Psychopathology Flashcards
What is Failure to Function?
When someone is unable to cope with the ordinary demands of everyday life and unable to maintain basic standards of nutrition and hygiene
Seligman: signs of this include distress and irrational behaviour
Evaluate Failure to function
+ Doesn’t only use objective views, acknowledges patients experiences, is useful to assess abnormality.
- Discriminates and limits freedom of minority groups, hard to distinguish behaviours from deviation of social norms
- Subjective judgement from individual psychiatrists may be incorrect in others opinions
What is Statistical Infrequency?
When an individual has a less common characteristic
Example: 2% of people have a IQ below 70, this is an abnormality
Evaluate Statistical Infrequency
+ Real-life application, diagnosis of intellectual disability disorder. Also used when measuring how severe symptoms of mental disorders are. High ecological validity.
- Unusual characteristics can be positive, an IQ above 130 is just as uncommon as those below 70, would not be applicable for diagnosis without using other methods
-Not everyone benefits from a label, labels may negatively affect how people view themselves.
What is deviation from social norms?
Behaviour that is different from the accepted standards of behaviour. Norms are specific to culture: Homosexuality was considered abnormal in the past and still is in some cultures.
2019 Brunei: Homosexual acts by men are punishable by death.
Evaluate deviation from social norms
+ Real-life application, Antisocial personality disorder, Deviation from social norms is part of the DSM-5 therefore is valued in psychology.
- Different cultures have different social norms and therefore different ideas of what behaviour is viewed as abnormal, Cultural relativism
- Can lead to absence of human rights if it is relied on for too long, to maintain control over groups, removes individuality.
What is Deviation from ideal mental health?
When someone doesn’t meet a set of criteria for good mental health.
Jahoda: Ideal mental health criteria:
-Ability to self actualise
-Rational thinking
-Independence
- Realistic view of the world
Evaluate Deviation from ideal mental health
+ Highly comprehensive, sets good examples to discuss mental health, checklist for diagnosis and a checklist for people to work towards to improve their mental health
- Cultural Relativism- it is focused for individualist cultures not collectivist
- Sets an unrealistically high standard for mental health
What is a phobia?
An irrational fear of an object or situation
Phobia: DSM-5 categories
When a fearful response is taken out of proportion compared to the object they fear.
-Specific phobia: Object
-Social Anxiety: Social situations
-Agoraphobia: Public/ outdoor spaces
Phobia: Behavioural categories
-Panic: crying, running away, children may freeze or tantrum
-Avoidance: conscious effort to avoid contact with the phobic stimulus
-Endurance: remains in presence of the phobic stimulus but experiences high levels of anxiety.
Phobia: Emotional characteristics
-Anxiety: unpleasant state of high arousal (fear: immediate and extremely unpleasant response to a phobic stimulus)
Phobia: Cognitive characteristics
-Selective attention: unable to focus on anything rather than the phobic stimulus
-Irrational beliefs: increases pressure to perform well
-Cognitive distortions: unrealistic perceptions
Phobia: Behavioural approach
Explains behaviour in observable terms
MOWRER: 2 process model
-Acquisition by classical conditioning: pairing of the NS with the UCS (triggering a fear response), creates a CS that causes the CR, this is then generalised to similar objects.
-Maintenance by operant condition: Negative Reinforcement= avoidance of the phobic stimulus this results in the desired consequence which means the behaviour will be repeated
Phobia: Treatments: SD
Systematic desensitisation: Gradually reduces the phobic anxiety through classical conditioning
-Counterconditioning: Learning a new response to the same stimulus
-Reciprocal inhibition: One emotion prevents the other
Method:
1. Anxiety hierarchy: list of situations related to the phobic stimulus, rated least to most frightening
2. Relaxation: teaches how to deeply relax
3. Exposure: exposed to the phobic stimulus whilst in a relaxed state, over several sessions the stimulus becomes stronger.
Phobia: Evaluate SD
+ Effective, Gilroy: after 33 months patients became less fearful , it is effective for specific phobias.
+ Effective for learning disabilities, not a stressful experience and doesn’t include rational thinking
+ Accessible and pleasant experience
Phobia: Treatments: Flooding
Immediate exposure to phobic stimulus, removes the ability of avoidance
-Extinction: The CS is experienced without the UCS, the CS no longer produces the CR
- Ethical issues are likely, patients must be fully aware and prepared and provide full informed consent
Phobia: Evaluate Flooding
+ Cost-effective, can work in one session unlike SD, and is cheaper and more effective for some phobias
-Not effective for social phobias as they are more complex and every social situation is different
-Traumatic: many patients withdraw, is a waste of time and money and leaves patients traumatised and more fearful of the phobic stimulus
What is Depression?
Mental disorder characterised by low mood and energy levels
Depression: DSM-5 categories
-Major depressive disorder: severe short term
-Persistent: long-term or reoccurring
-Disruptive: childhood tantrums
- Premenstrual: prior to or during menstruation
Depression: Behavioural characteristics
-Activity levels: reduced or or psycho-motor agitation (increased)
-Disrupted sleep and appetite
-Aggression and self-harm
Depression: Emotional characteristics
- Lowered mood: worthless feelings
-Anger: towards themselves of others - Lowered self-esteem
Depression: Cognitive characteristics
-Poor concentration: interferes with work/school
-Dwelling on negative thoughts: recall of unhappy events, glass half-empty
-Absolutist thinking: thinking events are all-good or all-bad, absolute disasters
Depression: Cognitive approach: BECK
3 parts to cognitive vulnerability
-Faulty information processing: focusses on negative aspects of a situation, ‘black and white’
-Negative self-schemas: interpret all information about themself negatively
-Negative triad: negative view of the world, future and self
Depression: Evaluate Beck
+ Supporting evidence of faulty processing, GRAZIOLI; 65 pregnant women for cognitive vulnerability before and after birth, those who were ‘more vulnerable’ were more likely to suffer post-natal depression
+ CBT: identifies the negative triad and challenges if they are true (rational?)
- Doesn’t explain all aspects of depression, anger isn’t explained, or hallucinations, cannot be applied to all symptoms
Depression: Cognitive approach: ELLIS
ABC model: rational thinking = good mental health
A: activating event; negative event that triggers irrational beliefs
B: beliefs that are irrational; Musterbation: must always be perfect
C: consequences; emotional and behavioural
Depression: Evaluate Ellis
+ Led to a successful treatment, challenges the irrational beliefs that Ellis identifies and challenges them, which reduces the patients depression.
- Doesn’t explain all aspects of depression, some people are more vulnerable than others due to their cognition, also fails to explain anger and hallucinations
- Only applies to some cases of depression, reactive depression is caused by the ‘activating event’, partial explanation
Depression: Treatments: Behavioural Activation
The therapist may encourage the patient to become more active and engage in enjoyable activities, provides more evidence to challenge the irrational beliefs.
Depression: Treatments: Beck’s CBT
- Identifies the negative triad and challenges it, by testing the reality of the patients negative beliefs
-Patient as a scientist: the patient investigates the reality of the negative beliefs; this is then later used as evidence to challenge the patients irrational thoughts
Depression: Treatments: Ellis’ REBT
Extends the ABC model;
D: Dispute
E: Effect
-The aim of REBT is to identify and dispute the patients irrational thoughts, using vigorous argument to break the link between negative events and depression
-Empirical argument: Dispute whether there is evidence to support the irrational beliefs.
-Logical argument: Dispute whether the negative thoughts logically follow facts.
Depression: Evaluate the treatments
+ CBT is effective, MARCH; after 36 weeks found that CBT and antidepressants had a higher success rate (86%), CBT should be used as a first choice for NHS
- CBT involves hard work and logical thinking, depressed patients may lack the motivation and focus to finish the course, antidepressants may be a better choice in some cases.
+ Allows patient to develop at their own pace, embraces free will as sessions adapt for each patient.
What is OCD?
An anxiety disorder, distressing thoughts with repetitive behaviours or mental acts to reduce anxiety.
OCD: DSM-5 categories
-Trichotillomania: Compulsive hair pulling
-Hoarding: Gathering possessions, unable to part with any
-Excoriation: Skin picking
OCD: Behavioural categories
-Compulsions: 2 elements;
Repetitive: compelled to repeat a behaviour
Reduce anxiety: Behaviour carried out to reduce anxiety levels
-Avoidance: Avoid situations that may trigger anxiety
OCD: Emotional categories
-Anxiety and distress: anxiety an unpleasant feelings
-Depression: often accompanies OCD, low mood and lack of enjoyment
-Guilt and disgust over compulsions
OCD: Cognitive characteristics
-Obsessive thoughts: Reoccurring unpleasant thoughts
-Cognitive strategies: act to distract, such as prayer, meditation
-Insight into excessive anxiety: suffer from catastrophic thoughts, may become hypervigilant
OCD: Biological explanation (GENETIC)
-DNA and inherited genetics trigger the condition.
-Candidate genes: Create vulnerability for OCD, some are involved in the serotonin system
-OCD is polygenic (caused by several genes)- (Taylor; up to 230 genes found to be linked to OCD)
-SERT gene: creates lower levels of serotonin, linked to OCD: (Ozaki; SERT gene mutation in 2 unrelated families= 6/7 members of the families had OCD)
-OCD is Aetiologically Heterogenous
OCD: Evaluate the GENETIC explanation
+ Strong evidence; NESTADT: twin-studies, 68% of identical twins share OCD, 31% of non-identical, strong evidence of the biological influence on OCD
-Environmental factors have an influence into triggering OCD; CROMER: over half of OCD patients have experienced a traumatic event, suggests that OCD isn’t entirely genetic, should focus on environmental causes.
OCD: Biological explanation (NEURAL)
- The view that physical and psychological characteristics are determined by the nervous system.
-Serotonin: helps to regulate mood, low levels of neurotransmitter= low levels of transmission, affecting mood and mental processes.
-Decision-making systems: some cases of OCD are linked to impaired decision making, may be linked to abnormal functioning of lateral areas in the frontal lobes (that are responsible for logical thinking)
-> Left para hippocampal gyrus: associated with processing unpleasant emotions, found to function abnormally in OCD patients
OCD: Evaluate the NEURAL explanation
+ Evidence of neural mechanisms in OCD, antidepressants work purely on serotonin, increasing levels have resulted in reduced OCD symptoms. This provides validity for the neural explanation of OCD.
-Many people with OCD suffer from depression (co-morbidity), this causes disruption to serotonergic system, the serotonin levels may be due to depression and not OCD, this causes a lack of reliability.
OCD: Biological treatment
Drug therapy: aims to increase or decrease neurotransmitters, aiming to adjust behaviours
-SSRI’s: act to prevent reabsorption and the breakdown of serotonin, to increase levels of serotonin in the synapse to stimulate the postsynaptic neuron. (Fluoxetine: average 20mg daily, take 3-4 months to impact the symptoms of OCD)
- SSRI’s + CBT: the drugs reduce emotional symptoms, this allows CBT to have more engagement and tackle the other symptoms.
-Tricyclics: have the same effect as SSRI’s, but have more severe side effects
-SNRI’s: Increase serotonin and noradrenaline
OCD: Evaluate the biological treatment
+ Drugs are effective for OCD, SOOMRO; SSRI’s showed significantly better results compared to placebo’s, effectiveness is greatest when CBT + SSRI’s combine.
SSRI’s alone show 70% improvement.
- A minority will experience no benefit from drugs or suffer side effects; Clomipramine: 1 in 10 suffer erection problems
+ Drug therapy is cheaper and non-disruptive, doesn’t require ‘hard work’ and rational thinking unlike CBT
- Publication bias: companies who are sponsored by drug companies favour biased evidence showing drug treatments to be the best option.
