Psychopathology Flashcards
Abnormality
- Failure to function adequately ex. Avoiding eye contact, personal distress, irrational/dangerous behaviour
- Deviation from mental health (see Jahoda’s list)
Abnormality-evaluation
Strengths:
-Access of subjective experience of the patient
-Comprehensive as it covers broad criteria for mental health
Weaknesses:
-Deviation from social norms depends on person as they can just choose to behave that way, ex) religion can be seen as irrational
-Judgement made by psychiatrist is subjective
-Jahoda’s list may only apply to individualist culture
-Standards are too high
-Incorrect labelling of people ex) people losing jobs will obvi feel depressed, doesn’t mean they have problems
Phobia-types
Specific phobia-of an object/situation
Social phobia-of a social situation
Agoraphobia-of being outside/in public
Phobias-behavioural
- Panic in response of phobic stimulus (crying, screaming, freezing, etc)
- Avoidance-avoid contacting the phobic stimulus (affects daily life)
- Endurance-person remains within phobic stimulus but experiences anxiety
Phobias-emotional
Anxiety (unpleasant state of high arousal)-evoke negativity, fear, long term, unreasonable
ex. arachnophobia (spiders)-anxiety increase in places linked to spiders (such as zoo), fear increase when encountering it
Phobias-cognitive
- Selective attention to stimulus
-person finds it difficult to look away from stimulus (helps reacting quickly to the threat) - irrational beliefs
ex. social phobias can involve thoughts ‘I must always be smart’-increase pressure - Cognitive distortions
-Person’s perception of the stimulus is distorted (sees random things as ugly/disgusting)
Depression-behavioural
- Activity levels
Most have reduced level of energy and are lethargic
Psychomotor agitation-individuals struggle to relax (opposite effect) - Disruption to sleep and eating
Reduced/Increased levels (insomnia/hypersomnia) - Aggression and self harm
-verbal/physical aggression directed to others/self
Depression-emotional
- Lowered mood-lethargic and sad
- Anger-extreme, directed to self/others, can lead to aggression
- Lowered self esteem (like themselves less than usual)-self loathing (hating themselves)
Depression-cognitive
- Poor concentration-difficulty in task, decision making
- Attending to and dwelling on the negative-pay attention to the negatives, recall sad events
- Absolutist thinking (black and white)-see bad situation as an absolute disaster
OCD-behavioural
- Repetitive compulsion-repeat behaviours such as hand washing
- Compulsion reduce anxiety-10% show compulsion alone not other symptoms-responding to obsessive thought reduce anxiety
- Avoidance-Avoiding situation that trigger anxiety such as emptying bins
OCD-emotional
- Anxiety and distress-distress from obsessions, anxiety from compulsion
- Accompanying depression-low mood (compulsion bring relief but temporary)
- Guilt and disgust
OCD-cognitive
- Obsessive thoughts (recur over and over again)
- Cognitive strategies to deal with obsessions-people adopt coping strategies to manage anxiety, can seem abnormal to others
- Insight into excessive anxiety-aware that their obsession is irrational, thinks about what happens if their anxiety are justified (hypervigilant-alert)
Two process model
- Classical conditioning
-Baby called Albert had no anxiety, shown a rat but every time rat was near they made a frightening sound. Noise (UCS) created fear (UCR), so rat (NS) was associated with UCR and became CS to produce CR
-generalised to similar objects such as rabbit - Operant conditioning
-Happens when behaviour is reinforced (rewarded) or punished (positive/negative reinforcement)
-Avoidance results in desirable consequence-repeated
Two process model-evaluation
Strengths:
-Application to therapy as it explained how it was maintained
Weaknesses:
-Some avoidance happens by positive feelings of safety, avoidance is to stick with safety factor
-Evolutionary factors may play a part, phobic stimulus is dangerous and avoidance is adaptive (biological preparedness-innate predisposition to acquire fears)
-Some phobias are not followed by a trauma
-Doesn’t explain cognitive aspect of phobia
Systematic desensitisation
Behavioural therapy to reduce anxiety through classical conditioning and counterconditioning (learning different response), reciprocal inhibition (can’t feel multiple emotions at once)
- Anxiety hierarchy-list of situations related to phobic stimulus, least to most
- Relaxation-patient encouraged to relax/mental imagery techniques/drugs such as valium
- Exposure-exposed to stimulus in a relaxed state, encouraged to maintain relaxed
Flooding
immediate exposure to phobic stimulus
-Patient immediately leans that the simulus is harmless (extinction)
-Learned response extinguished when conditioned stimulus (spider) is encountered without the unconditioned stimulus (being bitten) so no longer produce conditioned response (dear)
-Some exhausted by their own fear response
-INFORMED CONSENT needed
Systematic desensitisation-evaluation
Strengths:
-effective, Gilroy et al did systematic desensitisation and relaxation w/o exposure, desensitisation were less fearful
-Suitable for diverse range of patients
-Preferred by patients as it is less traumatic, and relaxing is pleasant
Flooding-evaluation
Strengths:
-Cost effective and quicker
Weaknesses:
-Complex phobias such as social phobias are harder to treat (as cognition may be involved)
-Traumatic for patients, unethical (not preferred)
Beck’s theory
- Faulty info processing-black and white, focus on the black
- negative self schema (info about ourselves)
- Negative triad
-of the world-‘world’s unfair’ (loss of hope)
-of the future-‘there’s no chance it will get better’
-of self-‘I am a failure’ (low self esteem, depression)
Ellis’s ABC model
A-activating event occurs which may trigger emotional beliefs
B-beliefs
-musturbation: belief that we should be perfect
-I can’t stand it itis-belief that any mistake is a major disaster
-Utopianism: life should always be fair
C-Consequences due to irrational beliefs, emotional and behavioural
Beck’s theory-evaluation
Strengths:
-Supporting evidence on negative schemas and triad (Grazioli and Terry found that depression associated with cognitive vulnerability)
-Practical application in CBT as it can challenge negative schemas and triad
Weaknesses:
-Can’t explain why some depressed people are angry, or coward syndrome (delusion that there are zombies)
ABC model-evaluation
Strengths:
-Practical application to CBT
-Insecure attachment is vulnerable to depression
Weaknesses:
-Only explain reactive depression and not ones without any clear cause
-Can’t explain anger associated with depression, or how some suffer hallucinations
-Could lead to cognitive primacy (emotions are influenced by cognition) but other theories suggest that emotion comes after an event
CBT
Identifies and challenges irrational problems, therapist and patient work together
Behavioural activation-patient tries enjoyable activities
CBT-Beck
-identifies negative triad and challenges them directly
-homework task for patents (‘patient as scientist’)
-Therapist challenges irrational thoughts through evidence
CBT-Ellis (REBT)
-Extends ABC model to ABCDE model (D-dispute, E-effect)
-Argument on irrational thoughts (dispute) to challenge the irrational thought (effect)
CBT-evaluation
Strengths:
-Effective, March et al showed 81% improvement in antidepressants and 86% CBT and drug
Weaknesses:
-May not work with severe cases where patient isn’t motivated to engage
-Result may be due to therapist patient relationship (having someone to talk to is important)
-Patient want to explore their past and the effect of it, CBT only focuses on present and future
-Overemphasis on cognition and undermining circumstance of patient’’s living, demotivate people to change their situation
Genetic explanation to OCD
Diathesis stress model-certain genes can make person more susceptable to mental health problems but environment stress also needs to be present
- Candiate genes are genes that create vulnerability to OCD, such as 5HT1-D beta affecting transport of serotonin across synapse
-OCD is polygenic (multiple genes), Taylor found that up to 230 genes are involved, dopamine, serotonin involved - Aetiologically heterogeneous-origins have different causes, could be due to genetic variation
Neural explanation to OCD
- Low levels of serotonin (helps to regulate mood)
- Decision making system-OCD related to impaired decision making, linked to abnormal functioning of frontal lobes (responsible for decision making and logical thinking)
left parahippocampal gyrus is liked to processing unpleasant emotions
Genetic explanation to OCD-evaluation
Strengths:
-Support from twin studies, Nested et al found that 68% identical twins shared OCD compared to 31% non identical ones
Weaknesses:
-Lack of application due to having too many candidate genes
-Environmental factors are also important, Cromer et al found that over half of patients had traumatic event in the past, OCD more severe with those with multiple trauma
Neural explanation of OCD-evaluation
Strengths:
-Support from antidepressants as it can treat OCD
-Those with OCD also become depressed, could be linked to serotonin system
Weaknesses:
-Unclear evidence on which neural mechanisms are involved, sometimes brain is involved and sometimes doesn’t
-Causation doesn’t mean correlation
Drug therapy for OCD
-SSRI prevent the reabsorption and breakdown of serotonin, and increase its levels in the synapse and the amount of it being passed to postsynaptic neuron
-takes over 4 months for it to have an impact
-Reduce emotional symptoms so patients can engage with CBT better
-Tricyclics (antidepressant) such as clomipramine used, but more side effect
-SNRI (selective noradrenaline reuptake), increase serotonin and noradrenaline
Drug therapy for OCD-evaluation
Strengths:
-Reasearch support for OCD-better results for SSRI compared to a placebo, symptoms decline 70% of the time
-Cheap compared to CBT and non disruptive to life
Weaknesses:
-Negative side effects such as indigestion, blurred vision
-Some contrasting evidence, as placebo and SSRI had similar results, and drug companies could sponsor it
-some OCD is followed by trauma so inappropriate to treat with just drugs
