Psychopathology

Question 1

what are the 4 definitions of abnormality

Answer 1

1) deviation from social norms
2) statistical infrequency
3) failure to function adequately
4) deviation from ‘ideal mental health’

Question 2

A01
explain deviation from social norms

Answer 2

• society sets rules for behaviour based on set of moral standards which become social norms
• any deviation from these is seen as abnormal
• behaving in a way that is different from what we expect
• example of this is anti social personality disorder, whereby individuals show no regard e.g criminal behaviour

Question 3

A03
what is a strength of the deviation from social norms definition (real life application)

Answer 3

• useful for diagnosis conditions such as anti social personality disorder (ASPD)
• diagnoses mental health conditions linking to criminal and anti social behaviours

Question 4

A03
what are the weaknesses of the deviation from social norms definition
(cultural relativism + human rights abuse)

Answer 4

1) cultural relativism- what is considered normal in one culture may be different to another
- lead to mislabelling and misdiagnosis of illness
- social norms can also chafe within a culture e.g homosexuality was deemed a mental illness up until the 1960s in the UK
- classification systems used to define mental conditions are based on Western standards e.g the DSM
- therefore we cant use the definition cross culturally

2) human rights abuse- poor treatment of groups in society that are different
- homosexuality as an example, when it was listed in the DSM as a mental illness people were mistreated and abused due to their behaviour seen as deviant according to the social norms at the time
- therefore can lead to the mistreatment of individuals just for being different

Question 5

A01
explain the statistical infrequency definition

Answer 5

• uses stats e.g mean median and mode to represent values in data to see what is considered as typical or normal behaviour for a population
• any behaviour that is statistically unusual in the general population then it can be thought as abnormal
• behaviour is abnormal if it deviates from the mean average, meaning it’s statistically rare
• common/uncommon data, not desirable or undesirable

Question 6

A03
what are the weaknesses of the statistical infrequence definition (desirable behaviour + subjective cut off point)

Answer 6

1) some abnormal behaviours are desirable- definition fails to distinguish between desirable/undesirable behaviour
- some ‘abnormal behaviours’ such as really high IQ are highly advantageous traits
- some common/typical behaviours such as depression may be undesirable as a trait
- therefore lacks detail and isn’t full explanation when referring to abnormal behaviour

2) cut off point is subjective- abnormality being defined in terms of statistically uncommon behaviours, who decides the cut off point
-e.g for depression sleeping difficulties are defined by sleeping less than 6hrs a night, but some ppl think that it should be a lot less
- internal disagreements mean it’s difficult to define abnormality in terms of statistically common or uncommon behaviours

Question 7

A03
what is a strength of the statistical infrequency definition (real life diagnosis)

Answer 7

• real life diagnosis- useful for diagnosis e.g intellectual disability is defined in terms of normal distribution
• therefore when a person as a certain limitation in cognitive functioning and skills, we can use statistics to see where the the individual should fall using standard deviation of the normal distribution for ID

Question 8

A01
explain the failure the function adequately definition

Answer 8

• abnormality based on an inability to cope with day-to-day life caused by psychological distress or discomforts which may lead to harm of self or others
• e.g. having a mental health condition, interfering with their ability to go to work, wash clothes, eat meals etc, then they are classed as abnormal
• not functioning adequately causes distress and suffering for the individual, but also may cause ‘distress to others’
• e.g. for schizophrenia patients lack general awareness and may cause distress to others

Question 9

A03
what are weaknesses of the failure to function adequately definition

Answer 9

1) Very subjective: an individual experiencing personal distress and unable to fulfil everyday tasks may recognise this and seek help, however another person may be happy and content in the situation as they are unaware they are not coping with the demands of day to day life
- therefore abnormality is down to another person making the judgment

2) Cultural relativism: criteria is likely to result in different diagnosis when applied to people from different cultures as the standard of one culture is being used to measure another
- cultural norms and practices vary from culture to culture and could lead to differing diagnosis

Question 10

A01
explain the deviation from ‘ideal mental health’ definition

Answer 10

• Jahoda proposed the following criteria for ‘ideal mental health’ whereby instead of focusing on abnormality, Jahoda looked at what would comprise to an ideal mental health
• being able to self-actualise
• having an accurate perception of ourselves
• not being distressed
• mastery of the environment- being able to love, function at work and adapt to new situations
• absence of this criteria indicates abnormality and potential mental disorder

Question 11

A03
what are the weaknesses of the deviation from ‘ideal menta health’ definition

Answer 11

1) Unrealistic criteria: according to ideal mental health criteria most of us are abnormal
- criteria seen as very difficult to measure and may be seen as subjective and vary in different contexts and from person to person, weakening acceptance of this definition

2) equates mental and physical health: possible that some mental disorders also have physical causes e.g brain injury or drug abuse but many do not. They are consequences of life experiences, so mental and physical health aren’t the same as Jahoda assumes
- what makes a good physical health may not apply to mental health
- mental and physical health should be viewed as very different things

Question 12

A03
what is a strength of the deviation from ‘ideal mental health’ definition

Answer 12

1) focuses on the positives rather than the negatives
- offers an alternative perspective on mental disorders that focus on the ‘ideal’
- it has real-life application and has influence on the wider context of psychology e.g positive psychology movement and humanistic approach
- definition gives a clear direction of wat we should all strive for the best and reach our full potentials in this area

Question 13

A01
what is a phobia

Answer 13

• instances of ‘irrational fears’ that produce as conscious avoidance of the feared object or situation
• included in the DSM (diagnostic and statistical manual) in anxiety disorders

Question 14

A01
what are the emotional characteristics for phobias

Answer 14

• fears are excessive and unreasonable
• feelings of anxiety and panic
• these feelings are cued by the presence or anticipation of a specific object or situation
• feelings are out of proportion

Question 15

A01
what are the behavioural characteristics for phobias

Answer 15

• panic, heightened physiological arousal caused by hypothalamus triggering increased levels of activity
• avoidance, behaviour is negatively reinforced as behaviour is carried out to avoid unpleasant consequence
• endurance, when patient remains exposed for extended period of time and experiences heightened levels of anxiety

Question 16

A01
what are the cognitive characteristics for phobias

Answer 16

• irrational beliefs and though processes
• resistance to rational arguments
• e.g person with a fear of flying isn’t helped by argument that ‘flying is the safest mode of transport’
• however person does recognise that their fear is excessive and unreasonable
• selective attention, person remains focused on phobic stimulus

Question 17

A01
describe the two process model in terms of explaining phobias

Answer 17

• behavioural explanation
• suggests phobias are learned through association and maintained through operant conditioning processes
• two process model suggests that we acquire a phobia via classical conditioning, but that it’s maintained/continues by operant conditioning
• once phobia is acquired via classical conditioning, fears can generalise to similar stimuli e.g in Albert’s case he was also scared of the white rabbit and white santa clause mask, stimulus generalisation
• maintained via operant conditioning
• negative reinforcement: rewarded by avoiding unpleasantness
• so we continue to avoid the phobic stimulus or situation, this in turn maintains the phobia

Question 18

A03
what are weaknesses of the two process model as an explanation for phobias

Answer 18

1) an incomplete explanation of phobias: the original explanation ignores the role of biological and evolutionary factors involved
- Bounton suggests that evolutionary factors play an important role in phobias as we easily acquire phobias that have been a source of danger in our evolutionary past e.g snakes/spiders

Question 19

A01
What are the emotional characteristics of depression

Answer 19

• lowered mood, feeling lethargic and sad
  -feeling worthless and empty, low self esteem
• extreme anger, directed to others or self, possibly leading to self harm

Question 20

A01
What are behavioural characteristics of depression

Answer 20

• reduced energy, sense of tiredness
• however increased energy, increasingly agitated and restless
• difficulty to sleep
• received appetite or eating considerably more than usual

Question 21

A01
What are cognitive characteristics of depression

Answer 21

• negative thoughts and negative self concept
• dwelling on the negative, ignores the positive
• recall of negative memories rather than happy ones
• absolutist thinking, either very good or very bad
• negative thoughts are irrational

Question 22

A01
What are the behavioural characteristics of OCD

Answer 22

• compulsions: reduce anxiety created by obsessions (intrusive thoughts) - repetition of tasks e.g. washing hands, also mental acts such as counting or praying
• patients feel as though they have to perform the action or something dreadful might happen, therefore increase anxiety
• avoidance behaviours: keeping away from situations that may trigger anxiety, e.g. to touching things that may make their hands dirty
• may affect ability to live ‘normally’ as won’t want to tale out their rubbish

Question 23

A01
What are the cognitive characteristics of OCD

Answer 23

• obsessive thoughts: 90% of suffers have obsessive thoughts/ intrusive thoughts, often negative ones, that repeat over and over again
• excessive anxiety: experience catastrophic thoughts about worst case scenarios
• tend to be hyper-vigilant (attention) and maintain constant alertness

Question 24

A01
What are emotional characteristics of OCD

Answer 24

• anxiety and distress: obsessive thoughts are unpleasant and cause anxiety, urge to repeat behaviour creates anxiety
• accompanying depression, low mood and lack of enjoyment in activities. Compulsive behaviour tends to bring some relief from anxiety but this is temporary
• guilt and disgust: involves negative emotions such as irrational guilt or disgust, directed at something external like dirt or internal such as self

Question 25

A01
What is the cycle of OCD (cycle of feelings and behaviour)

Answer 25

1) obsessive thought
2) anxiety
3) compulsive behaviour
4) temporary

This cycle repeats

Question 26

A01
What are the two cognitive explanations of depression

Answer 26

1) Beck’s cognitive theory
2) Ellis ABC model

Question 27

A01
Explain does Beck’s cognitive theory

Answer 27

• depression can be explained by the way people think ‘cognition’
• they have cognitive vulnerability due to autonomic processing
  1) faulty information processing- focus on the negative, catastrophic ( absolutist thinking)- automatic
  2) negative self schema- mental framework for interpreting the world, negative world view and self, poor self esteem
  3) the negative triad
  A) the negative view of the word
  B) the negative view of the future
  C) the negative view of the self
• believe that depressed individuals feel as they do because their thinking is biased towards negative interpretations of the world (automated thinking)
• he also believes that these individuals lack a perceived sense of control
• believes depressed people have acquired a negative schema through childhood

Question 28

A01
Explain Albert Ellis’ ABC model

Answer 28

A- activating event
B- Beliefs
C- consequences
- Ellis proposed that an activating event (A), leads to an irrational belief (B), which results in an emotional consequence (C) in the form of depression. The key here is the specific interpretation of the irrational belief, which is why some people have depression, whilst others don’t, according to the ABC model.
- irrational belief are not thoughts that are illogical or unrealistic but are thoughts which stop us feeling happy
- source of irrational thinking comes from ‘musturbatory’ thinking (perfectionism)
- e.g thinking you must always perform well in an exam, failure leads to irrational belief

Question 29

A03
What are strengths of Beck’s cognitive theory

Answer 29

1) good supporting evidence: Grazioli and Terry assessed 65 pregnant women for cognitive vulnerability and depression before and after birth.
- those who were judged high in cognitive vulnerability were more likely to suffer post nantal depression
- supports central prediction of theory
- e.g automatic processing increases a persons susceptibility to depression and that the vulnerability exists before the symptoms of an illness appear

2) practical application in CBT
- increased understanding of the cognitive basis of depression translates to more effective treatments
- e.g aspects such as the negative triad, faulty information processing can be identified and challenged by the therapist
- strength as therapist can identify and challenge irrational and negative thinking patterns and develop more rational beliefs
- led to successful treatment of depression

Question 30

A03
What is a weakness of Beck’s cognitive theory for depression

Answer 30

• doesn’t explain all aspects of depression: some depressed patients are deeply angry and Beck can’t explain this extreme emotion. Some sufferers suffer from hallucinations and bizarre beliefs
• this theory is incomplete and can be said doesn’t apply for all cases of depression

Question 31

A03
What is a weakness of Ellis’ ABC model

Answer 31

• cannot explain all types of depression, apart from those which clearly have an activating event. However many suffer from depression without an apparent cause (reactive depression), and may feel frustrated that their concerns/experiences are not reflected in this theory.

Question 32

A03
What is a strength of Ellis’ ABC model

Answer 32

• shares same advantage as Beck’s cognitive theory
• provides practical application in CBT suggest that identifying and challenging irrational beliefs are at the core of ‘curing’ depression
• supports the theoretical basis of the model, through specific focus on the role of faulty cognitions in the development of depression and specifically in the interpretation of an activating event

Question 33

A01
Explain cognitive behavioural therapy as the cognitive approach to treating depression

Answer 33

• Ellis developed a form of CBT
• aim of the therapy is to focus on the ‘irrational’ thoughts/ faulty beliefs and change them into ‘rational’ ones
• a trained therapist will work with the ‘client’ over a number of sessions (one to one therapy)
• rational emotive behavioural therapy: specific form of CBT
• therapy also focuses on resolving emotional problems and it also focuses on resolving any behavioural problems
• Ellis stated that it’s not the activating event that cause the depression, it’s the beliefs
• therapist will provide respect and appreciation regardless of what the client says

Question 34

A01
What are the types of disputing in Ellis’s REBT (rational emotive behaviour therapy)

Answer 34

1) logical disputing: does this way of thinking make sense?
2) Empirical disputing: are the beliefs consistent with reality?
3) pragmatic disputing: emphasises the lack of usefulness of self-debating beliefs

Question 35

A03
What is a strength of Ellis’s REBT

Answer 35

1) Research support: effectiveness of REBT (90% success rate)
- in studies where CBT has been used as the main therapy it’s superior to other therapies

HOWEVER CBT may not always be effective, it depends on willingness of client
- lack of client engagement decreases the effectiveness of CBT

Question 36

A03
What is a weakness of CBT

Answer 36

1) Individual differences: CBT appears to be less suitable for people who have high levels of irrational beliefs that are both rigid and resistant to change
- less suitable in situations where high levels of stress in the individual and therapy can’t resolve it

Question 37

A01
What is the biological approach to explaining OCD

Answer 37

• diathesis stress model suggests that some have a genetic vulnerability towards developing depression or that environmental experiences (stressors) are necessary to trigger the condition
• Lewis et al found that of his OCD patients, 37% had parents with OCD and 21% had siblings with OCD
• 60% concordance rate
• OCD is polygenic: 230 genes are involved (Taylor)
• candidate genes: increase a persons vulnerability towards developing OCD, these genes are involved in regulating development if serotonin system and dopamine
• example of a candidate gene: SERT gene (5HT1), affects the transport of serotonin across synapses, lower levels of serotonin
• COMT gene, regulates production of dopamine
• faulty version of this has been found in patients with OCD, too much dopamine

Question 38

A01
What are the neural explanations of OCD

Answer 38

• role of serotonin (regulates mood), low levels = mood/mental processes are affected
• OCD may be explained by a reduction in the functioning of serotonin
• role of dopamine, levels are abnormally high in OCD
• excess of binding and constant simulation at dopamine synapse
• can explain the hyper vigilance and compulsions associated with OCD
• brain circuits: frontal lobes, mcaudate nucleus in patients with OCD is damaged, fails to suppress ‘minor worrys’ signals and the thalamus is alerted, acting as a ‘worry circuit’
• PET scan evidence, scans taken while symptoms are active (washing hands excessively), show heightened activity in frontal cortex

Question 39

A03
What is a strength of the biological approach to explaining OCD

Answer 39

1) supporting evidence: Nestadt found that MZ twins were more than 2x likely to develop OCD if their twin had the disorder compared to DZ twins
- found that ppl with a 1st degree relative had a 5x greater risk of having OCD
- clearly shows a genetic basis for OCD and the role of vulnerability through genetic influences being passed down

• however, it is important not to be deterministic, the genetic vulnerability must be paired with an environmental stressor to result in OCD (diathesis stress model)

Question 40

A03
What are weaknesses of the biological approach to explaining OCD

Answer 40

1) too many candidate genes, with over 230, hard to assess which candidate genes have the greatest influence and which genes drug treatments should target, explanation is likely to have little predictive value in future

2) ignores environmental factors- Cromer et al found that of his OCD patients, over half experienced a trauma in their lives, and positive correlation between trauma and OCD

Question 41

A01
Explain the process of synaptic transmission

Answer 41

• a nerve impulse enters the ore synaptic neuron and reaches the axon terminal
• the vesicles then fuse with the cell membrane, causing the neurotransmitters to diffuse from a high to low concentration across the synapse
• neurotransmitters bind to the receptors using a lock and key mechanism
• electrical impulse is received by the post-synaptic neuron

Question 42

A01
Explain the biological approach to treating OCD

Answer 42

• selective serotonin reuptake inhibitors (SSRIs) are a group of anti-depressants that prevent the reuptake of serotonin on the pre-synaptic neuron
• means that serotonin concentration increases, causing the post-synaptic neuron to be continually stimulated
• example of an SSRI is fluoxetine
• tricyclics are another group of antidepressants, prevent reuptake of serotonin and noradrenaline (linked to mood)
• used for those who don’t respond to SSRIs
• example of a tricyclic is clomipramine

Question 43

A03
What is a limitation of the biological approach to treating OCD

Answer 43

1) serious side effects, e.g taking clomipramine more than 1 in 10 suffer from erection problems, weight gain and temors
- if patient stops complying with the medication then their OCD can actually worsen and become more severe
- may solve one issue but create more medical and psychological issues

2) not a lasting cure:
- Marina et al found that patients relapse within a few weeks of medication is stopped
- means the symptoms will return and the effectiveness of the medication is compromised

Question 44

A03
What are strengths of treatment for OCD

Answer 44

1) SSRIs are effective treatment for OCD
- Soomro reviewed 17 students of the use of SSRIs with OCD patients and and found these to be more effective compared to ‘placebo’ these drug were effective in reducing symptoms up to 3 months
- indicates that OCD is biological, strengthens acceptance of SSRIs of treatment for OCD

2) preferred to other treatments
- requires little input from the user in terms of effort and time
- cost effective and require minimal effort
- don’t interfere with every day life
-

Question 45

A01
What are the 2 behavioural treatments for phobias

Answer 45

1) systematic desensitisation
2) flooding therapy

Question 46

A01
Explain systematic desensitisation as a treatment for phobias

Answer 46

• behavioural therapy designed to reduce phobic anxiety through gradual exposure to phobic stimulus
• relies upon counterconditioning (learning a new response to the phobic stimulus)
• phobic stimulus is paired with relaxation instead of anxiety
• it’s impossible to be afraid and relaxed at the same time, one emotion prevents the other, known as reciprocal inhibition

Question 47

A01
What is the process of systematic desensitisation

Answer 47

1) Relaxation: starts with teaching individual how to relax using muscle relaxation techniques, deep breathing, visualisation and meditation methods

2) hierarchy of anxiety provoking situation: patient and therapist build schedule of increasingly anxiety provoking situations with feared object, starting with least to most

3) Exposure: patient is exposed to the feared stimuli when in a relaxed state. Takes place over several sessions
- when patient can stay relaxed in the presence of lower levels of the phobic stimulus they move up the hierarchy
- treatment is successful when the patient can stay relaxed in situations high in the anxiety hierarchy

• low attrition rate (drop out)

Question 48

A01
Explain flooding as a treatment for phobias

Answer 48

• designed to reduce phobic anxiety in one session through immediate exposure
• stops phobic responses rapidly as without the option of avoidant behaviour the patient quickly learns that the feared stimulus is harmless, physically impossible to maintain a state of heightened anxiety for a prolonged period
• in classical conditioning terms, its called extinction
• means that conditioned stimulus (e.g spider) no longer produces the conditioned response (fear)
• must be relaxed to move on

Question 49

A03
What is a strength of systematic desensitisation

Answer 49

1) evidence to support effectiveness
-Gilroy followed up 42 patients treated in 3 sessions for a spider phobia. Progress was compared to a control group of 50 patients who learnt only relaxation
- at both 3 and 33 months after the treatment, the SD group were less fearful of spiders than the control group
- shows SD to be effective both short and long term

• also low attrition rates, so more acceptable to patients

Question 50

A03
What is a weakness for flooding as a treatment for phobias

Answer 50

1) not effective treating phobias rooted in evolution- some fears e.g dark or heights could’ve evolved due to their survival advantage
- these phobias can’t be cured through the principles of counterconditioning as they are rooted in our biology and genetic influences
- only effective for treating phobias that have resulted due to learning

Question 51

A03
What is a strength of flooding as a treatment for phobias

Answer 51

• cost effective: found to be cheaper as the patients phobia will typically be cured in one session, freeing them of their symptoms and allowing them to continue living a normal life

Question 52

A03
What is a strength of behavioural therapies as a treatment for phobias

Answer 52

• faster, cheaper and require less effort on patients behalf
• CBT requires a willingness for patients to think deeply about their mental problems
• in behavioural therapy the lack of thinking is useful for those who lack insight to their motivations or emotions