psychopathology Flashcards
define a phobia
an irrational fear to an object or situation
3 behavioral characteristics of phobias
panic/fear
avoidance
endurance
the emotional response to a phobic object is …
anxiety that is out of proportion to the threat the posed by the phobic object
cognitive characteristics of phobias
selective attention
irrational beliefs
cognitive distortions
emotional characteristics of depression
low mood
low self esteem
anger
behavioral changes that commonly occur with depression
anxiety levels decrease or increase
aggression and self harm
disruption to sleep and eating patterns
3 cognitive characteristics of depression
poor concentration
absolutist thinking
attending to dwell on the negative
behavioral characteristics of OCD
compulsions (repetitive and reduce anxiety
avoidance
emotional characteristics of OCD
guilt and disgust
accompanying depression
anxiety and distress
cognitive characteristics of OCD
obsessive thoughts
cognitive strategies to deal with obsessions
insight into excessive anxiety
how do we explain the genetic basis of OCD
we get 50% of genes from each parent, in which our brains our built from. Brains are the source of mental state so if we inherit anything then disorders may also be inherited
Identity 2 findings from Lewis’s family study
- 37% of patients had a parent with OCD
2. 21% of patients had a sibling with OCD
why is Lewis’s study only weak evidence for the role of genes in inheritance of OCD
- the numbers are not high enough, share 50% of genes so we expect concordance rates to be closer to that
- family studies do not separate the influence of genes and environment
Identify two findings of Nestadt’s twin study of OCD
MZ - 68%
DZ - 31%
what model claims that OCD is a result of interaction between genes and environment
diathesis stress model
What did Cromer find in relation to OCD
54% of people who have OCD and took the survey had had a ‘traumatic life event’
what is molecular genetics
tries to identify specific candidate genes that lead to a disorder
what type of genes are closely associated with OCD
those involved in serotonin production
how many genes did Taylor identify were associated with an increased risk of OCD
230
what model suggests that OCD is a result of many genes all which have a small effect
polygenic
what is serotonin and what specific symptom is it thought to lead to
a neurotransmitter that regulates mood, in people in OCD it is low and thought to lead to the repetition of tasks
what type of drug is used to raise serotonin levels
SSRI’s - selective serotonin reuptake inhibitors
how do drug trials using SSRI’s
SSRI’s increase serotonin
this reduces symptoms of OCD
so serotonin must be a factor involved in OCD
why does the fact many OCD patients also have depression affect the evidence drawn from scans and drug trials
- low serotonin could cause the depression but not the OCD so scans can show the link to depression
- trials could improve mood relating to depression so it looks like OCD has been treated
what part of the brain is impaired with OCD
orbital frontal cortex
identify 2 functions of the orbital frontal cortex
- logical thinking and decision making
2. ignoring impulses to behave
what might be the effect of an impaired orbital frontal cortex
- lack of logical thinking, including hoarding
2. cant resist urge to hoard
What did Ursu and Carter find in their scanning study about the orbital frontal cortex and what did it suggest
hyperactivity, suggesting inability to stop obsessive thoughts
who else found supporting evidence for the link between hyperactivity and the inability to stop obsessive thoughts
Saxena & Ruach - review of previous studies
why is evidence from scanning studies inconclusive
- other brain areas are impaired
2. scans are correlational - can not identify cause and effect
What do SSRI’s do to increase serotonin level
- it is normal for neurotransmitters to not be taken at the post synaptic receptor sites and are instead reabsorbed into the synaptic vesicle
- SSRI’s block the synaptic vesicle to accelerate circulation of serotonin
Identify other drugs used to treat OCD
- anti - depressants
- anti - psychotics
- anti - anxiety
Fineberg’s study
clinical trial where patients either took SSRI (Escitalopram) or a placebo
- Escitalopram 23% reported recurring symptoms
- Placebo 52% reported recurring symptoms
Soomro’s study
meta analysis - 17 studies all showed better results for SSRI’s than placebos
why are clinical trials convincing evidence for effectiveness of SSRI’s
experimental - patients randomly allocated with a double blind procedure
what % are SSRI’s affective for
70%
why might these results exaggerate the effect of SSRI’s
file drawer problem - negative results not published
Why is it best to combin CBT with drug treatment
- drugs help them engage with CBT in short term
2. CBT gives coping strategies in long term
Why do SSRI’s sometimes have reduced compliance rates
side effects
- indigestion
- blurred vision
- loss of sex drive
what are the 3 elements of Beck’s negative triad
- negative view of self - I’m worthless
- negative view of world - nothing good happens to me
- negative view of future - nothing is ever going to change
when should we be able to identify the negative beliefs
they precede the depression so should be identifiable before the depression develops
according to Beck what is the initial cause of the negative triad
traumatic events
childhood loss
abuse
identify Ellis’s ABC model
A - activating event
B - beliefs
C - consequences
Identify Ellis’s definition of irrational beliefs
any belied that stops us from being happy and free from pain
what are the three types of irrational beliefs
- musturbation
- I - can’t - stand - it -itis
- Utopianism
Koster et al
- presented participants with positive, neutral or negative word
- asked to press a button on where it was on the screen
- depressed patients took longer to press the button when the word was negative
- suggests people with depression focus on negative - proof for cognitive theory
why is the result of Kroster’s study not conclusive evidence for the cognitive explanation for depression
we can’t tell if the beliefs caused the illness, were a part of it or an effect of the illness
who were the participants in Grazioli and Terry’s study
pregnant women - a high risk group, can identify negative triad before depression
what other evidence is there for the cognitive explanation for depression
clinical trials - cognitive therapies are effective suggesting that the cognitive theory is valid
what is an alternative explanation for depression and what evidence is there
genetics - twin studies concordance rates for MZ higher than DZ - depression has a genetic component
how can genetics be an alternative or complimentary explanation
alternative - genes are a direct cause of depression
complimentary - genes cause negative beliefs, which cause depression
what are three components of Beck’s cognitive therapy
- identify negative beliefs
- challenge negative beliefs by rational arguments and evidence
- homework is set to record events + try new things
In Ellis’s rational - emotive behavioral therapy what is the addition of D and E
D - disputing irrational beliefs
E - effective rational beliefs
identify 2 ways of disputing irrational beliefs and what they involve
- empirical argument - showing the patient is factually mistaken
- logical argument -showing the patient has reached an unjustified conclusion that doesn’t add up/ follow through
In march’s study identify % recovery rates for the 3 conditions
CBT - 81%
drugs - 81%
CBT + drugs - 86%
well controlled field experiments
Cuijper’s study
meta analysis - 0.71 effect size ( large - moderate)
compare drugs and CBT as treatment for depression
- drugs don’t provide coping mechanisms CBT does
- drugs have side effects CBT doesn’t
- drugs may be needed to improve alertness and motivation to be able to carry out CBT
Why is CBT the most common use treatment for depression
it is cheaper - has a standard time session of 12 minutes
why is CBT effective
builds a trusting relationship useful for patients to be listened to and taken seriously
statistical infrequency
any unusual behavior is abnormal and any relatively usual behavior is considered normal
e.g. intellectual disability disorder 2% have IQ lower than 70 so are classified abnormal
evaluation of statistical infrequency
real life application - most diagnosis involve a test of how severe symptoms are compared to social norms
unusual can be positive - IQ of over 130 is also in the 2% but is positive
labelling sometimes negative - people with a low IQ may be living and working etc. well being labelled as abnormal may affect how they view themselves and ho others view them
deviation from social norms
defining people as abnormal when they challenge what is thought of as normal or a social norm
specific to separate cultures so homosexuality may be considered abnormal somewhere but normal somewhere else
e.g. antisocial personality disorder
deviation from social norms evaluation
not a sole explanation - other factors to consider such as distress to other people
cultural relativism - something may be considered normal in one culture but abnormal in another makes it hard for people living in different cultures
human rights abuse - used to be to maintain control of minority group now possibly refusing the right to be different
failure to function adequately
abnormal when they can no longer cope with normal everyday life - not maintaining hygiene or nutrition
- no longer has regards for standard interpersonal rules
- when they experience some severe distress
- behavior comes irrational and dangerous to themselves or others
failure to function adequately evaluation
looks at their own subjective experiences and helps those who do need the help
risk limiting personal freedom and discriminating against minority groups
subjective judgements - a person e.g. a psychiatrist makes the decision to say whether this person is distressed and suffering
deviation away from ideal mental health
consider what makes someone have the ideal mental health and then see who deviates away from that
e.g. good self esteem
can cope with stress
able to self actualize
deviation away from social norms evaluation
comprehensive - covers a broad range of things that people would go seek help for
cultural relativism - the ideal mental health may categories things that may seem or be thought of as negative
unrealistic high standards - makes clear the ways in which people could benefit from getting treatment but also can be negative thinking of how people would benefit against their will
