Psychopathology

Question 1

A01 for statistical infrequency

Answer 1

Numerical definition makes it objective
Looks at behaviour in terms of a normal distribution curve
If we know most common behaviour then we also know when behaviour is unusual
Unusual behaviours are far away from peak of normal distribution curve
Defines behaviour in terms of typical values such as mean median n mode

Question 2

A03 for statistical infrequency limitations

Answer 2

Not all infrequent behaviours are undesirable and not all frequent behaviours are desirable with high IQ and depression
Subjective cut off on normal distribution curve eg lack of sleep constituting as depression as some people are able to function well with fewer hours sleep than others or the majority.

Question 3

A03 statistical infrequency support

Answer 3

When used in conjunction with failure to function or other definitions of abnormality it makes defining abnormality more reliable to be correct and thus help people
Objective measure due to being numerical statistical definition using empirical data

Question 4

A03 statistical infrequency cultural relativism

Answer 4

Statistically frequent behaviours in one culture may be statistically infrequent in others
Hearing voices of loved ones who are dead may be considered desirable in some cultures but in western societies considered undesirable and a likely indication of schizophrenia

Question 5

A01 deviation from social norms

Answer 5

Socially based definition - based on social norms which refers to the expected/unusual behaviour in a culture or society
Are explicit and implicit rules that a society has about socially acceptable behaviours values and beliefs
Deviance from social norms are undesirable often leads to rejection being considered abnormal

Question 6

A03 support for deviation from social norms

Answer 6

Focus on social norms which helps society function and considers the impact of behaviour of others thus protecting society

Question 7

A03 limitations of deviation from social norms

Answer 7

Based on politics and morality at a given time
Behaviour can be adaptive while seen as socially abnormal such as cross dressing helping men express themselves
Role of context - different ways of acting in different situations alongside extremity of behaviour eg shouting in the street vs a football match
Changes in societal norms overtime for example homosexuality used to be listed in the DSM as a mental disorder

Question 8

A03 cultural relativism for deviation from social norms

Answer 8

Social norms can vary from one culture to another
What is considered socially acceptable in one culture may not be to another eg ideas on personal space can vary between cultures
Danger of being ethnocentric (assumption that own culture is the norm) so any deviations from this indicates abnormality
DSM makes reference to different cultural behaviours in terms of panic attacks as some cultures count crying as a symptom of a panic attack rather than just breathing rate

Question 9

A01 failure to function adequately

Answer 9

About every day activities
People with psychological disorders often experience considerable suffering and distress leading/meaning to/of a general inability to cope with every day activities eg may be unable to go to work or lose the motivation to care for themselves
Distress may also be to others as individuals may not be aware of how much they are suffering or causing distress eg hallucinations with schizophrenics

Question 10

A01 failure to function adequately WHODAS scale

Answer 10

Includes ratings on
Understanding n communicating
Ability to do life activities n participate in society
Getting along with others and being able to get around

Question 11

A03 failure to function adequately limitations and strength

Answer 11

Strength can be measured objectively by using WHODAS scale
Limitations
Behaviour may be adaptive eg eating disorder reinforced by attention meaning becomes adaptive n functional for the individual
Subjective judgement for those that don’t recognise disorder and only have those around them to persuade case
Cultural relativism
Behaviours common to one culture may be considered dysfunctional in another eg siestas

Question 12

A01 deviation from ideal mental health

Answer 12

Positivist approach - looks at what is mentally healthy rather than mentally ill
6 criteria by jahoda who set up the notion of ideal mental health in defining abnormality
Anyone lacking the qualities of the criteria signifies them to have a tendency towards a mental disorder

Question 13

Deviation from ideal mental health 6 criteria

Answer 13

1. Positive attitude towards self
2. Have personal growth and self actualise
3. Resistance to stress
4. Personal autonomy
5. Accurate perception of reality
6. Accepting and mastering environment

Question 14

A03 deviation from ideal mental health strength and limitations

Answer 14

Strength positivist approach considers what it means to be healthy allowing people to work towards something in being able to cope with mental disorder
Limitations
Ideals are unrealistic and overly optimistic as by definition an ideal is hard to define so in this case most of us would be defined as having a mental disorder
Subjective assessment involved in jahodas criteria assessment eg how we assess personal growth
Cultural relativism
Criteria of self actualisation may apply to those in individualist culture like the west but not in a collectivist approach like japan with the meaning and significance of the definition differing

Question 15

Describe the behavioural approach to explaining phobias in terms of the two process model A) classical conditioning

Answer 15

Involves learning through association
A neutral stimulus is becomes paired with an unconditioned stimulus
This association brings unconditioned response
Pairing the unconditioned stimulus with the neutral stimulus makes the neutral stimulus became a conditioned stimulus which leads to a conditioned response
Explaining a dog phobia NS = dog UCS = bite UCR = fear. Dog becomes associated with bite. Bite causes fear. Then so dog = fear

Question 16

Describe the behavioural approach to explaining phobias in terms of the two process model B) operant conditioning

Answer 16

Maintenance of phobia
Reward = increased likelihood of behaviour being repeated
Avoidance of feared object = reward = negative reinforcement
Eg spiders being removed

Question 17

Social learning behavioural approach to explaining phobias

Answer 17

Phobias can be acquired through observation of models (vicarious learning) spider phobia can be learned vicariously through observation of a parent who displays extreme fear of something which may be imitated by observer.

Question 18

Evaluation of the behavioural explanation of phobias

Answer 18

Not everyone can relate their phobia to an experience so therefore different phobias could be the result of different processes brought about by either a specific incident or modelling with agoraphobics being specific incident types and arachnphobics developing phobia due to modelling

Diathesis stress model explains why not everyone develops a phobia from a negative experience saying we inherit genetic vulnerability for developing mental disorders. Disorder manifests when triggered by life event for those with a high genetic vulnerability using a biological explanation in place of behavioural

There is research evidence to support social learning as an explanation for phobia development from bandura and rosenthal where ps learned to aquire a fear response to sound of a buzzer by observing a role model.

A problem with the two process model as an explanation for the development of phobias is that cognitive factors get overlooked as irrational thinking plays a part and doesn’t give the opportunity for CBT which has been widely used (is generally very effective for social phobias eg public speaking)

Biological preparedness might explain why some phobias are more prevalent than others as an adaptive advantage. The association between life threatening stimuli n fear explains ancient fears such as snakes. (Biologically programmed to be predisposed towards) explaining why we are less likely to develop fears around every day objects. Evolutionary

Question 19

Behavioural approach to treating phobias systematic desensitisation and flooding description.

Answer 19

Step 1 - learn relaxation techniques
Step 2 - construction of hierarchy of fear
Step 3 - move through hierarchy - at each stage achieve relaxation instead of fear
Step 4 - start w first stage of hierarchy practicing relaxation around stimuli of fear final stage of hierarchy reached with use of relaxation techniques
Step 5 - counter conditioning achieved

In SD gradually exposed to fear but flooding exposed to extreme form of threatening situation under relaxed conditions for extended period of time in a controlled environment in vivo. Sees fear as a time limited response the bodily arousal caused by hormones can only last so long.

Both create a new association between feared object or situation and prevent reinforcement of a phobia through avoidance behaviours.

Question 20

Evaluation of systematic desensitisation

Answer 20

Effectiveness- research found 75% respond to SD is faster and require less effort than CBT quick to work

Appropriateness - not as effective for treating phobias that have an evolutionary survival component in comparison to fears as a result of personal experience as they are more difficult to counter condition because innate

Strength - can be self administered thus cheaper. Lack of thinking can be good for those who aren’t as insightful eg children.

Question 21

Evaluate flooding as a treatment for phobias

Answer 21

Individual differences - high risk therapy can be highly traumatic some people may quit thus reducing effectiveness of therapy. Risk of increase in fear rather than reduction. People with weak hearts may not be able to cope.

Effectiveness - been around since 1950s and still used. Only successful if phobic is able to remain in fearful situation till calm and relaxed. Effectiveness also depends on length of exposure height phobics best to have prolonged exposure till levels fall back to normal. Cannot be used unless as a last resort however survey of therapists in 1980 showed very few neg side effects showing is appropriate and safe for most people.

Question 22

Describe the cognitive explanation for depression

Answer 22

Fundamental belief - thought processes cause behaviour and irrational thought process result in irrational behaviour
Irrational thought processes - interpretation of the event more important than the event itself
Ellis’ ABC model - Activating event Belief about event Consequence of belief eg fail exam belief is I’m not clever the consequence of this belief is I won’t pass anything
Mustabatory thinking - a source of irrational beliefs based on idea that assumptions made must so have to be true and in order to achieve happiness musts need to be challenged, the way we interpret.
Negative schemas - acquired during childhood. Adopting a negative view of the world. Associated with the idea of expecting to fail. Is activated in new situations. Overgeneralising leads to cognitive distortion having cognitive bias about the world in a neg way.
Beck’s negative triad - neg view of self neg view of world neg view of future.

Question 23

Evaluate cognitive explanation for depression

Answer 23

Research evidence for relationship between neg thoughts and depression (pos/neg) - Bates et al found that depressed ps who were given negative automatic thought statements became more n more depressed supporting relationship between negative thoughts and depression. However the fact that there is a link between neg thoughts and depression does not mean that neg thoughts cause depression for example it may be that a depressed individual develops a negative way of thinking because of their depression plus genetic predisposition can be involved in development of depression

Contrasting views of cognitive approach on blaming the client - in one sense a good thing bc gives client the power to change how things are however the disadvantages are that it may lead to the overlooking of situational factors eg not considering how life events or family problems may have contributed to the disorder. Sees disorder in clients mind and this being the thing to fix

CBT associated with explanation - usefulness in application in CBT which has been consistently found to be the best treatment for depression especially when used in conjunction with drug treatments. If use of CBT is successful also suggests that irrational thinking in being challenged has a role in the development of depression.

Irrational beliefs being realistic - some beliefs may simply seem irrational suggesting that depressive realists tend to see things for what they are finding in research that depressed people gave more accurate estimates of the likelihood of a disaster than control was named the sadder but wiser effect.

Alternative explanation- biological approach with research showing that low levels of serotonin are related to depression and the success of drug therapies further supports this. Diathesis stress individuals with genetic vulnerability for depression are more prone to effects of living in a negative environment thus leading to negative thinking

Question 24

Describe the cognitive approach to treating depression

Answer 24

CBT Cognitive Behavioural Therapy
Ellis’ DEF model - Disputing Effective attitude Feelings that are positive created
Disputing beliefs logical - asking whether thoughts logical given info available. empirical - asking whether there is actually any evidence for thought. pragmatic - asking whether thought useful to client.
Other characteristics of CBT
Homework - clients asked to carry out given behaviours between sessions as a way of testing their irrational thoughts eg asking someone to go out with them
Behavioural activation - taking part in an activity and dealing with perceived obstacles
Unconditional positive regard - given by therapist to client to help self esteem

Question 25

Evaluation of CBT as a treatment for depression

Answer 25

Research support for the effectiveness of a CBT - Ellis 1975 claimed 90% success rate for the therapy taking an average of 27 sessions to complete the treatment. It was recognised that the therapy was not always effective perhaps because clients did not put their revised beliefs into action. Research has also found variance in therapist competence with 15% variance in outcome attributable to therapist competence.

Not suitable for everyone - less suitable for those who have high levels of irrational beliefs that are both rigid and resistant to change. Also found that less suitable in situations of stress where depression due to environment and realistic stressors. Lack of success linked to suitability with some people not wanting the direct advice that CBT dispenses. They prefer to share their worries with a therapist without getting involved in the cognitive effort that is associated with recovery.

Research support for behavioural activation in relieving the symptoms of depression - the belief that changing behaviour can help in partially alleviating depression is supported by a study on the benefits of exercise. Babyak et al studied over 100 adults diagnosed with major depressive disorder and randomly assigned to 4 month course of aerobic exercise, drug treatment or a combination of the two. All 3 groups exhibited significant improvements at end of course. Six months after study those in exercise group had significantly lower relapse rates than those undergoing drug therapy particularly those who’d continued exercise regime on their own.

CBT especially effective when used in conjunction with drug treatments.

Dodo Bird effect - all methods of treating a mental disorder pretty much equally effective. Research does tend to find fairly small differences in success rates. Argued that a lack of difference due to there being so many common factors such as talking to someone likely to be sympathetic which may enhance self esteem in being able to express thoughts.

Question 26

Describe the biological approach to explaining OCD

Answer 26

Fundamental belief - physical elements of our body can be used to understand behaviour. Includes genes that provide info for our physical and psychological characteristics. Also concerns neural explanations in terms of brain and neurotransmitters
Role of COMT gene in development of OCD - regulates production of dopamine one form of the COMPT gene has been found to be the most common in OCT patients . The lower the amount of COMT gene the higher the amount of dopamine.
Role of SERT gene - affects the transport of serotonin. The lower levels of serotonin as a result of the presence of the SERT gene.
Roles of genetics investigated via family studies
Diathesis stress - genes only create a vulnerability for disorders such as OCD as well as stresses which may also contribute to the likeliness of having a disorder.
Neural
Dopamine - high in people with OCD
Serotonin - low levels in people with OCD (increase in serotonin lead to alleviation of symptoms)
Worry circuit - Abnormal brain circuit which suppresses signals from orbital frontal cortex (OFC) which is known to be the anxiety region.
OFC sends signals to thalamus . The caudate nucleus being damaged which usually acts as a filter results in failing to suppress minor worry signals. thalamus alerted and sends signals back to OFC acting as a worry circuit. Both serotonin and dopamine play a role in the worry circuit serotonin plays key role in operation of OFC and CN low levels lead to malfunction of these. Dopamine leads to overactivity of ganglia where CN situated.

Question 27

Evaluate the biological approach to explaining OCD

Answer 27

Research evidence from family studies (pos/neg) - A family study showed that people who had a first degree relative with OCD had a five times greater risk of having the illness themselves. A meta analysis found that identical twins are two times more likely to develop OCD than in comparison to non identical twins. however concordance rates are never 100% indicating influences in the environment to play a role in the development of OCD.

Genes act as predisposing factor towards obsessive behaviours but no disorder specific genes - research has found that OCD is one form of expression of the same gene that determines terets systems also found in Autistic children. OCD is also a characteristic of common eating disorders two out of three patients with OCD will have at least one episode of depression.Shows evidence of genes to be a predisposing factor but also but there is not one specific gene or genes unique to OCD.

Real world application - use of gene therapy In being able to flag presents of genes that may predispose towards disorder in unborn babies however this isn’t a simple solution and has its risks and ethical issues.

Alternative to biological explanations - to process model in that the Neutral stimulus is associated with anxiety. Association maintained because anxiety stimulus avoided thus obsessive formed. Individuals learned to link compulsions to be preventive measures. Treatment using this explanation is similar to systematic desensitisation (exposure response prevention).

Research evidence for differences in inherited brain structure - brain scans reveal OCD patients and relatives had reduced grey matter in key regions of the brain including the OFC. This shows anatomical differences can be inherited and related to OCD risk

Question 28

Describe the biological approach to treating OCD

Answer 28

Drug therapy

SSRIs - inhibit uptake process of serotonin. Inhibit reabsorption of serotonin to make more available. Used to reduce the anxiety associated with OCD. Blocks receptor cells at neuronal receptor sites involved in re uptake of serotonin.

Tricyclics - effect noradrenaline as well as serotonin. Results in more neurotransmitters being left in synapse process prolonging their activity easing the transmission of the next impulse. Used as a secondary treatment.

Anti-anxiety drugs - slow down activity of the CNS. Enhance activity of the neurotransmitter GABA. When GABA released has general quieting effect on many neurone in the brain. Reacts with GABA receptors, opens channel that increases flow of chloride ions into neurone. Chloride ions make it harder for neurone to be stimulated making individual relaxed.

Question 29

Evaluate drug therapy to treat OCD

Answer 29

Evidence for effectiveness of drug therapy - randomised control trial with real drug vs placebo and meta analysis by researchers found SSRIs to be more effective than placebos in reducing symptoms having taken drug for 3 months. However most studies only provide short term data n little long term knowledge of effects.

Advantages for individuals and health service - for the individual it reduces symptoms of OCD allowing them to live a functional life. Little energy or time required of user. For health service is cheaper requiring little maintenance and reduce employment although just talking about condition may help.

Side effects of treatment (3 types of drugs) -
SSRIs nausea, headache, insomnia result in patient wanting to not take drug
Tricyclics hallucination, irregular heartbeat, only used as a substitute when SSRIs are not effective.
BZs aggression, addiction, 4weeks allowance.

Disadvantage compared to CBT - potential to have symptom substitution if there is an underlying psychological cause, not a lasting cure, patients relapse, Short term solution, only relieves symptoms

Publication bias - show pos outcome don’t publish as many neg results as interest needed in drug companies. Whole story not given and results published favourably.