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Psychopathology Flashcards

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1
Q

What is statistical infrequency?

A

Less common characteristics then the rest of the population

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2
Q

What is an example of statistical infrequency ?

A

IQ and intellectual disability disorder
IQ is normally distributed
Average = 100
68% are between 85-115
2% have IQ < 70 , which is the diagnosis for IDD

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3
Q

2 evaluation points for statistical infrequency

A

Real world application
Unusual characteristics can be positive

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4
Q

What is the real world application for statistical infrequency ?

A

Used in clinical practice for diagnosis
For IDD or used to Becks Depression Inventory ( a score of more then 30 (top 5%) = severe depression)
Used in assessment processes

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5
Q

Why is unusual characteristics being positive a weakness of statistical infrequency?

A

2% of IQ above 130
They wouldn’t be considered abnormal
Being statistically infrequent doesn’t always = abnormality
Not sufficient as sole basis for defining factir in abnormality

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6
Q

What is deviation from social norms?

A

Concerns behaviour that is different from the accepted standards of society. Anything that is different from what society expects is considered abnormal.

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7
Q

How is deviation from social norms culture specific?

A

Culture over time - homosexuality
Some universally abnormal behaviours
Some different depending on culture

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8
Q

What is an example of deviation from social norms?

A

APD - antisocial personality disorder
Used to diagnose
Failure to conform with cultural norms
‘Failure to conform to lawful and culturally normative ethical behaviour’

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9
Q

2 evaluation points deviation from social norms

A

Real world application
Cultural and situational relativism

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10
Q

How does deviation from social norms have real world application?

A

APD and Schizotypal PD
Failure conform to cultural norms
Value in psychiatry

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11
Q

How is deviation from social norms culturally and situationally relative and why is this a bad thing ?

A

Variability between cultures
One cultures standards may label them as abnormal, others will not .
For example, hearing voices = message from ancestors in some cultures. Aggressive behaviour is more acceptable in family
Therefore difficult to judge across cultures.

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12
Q

What is failure to function adequately?

A

Unable to cope with ordinary demands of every day life.

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13
Q

What does it mean to fail to function?

A

Rosenhan and Seligman (1989)
No standard interpersonal rules (eye contact)
Serve personal distress
Irrational and dangerous

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14
Q

What is an example of failure to function adequately?

A

For intellectual disability disorder
Person must also be failing to function for diagnosis

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15
Q

2 evaluation points for failure to function adequately

A

Represents threshold for help
Discrimination and social control

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16
Q

How does failure to function adequately represent a threshold for help?

A

If cannot function, help is obviously needed
Treatment and services can be targeted to those who need it most

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17
Q

Why could failure to function adequately be used for discrimination and social control ?

A

Label non standard life style
E.g base jumpers and New Age travellers
Unusual ≠ abnormal
Freedom of choice

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18
Q

What is deviation from ideal mental health?

A

When someone doesn’t meet the criteria for good mental health

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19
Q

What is the criteria for ideal mental health?

A

Jahoda (1958)
No symptoms of distress
Can self actualisation
Independent of others
Good self esteem
Realistic world view
Can cope with stress

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20
Q

2 evaluation points for ideal mental health

A

Comprehensive
May be culture bond

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21
Q

How is deviation from ideal mental health comprehensive?

A

If includes most criteria as to why someone would seek help
Checklist to assess our selves against
So we can discuss with professionals

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22
Q

How is deviation from ideal mental health culture bound?

A

‘We can self actualise’
More common in individualistic cultures
Cannot be applied to collectivist cultures
List cannot be applied cross culturally.

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23
Q

What is the two process model?

A

Acquisition by classical
Maintenance by operant

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24
Q

What is an example of the two process model?

A

Little Albert - Watson and Rayner (1920)
White rat associated with loud noise

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25
Q

4 evaluation points for behavioural approach to explanation phobias (two process model)

A

Real world application
Ignores cognitive aspects
Reductionist
Phobias and traumatic experience

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26
Q

What is the real world application for the two process model ?

A

Systematic desensitisation
Flooding
Counter conditioning to unassociate phobic stimulus and fear response

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27
Q

How is the two process model reductionist ?

A

Evolutionary aspects of phobias ignored
Eg snakes and the dark
Biological factors such as an overactive amygdala
Doesn’t take into all factors leading to phobias

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28
Q

How does the two process model ignore cognitive factors?

A

For example , avoidance and irrational beliefs
Phobias have significant cognitive component
Doesn’t explain phobic cognitions
Not all symptoms of phobias

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29
Q

What is the link between phobias and and traumatic experience?

A

Ad De Jongh et al (2006)
73% of those with dental phobia had trauma
21 with trauma had no phobia
Shows conditioning leads to phobia

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30
Q

How is systematic desensitisation done?

A
  1. Anxiety hierarchy
  2. Relaxation - fear and relaxation = reciprocal inhibition as both cannot happen at once
    Relaxation by imagery or meditation
  3. Exposure
    Whilst in relaxed state
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31
Q

2 evaluation for systematic desensitisation

A

Evidence for effectiveness
People with learning disabilities

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32
Q

What is the evidence for effectiveness of systematic desensitisation?

A

Gilroy et al (2003)
SD group better then relaxation alone group
Weshchler (2019)- effective for specific , social and agoraphobia’s.
So likely helpful

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33
Q

Why is systematic desensitisation suitable for people with learning disabilities?

A

CBT not suitable as complex rational thought is required and flooding is too traumatic
Therefore, SD is appropriate treatment

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34
Q

What is flooding?

A

No gradual build up
Immediate exposure
Very few sessions needed

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35
Q

How does flooding work?

A

Extinction
Cannot avoid phobic stimulus so fear response eventually leaves and person becomes relaxed.

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36
Q

What are the ethics of flooding?

A

Unpleasant experience so informed consent is required
Patients often given a choice between SD and flooding

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37
Q

2 evaluation points for flooding ?

A

Cost effective
Traumatic

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38
Q

How is flooding cost effective ?

A

Less sessions
Same outcome as SD in less time
Less money
Better for NHS

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39
Q

How is flooding traumatic ?

A

Schumacher et al (2015) found participants rated flooding more stressful then SD
ethical issues
High attrition rates ( drop out)
Therefore therapists avoid this treatment

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40
Q

What did Beck say is the cause of depression?

A

People with depression have a cognitive vulnerability
Faulty information processing
For example, Absolutionist thinking
Negative self schema - interpret information about our selves negatively and only focus on the bad things.

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41
Q

What is Becks negative triad ?

A

1) negative view of world
2) negative view of future
3) negative view of self

42
Q

2 evaluation points for Beck negative triad

A

Research support
Real world application

43
Q

What is the research support for Becks negative triad?

A

Clark and Beck (1999) review concludes cognitive vulnerabilities are more common for a depressed person.
Cohen et al (2019) 473 adolescents , cognitive vulnerability is associated with depression

44
Q

What is the real world application for Becks negative triad?

A

Cognitive vulnerability can be screened in teenagers and identify who is most at risk for depression and allocate them help.
Can also be applied in CBT by challenging negative thoughts
Understanding of cognitive vulnerability is useful in many aspects of clinical practice

45
Q

What is Ellis’s ABC model?

A

Depression is caused by irrational thoughts
A- activating events (e.g break up)
B- Beliefs ( musterbation , Utopianism)
C- consequences ( emotional and behavioural eg depression)

46
Q

2 evaluation points for Ellis ABC model

A

Real world application
Reactive and endogenous depression

47
Q

What is the real world application for Ellis’s ABC model?

A

REBT - rational emotional behavioural therapy
Arguing with patient about their irrational thoughts
ABCD ( d for dispute)
Change negative beliefs
This shows its real world value .

48
Q

Why can Ellis’s ABC model not explain all types of depression?

A

Can only explain reactive depression , not endogenous depression.
Many cases of depression are not traceable to a specific life event
Can only explain some cases of depression

49
Q

What is CBT ?

A

A method for treating mental disorders based on both cognitive and behavioural techniques.

50
Q

What is the cognitive element of CBT?

A

Begins with assessment in which the client and cognitive behaviour therapist work together to clarify clients problems.
Identify where irrational thoughts can be challenged

51
Q

What is the behavioural element of CBT?

A

CBT then involves working to change irrational thoughts and put more effective behaviours in place

52
Q

What is Becks Cognitive therapy ?

A

Therapy applying becks cognitive theory of depression.
Identify negative thoughts about self, future and world. These thoughts then challenged.
Encouraged clients to test the reality of negative beliefs by being set homework such as record events in life.
‘Client as scientist’ as they investigate them selves

53
Q

Outline Ellis’s rational emotive behaviour therapy?

A

REBT extends ABC model to ABCDE
D for dispute
E for effect
Identity examples of rational thoughts and therapist challenges these events by vigorous argument
To break the link between negative life events and depression.
Empirical argument - showing them actual evidence
Logical argument - is the negative thought logical

54
Q

What is meant by behavioural activation?

A

Work with depressed individuals to gradually decrease their avoidance and isolation and increase their engagement in activities that improve mood ( eg exercise)
Therapist aims to reinforce such activity.

55
Q

4 evaluation points for cognitive approach for treating depression

A

Evidence for effectiveness
Suitability for diverse clients
Relapse rates
Client preference and convenience

56
Q

What is the evidence for effectiveness of CBT?

A

March et al (2007) studied 327 depressed adolescents being treated for depression and found
A) SSRIs- 81%
B) CBT- 81%
C) CBT and SSRIs - 86%
% = significantly improved symptoms
CBT is usually first choice of treatment and is just as effective as other treatments .

57
Q

How is CBT not suitable for diverse clients ?

A

Requires motivation so in some cases of severe depression they cannot motivate them selves to engage with cognitive work.
Also complex rational thought makes it unsuitable for people with learning disabilities.
Any form of psychotherapy ( talking therapy ) is not suitable for people with learning disabilitiesz
Only suitable for some types and some people with depression.

58
Q

What are the relapse rates of CBT and how is this a negative ?

A

Although it is effective, benefits may only last a small amount of time. Shehzad Ali et al (2017) assessed depression in 439 clients who had CBT and found 53% relapsed within a year.
This shows that CBT may need to be periodically repeated

59
Q

How can CBT be inconvenient?

A

Some clients may prefer to tackle depression in other ways.
By getting rid of their depression as quickly and easy as possible so prefer medication (SSRIs).
Yrondi et al (2015) found that depressed people rated CBT as least preferred psychological therapy

60
Q

What was found about OCD in siblings and parents.

A

Lewis (1936) observed of his OCD patients , 37% had parents with OCD and 21% had siblings with OCD.

61
Q

How can the diathesis stress model explain OCD?

A

Genetic vulnerability for OCD but environmental trigger needed to develop OCD.

62
Q

What are candidate genes in OCD?

A

Researchers have identified genes that create OCD vulnerability.
For example, genes involved with serotonin regulation
The SERT gene is implicated in the transport of serotonin across synapses.

63
Q

How is OCD polygenic?

A

OCD is caused by a combination of genetic variations that together significantly increase OCD.
Taylor (2013) found evidence that up to 230 genes may be involved in OCD.
Genes are often associated with dopamine and serotonin action.

64
Q

How is OCD aetiologically heterogeneous ?

A

One group of genes may cause OCD in one person but a different group of genes may cause disorder in another person.

65
Q

How are different types of OCD caused by different genes?

A

Particular genetic variations could course hoarding disorder and religious obsession.

66
Q

2 evaluation points for genetic explanation for OCD

A

Research support
Environmental risk factors

67
Q

What is the research support for genetic explanations for OCD ?

A

Evidence from twin studies
Nedstadt et al (2010) reviewed twin studies and found 68% of MZ twins shared OCD opposed to 31% of DZ twins.
This study suggests that there must be some genetic influence on the development of OCD.

68
Q

How does the genetic explanation for OCD ignore environmental risk factors?

A

OCD doesn’t appear to be entirely genetic in origin and environmental factors can increase and decrease the risk of developing OCD.
Cromer et al. (2007) found over half of OCD clients in sample had a traumatic life event.
OCD more severe in people with more traumas .
Genetic vulnerability is only a partial explanation for OCD.

69
Q

What is the role of serotonin in OCD?

A

Low levels of serotonin means normal transmission of mood relevant information doesn’t take place so may cause low mood.
Reduction in functioning of serotonin system.

70
Q

How is OCD related to decision making systems ?

A

Abnormal functioning of lateral parts of frontal lobe. ( reposnible for logical thinking and making decisions.

Also evidence to suggest that an area called left parahippocampal gyrus ( associated with processing unpleasant emotions ) functions abnormally in OCD.

71
Q

2 evaluation points for the neural explanation for OCD.

A

Antidepressants that work on the action of serotonin are effective in reducing OCD symptoms.
OCD also form part of the symptoms of conditions that are known to have a biological organ such as Parkinson’s disease (Nedstadt 2010) .
This suggests biological factors may be responsible for OCD.

72
Q

How might OCD have no unique neural system and why is this a bad thing?

A

Serotonin OCD link may not be unique to OCD
many people with OCD experience clinical depression . They are often comorbid.
So is the disruption to the action of serotonin caused by the depression or by the OCD.
This means that serotonin may not be relevant for OCD symptoms.

73
Q

How can SSRIs be used to treat OCD?

A

work on increasing the amount of serotonin at the synapses as less serotonin is reabsorbed and broken down.
Dosage and other advice vary according to which SSRIs are used.
Fluoxetine = baseline dose 20mg .
As liquid or drugs
3 to 4 months to have impact

74
Q

What does SSRIs stand for ?

A

Selective serotonin reuptake inhibitors

75
Q

How are SSRIs combined with other treatments?

A

Drugs are often used alongside CBT.
As the drugs can reduce symptoms enough so they can engage effectively with CBT.
Occasionally other drugs are prescribed

76
Q

Why might an alternative to an SSRI be used?

A

When SSRI is not effective after 3 to 4 months dosage can be increased or it can be combined with other drugs.
Sometimes different antidepressants are tried as people respond differently to drugs.

77
Q

What are the alternatives to SSRIs?

A

Tricyclics
SNRIs

78
Q

What is a tricyclic ?

A

Older type of antidepressant
Eg clonipramine
Act on various systems including serotonin systems
Has more severe side effects then SSRIs
So is used as a reserve when SSRIs do not work

79
Q

What is an SNRI?

A

Serotonin-noradrenaline reuptake inhibitors
More recently used to treat OCD.
Used for people who don’t respond to SSRIs
Increase levels of serotonin and noradrenaline

80
Q

4 evaluation points for drug therapy in treating OCD

A

evidence for effectiveness
Not most effective treatment
Cost effective and non disruptive
Serious side effects

81
Q

What is the evidence that shows the effectiveness of using SSRIs for treating OCD?

A

evidence to show SSRIs reduce symptom severity and improve quality of life for people with OCD.
Soomro et al (2009) reviewed 17 studies that compare SSRIs to placebos in treating OCD.
All studies show better outcomes for those taking SSRIs.
Symptoms reduce for 70% of people.
Remaining 30% can be helped using other drugs or combination of therapies
Meaning drugs appear to be helpful for most people with OCD.

82
Q

Why might drug therapy not be the best treatment for OCD?

A

There is some evidence to suggest that even if drug treatments are helpful for most people with OCD, they may not be most effective treatment available.
Skapinakis et al (2016) carried out systematic review of outcome studies and concluded both cognitive and behavioural ( exposure) therapies were more effective than SSRIs in the treatment of OCD.
This shows drugs aren’t the optimum treatment for OCD.

83
Q

How are SSRIs a cost effective and non-disruptive way of treating OCD and why is this a benefit?

A

Do not disrupt people’s lives
Cheap compared to psychological treatments as tablets or liquid can be mass produced quicker then a session of psychological therapy.
Good for public health systems and NHS.
Taking a drug is quicker then going to a therapy session
Drugs are popular with patients, doctors, and public health systems

84
Q

What are the side effects of SSRIs and why is this a weakness ?

A

They could have potentially serious side effects.
Small minority will get no benefit.
Side effects such as indigestion, blurred vision and loss of libido.
In addition, in summer people taking SSRIs need to be careful as SSRIs deplete the sodium in the body so people taking become more easily dehydrated so at risk of heat stroke .
Some people have a reduced quality of life as a result of taking the drugs and they may stop taking the drugs as a result.

85
Q

3 behavioural characteristics of phobias

A

Panic- crying, screaming
Avoidance- avoid phobic stimulus
Endurance - keep eye on phobic stimulus

86
Q

3 types of phobias

A

Specific- object / situation
Social phobias- public speaking
Agoraphobia - being outside

87
Q

What is a phobia ?

A

Anxiety disorder characterised by excessive fear and anxiety triggered by objects or situation

88
Q

3 cognitive characteristics of phobias

A

Selective attention - finding it hard to look away
Irrational beliefs- unfounded thoughts, not explainable
Cognitive distortions- inaccurate and unrealistic perceptions

89
Q

3 emotional characteristics of phobias

A

Anxiety- unpleasant state of high arousal
Fear- more intense and shorter periods then anxiety
Unreasonable- disproportionate to threat posed

90
Q

What is depression?

A

A mood disorder characterised by low mood and low energy levels.

91
Q

What are the types of depression?

A

Major depressive disorder
Persistent depressive disorder
Disruptive mood disregulation disorder
Premenstrual depression disorder

92
Q

3 behavioural characteristics of depression

A

Change in activity levels- lethargy or psychomotor agitation
Disruption to sleep/eating habits insomnia/hyposomnia
Aggression and self harm- against others or self

93
Q

3 cognitive characteristics of depression

A

Poor concentration- can affect work
Dwelling on negative- pessimism
Absolutionist thinking - black and white thinking

94
Q

3 emotional characteristics of depression

A

Lowered mood- empty and worthless
Anger- to self and others
Lowered self esteem - not liking one’s self , self loathing

95
Q

What is OCD?

A

Anxiety disorder characterised by obsessions and/or compulsive behaviours

96
Q

What are the types of OCD ?

A

Trichotillomania - hair pulling
Hoarding disorder
Excoriation disorder - skin picking
OCD

97
Q

3 behavioural characteristics of depression?

A

Compulsions are repetitive - eg hand washing
Compulsions reduce anxiety- response to obsession
Avoidance - avoiding triggering situations

98
Q

3 cognitive characteristics of OCD

A

obsessive thoughts - that are unpleasant
Cognitive coping strategies- praying or meditation
Insight into anxiety - aware of irrationality

99
Q

3 emotional characteristics

A

Anxiety and distress - unpleasant state of high arousal
Accompanying depression- comorbidity
Guilt and disgust - at self or object

100
Q

What is meant by emotional, behavioural and cognitive characteristics?

A

Behavioural - ways people act
Cognitive- refers to the process of thinking, reasoning, remembering and believing
Emotional- related to a persons feelings or mood

Psychology P1 (8 decks)

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