Psychopathology Flashcards
Definitions of abnormality- Explain what is meant by deviation from social norms
Behaves in a way that is different from how we expect people to behave. Societies define abnormal behaviour on the basis it offends their belief of what is acceptable or the norm. Norms are specific to the culture we live in
What’s the cultural view on deviation from social norms
Unlikely behaviour is considered universally abnormal in every society and culture
What’s an example of how the deviation from social norms changes from culture to culture
Antisocial personality disorder (psychopathy) is impulsive aggressive and irresponsible. DSM-5 states “ an absence of prosocial internal standards associated with failure to conform to lawful or culturally normative ethical behaviour”
Evaluation of deviation from social norms
Not a sole explanation- strength of this definition is real life application in the diagnosis of anti social personality disorder. There is therefore place for this definition in thihnking about what is normal and abnormal
Lead to human rights abuses- too much reliance on this to understand abnormality can lead to systematic abuse of human rights. Some diagnoses from history were in place to maintain control over minority ethnic groups and women e.g drapetomania stops black slaves running away.
Explain failure to function adequately
When someone can no longer cope with the demands of everyday life e.g unable to maintain basic standards of nutrition and hygiene
Three categories from failure to function adequately and who developed then
From Rosenhan and Seligman
No longer conforms to standard interpersonal rules e.g making eye contact or maintaining personal space
Severe personal distress
Irrational or dangerous to themselves
Evaluation of failure to function adequately
Overlaps with/It is just a variation of deviation from norms e.g behaviour is irrational in base jumpers doesn’t mean mental health
Judgements- someone has to make the judgment about whether a patient is distressed or not. However there are methods for making judgements as objective as possible like global assessment of functi Ning scale
Explain statistical infrequency
Normal or abnormal depending on how often it occurs. Any usual behaviour or characteristic is normal. Any statistically infrequent behaviour is abnormal and may indicate mental health issues
evaluation of statistical infrequency
Real life application- compare how severe symptoms of patients are with those of statistical norms
Unusual characteristics can be positive e.g high IQ. Having an unusual characteristics doesn’t always mean you require treatment
If you’re statistically infrequent and there’s no negative consequences to you’re life then being labelled as abnormal has no benefits. Stigma
Explain deviation from ideal mental health
Look at what makes someone normal and once have a picture of how we should be psychologically healthy we can begin to identify who deviates from this idea.
Who came up with the categories for ideal mental health and name the 7
Marie Jahoda No symptoms or distress Rational perceive ourselves accurately Self actualise Cope with stress Realistic view of world Good self esteem lack guilt Independent of others Successfully work love and enjoy leisure
Evaluation of deviation from ideal mental health
Comprehensive definition- covers broad range of criteria for mental health and mentions most of the reasons someone would seek professional help.
Unrealistically high expectation for mental health- very few of us attain all of the criteria for mental health at the same time or keep it up for long. Too demanding
What’s a phobia and the three types
Excessive fear and anxiety triggered by an object place or situation. Extent of fear is out of proportion to any real danger represented by the phobic stimulus. Irrational fear response
Specific social and agoraphobia
What’s a specific phobia
Phobia of an object such as an animal or body part or a situation such as flying or having an injection
What’s social anxiety/phobia
Phobia of a social situation such as public speaking or using a public toilet
What’s a agoraphobia
Phobia of being outside or in a public place
What are the behavioural characteristics of phobias
Panic- crying screaming or running away.
Avoidance- go to extremes to avoid the phobic stimulus can make every day life hard.
Endurance- alternative to avoidance. Remains in presence of stimulus but continues to experience high levels of anxiety
Emotional characteristics of phobias
Anxiety- emotional response of anxiety and fear. Unpleasant state of high arousal. Prevents relaxation stops positive emotions and can be long term. Fear immediate and unpleasant response to phobic stimulus
E.g arachnophobia
Emotional responses are unreasonable
Cognitive characteristics of phobias
Selective attention- can’t look away. Keeping attention on dangerous thing is good but not useful when fear is irrational.
Irrational beliefs- irrational beliefs in relation to phobic stimulation e.g I must always sound intelligent. It Can lead to increasing pressure on the sufferer to perform well in social situations.
Cognitive distortions - perception of stimulus may be distorted.
Behavioural characteristics of depression
Activity levels - reduced energy, lethargic. Withdraw from education work and social life. Extreme cases can’t get out of bed
Opposite is psychomotor agitation lead to pacing
Disrupting sleep and eating- insomnia (reduced sleep) premature waking or hypersomnia which is a need for more sleep. Appetite may increase or decrease. Weight gain or loss
Aggression self harm- verbally and physically aggressive. Physical aggression directed against self. Cutting or suicide attempts
What are the 4 types of depression
Major depressive disorder = severe but short term
Persistent d.d= long term or recurring depression, including sustained major depression and dysthymia
Disruptive mood dysregulation disorder= childhood temper tantrums
Premenstrual dysphoric disorder = disruption to mood prior to and or during menstruatiob
Emotional characteristics of depression
Lowered mood- feeling sad. Describe themselves as worthless and empty
Anger- directed at selves or others. Could lead to aggression or self harm
Lowered self esteem- emotional experience of how much we like ourselfves. Can be extreme with people describing themselves as self loathing
Cognitive characteristics of depression
Poor concentration - unable to stick to a task, hard to make decisions, interfere with work
Attending to and dwelling on the negative- pay more attention to negative aspects of a situation. Bias towards recalling negative memories over positive ones.
Absolutist thinking- black and white thinking. When a situation is unfortunate they see it as a disaster
What is OCD
Characterised by either obsessions and or compulsions. Most people diagnosed have both
Give three examples
Trichotillomania- hair pulling
Hoarding disorder- compulsive gathering of possessions and the inability to part with anything regardless of its value.
Excoriation disorder- compulsive skin picking
Behavioural characteristics of OCD
Compulsions are repetitive and sufferers feel compelled to repeat behaviours. E.g handwashing
Compulsions carried out to reduce anxiety =10% of sufferers of OCD only show compulsive behaviour without obsessions but most of the time they’re done to reduce anxiety produced by obsessions
Avoidance- attempt to reduce anxiety by keeping away from situations that trigger it e.g avoid surfaces with possible germs to avoid setting the compulsion of handeashing off interfere with normal life
Emotional characteristics of OCD
Anxiety and distress- anxiety comes with obsessive thoughts as they’re frightening and overwhelming. The urge to repeat behaviours causes anxiety too
Accompanying depression- low mood and lack of enjoyment in activities
Guilt and disgust- irrational guilt over minor moral issues and disgust sometimes at oneself sometimes external line dirt
Cognitive characteristics of OCD
Obsessive thoughts- 90% of OCD sufferers have this as the major cognitive feature of their condition. Thoughts recur over & over
Cognitive strategies to deal with obsessions- use compulsions to calm anxiety from obsessions but make them seem abnormal
Insight into excessive anxiety- ocd sufferers know they’re behaviour is irrational. tend to be hyper vigilant and maintain constant alertness in case worst case scenario occurs
What’s the two process model
For explaining behaviour characteristics of phobias. Hobart and Mowrer proposed the two process model based on the behavioural approach to phobias. Phobias are acquired by classical conditioning and continue because of operant conditioning
What’s the research for classical conditioning in two process model
Little Albert. Watson and raynor. Created phobia in 9 month old baby no unusual anxiety at start of study to white rat and played with it. Accompanied with noise then phobia
Evaluation of behavioural approach to explaining phobias
Incomplete explanation- not everyone with phobia has experienced a dog bite. Explained by diathesis stress model. Inherit a genetic vulnerability to devleping mental issues. Triggered by life event.
Cognitive aspects- doesn’t address cognitive elements so is an incomplete explanation
Practical application- by addressing how phobias are maintained over time it highlighted the important of exposing patients to the feared stimulus in therapies
What’s systematic desensitisation
Classical conditioning to gradually reduce phobic response. New response to stimulus is learnt this is counterconditioning
Learn to be relaxed
Can’t be afraid when relaxed as they cancel each other out, this is reciprocal inhibition.
The anxiety hierarchy
Relaxation
Exposure
How does flooding work
Extinction = Conditioned stimulus is encountered without unconditioned stimulus so Conditioned stimulus no longer provokes the conditioned response
Could experience relaxation in presence of phobic stimulus due to exhaustion from prolonged fear response
Need fully informed consent as it can be a traumatic experience
Evaluaiton of behavioural approach to treating phobias
Effective- Gilroy et al followed up 42 patients who treated with spider phobia with systematic desensitisation. Phobia was assessed by questionart. Less fearful than control group
Suitable for diverse range of patients - people with learning difficulties struggle with reflective nature of cognitive treatments and flooding but can do systematic desensitisation
Can’t cure all phobias in particular the survival based ones e.g fear of dark like it can the learned phobias
Cost effective- flooding is as effective as the others and requires less sessions making it cheaper
What are the aspects of becks explaining depression
Negative self schema- mental framework of how we see ourselves means interpret everything about self in a negative way
Faulty information processing- focus on negative aspects of a situation and not the positives, blow small things out of proportion
negative triad:
Negative view of world
Negative view of future
Nevatvie view of self
What’s Ellis ABC Model
Depression Due to irrational beliefs. These are thoughts that interfere with being happy or pain free
A= activating event triggers irrational beliefs
B = irrational beliefs. Example is Must always succeed or achieve perfection known as “musterbation”
C= consequences feel disappointed or worthless leads to depression
Activating agent, irrational belief, unhealthy emotion
Evaluation of cognitive approach
Support for the role of irrational thinking- bates et al depressed participants given negative automatic thought statements became more and more depressed supporting the view that negative thinking leads to depression. However could question the causal relationship here depression could cause neg thinking rather than the other way around
Doesn’t explain all aspects e.g deep anger, hallucinations and bizarre beliefs not explained by the cognitive explanations and may lead to patient blaming and overlooking situational factors
Practical applications to CBT. CBT created from this research
explain CBT
Developed from becks negative triad
Cognitive behavioural therapy
Clarify problem, identify goals, make a plan.
Identify negative and irrational thoughts of self world and future and challenge them.
Homework patient as scientist allows them to test and disprove negative beliefs
Write down positive events when someone was nice then when say no one is nice has evidence that they are
What’s REBT
Developed from ABC model
Rational emotive behavioural therapy
ABCDE
D= dispute. Argue with the patient about negative view so they realise it’s irrational. Involves vigorous argument. Empirical argument will dispute if there’s evidence for belief. Logical argument question if thoughts from facts
E= effect
Break the link between negative life events and depression
What’s behavioural action
Therapist encourage patient to be more active and engage in enjoyable activities
Provide more evidence for the irrational nature of their beliefs
Evaluation for cognitive treatments of depression
Effective- March compared effects of CBT and antidepresssant with 327 adolescents. 81% of CBT group and 81% of drug group significantly improved so just as good
May not work with severe cases as they can’t motivate themselves to engage with CBT. Could partner with drug therapy as interactionist approach. 86% improvement in March study
Support for behavioural action- babyak et al- 156 pp studies three groups one aerobic exercise one drugs and one with just drugs. Exercise one showed less relapse
Biological approach to explaining OCD the neural explanations
Neurotransmitter serotonin regulates mood. Low levels of serotonin means normal transmission of mood relevant info doesn’t take place. OCD can be explained by a reduction of serotonin system in the brain
Decision making
parahippocampal gyrus associated with processing unpleasant emotions but functions abnormally in OCD people . Abnormal functioning of lateral of the frontal lobe associated with cases of OCD as this is the part responsible for logical thinking and making decisions
Genetic explanations for OCD
Candidate genes-create vulnerability for OCD. Some are involved in the regulation of the serotonin system e.g the SERT
OCD is polygenic- caused by several genes. Taylor looked at studies and found evidence for 230 genes involved in OCD
Different types of OCD - some genes may cause OCD in one person but a different group of genes may cause it in the next. Term is aetiologically heterogenous means origin of OCD can be different. Could explain different types of OCD such as hoarding or religious obsession
Evaluation of biological approach to explaining OCD
Supporting evidence- some drugs target the serotonin system and have resulted in reduction of OCD symptoms.prsctical app of developing drugs
No neural system has been found that always plays a part in OCD so is not clear which ones exactly are responsible
Twin studies have shown genes have a large role but psychologist haven’t been able to identify all the genes. Twin study (Nedstadt) however showed 68% concordance between MZ compared to 31%
Environmental triggers are not very well understood but Cromer et al found traumatic events present in over half the OCD patients he studied. Implication for prevention focus on environmental causes before genetic as can do more about it
What’s a SSRI
SSRIs - selective serotonin reuptake inhibitor. Stop as many neurotransmitters being taken back up by the pre synaptic Neurone
Works on the seratonin system in the brain
What does a tricyclic do
Block transporter mechanism that reabsorbs serotonin and noradrenaline prolonging their activity in the synapse and easing transmission of next impulse. More severe side effect so kept in reserve for patients who don’t respond to SSRIs
Positive target more than one neurotransmitter
What do anti anxiety drugs do
Benzodiazepines slows down the activity of the CNS by enhancing activity of neurotransmitter GABA which quietens neirons in the brain. Increases flow of chloride ions into Neuron making it harder for it to be stimulated by other neurotransmitters making people feel more relaxed
Evaluation of biological approval to treating OCD
Effective- Soomro et al reviewed studies using SSRI and placebos and found significantly better results on the real drug. Decline significantly for about 70% of patients.
Cost effective good value for public systems like NHS. Can treat lots of people for the same price of one CBT. Non disruptive to patients lives.
Can have side effects- indigestion blurred visions loss of sex drive. More than one in ten tricyclic users see weight gain tremors and erection problems. This is a problem as people stop taking them and relapse, don’t get any better
Explain the two parts of the two process model for phobias
Classical- learning to associate something that triggers no fear (NS) with something that already triggers the fear response (UCR) so CS=CR
Operant - negative and positive reinforcement increases the frequency of the behaviour. Negative reinforcement, run away from phobic stimulus anxiety leaves- reduction in fear reinforces the avoidance behaviour
Describe the three components of systematic desensitisation
Anxiety hierarchy put together by therapist and patient, list of situations related to the phobic stimulus that provoke anxiety in order of least to most frightening
Relaxation- teach patient how to relax. Might involve breathing exercises, meditation, mental imagery etc to use later
Exposure - starting at the bottom of the hierarchy the patient is exposed to phobic stimulus. When they can stay relaxed on low level they move up. Treatment successful when relaxed at high levels of hierarchy
