of ability to function adequately weaknesses

A
  • abnormality is not always accompanied with dysfunction as people with dangerous personalities can function normally (Harold Shipman)
  • subjective to suggest what is dysfunctional or not
  • cultural relativism- different diagnosis for different cultures, lower class non white people are often misdiagnosed
  • questionnaire limitations like social desirability bias
  • people may not be able to function normally for a period of time, which may not be a mental health disorder e.g grief
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15
Q

define phobias

A

anxiety disorder characterised by high levels of distress in response to a a particular stimulus

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16
Q

cognitive characteristics of phobias

A
  • irrational nature of persons thinking
  • person recognises their fear is excessive or unreasonable
  • resistant to rational argument
  • decreased concentraiton
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17
Q

behavioural characteristics of phobias

A
  • avoidance of stimulus
  • freeze or even faint
  • fight or flight
  • body’s response to stress like breathlessness, hyperventilation and palpitations
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18
Q

emotional characteristics of phobias

A
  • fear that is persistent and excessive
  • anxiety and panic
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19
Q

define depression

A

mood disorder characterised by feelings of despondency and hopelessness

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20
Q

cognitive characteristics of depression

A
  • negative self concept
  • worthlessness
    -irrational
  • negative expectations
  • suicidal thoughts
  • slower thought processes
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21
Q

behavioural characteristics of depression

A
  • shift in activity level- reduced (tiredness) or increased (agitated and restless)
  • change in sleep- hypersonic or insomnia
  • appetite- reduced or increased
  • aches and pains
  • takes longer to complete daily activities
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22
Q

emotional characteristics of depression

A
  • sadness or feeling empty
  • worthless, hopeless or low self esteem
  • anhedonia- loss of interest and pleasure
  • anger
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23
Q

define OCD

A

anxiety disorder characterised by persistent anxiety inducing thoughts (obsessions) and consequential repetitive behaviours (compulsions) to reduce anxiety

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24
Q

cognitive characteristics of OCD

A
  • recurrent, intrusive thoughts, images, impulses or beliefs
  • uncontrollable and can be distressing
  • individual shows awareness that these obsessions are excessive
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25
Q

behavioural characteristics of OCD

A
  • compulsion- ritualistic and repetitive
  • reduced social anxiety
  • body’s response to stress like breathlessness, hyperventilation and palpitations
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26
Q

emotional characteristics of OCD

A
  • anxiety and distress
  • when they realised their behaviour is excessive, may be embarrassed
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27
Q

define two process model

A

explains how classical and operant conditioning produce and maintain a phobia

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28
Q

classical conditioning to explain initiation of phobias

A
  • learning through association
  • little albert was conditioned to fear white, furry objects as every time he reached for the white rat, a bar was struck and startled him
  • generalised to other white, furry objects like santa hats
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29
Q

operant conditioning to explain maintenance of phobias

A
  • learning by reinforcement
  • likely to repeat behaviour if outcome is rewarding e.g avoiding the stimuli so fear is not evoked
  • negative reinforcement
30
Q

behaviourist approach to phobias evaluation strengths

A
  • supported as people with phobias do often recall a specific incident which lead to phobia forming, like 50% of people with a fear of driving was in a road accident
  • behaviourist therapies have been effective in treating phobias by getting people to change their response to the stimulus, showing this is the cause
31
Q

behaviourist approach to phobias evaluation weaknesses

A
  • association between NS and fearful experience doesn’t always happen, like in Di Nardo et al research not everyone who is bitten by a dog becomes fearful
  • diathesis stress model- we inherit genetic vulnerability for developing mental disorders as some people may not be vulnerable
  • can be developed through irrational thinking and ignores cognitive factors
  • an alternative explanation is evolution, where we are genetically programmed to form an association with life threatening stimuli (ancient fears) like snakes with life
32
Q

how does social learning explain phobias

A

phobias can be acquired through modelling like parent and child

33
Q

evaluation of social learning to explain phobias

A

+ bandura and rosenthal supported this as they found that when a model acted like he was in pain every time a buzzer sounded, participants later showed an emotional reaction too

34
Q

behavioural treatment of phobias

A
  • systematic desensitisation- counter conditioning, relaxation, desensitisation hierarchy
  • flooding
35
Q

how does counter conditioning work in treating phobias

A
  • the person learns to associate the phobic stimulus with relaxation
  • slow process of gradual exposure or one single intense exposure
  • taught a new association to counter original and create relaxation rather than fear
  • reciprocal inhibition
36
Q

define reciprocal inhibition

A

relaxation inhibits anxiety as they cannot happen at the same time

37
Q

how does relaxation treat phobias

A
  • therapist teaches relaxation techniques
  • focus on breathing
  • progressive muscle relaxation- one muscle at a time is tensed and then released
38
Q

how is desensitisation hierarchy used to treat phobias

A
  • hierarchy of least to most feared type of contact with the phobic stimulus constructed before treatment commences
  • can go from imagined (in vitro) to actual (in vivo)
39
Q

evaluation of systematic desensitisation in treating phobias

A

+ found to be successful as McGrath et al reported that 75% of patients with phobias respond to SD, and in vivo was more successful
+ can be used on a wide range to patients, like those with learning disabilities, and can help more people
+ low drop out rates as it is a gradual treatment
- may not be effective with all phobias as Ohman et al found that SD may be ineffective in treating underlying survival phobias that haven’t come from personal experience

40
Q

define flooding and how it is used to treat phobias

A

exposing the patient to the phobic stimulus right away, without any relaxation or gradual build up
person suffers panic from adrenaline, however it soon wears off and they will calm down

41
Q

evaluation of flooding to treat phobias

A

+ successful with Wolfe when a girl with a phobia of cars was drive. around in one for 4 hours until she calmed down
+ quicker
- ethical issues as it causes patients a lot of anxiety, and if they drop out before the therapy is done it may cause even more harm
- some phobias are heard to treat, like those with cognitive elements

42
Q

becks negative triad to explain depression

A
  • negative view about self, world and future
  • negative schemes and cognitive biases maintain this triad
    -also prone to overgeneralisation and catastrophising
  • excessive responsibility
  • selective abstraction
43
Q

define negative schema

A

negative lens which an individual views and interprets life

44
Q

define cognitive biases

A

explain how a persons thinking is distorted in some way and prone to misinterpretation

45
Q

define overgeneralisation

A

making sweeping conclusions based on a. single incident

46
Q

define catastrophising

A

exaggerate a minor setback and believe it is a complete disaster

47
Q

define excessive responsibility

A

excessively taking responsibility and blame for things which happen

48
Q

define selective abstraction

A

only pays attention to certain features of an event and draws negative conclusions from these

49
Q

ellis’ abc model to explain depression

A
  • irrational thoughts in response to an event
  • a= activating event
  • b= the belief (rational or irrational)
  • c= consequence
50
Q

mustaburbatory thinking to explain depression

A
  • source of irrational beliefs where they think certain ideas or assumptions must be true for an individual to be happy
  • i must be approved or accepted
  • i must do well
  • i must be happy
51
Q

evaluation of cognitive explanation for depression strengths

A
  • support for the role of irrational thinking where Krantz found that depressed patients made more errors of logic compared to control
    => however correlation does not mean causation
  • practical application in therapy where CBT is found to be the best treatment for depression, which focused on challenging the irrational thinking
  • hopeful as it assumed people gave the power to change their behaviour
52
Q

evaluation for cognitive explanation for depression weaknesses

A
  • blames client rather than situation of actors like family problems, which may play a bigger role
  • biological approach may be a better explanation as research supports how low levels of serotonin and a hereditary gene makes depression more lesley (genes make its 10x more likely)
  • faulty cognition may be the consequence of depression rather than cause
  • “irrational beliefs” may be realistic as psychologists found depressive realists see things for what they are gave more accurate estimates if the likelihood of a disaster
  • Lewinsohn argues negative life experiences causes depression so it is learn
  • cognitive explanation cannot explain all symptoms like hallucinations
53
Q

define cognitive behavioural therapy and the features of it

A

aims to identify irrational thinking and challenge it
- challenge irrational thinking
- homework
- behavioural activation
- unconditional positive regard

54
Q

features of challenging irrational thoughts in CBT

A
  • D- distrusting irrational thoughts and beliefs
  • E- effects of diluting and effective attitude to life
    => logical disputing- self defeating beliefs do not follow logically from the information available (sense)
    => empirical disputing- self defeating beliefs may not be consistent with reality (proof)
    => pragmatic disputing- emphasis on lack of usefulness of self defeating beliefs (helpfulness)
  • F- new feelings that are produced
55
Q

feature of homework in CBT

A
  • complete assignments between therapy sessions
  • putting new rational beliefs in practice
56
Q

features of behavioural activation in CBT

A
  • focus on encouraging depressed patients to be more active and engage in pleasurable activities
57
Q

features of unconditional positive regard in CBT

A
  • convincing the client of their value
  • provide respect and appreication
58
Q

evaluation of cognitive treatment of depression strengths

A

+ ellis claimed a 90% success rate for REBT and review by Cuijpers et al found that 75 studies found CBT was superior to no treatment
+ support for beneficial effect of exercise- Babyak et as studied 156 adult volunteers with major depression and then completed 4 months of exercise or drug treatment, all groups exhibited significant improvements
+ “dodo bird effect” all methods are effective and only small differences between studies as all have similar methods
+ CBT reduced relapse rates (Hollon et al) which is better for the economy in the long run despite high start up rates

59
Q

evaluation of cognitive treatment of depression weaknesses

A
  • CBT is less effective for some people like individuals with high levels of stress
  • alternative treatments available like drug therapy are arguable more effective
  • economic factors have an effect on effectiveness as Whitfield and Williams found that NHS is unable to deliver weekly face to face sessions
60
Q

genetic explanation of OCD

A
  • COMT gene- regulates production of dopamine and one allele of this gene has been found to be more common in OCD patients which produces lower activity of COMT leader to HIGHER levels of dopamine
  • SERT gene- affects transportation of serotonin and mutations create lower levels, which is implicated in OCD patients
  • individuals can inherit specific genes from their family
  • aetiologically heterogenous- different combinations of genes cause different types of OCD in different people
61
Q

evaluation of genetic explanations of OCD strengths

A

+ Groothest et al conducted a review in over 70 years of data on twins and found it was more likely for identical twins to both have OCD than non-identical- concordance rate is higher
+ billet et al did a meta analysis in twins and found that 68% of identical twins both had OCD, compared to 31% for non identical

62
Q

evaluation of genetic explanations for OCD weaknesses

A
  • deterministic and assume a relative may suffer
  • diathesis-stress model- some are more vulnerable to develop a mental disorder
  • ignores environmental factors like trauma
  • too many candidate genes so it is hard to target the right one for drug therapy
63
Q

biochemical explanation for OCD

A
  • low levels of serotonin found in OCD patients
  • high levels of dopamine found in OCD patients
64
Q

evaluation of biochemical explanations for OCD

A

+ Insel found SSRIs which increase levels of serotonin can reduce symptoms of OCD in 50-60% of cases
- not 100% accurate
- link with serotonin is correlational and may not be the cause- could be symptom instead

65
Q

neural explanation for OCD

A
  • increased activity in orbital frontal cortex
  • OFC sends messages to the thalamus via the caudate nucleus about things that are worrying
  • caudate nucleus is meant to filter and suppress minor signals and worries
  • OCD patients have found to have a damaged caudate nucleus, which fails to suppress worry signals and cause a worry circuit
66
Q

evaluation of neural explanation for OCD

A

+ research support has showed reduced grey matter in OFC in OCD patients
+ PET scans with OCD shows increased activity in OFC, where serotonin and dopamine is linked to these regions
+ Max et al found increased rates of OCD in people after head injuries causing damage to basal ganglia
- basal ganglia damage not found in 100% of OCD patients

67
Q

drugs used in biological treatment of OCD

A

SSRIs (selective serotonin reuptake inhibitors)
tricyclics
BZs

68
Q

how do SSRIs work in treating OCD

A
  • antidepressant
  • helps increase serotonin levels by blocking reabsorption in the synapse and increase levels to increase stimulation to the receiving neuron
69
Q

how do tricyclics work in treating OCD

A
  • work like SSRIs by blocking uptake of serotonin
  • block reiptake of noradrenaline which governs autonomic nervous system
  • results in more neurotransmitters being at the synapse which prolongs their activity
70
Q

how do BZs work in treating OCD

A
  • slow down activity in CNS by enhancing activity of GABA, which has a quieting effect on neurons in the brain
  • GABA works by reacting with special sites and lock ti the receptors which opens a channel and increases flow of chloride ions
  • chloride ions makes it harder for the neuron to be stimulated by other neurotransmitters and slows down its activity
71
Q

evaluation of biological treatment of OCD strengths

A

+ lots of evidence to show it is effective- Soomro (2008) found SSRIs were more effective in reducing symptoms compared to a placebo
+ requires little input from user and is cheaper for health service- economical
+ research has found using other antidepressants that don’t affect serotonin levels are ineffective

72
Q

evaluation of biological treatment of OCD weaknesses

A
  • side effects like nausea, headaches, loss of sex drive and increased aggressiveness and even addiction problems with BZs
  • not a lasting cure as Maina et al found patients relapse within a few weeks of medication being stopped
  • publication bias only showing positive outcome of antidepressant treatment to promote more sales
  • CBT was found to be more effective, or in conjunction with drug treatments