Psychopathology Flashcards
Define statistical infrequency
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 behaviour to the rest of the population
What does the normal distribution curve show?
Shows a population average spread of specific characteristics. The mean median and modal scores are all at the highest point, the most common behaviour. At each end there are fewer people with those behaviours
E.g. IQ levels
Why it is a strength that statistical infrequency is objective?
Those who are assessed as being abnormal have been evaluated objectively this is better than other definitions that depend on the subjective opinion of a clinician
What is a criticism of statistical infrequency about the cutoff point?
The psychological community decides the cutoff point for what is statistically rare enough to be defined as abnormal this is a subjective decision with real implications. E.g people just under 70 iq might be refused support
Why is it a criticism of statistical infrequency if not all rare traits are negative?
This definition also includes those people at the higher end of intelligence. A good definition of abnormality shouldn’t identity people with high intelligence as having a psychopathology and in need of support
Why is it a criticism of statistical infrequency for there to be a range of common psychopathologies ?
The nhs found 17% of people surveyed met the criteria for a common mental health disorder so this definition isn’t appropriate when considering society’s high incidence of mental health disorders
Define failure to function adequately
The individual is defined as abnormal if they can’t cope in their daily lives including their ability to interact with the world and meet their challenges
What are the 5 features of rosenhan and seligmans features of failure to function?
Maladaptive behaviour- individuals behave in a way that go against their long term interests
Personal anguish- the individual suffers from anxiety and distress
Observer discomfort- the individuals behaviour causes distress to. Those around them
Irrationality- it is difficult to understand the motivation behind the individuals/unpredictability: unexpected behaviour
Unconventionality-behaviour doesn’t match what is typically expected by society
Why might failure to function adequately be biased?
Decision about whether someone is coping is subjective and based on the clinicians opinion so two observers might not agree on whether someone is managing
Why it is a criticism of FFA that it only includes people who can’t cope?
Psychopaths can often function in society in ways that benefit them personally having lower empathy can lead to success in politics however psychopathy often has negative implications for the people around them
Why is FFA a criticism that not all maladaptive behaviour indicated mental illness?
Taking part in extreme sports to drinking alcohol all risk health so they are arguable maladaptive however most people would disagree that these behaviours indicate mental illnesses
What is a strength of FFA which benefits the persons personal experience?
The definition respects the individual and their own personal experience
Define deviation from social norms?
A social norm is an unwritten expectation of behaviour that can vary from culture to culture and change over time. Additionally what is accepted in one context may not be acceptable in another
E.g. homosexuality, face and hair covering
Why it is a strength that deviation from social norms doesn’t impose a western view ?
It doesn’t impose a western view on other non western cultures so it isn’t ethnocentric and respects other cultures
Why is it a criticism to define people who move to a new culture as abnormal?
People from Afro Caribbean backgrounds living in the uk are seven times more likely to be diagnosed with sz than people living in the uk this is due to category failure which is a western definition of mental illness
Why it is a cirtisicm that deviation from social norms can be seen as punishing people who are trying to express their individuality?
It punishes people that try to express themselves and those who don’t conform to the repressive norms of their culture e.g the world health organisation declassified homosexuality as a mental illness in 1992
Define deviation from ideal mental health?
Marie jahodas definition comes from a humanistic perspective focusing on ways to improve and become a better person rather than dysfunction or deficit
What are the Marie jahodas 6 features of deviation from mental health ?
Environmental mastery- the ability to adapt and thrive in new situations
Autonomy- the ability to act independently and trust in ones own abilities
Resistance to stress- the internal strength to cope with anxiety caused by daily life
Self actualisation- the ability to reach one’s potential through personal growth
Positive attitude towards oneself-characterised by high self esteem and self respect
Accurate perception of reality-the ability to see the world as it is without being distorted by personal biases
Why can deviation from ideal mentla health be seen as culturally biased?
It reflects a western perspective on mental health as it is applied to all people
Many people value playing a role in supporting a family not focusing of them selves
Why is it a criticism of deviation from ideal mental health being strict ?
Many people would be defined as abnormal as its difficult to achieve the criteria
Why is it a strength of DIMH being a holistic approach?
DIMH considers multiple factors in diagnosis and provides a suggestions for personal development and suggests how the problem can be overcome
Define phobia
An extreme and irrational fear of objects or some situations.
What are the behavioural characteristics for phobias?
Avoidance-physically adapting normal behavior to avoid phobic objects
Panic-an uncontrollable physical response and its most likely to happen at the sudden appearance of the phobic object
Failure to function-difficulty taking part in activities required to perform a normal life
What are the emotional characteristics of phobias?
Anxiety- an uncomfortably high and persistant state of arousal making it difficult to relax
Fear-an intense emotional state linked to the fight or flight response a sensation of extreme and unpleasant alertness in the presence of phobia that only subsides when the phobic object is removed
What are the cognitive characteristics of phobias?
Irrational thoughts- negative and irrational mental processes that include an exaggerated belief in the harm the phobic object could cause them
Reduced cognitive capacity- people with a phobia can’t concentrate on day to day actives such as work due to the excessive attentional focus on the phobic objects and constant concerns about potential danger they feel
What are the behavioural characteristics of depression?
Reeducation in activity level- includes lethargy lacking the energy needed to perform everyday activities
Anhedonia is the lack of pleasure usually felt doing enjoyable activism leading to a reduction in social behaviour
A change in eating behaviour: often results in either significant weight gain or weight loss
An increase in aggression:this can be towards other people but these aggressive acts often take the form of self harm
What are emotional characteristics of depression ?
Sadness
Guilt
What are cognitive characteristics of depression?
Poor concentration
Negative schemas: automatic negative biases when thinking about themselves the world and the future
Define ocd
Defined by obsessions which are constant intrusive thoughts that cause high anxiety levels compulsions that are the behavioural response an attempt to deal with the continuous invasive thought processes
What are behavioural characteristics of ocd?
Compulsions- behaviours performed repeatedly to reduce anxiety however any anxiety reduction is only temporary
Avoidance-take or resist actions to avoid being in the presence of objects/situations that trigger obsessions
Social impairment: not ppts in enjoyable social activities. This social withdrawal is often due to difficulty leaving the house without triggering obsessions or the need to carry out compulsions becomes time consuming
What are emotional characteristics of ocd?
Anxiety
Depression
What are cognitive characteristics of ocd?
Obsessions- intrusive, irrational and recurrent thoughts that tend to be unpleasant catastrophic thoughts about potential dangers
Hypervigilance-a permanent state of alertness where the sufferer is looking for the source of their obsessive thoughts
Selective attention-this means the individual with ocd is so focused on the objects connected to the obsession they can’t focus on other things in their environment
Who introduced the two process model and what is it?
Mower
Phobias are acquired through classical conditioning. Phobias are maintained through operant conditioning.
How is phobia acquired through classical conditioning bee example?
NS (bee) - NR (no response)
UCS (sting) - UCR (fear)
UCS (sting) + NS (bee) - UCR(fear)
CS (bee)- CR (fear)
How are phobias maintained with operant conditioning bee example?
The person with the bee phobia will be aware of it and try to avoid it
The avoidance behaviour leads to a reduction in anxiety, which is a pleasant sensation this strengthens the phobia making them more likely to avoid the phobia
Which study supports classical conditioning to acquire phobias?
Watson and rayner little Albert where they paired a rat with hitting a large metal pole behind the child’s head scaring Albert.
A phobic response formed and a fear of rats
What did dinardo counter research to Albert’s experiment ?
Showed while conditioning events like dog bites were common in ppts with dog phobias 56% they were just as common in ppts with no dog phobia 65%
These findings show behaviourists don’t fully explain all phobias
What is a better explanation for phobias?
An evolutionary explanation as spiders and snakes were dangers that many ancestors faced
Those with that fear are more likely to survive and reproduce
How is the behaviourists approach used irl for phobias?
Used in therapy like flooding and desensitisation
Define reciprocal inhibition
Fear and relaxation are two antagonistic emotions as u can’t feel two opposite emotions sitmulatenously
If the therapist can help the client hold the phobic object without fear they have been successfully counter conditioned
What are the 4 stages of systematic desensitisation?
1) therapist teaches the client relaxation techniques like breathing excercsies
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 anxiety hierarchy the client must relax at each stage and they can only move onto the next step when that has happened
4) when the client can hold the phobic object without fear the association is extinct and a new association with relaxation is formed
What are the steps of flooding?
Immediate exposure to max level of phobic stimulus which can cause panic and the therapist has to stop the client from escaping the situation
The client will eventually calm down anxiety will now decrease with the phobia
Why is the client controlling systematic desensitatisation. A strength?
It makes it a more pleasurable experience as they limit their anxiety
Why might the therapy’s not be transferable to real life?
The office environment might not translate to real life experiences
Why is it a limitation that these therapy’s are only good at treating specific phobias?
They can’t treat social phobias
Why are therapies not the only option to treat phobias?
There are drugs like antidepressants which decrease anxiety and are cheaper and less stressful
What are the real life applications of therapies for phobias?
The principles of systematic desensitisation have been applied to virtual reality exposure therapy
Garcia palacios found 83% of ppts treated with vr exposure to spiders showed clinically significant improvement compared to 0% in the control group
Define a cognitive approach of depression ?
Depression is due to irrational thoughts resulting from maladaptive internal mental processes
Define schema
Mental framework/ expectations based on experience. Schemas allow us to quickly process large amounts of sensory information and make automatic assumptions and responses. Negative schemas result in automatically negative schemas result in automatically negative cognitive biases
What is the negative triad and its three features?
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”
This can lead to avoidance social withdrawal and inaction
When does the negative triad develop?
Develops in childhood but provides the framework for persistent biases in adulthood leading to cognitive disortions pericving the world inaccurately
What are the two types of cognitive distortions and what are they?
Overgeneralisation: one negative experience results in an assumption that the same thing will always happen
Selectively abstraction: mentally filtering out positive experiences and focusing on the negative
What are the three features of the Ellis abc model?
A: activating event. It can be anything that happens to someone
B: beleif. For people without depression beliefs about A are rational. People with depression have irrational beliefs
C: consequences. Rational beliefs lead to positive consequences, irrational beliefs lead to to negative C
What is mustabatory thinking ?
The consequence of not accepting we don’t live in a perfect world
The fact that we fail to achieve unrealistic goals othe people don’t behave the way we want them to or an unexpected event happens and ruins our plans leads to disappointment
What research supports the cognitive approach to depression?
Grazioli and Terry assessed the thinking styles of 65 women before giving birth and six weeks after it was found that those women with negative thinking styles were most likely to develop postpartum depression. This supports the idea that faulty thinking leads to depression
What cognitive therapies have come out of the cognitive theories?
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.
Why is it hard to explain some features of some types of depressions ?
Many people with depression also experience anger and people with bipolar depression experience manic phases these features are hard to explain using theories like becks model as schemas are resistant to change
What do families studies suggest about depression and why is that a negative of the cognitive theories?
Family studies and genetic research suggest a predisposition to depression is inherited likely genes that influence the activity of neurochemicals like serotonin in the brain which shows this definition isn’t complete
What do cognitive theories depend on and why is that a criticism ?
Cognitive theories depend on the assumption that the person with depressions thoughts are irrational it could be depression is a reasonable response to the challenges they face for example poverty
How can you use becks cbt to challenge irrational thoughts through cognitive restructuring ?
Patient as a scientist: patient generates and tests hypotheses about the validity of their irrational thoughts
Thought catching: identifying irrational thoughts coming from the negative triad of schemas
Homework tasks: include keeping a diary which is used to record negative thoughts
Behavioural activation: taking part in activities that the sufferer used to enjoy
How does Ellis rebt model work to treat depression?
Dispute: therapist confronting the clients irrational beliefs
Empirical arguments: challenge the client to provide evindence for their thoughts
Effect: reconstructing beliefs leading to better consequences
What research supports the cognitive approach to treating depression?
March randomly assigned 327 patients to one of three groups cbt drug therapy and the thrid group was given a combined treatment of cbt and drug therapy after 36 weeks cbt and drug therapy had an effectiveness rate of 81% cbt also had a more significant reduction in suicidal events than drug treatment the best results came from the combination treatment with an effectiveness rate of 86% and fewer suicidal events than either treatment alone
Why can cbt not be helpful for all people with depression?
Some people with depression are too severely depressed to engage with the demands of cbt therefore drugs maybe a better option
Why is it expensive cbt
Takes a lot of sessions and is a lot of Monet but it’s cost effective for the economy
What is the biological approach ?
Explains mental health conditions as being due to faulty physical process. This explanations includes the physical structure of your DNA inherited from your parents
What is OCD?
OCD affects approximately 1 in 50 people its symptoms include obsessive thoughts and compulsive behaviours.
Obsessive thoughts are repetitive, distressing mental images or concerns that provoke anxiety
Complusions are actions that individuals feel the need to perform to reduce the discomfort caused by these thoughts
What is the genetic explanation to ocd?
There is no one gene for ocd however its thought a vulnerability or predisposition to ocd is inherited from parents
There are 230 separate candidate genes found in people with ocd
This suggests ocd is polygenic
What evidence is there for heritability of ocd?
Evidence comes from family and twin studies as the rate of ocd in the general population is 2% the concordance rate between someone with OCD and a stranger is also 2%
But there’s a 10% concordance rate with first degree relatives and 31% with non identical twins and 68% with identical twins
What are the neural explanations for ocd?
Include biochemical causes an imbalance of neurotransmitters and the large neural structures in the brain that are made of many neurons
How does serotonin affect ocd?
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 post synaptic cell
Serotonin and other neurotransmitters are chemical messengers: presynaptic neurons release neurotransmitters and receptors on the post synaptic neuron detect these if the signal is strong enough then the message is passed on the neurotransmitters detach from the receptors and are taken back to the presynaptic neuron through a process called reuptake this process happens too quickly in people with OCD leading to reduced serotonin levels
What gene is responsible for serotonin transportation in the synapse?
SERT gene
How do neural structures affect ocd? And what is the worry circuit?
The worry circuit is a set of brain structures including the orbitofrontal cortex (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
How does the worry circuit work in normal people?
The basal ganglia filer out minor worries coming from the orbitofronal cortex but if this area is hyperactive even small worries get the the thalamus which is then passed back to the OFC forming a loop(recurring obsessive thoughts
How is the parahippocampal gryus involved in ocd?
An area of cortex close to the hippocampus on the brains 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
How study supports that ocd can be inherited?
Nestadt shows for ocd there is a high concordance rate between close family members non identical twins have a 31% concordance and identical twins have a 68%. MZ and DZ twins grow up sharing similar environments like food,upbringing and education and life events this suggest that the additional shared dna is responsible for the increased concordance
What does the not 100% concordance rate between MZ twins suggest?
The correlation in family and twin studies doesn’t equal causation it may not be shared genetics behind the high concordance rate it may be due to the environment
What could be a more valid response for ocd than biological processes alone? And how does Cromer back this
The diathesis stress model. Individuals inherit a genetic vulnerability to ocd however the disorder doesn’t develop unless there is an environmental factors such as a traumatic life experience.
Cromer showed 54% of 265 ppts with ocd reported at least one traumatic life event and those with traumatic life events reported increased severity of ocd symptoms
What have neuroimaging shown to support neural correlates to cause ocd?
PET scanners have shown hyperactivity in the OFC and the caudate nucleus in people with OCD both while scanning the brain at rest and when symptoms are stimulated but there is a problem with this evidence as they can’t be sure if this is the cause of ocd or the consequence of it
What does soomro meta analysis study suggest about SSRIs?
SSRIs are more effective than placebos suggesting there is a biological aspect to OCD however despite altering levels of serotonin in the synapse within hours these drugs take weeks to reduce synptoms and 40 to 60% of patients show no or just partial symptom improvement this shows low levels of serotonin ares the sole cause of ocd
What is the primary drug to control ocd?
Antidepressant drugs called SSRIs
What are SSRIs and how do they work?
Selective serotonin reuptake inhibitors
Which influence serotonin and act as reuptake inhibitors
They inhibit the reuptake process in the synapse within hours
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 worry circuit
How long do SSRIs take to reduce symptoms and which drugs can be used instead?
3-4months
Anti anxiety meds can be used instead like benzodiazepines these work by enchancing a neurotransmitter called GABA
SNRIS work by increasing serotonin and noradrenaline these drugs can be a replacement if SSRIs fail but these have more side effects
What does soomros meta analysis support about ssris?
Soomro conducted a meta analysis combining the data from 17 studies that compared ssris to placebos in total there were 3097 ppts the results of this showed that ssris significantly reduced the symptoms of ocd compared to placebos between 6 and 17 weeks post treatment. Drug therapy is effective in the short term
Why is it a problem that ssris are tested by companies that created them?
Goldacre points out that most research studies on drug therapies are conducted by the pharmaceutical companies that created them. This means they have a financial interest in showing the drugs are effective
What is good about drug therapy compared to therapy?
Drug therapy is relatively inexpensive and less time consuming
Why do some patients prefer cbt?
Drugs have a range of side effects like nausea heachache and insomnia and people can become dependant on drugs and it takes 4 months to work
Why might drug therapy not be effective when getting rid of ocd?
Doesn’t treat the cause only covers up the symptoms
