Psychopathology Flashcards

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1
Q

A01:Define deviation from social norms as a definition of abnormality

A

Social norms are unwritten behavioural expectations that vary depending on culture, time and context. “Social deviants” are individuals who break the norms of their society and are seen as abnormal. Examples of behaviours showing high cultural specificity are tolerance to homosexuality, religious experiences, and public displays of emotion.

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2
Q

A03: Explain one strength of using deviation from social norms to define abnormality.

A

Using social norms does not impose a Western view of abnormality on other non-western cultures. For this reason, it is argued diagnosing abnormality according to social norms is not ethnocentric.

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3
Q

A03: Explain one weakness of using deviation from social norms to define abnormality.

A

Defining people who move to a new culture as abnormal according to the new cultural norms can be inappropriate. E.g. People from an Afro-Caribbean background living in the UK are seven times more likely to be diagnosed with schizophrenia.

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4
Q

A01:Define failure to function adequately as a definition of abnormality.

A

When individuals cannot cope with the day-to-day challenges of daily life, such as maintaining personal hygiene. Rosenhan and Seligman’s features: They show maladaptive behaviour; their irrational and unpredictable actions go against their long-term best interests. They show personal anguish, and observers feel discomfort in their presence.

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5
Q

A03: Explain one strength of using failure to function adequately to define abnormality.

A

Failure to function adequately respects the individual and their own personal experience, which is something that other definitions, such as statistical infrequency and deviation from social norms, cannot
do.

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6
Q

A03:Explain one weakness of using failure to function adequately to define abnormality.

A

Failure to function adequately only includes people who cannot cope; psychopaths can often function in society in ways that benefit them personally. Having lower empathy can lead to success in business and politics.

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7
Q

Define statistical infrequency as a definition of abnormality.

A

Someone is mentally abnormal if their mental condition is very rare in the population; the rarity of the behaviour is judged objectively using statistics, comparing the individual’s behaviour to the rest of the population. The normal distribution curve shows a population’s average spread of specific characteristics. E.g. One element of a diagnosis of intellectual disability disorder (IDD) in the DSM5 is having 70 IQ points or fewer (Just over 2% of the population).

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8
Q

A03:Explain one strength of using statistical infrequency to define abnormality.

A

Individuals who are assessed as being abnormal according to statistical infrequency have been evaluated objectively; this is better than other definitions that depend on the subjective opinion of a clinician.

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9
Q

A03: Explain one weakness of using statistical infrequency to define abnormality.

A

Not all statistically rare traits are negative; for example, Qs of 130 are just as statistically rare as IQs of 70.
Also, there are common MH conditions like anxiety. NHS found 17% of people surveyed met the criteria for a common mental health disorder

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10
Q

A01:Define deviation from ideal mental health as a definition of abnormality.

A

Humanistic definition by Jahoda in
1958. Rather than defining abnormality, it defines features of ideal mental health, and deviation from these indicates abnormality. The six features are environmental mastery, autonomy, resisting stress, self-actualisation, a positive attitude to yourself and an accurate perception of reality.

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11
Q

A03:Explain one strength of using deviation from ideal mental health to define abnormality.

A

Deviation from ideal mental health
is a holistic definition, as it considers multiple factors in diagnosis and provides suggestions for personal development, Deviation from ideal mental health does not simply state what is wrong but also suggests how problems can be overcome.

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12
Q

A03:Explain one weakness of using deviation from ideal mental health to define abnormality.

A

It is too strict a set of criteria to define mental health, as it is challenging to achieve all of the requirements at any one time; most people would be defined as abnormal.

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13
Q

A01: Briefly outline 2 Cognitive characteristics of phobias

A

Irrational thoughts (fears): Negative and irrational mental processes that include an exaggerated belief in the harm the phobic object could cause
Reduced cognitive capacity: due to attentional focus on a phobic object.

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14
Q

A01: Briefly outline 3 Behavioural characteristics of phobias

A

Avoidance: Physically adapting normal behaviour to avoid phobic objects. Panic: An uncontrollable physical response (e.g. screaming, running). Failure to function: Difficulty taking part in normal day-to-day activities

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15
Q

A01:Briefly outline 2 Emotional characteristics of Phobias

A

Anxiety: An uncomfortably high and persistent state of arousal. Fear:
Intense emotional sensation of extreme and unpleasant alertness. It only subsides when the phobic object is removed.

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16
Q

A01:Briefly outline 2 Cognitive characteristics of depression

A

Poor concentration: People with depression cannot give their full attention to tasks. Negative schemas:
Automatic negative biases when thinking about themselves, the world and the future.

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17
Q

A01:Briefly outline 2 Behavioural characteristics of depression

A

Reduction in activity level: Includes lethargy, lacking the energy needed to perform everyday activities. A change in eating behaviour: Either significant weight gain or weight loss Aggression: to others/self-harm.

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18
Q

A01:Briefly outline 2 Cognitive characteristics of OCD

A

Obsessions: intrusive, irrational, recurrent thoughts that tend to be unpleasant, catastrophic thoughts.
Hypervigilance: A permanent state of alertness, looking for the source of obsessive thoughts.

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19
Q

A01:Briefly outline 2 Behavioural characteristics of OCD

A

Compulsions: behaviours performed repeatedly to reduce anxiety e.g. checking & cleaning behaviours.
Avoidance: take actions to avoid objects that trigger obsessions.

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20
Q

A01:Briefly outline 2 Emotional characteristics of OCD

A

Anxiety: an uncomfortably high and persistent state of arousal, making it difficult to relax. Depression: A consistent and long-lasting sense of sadness. Due to being unable to control thoughts.

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21
Q

A01: What is the two-process model applied to phobias?

A

Mower: Phobias are acquired through classical conditioning (learning through association).
Phobias are maintained through operant conditioning (learning from consequences reinforcement).

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22
Q

A01:How does someone acquire a phobia through classical conditioning?

A

A phobic object starts as a neutral stimulus (NS) and causes a neutral response (NR), no response. An unconditioned stimulus (UCS) (e.g. pain of being stung) produces an unconditioned fear response (UCR),
An association is formed when NS is paired with UCS. The object becomes a conditioned stimulus (CS), producing the conditioned response (CR) (fear)

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23
Q

A01: What does it mean for phobias to be generalised?

A

Phobias can be generalised, so a conditioned fear response is also experienced in the presence of stimuli that are similar to the conditioned stimulus. So fear of bees could be generalised to other small flying insects.

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24
Q

A01: How does someone maintain a phobia through Operant conditioning?

A

Avoidance behaviour leads to a reduction in anxiety, which is a pleasant sensation. This reinforcement strengthens the phobia, making the person more likely to avoid the phobic object in the future.

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25
Q

A03:Describe Watson and Rayner’s (1920) (Phobias)

A

Watson paired the rat with hitting a large metal pole behind a child’s (little albert) head, creating a loud noise and scaring the child. A phobic response formed, and the rat produced a fear response, demonstrating phobias can be acquired through association.

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26
Q

A03:What may be a better explanation for common phobias?

A

Phobias of snakes and spiders are more common than those of cars or knives. These phobias may be better explained by evolutionary theory, as these are dangers that many of our evolutionary ancestors faced

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27
Q

A03 : What is reciprocal inhibition in the context of Behaviourist therapies for phobias? (systematic desensitisation)

A

Fear and relaxation are two antagonistic emotions, as you can’t feel two opposite emotions simultaneously. If the therapist can help the client hold the phobic object without fear, they have been successfully counter-conditioned.

28
Q

A01: What are the stages of Systematic Desensitisation (SD)

A

1) Client learns relaxation techniques (breathing exercises)
2) The client creates an anxiety hierarchy, a list of feared situations with the phobic object, from the least to the most feared.
3) The client is exposed to each level of the anxiety hierarchy (relax at each stage!)
4) When the client can hold the phobic object without fear, the association is extinct

29
Q

A01: Describe Flooding as a treatment for phobia.

A

Flooding attempts to counter condition a phobia by immediate and full exposure to the maximum level of phobic stimulus. The therapist’s job is to stop the client from escaping the situation. A fear response takes energy. Eventually, the client will become exhausted and calm down in the presence of the phobic object.

30
Q

A01: What can go wrong if Flooding ends too early?

A

If the client ends the treatment before becoming calm, anxiety will decrease due to removing the stimulus, and the phobia will have been reinforced.

31
Q

A01: Briefly outline 2 Emotional characteristics of depression

A

Sadness: A persistent, very low mood.
Guilt: Linked to helplessness and a feeling that they have no value in comparison to other people.

32
Q

A03:Why may systematic desensitisation be seen as a preferable treatment compared to Flooding?

A

The client controls systematic desensitisation (SD), making it a more pleasurable experience as they limit their anxiety. Also, Due to its stressful nature, Flooding isn’t appropriate for older people, people with heart conditions or children.

33
Q

A03: Why may Systematic Desensitisation and Flooding not be as effective as they seem?

A

Effectiveness may be limited to the controlled environment of a therapist’s office but may not translate to real-world experiences.
For instance, a person may successfully conquer their fear of birds in the presence of a tame bird within the therapist’s room, but when confronted with numerous wild birds in the outside world, their phobia may resurface.

34
Q

A03:What is a common and effective alternate treatment program for phobias?

A

Pharmacological (drug) interventions, such as benzodiazepines and antidepressants, are considered effective alternative treatments for phobias. These medications effectively reduce anxiety and alleviate phobic responses and are generally quicker and less expensive than systematic desensitisation or Flooding.

35
Q

A03: Describe Garcia Palacios’s study
(2002)

A

found 83% of participants treated with “virtual reality exposure therapy” (based on SD) to spiders showed clinically significant improvement compared to 0% in the control group. This demonstrates the principles of SD are valid, and the use of VR allows a wider range of phobias to be treated.

36
Q

A01: How does the cognitive approach explain depression?

A

Depression is due to irrational thoughts resulting from maladaptive internal mental processes.

37
Q

A01: What is Beck’s negative triad?

A

Three Schemas with a persistent automatic negative bias.
The Self: Aka self-schemas, feeling “inadequate or unworthy.”
The World: Thinking people are “hostile or threatening.”
The Future: Thinking “Things will always turn out badly.”

38
Q

A01: According to Beck, what are Cognitive distortions?

A

Persistent biases in adulthood lead us to perceive the world inaccurately.
Two examples are 1)
Overgeneralisation: One negative experience results in an assumption that the same thing will always happen. 2) Selective abstraction:
Mentally filtering out positive experiences and focusing on the negative

39
Q

A01: What does ABC stand for in Ellis’s
ABC Model?

A

A: Activating event. It can be anything that happens to someone. (large or small)
B: Belief. For people without depression, beliefs about A are rational. People with depression have irrational beliefs.
C: Consequence.
Rational beliefs lead to positive consequences; irrational beliefs lead to negative C

40
Q

A01: According to Ellis, what is Mustabatory thinking?

A

Thinking things must be a certain way, The fact that we fail to achieve unrealistic goals, other people don’t behave the way we want them to, or an unexpected event happens and ruins our plans leads to disappointment.

41
Q

A03: Describe Grazioli and Terry’s (2000) study.

A

Found women with negative thinking styles were the most likely to develop postpartum depression, especially in women with infants who were identified as having a difficult temperament. This supports the idea that faulty thinking leads to depression but also that there is a diathesis-stress mechanism.

42
Q

A03: What practical application have cognitive theories of depression led to?

A

Highly effective cognitive therapies;
March showed CBT had an effectiveness rate of 81% after 36 weeks of treatment, the same as drug therapy. The fact these treatments are successful suggests the underlying cognitive explanations are valid.

43
Q

A03: What evidence is there that depression is biological, not cognitive?

A

Family studies and genetic research suggests a predisposition to depression is inherited, likely genes that influence the activity of neurochemicals like Serotonin in the brain; also, the effectiveness of drug treatments like SSRIs suggests the cognitive explanation is not complete, and there is a biological aspect to depression.

44
Q

A01: Why do cognitive theories struggle to explain all forms of depression?

A

Many people with depression also experience anger, and people with bipolar depression experience manic phases, times when they feel extremely happy, overly excited, confident and focused. These features of some types of depression are hard to explain with theories like Beck’s that explain depression as due to negative schemas, as schemas are resistant to change.

45
Q

A01: In Beck’s CBT, what is meant by
“Patient as a scientist” and “Thought catching.”?

A

Patient as a scientist: The patient generates and tests hypotheses about the validity of their irrational thoughts; when they realise their thoughts don’t match reality, this will change their schemas, and the irrational thoughts can be discarded.
Thought catching: identifying irrational thoughts coming from the negative triad of schemas.

46
Q

A01: In Ellis’s REBT, what is meant by “D” and “E”

A

Dispute: the therapist confronting the client’s irrational beliefs. Empirical arguments challenge the client to provide evidence for their irrational beliefs, while logical arguments attempt to show that the beliefs don’t make sense. Effect: reduction of irrational thoughts restructured beliefs B) leading to better consequences (C) in the future

47
Q

A01: What is the difference between Becks CBT and Ellis’s REBT?

A

In Beck’s CBT therapy, the client is helped to figure out the irrationality of their thoughts themselves by acting as a scientist. In Ellis’s REBT, the therapist explains the irrationality of the thoughts directly to the patient through disputation.

48
Q

A03: Describe March’s study (2007)

A

327 patients were assigned to one of three groups, CBT, drug therapy (the
SSRI fluoxetine and the third group was given a combined treatment of
CBT and drug therapy. After 36 weeks, CBT and drug therapy had an effectiveness rate of 81%, combined 86%. CBT also had a more significant reduction in suicidal events than drug treatment

49
Q

A03: Why may CBT and REBT be focused on the wrong thing?

A

Clients may want to discuss severe trauma in their past, also
reinterpreting present experiences does not necessarily improve the present situation; it may be that the client is in an unhealthy relationship, is experiencing unfulfilling work, discrimination or has financial problems, concerns about these social problems

50
Q

A03: Why may some patients prefer CBT over drug therapy to treat depression?

A

Due to the lack of side effects and a belief that CBT addresses the root cause of depression, not just reducing symptoms

51
Q

A01: What does the biological explanation for OCD include?

A

The biological explanation includes genetics, inherited from your parent’s DNA codes for other aspects of your biology, such as neural features, such as how neurotransmitters are processed in the synapse and the development and functioning of larger neural structures such as brain regions.

52
Q

A01: What genes are linked to OCD

A

Genetic analysis has revealed around 230 separate “candidate genes” found more frequently in people with
OCD, candidate genes influence the functioning of neural systems in the brain; for example, the SERT gene affects reuptake in the serotonin system. Other identified genes include gene 9, COMT gene, and 5HT1-D beta gene.

53
Q

A01: How is Serotonin thought to be linked to OCD?

A

Low serotonin levels are thought to cause obsessive thoughts, and the low level of Serotonin is likely due to it being removed too quickly from the synapse before it has been able to transmit its signal influence the postsynaptic cell.

54
Q

A01: What Neuronal structure is linked to OCD?

A

A set of brain structures including the orbitofrontal cortex (OFC) (rational decision making), the basal ganglia system, especially the caudate nucleus, and the thalamus. Communication between these structures in the worry circuit appears to be overactive in people with OCD

55
Q

How does the neuronal structures usually function, and how does it function in people with OCD?

A

In normal functioning, the basal ganglia filter out minor worries coming from the OFC, but if this area is hyperactive, even small worries get to the thalamus, which is then passed back to the OFC, forming a loop (recurring obsessive thoughts)

56
Q

A01: What other neural area other than the worry circuit is associated with OCD?

A

The Parahippocampal gyrus, an area of cortex close to the hippocampus on the brain’s underside, is also linked to OCD. It is responsible for regulating and processing unpleasant emotions and has been seen to function abnormally in cases of OCD.

57
Q

A03: Describe Nestadt’s 2010) study.

A

Shows for OCD; there is a high concordance rate between close family members. Non-identical twins have 31% concordance, and identical twins have 68%. This suggests that the additional shared DNA is responsible for the increased concordance.

58
Q

A03: Why may the correlation in OCD observed in family and twin studies not automatically equal genetic causation?

A

Closer family members also share similar environments; identical monozygotic twins may be treated more similarly because they look alike compared to dizygotic, non-identical twins. As the concordance rate for identical twins at 68%, not 100%, the level we would expect for an entirely genetically determined psychological feature

59
Q

A03: How can the diathesis-stress response be applied to OCD?

A

Individuals inherit a genetic vulnerability to OCD (diathesis).
However, the disorder does not develop unless there is an
environmental factor (stressor), such as a traumatic life experience. Cromer showed 54% of 265 participants with OCD reported at least one traumatic life event.

60
Q

A01:What are SSRIs, and what do they do?

A

SSRIs are a group of antidepressant drugs, including Fluoxetine, also known as Prozac. They are Selective Serotonin Reuptake Inhibitors. They only influence (select) Serotonin in the brain; as reuptake inhibitors, they inhibit (slow down) the reuptake process in the synapse.

61
Q

A01: How are SSRIs thought to influence OCD symptoms?

A

They inhibit (slow down) the reuptake process in the synapse. Therefore Serotonin is still present in the synaptic cleft and continues to stimulate the postsynaptic neuron.
This decreases anxiety by normalising the activity of the Neuronal structures (linked with/to OCD) .

62
Q

Asides from SSRIs, what other drug treatments are available for OCD, and how do they work?

A

Anti-anxiety drugs like benzodiazepines. These work by enhancing a neurotransmitter called GABA, slowing the central nervous system and resulting in general relaxation. Tricyclics and SNRIs work by increasing Serotonin and noradrenaline.

63
Q

A03: Describe Soomro’s (2008) study

A

conducted a meta-analysis combining the data from 17 studies that compared SSRIs to placebos. In total, there were 3097 participants. The results of this large-scale meta-analvsis showed that SSRIs significantly reduced the symptoms of OCD compared to placebos between 6 and 17 weeks post-treatment

64
Q

A03: Why may studies and meta-analyses on SSRIs be misleading?

A

The file drawer problem (the fact that many negative results stay unpublished) means any metanalysis may be skewed, and drug therapies may not be as effective as claimed.
Also, trials are conducted by pharmaceutical companies.

65
Q

A03: Why is drug therapy for OCD a common treatment?

A

Drug therapy is a relatively inexpensive and potentially more convenient treatment for the patient; this is in comparison to psychological therapies like CBT, which require the patient to find time for multiple sessions with a trained therapist.

66
Q

A03:Why do many patients prefer CBT to drug therapy?

A

One reason is drug therapy can have a range of potential side effects; in the Soomro meta-analysis, it was found nausea, headache and insomnia were the most common side effects.