Psychopathology Flashcards
What are the 4 definitions of abnormality?
- Statistical infrequency
- Deviation from social norms
- Failure to function adequately
- Deviation from ideal mental health
What is statistical infrequency?
How often we observe a type of behaviour is how we can see whether it is “normal” or “abnormal” behaviour.
Occurs when an individual has a less common characteristic. For example, being more depressed/intelligent than most of the population
What is deviation from social norms?
Concerns behaviour that is different from the accepted standards of behaviour in a community or society. In other words, when people are behaving differently to how we expect they should behave (norms).
Different cultures/generations have different norms and therefore different senses of abnormality.
What is failure to function adequately?
Occurs when someone does is unable to cope with ordinary demands of day-to-day living such as keeping up with basic hygiene and nutrition, keeping a job etc.
What signs did David Rosenham and Martin Seligmen suggest to show that someone is failing to function adequately?
- No longer able to conform to interpersonal rules such as eye contact, personal space
- Suffering from sever distress
- Irrational/dangerous behaviour
What is deviation from ideal mental health?
Occurs when someone does not meet a set criteria for good mental health.
List Jahoda’s criteria for ideal mental health
What good mental health looks like:
- no distress
- rational thinkers
- we reach our potential (self-actualise)
- cope/manage stress
- view the world in a realistic way
- good self-esteem and lack guilt
- independent to all others
- we work, love and enjoy our leisure successfully
Evaluate failure to function adequately
✗ Subjective and culturally based
✗ Outdated
✓ Acknowledges experience of individuals is important
✓ Helps define when people may need help
✗ Hard to distinguish between deviation from social norms + failure to thrive
✗ Risk discriminating against people with label
Evaluate deviation from ideal mental health
✗ Culturally bound - in some cultures people are more collectivist and less independent
✗ Outdated
✗ Labelling those with a diagnosis can worsen existing issues
✗ High, unrealistic standards
What is a phobia?
An irrational fear of an object or situation.
It is categorised by…
- excessive fear and anxiety
- the extent of the fear is out of proportion to any real danger presented by the phobic stimulus
What are the three categories the DSM-5 recognises of phobias?
- Specific - intense fear or anxiety about a specific object or situation e.g. arachnophobia (spiders)
- Social anxiety - intense fear of social situations e.g. enochlophobia (crowds)
- Agoraphobia - phobia of being outside
Behavioural characteristics of a phobia
Responding to fear by changing behaviours. This includes high levels of anxiety and trying to escape the phobia.
- Panic e.g. crying, screaming
- Avoidance - going out of their way to avoid the stimulus
- Endurance - when the person chooses to remain in the presence of the phobic stimulus e.g. keeping an eye on the spider on the wall
Emotional characteristics of a phobia
- Anxiety - unpleasant state of high arousal
- Fear - feeling terrified and screaming in fear
- Unreasonable emotional response - anxiety/fear is disproportionate to the threat
Cognitive characteristics of a phobia
- Selective attention to the phobia - if a phobic stimulus can be seen it is hard to look away from it (survival behaviour)
- Irrational beliefs - unfounded thoughts in relation to the phobic stimulus that can’t really be explained
- Cognitive distortions - perceptions of the stimulus are distorted
What does the Two-Process Model state about phobias
(Behavioural Approach)
Phobias are acquired by classical conditioning (learning through association) and then continue because of operant conditioning (learning through consequences)
Acquisition by classical conditioning
Maintenance by operant conditioning
For example,
Classical conditioning –> Little Albert. Learning to associate a neutral stimulus (white rat) with something that already triggers a fear response (unconditioned stimulus - loud bang). The conditioning is the generalised to similar objects.
Another example,
Operant conditioning –> In the case of negative reinforcement, an individual avoids an unpleasant situation. This has desirable a consquence meaning the behaviour will be repeated. The reduction in fear by avoiding the stimulus reinfornces the avoidant behaviour and so the phobia is maintained.
What 2 treatments does the behavioural approach believe in to treat phobias?
- Systematic desensitisation
- Flooding
What is systematic desensitisation?
Behavioural therapy designed to reduce unwanted response such as anxiety. Gradually reduces anxiety through the principle of classical conditioning.
If the person can learn to relax in the presence of the phobic stimulus they will be cured.
The learning of the new response in association with the phobic stimulus is called counterconditioning.
Explain the process of systematic desensitisation
- The anxiety hierarchy - client and therapist work together to create a list of situations with the phobic stimulus rated least to most frightening
- Relaxation - therapist teaches client to be as relaxed as possible. Relaxation prevents stress as they can’t be both at the same time
- Exposure - individual is exposed to the phobic stimulus in a relaxed state and gradually moves up the anxiety hierarchy over several sessions
What is flooding?
Rather than slowly building up to face their phobic stimulus over time, flooding immediately exposes the individual to an extreme, frightening situation.
For example, someone with arachnophobia may have a large spider crawl on them for a long period of time
Evaluate the Behavioural approach for explaining phobias
✓ Real world application (flooding and systematic desensitisation
✗ Does not account for cognitive aspects of phobias. The two-process model focuses on the behaviours of phobias but does not offer an adequate explanation for cognitive behaviours such as irrational thoughts
✓ Two process model is evidence for the link between bad experiences and phobias
✗ Not all phobias appear following a bad experience
Evaluate flooding
✓ Cost-effective
✗ Traumatic
Evaluate systematic desensitisation
✓ Effective
✗ Time consuming
✓ Can be used to help people with learning disabilities as it is gradual and explained better than flooding
✗ Potentially costly compared to flooding
What are the 4 types of depression?
- Major depressive disorder - short-term depression but still severe with its symptoms
- Persistent depressive disorder - this is a major depressive disorder that is more long term or recurring
- Disruptive mood dysregulation disorder - temper tantrums (what kids suffer with)
- Premenstrual dysphoric disorder - aka PMT. Low mood associated with menstruation (before or after)
Behavioural characteristics of depression
- Tiredness/fatigue caused by low energy levels
- OR the opposite (psychomotor agitation) and often pace up and down and cannot rest
- Insomnia or hyper insomnia (always wanting to sleep)
- Appetite may increase/decrease leading to weight gain/loss, consequently adding to depression
- Can feel irritable and may be aggressive/snappy. Aggression may be directed inwardly so they self-harm or attempt suicide
Emotional characteristics of depression
- Largely pronouced low mood (feeling worthless/empty)
- Negative mood leading to aggression to self and/or others
- Very low self esteem e..g hating themselves
Cognitive characteristics of depression
Everday aspects of life are usually processed in different ways. For example:
- Poor concentration levels (cannot stick to tasks or make decisions)
- Negatives of the world are focused on. They don’t manage to recall positive ones
- Very black and white thinking (absolutist thinking style. For example, an unfortunuate situation is seen as a disaster such as not getting the grade they wanted
What is Beck’s explantion for depression
(Cognitive Approach)
The way we think has the largest impact on the creation of depression in people.
We are vulnerable to three things:
- Faulty information processing - we think negatively rather than positively no matter what
- Negative self schemas - we interpret all things about ourselves as negative
-
The negative triad - we develop a dysfunctional view about ourselves because of..
- Viewing the world as negative
- Viewing the future as negative
- Negative view of self
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What is Ellis’ ABC model
(Cognitive explanation for depression)
Proposed that poor mental health is down to irrational thoughts. How these affect our thoughts and behaviours are as follows:
A - Activating Event -> irrational thoughts triggered by events e.g. failing a test or a relationship ending
B - Beliefs -> musturbation (belief that life has to be perfect, must always suceed) and utopianism (belief tha tlife must always be fair) = irrational thinking
C - Consequences -> when A triggers B there are emotional and behavioural consequences. For example, you think you must always succeed and don’t - this can trigger the C (depression)
Evaluate Beck’s cognitive theory of depression
✓ Practical application for CBT treatment
✗ Doesn’t explain all depression types such as those who suffer with visual disturbances due to their depression. Cotard syndome includes depression and the belief that the patient is a zombie
✓ Research support - Clark and Beck (1999) reviewed research on depression and cognition and suggested people show signs of the symptoms before being diagnosed and developed, suggestion cognition plays a part
Evaluate Ellis’ ABC model
✗ Only hold partial explanation for depression as the activating events are usually seen as reactive depression, also doesn’t explain depression that arises without a cause
✓ Practical application for CBT treatment (tackling irrational beliefs)
✗ Like Beck, it doesn’t explain why some people become angry or suffer hallucinations with depression
✗ Theories of attachment suggest infants with poor attachment are more vulnerable to depression
What are the stages of CBT
- Patient has an assessment with CBT therapist
- Therapist identifies problems
- Patient and therapist identify goals together and create a plan to achieve them
- Identification of negative and irrational thoughts that the therapy can try to eliminate
- Deal with and change the above thoughts and place effecive behaviours in place of them
Therapists will always try to encourage activities as well (example going for a run twice a week).
This is called behavioural activation and helps to provide evidence for the irrational nature of beliefs.
Evaluate CBT
✓ It is effective as a treatment - March et al (2007) compared it to using antidepressants and using them both in 327 adolescents with depression. The percentages of effectiveness were very high (81% for both separate groups and 86% for both together) suggesting CBT is an effective treatment
✗ May not work for severe cases - some people not alert or motivated enough to maintain CBT
✗ Rosenzweig (1936) suggested effectiveness may be down to therapist-patient relationship
✓ Luborsky et al (2002) suggested the opposite and that people are happy to talk to someone
✗ CBT focuses on the present and future, some want to discuss their past as there is a connection. Psychotherapy would do this, CBT does not
✗ Therapy may demotivate some people as their depression may be caused by circumstancial situations such as poverty. CBT cannot rectify this
What is OCD?
Obsessive Compulsive Disorder
A condition characterised by obsessions and/or compusive behaviour
Repetitive behaviour accompanied by obsessive thinking. Most people with OCD have both
Are obsessions cognitive or behavioural?
Cognitive
Are compulsions cognitive or behavioural?
Behavioural
Behavioural characteristics of OCD
- Compulsions - feeling compelled to repeat a behaviour e.g. hand washing. The compulsions are often performed to reduce the anxiety produced by their obsessions
- Avoidance - attempt to reduce anxiety by staying away from situations that trigger it
Emotional characteristics of OCD
- Anxiety and distress - obsessive thoughts are unpleasant and frightening. The urge to repeat a behaviour creates anxiety
- Accompanying depression - low mood + lack of enjoyment in activities. Compulsive behaviours bring temporary relief
- Guilt and disgust
Cognitive characteristics of OCD
- Obsessive thoughts - 90% of people with OCD have these e.g. that someone will get hurt
- Cognitive coping strategies - e.g. a religious person with obsessive guilt may pray or meditate
- Insight into excessive anxiety - are aware their compulsions are irrational. They have hypervigilance - high alertness on potential hazards
What do the genetic explantions of OCD say about it?
- Suggests OCD is inherited
- Specific genes cause OCD called candidate genes
- One group of genes may cause a type of OCD in one person while another group cause another type in someone else e.g. hoarding and religious obsession
Two genes linked to OCD:
- COMT gene : involved in the regulation of the neurotransmitter dopamine. Patients with OCD have a mutated variation of the gene causing higher levels
- SERT gene : linked to serotonin and the transport of it. Patient with OCD (and depression) have lower levels
Evaluate genetic explanations of OCD
Research Support - Aubrey Lewis
Observed his patients with OCD and found that..
- 37% had parents with OCD
- 21% had siblings with OCD
Suggests OCD runs in the family but odesn’t rule out environmental influences
Strength
Monozygotic (identical) twins are much more likely to share the characteristics of OCD than dizygotic (non-identical) twins – supporting the idea that there is genetic influence
Counterargument
However, twins usually have shared environments (dressed in same or similar clothing, play with same toys, etc.) – So they may well share the same characteristics of OCD through their environment rather than their genes.
What does the Diathesis Stress Model show?
(Genetic explantion of OCD)
Shows someone may have genes making them more likely to develop a mental disorder but it is not certain.
Some environmental stress is necessary to trigger the condition
OCD is said to be polygenic, what does this mean?
Polygenic -> more than one gene causes the condition
How many genes did Steven Taylor find may be involved in OCD?
Analysed findings from previous studies and found evidence that up to 230 genes may be involved in OCD. Mainly responsible genes are involved with dopamine and serotonin (mood regulators)
What do the neural explantions for OCD say about it?
- Serotonin is believed to regulate mood. Lower levels of serotonin are associated with low mood and other mental disorders
- SSRI drug therapy has been clinically proven to help some types of OCD
- Dopamine - higher levels of dopamine have been associated with behaviours of OCD (compulsions)
- Some types of OCD such as hoarding seem to be associated with impaired decision making. This may be associated with abnormal functioning of the lateral frontal lobes of the brain
- The frontal lobe is responsible for logical thinking and decision making
Evaluate neural explanations of OCD
✓ Supporting evidence from SSRI (selective serotonin reuptake inhibitors) treatments
✗ People with OCD also experience clinical depression together, called co-morbidity. Leaves the question whether they have low serotonin because they have depression and not OCD
✗ Parkinson’s disease is known to have a biological cause. Patients with Parkinsons often experience symptoms of OCD suggesting that OCD also has a biological basis
How do SSRIs treat OCD?
SSRIs are a form of anti-depressants that work to increase serotonin levels in the brain meaning they are useful for treating OCD as people suffering with it generally have lower levels.
- Serotonin is released by presynaptic neurons in the brain and travel across a synapse.
- The neurotransmitter transmits a signal from the neruon, across the synapse to a target cell.
- It takes the chemical signal from the presynaptic neuron (sending signal) to the postsynaptic neuron (recieving cell) where it is then reabsorbed by the presynaptic neuron, broken down and reused
- SSRIs prevent this reabsorption and break down in order to increase its level in the synapse which allows it to continue stimulating the postsynaptic neuron. This compensates for whatever is wrong with the serotonin within the OCD sufferer
