Psychopathology Flashcards
What is a statistical Infrequency?
When a persons thinking or behaviour is classified as rare or statistically unusual.
We use it when dealing with characteristics that can be measured ie. intelligence measured via an IQ test. Only 2% of people with an IQ under 75, these people are classified as abnormal and could be diagnosed with Intellectual Disability Disorder (IDD)
Evaluate Statistical Infrequency’s as a definition of abnormality.
Real- World Application- Statistical infrequency is used in clinical practice both as a form of diagnosis and as a way to assess severity (IQ). This shows a statistical infrequency has importance in everyday life.
Unusual Characteristics can be Positive-for example, an IQ above 130 is desirable and statistically infrequent, however we dont see someone with this IQ as being abnormal. This means that, although statistical infrequency can form part of an assessment and diagnostic procedures, it is never sufficient and the sole basis for defying infrequency
What are deviations from social norms?
When a person behaves in a way that is different from how people expect people to behave. Social norms are implicit rules about how to behave that a society may set.
Evaluate deviations from social norms.
Real-World Application- deviation from social norms is used in clinical practices, for example, defining a characteristic of antisocial personality disorder is the faliure to conform to normal behaviour. These signs are all deviation from social norms and therefore show it has value in psychiatric
Cultural Relativism- diagnosis of mental disorders and the social norms of an area is classified differently accross cultures. For example, the hearing of voices in some cultures is desirable whereas in the UK, its a sign of abnormality. This means that is hard to judge deviation accross different cultures and sitautions.
What does it mean when someone fails to function adequately?
When a person is unable to cope with the demands of everyday life for example unable to maintain the standards for nutrition and hygine or maintain relationships. This behaviour is also described as being maladaptive.
ROSENHAN AND SELIGMAN- proposed some signs that can help determin weather a person is coping or not.
- Personal distress
- Obserber Distress
- Maladaptive Behaviour- interferes with everyday life
- Unpredictable Behaviour
Evaluate faliure to function adequatly/
Represents a threshold for help- most people have symptoms of a mental disorder at some time, however, many people press on in the face of sever symptoms. It tends to be at the point we cease to function adequatly people seek profesional help or are refered by others. Therefore, this criteria means treatment and services can be targeted to those who need it most
Abnormality doesnt always lead to faliure to function adequatly- There are circumstances in which most fail to cope for a time. It may be unfair to gove someone the lable that may lead to future problems just because they react to hard circumstances.Therefore, this cant always be defined as being a definition of abnormality
What is deviation from ideal mental health?
MARIE JAHODA defied ideal mental health through a list of characteristics indicating psychological health and therefore the absence of these characteristics suggest abnormality:
S elfactualisation-achieving own potential
P ersonal Autonomy- independance
P ositive attitude to yourself
E nvironmental mastery- deal with day to day things
A ccurate perception of reality
R esistance to stress
Evaluate Deviation from ideal mental health.
A comprehensive Definition- It contains a wide range of criteria for distinguishing mental health from illness. This in turn means that an individuals mental health can be discussed meaningfully with a range of professionals who take different theoretical views. This means the ideal mental health can act as a checklist against which we can assess ourselves and discuss issues with a range of professionals.
Can be seen as culture bound- Different elements of ideal mental health arent equally applicable accross a large range of cultures. Most of Jahodas criteria is based on individualistic cultures like her emphasis on individual autonomy and personal growth. This means some may see the definition as subkective and ethnocentric and it may be hard to apply the concept between cultures
Talk about Obsessive Compulsive Disorder.
OCD is a mental health condition characterized by obsessions and/or compulsive behaviour. The DSM system recognizes OCD and a range of related disorder. They all have repetitive behaviour accompanied by obsessive thinking:
Trichotillomania- Obsessive hair pulling
Hoarding Disorder- The compulsive gathering of possessions and the inability to part with anything.
What are obsessions and compulsions?
Obsessions- Unwanted or unpleasant thoughts, images or urges that repeatedly enters a persons mind, causing feelings of anxiety, disgust or unease.
Compulsions- Repetitive behaviour or mental act that someone feels they need to carry out to try to temporarily relieve that unpleasant feelings bought on by obsessive thoughts. ie. hand washing, cleaning, hoarding.
What are the behabioural characteristics of OCD?
Compulsive behaviors which they are unable to control
Compulsions are repetitive, they feel repelled to repeat behaviour i.e.. hand washing
Around 10% of people with OCD show compulsive behaviour on its own- no obsessions, however the vast majority of people, compulsive behaviors are performed in an attempt to manage the anxiety produced by obsessions.
The behaviour of people with OCD may also be characterized by their avoidance as they try to to keep away from situations that trigger it
What are the cognitive characteristics of OCD?
the ways in which people process information. People with OCD are usually plagued with obsessive thoughts but they also adopt cognitive strategies to deal with these.
For about 90% of people with OCD, the major cognitive feature of their condition is obsessive thoughts- unpleasant thoughts that recur over and over again and are uncontrollable, images, impulses, worries and fears.
People respond by adopting cognitive coping strategies to deal with obsessions ie praying after guilt.
What are the emotional characteristics of OCD?
related to a persons feelings or mood.
OCD is regarded as a a particularly unpleasant emotional experience due to the powerful anxiety that accompanies the obsessions and behaviors which are irrational and abnormal.
OCD is also accompanied by depression, low lack of mood and and enjoyment.
What are the biological explanations of OCD?
Suggests that OCD is inherited in the diagnosed persons genes. There are two genes linked to OCD:
COMPT gene- regulates the neurotransmitter dopamine. 1 variation results in higher levels of dopamine and is more common in people with OCD.
SERT gene- linked to serotonin. It affects the the transport of serotonin accross synapses causing lower levels of serotonin which is linked with OCD and depression. lower levels tend to cause OCD.
Polygenic- However, like many conditions, OCD seems to be polygenic. This means that OCD is not caused by one single gene but a combination of genetic variations that together increase vulnerability.
Taylor (2014) has analysed findings of previous studies and found evidence for up to 230 different genes in OCD all with the associated action of dopamine as well as serotonin. Meaning different combinations affect different people.
Evaluate the genetic explanation for OCD.
One strength is there is a strong evidence base. There is evidence from a variety of sources which strongly suggest that some people are venerable to OCD as a result of their genetic makeup.
Twin Studies- 68% of identical twins (MZ) shared OCD opposed to 31% of non-identical twins → shows there is a strong genetic component. However, its not 100% so there must be other variables contributing i.e. how they are brought up
Family Studies- Examinations of patients worth OCD and found 37% of the patients with OCD had parents with the disorder, 21% had siblings with the disorder→ shows there is a genetic link.
However, its not 100% so there must be other environmental variables contributing i.e. evidence shows that half of the OCD clients tested had experienced a traumatic event in their past and OCD was more severe in those with one or more traumas. This means that genetic vulnerability only provides a partial explanation for OCD
Talk about the neural explanation of OCD.
Neurotransmitters and structures of the brain.
Role of Serotonin- neurotransmitters are responsible for relaying information from one neuron to another as what is known as a synapse. If a person has low levels of seretonin then normal transmission of mood-relevant information does not take place and a person experiences low moods. In some cases of OCD may be explained by a reduction in the functioning of seretonin in the brain.
Decision-making systems- Some cases of OCD, and in particular hoading disorder, seem to be assosiated with impaired decision making. This in turn may be assosiated with abnormal functioning of the Frontal lobes.
Orbitofrontal cortex- PET scans have found higher activity in the OFC in patients with OCD. This increases the conversion of sensory info to actions which results in compulsions and makes it harder for patients to ignore impulses
Basal Ganglia- Brain structure involved in things like coordination of movement. OCD is often found in people with tourettes and parkinsons disease which are all disorders in which the basal ganglia is implicated. Surgary which disconnects the basal ganglia from the frotal cortex can reduce symptoms of severe OCD
Evaluate the neural explanation for OCD.
Antidepressants- Ones that work purely on seretonin are effective in recucing OCD symptoms as they allow serotonin to easily diffuse accross a synapse. This suggests serotonin may be involbed in OCD.
Reductionism- The idea that the biological approach does not take into account thinking and learning. Some psychologists suggest OCD msy be learnt through classical conditioning and maintained through operant conditioning ie if a person washes their hands to reduce anxiety and negitivly reinforces compulsions
What are the treatments for OCD.
Antidepressants- SSRI’s are selective seretonin reuptake inhibitors. Seretonin is a neurotransmitter which diffuses accross a synapse, the movement of seretonin accross a synapse is involved in weather a person has OCD or not. Seretonin can be reabsrobed in the sending cell which reduces the amount of seretonin diffusing accross. This can be assosiated with OCD. SSRI’s block the area om the pre-synaptic preventing seretonin to be reabsorbed and furthermore increasing the amount of seretonin passing accross a synapse which can compensate for whatever is wrong eith the seretonin system in OCD
Anti-anxiety drugs- Benzodiazepines (BZ’s) are a range of anti-anziety drugs which enhance the action of the neurotranspitter GABA. GABA tells neurons in the brain to slow dowm. This means that BZ’s have a general quieting infulence on the brain and reduce the anxiety which can be experienced as a result of obsessive thoughts.
Cognitive Behaviour Therapy- CBT is sometimes used alongside drug therapy to treat OCD. The drugs can reduce a persons emotional symptoms like anxiety which means people can engage more effectivly eith CBT
Evaluate the treatments for OCD.
One strength is there is good evidence of the effectivness. ie. Soomero et al. did a review of the effectivness of SSRI’s and found that they were more effective than placebos in all 17 different trials.
Cost-effective compared with CBT’s
Non disruptive in normal lives
Criticised for treating symptoms not cause so a person can relapse if stops taking drugs.
The drugs can have serious side effects like indegestion and blurred vision.
What is depression?
Mood or affective disorder. This mental illness is a collection of physical, emotional and behavioural experiences that are severe, prolonged and damaging to everyday functioning
What are the emotional characteristics of depression?
Lowered Mood- depression is often described has having low moof or feeling sad and miserable.
Anger- Negative emotions are more common than positive ones during depression, but isn’t limited to sadness, it could also be anger focused on oneself or others and could lead to self harm
Lowered Self-Esteem- refers to how much we like ourselves, depression sufferers may not like themselves
What are the behavioural characteristics of depression?
Activity Levels- sufferers generally have less energy which could cause them to withdraw from activities like work and school
Disruption to sleep/ eating behaviour- both can increase or decrease in sufferers
Agression/ self-harm- becoming irritable is a common behaviour in people with depression and can lead to verbal and physical aggression toward others or themselves
What are the cognitive characteristics of depression?
Poor Concentration- sufferers may find it hard to focus. This may interfere with their ability to make decisions
attending to the negatives- sufferers will focus on the negatives and ignore any positives of situations
absolutist thinking- even though things aren’t bad, sufferers may think that way also know an black and white thinking
Talk about Aron Beck
suggested a cognitive reason as to why some people are more venerable to depression
The Negative Triad: Trapped in a cycle of negative thoughts
Negative thoughts about world -> future -> oneself ->
Faulty Information processing: Beck believed people made errors in logic, he proposed that depressed people tend to attend to the negative aspects of a situation and tend to have black and white thinking and blow things out of proportion
Negative Self-Schemas: they have negative ideas we hold against ourselves and therefore interpret all the info about themselves in a negative way
Evaluate Beck
Good Supporting Evidence- Joseph Cohen et al. tracked the development of 473 adolescents and measuring their cognitive vulnerability and found that showing vulnerability predicted later depression which shows that there is an association with cognitive vulnerability and depression.
Real-World Applications- It is used as screeing and treatment for depression. Cohen et al. shows that assessing the vulnerability of people allows psychologists to screen young people who are developing depression. This can also be applied in CBT that works by altering the kind of cognitions that make people venerable to depression. This means understanding vulnerability is useful in clinical practices.
Only offers a partial explanation- Although we can say for certain that people with depression show particular patterns of cognition, some psychologists say that it doesnt explain particular characteristics for example why some people experience extreme anger.
Talk about Albert Ellis.
Ellis suggested a different explanation for depression. He said that good mental health is the result of rational thinking, thinking in ways that allow people to be happy and conditions like anxiety and depression are a result of irrational thinking, thoughts that interfere with being happy and feeling no pain.
He proposed the ABC model to explain how irrational thoughts affect our emotional behaviour and state:
Activating Event- Ellis focused on situations where irrational thoughts are triggered by alike failing a test or ending a relationship
Beliefs- Irrational beliefs, that the event is major disaster whenever something doesnt go smoothly
Consequences- When an event triggers an irrational belief, there is emotional and behavioral consequences alike depression
Evaluate Ellis.
Real-World Application- Ellis’ approach to the cognitive theory is called rational emotive behaviour therapy (REBT) which is where a therapist argues with a person to alter the irrational beliefs and relieve from depression (more in explanations).
Only explains reactive depression- not endogenous depression. while depression is often triggered by life events, some causes may be at least partly due to our beliefs like in many cases where a life event isn’t traceable. Ellis’ model is less useful at explaining these types. So therefore it is only a partial explanation
Talk about Cognitive Behaviour Therapy.
The most commonly used psychological treatment for depression and more by breaking the vicious cycle of maladaptive and irrational thinking, feelings and behaviours. It focuses on the here andnow problems insted of focusing on the causes of distress or symptoms in the past. It looks for ways to improbe the state of mind right now and allows the person to do it themselves.
Assessment → Formulation, goals → monitoring, homework → treatment complete
Talk about Becks CBT2
Applies Becks theory of depression by directly challenging the negative triad. It also aims to help clients see the reality of their beliefs by setting homework like noting down when someone was nice or they enjoyed an experience. If a client has none, a therapist can produce evidence to show the client is incorrect- reality testing. This replaces a clients irrational beliefs with optimisitc ones
Talk about Ellis’ REBT
The rational emotive behaviour therapy argues that irrational thoughts are the main cause of all behavioural disorders. It extends the ABC model by adding D- dispute and E- effect. A client will argue with a therapst in order to break the link between negative life events and depression
Evaluate cognitive treatments for depression
What is a Phobia and its types?
A phobia is an anxiety disorder where a person has irrational fears that produce a conscious avoidance of the feared object or situation. There are three types:
Specific- phobias of a particular object or situation ie. dog or injection
Social- Social situations ie. injection
Agoraphobia- fear of open spaces
What are the characteristics of Phobias?
Emotional- unpleasant state of high arousal, cant experience positive emotions
Behavioral- panic, crying, screaming, avoidance
Cognitive- irrational thought processing
What is the two-process model?
Emphasizes the role of learning gearing toward explaining the characteristics of phobias
Mower (1947)- proposed the two-process model which states phobias are acquired by classical conditioning and then maintained by operant conditioning.
Talk about Watson and Rayner.
created a phobia in a 9-month-old baby called ‘little Albert’. When Albert was showed a white rat, he tried to play with it. Whenever he was showed the rat, the researders made a loud noise by banging an iron bar near his head. The noise is a US which creates a UR of fear. Then when the rat, NS and the US are shown together, Albert assosiates them two. Now Albert displays fear when around the rat, now a CS, he produces a CR of fear.
→ This is empirical support for Mower
Evaluate the behavioral explanation of phobias
CRITICISED FOR BEING REDUCTIONIST: The two-process model suggests that complex mental disorders are causes solely by our experience of association, rewards and punishments. This is a problem because the behavioral approach could be seen as too simplistic and ignores other factors like the role of evolution.
CRITICISED FOR BEING DETERMINISTIC; The two-process model suggests that when an individual experiences a traumatic event and uses this event to draw an assosiation between a neutral stimulus and unconditioned response. It ignores free will by suggesting we’re only conditioned by environmental experiences
REAL-WORLD APPLICATION: The distinctive element of the two-process model is the idea that phobias are maintained by the avoidance og a phobic stimulus. This is important in explaining why exposure to the stimulus is beneficial in curing phobias which is used in exposure therapies. This shows the value of the model as it identifies the means of treating phobias.
Talk about systematic desensitisation
SD is a behavioral therapy designed to gradually reduce anxiety through classical conditioning. It aims to reduce the fear response of a phobia and substitute it with a new learnt relaxation response. The learning of a different response is called counterconditioning. It includes:
- The Anxiety Hierarchy- a list put together by a client and therapist of situations related to the phobia that provoke anxiety, ordered from least to most frightening.
- Relaxation Techniques- deep muscle relaxation and breathing techniques involving reciprocal inhibition, when one response is inhibited as its competing with the other.
- Work up heirarchy- practicing the relaxation techniques and work up the heirarchy when they feel comfortable. They are able to return to an earlier stage if upset.
Evaluate Systematic Dessensitisation
Evidence of Effectivness- Studies for 42 people who had SD for arachnaphobia showed less fear than a control group who were treated with relaxation and not exposure at both 3 and 33 months. this means that SD is likely to be helpful for people with phobias.
Talk about Flooding
Exposes a person to theur feared stimulus without a gradual build up, insted via immediate exposure to a very frightening situation over an extended period. It aims to make the patient learn that the fear is harmless thus leading their phobia into extinction.
A learned response is extinguished when the conditioned stimulus is encountered without the unconditioned stimulus resulting in the conditioned stimulus no longer producing the conditioned respose of fear.
Evaluate Flooding
Cost-effective- patients are treated quickly and in less sessions than SD meanig it is more cost effective for health providers alike the NHS. This means that more people can be treated at the same cost with flooding than with SD making it a prefered treatment
Ethical Issues- Flooding is rarely used due to the fact it can be dangerous if not careful. This is due to the fact its an unpleasant sityation and traumatic for most clients and can lead to further trauma. This makes it not appropriate for many people.
It is highly effective for simple phobias, however, less effective for phobias alike agoraphobia. Some psychologists say phobias are due to irrational thinking and not unpleasant situations, therefore, CBT may be more effective.
