Psychopathology Flashcards
Definitions of abnormality
Deviation from social norms, Deviation from statistical norms, Failure to function adequately, Deviation from ideal mental health
Deviation from social norms
Society sets up rules for behaviour based on a set of moral standards which became social norms, any deviation is seen as abnormal. Good real life applications however, what is considered acceptable can change over time, also cultural differences and it can be used for social control for example to justify the removal of ‘unwanted’ people/opinions
Deviation from statistical norms
Deciding if behaviour is abnormal based off the number of times we observe it and a statistically rare behaviour will be seen as ‘abnormal’, must be more than 2 standard deviations from the mean. Quick and easy way to define abnormality and good real life application. However it doesn’t take into account the desirability of behaviour, no distinction between odd and abnormal behaviour, no definite cut-off point to say behaviour is abnormal
Failure to function adequately
An inability to cope with day-to-day life caused by psychological distress or discomfort which may lead to self-harm or harm to others. It allows a view from the patients perspective, which may be subjective but is still important. How do you label people as having a ‘failure to function’. Some people have psychological disorders but still function adequately
Deviation from Ideal Mental Health
Jahoda (1958) said that it was better to focus on positive aspects of mental health rather than the negative, so this is seen as a positive attempt to define abnormality as deviation from this. It is described in six categories. It’s comprehensive as it covers a broad range of criteria but it’s culturally bound for example autonomy is a western culture
The six categories of Ideal Mental Health
Positive self attitude, Self-actualisation, Resistance to stress, Personal autonomy, Accurate perception of reality, Adaptation to the environment
Symptoms associated with mental illness
Impairment of intellectual functions, such as memory
Alterations to mood that lead to delusional appraisals
Delusional beliefs
Disordered thinking
DSM (Diagnostic and Statistical Manual of Mental Disorders)
Used to classify disorders using defined diagnostic criteria. This includes a list of symptoms which can be used as a tool for diagnosis. The DSM makes diagnosis concrete and descriptive. Allows data to be collected about a disorder which helps development of treatments
Depression
A mood disorder. Major depression (unipolar): an episode of depression that can occur suddenly and can be caused by internal or external factors
Manic depression (bipolar): alternation between two extreme moods often cycles of days/weeks
Clinical characteristics of Depression
Physical/behavioural symptoms- sleep disturbance, change in appetite, pain, lack of activity
Cognitive symptoms- negative beliefs about oneself, suicidal thoughts, slower though process
Affective/emotional symptoms- extreme sadness and despair, mood variations, anhedonia ( no long find joy in old pleasurable activities or hobbies)
Phobia
A phobia is an irrational fear, an example of an anxiety disorder which interferes with daily life. Produces a conscious avoidance of the feared object or situation
The three types of phobias
Specific phobias- Fear of specific objects or situations
Agoraphobia- Fear of open spaces, public places, being outside
Social anxiety- Fear of being in social situations such as public speaking
Clinical Characteristics of Phobias
Cognitive- irrational beliefs about the stimulus that causes fear, hard to concentrate with anxious thoughts
Behavioural- behaviour is altered to avoid feared object/situation and trying to escape if encountered. People often restless and easily startled
Physical- adrenaline rush when feared object/situation is encountered or though about
Emotional- anxiety and a feeling of dread
DSM criteria for a phobia
Significant prolonged fear lasts more than 6months
Experience an anxiety response if exposed to stimulus
Out of proportion to any actual danger
Sufferers go out of way to avoid the stimulus
Phobia disrupts their lives
OCD
Obsessions and compulsions, most experience when linked. Obsessions are the cognitive aspect and compulsions the behavioural, tend to cause anxiety which is the emotional aspect
Obsessions
Intrusive and persistent thoughts, images and impulses. The internal aspect of OCD. To be classified by the DSM they need to be:
Persistent and reoccurring thoughts or impulses that are unwanted and cause distress to the person experiencing them, person tries to ignore but is unable to, have not been caused by anything else like drugs
Compulsions
Physical or mental repetitive actions, external aspect, problem is it only reduces anxiety for a short time so the obsession starts up again, DSM criteria is: Repeats physical behaviours or mental acts that relate to an obsession, compulsions meant to reduce anxiety or prevent feared situation when they are really excessive, have not been caused by other things like drugs
4 common OCDs
Checking- checking that the lights are off or if you have your wallet
Contamination- involves fear of catching germs by like shaking hands
Hoarding- keeping useless or worn-out objects like old newspapers
Symmetry and orderliness- things to be represented well
Ellis’s (1962) ABC model
Claims that disorders begin with an activating event (A), leading to a belief (B) about why this happened. This may be rational or irrational. The belief leads to a consequence (C). Rational leads to adaptive consequences while irrational leads to maladaptive consequences
Beck’s (1963) negative triad
Identified a ‘negative triad’ of automatic thoughts linked to depression from negative views about themselves (cannot succeed at anything), the world (must be successful to be a good person), and the future (nothing will change)
Pros and Cons of cognitive explanations of depression
Pros: offers a useful approach as it considers role of thoughts and beliefs, Hollon and Kendall (1980) found a correlation between negative thinking and depression, cognitive therapies have often treated depression
Cons: negative thinking may simply be a result of depression rather than the cause of it, person could begin to feel as though they are the cause of their own problems
Cognitive behaviour therapy (CBT)
Therapist and client identify clients fault cognitions. Therapist tries to help client see these cognitions aren’t true, together they set goals to think in more positive/adaptive ways. Treatment mainly focuses on the present situation although the client may have to look in the past. Therapist encourage client to keep a diary
Advantages of CBT
Empowers patients- puts them in charge of their own treatment through self help, means fewer ethical issues unlike drug therapy
DeRubeis (2005) compared drug and cognitive therapy and Hollon (2005) found that people who took CBT where significantly less likely to relapse after a year than those in drug therapy
Disadvantages of CBT
May take a long time and be costly, may be more effective when combined with other approaches. CBT may only be affective if the therapist is skilled and experienced, person could begin to feel that they are the cause of their own problems
Behavioural approach to phobias
Phobias can be obtained through classical conditioning as a natural fear response becomes associated with a particular stimulus. Another way is through operant conditioning, learning through the consequences. Operant conditioning is important in maintaining phobias
Two-Process Model
People develop phobias by classical conditioning and once developed it is maintained through operant conditioning, people get anxious around the phobic stimulus which acts as a negative reinforcement
Pros and Cons of Behavioural Approach to Phobias
Pros: Behavioural therapies are very effective at treating phobias by getting the person to change their response to the stimulus, suggesting they treat the cause of the problem
Cons: Davey (1992) found only 7% of spider phobics recalled having a traumatic experience with a spider, suggesting there are other explanations and causes
Two techniques to treat phobias with behavioural therapy
Systematic desensitisation
Flooding
Systematic desensitisation
Counter-conditioning so the person learns to associate phobic stimulus with relaxation rather than fear. Phobic person makes a ‘fear hierarchy’ from what they fear least to most. Then they are taught relaxation techniques like deep breathing. Patient then imagines anxiety-provoking situations starting low, encouraged to use relaxation techniques. This is repeated until the feared event is only linked with relaxation. Whole process repeated for each stage of the hierarchy until they are calm through most feared event
Flooding
Involves exposing the patient to the phobic stimulus straight away, without any relaxation or build up. Can be done in real life or patient asked to visualise it. Patient is kept in this situation until the anxiety they first feel has worn off, realise nothing bad has happened and fear should be extinguished
Pros and Cons of behavioural therapies
Pros: very effective for treating phobias, Zimbarg (1992) found systematic desensitisation was most effective known method for treatment. Works very quickly as well, Ost (1991) found anxiety was reduced in 90% of patients just after one session.
Cons: ethical issues in flooding as it causes a lot of anxiety, if patients drop out it may cause more anxiety, therapy only treats the symptoms and doesn’t tackle the cause
Genetic Factors of OCD
For: Billet (1998) did meta analysis of twin studies and found that if one twin had OCD then 68% of the time both had it for identical twins while only 31% for non-identical twins. Pauls (2005) also found that people with an immediate relative who had OCD were more likely to also have it
Against: no study has been found with a 100% concordance rate, genetics cannot be the full story, possible that children imitate, may be that general anxiety is genetic and the development of OCD is something else
Biochemical Factors of OCD
For: Insel(1991) found that a drug SSRIs can reduce symptoms of OCD in 50% of cases.
Against: SSRIs don’t work 100% so there must be other factors, simply a correlation but no cause and effect
Neurological Factors of OCD
Max (1995) found increased rates of OCD in people after head injuries that cause brain damage to the basal ganglia. Others found increased activity in this area during OCD- related thoughts.
Against: Basal ganglia damage hadn’t been found in 100% of people so it can’t be the only thing
Pros and Cons of the biological approach to OCD
Pros: has a scientific basis in biology as there is evidence for a correlation with low serotonin and damage to the basal ganglia but not casual relationship. Can be seen as ethical as people aren’t blamed for their disorders.
Cons: doesn’t involve effect of environment, family, childhood or other social influences, biological therapies raise ethical concerns as drugs can produce addictions
Biological Therapy to OCD
Drug therapy. Drug treatments by increasing serotonin in the brain using SSRIs, a type of antidepressant. Prevent the reuptake of serotonin in the gap between neurones so more serotonin is available for the next neurone.
Pros: other antidepressants that don’t affect serotonin levels are ineffective at reducing OCD symptoms.
Cons: 50% don’t experience improvement. Have to be taken for several weeks. Side-effects of nausea and headaches and maybe anxiety
The factors in the biological approach to OCD
Genetic Factors, Biochemcial Factors, Neurological Factors
