Psychopathology Flashcards
Abnormality
Difficult to define as it varies between cultures.
Statistical infrequency
Abnormal if fall outside typical statistical range - e.g. IQ normal distribution curve - IQ between 70 and 130 normal.
Statistical Infrequency evalutation
+ Sometimes statistics are appropriate to define abnormality.
- Arbitrary cut offs
- Ignores desirability
- Sometimes statistically frequent = abnormal
- Cultural relativism
Deviation from social norms
Abnormal is behaviour that deviates from accepted or expected behaviours in society.
Deviation from social norms evaluation
- Culture
- Varies over time
Failure to function adequately
Not being able to cope with every day living- causes distress fr person and others- may not know they are abnormal/ mentally ill.
Rosenhan and Seligman- FtFA signs
- No longer conforms to standard interpersonal rules (eye contact)
- Severe distress
- Irrational behaviour
7 criteria:
- Unpredictability
- Maladaptive behaviour
- Personal distress
- Irrationality
- Observer discomfort
- Violation of moral standards
- Unconventionality
Failure to function adequately evaluation
+ Subjective experience
+ Easy to judge
+ Includes others
- Subjective
- FtFA or deviation from social norms???
- Cultural relativism
- Some disturbed people appear normal
Deviation from ideal mental health
Absence of normality defines abnormality.
Jahoda 1958- 6 elements
- Self attitudes
- Personal growth
- Integration
- Autonomy
- Accurate perception of reality
- Mastery of environment
Deviation from ideal mental health evaluation
+ Positive approach
- Unrealistic
- Suggests mental health is the same as physical
- Cultural relativism
Phobia behavioural characteristics
Avoidance behaviours that trigger fight or flight response:
- Avoidance- interfering with routine
- Endurance- unavoidable
- Panic- fight or flight
Phobia emotional characteristics
Persistent emotional upset, anxiety (worry), fear (scared- caused by worry).
Phobia cognitive characteristics
Irrational thought processes, irrational beliefs (excessive), cognitive distortions, struggle focusing.
Specific phobia
Specific object/ situation
Social Phobia
Fear of public humiliation
Agoraphobia
Fear of public places
Clinical Depression
At least 5 symptoms for at least 2 weeks- 2.6% of population.
Symptoms of Depression
Poor/ increased appetite/ weight, too much/ too little sleep, tiredness, body slowed or sped up, loss of interest/ pleasure in usual activities, self reproach, guilt, distraction, thoughts of death/ suicidal behaviours.
Emotional Characteristics of depression
Sadness, low self esteem, loss of interest, anger
Behavioural Characteristics of Depression
Shift in activity, affected sleep/ appetite, aggression, self-harm
Cognitive Characteristics of Depression
Negative thoughts of self/ words, poor concentration, dwelling on negatives, catastrophic thinking
Obsessions
Uncontrollable and irrational thoughts/ images that interfere with functioning, causing anxiety.
Compulsions
Repeated actions or behaviours to relieve anxiety caused by obsessions
Cognitive characteristics of OCD
Obsessive, irrational, intrusive thoughts, catastrophic thinking, hyper-vigilance
Behavioural characteristics of OCD
Compulsions to reduce anxiety, avoidance
Emotional characteristics of OCD
Anxiety and distress, depression, guilt/ distress
Mowrer 1947- Two Process Model for Phobias
- Classical conditioning (initiation)
- Negatively reinforced by operant conditioning (maintenance)
Two Process Model Evaluation
- Diathesis stress model- not everyone develops a phobia from trauma- genetic vulnerability manifest if triggered.
- May forget event.
- Many phobias are different.
- Cognitive
- Ignores biology
Sue et al 1994- phobia events
- People often recall specific events.
- Different phobias result of different processes.
Ost 1987- phobia
People might have forgotten.
Engels et al- phobia cognitive
Ignores cognitive factors- social phobia more responsive to CBT.
Seligman 1970- phobia biological
Animals programmed to fear threatening stimuli.
Bregman 1934- conditioning phobias failed
Failed to condition a fear response in infants pairing a loud bell with wooden blocks- behaviourism can’t alone explain, nature vs nurture.
Wolpe 1958- Systematic Desensitisation
- Relaxation techniques
- Anxiety hierarchy
- Gradual exposure to each level (counter-conditioning)
Systematic Desensitisation Evaluation
+ Effective
+ Doesn’t involve trauma- low refusal/ dropout rates
- Still some ethical issues
- Individualised- expensive/ time consuming
- Biological
McGrath 1990- SD effectiveness
75% of people with specific phobias improved with SD.
Gilroy 2003- SD study
Followed up with 42 patients treated for spider phobia in 3 45 minute sessions of SD. Control group treated with relaxation. At 3 months and 33 months the SD group was less fearful.
Ohman 1975- SD biology
SD not effectively treating phobias with an underlying evolutionary survival component.
Flooding
Places client into a situation with phobia until the relax- extinction of phobia (can be in vivo (real) or virtual.)
Flooding evaluation
- Ethically challenged due to traumatic nature.
+ Effective - Individual differences - not effective for all.
- Less effective for complex phobias as it doesn’t tackle irrational thoughts.
Choy et al- flooding effectiveness
SD and flooding effective but flooding more effective.
Craske et al 2008- SD/ flooding effectiveness
SD and flooding equally effective.
Aaron Beck 1967- Negative Triad
Negative triad- depressed people have acquired a negative schema during childhood- tendency to adopt a negative view of the world, future and self. Focus on negatives so become depressed.
Albert Ellis 1962- ABC Model
ABC Model- activating event causes belief that’s rational or irrational which affects the consequential behaviour.
Albert Ellis- Mustabatory thinking
Mustabatory thinking- thinking that ideas must be true to be happy, e.g. I must do well or I am worthless.
Depression Cognitive Explanation Evaluation
+ Research support
- Blames client
- Are depressed people just realistic?
- Serotonin/ biology
- Doesn’t explain without an event
- Ignores situation
Hammen and Krantz 1976- depression logic
Depressed participants made more errors in logic when asked to interpret material.
Bates et al 1999- depressed people worsen
Depressed participants given negative thought statements became more depressed.
Cuijpers et al 2013- CBT vs Drugs
CBT best with drugs. Review of 75 studies found it was superior to no treatment- biology.
Alloy and Abrahmson 1979- depressed people realistic
Depressed realists tend to see things for what they actually are.
Zhang et al 2005- depression serotonin
Low serotonin levels in depressed people.
CBT
Changing irrational thought processes by focusing on affect (feeling), behaviour and cognition.
Ellis- REBT
‘Rational Emotional Behavioural Therapy (REBT)’- first form of CBT. Disrupt negative thoughts with effective ones: ABCDEF- activating events, beliefs, consequences, disrupting irrational thoughts, effects/ effective attitude, new feelings. Involves homework, behavioural activation and unconditional positive regard. Claimed 90% success rate with an average of 27 sessions.
Logical Disputing
Challenging beliefs that don’t make logical sense.
Empirical Disputing
Challenging beliefs inaccurate to reality.
Pragmatic Disputing
Challenging beliefs that aren’t useful.
Behavioural activation
Client takes part in pleasurable activities.
Unconditional Positive Regard
Therapist always positive and supportive- make client feel worthy.
CBT/ REBT Evaluation
- Best with drugs
- Not the best for rigid believers
- Stress
+ Research support
+ Equally effective
+ Ellis- 90% success rate with an average of 27 sessions.
Simons et al 1995- stress CBT
High levels of stress causing depression cannot be resolved with CBT.
Elkin et al 1985- CBT rigid believers
Less suitable for those with rigid irrational beliefs.
Babyak et al 2000- behavioural activation
Behavioural change can alleviate depression. Studied 156 depressed adults, assigned a four month cause of either aerobic exercise, drug treatment, and a combination. The exercise group had lower relapse rates.
Rosenzweig 1936- CBT effectiveness
All methods of treating mental disorders are equally effective.
COMT Gene OCD
Gene involved in production of COMT enzyme which is responsible for clearing the synapse.
Tukel et al 2013- COMT
Lower levels of activity of COMT gene lead to high levels of dopamine as genes not clearing synapse- cause OCD compulsions.
SERT Gene
Increase in transporter proteins so less serotonin in synapse due to faster rate of uptake.
Ozaki et al 2003- SERT
Mutation of SERT gene in 2 unrelated families where six out of seven family members had OCD.
OCD Biological Evaluation
+ Research support
+ Twin studies
- Comorbidity
+ MRI scanning techniques
- Gene mapping/ turning off expressive genes.
Nestadt et al 2000- family members OCD
80 patients with OCD and 343 of their relatives compared with 73 control patients and 300 relatives. Found that people with relatives with the illness had a 5 times greater chance of having it.
Billett et al 1998- twin studies
MZ twins twice as likely to develop OCD if their twin had the disorder.
Pauls and Leckman 1986- OCD Tourette’s
Patients with Tourette’s and found OCD is one form of expression of the same gene.
Rasmussen and Eisen 1992- OCD depression
2 out of 3 with OCD also experience at least one depressive episode.
Menzies et al 2007- MRI OCD
Used MRI to produce images of brain activity in OCD patients and immediate family members. OCD patients had reduced grey matter.
Lewis 1936- OCD family members
Observed that of OCD parents, 37% had parents with OCD and 21% had siblings with OCD- genes.
Selective Serotonin Re-uptake Inhibitors SSRIS
Inhibit re-uptake of serotonin to increase levels in the synapse.
Tricyclics
Block transporter proteins to increase levels of serotonin and noradrenaline- more side effects.
Benzodiazepines BZs
Slow down CNS activity by enhancing activity of GABA- natural anxiety reducer. Calms neurones by opening an channel to increase flow of chloride ions. Ions make it harder for neurone to be stimulated.
Drug Treatments for OCD Evaluation
+ Effective
- Only treats symptoms not cause
- Turner et al- drug companies fund research- potential bias.
+ Very little patient input/ cheap.
- Side effects including nausea, headaches and insomnia + more violent ones like hallucinations, palpitations, memory impairment, aggression and addiction for BZs /tricyclics.
Gava et al 2007- OCD drugs
Most common treatment for OCD is drugs.
Soomro et al 2008- SSRIs vs placebo
Reviewed 17 studies of SSRIs with OCD and found them to be more effective than placebos.
Koran et al 2007- CBT and drugs OCD
CBT should be used too to provide long term help.
Szechtman et al 1998- drugs research support
Animals given high dopamine drugs experienced compulsions.
Pigott et al 1990- anti-depressants for OCD
Anti-depressants reduced OCD symptoms.
Abnormal levels of neurotransmitters
- High dopamine = OCD, Low serotonin = OCD.
Abnormal brain circuits
Caudate nucleus (base of basal ganglia) usually suppresses orbito-frontal cortex’s warnings. OFC sends warnings to thalamus, so if not suppressed due to damage to caudate nucleus the thalamus will keep receiving unnecessary minor warnings- worry circuit.
- Comer- serotonin major role in operation of OFC and caudate nucleus.
