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Psychopathology Flashcards

1
Q

What is abnormality?

A

Going against the written or unwritten rules of society

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2
Q

What are the four definitions of abnormality?

A

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

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3
Q

What is meant by statistical infrequency?

A

Behaviours can be classed as abnormal depending on how many people do them
If the behaviour is rare on a normal distribution then it is abnormal

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4
Q

What is meant by deviation from ideal mental health?

A

Marie Jahoda developed the six criteria for ideal mental health
Failure to meet these criteria constitutes abnormality

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5
Q

What are Jahoda’s six criteria for ideal mental health?

A

1) positive self-attitudes
2) growth/greater meaning (ambition)
3) resistance to stress
4) autonomy (independence and choice making)
5) accurate perception of reality
6) environmental mastery: being able to meet the demands of everyday life

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6
Q

What is meant by failure to function adequately?

A

If someone is failing to perform the basic behaviours necessary for everyday life then they will be considered abnormal
E.g. maintain basic hygiene or hold down a job

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7
Q

What is meant by deviation from social norms?

A

We would define a behaviour as abnormal if it goes against social norms
This includes if it:
Violates the written or unwritten rules of society
Defies social conventions considered acceptable in a particular group
Causes observer discomfort

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8
Q

Statistical infrequency evaluation

A

Real world application - helps identify mental illness
Unusual characteristics can be positive (e.g. high IQ)

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9
Q

Deviation from ideal mental health evaluation

A

Jahoda gives a comprehensive list (holistic)
However it is unrealistic for people to maintain all of these criteria constantly
Not generalisable - ideal mental health varies between cultures
The list was made in the 1950’s - outdated and lacks temporal validity

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10
Q

Failure to function adequately evaluation

A

Everyone experiences this at some point (grief)
Represents a threshold for help and can identify mental health issues

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11
Q

Deviation from social norms evaluation

A

Can be used in clinical practice (anti-social personality disorder)
Cannot be generalised, social norms may vary between cultures
Other factors can cause deviation (autism makes it hard to maintain eye contact)

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12
Q

What is a phobia?

A

An anxiety disorder involving excessive and persistent fear of a situation or object
Exposure to the source can immediately trigger a panic response

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13
Q

What are the three types of phobia?

A

Social phobias
Agoraphobia
Specific phobia

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14
Q

What is a social phobia?

A

Social anxiety disorder, is marked by a fear of social situations in which a person might be judged or embarrassed

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15
Q

What is agoraphobia?

A

Involves irrational and extreme fear of being in places where escape is difficult
May involve fear of public spaces or leaving home

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16
Q

What are specific phobias?

A

Having a phobia of a specific object

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17
Q

Emotional characteristics of phobias

A

Excessive and unreasonable fear in response to a specific stimulus, anxiety/panic

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18
Q

Behavioural characteristics of phobias

A

Avoidance that interferes with day to day life, freezing or fainting

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19
Q

Cognitive characteristics of phobias

A

Irrational thinking, resistance to logical argument, awareness of own irrationality

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20
Q

How is classical conditioning linked to phobias?

A

In the case of little Albert the unconditioned stimulus (the bang) naturally produces fear which becomes paired with the rat producing a conditioned response of fear developing a phobia of rats

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21
Q

How are phobias maintained by operant conditioning?

A

Negative reinforcement - avoiding the stimulus helps us escape the fear and anxiety which reinforces the avoidance behaviour, maintaining the phobia

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22
Q

What is meant by the two-process model?

A

Acquisition by classical conditioning and maintenance by operant conditioning

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23
Q

Strengths of conditioning for phobias

A

There is support to show that classical conditioning leads to the development of phobias (Watson and raynor)

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24
Q

Weaknesses of conditioning for phobias

A

Overlooks the role of cognition which is problematic as irrational thinking is a key feature of phobias
Tomarken et al presented a series of slides of snakes and neutral images to phobic and non-phobic participants, the phobic ones tended to overestimate the number of snakes presented
Seligman suggests that humans have a biological preparedness to develop certain phobias because they were adaptive
Biological preparedness is further supported by Ost and Hugdahl who claim that nearly half of all people with phobias have never had an anxious experience with their fear

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25
What are the two ways to treat phobias?
Flooding and systematic desensitisation
26
What is the first step of flooding?
Relaxation The patient is taught relaxation techniques e.g. breathing exercises
27
What is the second step of flooding?
Intense exposure The patient is introduced to the phobic stimulus at its worst while using the relaxation techniques (reciprocal inhibition) Session lasts 2-3 hours to give fight or flight time to pass Once relaxation has occurred the patient has a neutral or positive experience with the stimulus so begins the unlearn the association Can be done in vitro or in vivo
28
What is meant by in vitro?
Imagined
29
What is meant by in vivo?
Actual conatct
30
What is the first step of desensitisation?
Relaxation The patient is taught relaxation techniques (breathing exercises)
31
What is the second step of desensitisation?
Hierarchy is created The patient is gradually introduced to the phobic stimulus while using relaxation thechniques The hierarchy is a series of agreed progressive steps, from least to most fearful, which must be mastered before moving on Can be administered same day or over multiple sessions and can be in vitro or in vivo
32
Is flooding effective?
Has similar effectiveness to similar therapies Some evidence that it is better than SD (Choy et al 2007) Evidence backed effective therapy
33
Is flooding appropriate?
Very intense and not appropriate for everyone Exposure could backfire and make things worse which might seriously undermine effectiveness of therapy
34
How does flooding fare economically?
Can be traumatic and some consider it unethical People might not turn up or give up because of the intensity which wastes resources Difficult and unethical to run online or alone
35
How effective is systematic desensitisation?
McGrath et al 1990 - 75% success rate In vivo more effective than in vitro (Choy et al) Works in the long run (Gilroy et al 2003, found the patients were less afraid of spiders than the control group at a three year follow up after just a 45-minute session) Can combine in vivo and in vitro in a hierarchy maximising effectiveness
36
How appropriate is systematic desensitisation?
Little insight needed May not be appropriate for all phobias, ancient fears are best treated by flooding
37
How does systematic desensitisation fare economically?
Allows patient buy-in since steps are agreed on meaning there is less distress/dropouts so doesn’t waste resources Can be self-administered and/or done online - cheap and widens access to those who cannot access conventional therapy
38
What is the role of serotonin?
Serotonin helps regulate mood Neurotransmitters are responsible for relaying information from one neuron to another 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 mood Some cases of OCD may be explained by a reduction in the functioning of the serotonin system
39
Decision making systems
Some cases of OCD (particularly hoarding disorder) seem to be associated with impaired decision making This may be associated with abnormal functioning of the lateral of the frontal lobes The frontal lobes are responsible for logical thinking and making decisions The left parahippocampal gurus is associated with processing unpleasant emotions, functions abnormally in OCD
40
What is meant of ‘OCD is polygenic’?
OCD is not caused by one single gene but a combination of genetic variations (Taylor 2013 - up to 230 different genes are involved in OCD) Genes studies in relation with OCD are associated with the action of dopamine as well as serotonin
41
The worry circuit
The orbitofrontal cortex sends signals to the thalamus about things that are worrying or threatening (obsessions) The caudate nucleus normally inhibits signals form the OFC If the worry signals get through, the thalamus is altered which in turn sends signals back to the OFC (reinforcing the worry so it gets acted on) Therefore OCD may be linked with caudate nucleus under actively (fails to suppress worry signals) and/or OFC over actively (stronger worry signals)
42
Strengths of neural explanations for OCD
Research support - Nestadt, twin studies Ant-depressants that work on serotonin are effective in reducing OCD symptoms Biological disorders can produce OCD symptoms, so biological processes underline OCD symptoms Animal studies - evidence shows that particular genes are associated with repetitive behaviour in mice (Amhari)
43
Weaknesses of the neural explanation of OCD
Environmental risk factors - OCD is not entirely genetic in origin, environmental risk factors can trigger the appearance of OCD Cromer et al - 1/2 of OCD patients experiences a traumatic event No unique neural system The serotonin OCD link is not unique to OCD, many people with OCD also experience clinical depression Serotonin systems do not work normally in people with OCD, this is a correlation between neural abnormality and OCD however correlation does not mean causation Behaviourist explanation Classical conditioning explains the initiation Operant conditioning explains the maintenance
44
What are the 4 types of OCD?
Intrusive thoughts and ruminations Checking Contamination or mental contamination Symmetry and orderliness
45
What are obsessions?
Are reoccurring and persistent thoughts
46
What are compulsions?
Repetitive behaviours
47
What are behavioural characteristics of OCD?
Compulsions (excessive repetitive physical or mental behaviours conducted to alleviate anxiety caused by obsessions)
48
What are cognitive characteristics of OCD?
Obsessions (recurrent, intrusive thoughts or impulses that create anxiety)
49
What are emotional characteristics of OCD?
Anxiety, disgust and shame
50
What are identical twins called?
Monozygotic
51
What are non-identical twins called?
Dizygotic
52
Research into the genetic basis of OCD
Lewis 1936 - OCD patients often have family members with OCD Nestadt 2000 - those with 1st degree relatives have a 5x risk of having OCD Nestadt 2010 - meta-analysis: MZ concordance rate is 68% vs DV at 31%
53
What are the two genes discovered related to OCD?
COMT gene SERT gene
54
What is the COMT gene?
Regulates dopamine (mutation=high dopamine=OCD)
55
What is the SERT gene?
Regulates serotonin transport (SERT mutation=low serotonin=OCD)
56
Cromer et al 2007
Most OCD patients have had a traumatic experience This suggests that OCD is also the result of an interaction between biology and environment, having a particular set of genes only creates a vulnerability for the condition
57
What is neural communication?
The body uses nerves (neurons) which are electrical to communicate Where neurons join, there is a small gap known as a synapse Neurotransmitters are needed to help the signals cross the gap Serotonin diffuses across the synaptic gap to stimulate the post synaptic cell by binding with its receptors Serotonin is recycled by presynaptic cell (reuptake)
58
How are SSRIs used to treat OCD?
In OCD serotonin levels are low so SSRIs inhibit reuptake of serotonin meaning that it remains in the synapse, thus increasing levels of serotonin This restores normal functioning of the OFC and caudate nucleus This relieves anxiety and obsessions
59
How are Tricyclics used to treat OCD?
They inhibit the reuptake of serotonin and noradrenaline This means that they remain in the synapse, increasing levels of both serotonin and noradrenaline This means they can be more effective than SSRIs but have more side effects
60
How are benzodiazepines used to treat OCD?
They alter GABA receptor function, meaning that GABA action is enhanced Because GABA has a calming effect, this means that BZs slow down neural signs and can relax the CNS They work by increasing chloride channel efficiency, enabling greater influx of chloride ions (which are negative) which reduce the membrane potential and prevent firing
61
What other methods can be used to treat OCD?
Combination of drugs D-Cycloserine (an antibiotic that affects GABA) Drugs with CBT
62
Harris et all 2018
50-60% of patients improve with SSRIs or Tricyclics However, there is mixed evidence for D-C
63
What are control trials?
Placebo trials
64
Cost benefit analysis of OCD treatment
Evidence of effectiveness (Mustafa) Cost effective and non-disruptive to people’s lives making it of good value to the public health system There can be serious side effects Some psychologists believe that research evidence if biased because researchers are sponsored by drug companies
65
What are emotional characteristics of depression?
persistent low mood/sadness loss of interest/pleasure in activities feelings of worthlessness and hopelessness anger
66
What are behavioural characteristics of depression?
reduced or increased activity reduced energy changes to sleep habits/tiredness changes to appetite
67
What are cognitive characteristics of depression?
negative thoughts and beliefs low self-esteem irrational perceptions of reality
68
What does it mean to take a 'cognitive approach' to explaining behaviour?
behaviour is a result of faulty information processing or irrational beliefs/perception mental frameworks (schemas) shape our interpretation and processing of the world
69
What is Ellis's ABC model 1962?
if we react rationally we experience healthy emotions if we react irrationally we experience unhealthy emotions A - B - C A - activating event B - belief C - emotional consequence
70
What is Beck's cognitive triad?
negative schemas are acquired (often in childhood as a result of rejection) which provides a negative framework for viewing events pessimistically these become biases such as: overgeneralisation, magnification, selective perception and absolutist thinking
71
strengths of the cognitive approach to depression
supported by research making it more reliable and giving it more validity has real world application (CBT)
72
weaknesses of the cognitive approach to depression
ignored other approaches e.g. genetics has evidence correlation doesnt mean causation
73
similarities between Ellis and Beck
depression is a result of dysfunctional cognitive processes they are both cognitive
74
differences between Ellis and Beck
Ellis - interpretation of events underlies depression Beck - role of cognitive biases and negative schemas underlie depression (childhood) Beck believes is starts in childhood so is more long term and therefore a better explanation
75
What is CBT?
Cognitive behavioural therapy A cognitive approach to treating mental disorders, which has elements of behaviourism
76
What is the cognitive element of CBT?
CBT begins with an assessment in which clients and therapists work together to clarify the client’s problems They identify goals and create a plan to achieve them One of the main tasks is to identify where there might be negative or irrational thoughts that will benefit from challenge
77
What is the behaviour element of CBT?
CBT involves working to change negative and irrational thoughts and finally put more effective behaviours into place
78
What is Beck’s cognitive therapy?
Once negative thoughts have been identified they must be challenged. This therapy aims to help clients test the reality of their negative beliefs, therefore they may be set homework such as to record when they enjoy an event ‘The client is the scientist’
79
What is Ellis’ REBT therapy?
Extends to ABC model to the ABCDE model D - dispute E - effect The central technique is to identify and dispute irrational thoughts A client may talk about how unfair things seem to be and REBT would identify this as uptopianism and challenge this irrational belief This would involve a vigorous argument
80
What is behavioural activation?
As individuals become depressed, they tend to increasingly avoid difficult situations and become isolated which worsens symptoms The goal is to work with depressed individuals to gradually decrease their avoidance and isolation and increase their engagement in activities that have been shown to improve mood
81
Strengths of CBT
Research support Effectiveness
82
What research supports CBT?
Ellis - 90% success rate for REBT taking an average of 27 sessions Cullpers et al - CBT is superior to no treatment Kuyken and Tsivrikos - 15% of the variance is due to therapist competence March et al - 81% of the CBT group saw improvement
83
What is the effectiveness of CBT?
90% effectiveness rate
84
Weaknesses of CBT
Appropriateness Alternatives Economic implications Relapse rates Client preference
85
What is meant by appropriateness (CBT evaluation)?
There is a lack of effectiveness in severe cases and for clients with learning difficulties Sometimes clients are unable to pay attention Sturmey - any type of psychopathology is unsuitable for people with learning difficulties Lewis and Lewis - CBT is just as effective as drugs for severe depression Taylor et al - CBT can be suitable for people with learning disabilities Elkin et al - most appropriate for people with lots of irrational beliefs Some people may not be committed to completing it
86
What is meant by alternatives to CBT?
Drugs may be more effective in terms of helping start therapy but cannot be used in the long term as can become addictive Drugs and CBT used in NHS
87
What are the economic implications of CBT?
CBT is less economical than drugs as it takes more time and costs more Treating people quickly means they can rejoin the workforce and workplaces don’t have to pay for cover
88
What are relapse rates for CBT?
High relapse rates Ali et al - 42% of clients relapsed within 6 months and 53% replaced within a year
89
What is meant by client preference for CBT?
Not all clients will want to tackle depression this way as it can be very challenging and they want their symptoms gone quickly and easily (though medication) Yrondi et al - depressed people rated CBT as their least preferred psychological therapy
90
Strengths of Beck’s model
Research support Cognitive vulnerability Clark and Beck - these vulnerabilities can also precede depression Cohen et al - showing cognitive vulnerability predicts depression in teenagers Real world application Understanding cognitive vulnerability allows us to identify those most at risk of depression and assign them to CBT
91
What is cognitive vulnerability?
Refers to ways of thinking that may predispose a person to becoming depressed, for example, faulty information processing and negative self-schemas
92
Weaknesses and Beck’s model
Partial explanation There is a pattern of cognition that can be seen before the onset of depression suggesting that Beck’s cognitive vulnerabilities is a partial explanation for depression
93
Strengths of Ellis’s model
Real world application REBT can change negative beliefs and relive the symptoms of depression - David et al
94
Weaknesses of Ellis’s model
Reactive and endogenous depression It only explains reactive depression Many cases of depression are not traceable to life events and cannot be explained by ABC model Ethical issues It locates responsibility for depression purely with the depressed person which is effectively blaming the depressed person

Pyschology (12 decks)

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