Psychopathology Flashcards
What are the 4 definitions of abnormality?
1) . Statistical infrequency.
2) . Deviation from social norms.
3) . Failure to function adequately.
4) . Deviation from ideal mental health.
Define statistical infrequency?
Any behaviour that is numerically rare on a standard distribution graph is deemed abnormal.
Define deviation from social norms?
Any behaviour that deviates from the expected behaviours of society is seen as abnormal.
Define failure to function adequately?
When an individual fails to cope with the demands of everyday life.
Define deviation from ideal mental health?
When an individual possesses behaviours that doesn’t conform with the criteria that make someone psychologically healthy.
What is an example of statistical infrequency?
IQ and intellectual disability disorder:
- Those scoring below 70 or above 130 are ‘abnormal’.
What is an example of deviation from social norms?
Antisocial personality disorder (APD):
- Psychopaths lack empathy and fail to conform to the ethical behaviour of society.
What are the signs Rosenhan and Seligman (1989) proposed of failing to cope?
1) . No longer conforms to interpersonal rules (e.g. eye contact).
2) . Experience personal distress.
3) . Behaviour is irrational or dangerous.
What is an example of failure to function adequately?
Intellectual disability disorder:
- In order for diagnosis, the person would have to fail to cope, not just be statistically abnormal.
Whats the difference between failure to function adequately and deviation from ideal mental health?
Failure to function adequately =
criteria has to be met in order to be abnormal.
Deviation from ideal mental health =
the criteria has to be absent in order to be abnormal.
Who suggested the criteria of ideal mental health?
Jahoda (1958).
What is Jahoda’s criteria of ideal mental health?
1) . No symptoms or distress.
2) . We are rational and perceive ourselves accurately.
3) . We self-actualise.
4) . We can cope with stress.
5) . We have a realistic view of the world.
6) . We have good self-esteem and lack guilt.
7) . We are independent.
8) . Successful at work, and love leisure.
What happens if any of these criteria are absent?
The individual is deemed abnormal.
How is there a blur between the symptoms of ideal mental health and failure to function adequately?
They symptoms may overlap;
e.g. inability to keep a job may be failure to function (cope with pressure of work), or; deviation from ideal mental health.
What are the evaluations of statistical infrequency?
1) . Real-life application.
2) . Unusual characteristics can be positive.
3) . Not everyone benefits from a label.
How is there real-life application of statistical infrequency?
All assessments of patients with mental disorders includes a comparison to statistical norms.
- Intellectual disability disorder is an example.
How come some unusual characteristics can be positive?
An IQ of 130 is just as rare as that of 70, but it’s desirable, and doesn’t require treatment.
- Means statistical infrequency should be used alone to diagnose disorders.
How come some people don’t benefit from a label?
People who live a happy life don’t require a label of abnormality;
- If your IQ is 70 and you live a happy life, a diagnosis of intellectual disability disorder is unnecessary.
- Being labelled as abnormal may have a negative impact on their life.
What are the evaluations of deviation from social norms?
1) . Not a sole explanation of abnormality.
2) . Social norms are culturally relative.
3) . Definition could lead to human rights abuse.
How is deviation from social norms not a sole explanation of abnormality?
APD (psychopathy) shows deviation from social norms is important in defining abnormality, however;
- Other factors should be consider - e.g. harm to other people.
How are social norms culturally relative?
Someone may label someone from a different culture as abnormal, based on their cultures standard of living;
- e.g. hearing voices is normal in some cultures, but labelled as schizophrenic in the UK.
How could the definition lead to the abuse of human rights?
Labelling someone as abnormal for deviating can have a negative impact;
- e.g. draptomania (where black slaves try to escape) –> in history, if a black slave tries to they are labelled as abnormal for deviating.
What are the evaluations of failure to function adequately?
1) . Recognises the patient’s perspective.
2) . This is the same as deviation from social norms.
3) . Based on subjective judgements.
How does failure to function adequately recognise the patient’s perspective?
Acknowledges that the experience of the patient is important - however, it is difficult to assess distress as most people are withdrawn to discuss distress.
How is failure to function adequately the same as deviation from social norms?
It’s hard to define when someone is behaving maladaptively;
- People who do extreme sport can be seen as behaving maladaptively, but defining this as abnormal may limit their freedom.
How is defining abnormality through failure to function adequately based on subjective judgements?
Someone has to decide whether patient is distressed, but a patient may say they are distressed, but may not be suffering.
- It’s hard to decide whether a psychiatrist has the right to make these judgements.
What are the evaluations of deviation from ideal mental health?
1) . Deviation from ideal mental health is comprehensive.
2) . Definition may be culturally relative.
3) . Unrealistically high standards for mental health.
How is deviation from ideal mental health comprehensive?
The definition covers a broad range of criteria fro mental health. Jahoda’s criteria are a good tool for thinking about mental health.
How can deviation from ideal mental health be culturally relative?
Some of the criteria are specific to Western European culture.
- Self-actualisation is irrelevant in collectivist cultures - some traits represent individualistic cultures.
How is there unrealistically high standards for mental health?
Not many people will meet all of Jahoda’s criteria, so most people are abnormal.
- However, this is positive for showing the benefits of improving their mental health.
What are the behavioural, emotional and cognitive characteristics of phobias?
Behavioural =
- Panic.
- Avoidance.
Emotional =
- Anxiety and fear.
- Unreasonable responses.
Cognitive =
- Selective attention to the phobic stimulus.
- Irrational beliefs.
What are the behavioural, emotional and cognitive characteristics of OCD?
Behavioural =
- Compulsions.
- Avoidance.
Emotional =
- Anxiety and distress.
- Guilt and disgust.
Cognitive =
- Obsessive thoughts.
- Insight into excessive anxiety.
What are the behavioural, emotional and cognitive characteristics of depression?
Behavioural =
- Reduced energy (low activity).
- Disruption to sleep and eating.
Emotional =
- Lowered mood.
- Anger.
Cognitive =
- Poor concentration.
- ‘Black and white thinking’ (absolutist thinking).
What approach is taken towards explaining and treating phobias?
Behavioural.
What approach is taken towards explaining and treating depression?
Cognitive.
What approach is taken towards explaining and treating OCD?
Biological.
What model did Mowrer propose to explain phobias?
Two-process model;
- Classical conditioning = learning phobia.
- Operant conditioning = maintaining phobia.
How is a phobia acquired through classical conditioning?
Learning by association =
- UCS =
triggers a fear response (being bitten). - NS =
is associated with the UCS (person wasn’t originally scare of the dog). - NS = CS producing a CR (dog becomes a CS causing a CR of anxiety/fear).
What is an example of a phobia being acquired through classical conditioning?
Watson and Raynor - Little Albert =
- A loud noise (UCS) was produced when Albert played with a white rat, producing a fear (UCR).
- Rat (NS) now produced a fear as Albert associated it with the bang.
- He showed fear (CR) every time he seen a rat (CS).
How is there a generalisation of fear to other stimuli?
e.g. Little Albert also showed a fear to white furry objects (Santa Claus mask).
How is a phobia maintained through operant conditioning?
Negative reinforcement =
individual produces behaviour that avoids something unpleasant.
- This allows them to escape the anxiety, and this maintains the phobia.
What is an example of negative reinforcement?
Coulrophobia (fear of clowns) =
- They will avoid circuses.
- This ensures the phobia is maintained rather than confronted.
What are the evaluations of the behavioural approach to explaining phobias?
1) . Two-process model has good explanatory power.
2) . There are alternative explanations for avoidance behaviour.
3) . Two-process model is an incomplete explanation of explaining phobias.
4) . Not all bad experiences lead to phobias.
5) . Doesn’t consider the cognitive aspects of phobias.
How does the two-process model have good explanatory power?
It has implications for therapy =
- If a patient is unable to avoid the phobia, the phobic behaviour declines.
What are the alternative explanations for avoidance behaviour?
Two-process model suggests avoidance is motivated by anxiety reduction, however =
- agoraphobics, for example, can leave the house with a friend –> some avoidance behaviours are motivated by positive feelings of safety.
How is the two-process model an incomplete explanation of phobias?
Some aspects of phobic behaviour require further explanation =
- Biological preparedness –> we innately fear some things more than others form our evolutionary past (fear of snakes).
- Shows acquiring some phobias is more complex than the two-process model.
How is it a limitation that not all bad experiences lead to a phobia?
DiNardo et al. found that not all bad experiences (being bitten by a dog) lead to developing a phobia.
- Conditioning alone cannot fully explain developing a phobia, only explain where vulnerability exists.
How come the two-process model doesn’t consider the cognitive aspects of phobias?
We know that phobias have cognitive characteristics, however, the behavioural approach is reductionist in only explaining avoidance as a behavioural characteristic.
What are the two behavioural approaches to treating phobias?
1) . Systematic desensitisation (SD).
2) . Flooding.
What is systematic desensitisation based on?
Classical conditioning, counter-conditioning and reciprocal inhibition.
What is systematic desensitisation?
Gradually reducing anxiety through counter-conditioning =
- Phobic stimulus (CS) is pared with relaxation (CR) instead of anxiety.
What is reciprocal inhibition?
It’s impossible to be afraid and relaxed at the same time, so, one emotion prevents the other.
What is the processes involved in SD?
1). Anxiety hierarchy =
a list of fearful stimuli in order of most-least feared.
2). Relaxation =
therapist teaches the patient to relax through relaxation techniques, such as, imagining themselves in relaxing situations.
3) Exposure =
patient is exposed to each level of phobic stimuli in a relaxed state, starting at the bottom of the hierarchy.
Whats the difference between SD and flooding?
Flooding also involves exposure, but without a gradual exposure up the hierarchy list, or relaxation techniques.
What is flooding?
Immediately exposing the patient to the phobic stimuli.
What is an example of flooding?
Arachnophobia =
they may have a spider crawl over their hand until they can fully relax.
How does flooding work?
Through extinction;
without avoidance behaviour, the patient understands that the phobia is harmless through exhaustion of their fear response.
What are the ethical safeguards of flooding?
It isn’t unethical, however;
- Full informed consent is required and they must be fully prepared as it’s an unpleasant experience.
What are the evaluations of SD?
1) . It’s effective.
2) . Suitable for a diverse range of patients.
3) . Tends to be acceptable to patients.
How is SD effective?
Gilroy et al. =
- followed up 42 patients who had SD for arachnophobia in 45-minute sessions.
- at 3 and 33 months, they were less fearful than the control group who had flooding.
How come SD is suitable for a diverse range of patients?
For example, those with learning difficulties will struggle to understand the process of flooding.
How come SD tends to be accepted by patients?
Patients tend to choose SD over flooding, and this is because its less traumatic and more pleasant.
- Low attrition rate as opposed to flooding (low drop-out).
What are the evaluations of flooding?
1) . Less effective for some types of phobias.
2) . Traumatic for patients.
How come flooding is less effective for some patients?
Its less effective for treating more complex phobias.
- for example; social phobias, as they tend to have cognitive factors (they also think negatively about social situations).
- may benefit more from cognitive treatments.
How is flooding traumatic for patients?
Although it isn’t unethical, patients often don’t continue to the end due to it being traumatic.
- therefore, its less effective and cost-consuming with a high attrition rate.
What are the two cognitive approaches to explaining depression?
1) . Beck’s cognitive theory of depression (negative triad).
2) . Ellis’ ABC model
How does Beck describe depressed patients?
Faulty information processing =
- i.e. thinking in a flawed way.
- when they look at the negative aspects of a situation, they ignore the positives and blow problems out of proportion –> ‘black and white’ thinking.
How does Beck discuss schemas in depressed people?
He argues they have negative self-schemas =
- they interpret all information about themselves negatively as they have a negative interpretation of the world.
What is Beck’s negative triad?
1) . Negative views of the world =
e. g. ‘the world is a cold, hard place’.
2) . Negative view of the future =
e. g. ‘there is much chance the economy will get better’.
3) . Negative view of the self =
e. g. ‘I am a failure’.
What are the evaluations of Beck’s cognitive theory of depression?
1) . Good supporting evidence.
2) . Practical application as a therapy.
3) . Doesn’t explain all aspects of depression.
What is the supporting evidence for Beck’s theory?
Grazioli and Terry (2000) =
- assessed 65 pregnant women for cognitive vulnerability and depression before and after birth.
- found those judged to have high cognitive vulnerability were more likely to suffer post-natal depression.
What practical application of Beck’s theory is there?
Forms the basis of CBT =
- elements of the negative triad can be identified and challenged, so a patient can test whether the elements of the triad are true.
How come Beck’s theory doesn’t explain all aspects of depression?
Beck doesn’t explain the anger present in depressed patients.
- Jarrett (2013) = Beck doesn’t explain why some depressed people experience hallucinations (e.g. Cotard Syndrome).
- Just focuses on one aspect of depression.
What does Ellis say depression is caused by?
Irrational thoughts –> any thoughts that interfere with our happiness.
What does Ellis’ ABC model explain?
How irrational thoughts affect our behaviour and emotional state.
What is Ellis’ ABC model?
A = activating event =
- we get depressed when we experience a negative event (e.g. failing an exam).
B = beliefs =
- negative events trigger irrational beliefs; ‘musturbation’ (belief that we must always succeed), ‘i-can’t-stand-it-it’s’ (belief that its a disaster when things don’t go smoothly), etc.
C = consequences =
- when an activating event triggers irrational beliefs, there are emotional and behavioural consequences.
What is an example of Ellis’ ABC model?
If you believe that you must always succeed, then fail an important exam, this can trigger depression.
What are the evaluations of Ellis’ ABC model?
1) . Only a partial explanation of depression.
2) . Cognitions may not cause all aspects of depression.
How is Ellis’ ABC model only a partial explanation of depression?
Ellis’ explanation only applies to some kinds of depression because, some people get depressed with an activating event.
- psychologists call depression after an activating event ‘reactive depression’.
How come cognitions don’t cause all aspects of depression?
Cognitive primacy –> emotions are influenced by thoughts, however;
- this isn’t always the case; some people get depressed some time after the causal event as emotions are stored like physical energy (other theories of depression).
How is depression treated?
CBT.
What does beck say CBT is?
Patient and therapist work together =
- identify negative/irrational thoughts to challenge.
How does CBT relate to the negative triad?
Identify negative thoughts about =
- self, world and future.
- challenge thoughts by taking an active role.
What is meant by the ‘patient as scientist’?
- Patients test reality of negative thoughts.
- Record good times.
- When they say no-one is nice to them, the therapist can show this isn’t true.
What is Ellis’ REBT?
Extends ABC model to ABCDE model =
- D = dispute (challenge) irrational belief.
- E = effect.
How does REBT challenge irrational beliefs?
1). Empirical argument =
disputing whether there is evidence to support the irrational belief.
2). Logical argument =
disputing whether the negative thought follows the fact.
What is behavioural activation?
Depressed people =
- become isolated, worsening symptoms.
Treatment =
- decrease isolation, increase involvement in activities to raise mood (exercising).
What are the evaluations of the cognitive approach to treating depression?
:) CBT is effective =
- March et al. = found combining CBT and antidepressants significantly improved 86% of P.
:( May not work for severe cases =
- can’t motivate themselves enough for CBT –> can’t be the sole tretment of depression.
:( Some patients want to explore their past =
- CBT explores present and future, can ignore important aspects of the patients experience.
:( Overemphasis on cognition =
- ignores environmental influences (poverty, etc) and can prevent progress.
What are the 2 biological explanations of OCD?
1) . Genetic explanation =
- candidate genes.
- OCD is polygenic.
- different types of OCD.
2) . Neural explanation =
- low levels of serotonin = low mood.
- decision-making system impaired.
- parahippocampal gyrus dysfunctional.
What are candidate genes?
Specific genes that create a vulnerability for OCD.
What are the OCD candidate genes?
1) . Serotonin genes =
- e.g. 5HT1-D beta.
- implicated in the transmission of serotonin across synapses.
2) . Dopamine genes =
- also implicated.
- both regulate mood.
How is OCD polygenic?
Caused by several genes.
How many different genes did Taylor (2013) identify in OCD?
230 different genes involved in OCD.
How is OCD aetiologically heterogenous?
One group of genes may cause OCD in one person but a different group of genes may cause the disorder in another person.
- different types of OCD = result of different variations.
What are the evaluations of the genetic explanation of OCD?
:) Supporting evidence =
- Nestadt = MZ (68%), DZ (31%).
:( Too many candidate genes have been identified =
- each variation only increases risk by a fraction.
:( Environmental factors =
- concordance rates arent 100%/50%.
- Cromer et al. = 50% OCD
