Psychopathology Flashcards
What is the psychodynamic perspective on abnormal psychology?
Mental disorders originate in intrapsychic conflict produced by the id, ego and superego
What is the medical perspective of abnormal psychology?
- Originated with Hippocrates who thought that an excess in the 4 humours (black bile, yellow bile, blood and phlegm) led to emotional problems
- Now thought that mental disorders are caused by specific abnormalities in the brain
What is the cognitive behavioural perspective of abnormal psychology?
Mental disorders are learned maladaptive behaviour patterns that can be best understood by focusing on environmental factors and a person’s perception of those factors
What is the humanistic and sociocultural perspective of abnormal psychology?
Mental disorders arise when people believe that they must earn the positive regard of others
What is the diathesis-stress model?
The combination of a person’s genetics and early learning experiences yields a predisposition for a particular mental disorder, but the disorder will only develop if the person is exposed to stressors which exceed their coping ability
Which two systems are used to classify mental disorders?
- Diagnostic and Statistical Manual IV (DSM-IV)
- International Classification of Diseases 10 (ICD-10)
What is Axis I?
Information on major clinical syndromes
What is Axis II?
Personality disorders
What is Axis III?
Physical disorders accompanying the psychological disorder (skin rashes etc.)
What is Axis IV?
Specifies the severity of stress that the person has encountered
What is Axis V?
Describes the person’s overall level of psychological, social or occupational functioning
What is the unit of Axis V?
Global Assessment of Functioning (GAF)
What does GAF 100 mean?
No/nearly no absence of functioning
What does GAF 50 mean?
Serious problems in functioning
What does GAF 10 mean?
Impairments which may result in injury to oneself or others
Problems with the DSM?
- Tends to be more consistent with the medical approach; treatments emphasise biological factors
- Cognitive and environmental determinants may be overlooked
- Questionable reliability due to complex nature of diagnosis
- Encourages false-positives
Who is cited in the text as one of the first to challenge the practice of witchcraft?
Johann Wier
Who believed that patients would respond to kind treatment?
Philippe Pinel
What does the id represent?
Biological urges
What does the superego represent?
Moral dictates of society
What does the ego represent?
Reality
What is a dream’s manifest content?
The actual images and events which occur in the dream
What is a dream’s latent content?
The hidden meaning or significance of the dream
What criteria must people meet to be considered for psychodynamic therapy?
- Intelligent
- Articulate
- Motivated to spend 3 hours a week working hard to uncover unconscious conflicts
- Be able to afford therapist fees
Evaluation of the psychodynamic approach to therapy
- Many people not eligible/don’t complete course of treatment: sample is not representative so cannot conclude this therapy works
- Therapists can blame the patient when it doesn’t work
What is the aim of humanistic therapy?
To release one’s potential for personal growth (which psychological problems are blocking)
The discrepancy between the real and the idea perceptions of self is called ______
Incongruence
Client-centred therapy involves…
- The client decides what to talk about with their therapist without direction or judgement from the therapist
- The client is responsible for solving their own problems
- Aim is to reduce incongruence by fostering experiences which will make the attainment of their ideal self possible
What is Gestalt therapy?
Emphasises the unity of the mind and body by teaching the client to get in touch with body sensations and emotional feelings hidden from awareness
Evaluation of Gestalt therapy
- Not suitable for serious psychoses
- Most effective for intelligent, motivated people
What is systematic desensitisation?
- The client is taught how to completely relax
- The client and therapist construct a hierarchy of anxiety-related stimuli
- The conditioned stimuli are paired with stimuli which elicit relaxation
What is aversion therapy?
A negative reaction to a neutral stimulus is caused by pairing it with an aversive stimulus e.g. painful electric shocks when seeing shoes to get rid of a fetish
What is behaviour modification?
The use of rewards/punishments to increase positive/reduce negative behaviours
What is a token economy?
A list of tasks is complied and residents gain tokens for each task performed, which they can later exchange for snacks or other desired articles
What is Cognitive Behavioural Therapy?
A focus on changing the client’s maladaptive thoughts, beliefs and perceptions in an attempt to therefore change their behavioural outcomes
Evaluation of CBT?
- Symptom focused rather than focusing on the root cause
- Removal of one symptom will simply result in another potentially more serious one - symptom substitution
What are the advantages of group therapy?
- Allows the therapist to observe real interactions and not rely on the patient’s description
- A group brings social pressure, if someone receives the same comments from all members it will be more powerful
- Seeing the causes of maladaptive behaviour in others can help with insight into one’s own problems, learning from the mistakes of others
- Knowing that other people have similar problems can bring comfort
What are the main classes of drugs used in psychopharmacological interventions?
- Antipsychotic drugs
- Anti-depressant drugs
- Anti-manic drugs
- Anti-anxiety drugs
What is ECT?
- Electroconvulsive therapy
- Electrodes are placed on a person’s head and a brief electrical current is passed through them
- Reduces depression symptoms immediately (compared to 10 - 14 days for anti-depressants)
Problems with ECT
- Can cause permanent memory loss
- Administered only to the right hemisphere now to reduce verbal memory loss
What is psychosurgery?
Brain surgery to treat psychological disorders
What psychosurgery used to be performed?
Prefrontal lobotomy
What psychosurgery is performed now?
Cingulotomy (cutting of the cingulum bundle)
Evaluation of the biological approach to treatment
- Drugs are only effective for the period of use
- People forget to take their drugs
- Psychosurgery is extreme and controversial
Anxiety definition
The sense of apprehension or doom that is accompanied with physiological reactions such as increased heart rate, sweaty palms and tightness in the stomach
What are the most important anxiety disorders?
- Generalised anxiety disorder
- Panic disorder
- Phobic disorder
- Obsessive-compulsive disorder
- Post-traumatic stress disorder
What is generalised anxiety disorder?
- Excessive worry about all aspects of a person’s life: health, money, work, relationships etc.
- Must be present on most days for at least 6 months
- Difficult to control the worry
- At least 3 symptoms
What are the symptoms of GAD?
- Restlessness
- Easily fatigued
- Difficulty concentrating
- Irritability
- Muscle tension
- Sleep disturbance
Borkovec’s aetiology of GAD (1994)
- Arises from the individual’s drive to set and anticipate a set of goals which are desirable
- Anxiety arises when there is a history of frustrated failure which affects the perception of cues associated with the goals
Eysenck’s aetiology of GAD (1992)
- Worry or anxiety serves as an alarm function which brings information concerning threat-related stimuli to awareness
- Prompts individuals to anticipate future situations and their solutions
Gray’s aetiology of GAD (1982)
Anxiety is evoked by signals of….
- Punishment
- Lack of reward
- Novel stimuli
- Innate fear stimuli
The individual detects threats by means of a behavioural inhibition system (BIS) which also generates anxiety
What is the two-factor model?
Individuals exhibit a vulnerability to anxiety owing to high trait anxiety and poor coping skills
Treatment for generalised anxiety disorder
- Benzodiazepines
- Barbiturates
- Antidepressants
- CBT
What is panic disorder?
- Panic = a fear of fear
- People with panic disorder suffer from episodic acute anxiety attacks
- Onset in young adulthood (rarely starts after age 35)
Genetic explanation of panic disorder
- Seems to be a hereditary component
- 30% first-degree relatives of a person with panic disorder also have it
- Pattern suggests it is caused by a single dominant gene
Clark’s model of panic disorder
- Panic attacks are caused by catastrophic misinterpretation of bodily events
- Slight changes in bodily sensation are interpreted as a threat and so anxiety occurs
- More anxious they become the more intense the bodily sensations
- Hypervigilance - the individual repeatedly checks for changes in body sensation
- Avoidance strategies - the individual avoids behaviours they feel will exacerbate the bodily sensations
Treatment for panic disorders
- CBT
- Cognitive restructuring
- Antidepressants
- Anxiolytics
What is a phobic disorder?
Irrational fear of specific objects or situations which make life difficult for the individual
What is agoraphobia?
Fear of open spaces
What is social phobia?
Exaggerated fear of one or more situations in which the person is exposed to possible scrutiny by others and fears that he or she may do something or act in a way that will be humiliating or embarrassing
What is specific phobia?
All other phobias such as fear of snakes, spiders, darkness or heights
Aetiology of phobic disorders
- Preparedness hypothesis for animal phobias
- Pairing of a phobic object with an aversive stimulus so phobic stimuli become phobic by association
- Inherent fear of disease (animals like slugs seem disgusting)
Treatment of phobic disorders
- Systematic desensitisation
- Modelling
What is post-traumatic stress disorder?
Anxiety that follows a traumatic event
Symptoms of PTSD
- Re-experiencing the feelings related to the event (memories, intrusive thoughts and images)
- Avoidant behaviour
- Arousal such as hypervigilance for trauma related stimuli
- Sadness
- Guilt
- Anger
Aetiology of PTSD
- There is first a stunned reaction to the trauma
- Then a feeling of information overload
- Such information cannot be accommodated in existing schemata and so the individual puts up defence mechanisms such as denial
- Completion tendency keeps the memory alive with flashbacks/nightmares
Treatment of PTSD
- Debriefing appears ineffective
- Drug treatment has mixed success
- Exposure treatment seems to be effective
What is obsessive-compulsive disorder?
Individuals suffer from thoughts which will not leave them (obsessions), and behaviours that they cannot keep from performing (compulsions) which interfere with their daily life
Aetiology of OCD
- Obsessions may serve as devices to occupy the mind and displace painful thoughts
- May engage in checking behaviour to reduce the anxiety caused by fear of being perceived as incompetent and avoid others’ criticism
- Associated with Tourette’s syndrome
Treatment of OCD
- Behavioural exposure therapy
- SSRIs
What is a somatoform disorder?
A bodily or physical problem for which there is no physiological basis. The two most important are somatisation disorder and conversion disorder
What categories do the somatisation disorder symptoms fall into?
- Gastrointestinal
- Pain
- Cardiopulmonary
- Pseudoneurological
- Sexual
- Female reproductive
What does the work hysteria mean in Greek?
Uterus
Aetiology of somatisation disorder
- Genetic link - 20% first degree female relatives also have the disorder
- Closely associated with antisocial personality disorder
What is conversion disorder?
Physical complaints which resemble neurological disorders but have no underlying organic pathological basis
What are the symptoms of conversion disorder?
- Blindness
- Deafness
- Loss of feeling
- Paralysis
Aetiology of conversion disorder
Psychic energy of unresolved conflicts becomes displaced into physical symptoms
Treatment of conversion disorder
- Behavioural therapy
- Rewarding ways of adapting and coping with the illness
What are dissociative disorders?
Anxiety is reduced by a sudden disruption in consciousness, which in turn produces changes in one’s sense of identity
What is dissociative identity disorder?
Very rare disorder which is characterised by two or more separate personalities within the same individual, either of which may be dominant at any given time
What is psychogenic amnesia?
A person forgets their past life, in which the conflicts occurred, and begins a new one
What is a psychogenic fugue?
A special form of amnesia in which a person chooses to leave home and start a new life elsewhere
Aetiology of dissociative disorders
Usually explained as responses to severe conflicts resulting from intolerable impulses or as responses to guilt stemming from an actual misdeed
Treatment of dissociative disorders
- Patient recounting their past and present traumas
- Acknowledging and accepting these traumas to avoid the need to dissociate
- Anti-anxiety drugs may be prescribed
What is antisocial personality disorder?
A failure to conform to standards of decency, repeated lying and stealing, failure to sustain long-term and loving relationships, low tolerance of boredom and complete lack of guilt
Aetiology of antisocial personality disorder
- Unresponsive autonomic nervous system therefore no anticipatory fear of punishment
- Little or no emotional response to other people, less likely to from relationships
Treatment of antisocial personality disorder
- No standard, effective treatment
- Treatment usually focusses on anger management or reducing sexually deviant behaviour
What is the name of a less severe form of depression?
Dysthymic disorder
What is the name of a less severe form of bipolar disorder?
Cyclothymic disorder
Dysthymic comes from the Greek words for ____ and _____
Bad; sprit
What is mania?
Wild, exuberant, unrealistic activity unprecipitated by environmental events
What is seasonal affective disorder?
Some people become depressed during the winter season when days are short and nights are long
What are the symptoms of SAD?
- Lethargy
- Sleep disturbances
- Low mood
- Craving for carbs resulting in weight gain
What may cause SAD?
It is thought that people with SAD have a defective light-sensitive hormone, melatonin
How is SAD treated?
Exposure to bright light for several hours of the day
What is schizophrenia?
A group of disorders involving distortions of thought, perception and emotion, bizarre behaviour and social withdrawal
What are the positive symptoms of schizophrenia?
- Thought disorders
- Delusions
- Hallucinations
What are the negative symptoms of schizophrenia?
- Flattened emotional response
- Poverty of speech
- Lack of initiative and persistence
- Inability to experience pleasure
- Social withdrawal
What are the different types of schizophrenia?
- Catatonic
- Undifferentiated
- Paranoid
- Disorganised
What is catatonic schizophrenia?
- Patients have various motor disturbances
- They form bizarre, stationary poses for many hours
What is paranoid schizophrenia?
Have delusions of persecution, grandeur (beliefs in one’s power/importance) and control
What is disorganised schizophrenia?
- A serious, progressive and irreversible disorder characterised by disturbances of thought
- Often display emotions which are inappropriate to the context
If both parents are schizophrenic, the likelihood of their child becoming schizophrenic is….
30% or less
Is schizophrenia inherited?
There is support that schizophrenia is heritable, however it is not a simple trait that is inherited, environmental factors are likely an important trigger for the activation of the biological predisposition
What is the dopamine hypothesis of schizophrenia?
Positive symptoms of schizophrenia are caused by overactivity of synapses which use dopamine as a transmitter substance
Which receptor is thought to have an influence on schizophrenia?
- D2 receptors in the striatum
- Antipsychotic medication blocks these
- Cocaine activates these and so makes symptoms worse
Treatment of schizophrenia
D2 antagonists (antipsychotics)
What is the side effect of schizophrenia treatment?
- Tardive dyskinesia
- Often irreversible and untreatable syndrome which results in involuntary lip smacking, grimacing and drooling
What are the symptoms of depression?
- A sad and apathetic mood
- Feelings of worthlessness and hopelessness
- A desire to withdraw from other people
- Sleeplessness and loss of appetite and sexual desire
- Change in activity level to lethargy or agitation
Cognitive aetiology of depression?
Negative statements about themselves strain interpersonal relationships, which results in others withdrawing or failing to initiate social support, which, in turn, reinforces the depressive’s negative statements
According to Beck, depressed people’s thinking is characterised by…
- Self-blame
- Overemphasis on the negative aspects of life
- Failure to appreciate positive experiences
What is the cognitive triad?
Negative thoughts about the self, the present and the future
Biological aetiology of depression?
- Depression results from a depletion in monoamines, dopamine, norepinephrine or serotonin
- The serotonin hypothesis states that serotonin is the most important as SSRIs are seen to be effective treatments
Treatments for depression
- CBT
- Tricyclic antidepressants
- MAOIs
- SSRIs (Prozac)
What is lithium carbonate used to treat?
Bipolar disorder
The need for a comprehensive classification system of psychological disorders was first recognised by?
Kraepelin
Mental health professionals holding the psychodynamic perspective view mental disorders to be the result of…
Intrapsychic conflict
Diagnostic and Statistical Manual of Mental Disorders is to the __________ as International Classification of Diseases is to the __________
American Psychological Association; World Health Organisation
What are the criticisms of the DSM?
- It can be used to label people
- It is biased toward the medical perspective
- It is not perfectly reliable
A person who has suggested that we should not make any attempts to classify and diagnose mental disorders is?
Thomas Szasz
Reasons for developing a system for classifying and diagnosing mental disorders are that
- Accurate classification of a disorder allows researchers to learn more about the causes of that disorder
- Diagnosis of a disorder aids in finding successful treatments for it
- It allows the person with the disorder as well as his or her family members to know what to expect as the disorder runs its course and as mental health professionals attempt to treat the disorder
Mentally ill people who were confined to the earliest mental institutions were treated
Inhumanely
The kind of therapy that is directed at providing people with insight into their unconscious motivations and desires is called
Psychoanalysis
Last night Clare dreamed that the hot water tank located in the attic burst and flooded the house. The bursting of the hot water heater and the flooding of the house constitute the __________ content of the dream
Manifest
The tendency of clients in psychoanalysis to project their attitudes and emotions onto the therapist as a result of “reliving” some of their unpleasant childhood experiences is called
Transference
The tendency of the therapist in psychoanalysis to project attitudes and emotions onto the client while attempting to provide insight into the client’s unconscious is called
Countertransference
The first humanistic therapy was developed by __________ in the 1940s
Carl Rogers
The therapy process that involves teaching the client to relax in the face of progressively more anxiety-producing stimuli is called
Systematic desensitisation
Cognitive behavioural treatment of panic disorder involves what?
Cognitive restructuring
A mental disorder characterised by physical problems for which there is no physiological basis is called a __________ disorder
Somatoform
The word hysteria comes from the Greek word meaning
Uterus
Beck used the term “cognitive triad” to refer to negative thoughts about
- The self
- The present
- The future
A depressed person who makes the statement, “I am a failure at everything I do and I will never be good at anything I do,” is said to have a(n) __________ attributional style
Hopeless
The kind of therapy that is directed at providing people with insight into their unconscious motivations and desires is called?
Psychoanalysis
