Psychopathology Flashcards
Explain what deviation from ideal mental health is (DIMH)
6 criteria that have to be met to achieve ideal mental health: •positive attitude towards ourselves •self-actualism •autonomy •resisting stress •accurate perception of reality •environmental mastery
Give one strength of DIMH
The definition emphasises positive achievements rather than failures and distress - it focuses on the desirable and not the undesirable
Give one limitation of DIMH
Meeting all 6 criteria is unrealistic and everyone has a time where they are unable to meet all 6 criteria however does not mean they have a mental illness
Explain what statistical frequency is (SI)
Researchers and government agencies collect data to inform us as to what is normal. These statistics can be used to define the ‘norm’ for any group of people
Give one strength of SI
Objective : only a way of collecting data about a behaviour has been agreed and a ‘cut off point’ is decided - it becomes an objective way of deciding who is abnormal
Give one limitation of SI
Statistics can also be misleading - they did not include people who are mentally ill but have not seen a professional - so are of part of the official statistics
Explain what deviation from social norms are (DSN)
Behaving in a way that is considered abnormal and not applying to the expected behaviour of a society, however can be seen as abnormal of eccentric
Give 1 strength of DSN
Establishes what behaviour is normal based on the context of the behaviour
Give 1 limitation of DSN
Social norms change over time
E.g. Homosexuality was regarded as a mental illness in 1973
Explain what failure to function adequately means? (FFA)
A person is considered abnormal is they are unable to cope with the demands of everyday living
Give 1 strength of FFA
It allows judgement by others of whether individuals are functioning properly
E.g. GAF
Give 1 limitation of FFA
Most people fail to function adequately at some time, but are not considered abnormal
E.g. Bereavement
Outline what is meant by DSM
Diagnostic and statistical manual of mental disorders- provides a common language and standard criteria for the classification of mental disorders
Outline what is meant by ICD
The international classification of diseases -
Is the standard diagnostic tool for health management and clinical purposes. It is known as a health care classification system that provides codes to classify disease.
What category of disorders are phobias classes as in the DSM and ICD?
Phobias are a types of anxiety disorder
What are the 3 different types of phobias?
-specific phobias : Different subgroups (animals, natural environment, injections, situational
-social phobias :
Involves fear of being observed doing something humiliating
-agoraphobia :
Involves fear of places of assembly, crowds and open spaces and is most prevalent of phobias
What are the emotional characteristics of phobias?
Persistent, excessive fear - phobias produce high levels of anxiety due to the presence of an anticipated of feared objects and situations
What are the behavioural characteristics of phobias?
Avoidant/anxiety response- as confrontation with feared objects and situations produces high anxiety response, efforts are made to avoid the feared object or situation
What are the cognitive characteristics of phobias?
Recognition of exaggerated anxiety- generally phobics are consciously aware that the anxiety levels they experience in relation to their feared objects or situations are overstated
What category of disorder is depression classes as in the DSM/ICD?
Depression is an affective mood disorder involving lengthy disturbance of emotions
What is uni-polar depression?
Just depression on its own
What are the emotional characteristics of uni-polar depression?
- loss of enthusiasm
- constant depressed mood
- worthlessness(those suffering from depression often have constant feelings of reduced worth)
What are the behavioural characteristics of uni-polar depression?
- loss of energy
- social impairment
- weight changes
- poor personal hygiene
- sleep patterns disturbed
What are the cognitive characteristics of uni-polar depression?
- delusions
- reduced concentration
- thoughts of death
- poor memory (some depressives will have trouble with retrieval of memories)
What is bi-polar depression?
When you have both uni-bipolar and the other extreme
What are the emotional characteristics of bi-polar depression?
- elevated mood states
- irritability
- lack of guilt (the condition is characterised by social inhibition and a general lack of guilt concerning behaviour)
What are the behavioural characteristics of bi-polar depression?
- high energy levels
- reckless behaviour
- talkative (the condition is generally characterised by fast, endless speech without regard to what others are saying)
What are the cognitive characteristics of bi-polar depression?
- delusions
- irrational thought processes (often characterised by reckless and irrational thinking and decision making)
What category of disorder is OCD classed as in the DSM/ICD?
OCD is an anxiety disorder
What are the 2 main components of OCD?
- obsessions
- compulsions
Explain what is meant by obsessions and compulsions? Inc examples
Obsessions - things people think about e.g. Forbidden or inappropriate ideas and usual images
Compulsions - what people do as a result of obsessions e.g. Intense, uncontrollable urge to repetitively perform tasks and behaviours
What are the emotional characteristics of obsessions?
-extreme anxiety (persistent inappropriate or forbidden ideas create excessively high levels of anxiety)
What are the behavioural characteristics of obsessions?
- hinder everyday functions
- social impairments (the anxiety levels generated are so high as to conduct meaningful interpersonal relationships
What are the cognitive characteristics of obsessions?
-recurrent and persistent thought
Recognised as self generated(most sufferers understand their obsessional thoughts; impulses and images are self invented)
-realisation of inappropriateness
-attentional bias
What are the emotional characteristics of compulsions?
Distress- the recognition that compulsive behaviours cannot be consciously controlled can lead to strong feelings of distress
What are the behavioural characteristics of compulsions?
- repetitive (sufferers feel compelled to repeat behaviours as a response to their obsessive thoughts, ideas and images)
- hinders everyday functioning
- social impairment
What are the cognitive characteristics of compulsions?
- uncontrollable urges
- realisation of inappropriateness (sufferers understand their compulsions are inappropriate but cannot consciously control them)
What is the two-process model?
Orval Hobart Mowrer in 1947 proposed the two process model to explain how phobias are learned. The first stage is classical conditioning and then, in the second stage operant conditioning occurs. These two processes can explain the initiation and maintenance of a phobia
Outline the case of Little Albert using the terms UCS/UCR/NS/CS/CR to explain how he learned to fear a white rat
Classical conditioning UCS: will produce fear and crying (loud noise) UCR: fear NS: white rat CS: white rat CR: fear
What is a way of explaining how phobias are maintained?
Operant conditioning involves learning through reinforcement
- if behaviour is rewarding it is said to be reinforced and this increases the chances that it will be repeated
- there are two types of reinforcement
What are the 2 types of reinforcement? Explain them
POSITIVE REINFORCEMENT:
A behaviour is more likely to happen again because you get something pleasant
NEGATIVE REINFORCEMENT:
A behaviour is more likely to happen again because of avoidance of negative, unpleasant consequences
Explain how positive and negative reinforcements explain phobias
Avoidance of the feared object/situation is rewarded by a reduction of anxiety (fear) and acts as a negative reinforcer. This makes it likely the avoidance response will be repeated again
How could the principles of SLT explain the imitation of a phobia?
SLT could explain certain terms of abnormal behaviour (phobias) if a child sees a parent (model) responding to a spider with extreme fear, this may lead the child to acquire a similar behaviour because the behaviour appears rewarding (attention)
Why does the effectiveness of treatments that use behaviourist principles lend support to the theory? (Strengths of behavioural approach explaining phobias)
- behavioural therapy is very effective (about 85% success)
- therapists involve counter conditioning where by a fear response to an object or situation is replaced with a relaxation response. This is a form of classical conditioning
Does everyone who has a phobia recall a traumatic event that could of caused it? (Weakness of behavioural approach explaining phobias)
Some people with a phobia can’t recall ever experiencing their feared objects (e.g. Only 7% arachnophobic recall encountering a spider -Davey -1992)
An indent may have been simply forgotten or perhaps they have repressed a memory of a frightening encounter
How can the two-process model be criticised?
Ignores the cognitive approach
- phobias are an example of irrational beliefs. People with a phobia may process threatening stimuli differently
- irrational thinking may lead to a phobia
What is systematic desensitisation?
A behavioural therapy where people gradually desensitised to a feared object/situation. This is done by using gradual exposure from the least up to the most feared situation
Based on the idea of counter balancing
How does systematic desensitisation work?
1) the patient is taught muscle relaxation techniques
2) the therapist and patient construct a hierarchy of anxiety provoking situations
3) patient works through the desensitisation/ fear hierarchy
4) when patient remains calm, they can move onto the next step
5) the patient successfully masters the feared situation
What has research shown in terms of effectiveness of systematic desensitisation when treating patients with anxiety?(refer to Emmelkamp 1994)
The ability to tolerate imagined situations is followed by a reduction in anxiety in real life situations
Can you identify any other strengths of this therapy compared to others, such as drug therapy and ECT?
No major side effects and it can be self administrated after training
Give 1 other strength for systematic desensitisation
It works for many- success especially for specific phobias- but works for a range of phobias (McGrath et al. 1990) has 75% success rate- higher rate than for other types of therapy
In treating an abnormality with systematic desensitisation, symptom substitution may occur. What is meant by this concept? How has research challenged this assertion?
Does not deal with underlying causes and can lead to symptom substitution
Systematic desensitisation- in vitro- requires a very vivid imagination. What is the problem with this? What has research found in term of the effectiveness of in vitro procedures compared to in vivo procedures?
Requires a vivid imagination- not everyone can do this
-research has found that in vivo procedures are generally more successful and more effective than in vitro procedures
Are there any faster acting alternatives to systematic desensitisation?
- flooding involves real exposure to a feared object / situation BUT without taking the steps (as in SD) escape is prevented and the therapists forces the person to continue
- eventually anxiety will decrease. Flooding can cause intense anxiety and lead to drop out - ethical issues are also involved
Define desensitisation hierarchy
Process of trying to relax and stay calm whilst using either vivo (using a real object or situation) or vitro (using an imagined object or situation)
Explain one advantage of flooding compared to systematic desensitisation in the treatment of phobias
Flooding does not involve any steps, and is a harsh/quick yet effective way of getting rid of a phobia. Exposing the patient to a direct fear means anxiety is often over faster than when using systematic desensitisation
Give one limitation of flooding as a treatment of phobias
Flooding can cause intense anxiety and eventually drop outs, ethical issues also take a role in limitations
Outline how flooding is used in the treatment of phobias
Instead of using step-by-step approach, patients go straight to the top of the hierarchy and imagine, or have direct contact with, their most feared object / situation. The patient is unable to leave the room or stop
What are the assumptions of the cognitive approach about the origin of behaviour?
Suggests thinking shapes behaviour
Define schema
A cognitive framework that helps organise and interpret information. A schema helps an individual male sense of new information
what did Beck in 1987 believe?
People become depressed because the work is seen negatively though negative schemas
Explain Beck’s Negative Triad
- people become depressed because the world is seen negatively through negative schemas
- these negative schemas dominate thinking - leading to a negative view of the world, and are triggered whenever individuals are in situations that are similar to those in which negative schemas were learned
What did Beck propose?
That negative schemas develop during childhood and adolescence when authority figures such as parents place unrealistic demands on an individual and are highly critical of them, therefore the schema leads them to expect to fail
What is selective abstraction? (Cognitive biases?
Conclusions drawn from just one part of a situation
What is overgeneralisation? (Cognitive biases)
Sweeping conclusions drawn on the basis of a single event
What did Ellis (1962) believe? (ABC model)
Believed that irrational thinking could was to psychological disturbances, mainly due to the fact that individuals fall into a cycle of irrational thinking, which prevents the individual from behaving in an adaptive way
What is meant by adaptive in this context? (Ellis’ ABC model)
Being rational, it is a healthy response to a situation
What does the ‘A’ stand for in Ellis’ ABC model?
ACTIVATING EVENT - something happens in the environment around you
What does the ‘B’ stand for in Ellis’ ABC model?
BELIEFS- you had a belief about the event or situation
What does the ‘C’ stand for in Ellis’ ABC model?
CONSEQUENCE- you have an emotional response to your belief
Use PEC to explain why the cognitive approach has therapeutic success
P: CBT has been found to be a very successful therapy for treating depression
E: it is one of the best treatments for depression, especially in the conjunction with drug treatments
C: the fact that cognitive therapy is successful adds support to cognitive explanations for depression
Give positive research support for the cognitive approach explaining depression
Hammen and Krantz (1976) found that depressed participants made more errors in logic when asked to interpret written material that non-depressed participants.
This support the cognitive theory as it shows that when depressed you are biased in your thinking. The cognitive approach suggests that depression is linked to irrational thinking
Explain how the cognitive approach to explaining depression lacks cause-effect (negative)
There is no link between negative thoughts and depression, however this does not mean negative thoughts cause depression. It could be that depression leads to more negative thinking
Explain how the cognitive approach to explaining depression does not acknowledge current situational factors (negative)
Some argue it is important to consider situational factors such as family problems, money problems and life events making a negative contribution to mental health problems
Negative/irrational beliefs may be realistic… explain how… (cognitive approach to explaining depression)
Not all irrational beliefs are irrational- they may simply seem irrational.
Alloy & Abrahmson (1979) suggest that depressive realists tend to see things for what they really are.
So, some irrational beliefs may actually be rational
What does CBT stand for?
Cognitive behavioural therapy
Why use CBT?
- the rationale behind CBT is that thought interact with and influence emotions and behaviour
- if thoughts are persistently negative and irrational, they can lead to maladaptive behaviour
What is CBT?
- to encourage people to examine beliefs and expectations underlying unhappiness to replace irrational, negative thoughts with a more positive, adaptive pattern of thinking
- therapists and clients work together to set new goals for the clients to bring about more realistic and rational beliefs that are incorporated into their thinking
What does CBT involve?
- cognitive element
- behavioural element
What is the cognitive element? (CBT)
A therapist encourages the client to become aware of beliefs that contribute to anxiety or depression or are associated with general dysfunctions. The client needs to understand better where their faulty thinking is leading them
What is the behavioural element? (CBT)
The client and therapist works together by doing role play or homework assignments. The aim is to make the client recognise the consequences of their faulty thinking. Client and therapist work together to set goals. Done in stages, client builds on their own success
Explain what REBT is
Ellis,1962 -believed that it's not the beliefs that lead to self-defeating consequences. Therefore REBT focuses on encouraging patients to challenge or dispute any self defeating beliefs, replacing them with effective, rational beliefs •logical disputing •empirical disputing •pragmatic disputing
Explain what these are: REBT
•logical disputing
•empirical disputing
•pragmatic disputing
•logical disputing :
Self defeating beliefs do not follow logically from the information available
•empirical disputing :
Self defeating beliefs may not be consistent with reality
•pragmatic disputing :
Emphasises the lack of usefulness of self defeating beliefs
Describe 2 other different types of CBT. (Apart from REBT)
- beck’s cognitive therapy- mainly used to treat people with depression, encouraging clients to monitor situations where they make negative assumptions
- Meichenbaum’s Stress Inoculation Therapy (SIT) -a type of CBT used to manage stress
Why is CBT a good long-term treatment? (Strength)
P:there may be long term beliefs for some people using CBT
E:because once they learn techniques to deal with negative irrational thinking these skills can be used in as range of situations. It is a skill that once developed could be potentially be used over a lifetime
C: this is a positive thing because teaching people to deal with potential problems will reduce their chances of developing depression
Why may CBT not be effective for everyone? (Weakness)
CBT may not work for everyone. For some they may find it difficult to work with a therapist & focus on their thinking. For patients who find it hard to concentrate, CBT may not be suitable. People with depression often find it hard to concentrate.
Also, some people may not want to talk about inner feelings. Also, CBT may not be treating the cause of the depression such as having no money and being in debt.
How is CBT cost and time effective? (Strength)
The application (and success) of CBT can occur over a very short time period compared to other treatments. It is therefore more cost effective to carry out
Explain what the ‘worry circuit’ is
The OFC (orbitofrontal cortex) sends ‘worry’ signals to the thalamus. These are normally suppressed by the caudate nucleus but, if damaged, then the thalamus is alerted and confirms the ‘worry’ to the OFC, creating a worry circuit
What is a gene?
A part of the chromosome of an organism that carries information in the form of DNA
What does the orbitofrontal cortex do?
The OFC sends signals to the thalamus about things that are worrying, such as germs
What does the caudate nucleus do?
Normally suppresses signals from the OFC
What are the 2 biological approaches to explaining OCD?
- genetic explanations
- neural explanations
What does genetic explanation mean?
A popular explanation for mental disorders such as OCD is that they may be inherited. This would mean that an individual inherits a specific gene from their parents that relates to the onset of OCD
What 2 genes are involved in the genetic explanation of explaining OCD?
- COMT gene
- SERT gene
What is the COMT gene short for?
Catechol-O-methyltransferase
What is the COMT gene?
Is involved in the regulation of the neurotransmitter dopamine. Dopamine has been implicated in OCD. All genes come in different forms, known as alleles, and one form of the COMT gene has been found to be more common in patients with OCD. This variation of the gene produced lower activity of the COMT gene and so results in higher levels of dopamine
What does the SERT gene do?
Affects the transport of serotonin, creating lower levels of the neurotransmitter
Explain why some people may possess both the COMT and SERT gene, yet never develop OCD whilst others do
It may be the case that there is an interaction between genes and the environment- the gene may provide a genetic predisposition (vulnerability) to developing OCD, and this is triggered by another factor, perhaps from the environment
When looking at neural explanations for explaining OCD, explain how dopamine and serotonin may be involved in OCD
P:evidence for the role of serotonin in OCD comes from Hu(2006) who compared serotonin activity in 169 OCD sufferers
E: and found that serotonin levels were lower in the OCD patients
C: which support ls the idea that low levels of serotonin are associated with the onset of OCD
When looking at neural explanations for explaining OCD, explain how dopamine and serotonin may be involved in OCD in ANIMALS
Animal research has shown that when drugs that increase levels of dopamine are administered, the animal often displays stereotyped movements that resemble compulsive behaviours found in patients with OCD (Szechtman et al, 1998)
What does the fact that there is not a 100% concordance rate between MZ twins for OCD suggest? (Weakness in the evaluation of biological explanations for OCD)
This suggest that there must be other possible causes of OCD (e.g. Environment) because it was genetic then there should be 100% concordance rates e.g. If one identical twin has OCD, then you would expect to find their twin also suffering from OCD, but you don’t always find this
What does the meta-analysis by Grootheest et al (2005) suggest? (Strength of the evaluation of biological explanations for OCD)
- findings suggest that twin studies indicate a genetic component to the transmission of OCD.
- heritability of OCD appears to be greater in children than adults
Explain why there is an issue of cause-effect within neural explanations
- we can’t say for sure that the biological factors identified (low levels of serotonin , abnormal brain circuits) and causing OCD as it could be the case that they are an effect of the OCD
- this presents issues of cause-effect within this theory and as such reduces its validity
Why does the fact that some anti-depressants, which increase levels of serotonin, alleviate symptoms of OCD in some patients support this explanation?
P:it suggest that low levels of serotonin are linked to OCD
E: for example, some anti-depressants increase the availability of serotonin, which in turn have been shown to reduce the symptoms of OCD
C: this seems to strongly link serotonin as a possible explanation of OCD symptoms
What is the anti-depressant drug?
SSRIs
What is the anti-anxiety drug?
BZs
Explain how SSRIs work
Serotonin is released into the synapse from one neuron. It targets receptor cells on the receiving neuron at receptor sites and afterwards is reabsorbed by the initial neuron sending the message. In order to increase levels of serotonin at the synapse, and increase stimulation to the receiving neuron, this re-absorption (re-uptake) is inhibited
Explain the role of GABA and why BZs can help the symptoms of OCD
- These are 2 of the most prescribed drugs for psychological disorders and they can be very effective against states of stress and anxiety
- they appear to act by reducing ‘BRAIN’ arousal
- BZs help by enhancing the action of a natural brain chemical called gamma-amino-butyric acid(GABA)
- GABA has a general ‘quieting influence’ on many of the neurons in the brain
- BZs work by boosting the action of GABA
Give examples of BZs
-examples of BZs are Librium and Valium
Would you consider drug therapy to be a cure? (Limitation)
Generally, drugs don’t cure OCD, but they do reduce obsessive thoughts and compulsive behaviours to such a Level that a more normal lifestyle can be achieved
Are drug therapies for OCD a long term treatment? (Limitation)
Ideally, drugs could be used together with CBT
- some drugs should only be taken for a short period of time
- once drugs are stopped there is the problem of relapse
What are some side effects of drug therapies to cure OCD?
SSRIs- nausea, headaches, insomnia
BZs-increased aggressiveness, problems with memory, addition
Why might drug therapy be preferable to a psychological therapy such as CBT? (Strength)
Although, CBT is seen to be effective and does not have side effects, it isn’t suitable for patients who have difficulty talking about their inner feelings. Some patients don’t have verbal skills and find it hard to express themselves when talking. These patients would probably benefit from drug therapies
