psychopathology

Question 1

what is a phobia?

Answer 1

an irrational fear of an object or situation.

Question 2

what are the DSM-5 categories of a phobia?

Answer 2

• specific phobia (phobia of a specific object or situation)
• social anxiety/phobia (phobia of a social situation)
• agoraphobia (phobia of being outside or in a public space)

Question 3

what are the behavioural characteristics of phobia?

Answer 3

• panic (may show in different ways such as crying or running away)
• avoidance (phobics will go to a lot of effort to avoid their phobia in their day to day life)
• endurance (if the phobic makes a conscious effort to remain near the stimulus but experiences high levels of anxiety.

Question 4

what are the emotional characteristics of phobia?

Answer 4

• anxiety (an unpleasant state of high arousal that prevents the person from relaxing)
• fear (immediate and extremely unpleasant response to the phobic stimulus that is usually coupled with anxiety)
• unreasonable responses (our emotional response to a phobia goes beyond what we know is reasonable)

Question 5

what are the cognitive characteristics of phobia?

Answer 5

• selective attention (as a survival response our attention is drawn to the thing we think poses a threat. a phobic person will often be unable to look away from the stimulus)
• irrational beliefs (a phobic may hold irrational beliefs that increases the pressure of the situation)
• cognitive distortions (a phobic may see their phobia as something disgusting or alien looking. not how it appears to most people)

Question 6

what is depression?

Answer 6

a mental disorder classified by low mood and low energy levels.

Question 7

what are the DSM-5 categories of depression?

Answer 7

• major depressive disorder (severe but often short term depression)
• persistent depressive disorder (long term or recurring depression, including sustained major depression)
• disruptive mood dysregulation disorder (childhood temper tantrums out of proportion to others of the age group)
• premenstrual dysphoric disorder (disruption to mood prior and/or during menstruation.)

Question 8

what are the behavioural characteristics of depression?

Answer 8

• activity levels (typically lethargy and not being able to get out of bed, but can also be psychomotor agitation where the sufferer cannot relax )
• disruption to sleep and eating habits (sufferers may experience insomnia or hypersomnia as well as an increase or decrease in appetite leading to weight gain or loss)
• aggression or self harm (sufferers can become irritable and lash out aggressively to others. this can include displaying aggression towards themselves in the form of self harm)

Question 9

what are the emotional characteristics of depression?

Answer 9

• lowered mood (beyond just feeling sad, sufferers often describe themselves as empty)
• anger (sufferers do not just feel sad, they can be angry and even show extreme anger, often leading to aggressive behaviours.)
• lowered self esteem (sufferers of depression often have a lowered view of themselves. in extreme cases even experience self loathing)

Question 10

what are the cognitive characteristics of depression?

Answer 10

• poor concentration (sufferers may not be able to concentrate on particular tasks and have difficulty making decisions)
• dwelling on the negative (they often focus on the negative side of things rather than the positive and often have a bias towards recalling unhappy events rather than happy ones)
• absolutist thinking (sufferers tend to think in black and white, everything is either all good or all bad, they no longer see the spectrum)

Question 11

what is Obsessive Compulsive Disorder?

Answer 11

a condition characterised by obsessions and/or compulsive behaviour.

Question 12

what are the DSM-5 categories of OCD?

Answer 12

• OCD (characterised by obsessions - recurring thoughts and/or compulsions - repetitive behaviours)
• trichotillomania (obsessive hair pulling)
• hoarding disorder (the compulsive gathering of objects and the inability to part with anything, regardless of value)
• excoriation disorder (compulsive skin picking)

Question 13

what are the behavioural characteristics of OCD?

Answer 13

• compulsions: (there are two elements to this behaviour. 1. compulsions are repetitive, sufferers feel compelled to repeat the action. 2. compulsions reduce anxiety, sufferers experience a temporary lapse in anxiety after performing the action.)
• avoidance (OCD sufferers will attempt to avoid situations that would trigger anxiety at all costs)

Question 14

what are the emotional characteristics of OCD?

Answer 14

• anxiety and distress (powerful anxiety accompanies both obsessions and compulsions)
• accompanying depression (OCD is often accompanied by depression, a low mood and lack of enjoyment in activities.)
• guilt and disgust (OCD can involve other negative emotions such as guilt over small moral issues or disgust at an object or the self)

Question 15

what are the cognitive characteristics of OCD?

Answer 15

• obsessive thoughts (thoughts that recur over and over. they are always unpleasant but can vary from person to person)
• cognitive coping strategies (sufferers respond by creating coping strategies such as extensive prayer to help reduce anxiety. often appears abnormal to others)
• insight (sufferers of OCD are aware that their thoughts are irrational, if they weren’t they’d be suffering from psychosis not OCD. they also tend to be hyper vigilant and focus of potential hazards)

Question 16

How does the behavioral approach explain phobia?

Answer 16

Mowrer (1960) proposed the two process model in which phobias are learnt through classical conditioning and maintained through operant conditioning

Question 17

How does the behavioural approach explain the acquisition of phobias?

Answer 17

When a UCS that causes the UCR of fear is paired with and associated with a neutral stimulus. The person will associate the two and the NS becomes a CS producing a CR. For example if a dog is a neutral stimulus but it attacks which causes fear the dog becomes a CS, and the person may develop a phobia of dogs

Question 18

How does the behavioural approach explain the maintenance of phobias?

Answer 18

The behavioural approach says that when people avoid their phobic stimulus they are negatively reinforced by the reduction of anxiety. Reinforcement increases the likelihood that the behaviour will be repeated, explaining the continued avoidance of the phobic stimulus.

Question 19

How does the Little Albert study support the behavioural explanation for phobias?

Answer 19

Little Albert showed no fear of the white rat at first sight but when the presence of the rat was paired with a loud and frightening noise Little Albert would show fear and try to avoid the rat. This proves that classical conditioning can be used to teach a human to fear something.

Question 20

Evaluate the behavioural explanation for phobias.

Answer 20

• the theory was applied to therapies and seemed to work. Stopping the avoidance behaviour to reduce negative reinforcement etc.
• there is an alternative theory for avoidance behaviour that it’s about safety - agoraphobics can leave the house when with someone else.
• it is an incomplete explanation as it doesn’t explain why it’s easy to fear snakes but not cars. The biological preparedness theory is a more complete explanation.

Question 21

What is systematic desensitisation?

Answer 21

A behavioural therapy designed to reduce an unwanted response such as anxiety to a stimulus. It involves drawing up a hierarchy of anxiety provoking situations related to the phobic stimulus, teaching the patient to relax and then exposing them to phobic situations. The patient works their way through the hierarchy whilst staying relaxed.

Question 22

What is counterconditioning?

Answer 22

Learning a different response of relaxation to a phobic stimulus, replacing the fear response.

Question 23

What is reciprocal inhibition?

Answer 23

It is impossible to be afraid and relaxed at the same time. One emotion inhibits the other.

Question 24

What is flooding?

Answer 24

A behavioural therapy in which a phobic patient is exposed to an extreme form of a phobic stimulus in order to reduce anxiety triggered by that stimulus. It takes place across a small number of long sessions.

Question 25

What are the ethical issues involved with flooding?

Answer 25

It is not necessarily unethical but because of its unpleasant nature it’s important to get full informed consent from the patient.

Question 26

Evaluate systematic desensitisation.

Answer 26

• it has been proven to be effective and long lasting. Gilroy et al. Followed 42 spider phobics and the effects of SD had remained 33 months later.
• it is suitable for a diverse range of patients and phobias
• patients tend to prefer SD over flooding as it seems to be just as effective but more pleasant as you’re going through the therapy. Flooding can be quite unpleasant.

Question 27

Evaluate flooding.

Answer 27

• it is cost effective as it takes place over a fewer amount of sessions but still shows results.
• it can be less effective for certain phobias such as social anxiety etc. it’s only used in specific phobias.
• the treatment can be traumatic for patients, some patients will not see the treatment through to the end because of this.

Question 28

What is Beck’s cognitive theory of depression?

Answer 28

Beck proposed the theory of the negative triad - that there were three types of thinking that could contribute to becoming depressed. These are a negative view of the world, a negative view of the future and a negative view of the self (linked to a negative self schema). Thoughts like this would lead a person to interpret their lives in a negative way and make them more vulnerable to depression.

Question 29

Evaluate Beck’s cognitive theory of depression.

Answer 29

• good supporting evidence: Grazioli and Terry assessed 65 pregnant women for cognitive vulnerability before and after birth. Those with cognitive vulnerability were more likely to suffer fro, post natal depression.
• it forms the basis for cognitive behavioural therapy so has a real lie, large scale application.
• it doesn’t explain some extreme cases of depression such as why some patients suffer from delusions or hallucinations.

Question 30

What is Ellis’s ABC model for depression?

Answer 30

Ellis proposed that depression occurs when an Activating event causes an irrational Belief, which in turn produces a Consequence such as depression.

Question 31

What are Ellis’s three types of irrational belief?

Answer 31

Musterbation - the belief that we must always succeed or achieve perfection
I-can’t-stand-it-itis - the belief that it is a major disaster when something doesn’t go as planned
- Utopianism - the belief that life is supposed to be fair.

Question 32

Evaluate Ellis’s ABC model.

Answer 32

• it only explains one type of depression (reactive depression) it does not explain why or how depression can occur without an obvious activating event.
• it has led to effective CBT where therapists challenge irrational beliefs, proving these beliefs play a role in depression.
• it doesn’t explain hallucinations or delusions that some patients experience or the extreme bouts of anger etc.

Question 33

What is cognitive behavioural therapy?

Answer 33

A method for treating mental disorders based on both cognitive and behavioural techniques. From the cognitive viewpoint the therapy aims to deal with thinking, such as challenging negative thoughts. The therapy also includes some behavioural techniques such as behavioural activation.

Question 34

Describe Beck’s cognitive therapy

Answer 34

• identify the negative thoughts (negative triad)
• challenge the negative thoughts, both directly and the logic behind them - like identifying when people are nice to them etc.

Question 35

Describe Eliis’ Rational Emotive Behavioural Therapy (REBT)

Answer 35

• ABCDE
• identify the activating event, irrational beliefs and consequences
• the D stands for disputing the irrational belief
• the E stands for the effect of this dispute.
• disputing the beliefs involve challenging the logic behind them using empirical data.

Question 36

What is behavioural activation?

Answer 36

Encouraging a patient to become more active and social so they will find more evidence to dispute their irrational beliefs

Question 37

Evaluate cognitive behavioural therapy.

Answer 37

• it is effective: March et al. Compared the effects of CBT with antidepressants in 327 adolescents. After 36 weeks 81% of both antidepressants and CBT group significantly improved. 86% of the CBT + antidepressants group.
• drugs may need to be used in severe cases of depression as some patients may not even be able to get out of bed.
• success in CBT may be due to the generic features of therapy such as the therapist patient relationship not the therapy itself. Like being listened to and taken seriously.

Question 38

Describe the genetic explanation for OCD.

Answer 38

• researchers have identified genes which create candidate genes, some of which are involved in regulating the seratonin system.
• OCD is polygenic. Taylor analysed different studies and found that there may be 230 genes involved in OCD. often the genes are involved in regulating neurotransmitters.
• OCD is aeteologically heterogenous, meaning that the origin of OCD may have different causes in different people.

Question 39

Evaluate the genetic explanation for OCD.

Answer 39

• twin studies provided evidence. Nested et al. Did a meta analysis and found that 68% of mz twins shared OCD as opposed to 31% of dz twins.
• it is unlikely to be a useful explanation as scientists cannot pinpoint specific genes.
• OCD cannot be entirely genetic. Cromer et al. Found that over half their sample had suffered a serious traumatic event in their past.

Question 40

Explain the neural explanation for OCD.

Answer 40

• it is thought that OCD sufferers have low levels of certain neurotransmitters such as serotonin which effects mood.
• may be caused by abnormal functioning of the frontal lobes of the brain, they are involved in logical thinking and decision making.

Question 41

Evaluate the neural explanation for OCD.

Answer 41

• there’s evidence from drug trails in that some antidepressants that work are focused entirely on levels of seratonin.
• it is not clear exactly which structures of the brain are involved. Some systems are involved sometimes but not others. Meaning that it’s not quite a full explanation.
• correlation does not equal causation so we cannot be sure that biological abnormalities cause OCD rather than the other way round.

Question 42

What is drug therapy?

Answer 42

Treatment involving drugs. In the case of psychological disorders the drugs usually have an effect on levels of neurotransmitter in the brain.

Question 43

What is an SSRI?

Answer 43

A selective serotonin reuptake inhibitor

Question 44

How do SSRI’s work?

Answer 44

They block the reabsorption of seratonin in the presynaptic Neuron. Leaving more seratonin in the synapse itself so more is produced and released. This means that the post-synaptic neuron will continue to fire

Question 45

What is the average dose of seratonin?

Answer 45

Usually 20mg a day but this can be increased to 60mg if needed. The drug can be taken as capsules or as a liquid. It usually takes 3 to 4 months of daily doses to have an impact on the patient.

Question 46

How can SSRI’s be combined with other treatments?

Answer 46

They are often used alongside CBT. The drugs reduce emotional symptoms such as anxiety and allow the patient to engage more effectively with the CBT.

Question 47

What are some alternatives to SSRI’s?

Answer 47

Tricyclics - older type of SSRI that has more side effects but can be used on patients who don’t respond to current SSRI’s
SNRI’s - increase levels of seratonin and another neurotransmitter called noradrenaline

Question 48

Evaluate drug therapy to treat OCD.

Answer 48

• Soomro et al did a meta analysis and found that 17 studies found SSRI’s to be more effective than placebos and symptoms of OCD declined in 70% of patients taking SSRI’s
• drugs are cost effective and non disruptive so doctors and the NHS often favour them
• drugs can have unpleasant side effects which may lead to some people stopping taking them - reducing the effectiveness.

Question 49

explain the statistical infrequency definition of abnormality.

Answer 49

when an individual has a less common characteristic than most people. this is determined by an arbitrary point on a normal distribution curve. for example those in the bottom 2% of the IQ distribution are said to have intellectual disability disorder.

Question 50

evaluate the statistical infrequency definition of abnormality.

Answer 50

• it has real life applications as it can be used to diagnose certain disorders and see how far someone deviates from the statistical norm
• unusual or rare characteristics such as abnormally high intelligence can be thought of as positive rather than needing a diagnosis.
• some people can live their lives perfectly fine and happily while being considered statistically abnormal and will not benefit from a diagnosis.

Question 51

explain the deviation from social norms definition of abnormality.

Answer 51

when an individual displays behaviour that the society or community they are in considers different from the expected standards. these are bound to the culture we live in and will depend on our society. although things such as antisocial personality disorder (being a psychopath) is considered abnormal in most societies.

Question 52

evaluate the deviation from social norms definition of abnormality.

Answer 52

• it cannot be the sole reason for defining abnormality as some people are different without harming anyone or themselves
• cultural relativism is a problem as social norms are bound entirely to the culture.
• it can lead to the abuse of human rights, for example dictatorships like Stalins would claim that anyone who opposed them was psychologically abnormal and arrest them.

Question 53

explain the failure to function adequately definition of abnormality.

Answer 53

when someone is unable to cope with the daily demands of living. this could include being unable to maintain health and hygiene or hold down a job. Rosenham and Seligman proposed that it could be defined as not conforming to standard interpersonal rules, experiencing severe personal distress or being dangerous to themselves or others.

Question 54

evaluate the failure to function adequately definition of abnormality.

Answer 54

• it includes an element of patients choice and acknowledges that their distress matters in a diagnosis.
• it doesn’t distinguish between a failure to function and deviation from social norms. new age travelers may not fit the criteria but also may not be abnormal
• it is not the patient but a psychiatrist who decides whether the patient is functioning adequately or not so it is still slightly subjective.

Question 55

explain the deviation from ideal mental health definition of abnormality.

Answer 55

this definition has a criteria for the things that a normal person should do or be and if an individual does not meet these criteria they are abnormal. these criteria include things such as self actualising, coping with stress, having good self esteem, being independent and working successfully.

Question 56

evaluate the deviation from ideal mental health definition of abnormality.

Answer 56

• it is comprehensive and covers a broad range of criteria for mental health
• it is culture bound to some extent - mostly to individualistic countries. individualist countries see independence as good whereas being dependent on others in a collectivist culture is seen as normal.
• it sets an unrealistically high standard for mental health. very few people meet all the criteria. this is a strength as it shows us what we should be working towards and what we would benefit from but it also means that some people may receive treatment they didn’t feel they needed.