Psychopathology

Question 1

what are the four definitions of abnormality?

Answer 1

• statistical infrequency
• deviation from social norms
• failure to function adequately
• deviation from ideal mental health

Question 2

what is statistical infrequency?

Answer 2

occurs when an individual has a less common characteristic , for example being more depressed or less intelligent than most of the population

Question 3

evaluation of statistical infrequency

Answer 3

strength
- it is very useful
- used in clinical practice as a way to assess the severity of an individuals symptoms
- for example, the Beck Depression Inventory. If scored above a 30, the person is in the top 5%, widely indicating a severe depression
limitation
- infrequent characterists can be positive as well as negative
- for example, having a really high IQ is positive, however, the same number of people who have a low IQ have a high IQ
- this shows that being unusual does not necessarily make someone abnormal
- it is never sufficient as the only basis on defining abnormality

Question 4

what is deviation from social norms?

Answer 4

concerns behavior that is different from the accepted standards of behavior in a community or society
norms are specific to the culture we live in, so it’s unlikely that a behavior, such as homosexuality, is abnormal universally, as some cultures accept this a the norm while others view the same behavior as abnormal

Question 5

example of statistical infrequency

Answer 5

• IQ and intellectual disability disorder
• people who score below 70, bottom two percent, are very unusual or ‘abnormal’ and are liable to receive a diagnosis of a psychological disorder, intellectual disability disorder

Question 6

example of deviation from social norms

Answer 6

antisocial personality disorder
- someone with this is impulsive, aggressive, and irresponsible
- one symptom is an absence of prosocial internal standards associated with failure to conform to lawful and culturally normative ethical behavior
- the social judgement is made that these people are abnormal, as they don’t conform to our moral standards
- psychopath behavior would be considered abnormal is a wide range of cultures

Question 7

evaluation of deviation from social norms as a definition of abnormality

Answer 7

strengths
- used in clinical practice
- for example, with APD, the recklessness, aggression, and violating the rights of others, are deviation from social norms
- therefore deviation from social norms has value in psychiatry
limitations
- social norms differ from culture to culture
- someone may be defined as abnormal in on culture, but normal in another, for example, hearing voices
- also, being aggressive may be more abnormal in one setting than another, for example, in the work force
- therefore it’s difficult to judge deviation from social norms across different situations and cultures

Question 8

what is failure to function adequately?

Answer 8

occurs when someone is unable to cope with ordinary demands of day-to-day living, like nutrition and hygiene
Rosenhan and Seligman proposed additional signs
- when a person no longer conforms to standard interpersonal rules, ie, maintaining eye contact and respecting personal space
- when a person experiences severe personal distress
- when a persons behavior becomes irrational or dangerous to themselves or others

Question 9

example of failure to function adequately

Answer 9

intellectual disability disorder
- in addition to a low IQ, the person would need to be failing to function adequately before a diagnosis would be given

Question 10

evaluation of failure to function adequately as a definition of abnormailty

Answer 10

strength
- represents a sensible threshold for when people need professional help
- most people have some symptoms of abnormailty, however, when they get so bad that the person is unable to function, then they get help instead of pushing through
- this means that treatment and services can be targeted to those who need them most
limitation
- however, its easy to label non standard lifestyle choices as being abnormal, such as living in a van and travelling
- this means that people who make unusual choices are at risk of being labelled abnormal and their freedom of choice may be restricted
- also not all illnesses impact someone’s ability to function adequately, as someone may have very good coping skills and their daily life is not affected

Question 11

what is deviation from ideal mental health as a definition of abnormality

Answer 11

occurs when someone does not meet a set of criteria for good mental health

Question 12

who made the ideal mental health criteria

Answer 12

jahoda

Question 13

what are the criteria for having an ideal mental health?

Answer 13

• we have no symptoms or distress
• we are rational and can perceive ourselves accurately
• we can self-actualize
• we can cope with stress
• we have a realistic view of the world
• we have good self-esteem and lack guilt
• we are independent of other people
• we can successfully work, love and enjoy our leisure

Question 14

evaluation of deviation from ideal mental health as a definition of abnormality

Answer 14

strengths
- high comprehensive as it covers most of the reasons why we might seek help with mental health
- many psychologists can help to treat, as it includes many aspects
- provides a checklist against which we can assess ourselves and others and discuss psychological issues with a range of professionals
limitations
- different elements are not equally applicable across a range of cultures
- the idea of self actualization is viewed as self-indulgent in places other than the US and europe
- independence is not necessarily seen as a good thing, and what defines success in our working, social and love-lives is very different in different cultures
- therefore difficult to apply the concept of ideal mental health from one culture to another

Question 15

what are the three types of phobias?

Answer 15

• specific phobia, phobia of an object, such as an animal, or situation, such as flying
• social anxiety, phobia of a social situation such as public speaking
• agoraphobia, phobia of being outside or in a public place

Question 16

what are the behavioral characteristics of phobias?

Answer 16

Panic
- crying, screaming, running away, freezing, clinging, having a tantrum
Avoidance
- people go into efforts to prevent coming into contact with the phobic stimulus
Endurance
- the person chooses to remain in the presence of the phobic stimulus. For example, someone with arachnophobia may choose to stay in the room with a spider to keep and eye on it

Question 17

what are the emotional characteristics of phobias?

Answer 17

anxiety
- prevents a person relaxing and makes it very difficult to experience any positive emotion, can be long term
fear
- the immediate and extremely unpleasant response we experience when we encounter or think about phobic stimulus.
- more intense but shorter than anxiety
emotional response is unreasonable
- anxiety or fear is greater than normal and disproportionate to the stimulus

Question 18

what are the cognitive characteristics of phobias?

Answer 18

selective attention to the phobic stimulus
- it is difficult to look away from the phobic stimulus
irrational beliefs
- holds unfounded thoughts in relation to phobic stimuli
- for example, “if I blush then people think I’m weak”
cognitive distortions
- perceptions may be inaccurate and unrealistic
- ophidophobic may see snakes as alien and aggressive lookin

Question 19

what are the behavioral characteristics of depression?

Answer 19

activity levels
- people tend to withdraw from work, education, and social life
- could also increase by agitated individuals struggling to relax and may end up pacing up and down a room
disruption to sleep and eating behavior
- people may experience reduced sleep, insomnia or increased need for sleep, hypersomnia
- appetite and eating may increase or decrease, causing weight gain or loss
aggression and self harm
- often irritable and can become aggressive to others, for example when quitting a job, or to themselves, suicide attempts

Question 20

what are the emotional characteristics of depression?

Answer 20

lowered mood
- feeling worthless and empty and lethargic and sad
anger
- frequently experience anger which can be directed at others or themselves
lowered self-esteem
- they like themselves less than normal and can be extreme with some people describing a sense of self loathing

Question 21

what are the cognitive characteristics of depression?

Answer 21

poor concentration
- people are unable to stick with a task that they normally would find straightforward
- poor concentration and poor decision making are likely to interfere with the individuals work
attending to and dwelling on the negative
- inclined to pay more attention to the negative and ignore the positive, recalling negative memories before happy ones
- for example see a glass as half empty instead of half full
absolutist thinking
- black and white thinking
- if a situation is unfortunate, they see it as an absolute disaster

Question 22

what are the behavioral characteristics of OCD?

Answer 22

compulsions are repetitive
- people feel compelled to repeat a behavior
- examples include washing hands, counting, tidying
compulsions reduce anxiety
- compulsive checking is in response to the obsessive thoughts that it might have been left unsecured in terms of a locked door
avoidance
- people try to reduce anxiety by avoiding situations that trigger it
- for example, compulsive handwashing might be avoided by avoiding germs
- can interfere with normal life

Question 23

what are the emotional characteristics of OCD?

Answer 23

anxiety and distress
- powerful anxiety accompanies both obsessions and compulsions
- the urge to repeat a behavior causes anxiety
accompanying depression
- low mood and lack of enjoyment in activities
guilt and disgust
- irrational guilt over minor moral issues, or disgust over something like dirt or at themselves

Question 24

what are the cognitive characteristics of OCD?

Answer 24

obsessive thoughts
- thoughts that recur over and over again and vary from person to person but are always unpleasant
cognitive coping strategies
- people respond with coping mechanisms to deal with the obsessions
- this can help manage anxiety, but can make the person appear abnormal to others and can distract them from everyday power
insight into excessive anxiety
- they are aware their obsessional and compulsions are not rational
- tend to be hyper vigilant

Question 25

through what approach are phobias explained?

Answer 25

the behavioral approach

Question 26

who created the two process model, and what does it state?

Answer 26

mowrer
phobias are acquired by classical conditioning and continue because of operant conditioning

Question 27

how is a phobia acquired by classical conditioning?

Answer 27

Watson and Reyner created a phobia in a 9 month old baby called little albert
- he showed no signs of a phobia towards white rats before the investigation
- the neutral stimulus is the white rat
- the unconditioned stimulus is a loud noise which produced the unconditioned response fear
- the NS and US are paired to produce the UR until the NS, now the conditioned stimulus produces the conditioned response fear
- the conditioning is then generalized to similar objects, such as white fur coats and a non-white rabbit

Question 28

how is a phobia maintained by operant conditioning?

Answer 28

• a phobia is reinforced through negative reinforcement, as the person avoids a situation that is unpleasant, resulting in a desirable consequence, which means the behavior will be repeated
• when we avoid a phobic stimulus, we escape the fear and anxiety that we could have experience by staying, reducing fear and reinforcing the avoidance behavior and maintaining the phobia

Question 29

Evaluation of the behavioral approach to explaining phobias

Answer 29

strengths
- has been useful in the real world as it led to the treatment of phobias, systematic desensitization and flooding
- once the stimulus isn’t avoided, the reinforcement stops and the phobia is cured
- there is a link between bad experiences and phobias
- Ad De Jongh found that 73% of people with a fear of dental treatment had experienced a traumatic experience, mostly involving dentistry, compared to a control group where only 21% had experienced a traumatic event
- this confirms that the association between stimulus and an unconditioned response does lead to the development of the phobia
Weaknesses
- the two process model does not account for the cognitive aspects of phobias
- this model only explains the behavior, however, does not explain the irrational beliefs, such as a person thinking a spider is dangerous
- explains avoidance behavior but not irrational thinking and is therefore only a partial explanation
- also, not all phobias follow a bad experience, such as a fear of snakes, where snakes are quite rare to see, and not all bad experiences create a phobia
- therefore the association between phobias and experience isn’t as strong as originally thought

Question 30

describe systematic desensitization as a treatment for phobias

Answer 30

1. anxiety hierarchy - put together by the therapist and client to create a list of situations involving the phobic stimulus and rank in an order of least to most frightening
2. relaxation - the client learns techniques of relaxation, as we are unable to be scared and relaxed at the same time, reciprocal inhibition.
3. exposure - the client is then exposed to the phobic stimulus at the lowest level and told to remain calm and then moves up the pyramid, maintaining relaxation until the highest level

Question 31

describe the process of flooding as a treatment for phobias

Answer 31

the client learns that the phobic stimulus is harmless, as they are unable to avoid the stimulus, and therefore cause extinction of the conditioning effect, as the conditioned stimulus does not produce the conditioned response
informed consent must be provided for flooding, as it is an unpleasant experience

Question 32

evaluate systematic desensitization as a treatment of phobias

Answer 32

effectiveness
- Gilroy followed up 42 people who had SD for spider phobia in three 45 minute sessions.
- they found that at both3 and 33 months, the SD group were less fearful than a control group treated by relaxation without exposure
- Wechsler concluded that SD is effective for specific phobia, social phobia, and agoraphobia
evaluation
- can be used to help people with learning disabilities, as the cognitive therapies often require complex thought, and flooding may cause them to feel confused and distressed by the trauma

Question 33

evaluate flooding as a treatment of phobias

Answer 33

cost effective
- flooding can work in as little as one session, compared to SD to achieve the same result
- even allowing for a longer session makes flooding more cost effective, meaning more people can be treated with flooding than with SD
traumatic
- flooding is highly unpleasant and provokes anxiety
- Schumacher found that participants and therapists rated flooding as significantly more stressful than SD
- this raises the ethical issue of psychologists knowingly causing stress, but this is not a major issue if informed consent is obtained
- there are higher dropout rates for flooding than SD, overall suggesting that psychologists may avoid using this treatment

Question 34

what approach is used to explain depression?

Answer 34

the cognitive approach

Question 35

what are the two models of explaining depression?

Answer 35

Beck’s negative triad
Ellis’s ABC model

Question 36

Explain Beck’s negative triad

Answer 36

some people are more vulnerable to depression because their way of thinking is faulty
faulty information processing
- depressed people focus on the negative aspects of the situation and ignore the positives
- absolutist thinking
negative self-schema
- they interpret all information about themselves in a negative
the negative triad
- negative view of the world ( the world is a cold hard place)
- negative view of the future (there isn’t much chance that the economy will really get better)
- negative view of the self (I am a failure)

Question 37

explain Ellis’s ABC model

Answer 37

irrational thoughts interfere with us being happy and free from pain
A - Activating event
- irrational thoughts are triggered by external events, such as failing an important test
B - Beliefs
- a range of irrational beliefs, including musturbation or utopianism
C - Consequences
- when an events triggers beliefs, there are emotional and behavioral consequences

Question 38

Evaluate Beck’s negative triad as an explanation of depression

Answer 38

research support
- Clark and Beck concluded that not only were these cognitive vulnerabilities more common in depressed people but they preceded the depression
- Cohen found that cognitive vulnerability predicted later depression in 473 adolescents
real-world application
- has application in screening and treatment for depression
- has allowed for those to be indentified who is at the highest risk of developing depression and monitoring them
- can also be applied to CBT which makes them more resilient to negative life events

Question 39

evaluate Ellis’s ABC model as an explanation of depression

Answer 39

Real-world application
- helped to create REBT where the person is viciously argued with to challenge the irrational beliefs that are making them unhappy
- therefore helps treat the symptoms of depression and change negative beliefs
Reactive and endogenous depression
- however, only explains reactive depression and not endogenous depression
- many cases of depression cannot be traced to life events and there is no obvious cause of the depression
- therefore the explanation is at best incomplete

Question 40

how is depression treated?

Answer 40

cognitive behavior therapy
the client and therapist work together to make plans and change the irrational thoughts
more effective behaviors are also put in place

Question 41

explain becks cognitive therapy

Answer 41

• the client challenges the negative thought of the self, world, and future
• the therapy also aims to help test the reality of their negative beliefs by setting homework
• if the client then says that no one likes them, the therapist can produce the evidence from their own life that prove that people do like them

Question 42

explain ellis’s rational emotive behavior therapy

Answer 42

• D for dispute where the therapist challenges the irrational beliefs from the client
• E for effect where the irrational belief is changed and therefore breaking the link between negative life events and depression
• a very vigorous argument

Question 43

what is behavioral activation?

Answer 43

• gradually decreases their avoidance and isolation and increases their engagement in activities that have been shown to improve mood, eg, exercising
• the therapist aims to reinforce this behavior

Question 44

Evaluation of cognitive behavior therapy as a treatment for depression

Answer 44

Strengths
effectiveness
- march compared CBT to antidepressant drugs and to a combination in 327 depressed adolescents
- found that after 36 weeks, 81% of the CBT group, 81% of the antidepressants group, and 86% of the CBT plus drugs group were significantly improved
- requires only 6 to 12 sessions so cost effective
- therefore the fist choice of treatment
Limitations
- high relapse rates for CBT
- while effective, the effects may not last
- Ali assessed depression in 439 patients every month for 12 months following CBT
- 42% had relapsed within six months
- 53% had relapsed within a year
- therefore needs to be repeated
suitability for diverse clients
- in some cases, depression is so sever that clients can’t motivate themselves to engage in the cognitive aspect
- also those with learning disabilities will find it difficult
- therefore not suitable for everyone
- however, Lewis concluded that CBT was as effective as antidepressant drugs and behavioral therapies for severe depression
- Taylor also concluded that when used appropriately, CBT is effective for people with learning disabilities
- therefore may be more suitable than originally thought

Question 45

what is the approach and two explanations for OCD?

Answer 45

biological approach
genetic explanations
neural explanations

Question 46

explain the genetic explanation of OCD

Answer 46

Lewis observed that of his OCD patients, 37% had parents with OCD and 21% had siblings with OCD, suggesting that a genetic vulnerability is passed through generations
Candidate genes
- some are involved in regulating the development of the serotonin system
- for example 5HTI-D beta is implicated in the transport of serotonin across synapses
OCD is polygenic
- not caused by a single gene, but instead a combination of genetic variations that together increase vulnerability
- Taylor found evidence that up to 230 different genes may be involved in OCD
Different types of OCD
- a group of genes in one person may cause OCD, but a different group in another person causes OCD
- aetiologically heterogenous
- different types may be the result of different combinations

Question 47

explain the neural explanation of OCD

Answer 47

the role of serotonin
- if a person has low levels of serotonin then normal transmission of mood relevant information does not take place and a person may experience low moods
- some cases are definitely explained due to a decrease level of serotonin
decision making systems
- abnormal functioning of the lateral of the frontal lobes is associated with impaired decision making
- the left parahippocampal gyrus is associated with processing unpleasant emotions, and functions abnormally in OCD

Question 48

Evaluate the genetic explanation of OCD

Answer 48

research support
- Nestadt reviewed twin studies and found that 68% of identical twins shared OCD as compared to 31% of non-identical twins.
- research has found that a person with a family member diagnosed with OCD is around 4 times as likely to develop as someone without
environmental risk factors
- while genetic variation can make a person more or less vulnerable, it is not the entire explanation, as environmental risk factors can also trigger or increase the risk of developing OCD
- Cromer found that over half of the OCD clients in their sample had experienced a traumatic event in their past and that OCD was more severe in those with one or more traumas

Question 49

Evaluate the neural explanation of OCD

Answer 49

research support
- antidepressants that wok on serotonin are effective in reducing symptoms
- if a biological system produces OCD symptoms, then we can assume the biological processes underlie OCD
No unique neural system
- the serotonin OCD link may not be unique to OCD
- many people with OCD also have depression, called co-morbidity, and depression disrupts the action of serotonin as well
- therefore, the disrupted serotonin activity could be due to the accompanying depression and not the OCD itself and that serotonin may not be relevant to the OCD symptoms

Question 50

Explain drug therapy as a treatment for OCD

Answer 50

SSRI’s
- selective serotonin reuptake inhibitor
- serotonin is released from the pre-synaptic neuron into the synaptic cleft where it diffuses across the synapse and binds to complementary receptors on the post synaptic neuron membrane
- the SSRI prevents the serotonin from being reabsorbed into the pre synaptic neuron, increasing levels of serotonin that can be received and pass on the chemical message, compensating for whatever is wrong with the serotonin system
- prozac is prescribed in 20mg and takes three to four months of daily use to have much of an impact on symptoms
combining SSRI’s with other treatments
- CBT
- the SSRI’s reduce symptoms so a person can engage more effectively with the CBT
- the benefits vary from person to person
Alternative to SSRI’s
- tricylics act on various systems and produce the same general effect as SSRI’s, but has more sever side effects
- SNRI’s (serotonin-noradrenaline reuptake inhibitors) increases levels of serotonin and noradrenaline and used for those who don’t respond to SSRI’s

Question 51

Evaluate the use of drug therapy in treating OCD

Answer 51

Strengths
Evidence of effectiveness
- Soomro reviewed 17 studies that compared SSRI’s to placebos in the treatment of OCD. All 17 studies showed significantly better outcomes for SSRI’s than for the placebo
- for 70% of people SSRI’s reduced symptoms
- for the other 30%, alternate drugs, a combination of drugs, and psychological therapies can help
- however, even if they are helpful, they may not be the most effective
- Skapinakis carried out a systematic review of outcome studies and concluded that both cognitive and behavioral therapies were more effective than SSRI’s
Cost effective and non-disuptive
- drugs are cheap and can be manufactured many time of one therapy session and is therefore good for the public
- not a lot of energy is required to take pill and is easy if the ODC is quite severe
Limitations
Serious side effects
- indigestion, blurred vision, loss of sex drive
- these can be quite distressing and may be long term
- this result in a reduced quality of life and some people may decide to stop taking them, meaning the drugs are no longer effective