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psychopathology Flashcards

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1
Q

Four types of abnormal

A

Statistical infrequency
Deviation from social norms
Failure to function adequately
Deviation from ideal mental health

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2
Q

1: STATISTICAL INFREQUENCY:

A

1: STATISTICAL DEVIATION:
based on frequency of normal/abnormal behaviours
Behaviour different to usually observed normal = abnormal
Not necessarily bad, some people with high IQ isnt a bad trait, or having low anxiety
How far on the NORMAL DISTRIBUTION graph is the cut off point
Some behaviour might be common but it doesnt make them normal, aka genocide in nazi germany 1940’s

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3
Q

Deviation from social norms

A

behaviour is different to expectation
Behavioural norms are specific to culture/time
Society will define different things as normal
EG; tips in Japan/USA
EG; psychopathy ( antisocial personality disorder ) the literal absence of social standards and normal ethical behaviour.

PRO: takes context into account

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4
Q

Failure to function adequately

A

when someone cant meet demands of everyday life
Eg: nutrition, hygiene, relationships, jobs
ROSENHAN AND SELIGMAN (1989) ; 3 signs that someone isnt coping:
. Irrational/dangerous behaviour
. Severe personal distress
. Doesnt conform to persona rules aka lack of personal space

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5
Q

Deviation from ideal mental health

A

Jahoda (1958): no distress, rational view of yourself, self actualise, cope with stress, independent, work love and enjoy leisure(environmental mastery)
Based on what we constitute as normal mental health.

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6
Q

Phobia definition

A

irrational fear of something
the extent of the fear is out of proportion to any real danger presented.

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7
Q

Three types of phobias

A

Specific phobia = phobia specific to an object/situation
Social phobia ( social anxiety ) = phobia to a social situation
Agoraphobia = phobia of being outside/in a public place.

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8
Q

Spécial phobia

A

phobia specific to an object/situation

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9
Q

Social phobia

A

social anxiety ) = phobia to a social situation

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10
Q

Agoraphobia

A

phobia of being outside/in a public place.

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11
Q

Behavioural signs of fear and what is it

A

things we physically do ( EPA )
panic: freeze, cry, cling
Avoidance ( of that thing ) : results
Endurance ( if you cant avoid it ) results in prolonged anxiety

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12
Q

Emotional signs of fear and what is it

A

how we feel : ANXIETY
phobias are classified as an anxiety disorder ( like OCD ). Extreme state of fight/flight
Unreasonable amount of anxiety based on actual danger of the thing.

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13
Q

Cognitive signs of phobia SID

A

how we think ( SID )
selective attention ( hard to look away from phobic stimulus ): fixated state
Irrational beliefs = belief that the stimulus is more dangerous than it is, even though they acknowledge its irrational
Cognitive distortions = beliefs about phobia stimulus is distorted. Like being scared of a snake and thinking its alien and therefore evil therefore a monster. Like overthinking it.

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14
Q

What is behavioural explanation of phobias and name a study

A

Behavioural explanation:

MOWRER (1960) : Said that phobias are learnt
Acquisition by classical conditioning = associating neutral stimulus with an unconditioned stimulus

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15
Q

Mowrer (1960)

A

MOWRER (1960) : Said that phobias are learnt THROUGH The two process model
Acquisition by classical conditioning = associating neutral stimulus with an unconditioned stimulus
Maintained by operant conditioning
behavi ours are reinforced
Positive = giving something
Negative = taking something away
Reinforcement = to increase a behaviour
Punishment = to decrease likelihood of behaviour
Especially avoidance behaviours. When avoidant behaviours are negatively reinforced it enhances the phobia.
Eg : LITTLE ALBERT FROM Behaviourist approach, he was conditioned to associate Louis noise with white rat and then generalised to non white rabbits such as Santa Claus, fur coat..

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16
Q

What is vicarious reinforcement and give an eg in phobias

A

SLT: Vicarious reinforcement ( a behaviour being reinforced because you role models do it ) >
EG: Seeing a parent be scared of a spider, then vicariously reinforced to also be scared.

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17
Q

Pros / cons of behaviourist approach

A

P: Real life application: develops effective treatment eg
counter conditioning = expose a patient to conditioned stimulus without the unconditioned stimulus to be try reverse the conditioning and un scare them.
Systematic desensitisation(gradually reduce anxiety through classical conditioning). /flooding to treat phobic behaviour

C: doesnt consider cognitive factors with phobias,
Deterministic (Hard)
assumes phobias are responses to environments. ENVIRONMENTALLY REDUCTIONIST: thinks we are just S-R in our actions and behaviour.
Fails to acknowledge irrational cognitions meaning it is a partial explanation and cant consider all phobic behaviour
Reductionist: not everyone who gets bitten by dogs have a phobia of them, other factors have to be considered.

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18
Q

Bounton (2007)

A

PHOBIAS ARE INNATE ( nature approach )
evolutionary facts could play a role.
For example, our ancestors might’ve been avoidant to a particular stimulus ( cliffs, snakes..) because it would’ve caused them actual pain/death.
These types of phobias are ‘innate’, a survival mechanism for our anscestors
This is called biological preparedness

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19
Q

Study for biological preparedness as a reason for phobias

A

Conditioning: nurture type approach
Bounton (2007) : innate ( nature approach )
evolutionary facts could play a role.
For example, our ancestors might’ve been avoidant to a particular stimulus ( cliffs, snakes..) because it would’ve caused them actual pain/death.
These types of phobias are ‘innate’, a survival mechanism for our anscestors
This is called biological preparedness

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20
Q

What is epigenetics

A

Epigenetics:
Change in genetic activity without actually changing the genes themselves

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21
Q

Study for epigenetics

A

DIAS AND RESSLER >
gave electric shocks to male mice every time they were exposed to a chemical used in perfumes
Mice demonstrated fear through classical conditioning
Mice children also demonstrated a fear to that chemical even with no exposure to the chemical or electric shocks, and their GRANDCHILDREN TOO.
Not nature or nurture but an interactionist approach ( mix of both )

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22
Q

Dias and Ressler

A

DIAS AND RESSLER >
gave electric shocks to male mice every time they were exposed to a chemical used in perfumes
Mice demonstrated fear through classical conditioning
Mice children also demonstrated a fear to that chemical even with no exposure to the chemical or electric shocks, and their GRANDCHILDREN TOO.
Not nature or nurture but an interactionist approach ( mix of both )

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23
Q

Two treatments for phobias

A

Systematic desensitisation ( counter conditioning)
Flooding

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24
Q

What did NESTADT ET AL (2010) say and what theory does it support

A

NESTDADT et al (2010) : heritability of OCD is 76% showering there are other factors

Diathesis-stress model: ( INTERACTIONIST: not just on the behalf of one belief )
says that genetically we might have a predispositioned to develop a phobia
This assumes people are genetically vulnerability to a phobia if exposed to a specific trigger ( stress)

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25
Q

What’s systematic desensitisation ( 3 steps ) adn what part is it for

A

PHOBIAS

Systematic desensitisation :
gradually reduce anxiety through classical conditioning ( pairing conditioned repsonse with relaxation ) - STRENGTH of behaviourist approach
COUNTERCONDITIONG: how to:
Anxiety hierarchy - list of situations related to phobic stimulus from least> most frightening.
Relaxation - during each step of anxiety hierarchy they get them to relax ( deep breathing, massages..)
Exposure - individual is exposed to phobic stimulus in relaxed state, learning to associate both of them.
Reciprocal inhibition: cannot feel relaxed and anxious simultaneously

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26
Q

What’s flooding
what part is it for?
What is the goal? (KW)

A

Flooding:
prevents avoidance because it is immediate exposure to phobic stimulus
Sessions last 2/3 hours
Quicker method + cheaper
Extinction: conditioned stimulus no longer produces conditioned response

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27
Q

Behavioural characteristics of depression ( 3 )

A

low activity levels : withdrawal from social situations, feeling lethargic ( tired ) . Or psychomotor agitation ( the opposite = cannot relax at all )
Sleep and eating disruption: could be either more or less, insomnia or hypersomnia
Agression and self harm

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28
Q

Emotional characteristics of depression

A

Emotional:

lowered mood: feeling sad, worthless or anger
Anger ( minority ) : can be directed at self or others
Lowered self esteem: like themselves less, can lead to self loathing..

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29
Q

Cognitive characteristics of depression PAAC

A

Cognitive:
poor concentration:
Attending/dwelling on negative: hyper focus on bad things
Absolutist thinking: black or white thinking, extreme thinking that leads to emotional distress.
Catastrophising: exaggerating a minor set back

30
Q

Exam question: linking to the economy. How solutions to depression would benefit the economy.
Give three ideas

A

people taking less time off work, which would reduce costs to the economy cause the gov cant take income tax. It would increase need for therapy/meds.
Less employers = less productivity = less profit.
Less goods are sold due to lack of employees, which means bad image for companies especially if they are bad quality.

31
Q

Two explanations for depression

A

COGNITIVE

Beck: thinks we have faulty information processing aka negative triad and negative self schema

Ellis: internal mental process as well as an activating event

32
Q

Explain Becks Cognitive theory for depression

A

Faulty information processing: depressed individuals are more likely to think about negative part of situations
Negative self-schemas: schema about yourself is negative, success, abilities and appearance.
Eg:
Self-blame schema = makes them feel responsible for any misfortunes
Inept schema = they expect to fail

Overgeneralisation = thinking that because one thing went bad similar events will go bad “I failed one exam so I’m going to fail them all.”
Catastrophising =

The negative triad : How we maintain depression
- negative view of world, future and the self.

33
Q

Explain ELLIS ABC MODEL
For (B) give two examples

A

caused by an activating event aswell as an internal mental process.

ABC MODEL = how irrational thoughts affect behaviour and emotional state. (A+B=C)

A: ACTIVATING EVENT
- Situation in which irrational thoughts are triggered aka environmental triggers

B: BELIEFS
range of irrational thoughts eg:
Musturbation: always wanting to succeed and achieve
Utopianism: belief that life is always meant to be fair.

C: CONSEQUENCES
activating event that triggered the irrational beliefs results in emotional and behavioural consequences, such as depression.

34
Q

What are the two treatments for depression and which one is a response to Ellis and which for beck?

A

REBT = Rational Emotive Behaviour Therapy: RESPONSE TO ELLIS’ THEORY
Extension of ABC MODEL to ABCDE MODEL, d = dispute and e= effective beliefs.

CBT = Cognitive Behavioural Therapy : RESPONSE TO BECK
Patient is given ‘homework’ outside of lessons ( ‘patient as scientist’ ), record positive events that will challenge the negative beliefs they have. Allows the therapist to disprove irrational beliefs

35
Q

What is cognitive behavioural therapy a treatement for and explain.

A

CBT = Cognitive Behavioural Therapy : RESPONSE TO BECK
Patient is given ‘homework’ outside of lessons ( ‘patient as scientist’ ), record positive events that will challenge the negative beliefs they have. Allows the therapist to disprove irrational beliefs

36
Q

What is Rational Emotive Behaviour Therapy treatement for and explain.

A

REBT = Rational Emotive Behaviour Therapy: RESPONSE TO ELLIS’ THEORY
Extension of ABC MODEL to ABCDE MODEL

D- dispute
E- effective ( come up with effective beliefs )
The therapists will target irrational beliefs and challenge the patient which involves vigorous arguments.
Two types of arguments:
Empirical dispute: asking clients for evidence of their beliefs
Logical dispute: getting client to think about if their thought process actually ‘makes sense’
A03:

37
Q

Problems with treatement for depression (5)

A

CBT/REBT could be treating the symptoms not the cause.
Reductionist cause it uses the simple unit of FIP (Faulty ) to explain depression
For the dispute in ( REBT ) it might be weak cause some people might not want to get better or might not allow themselves to be convinced by therapists
Cognitive explanation is more about the symptoms and signs, but doesnt provide a cause for cognitive vulnerability. It could be caused by something else like Biological ( low serotonin )

There can be individual differences, eg: Anger or Cotard syndrome ( extreme type of depression where people are convinced they’re dead JARRET 2013)
.

38
Q

Grazioli and Terry (2000)

A

Grazioli and Terry (2000) :
Assessed pregnant woman for cognitive vulnerability and depression before and after pregnancy.
Did a questionnaire that assessed to what extent they had irrational thought processing
Formed basis of CBT which is very effective, plus Rational Emotive Behavioural Theraphy from Ellis’ ABC Model.

39
Q

Behavioural characteristics of OCD

A

Compulsions: are repetitive, they feel compelled to repeat a behaviour
Compulsions reduce anxiety:

Avoidance: ( also in phobias, its s symptom overlap aka Co-mobility )
may avoid situations that trigger OCD which could be disruptive.

40
Q

Emotional characteristics of OCD

A

Anxiety and distress- if the compulsions arent completed

Accompanying depression - anxiety results in low mood, and lack of enjoyment in day to day life ( failure to function adequately )

Guilt and disgust - both are irrational and can be directed at external objects instead of the self. So feeling disgust towards dirty thing if you have a dirt trigger and then doing compulsions

41
Q

Cognitive characteristics of OCD (OCI)

A

COGNITIVE: know that its irrational, not psychosis, but they know its not rational anxiety.

Obsessive thoughts - reoccurring repetitive thoughts ( obssessions ), usually unpleasant ones.

Cognitive strategies - people adopt coping strategies to try and deal with obsessive thoughts which can disrupt day to day life.

Insight into excessive anxiety - hyper vigilance and catastrophising. Aware that their obsessions are irrational but they catasrophise scenarios in their heads if their thoughts were justified

42
Q

3 Explanation for OCD

A

Biological:
Genetic:
Candidate genes exist that contribute with increasing risk of having OCD
Eg: comt/ sert genes
Neural:
Drugs found to increase serotonin activity reduce OCD symptoms, neurotransmitters might be linked.

Brain structures:
Basal ganglia - a cluster of neurons at the base of forebrain which is responsible for coordination and movement. Damage here links with OCD symptoms.
Or the orbitofrontal cortex found high activity in OCD patients when triggered

43
Q

Genetic explanation for OCD and pros/cons

A

People with OCD, there’s different variations of genes that contribute with different types of OCD. There is however a few genes that increase a risk of having OCD.
These are called candidate genes - aetiologically heterogenous ( meaning different cause for different people )

COMT GENE- regulates the neurotransmitter (NT) dopamine. One variation of this genes results in higher levels which is common in OCD patients

SERT GENE- ( Serotonin transporter ) - less serotonin being transported - also associated with OCD as well as depression.

OCD is polygenic ( caused by multiple genes ) - there are several genes involved.
Taylor (2003) found up to 230 different genes for OCD: this is good because it can account for lots of differences.

Behaviour is biologically determined ( biologically determinist )

44
Q

Taylor (2003)

A

OCD
Found up to 230 different genes for ocd, which can be a strength cause it accounts for individual differences.

45
Q

Neural explanations for OCD and pros/cons

A

Piggot et al (1990) - found drugs ( SSRIS ) that increase serotonin can help OCD patients.

‘Treatment causation fallacy’ = what you use to help it doesnt mean a lack of it is a cause.
Neurotransmitters can have an effect on ocd, eg:

46
Q

Brain structures biological explanation for OCD pros/cons

A

BRAIN STRUCTURES:

Basal ganglia - cluster of neurons at the base of the forebrain which is responsible for coordination and movement. Damage here showed OCD symptoms.

Orbitofrontal cortex = PET scans ( radioactive glucose in blood ) and found high activity in OCD patients in orbitofrontal cortex when they are triggered by something. ( eg holding a dirty item )

Neural correlates - mapping activity when symptoms are experineced, basically assuming things about the brain but we can’t observe internal mental processes.
One suggestion is that the heightened activity in the OFC increases the conversion of sensory info, as in acting on it or converting thoughts into actions.

47
Q

Billet et al (1998)

A

did a meta analysis of 14 twins, finding MZ twins have 3x the risk of OCD rather than DZ twins. ( STRONG CAUSE OF META ANALYSIS BUT WEAK cause NOT 100% CONCORDANCE RATE ) - suggests not genetic influences on ocd causes.
MZ twins: shared environment assumption, treated more similarly than DZ twins.

In support of gene explanation

48
Q

Nestadt et al (2000)

A
  • individuals with first-degrees relatives with OCD are up to 5x more likely to develop OCD. But this could be learnt from the environment or jsut seeing the relatives do the compulsions.
49
Q

Cons of the biological explanation for OCD
(6)

A
  • causation problem ( in the brain structures, is it the abnormality that causes OCD or OCD causes abnormality? )
  • Albucher et al (1968) : Behavioural treatement (exctinction= trying to stop association between trigger and fear) , have improved OCD for 60-90% of adults.
    This is weak cause it suffers from treatement-causation fallacy. Just because something cured something it doesn’t mean a lack of it is the cause.
    Lack of cross-cultural studied = ethnocentric bias
    Reduced predictive bias because we dont have a main cause out of three biological causes.
    Diathesis-stress model: behavioural as well as biological reasons
    Not only biological cause you need a vulnerability and a trigger.
    assumes that people have a genetic vulnerability to a mental illness (dia thesis) but it only develops when paired with environmental trigger.
    Cromer et al (2007): found that over half the OCD patients in their sample had a traumatic event in the past, and that OCD was more severe with patients with more than one trauma. ( supports this model cause of vulnerability )
    Nestadt et al (2010) put heritability at .76

Genes without stressor = no condition
Stressors with no genes = no condition
Genes and stressor = condition.

50
Q

What are the treatments for OCD?
4 examples

A

Drug therapy medication: aiming to increase or decrease specific neurotransmitters.
Eg:
SSRIS
TRICYCLICS
SNIRS
BENZODIAZEPINES

51
Q

What are SSRIS and pros/cons

A

Drug therapy medication: aiming to increase or decrease specific neurotransmitters

SSRIS: Selective Serotonin Reuptake Inhibitors. ( increase of serotonin activity because it keeps it there firing )
Used as antidepressants and reduces OCD and anxiety.

PROS

CONS
takes 3-4 months of daily use before it begins to reduce OCD symptoms.

52
Q

Alternatives to SSRIS for OCD

A

Tricyclics - older type of antidepressants that have same effect as the SSRI but more severe side effects( SIEZURES ), given only after SSRIS are attempted and those dont work.
Eg: clomipramine

Benzodiazepines - Enhances GABA ( inhibitory drug ) > calms obsessive thoughts of breaks

SNRIS: ( Serotonin-noradrenaline reuptake inhibitory ) - increase of serotonin and noradrenaline.

53
Q

What are tricyclics

A

Drug therapy med for OCD
Tricyclics - older type of antidepressants that have same effect as the SSRI but more severe side effects( SIEZURES ), given only after SSRIS are attempted and those dont work.
Eg: clomipramine

54
Q

What is benzodiazepines

A

Drug therapy med for OCD

Benzodiazepines - Enhances GABA ( inhibitory drug ) > calms obsessive thoughts of breaks

55
Q

What is an SNRI

A

Drug therapy med TREatment for OCD
SNRIS: ( Serotonin-noradrenaline reuptake inhibitory ) - increase of serotonin and noradrenaline.

56
Q

Pros/cons of drug therapy medication for OCD

A

PROS
drugs are cost effective : cheaper for NHS dont need to train therapists, and cheaper to buy meds for patients.
Also non disruptive, therapy or behavioural might be inconvenient and costly and disrupt lifestyle.
SOOMRO ET AL (2009) - found SSRIS better than control group with nothing across 17 studies. But they were more effective when combined with CBT. ( this is limited cause of predictive value, only a partial explanation )
Drugs cause symptoms to decline significantly for MOST - around 70% of patients.

CONS
- Side effects: indigestion, blurred, sex drive
With clomipramine, side effects can include tremors and weight gain
> this could reduce effectiveness because patients might stop taking the meds altogether and may increase feelings of anxiety WHICH MIGHT CAUSE A RELAPSE!!! ( symptoms worse than before )

Might lead to dependency

Causation problem, treating symptoms but not the root cause. Like with antipsychotics dont really treat the cause just calm them down and the symptoms are less apparent

Biologically reductionist.
Nomothetic ( everyone’s OCD is caused by naurotransmitters ), should be idiographic, where its more individual reasons/compulsions/triggers.

57
Q

Alternative idea from drug therapy treatment for OCD

A

ALTERNATIVE IDEA: SSRIS are a good initial step to then having and able to engage in therapy.
The drugs reduce anxiety and emotional symptoms
Allows patients to engage more actively in therapy
CBT targets obsessions to help compulsions reduce

58
Q

Piggot et al (1990)

A

Found drugs (ssris) that increase serotonin that helps ocd patients
Supports neural and genetic biological explanations for OCD

59
Q

What is biological preparedness

A

Theory for why phobias exist
Idea that we have phobias because or ancestors used them to protect themselves as a survival mechanism
Bounton ( 2007) said that phobias are biologically innate
Our ancestors had avoidance to certain things like snakes or cliffs because it would’ve been an actual threat, and they acted as survival mechanisms for our ancestors

60
Q

Rosenham and seligman

A

Have three things to identify abnormality ‘failure to function adequately’

ROSENHAN AND SELIGMAN (1989) ; 3 signs that someone isnt coping:
. Irrational/dangerous behaviour
. Severe personal distress
. Doesnt conform to persona rules aka lack of personal space

61
Q

Jahoda 1958

A

Found characteristics for abnormality deviation from ideal mental health
Jahoda (1958): no distress, rational view of yourself, self actualise, cope with stress, independent, work love and enjoy leisure(environmental mastery)

62
Q

Give two examples of negative self schema in BECKS cognitive explanation

A

Negative self-schemas: schema about yourself is negative, success, abilities and appearance.
Eg:
Self-blame schema = makes them feel responsible for any misfortunes
Inept schema = they expect to fail

63
Q

In ELLIS ABC model give two examples of the B (beliefs)

A

Beliefs = any irrational thoughts
Musturbation = always wanting to succeed and achieve
Utopianism = thinking that life is alwyas meant to be fair.

64
Q

Two types of dispute in REBT model

A

Logical: getting client to think about if thought process ‘makes sense’
Empirical: asking client for evidence to support their beliefs.

65
Q

Lewis (1936)

A
  • found that 37% of patients parents had OCD
  • 21% of patients siblings had it
    Could support genetic explanation for ocd but has confounding variable of shared environment
66
Q

Billet (1998)

A

Meta analysis of 14 twins
Found MZ (share 100% dna) have 3x likelihood of OCD than DZ twins
Strong > meta analysis
Weak > not 100% concordance rate
Suggests shared environment assumptions for MZ twind

67
Q

Albucher et al (1968)

A
  • behavioural treatment for OCD (alternate to drug therapy meds)
    Attempt at extinction ( stop conditioned response to conditioned stimulus )
  • improved ocd for 60-90% of adults
  • suffers from treatment - causation fallacy , just cause something cured something doesnt mean its a lack of it = cause
    Ethnocentric bias cause its mainly studied in western studies
    Reduces predictive value
68
Q

Diathesis stress model
What is it
2 studies in support

A
  • idea that for OCD it isnt only biological but also a trigger. You need to have a vulnerability and a trigger, which might explain why BIllet didnt find 100% concordance rate with his meta analysis of MZ twins

CROMER (2007) - over half of OCD patients had a traumatic event in past, and those with more than one had a more severe OCD ( supports idea of vulnerability )
NESTADT ET AL (2010) - heritability at 76% for OCD
Lewis (1936) : 37% of parents and 21% siblings of patient had OCD - supports the gene part of the diathesis stress model
Must be genes + stressor = ocd

69
Q

CROMER (2007)

A

over half of OCD patients had a traumatic event in past, and those with more than one had a more severe OCD ( supports idea of vulnerability )

70
Q

Nestadt tel al (2010)

A

NESTADT ET AL (2010) - heritability at 76% for OCD

71
Q

Soomro (2009)

A

SOOMRO ET AL (2009) - found SSRIS better than control group with nothing across 17 studies. But they were more effective when combined with CBT. ( this is limited cause of predictive value, only a partial explanation )
Drugs cause symptoms to decline significantly for MOST - around 70% of patients.

72
Q

March 2007

A

81% of ocd patients compulsions improved with CBT

81% of ocd patients compulsions improved with SSRI

86% improved with combination
Shows interactionist approach for treatments is the most effective

psych - miss jones (9 decks)

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