Psychopathology Flashcards
1
Q
Define statistical infrequency
A
Occurs when an individual has a less common characteristic, for example being more depressed or less intelligent than most of the population
2
Q
Define deviation from social norms
A
Occurs when behaviour is different from the accepted standards of behaviour in a community or society
3
Q
What is the example for statistical infrequency?
A
- IQ and intellectual disability disorder
- IQ average of 100, those with scores of 70 or lower (2%) considered abnormal and could be diagnosed with intellectual disability disorder
4
Q
Why are there few behaviours considered universally abnormal on the basis of social norms?
A
There are many different societies and hence social norms may not be in breach of every social norm
5
Q
What is the example for deviation from social norms?
A
- Antisocial persoanlity disorder
- DSM-5 states a symptom as lack of prosocial standards and failure to conform to laws
- Social judgement that a psychopath is abnormal due to lack of conformity
6
Q
AO3: What is the real-life application of statistical infrequency?
A
- Diagnosis of intellectual disability disorder
- Place for statistical infrequency in how we think about normal/abnormal behaviours
- Useful for clinical assessment
7
Q
AO3: Why can statistical infrequency have a negative effect on unusual characteristics?
A
- IQ over 130 just as rare as IQ under 70
- However, IQ over 130 not undesirable and hence treatment not needed
- Some unusual characteristics can be positive
- Limitation as it cannot be used alone to make a diagnosis
8
Q
AO3: Why can statistical infrequency have negative impact by labelling people?
A
- Someone may be happy and hence no benefit with a negative label of abnormal
- Negative view of themselves and how people look at them
- Limitation as not useful
9
Q
AO3: Why is deviation from social norms not a sole explanation?
A
- Strength as real life application in diagnosis of antisocial personality disorder
- Helps determine normal/abnormal behaviour
- Other factors such as degree and context. E.g topless on a beach vs in an office
- Not used as a sole reason for identifying abnormality
10
Q
AO3: Why does deviation form social norms have cultural relativism
A
- Social norms vary from one culture and generation to another
- Limitation as no global standard for defining behaviour as abnormal and therefore abnormality is not standardised
11
Q
AO3: Why can deviation form social norms lead to human rights abuse?
A
- Over reliance can lead to human rights abuse
- Social norms change over time (hindsight bias) and many deviations from social norms may be in place to control minorities
- Abuses peoples right to be different
12
Q
AO3: Why is deviation form social norms preferred over statistical infrequency?
A
- Takes into account desirability of behaviour
- More useful than statistical infrequency
13
Q
Define failure to function adequately
A
Occurs when some is unable to cope with the ordinary demands of day to day life
14
Q
Define deviation from ideal mental health
A
Occurs when someone does not meet a set of criteria for good mental health
15
Q
When is someone failing to function adequately?
A
- Rosenham and Seligman (1989) suggested:
- No conformity to interpersonal rules
- Personal distress
- Irrational or dangerous behaviour
16
Q
What is the example for failure to function adequately?
A
- Intellectual disability disorder
- Used in conjunction with statistical infrequency for diagnosis to be given
17
Q
What are the criteria for ideal mental health?
A
- Jahoda (1958) suggested:
- No distress
- Rational
- Self actualise
- Cope with stress
- Realistic view of world
- Good self-esteem and lack guilt
- Independant
- Successfully work, love and enjoy leisure
18
Q
AO3: Why does failure to function adequately have individual differences?
A
- Two people could gave OCD
- One person rituals could interrupt their daily life
- Another could cope and carry on with daily tasks
- Same symptoms but different diagnosis
- Questions validity
19
Q
AO3: Why is it a strength that failure to function adequately takes into account personal perspective?
A
- Considers thoughts and feelings of person
- Judgement made with viewpoint
- Useful model in assessing psychopathological behaviour
20
Q
AO3: Why can it be hard to distinguish between failure to function and deviation form social norms
A
- Behaviour may appear to be failure to function adequately
- Person may choose to live another lifestyle
- Accused of maladptiveness and if we treat this as “failure,” personal freedom is limited
21
Q
AO3: Why is deviation from mental health a comprehensive definition?
A
- Positive and holistic approach
- Covers a broad range of factors and why people may seek help
- Strength as it is fully comprehensive
22
Q
AO3: Why does deviation from mental health suffer from cultural relativism?
A
- Criteria may be Western due to origin
- E.g personal growth and self actualisation may be seen as self centred in collectivist cultures
- Limitation as culture bound
23
Q
AO3: How does deviation from ideal mental health set an unrealistic high standard?
A
- No one can achieve all for very long due to stress etc
- Positive as we can see how to improve
- Treatment against will may occur with no factors taken into account
- How many criteria should be absent for treatment to occur
24
Q
Define phobia
A
An irrational fear of an object or situation
25
Define behavioural characteristic
Ways in which people act
26
Define emotional characteristic
Ways in which people feel
27
Define cognitive characteristic
Ways in which people think, know, perceive and believe
28
Define specific phobia
Phobia of an object or situation
29
Define social anxiety (social phobia)
Phobia of a social situation such as public speaking
30
Define agoraphobia
Phobia of large outside spaces or public spaces
31
State and give examples/summarise the three behavioural characteristics of phobias
Panic - screaming, crying or running away
Avoidance - Active avoidance of situation
Endurance - Remain in presence of phobia with high anxiety
32
State and give examples/summarise the two emotional characteristics of phobias
Anxiety - Unpleasant state of high arousal and fear
| Unreasonable response - Response disproportionate to danger posed
33
State and give examples/summarise the three cognitive characteristics of phobias
Selective attention - Fixated on object due to irrational belief
Irrational belief - Belief that is not necessarily true
Cognitive distortions - Likely to see phobic stimulus differently from everyone else
34
Define depression
A mental disorder characterised by low mood and low energy levels
35
Define major depressive disorder
Sever but short term depression
36
Define persistent depressive disorder
Long term or recurring depression
37
State and give examples/summarise the three behavioural characteristics of depression
Activity levels - low energy and lethargic but may also struggle to relax
Disruption to sleep/eating
Aggression and self harm
38
State and give examples/summarise the emotional characteristics of depression
Lowered mood - depressed and lack of interest
Anger at self or others
Low self esteem
39
State and give examples/summarise the three cognitive characteristics of depression
Poor concentration
Focusing on the negative
Absolutist thinking - all good or all bad
40
Define OCD
A condition characterised by obsessions and/or compulsive behaviour
41
State and give examples/summarise the two behavioural characteristics of OCD
Compulsions that are repetitive and reduce anxiety
| Avoidance
42
State and give examples/summarise the three emotional characteristics of OCD
Anxiety and distress
Depression
Guilt and Disgust
43
State and give examples/summarise the three cognitive characteristics of OCD
Obsessive thoughts
Cognitive strategies to deal with obsessions
Insight into excessive anxiety
44
Define behavioural approach
A way of explaining behaviour in terms of what is observable and in terms of learning
45
Define classical conditioning
A conditioning where people learn by association. UCS paired with NS to produce the CR which was the UCR and the UCS becomes the CA
46
How are phobias acquired and maintained?
Acquisition by classical conditioning
| Maintenance by operant conditioning
47
Who proposed the two process theory for the behavioural explanation of phobias
Mowrer (1947)
48
Outline the procedure of Watson + Rayner (1920)
- 11 month old "little Albert"
- No response to white rat first
- Struck metal bar with hammer every time he reached for the rat
49
Outline the findings and conclusion of Watson + Rayner (1920)
- Little Albert cried when he saw the rat
- Fear could be induced through classical conditioning
- Developed fear of similar objects e.g Santa and cotton balls
- Shows fear can generalise to other objects/situations
50
What is the UCS, UCR, N, CS and CR in the study of Watson + Rayner (1920)
```
UCS - Loud noise
UCR - Fear
NS - Rat
CS - Rat
CR - Fear
```
51
How are phobias maintained by operant conditioning?
- Behaviour reinforced (rewarded)
- Reinforcement increases likelihood of behaviour
- Avoidance occurs in phobias
- This negative reinforcement leads to desirable consequence
- Avoidance reinforced and phobia maintained
52
AO3: What is the research support for the behavioural approach explaining phobias?
- Watson + Rayner (1920) demonstrated classical conditioning forming a phobia
- Supports theory of acquisition
- Supports generalisation
- Case study difficult to generalise
53
AO3: Why is the behavioural explanation of phobias incomplete?
- Ignores evolutionary factors (Bounton 2007) e.g the dark which was a source of danger in our evolutionary past
- Two process model cannot explain this
- Seligman (1971) called this biological preparedness: innate predisposition to acquire certain fears
- Two process model canont explain why many of us don't fear cars after bad experiences or phobias without trauma
54
AO3: What is the alternative explanation for avoidance behaviour?
- Not all avoidance is for anxiety reduction for more complicated phobias e.g agoraphobia
- Some avoidance motivated by feelings of safety
- Hence some patients with agoraphobia can leave with little stress (Buck 2010)
- Limitation as two process model does claims avoidance is for anxiety reduction
55
Define systematic desensitisation
A behavioural therapy designed to reduce an unwanted response, such as anxiety, to a stimulus on the principle of classical conditioning. SD draws upon a hierarchy of anxiety-provoking situations, teaching the patient to relax, and then exposure. Patients work through the hierarchy whilst staying relaxed
56
Define flooding
A behavioural therapy in which a phobic patient is exposed to an extreme phobic stimulus in order to reduce anxiety. Thus occurs over a small number of long therapy sessions
57
Define counterconditioning
Being taught a new association that is the opposite of the original association, removing the original association
58
Summarise systematic desensitisation
- Anxiety hierarchy from least to most frightening
- Relaxation techniques to achieve the most relaxation
- Exposure
59
What two things do systematic desensitisation achieve that cure the phobia?
Counterconditioning and reciprocal inhibition (inability to feel anxiety and relaxation at the same time)
60
How does flooding work?
Extinction is achieved as negative reinforcement does not occur and hence the phobia is not avoided. Fear is time limited and so subsides creating calm and relief which is the new association for the stimulus
61
AO3: How do we know systematic desensitisation is effective?
- Gilroy (2002) followed up 42 patients of SD
- Spider phobia assessed with questionnaire
- Control group treated by relaxation without exposure
- At 3 and 33 months, SD group less fearful than control
- Strength as shows SD reduces anxiety in spider phobia and effects are long lasting
62
AO3: Why is systematic desensitisation appropriate to.a range of patients?
- Flooding and cognitive may not be suitable for learning difficulty patients
- They cannot understand what is happening during flooding
- SD also more ethical as lower distress levels
- Low attrition rates for SD support this
- Hence more appropriate for range of people
63
AO3: Why may SD not be appropriate for all phobias?
- Phobias that did not develop through classical conditioning
- These evolutionary fears and biological dispositions are for survival and not the result of learning
- Limitation as cannot read evolutionary phobias with an innate basis
64
AO3: How is flooding cost-effective?
- Ougrin (2011) found flooding was just as effective as other treatments and quicker than alternatives
- Patients free from symptoms faster and hence less sessions creates lower cost
65
AO3: Why is flooding not appropriate for all phobias?
- Good for specific phobia
- Complex phobias such as social phobia have cognitive aspects
- Not entirely behaviourist
- Limitation as other therapies may treat these phobias more effectively
66
AO3: What is bad about the trauma caused by flooding?
- High anxiety
- Wolpe (1969) recalled a case where anxiety was so high patient was hospitalised
- Not unethical as consent given
- May not complete treatment and hence waste of time and money
67
Define negative triad
Three types of negative thinking as proposed by Beck (1967). Negative views of the world, self and the future. This leads to negative interpretation of experiences and makes them more vulnerable
68
Define ABC model
Model proposed by Ellis (1962) claiming depression is caused by an (A)ctivating event triggering an irrational (B)elief prodding a (C)onsequence such as depression
69
What are the three parts to Becks theory of cognitive vulnerability?
- Faulty information processing/cognitive bias
- Negative self-schemas
- Negative triad
70
What is faulty information processing/cognitive bias?
When information is received, people either tend to focus on the negative or exaggerate the negative
71
What are negative self schemas?
A negative view of information about ourselves
72
What are the two types of beliefs in Ellis' model and what does this lead to?
```
Rational = healthy emotions
Irrational = unhealthy emotions
```
73
AO3: Why does Beck's theory have good supporting evidence?
- Range of evidence that depression due to faulty information processing, self schemas and cognitive triad
- Grazioli + Terry (2000) assessed 65 pregnant for cognitive vulnerability before and after birth
- Higher vulnerability lead to higher post natal depression
- Beck (1999) reviewed this and saw cognition preceded depression and hence may cause it
74
AO3: How does Beck's theory have a practical application?
- Basis of CBT
- All cognitive aspects can be identified and challenged
- Translates well into successful therapy
75
AO3: Why doesn't Beck's theory explain all aspects of depression
- Explains basic symptoms
- Depression more complex e.g extreme anger, hallucinations
- Beck does not account for this and hence this is a limitation
76
AO3: Why is Ellis' model a partial explanation?
- Some depression follows activating event
- This is reactive depression
- Not all depression follows events
- Limitation as cannot explain all depression
77
AO3: How does Ellis' model have a practical application?
- Led to successful therapy such as CBT
- This reduces depression (Lipsky 1980)
- Supports theory as it suggests irrational beliefs have a role in depression
78
AO3: Why doesn't Ellis' model explain all aspects of depression?
- Ellis says why people appear more vulnerable due to cognitions
- Does not explain anger etc
79
Define CBT
A method for treating mental disorders based on both cognitive and behavioural techniques. Cognitive viewpoint deals with thinking and behavioural viewpoint deals with behavioural activation
80
Define irrational thoughts
Dysfunction thoughts that are defined as thoughts likely to interfere with a person's happiness as proposed by Ellis. The lead to mental disorders
81
Summarise Beck's CBT
- Assessment to clarify problems
- Goals identified
- Negative triad identified
- Thoughts challenged and evidence discussed
- Homework and tests for the validity of their negative thoughts
82
Summarise Ellis' REBT
- ABCDE model
- D = Dispute
- E = Effective
- Assessment to clarify problems
- Goals identified
- Patients thoughts disputed and more effective beliefs put in place
- Logical dispute = logic questioned
- Empirical dispute = Evidence for thoughts
83
AO3: Why may CBT not work for the most severe cases?
- Depression so severe patients lack motivation
- Antidepressant used and commence CBT when mood higher
- Limitation as CBT not the sole role of treatment
84
AO3: Why may CBT success be due to therapist patient relationships?
- Rosenzweig (1936) suggested differences between CBT and SD are small
- Quality of relationship is what determines success
- Evidence supported by Luborsky (2002) showing little different between psychotherapy
- Limitation as CBT not the cause of success
85
AO3: What is the support for CBT?
- Effective
- March (2007) compared effects of CBT, antidepressants and a combination
- After 36 weeks, 81% of solo group improved
- 86% of combination group improved
- Good case for CBT to be main choice for NHS and combination may be best choice
86
Summarise the genetic explanations of OCD
- Candidate genes create vulnerability for OCD such as the COMT and SERT gene
- COMT regulates dopamine (one variation produces too much dopamine)
- SERT linked with serotonin
- Ozaki (2003) published results with from two families with mutated SERT genes. 6/7 had OCD
87
Why is OCD described as polygenic?
- Several genes involved
| - Taylor (2003) suggests up to 230 genes so possibly different genes cause different types
88
What is the research support for the genetic explanation of OCD?
- Lewis (1936) observed 37% of OCD patients had parents with OCD and 21% had siblings with OCD
- Genes passed from family so genetic disposition possible
89
Summarise the neurotransmitter neural explanation of OCD
- Neurotransmitter responsible for relaying information
- Low serotonin, mood relevant information not transmitted and mood affected
- Piggott (1990) found drugs increasing serotonin effective for OCD
90
Summarise the brain structure neural explanation of OCD
- Structural dysfunction causes worry circuit
- Abnormal brain circuits in basal ganglia and orbitofrontal cortex
- OFC sends worry signals picked up by thalamus
- Caudate nucleus does not work and worry signals not supressed
- Too much worry causes OCD
91
AO3: What is the supporting evidence for the genetic explanation of OCD?
- Lewis (1936) found 37% of OCD patients had a parent with OCD and 21% a sibling
- Nestadt (2010) reviewed twin studies and found 68% of identical twins shared OCD compared to 31% of no identical twins suggesting genes involved
92
AO3: What is bad about having too many candidate genes?
- Less success with pinning down certain genes as several genes involved with other risk factors
- Not very useful as little predictive value
93
AO3: Why do environmental factors limit the genetic explanation?
- Cromer (2007) found over half of OCD patients had a traumatic event
- OCD more severe if multiple traumas
- Suggests OCD cannot be entirely genetic
94
AO3: What evidence is there to support neurotransmitter neural explanations of OCD?
- Some antidepressants work purely on serotonin
| - These drugs effective in treating OCD
95
AO3: Why is not clear what neural mechanisms are involved in OCD?
- Neural systems in decision making are abnormal in OCD patients
- Other systems also identified
- No system that always causes OCD
- Cannot claim to fully understand neural mechanisms
96
AO3: Why should we not assume neural mechanisms cause OCD?
- OCD may cause these biological abnormalities
| - Alternative explanation of behaviourism may also apply
97
Define drug therapy
Treatment involving drugs i.e chemicals that have a particular effect on the functioning of the brain or some other body system. In the case of psychopathology, these drugs affect neurotransmitters
98
What are the three types of drugs used in treating OCD?
Antidepressant drugs, anti anxiety drugs and benzodiazepines
99
Summarise how SSRIs are used in the treatment of OCD
- Prevents reabsorption of serotonin in the synaptic cleft
| - Compensates for what is wrong with the serotonin system
100
Why are drugs used alongside CBT in the treatment of OCD?
- Drugs reduce a patients emotional symptoms
| - Person engages in CBT more actively and successfully
101
State and describe the two alternatives to SSRIs
Tricyclics - A type of antidepressant with more severe side effects so reserved for those who do not response to SSRIs
SNRIs - Second line of defence for those who don't respond to SSRIs also acting on noradrenaline
102
How do benzodiazepines work in the treatment of OCD?
- Enhances action of neurotransmitter GABA
- Reduces chances of neurons firing as around 40% of neurons respond to BZ
- Reduces anxiety caused by OCD
103
AO3: What is good about drugs being cost effective and non disruptive in the treatment of OCD?
- Cheap makes them good for public health system and widely available
- No hard effort required and day to day life can continue
- Preferred because of this
104
AO3: What is negative about drugs in the treatment of OCD?
- Side effects e.g indigestion, blurred vision and loss of libido
- This reduces effectiveness of the drug as people ultimately stop taking the drug
105
AO3: What is negative about drug therapy for OCD and the treatment of only symptoms?
- Relieves symptoms and not cause
- Prone to relapse after drug not taken
- OCD thought to be biological in origin and hence OCD following trauma cannot be treated by drugs for the same reason
- May not be as effective and hence limitation
106
AO3: What is good about drug therapy being effective in the treatment of OCD?
- Reduce OCD symptoms
- Improves quality of life
- Soomro (2009) reviewed studies if SSRI and placebo
- All studies showed better results for SSRI and best when combined with CBT
- SSRI effective for around 70% so helps people with symptoms
