Psychopathology Flashcards
Definition of Statistical infrequency
Abnormal behaviour is statistically rare
Any behaviour that is infrequent is regarded abnormal
What do Standard Deviation curves show? + example
- The distribution of the population from the mean, with the average score in the middle
- Each point to the left/right of the centre represents one standard deviation away from the
EXAMPLE
Mean IQ = 100
13.59% have an IQ of 115-130 = 1 SD away from mean
50% of people have an IQ of 100 or less
48% have an IQ of between 70-100
4.54% have an Abnormal IQ = 2 or more SD away from the mean
What is a strength of statistical infrequency as an explanation on abnormality?
It is the most STRAIGHT FORWARD AND OBJECTIVE definition
- A single figure is taken as a cut off point with normal on one side and abnormal on the other
e.g. IQ of 68 = Abnormal
IQ of 73 = Normal
Means that this quantitative data provided needs little interpretation
What are the weaknesses of statistical infrequency as an explanation of abnormality? (3)
1) It is hard to decide the cut off point beyond which behaviour is abnormal
This is too arbitrary of a definition e.g. little difference between and IQ of 68 and 73
Implies theoretical problems
2) Not all rare behaviours are undesirable such as genius and super athletic
These are rare/abnormal but are valued in society
Illustrates problems in real life applications
3) Not all abnormal behaviours are rare
e.g. 1/4 people will suffer from mental health issues, NIMH says 18% of Americans suffer from phobias
This scientific definition can be problematic in the real world
Definition of deviation from social norms
A social norm is an expected behaviour in a certain situation
Going against these expected behaviours is deviating from social norms
How does the deviation from social norms definition describe abnormality?
- It considers the norms in a society and marks any behaviours which deviate from it as abnormal
- This definition if cumulative as the more social norms that are broken the more abnormal they are considers
- Definition can result in normal behaviour not being recognised as normal due to cultural differences
Strength of deviation from social norms as a definition of abnormality
The definition has FACE VALIDITY
- Norms do reflect how society operates
- If people do not behave in a certain way this can be identified and they can be helped
e. g. if a person is suffering from a bird phobia they can easily access treatment
Cultural relativism as an evaluation of deviation from social norms
- Social norms are particular to societal groups
- In one society what may be considered deviant may not be considered that in another culture
e.g. in traditional Cheyenne India it is normal for a man to not speak to his parents-in-law, and if he was in the same room as them he would cover himself with a blanket - but this is not normal in the UK
The definition if NOT universal
Era dependence as an evaluation of deviation from social norms
- Social norms change over time
e. g. Homosexuality was regarded a psychiatric illness until 1973 - Therefore this explanation of abnormality is based on the social morals of a time period
A weakness of deviation from social norms as an explanation of abnormality
Behaviours are not always abnormal
- Social norms are related to the context in which the behaviour is shown
e. g. wearing a bikini to a beach is ‘normal’ but to a funeral it is not - There is not really a clear line between abnormality and ecentricity
Definition of Failure to Function adequately (F2F)
When someone is unable to manage everyday tasks of cope with everyday demands such as college, work, shopping etc. they would be identified as abnormal
Rosenham and Seligmans 7 abnormal characteristics in F2F explanation
Irrational Observer discomfort Unpredictability Maladaptiveness Suffering Vividness Violation of Moral codes
Irrationality as a characteristic of F2F
Any behaviour that defies logical sense
Observer discomfort as a characteristic of F2F
Behaviour that makes other around uncomfortable
Unpredictability as a characteristic of F2F
Behaviour that seems to be unexpected and unpredictabe
Maladaptiveness as a characteristic of F2F
Behaviour that prevents a person from reaching a desired goal
Strengths of Failure to Function as an explanation of abnormality. (2)
1) It is easy to assess the consequences and signs of F2F due to the stages
e.g. people who can’t show up to places on time due to maladaptivness show signs of not functioning properly
This quantitative data makes this explanation more reliable
2) This is a more realistic definition
It suggests that various thing contribute to a situation, and it assess abnormality on a contium
e.g. it is dependant on the situation if it is irrational or creates observer discomfort
Means that this definition if more realistic
Weaknesses of Failure to Function as an explanation of abnormality. (2)
1) It is influenced by subjectivity
What may make one person uncomfortable may not affect another, so the definition is opinionated
Thus this definition can be problematic when applied to the real world as it is not falsifiable
2) Cultural factors need consideration
e.g. eating disorders can be seen to mainly exist in western cultures
Therefore this definition is culturally relative
Definition of deviation from ideal mental health. (DIMH)
Any deviation from the perceived state of ideal mental health is classified as abnormal
This utilises a continuum and defines mental health rather than abnormality
What are Jahodas 6 criteria of Ideal mental health?
Personal Growth Accurate perception of reality Autonomy Integration Self attitudes Environmental mastery
Define personal growth (DIMH)
Achieving potential and becoming everything that you are capable of
Define accurate perception of reality (DIMH)
Perceiving the world without distortion and having an object/realistic view
Defined autonomy (DIMH)
The ability to function as an independent person and take responsibility for your actions
Define Integration (DIMH)
Synthesising self attitudes and personal growth to resist stress
Define self attitudes (DIMH)
Having high self esteem and a sense of identity
Defined environmental mastery (DIMH)
Being competent and meeting the demands of all situations
Strengths of deviation from ideal mental health as an explanation of abnormality. (2)
1) It is a more positive approach
This definition identifies characteristics needed to be psychologically healthy rather than being abnormal
This gives hope to people to work to goals rather than portraying failure
2) This has practical applications
Therapists can focus on setting goals for patients to achieve ideal mental health
This means the criteria can be used effectively in therapy
Weaknesses of deviation from ideal mental health as an explanation of abnormality. (2)
1) Not all criteria are seen as important or relative in all cultures
High self esteem is valued in individualistic cultures but not as much in collectivist cultures
This means that not all societies feel that these are the aims from ideal mental health
2) It is hard to meet all criteria and they are subjective
Ideas on what each criteria mean differ from person to person, and it is unlikely that a mentally healthy persona will uphold all criteria at all times
This may mean that the definition can lack validity
Emotional characteristics of Phobias
- Persistent fear which creates high anxiety due to the anticipation of the feared object/situation
- Exposure to the phobic stimuli can produce panic attakcs
Behavioural characteristics of Phobias
- Phobias produce anxiety so efforts are made to avoid the phobia in order to reduce anxiety
- Interference of everyday life
- Crying, screaming, running away, freezing
Cognitive characteristics of Phobias
- Recognition of the exaggerated anxiety
- Consciously aware that anxiety levels are overstated
- Irrational beliefs or distortion
Emotional characteristics of OCD
- Extreme anxiety due to innapropriate of forbidden ideas
- Low mood or depression
- Anxiety and distress
- Guilt and disgust
Behavioural characteristic of OCD
- Limited social interactions and relationships
- Avoidance of anxious situations
- Compulsions = repetitive behaviours
- Obsessive ideas create anxiety
Cognitive characteristics of OCD
- Repetitive thoughts a intrusive ideas - ‘obsessions’
- Understanding that obsessive thoughts are self induced
- Perception is focused on stimuli
Emotional characteristics of Depression
- Lessened concern and lack of pleasure in daily activities
- Sadness, worthlessness, reduced worth, guilt
- Low mood and self esteem
- Anger
Behavioural characteristics of Depression
- Fatigue, lethargy, inactivity, low energy
- Poor hygiene, sleep disturbance and reduced social interaction
- Weight fluctuations and disturbance of appetite
- Aggression, insomnia, hypersomnia
Cognitive characteristics of Depression
- Delusion of guilt, inadequacy or punishment
- Delusions (visual, auditory, haptic)
- Slow thinking and concentration
- Thoughts of suicide
What is a phobia?
When you have an intense, persistent and irrational fear of a particular object, activity or situation
- estimated 15-20% of population will suffer with phobias
What is OCD?
An anxiety disorder characterised by obsessions (thoughts) and compulsions (behaviours)
- only 2% of population will suffer with OCD
What is depression?
A mood disorder that causes persistent feelings of sadness and loss of interest. It affects how you feel, think and behave and can lead to a variety of issues
- estimated 17% of population will suffer at some point
Mowrer’s two process model - Acquiring phobias through classical conditioning (BEHAVIOURIST)
UCS/R = Unconditioned Stimuli/Response CS/R = Condition Stimuli/Response NS = Neutral Stimuli
Fear of Dogs Bite (UCS) = Fear/Anxiety (UCR) Dog = NS Bite (UCS) + Dog (NS) = Fear/Anxiety (UCR) Dog (CS) = Fear/Anxiety (CS)
Phobias are a conditioned emotional response resulted from association
Mowrer’s two process model - Maintaining phobias through operant conditioning (BEHAVIOURIST)
- Avoidance of phobia maintains it as it reduces anxiety (negative reinforcement)
e. g. Phobia of dogs is reinforced by the avoidance of dogs and the absence of fear - avoidance becomes a reward and develops the phobia - Stimulus generalisation can occur with subsequent objects/situations that are associated with the phobia
Strengths of the behavioural account of phobias. (3)
1) Has experimental support from Watson and Raynors little Albert study
Condition Albert to be phobic of a white rat by making the association with a loud bang
Then generalised to other white fluffy objects
Provides support for the explanation
2) Based off of scientific principles
Model uses scientific and reliable data by focusing on characteristics which are observable
3) Practical applications
Has helped to devise treatments that aim to unlearn behaviours
Systematic desensitisation is based of CC which gradually exposes the patient to the phobia - is 91% effective
Thus has helped the 20% of population that suffer from phobias
Weaknesses of the behavioural account of phobias. (1)
The theory is REDUCTIONIST as it only examines learning
- The biological approach argue phobias have served an adaptive purpose and some are coded in our DNA e.g. heights and spiders
The model provides an incomplete explanation
What is Systematic Desensitisation?
Developed by Wolpe (1958;1969)
AIM: To use the principles of association to replace the anxiety response with a relaxation response to remove the phobia
How are fear hierarchy’s used in systematic desensitisation?
- A list of phobic situations is made and they are rated most to least anxiety inducing
- The patient devises this list alongside the therapist
- The decide treatment goals to work to in order to work their way up the hierarchy
What relaxation techniques are used in systematic desensitisation?
- The patient will be taught relaxation techniques such as breathing techniques (7/11) and Progressive muscle relaxation
- They will use these to calm them down in anxious, phobic siuations
How is graduated exposure used in systematic desensitisation?
- Over 6-12 sessions the patients will be brought into conatct with the phobia working their way up the fear hierarchy one step at a time
- Will use IN VITRO (imagine) or IN VIVO (real life) methods
- They will use relaxation techniques at each stage until they can move on to the next level
Define reciprocal inhibition.
The idea that two opposite emotional states or mutually exclusive emotions cannot co-exist at the same time
Strengths of systematic desensitisation as a treatment for phobias. (2)
1) It has supporting evidence from Wolpe
He reported on 39 cases in which 35 patients were completely or partially successful in the treatments
Showed a 91% success rate, with the 9% failure due to specific methods e.g. not being able to use in Vitro methods
2) Has ethical praise
It is more ethical method based on classical conditioning that flooding it
The patient has more control in the procedure
Protected from harm
Weaknesses of systematic desensitisation as a treatment for phobias. (2)
1) Doesn’t deal with the root cause
It appears to rectify the issue but suppressing symptoms may cause others to occur and develop responses to new things
Could be superficial and temporary
2) Not suitable for all phobias
Complex and social phobias don’t respond well and have high relapse rates
Crask and Barlow found agoraphobics relapse after 6 months
SD has limited use
What is flooding?
AIM: To expose to phobia for extended period of time in a safe and controlled manner via in vivo methods
- May be taught relaxation techniques prior to treatments
- Prolonged exposure creates the association between the phobia and a calm response as it prevents avoidance
What is the key idea in flooding?
FEAR IS A TIME LIMITED RESPONSE - adrenaline will eventually run out and the body will calm down as anxiety is exhausted
Strengths of flooding as a treatment for phobias. (2)
1) Supporting evidence from Wolpe
Removed a girls phobia of cars by driving her around for 4 hours and eradicating her anxiety
Shows the potential for flooding as a treatment
2) Effective in time and resources
It requires little time for functional analysis as no fear hierarchies
It takes less time and so is more cost effective
Thus this is an attractive option for health providers e.g. NHS
Weaknesses of flooding as a treatment for phobias. (2)
1) It is less effective with complex and social phobias
Social phobias involve more cognitive aspects as they are involved with unpleasant thoughts
Means that flooding is not always appropriate and that the root cause of phobias may not be behavioural
2) It is unethical as it compromises the rights to withdraw since the method is based on exposure until anxiety is gone - no option to opt out
Means the therapy may not always be appropriate
What does the cognitive explanation say about abnormality?
It says that abnormality is caused by irrational though processes i.e. faulty information procession
What are the 3 components of Beck’s negative triad? (COGNITIVE THEORY)
Negative views on SELF - sees themselves as helpless and worthless
Negative views on WORLD - creates the impression that there is no hope
Negative views on FUTURE - reduce any hopefulness and enhance depression
What does Beck say about where negative views come from? (COGNITIVE THEORY)
The come negative self schema, which are maintained by errors called ‘cognitive biases’
What is an ineptness schema? (COGNITIVE THEORY)
A schema that makes depressives expect to fail
What is a self blame schema? (COGNITIVE THEORY)
A schema that makes depressives feel responsible for all misfortunes
What is a cognitive bias? (COGNITIVE THEORY)
- An error in thinking that can cause further misconceptions of reality - where conclusions are drawn without sufficient evidence
What does Ellis suggest about depression? (COGNITIVE THEORY)
- Said that depression was the result of irrational thoughts about external events
- Suggested that depression was the result of beliefs about an activating event
- He composed the ABC model to show this
Ellis’s ABC model (COGNITIVE THEORY)
A) ACTIVATING EVENT e.g. Mary and her boyfriend spilt up
B) BELIEFS ABOUT A - Ellis says these are the crucial difference between individuals who become depressed and those who don’t — i) RATIONAL THOUGHTS e.g. Mary’s break up is not to do with her OR ii) IRRATIONAL THOUGHTS e.g. Mary believes it is her fault, she isn’t lovable and other relationships will fail
C) CONSEQUENCES OF B i) Desirable emotions and thoughts e.g. Mary moves on and doesn’t worry OR ii) Undesirable emotions and thoughts e.g. Mary feels guilty and unlovable
Strengths of the Cognitive theory of depression. (2)
1) Evidence to support role of cognition in depression in the Temple Wisconsin Study of Cognitive Vulnerability to depression - assessed Uni students w/o depression every 2 months for 2 years - Found 17% of high scores on negative thinking experienced depression compared to 1% of low scorers - shows role of cognition
2) Practical applications that has helped society
CBT had been used to treat depression and challenging irrational thoughts & helps to inoculate them against further episodes - has helped society and removed psychological distress
Weaknesses of the Cognitive theory of depression. (2)
1) Argued that faulty information processing is an effect not a cause
Bio-psychologists emphasise that low levels of serotonin is a cause of depression and this is what leads to negative thought patterns
Suggests theoretical weaknesses in the explanation
2) Evidence that the approach neglects critical factors in the onset of depression
McGuffin et al - suggests depression has a genetic component - 46% concordance rate between MZ twins and only 20% between DZ twins
The theory is incomplete and reductionist
What is the aim of CBT?
To help rationalise and challenge irrational thinking as this can help the depressive states that patients find themselves in
What are the basic considerations in CBT for depression?
- Therapy is usually weekly/fortnightly sessions of 30-60 mins and can last 6 weeks - 6 months
- Mainly focuses on the present, but can talk about the past if it has any bearing
- The client and therapist agree on what to talk about each session
- Problems are broken down into parts to identify patterns of thoughts, emotions and actions
What are the 4 parts to CBT for depression?
1) Identifying negative thinking patterns
2) Challenging irrational thoughts
3) Skill acquisition and application
4) Follow up
Identifying negative thinking patterns in CBT for depression
- The first stage of CBT encourages the patient to talk about specific difficulties they experience and identify automatic negative thoughts
- Patient may complete a questionnaire to assess thoughts and feelings e.g The Beck Depression Inventory (BDI)
- Helps to establish initial goals and treatment plans
What is the Beck Depression Inventory (BDI)?
- A questionnaire containing 21 Questions scored between 0-3, with a total score of between 0-36
- Each Questions relates to different symptoms but usually a score 21 could indicate depression
Challenging irrational thoughts in CBT for depression
- The therapist seeks to challenge the negative thoughts that underline depression and then present alternative thoughts
- Ellis named the alternative thoughts ‘Disputing Beliefs’ that are then used to rationalise their thinking
- Sometimes called ‘reframing
Skill acquisition and application in CBT for depression
- The therapist will teach the client new skills and ways of thinking
- May use relaxation techniques and optimistic self statements to challenging negative cognition’s in relation to their depression
- Can enhance coping mechanisms
- A collaborative process, so often these skills will be given to practice as homework
The follow up in CBT for depression
- The therapy will undergo a final assessment using self report questionnaire i.e. the BDI and will compare before and after scores
- The ending of the treatments and maintaining positive changes is discussed alongside possible top up sessions
Strengths of CBT for depression. (2)
1) Evidence to support the use of it by March et al
Compared effectiveness of anti-depressants, CBT and both in 327 adolescents aged 12-17
After 36wks 81% of those in separate groups improved and 86% in combination improved
Shows the effectiveness of the treatments is just as much as drug therapy
2) Evidence to suggest the benefits are long lasting
Hollon et al found that following a 16 weeks treatment, only 40% of those using CBT relapsed compared to 45% with anti depressants and 80% of placebos
Suggests CBT is more effective and appropriate in the long term
Weaknesses of CBT for depression. (2)
1) Theoretical issues in that it works better with patients who have certain traits
CBT is collaborative so the patient must be willing and motivated, can include openly discussing inner thoughts & feelings and being open to change
Depression often involves lack of energy and emotion which may be an issue
Better suited to individuals with time and motivation
2) Argued that improvements are rooted in therapist-patient relationships
The quality of therapeutic relations may determine improvement, not the techniques - Luborsky found little differences between therapies showing someone to talk to is most important
What does the biological approach suggest about OCD?
It assumes that OCD is cause by physiological factors such as brain biochemistry, neuroanatomy and genetics
What are the genetic explanations of OCD?
- Found that 1st degree relatives of people with OCD had a higher vulnerability to the disorder
Nedstadt et al found 1st degree relatives have a 12% chance of developing the disorder compared to 3% of the general pop - Found that ‘candidate genes’ could be responsible - responsible for regulation of serotonin which implicates OCD
- Also if the ‘sert gene’ is impaired this can cause low levels of serotonin
Ozaki found a mutation of this gene was found in 2 families with 6/7 of the suffering OCD - Overall suggests a genetic predisposition
Strengths of the genetic explanation of OCD. (2)
1) Research support for the role of genes in Nesdadts 2010 review of twin studies
Found a concordance rate of 68% for MZ twins but only 31% in DZ twins
Shows a possible genetic influence
2) The explanation promotes psychology as a scientific disipline
The study of genetic inheritance is based on scientific methods e.g. examining DNA and family history, Concordance rates can be studied objectively and reliably
Means that the explanation is falsifiable
Weaknesses of the genetic explanation of OCD. (2)
1) Nesdadts research also suggests that genes are not the only factor - if they were then MZ twins would have a 100% concordance rate as they have the same genotype
Unlikely that 1 gene codes for OCD, more likely to be polygenic
Thus the explanation is incomplete
2) Explanation can be considered reductionist as it ignores any other factors e.g. environmental influences
Better alternative is the diathesis stress model that accounts for genes and the environment
The role of serotonin in the neural explanation for OCD
- Serotonin influences mood regulation and mental processes such as anxiety, sleep, memory and social behaviour
- The influence of lowered levels of serotonin is unclear but there is a possibility that it may play a role in preventing behaviour repetition
- So low levels can be linked to compulsions
The role of neuroanatomy in the neural explanation for OCD
- The orbital frontal cortex (OFC) specifically the caudate nucleus is able to anticipate the possible outcomes of behaviour - this area is implicated in the onset of OCD
- The OFC relays messages to the Thalamus about worries/concerns and the caudate nucleus usually suppresses these
- If the CN is damaged and fails to suppress these messages then they may turn into obsessions that need to be acted on in the form of compulsions
- If there is an impairment in this area then this may result in the compulsive behaviours that are seen in OCD
Strengths of the neural explanation of OCD. (3)
1) There is research support for the role of brain dysfunction form Ursu and Carter
They looked at the brain activity if 15 OCD patients using fMRI scans and found hyperactivity in the orbital frontal cortex - supports the idea that abnormal brain structures may be a causal factor
2) Support for the role of seratonin
It has been found that OCD is often co-morbid with depression and given that low levels of serotonin are implicated in both this strengthens the role of it in both
3) Practical applications
Has helped society and the 2-3% that suffer with it
Evidence that anti-depressants aimed to increase serotonin are also helpful in reducing OCD symptoms
Illustrates how the explanation has helped
Weaknesses of the neural explanation of OCD. (1)
1) Like brain dysfunction explanations research into OCD is cor relational, so OCD may actually cause a disruption in NT’s - presents a potential theoretical flaw
