Psychopathology Flashcards

Question

What is the 2-process model?

Answer 1

The two process model argues that phobias are learnt through classical and operant conditioning.

Answer 2

Behaviours are acquired through 'stimulus-response' associations: e.g. an event in the environment (stimulus) will cause a physiological effect (response) such as fear. For example, repeated negative experiences with dogs such as being bitten may lead to a phobic response when you see dogs.

Answer 3

Operant conditioning is a method of learning that occurs through reward and punishment for behaviour. Through operant conditioning, as association is made between a behaviour and a consequence for that behaviour.

Answer 4

The Phobia is maintained through OC. When a behaviour is reinforced (rewarded) it is more likely to be repeated. Avoidance of phobic objects is rewarding because we avoid the fear we believe they will cause. This is an example of negative reinforcement as we are being rewarded for escaping an unpleasant situation. For example, the behaviour of not taking a lift to avoid claustrophobia strengths the behaviour of not taking lifts as one avoids the anxiety that would occur if one did take the lift.

Answer 5

SLT would also emphasise how fears can be learnt from parents via observations and imitation. An infant may either: Simply imitate a behaviour: e.g. mother's phobic behaviour (modelling) or, Imitate a behaviour because they expect a reward (vicarious learning): e.g. seeing one's mother being given care after a phobic response so imitating her hoping to receive the same reward.

Answer 6

Watson 1920 classical conditioned a phobia of a white rat in an 11-month old boy named Little Albert.

Answer 7

At the beginning of the study he showed no fear of white fluffy objects such as cotton wool, a white rat and a white rabbit these were neutral stimuli. Watson presented the white rat to Albert whilst scaring him by banging metal bars together to create a frightening noise. This was done 3 times then repeated a week later. From then on, whenever Albert was shown the white rat without the noise he began to cry as he generalised this fear to other similar white, fluffy objects.

Answer 8

Watson claimed Phobias were classically conditioned through negative stimulus response associations between objects (the stimulus) and the fear (the response)

Answer 9

Watson 1920 study on Little Albert claimed that Phobias were classically conditioned through negative stimulus response associations between objects and the fear, supporting Behaviourists explanations that classical conditioning causes phobias.

Answer 10

Fears may be evolutionarily determined and genetically inherited to help us avoid and escape potentially dangerous situations and animals. This seems clear from the fact that the most common phobias -snakes, rats, heights, etc are potentially dangerous. This is supported by Seligman who used the concept of 'biological preparedness' when examining phobias. He found that rats could easily be conditioned to avoid-life threatening stimuli such as toil liquids or electric shocks, but could not be easily conditioned to avoid non-harmful stimuli such as flashing lights. This provides evidence against Behavioural explanations in that it seems to suggest that phobias are innate, not learnt and it explains why particular types of phobias are more common. Many people have bad experiences with stimuli but do not go on to develop a phobia, and many people develop a phobia despite having no previously negative experiences with their phobic object. Behavioural explanations argue that we develop phobias of objects we have frightening experiences with, e.g. guns or cars. However, phobias of these stimuli are extremes and despite the fact that most people rarely encounter snakes, this phobia is very common.

Answer 11

Systematic desensitisation is a type of behavioural therapy based on the principle of classical conditioning. It was developed by Wolpe during the 1950s. This therapy aims to remove the fear response of a phobia, and substitute a relaxation response. It can be used to treat both simple and social phobias.

Answer 12

1- The client and therapist will draw up an 'anxiety hierarchy' of situations that cause anxiety, from minor discomfort to major suffering. 2- The therapist induces a state of deep relaxation in the client using progressive muscle relaxation, hypnosis or tranquillisers. 3- In this relaxed stat the client is repeatedly exposed to the 1st step on the anxiety hierarchy until feelings of anxiety are replaced by relaxation. 4- The client gradually progresses upward through the stages of anxiety hierarchy until their most feared situation is paired with relaxation rather than anxiety.

Answer 13

They are taken down a step on the hierarchy.

Answer 14

SD can be in either vivo or in vitro?

Answer 15

Actual exposure to real life feared stimuli.

Answer 16

Imagining feared stimuli.

Answer 17

Research has indicated SD is an effective treatment for Phobias. McGrath 1990 reported that 75% of patients with phobias were treated when using vivo SD. Also Capafons 1998 reported that people who had aerophobia who had undergone SD reported lower levels of fear and showed lower levels of physiological arousal compared to a control group when subjected to a flight simulation. Behavioural therapies are quick and require less effort on the patient's behalf than psychotherapies where patients must play a more active part in their treatment. As a result, successful outcomes can be achieved fairly quickly. As SD does not require the intellectual engagement required with talking therapies SD may be the only appropriate form of treatment for those of lower general intelligence.

Answer 18

Ohman 1975 suggests that SD may not be effective for treating anxieties which have evolutionary origins. The logic behind this alternative explanation of phobias is that phobias are exaggerated anxieties of stimuli which posed survival threats to our ancestors which have become genetically hard-wired into behaviour. Thus, these types of phobias have a different cause and are harder to unlearn. SD has been successful in treating simple phobias, however, treatment may not provide a long-lasting solution. This may be because the symptoms of the phobia (anxiety) are just the external signs of a much deeper-rooted problem. If SD manages to remove the symptoms of a phobia, a new set of symptoms may arise: this is referred to as symptom substitution. Because Behaviourism assumes that phobias are learned, SD makes no attempt to address and deeper psychological or emotional causes of the disorder.

Answer 19

An alternative to the gradual exposure to the phobic object in SD, there is immediate and full exposure. The logic behind the flooding is that as time goes on adrenaline levels will decrease, panic will eventually subside and the individual will form a new stimulus response association between the phobic object and relaxation. It can either be in vivo or vitro.

Answer 20

Flooding can be highly traumatic and is therefore likely to be unethical as it fails to protect subject from psychological harm, given this it is rarely carried out.

Answer 21

A study by Choy 07 reported that flooding was more successful than SD when treating phobias.

Answer 22

Its failure to take human thought process into account when explaining behaviour.

Answer 23

Depression is a mood, or affective disorder. This mental Illness is a collection of physical, emotional, mental and behavioral experiences that are severe, prolonged and damaging to everyday functioning.

Answer 24

The Cognitive model argues that psychological and emotional disturbance can often be attributed to maladaptive cognitions e.g. irrational, illogical, negative, distorted patterns of thinking about oneself, others and the world. For example, a depressive may automatically think about themselves and their life in entirely negative and unrealistic terms.

Answer 25

Beck's Negative Triad Ellis's ABC Model

Answer 26

Albert Ellis (1957, 1962) proposes that each of us hold a unique set of assumptions / beliefs about ourselves and our world that serve to guide us through life and determine our reactions to the various situations we encounter. Unfortunately, some people’s assumptions are largely irrational, guiding them to act and react in ways that are inappropriate and that prejudice their chances of happiness and success. Albert Ellis calls these basic irrational assumptions. According to Ellis, depression does not occur as a direct result of a negative event but rather is produced by the irrational thoughts (i.e. beliefs) triggered by negative events.

Answer 27

Ellis's model proposes that each of hold a unique set of assumptions about ourselves that serve to guide us through life and determine our reactions to various situations. Unfortunately, some people's assumptions are largely irrational, guiding them to act and react in ways that are inappropriate and that prejudice their chances of happiness and success. Albert Ellis calls these basic irrational assumptions. According to Ellis, depression does not occur as a direct result of negative event but rather is produced by the irrational thoughts trigged by negative events.

Answer 28

People may acquire negative schemas during childhood, adopting a negative view of themselves, the world and the future. This may be caused by parental or peer rejection or criticism. Such thinking leads to depressives to have distorted, limited outlook on life and de-motivates them from engaging in activities which might reduce their depression. Depressives also display a distinctive pattern of selective attention whereby they pay excessive amounts of attention to the negative aspects of events and minimal to positive aspects of events.

Answer 29

The Cognitive model suggests that it is the patient's faulty thinking which is responsible for their disorder, e.g. they are depressed as a result of engaging in irrational, negative thinking. This may lead one to overlook the role of biological or environmental factors in causing mental disorders e.g. biochemical imbalance, abuse etc. The biological approach would argue that it is biochemical imbalances low levels of serotonin which cause negative thinking and negative thinking would improve by altering the body's biochemistry (prescribing anti-depressants). Thus the cognitive model's cause effect beliefs may be incorrect. The Cognitive model argues that depressives' cognitions are irrational. It could well be argued that if someone has experienced a lot of negative life events these cognitions are quite rational and realistic.

Answer 30

Strong RWA, the cognitive model focuses on neurotic disorders such as depression, anxiety and eating disorders, but is also widely employed within the NHS to treat stress and 'life problems', and within the prison shrive with sexual offenders and those with anger management issues. Therapies based on Cognitive approach are popular as they are fairly quick, cheap, easy to understand and seem to have a fairly good success rate. The Cognitive Model addresses the important role that thought processes have in effecting emotional and behavioural responses in a wide range of mental disorders. Cognitive therapies are popular and place the client in a central, active role in helping overcome their own problems - thus these forms of therapy are seen as 'empowering'.

Answer 31

Cognitive Behaviour Therapy

Answer 32

CBT is based on the assumption that if we alter cognitions this will result in positive change to patient's emotions and behaviour.

Answer 33

That negative, irrational thinking influences emotions and behaviour.

Answer 34

In CBT the therapist attempts to challenge and expose the client's automatically negative, irrational thinking and encourage more positive and rational cognitions regarding how they view themselves, the world and their future. CBT particularly focuses on testing and attempting to disprove clients' negative cognitions and encouraging clients to carry out practical activities and tasks. Hopefully, engaging in activities will lead to rewarding experiences which reinforce behaviours and make it more likely the client will repeat them: i.e. going out with friends will be pleasurable so it's more likely the client will do it again. This will lead to a positive cycle of reinforcement. Commonly employed ways of challenging negative thinking include, logical disputing, empirical disputing and pragmatic disputing.

Answer 35

Explaining to the client how their self-defeating beliefs are irrational/illogical e.g. their way of thinking does not make sense.

Answer 36

Explaining a client's self-defeating beliefs are not backed up by evidence. E.g. there is no proof that a particular belief is accurate.

Answer 37

Emphasising to the client how unhelpful negative thinking is. E.g. This way of thinking is not going to help me.

Answer 38

CBT has been proven effective in outcome studies which measure responses to treatment. Such as Engels (93') who conducted a meta analysis of 28 studies and concluded that Rational Emotive Behaviour Therapy a form CBT was an effective treatment for depression. Ellis claimed that over an average of 27 sessions, REBT had a success rate of 90%. CBT can be delivered via computer. Christensen ('04) examined the effectiveness of MoodGYM- an online form of CBT for depression. The program contains anxiety and depression assessments, relaxation techniques and tasks to complete. Participants were assigned to MoodGYM, another depression information website or a placebo group. MoodGYM was found to be as effective as face-to-face therapy and drug treatments for depression. it was also the most cost-effective treatment and overcomes therapist subjectivity and potential client embarrassment

Answer 39

CBT fails to address the root cause of outside factors which may be producing irrational thinking in the first place either in the present e.g. marriages with bullying, or in the past e.g a history of childhood neglect. As a result, outside environments or past events may continue to contribute to the likelihood of irrational thinking continuing. REBT fails to consider that what appears to be irrational thinking e.g. depression and a sense of helplessness, may in fact be a logical response to life events e.g. unemployment, poverty and loneliness. CBT takes time and effort on the depressive's behalf. Considering severe depressives may not have the motivation to engage in CBT, antidepressants may be more suitable for extreme cases where the client requires quick treatment e.g. they are suicidal or do not have the motivation to engage with therapy.

Answer 40

OCD is an anxiety disorder where suffered have obsessions and compulsions. Obsessions are recurring intrusive thoughts and compulsions are repetitive actions that the sufferer feels they must complete in order to stop the obsessions.

Answer 41

The Biological approach explains the existence of OCD through Genetic and Neural explanations.

Answer 42

The Biological approach argues that many mental disorders are genetically inherited and the cause of the disorder may lie in genetic abnormalities which cause changes in brain structure and or abnormal levels of neurotransmitters. An example of a gene is COMT which controls and regulates the production of the neurotransmitter dopamine. One abnormal form of the COMT gene producers excessively high levels of dopamine. Dopamine influences motivation and 'drive', excessive amounts can produce obsessive behaviour. Further abnormalities in the gene SERT may cause lower levels of the neurotransmitter serotonin to be present and low levels of serotonin are often associated with OCD.

Answer 43

Biochemicals in the brain.

Answer 44

Neurotransmitters Neurology

Answer 45

Low levels of serotonin found in OCD suffers can be treated with anti-depressants which raise levels of serotonin e.g. Seroxat have been found to reduce the symptoms of OCD. Artificially producing abnormally high dopamine levels in animals have been found to produce behaviour similar to the repetitive movement characteristic of OCD In humans.

Answer 46

Several areas in the brain have been associated with OCD. The caudate nucleus normally surpasses signals from brain areas which relay messages about hazards (such as germs or infection). When the caudate nucleus is damaged it may not suppress these concerns about hazards thus leading to obsessions about hazards leading to obsessions about danger from, for example, germs.

Answer 47

Nestadt 2000 found that the risk of 1st degree relative of an OCD sufferer also having OCD was x5 greater than for someone with an unaffected relative. Supporting the explanation that OCD is genetically inherited. Further Billett (98) found that Monozygotic twins were x2 timess as likely to get the disorder if they had an affected twin as Dizygotic twins. Therefore the more genetic material shared with an OCD sufferer the more likely an individual is to suffer the disorder themselves. However, concordance rates are usually fairly low meaning that the disorder is not entirely genetic and social and environmental factors must play a role. Research by Hu (06) found genetic differences between 169 OCD sufferers and 253 controls that impacted the function of serotonin transfers in the brain. Supporting genetic and neural explanations.

Answer 48

The high levels of dopamine and low levels of serotonin associated with OCD may not be the cause of the disorder, they may be an affect, i.e. it may be that OCD leads to abnormal neurotransmitter levels rather than being caused by them. The diathesis-stress model says that complex behaviours like OCD are probably controlled by multiple biological and social factors. For example, the SERT gene is also present in sufferer of depression and bipolar disorder. This implies that although we may develop a genetic predisposition to developing OCD whether we do or don't develop it is influenced by other 'stressors' such as family life or life events.

Answer 49

Biological approach employs drugs to re-balance imbalances in neurotransmitters

Answer 50

Antidepressants: SSRIs (selective serotonin re-uptake inhibitors) Antidepressants: Tricyclics Benzodiazepines

Answer 51

To combat low levels of serotonin, SSRIs have the effect of increasing levels of serotonin. When serotonin molecules cross the gap between neurones they trigger receptor cells on the adjacent neurone and then are re-absorbed into the neurone which realised them. SSRIs reduce the amount of re-absorption, thus increasing the amount of serotonin available which acts to increase mood and decrease OCD.

Answer 52

Selective serotonin re-uptake inhibitors

Answer 53

WTricyclics block the re-absorption of serotonin and noradrenaline leaving more of these neurotransmitters available. This increases mood and decreasing OCD behaviours but tricyclics have more side-effects than SSRIs do so are only used if SSRIs have not been effective.

Answer 54

BZs slow down the activity of the central nervous system and thus reduce the anxiety which is a main symptom of OCD. GABA is a neurotransmitter which is the body's natural form of anxiety relief. GABA has a general quietening effect on about 40% of neurones in the brain. BZs enhance the action of GABA by binding to special sites on the GABA receptor, thus boosting the action of GABA. This allows more chloride ions to enter the neurone, making it even more resistant to excitation and making the person feel calmer and less anxious.

Answer 55

Soomro (08) conducted a meta-analysis of 17 studies using SSRIs with OCD and found them more effective than placebos in reducing symptoms for the 3 months following treatment. One of the benefits of using drugs for OCD is that the therapy requires little effort from the user. In comparison to psychological therapies such as CBT which requires a lot of time, effort and motivation on the part of the client. Thus, drug therapies may be beneficial for those who do not have the motivation to engage with psychological therapies or emergency cases who require quick, immediate treatment (e.g. those at risk of suicide).

Answer 56

Addiction. it was recognised in the 1970s that dependency/addiction may occur with Benzodiazepines. Patients taking even low doses of BZs show marked withdrawal symptoms when they stopped taking them. Due to these addiction problems there is a recommendation that the use of BZs should be limited to a maximum of 4 weeks. Treating the symptoms rather than the problem. Drugs may be effective at treating symptoms of OCD such as stress and anxiety but the effect only lasts while the person is taking the drug. In cases of chronic OCD it may be preferable to seek psychological treatment that addresses the underlying problem that is causing OCD. Thus, drugs offer only a superficial, temporary, short-term solution. Side effects of BZs include increased aggressiveness, memory impairment (particularly LTM). Some studies have also linked beta-blockers with an increased risk of development of diabetes.

Answer 57

This topic is concerned with the way psychologists and psychiatrists have tried to establish useful ways of distinguishing between 'normal' and 'abnormal' behaviour in relation to the classification of individuals as suffering from mental disorders.

Answer 58

Deviation from Social norm Statistical frequency Deviation from ideal mental health Failure to function adequately

Answer 59

Social norms are rules or guidelines for what are considered socially acceptable behaviours, beliefs and attitudes within any one culture. This definition argues that anyone who deviates from these social norms may be regarded as abnormal. We are socialised into sets of social norms by our family and culture, and may be 'punished' if we deviate from by disapproval, humiliation, imprisonment or possibly be labelled 'insane' and incarcerated in a mental institution.

Answer 60

The definition is limited by cultural and historical relativism. This means that definitions of what is socially normal and abnormal vary through space from culture to culture and time (history). For example in many countries homosexuality is still illegal and until 1973 in the UK it was listed as a mental disorder on the DSM. Today, homosexuality in the UK is not viewed as a deviation. This definition does not take in account of context (e.g. being semi-naked on a beach is judged okay whereas it is not at a funeral) and that certain socially abnormal behaviours are considered 'eccentric' (e.g. having multiple facial piercings), whilst others are definitely regarded as a sign of mental disorder (e.g. holding a loud conversation with oneself in public).

Answer 61

Statistical frequency states any behaviour that are statistically infrequent in society can be regarded as abnormal. In the same way that most people have fairly average (or statistically frequent) shoe size, height, weight, psychological characteristics and behaviours generally fall within a statistically frequent norm. Examples of statistically infrequent behaviours may be experiencing aural hallucinations (schizophrenia), feeling suicidal or refusing to eat.

Answer 62

There is no definite way of defining how far an individual must deviate from statistically frequent behaviours to be defined as abnormal e.g. at what point are negative emotions defined as abnormal and labelled as the mental disorder of depression? The cut-off point at which a behaviour is judged to be abnormal is subjective. This definition does not distinguish between statistically frequent behaviours which are regarded as desirable and undesirable. This definition should really focus on infrequent and undesirable behaviours which require treatment.

Answer 63

Jahoda identified several criteria relating to mental health. He argued that if these weren't met an individual could be considered abnormal. - Positive attitudes to self - Resistance to stress - Self-actualisation of one's potential - Environmental mastery - Accurate perception of reality

Answer 64

it is likely that most people do not fulfil these criteria all of the time. We are capable of lacking self confidence, suffering from stress, distorting our perception of reality. This definition implies, therefore, that we are all abnormal at times. This definition is limited by cultural and historical relativism. This means that definitions of what is deal mental health may vary through space and time. For example, in many countries homosexuality is still illegal and until 1973 in the UK it was listed as a mental disorder on DSM. Today, homosexuality in the UK is not viewed as a deviation.

Answer 65

This refers to a range of behaviours that might be seen as 'signs' of symptoms of mental disorders: e.g. feeling anxious or depressed, sleeplessness, loss of motivation, bizarre, unexpected or inappropriate behaviours or emotional responses. If these behaviours start to interfere with work, relationships, looking after oneself, etc, the individual may be defined as abnormal.

Answer 66

Whilst this definition may be useful in identifying individuals suffering from mental disorders, these behaviours may also be logical responses to situations: e.g. feeling depressed after the death off a loved one or due to unemployment is a normal emotional response as long as it doesn't continue for an excessively long period after the event. Psychiatrists and families may make definitions of others as failing to function adequately when the individual themselves do not feel they are abnormal. Thus there is a danger that individuals who display non-comformist or eccentric behaviours may be labelled as mentally ill when they are in fact just different to others.