Psychopathology

Question 1

How do we define something as ‘abnormal’ using the method of Statistical Infrequency?

Answer 1

According to statistical infrequency anything that is relatively usual can be considered “normal”, and anything different is considered “abnormal”.
For example the average IQ is 100 and 68% of the population have an IQ between 85-115. Those within this range are considered to have a normal IQ. There are also people that have an IQ below 70 - but these only make up 2% of the population. They are however considered to be “abnormal”

Question 2

How do we define something as ‘abnormal’ using the method of deviation from social norms?

Answer 2

When a person behaves in a way that is different from the way society expects, because society makes different judgements about ‘correct” behaviours in particular circumstances.
This is often related to cultural context and can change through time; as there are relatively few behaviours that are universally considered abnormal.
For example homosexuality was once considered abnormal, and still is in some cultures.
A person with anti-social behaviour disorder is also considered abnormal as they fail to conform to “lawful and culturally normative ethical behaviour”. In other words they deviate from social norms and standards.

Question 3

What are the evaluation points for definitions of abnormality through deviations from social norms?

Answer 3

Weakness - not the sole explanation of abnormality. for examine APD shows there is a benefit but should consider other things - such as distress to others. so deviation is not the only reason.
weakness - social norms are culturally relative - creates problems for integration within cultures + no defined standards.
Weakness - could lead to human rights abuses - i.e drapetomania and nymphomania shows how diagnosis was used to control. these appear ridiculous but psychologists argue there are still cases of this.

Question 4

What are the behavioural characteristics of phobias?

Answer 4

Panic - may involve behaviours such as crying, screaming or running away from the phobic stimulus.
Avoidance - considerable effort to avoid coming into contact with the phobic stimulus, can make it hard to go about everyday life - especially if the phobia is common (such as public spaces.)

Question 5

What are the emotional characteristics of phobias?

Answer 5

Anxiety and fear - Fear is the immediate experience when a phobic encounters or thinks about the phobic stimulus. this fear then leads to anxiety
Responses are unreasonable - response is widely disproportionate to the threat posed - i.e an arachnophobic will have a strong response to a small spider.

Question 6

What are the cognitive characteristics of phobias?

Answer 6

Selective attention to the phobic stimulus - The phobic finds it hard to direct attention away from the stimulus - i.e an arachnophobic will struggle to concentrate if there is a spider in the room.
Irrational beliefs - For example, social phobias will include beliefs such as “if i blush people will think I’m weak” or “I must always sound intelligent”.

Question 7

What are the behavioural characteristics of depression?

Answer 7

Activity levels - Suffers of depression have reduced energy levels making them lethargic, in some cases this can be so extreme they cannot get out of bed.
Disruption to sleep and eating behaviour - Suffers may experience reduced sleep (insomnia) or an increased need to sleep (hypersomnia).
Appetite may increase of decrease - leading to wait gain or loss.

Question 8

What are the cognitive characteristics of depression?

Answer 8

Poor concentration - sufferers may find themselves unable to stick with a task as they usually would, or they might find a simple decision difficult.
Absolutist thinking - ‘Black and white thinking’ when a situation is unfortunate it is seen as absolute disaster.

Question 9

What are the emotional characteristics of depression?

Answer 9

Lowered mood - More pronounced than the daily experience of feeling lethargic or sad. Sufferers often describe themselves as ‘worthless’ or ‘empty’.
Anger - On occasion, such emotions lead to aggression or self-harming behaviour.

Question 10

How are classical and operant conditioning involved in phobias?

Answer 10

Orval Hobart Mowrer (1960) argued that phobias are learned by classical conditioning and then maintained by operant conditioning - so two processes are involved.

Question 11

How phobias acquired?

Answer 11

Unconditioned stimulus triggers a fear response (the unconditioned response). e.g being bitten creates anxiety
Neutral stimulus is associated with the unconditioned stimulus e.g being bitten by a dog. (Dog did not previously create anxiety.
Neutral stimulus becomes a conditioned stimulus, producing fear (which is now the conditioned response). The dog becomes the conditioned stimulus, causing a conditioned response of anxiety/fear following the bite.

Question 12

How is the behavioural approach shown in little Albert?

Answer 12

Watson and Raynor (1920) showed how a fear of rats could be conditioned in “Little Albert”.
Whenever Albert played with a white rat, a loud noise was made close to his ear. The noise (UCS) caused a fear response (UCR).
Rat did not create fear until the bang and the rat had been paired together several times.
Albert showed a fear response (CR) every time he came into contact with the rat (now a CS).

Question 13

How was Little Albert’s fear generalised to other stimuli?

Answer 13

Albert showed a fear response to other white, furry items - such as a fur coat and a Santa Claus mask.

Question 14

How does operant conditioning maintain a phobia?

Answer 14

Operant conditioning is when are phobia is reinforced or punished.
Negative reinforcement - individual produces a behaviour that avoids something unpleasant.
When a phobic avoids a phobic stimulus they escape the anxiety that would have been experienced. This reduction in fear negatively reinforces the avoidance behaviour and the phobia is maintained.

Question 15

What is an example of negative reinforcement?

Answer 15

If someone has a morbid fear of clowns (coulrophobia) they will avoid circuses and other situations where they may encounter clowns.
The relief felt from avoiding clowns negatively reinforces the phobia and ensures it is maintained rather than confronted.

Question 16

What is a strength and limitation of the two process model?

Answer 16

Strength:
Has good explanatory power - it goes beyond Watson and Rayner’s simple classical conditioning explanation. It has important implications for therapy, if a patient is prevented from practising their avoidance behaviour then the phobic behaviour declines. The application to therapy is a strength.
Limitation:
Incomplete explanation. Even if we accept that classical and operant conditioning are involved in the development and maintenance of phobias, there are some aspects that need explaining. For example biological preparedness suggests that we easily acquire phobias of things that were a danger two us in the past, because we are innately prepared to fear them more. This is a weakness for the two-process model as it shows there’s more to the two-process model than simple conditioning.

Question 17

What is Beck’s theory of explaining depression?

Answer 17

He suggested that it comes from some peoples faulty information processing. When depressed they tend to highlight the negatives and ignore the positives, they will also blow small problems out of proportion and think in black and white terms.
They also have negative self-schemas - meaning that they interpret all information about themselves in a negative light.
Beck also suggested that there is ‘negative triad’, the three elements of this triad are;
Negative views of the world - ‘The world is a cold hard place’
Negative view of the future - ‘There isn’t much chance that the economy will get much better’
Negative view of the self - For example thinking ‘I am a failure’, which negatively impacts on self-esteem.

Question 18

What is Ellis’ ABC model?

Answer 18

A - activating event. Ellis suggested that depression occurs when we experience a negative event for example failing an important test or ending a relationship.
B - Beliefs. Ellis belived that negative events trigger negative irrational beliefs, for example
‘Musterbation’, the belief that we must always succeed.
‘I-can’t-stand-it-itis’ the belief that it is a disaster when things go smoothly.
‘Uptopianism’ - the belief that the world must be fair and just.
C - Consequences. When an activating event triggers irrational beliefs there are emotional and behavioural consequences. For example if you believe that you must always succeed and then fail at something, the consequence is depression.

Question 19

What are two strengths of Beck’s model?

Answer 19

It has good supporting evidence. One study assessed 65 pregnant women for cognitive vulnerability and depression before and after birth. They found that those with high congnitve vulnerability were more likely to suffer post-natal depression. This thus gives the theory better reliabity as it can be shown to work in real life.
It also has a practical application as a therapy as it forms the basis of CBT. This is because the components that make up the negative triad can be identified and challenged in CBT - so they can test whether elements in the negative triad are true. This is a strength because it gives the theory better external validity as it can be utilised.

Question 20

What is a limitation of Beck’s theory?

Answer 20

It does not explain all aspects of depression. Depression is complex, for example some patients are deeply distressed and beck cannot explain this extreme emotion. For example some suffer hallucinations and bizarre emotion. This reduces the internal validity of the theory as it cannot explain all aspects of depression.

Question 21

What is a limitation of Ellis’ theory?

Answer 21

It is a partial explanation of depression. Some cases of depression do follow from activating events. This is called reactive depression and it is seen as different from depression that has no obvious cause. So Ellis’s explanation only applies to some kinds of depression - which reduces its validity.

Question 22

How is Beck’s CBT used to treat depression?

Answer 22

With Beck the patient and the therapist work together to clarify the patients problems and identify where there are negative or irrational thoughts that will benefit from the change.
The aim of these sessions is to identify thoughts within the negative triad and challenge them with the patient taking an active role in their treatment.
The patient is also encouraged to test the reality of their beliefs - by recording when somebody was nice to them or when they enjoyed an event. This is referred to as ‘Patient as scientist’.
If the patients they say the nobody is nice to them or that it is pointless the therapist can produce this.

Question 23

How is Ellis’ version of CBT used to treat depression?

Answer 23

Ellis’ version is known as Rational Emotive Behaviour therapy (REBT). It extends the ABC model to D+E with D for dispute and E for effect.
It encourage patients to challenge irrational beliefs. for example if a patient discussed how unfair life was this would be interpreted as utopinainsim and challenge it.
These beliefs can be challenged through disputing whether there is evidence for these beliefs or whether the negative thought can be drawn from the facts.
As individuals become depressed they increasingly avoid difficult situations and become isolated - which maintains or worsens symptoms. The goal of therapy is thus to work with individuals to decrease their avoidance + isolation and increase their engagement in activities that improve mood, exercising going out to dinner etc.

Question 24

What are two strengths of CBT?

Answer 24

It is a effective. There is a lot of evidence two support the effectiveness of CBT. One study compared CBT, antidepressants and a combination of the two when used in adolescents. After 36 weeks both the antidepressant group and the CBT group were 81% improved - whilst 86% of the antidepressants + CBT group were improved. So CBT is just effective as medication and helpful alongside it. This increases the reliability for using it as a treatment.
However the success of CBT may be down to the patient-therapist relationship. One researcher has noted that differences in therapy are quite small - it may be the quality of the relationship between patient and therapist that matters. This has been supported by many different studies.

Question 25

What are two weaknesses of CBT?

Answer 25

It may not work in the most severe cases of depression. Some cases are so severe that pateints cannot motivate themselves to take on the hard work required for CBT. In some cases it is required to treat patients with antidepressants and then commence CBT when they are more motivated and alert. This weakens its reliability however as it cannot be used as a sole treatment for CBT.
Another weakness is that there is an over emphasis on cognition. CBT minimises the circumstances in which the patient is living. For example if a patient lives in poverty or suffers abuse then they need to change this - but any approach that emphasises what’s going on in their mind can prevent this. CBT techniques used inappropriate can demotivate people to change their situation.

Question 26

What are two limitations of the behaviour approach to phobias?

Answer 26

There are alternative explanations for avoidance behaviours. In more complex behaviours like agoraphobia there is evidence that avoidance is motivated by feelings of safety. this explains why agoraphobics are able to leave their house with a trusted friend-but not alone. This reduces the reliability of the two process model as it may not fully explain phobias.
Another issue is that not all bad experiences lead to phobias. Some phobias do develop because of bad experiences and so it is easy to see how they could be the result of conditioning. However not all bad experiences lead to phobias. This reduces the validity of the theory as it suggests that it is not just conditioning alone that leads to phobias.

Question 27

What is systematic desensitisation?

Answer 27

It is the behaviour approach to treating depression. It is based upon classical conditioning, counterconditioning and reciprocal inhibition. The therapy aims to gradually reduce anxiety through counter conditioning - as the CS produces a CR. The CS is paired with relation and becomes the new CR. This is part of reciprocal inhibition, as it is not possible to be afraid and relaxed at the same time.

Question 28

How do anxiety hierarchies work within systematic desensitisation?

Answer 28

The patient and the therapist work to design an anxiety hierarchy - arranged in order from least to most frightening. An arachnophobic might identify seeing a picture of a spider as least frightening and holding a tarantula as the final item.
The individual is taught relaxation techniques-such as deep breathing and/or meditation. They then work through the anxiety hierarchy, at each level the phobic is exposed to the phobic stimulus in a relaxed state. This takes place over several sessions starting at the bottom of the hierarchy.Treatment is considered successful when the patient can stay relaxed in situations high on the hierarchy.

Question 29

What is flooding?

Answer 29

Flooding is the immediate bombardment of the patient with phobic stimuli - without a gradual build up. For example an arachnophbic may have a large spider crawl on them until they can relax fully. Without the option to avoid the stimuli they patient learns quickly that the phobic object is harmless through the exhaustion of their fear response.
It is not unethical, but it is unpleasant experience. This means that patients must give informed consent be fully prepared and know what to expect.

Question 30

What are two strengths of SD?

Answer 30

It is effective. Gilroy et al (2003) followed up 42 patients who underwent SD for aranchnophiobia in three 45-minute sessions. At both 3 months and 33 months the SD group were less fearful than a control group treated by relaxation without exposure. This increases the validity of the treatment as it has been shown to work.
SD is also more acceptable to patients and given the choice they tend to choose SD over flooding. This is because it does not cause the same amount of trauma as flooding. It also includes some elements that are pleasant - such as talking with a therapist. This means that SD has low refusal rates and low attrition rates (patients dropping out).

Question 31

What are two limitations of flooding?

Answer 31

Flooding is less effective for some types of phobia. It is highly effective for treating some types of phobias, but appears to be less so for other more complex phobias. This may be because social phobias also have cognitive aspects-the sufferer doesn’t just experience social anxiety but also think unpleasant thoughts about the situation. This decreases the reliability of flooding as a treatment - because it does not always work.
It is also traumatic for patients, which is perhaps the most serious issue with flooding. It is not unethical (informed consent), but patents are unwilling to see it through to the end. This is a weakness of the treatment - as time and money is spent trying to prepare patients only to have them refuse to complete treatment.

Question 32

What is the biological explanation to explaining OCD?

Answer 32

Genetically it can be explained by specific genes which create a vulnerability for OCD (called candidate genes). Serotonin genes (5HT1-D beta) are implicated in the transmission of serotonin across synapses. Dopmine genes are also implicated in OCD. Both dopamine and serotonin are neurotransmitters that have a role in regulating mood.
OCD is also polygenic as it is not caused by a single gene. One researcher has found evidence to suggest that upto 230 genes could be involved in OCD.
One group of genes may cause OCD in one person but a different group may cause it in another - meaning that it is aetiologically heterogeneous. There is also evidence to suggest that different types of OCD may be caused by different genes - such as hoarding and religious obsession.

Question 33

What are the neural explanations to OCD?

Answer 33

Low levels of serotonin lowers mood. Neurotransmitters are responsible for relaying information from one neuron to another. For example if a person has low levels of serotonin then normal transmission of mood-relevant information does not take place (and other mental processes are affected.
Some cases of OCD (and in particular hoarding) are associated with impaired decision making. This in turn is associated with abnormal functioning of the lateral frontal lobes in the brain. The frontal lobes are associated with logical thinking and making decisions. There is also evidence to suggest that an area in the left parahippocampal gyrus associated with processing unpleasant emotions, functions abnormally in OCD.

Question 34

What are two strengths of the biological explanation of OCD?

Answer 34

There is good supporting evidence. A variety of sources suggest that some people are vulnerable to OCD as a result of their genetic make-up. One study reviewed twin studies and found that 68% of MZ shared OCD as opposed to 31% of DZ twins. This increases the validity of the theory, as their is strong evidence to support it.
There is some supporting evidence for neural explanations of OCD. Antidepressants that work purely on the serotonin system are effective in reducing OCD system. Also OCD symptoms form part of the biological conditions such as Parkinson’s. This suggests that the biological processes that cause those conditions may also be responsible for OCD.

Question 35

What are two limitations of the biological approach to OCD?

Answer 35

Too many candidate genes have been identified. Twin studies suggest that OCD is largely genetic but psychologists cannot pin down all the genes involved. One reason for this is that it appears that several genes are involved and each variation only increases the risk of OCD by a fraction. This reduces the reliability as the genetic explanation is never going to offer strong predictive value.
The serotonin-OCD link may not be unique to OCD. Many people who suffer from OCD become depressed (this is called co-morbidity). This depression probably involves (but is not necessarily caused by) disruption to the serotonin system. This leaves a logical problem when it comes to the serotonin system as a basis for OCD. It reduces the validity - as the serotonin system may be disrupted due to the depression.

Question 36

How is OCD treated?

Answer 36

Drug therapies for mental disorders aim to increase or decrease levels of neurotransmitters in the brain or to increase/decrease their activity. Low levels of OCD are associated with OCD - so drugs work in various ways to increase the level of serotonin in the brain.

Question 37

What are SSRI’s?

Answer 37

Selective Serotonin Reuptake inhibitors (SSRIs). Prevent the reabsorption and breakdown of serotonin in the brain. This increases its levels in the synapse and so it continues to stimulate the postsynpaitc neuron. This compensates for whatever is wrong with the serotonin system in OCD.
A typical does of Fluoxetine (an SSRI) is 20mg,but this can be increased up to 60mg if it is appropriate. It takes 3-4 months of daily use before SSRIs start to effect symptoms.
SSRI’s are also used alongside CBT in treating OCD. They reduce a patient emotional symptoms such as anxiety or depression, this helps patients engage more effectively with CBT.

Question 38

What alternatives are there to SSRIs?

Answer 38

Tricyclics:
An older type of antidepressant that can be used - such as Clomipramine. They have the same effects but more severe side-effects.
SNRIs:
A different class of antidepressant called serotonin noradrenaline reuptake inhibitors that are used to treat OCD. Like tricylics they are used as an alternative for those that don’t respond to SSRI’s. They increase levels of serotonin + noradrenaline.

Question 39

What are two strengths of the biological approach to treating OCD?

Answer 39

Effective. One study reviewed 17 studies that compared placebos and SSRI’s in treating OCD. They all showed better results for SSRI’s than for placebos. SSRI’s are also more effective when coupled with CBT. typically symptoms reduce for 70% of patients taking SSRIs and the rest are helped by alternative drugs or CBT+drugs. This increases the validity of the treatment, as it shows SSRIs are the most effective.
They are cost effective and non-disruptive. Drugs tend to be cheaper in general than it would cost for therapy, which means it is good value or the NHS. SSRIs are also non disruptive to patients lives, the drugs can be taken until symptoms decline and not engage with the hard work of therapy. This means that it is preferred by doctors and patients.

Question 40

What are two limitations of the biological approach to treating OCD?

Answer 40

The drugs can have side-effects. Whilst they help most people SSRI’s will have no effect for some people. Some patients experience side-effects such as indigestion, blurred vision and loss of sex drive (these are usually temporary though). For those taking Clomipramine, side-effects are more common and serious. 1 in 10 experience erection problems and weight gain, 1 in 100 can become aggressive and suffer disruption to blood pressure and heart rhythm. These reduces the effectiveness of drugs as it means that some will not gain from them and patients stop taking the medication.
Some evidence for drugs is unreliable. Although SSRI’s are fairly effective and side effects tend to be short term there is some controversy surrounding the evidence for them. Some believe that the evidence that favours treatments is biased because it comes from drug companies that suppress some evidence to maximise economic gain. This reduces the validity of the study due to researcher bias.