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Psychopathology Flashcards

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1
Q

Ellis’ ABC model

A

A - activating event
B - belief
C - consequence

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2
Q

Examples of ABC model

A 
Person not suffering from depression =
A - trolley hits car
B - knows it was accident
C - healthy emotion and eventually acceptance
Person suffering from depression =
A - trolley hits car
B - believe it happened with malicious intent and is their own fault
C - extreme anger and elongated upset
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3
Q

Ellis’ cognitive explanation of depression

A

IRRATIONAL BELIEF causes depression. Irrational thinking stems from the idea that something ‘must’ be in order to be happy:
1) I must be accepted
2) I must do well
3) I must be happy
The individual will not be depressed because of these thoughts, but because they aren’t happening (they are unrealistic) but this makes the depressive feel worthless.

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4
Q

Cognitive explanations to depression

A
  • Ellis’ ABC model

- Beck’s Negative Triad

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5
Q

Beck’s Negative triad

A
  • Depressed individuals thinking is biased towards negative interpretation.
  • NEGATIVE SCHEMAS acquired at childhood. Schemas are activated when a new situation resembles the original. A negative schema causes:

1) Negative view of self
2) Negative view of world
3) Negative view of future

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6
Q

Systematic Cognitive Biases

A

When individuals over-generalise, making conclusions on self-worth based off one piece of negative feedback.

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7
Q

Support for Ellis’ ABC model

A

Hammen and Krantz, 1976 - depressed patients made more errors in logic test than non-depressed patients (depression linked to irrational thinking).

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8
Q

Negatives of the cognitive explanation

A
  • We don’t know whether irrational beliefs cause depression or are a result of depression.
  • Suggests patients are responsible for disorder as its their thought process. Can be a set back in their recovery.
  • Alternative explanations. Biological/ role of genes.
  • Alloy and Abrahamson, 1979. Depressive realists just see things for how they really are. Implies negative beliefs aren’t irrational.
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9
Q

Positives of cognitive explanation

A

Useful applications for treating depression. CBT is successful proving theory correct. Improves quality of patient’s life.

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10
Q

Cognitive approach to treating depression

A

CBT
Ellis’ ABCDEF model
Disputing

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11
Q

Diathesis Stress

A

We have genetic vulnerability to depression which is triggered by environmental stressors. Considers more than one factor - not reductionist.

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12
Q

Cognitive Behavioural Therapy

A

A way of challenging irrational thoughts. Rational Emotive Behavioural Therapy:

  • Challenges irrational belief (through dispute)
  • To resolve emotional problems…
  • Which improves behaviour.

Homework tasks given to encourage a change in behaviour in everyday life. Behavioural activation (encouraging patients to do something they used to enjoy). Unconditional positive regard (acceptance from therapist no matter what).

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13
Q

Ellis’ ABCDEF model

A

ABC as usual…
D - disputing irrational belief
E - effects of dispute, peoples thoughts improve
F - feelings, new emotions are produced.

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14
Q

Types of disputing

A

Logical - challenging negative thoughts by showing they are not rational.
Empirical - showing self defeating beliefs aren’t consistent with reality.
Pragmatic - emphasising lack of usefulness of negativity.

Designed to make patient think more rationally. Often given homework to encourage behavioural activation. Also shown unconditional positive regard to aid the patients self-belief.

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15
Q

Abnormality - deviation from social norms

A

Unstated rules about how we should behave in society. Anyone behaving differently to this is classed abnormal.

:) = easy to define someone as this.

\:( = culturally relative (what's normal in one culture might not be in another; we shouldn't make judgment).
\:( = context dependent (man dressed as rabbit on stag do not abnormal; is in everyday life).
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16
Q

Abnormality - deviation from ideal mental health

A

There is an ideal state of mental health:

P-ostive attitude to self
R-esistance to stress
A-utonomy (independence)
A-ccurate perception of reality
M-astery of environment
S-elf actualisation

The absence of any of the above criteria is classed as abnormality.

:) = positive view. Rather than focusing on what someone doesn’t have, provides ideal criteria to aim for.

\:( = culturally bias (individualistic aspiration, focuses on self. May not apply to collectivist cultures who focus more on the betterment of everyone).
\:( = unrealistic and difficult to achieve. Criteria cannot be fulfilled at all times.
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17
Q

Abnormality - failure to function

A

An inability to function adequately or cope with everyday life/stress. Distressed with life and themselves and their behaviour will often affect others as well.

:) = easy to categorise.

\:( = subjective, stress varies from person to person so how can we be sure what levels are required to be classed as abnormal.
\:( = Harrold Shipman didn't appear to fail to function but was a murderer. He was happy and coped so wouldn't be classed as abnormal despite killing people. Hence, this category cannot be applied to all situations/people.
\:( = culturally bias, eg, morning in one country may be seen as failing to function or cope (as death should be celebrated) but in others it is acceptable.
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18
Q

Abnormality - statistical infrequency

A

Behaviours that are extremely rare. Anyone who falls at top or bottom of statistical data is classed as abnormal.

:) = data is quantitative and easy to handle/measure.

\:( = some people just fall into a category whilst others are at the far end; both will be classed as the same thing despite their difference, so not always accurate.
\:( = disorders (depression) considered abnormal by other definitions, actually common so wouldn't be classed as abnormal by this one.
\:( = assumes rare behaviours are abnormal (high IQ) but people may not want to be classed as this.
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19
Q

What are phobias?

A

Irrational, consistent fears that produces out of proportion reactions. Disrupts everyday life and conscious avoidance tactics will be made.

3 forms of phobia:

1) agoraphobia - trapped in public space with no escape
2) social phobia - anxiety related to social situations
3) specific phobia - fear of object or situation

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20
Q

Responses to phobias

A

Emotion = excessive stress / panic / terror

Behaviour = freeze / hyperventilate / avoid / cry

Cognitive = irrational belief that they will die / its a huge danger / how to get away

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21
Q

Behaviourist explanation of phobias

A

Two process model - classical conditioning develops phobia, operant conditioning maintains phobia.

Classical conditioning = develop phobia by associating object or situation with a traumatic event (see Little Albert case study).

Operant conditioning/negative reinforcement = repeating a behaviour to avoid a negative consequence. One will repeatedly use avoidance tactics to escape their fear. Therefore because they never confront their fear, it is maintained.

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22
Q

Little Albert (behaviourist approach to phobias)

A
  • Albert presented with a rat (NS). No response.
  • Exposed to loud noise (UCS), causing distress (UCR).
  • Rat and loud noise presented together, causing upset.
  • Eventually only rat was presented (CS).
  • Even without noise, an association of trauma had been made with the rat, and upset was caused each time it was presented. Albert’s phobia of white rats becomes the conditioned response (CR).
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23
Q

Positive applications of behaviourist explanation to phobias

A

Knowledge of how phobia was acquired can help improve treatment. This will improve someone’s quality of life and the economy (back in the work place).

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24
Q

Negatives of behaviourist explanation to phobias

A

Alternative explanations. For example:

Cognitive approach = logically thinking about the danger something can bring.

Evolutionary = natural, genetic fears that prevent us from putting ourselves in danger (eg, heights).

Social learning theory = we learn phobias from role models. Similarly, if role model is rewarded for phobia (receives sympathy) imitation is more likely (so as to get attention).

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25
Q

Counterconditioning (phobias)

A

Reversing the conditioning process, by pairing the feared stimulus with something positive.

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26
Q

Reciprocal inhibition (phobias)

A

The process of inhibiting anxiety by replacing feelings of fear and distress with positive, relaxed thoughts.

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27
Q

Systematic desensitisation

A

1) client creates anxiety hierarchy.
2) trained in relaxation techniques/controlling anxiety.
3) exposed to each thing on hierarchy one at a time, only moving on when client is calm.

28
Q

Systematic desensitisation - positives

A
  • Effective in treating specific phobias.
  • Patient controls process (which encourages them to take part in first place).
  • Less traumatic than flooding, so less likely to drop out.
  • Overall positive effect on lifestyle and economy as it eliminates phobias from society.
29
Q

Systematic desensitisation - negatives

A
  • Not effective with social phobias.
  • Time consuming, patients more likely to drop out.
  • Less likely to have long lasting effects as done in stages.
30
Q

Flooding

A

Intense, overwhelming exposure to a phobia. Anxiety cannot be maintained so overtime the fight or flight calms down and patient realises stimulus is harmless.

31
Q

Flooding - positives

A
  • Quick, effective process (less time = less money).
  • The speed encourages people to take part.
  • Strong long term effects, person explicitly realises the object can’t hurt them.
32
Q

Flooding - negatives

A
  • Less affective for social phobias.
  • Very traumatising, p’s likely to drop out.
  • Not appropriate for children/health conditions.
  • Can make phobia worse (Wolpe 1950, poured urine on hands which left p traumatised).
33
Q

Behavioural characteristics of depression

A
  • Agitation
  • Low energy
  • Disrupted sleep
34
Q

Emotional characteristics of depression

A
  • Low self esteem
  • Anger
  • Self harm
  • Low mood
35
Q

Cognitive characteristics of depression

A
  • Poor concentration
  • More attention to negatives than positives
  • Recalling unhappy events rather than good ones.
36
Q

Positives of the cognitive approach to treating depression

A
  • March et al (2007) found that CBT was as effective as drug treatment, 81% greatly improving.
  • Positive implications on economy, increased productivity as more people in the workplace.
  • CBT puts responsibilty in hands of patient so relieves pressure on health care.
  • Treats the cause not symptoms, so less likely to relapse.
37
Q

Negatives of the cognitive approach to treating depression

A
  • Motivation needed to attend therapy which depressives lack, so drugs might be needed first.
  • Individual differences mean that the extent of improvement varies. CBT doesn’t work for everyone.
  • Reductionist as it only considers the role of cognition rather than genetics or environment, etc.
  • Time consuming and costly, drugs may be prefered.
38
Q

Behavioural characteristics of OCD

A

Repetitive, ritualistic actions that dominate someone’s life.

39
Q

Emotional characteristics of OCD

A

Distress, anxiousness, exhaustion, depression.

40
Q

Cognitive characteristics of OCD

A

The belief that something bad will happen unless they complete an action.

41
Q

Behavioural symptoms of OCD

A

Compulsions or avoidance of triggering situations.

42
Q

Emotional symptoms of OCD

A

Depression, guilt, lack of enjoyment for life.

43
Q

Cognitive symptoms of OCD

A

Obsessive, irrational thoughts, praying as a coping strategy.

44
Q

Compulsion

A

External behaviour that is repeated.

45
Q

Obsession

A

Cognitive thought that is repeated.

46
Q

How OCD works

A

An obsession will bring irrational, negative thoughts to mind repetitively. Compulsions offer temporary relief, so is therefore repeated. This leads to guilt which causes depression, but the fear is too great that the compulsion cannot be prevented.

47
Q

The biological approach to explaining OCD

A

Said to be caused by genes. It is polygenic (multiple genes involved).

Pauls et al - higher percentage of OCD in relatives of patients with OCD than the control group. Showing that it is passed on through genetics.

48
Q

Candidate genes - COMT

A

Gene associated with dopamine. In OCD patient, levels of dopamine too high as gene works irregularly. Dopamine related to addictive behaviour/pleasure. As levels are to high, compulsions become addictive and are repeated.

49
Q

Candidate genes - SERT

A

Gene associated with serotonin. OCD patients levels of serotonin too low as gene works irregularly. Serotonin aids relaxation, so low levels lead to anxiety and cause obsessive, irrational belief.

50
Q

Diathesis stress

A

Genetic vulnerability to OCD, triggered by environmental factors.

Cromer (2007) - over 50% of OCD patients had experienced a traumatic event. The worse the event the more severe the OCD. Shows that genes cause it but environment triggers it.

51
Q

Positives of biological explanation of OCD

A
  • Reliable evidence to support theory (Pauls et al).
  • Useful application for the treatment of OCD, eg, drugs created to balance dopamine and serotonin.
  • Knowledge leads to treatment, improves quality of life.
  • Diathesis stress isn’t reductionist (considers genes and environment) so used to understand disorder.
52
Q

Negatives of biological explanation of OCD

A
  • Alternative explanations (cognitive - irrational belief causes compulsion / SLT - if role model is prone to compulsion then someone may imitate).
  • Reductionist to only assume genetics as a cause and disregards environmental factors, etc.
  • Doesn’t take individual differences into account, assumes everyone is the same.
53
Q

Neural explanation of OCD

A

“OCD is caused by faulty circuits”

54
Q

Neural explanation to OCD - normal circuit

A

= OFC becomes active in response to stimuli.

= Info sent to Thalamus.

= Before response is produced, info is sent to caudate nucleus.

=This prevents us from repeating the ‘checking’ response. We can move on from the worry.

55
Q

Neural explanation to OCD - faulty circuit

A

= OFC is overactive so increasingly worried and paranoid, becoming an obsession.

= Thalamus is overactive as the ‘checking’ action has to be repeated in response to the OFC. This becomes a compulsion.

= Caudate nucleus us inactive, so no filter to prevent the checking action.

= Therefore consists only of OFC and Thalamus, creating constant cycle of anxiety (obsession) and response (compulsion).

56
Q

OFC

A

Involved in decision making and worrying (overactive in OCD patients, creating obsessions).

57
Q

Thalamus

A

Produces a ‘checking’ response to OFC, making sure the worry is not a hazard (overactive in OCD patients, creating compulsions).

58
Q

Caudate nucleus

A

Filters ‘checking’ response from the thalamus, concluding that the worry won’t harm us and that its safe to move on (inactive in OCD patients, so they continuously ‘worry and check’, causing repetition of obsessions and compulsions).

59
Q

Example of the neural explanation to OCD

A

The OFC detects that a door may have been left open so someone could burgle the house. This info is sent to the thalamus where a ‘checking’ response is produced and the person will go and make sure it is closed. Once the action has been carried out, the caudate nucleus will filter this response and let us know that we are now safe and the door is closed. In someone with OCD, their caudate is inactive, meaning that once they have checked the door, the worry will instantly come back, as they have had no filter to ensure that they are safe. This leads to repetitive worrying and therefore compulsion to check the door. It will continue like this until the caudate nucleus gains the ability to let the person know they are safe.

60
Q

Positives of the neural explanation to OCD

A
  • Practical applications (medicine developed to improve functioning of faulty circuits).
  • Medication improves quality of life and economy.
  • Scientific brain scans show that ‘checking’ behaviours are located in the Thalamus. Provides strong evidence to back up the explanation.
61
Q

Negatives of the neural explanation to OCD

A
  • Neural changes could be a result of OCD not a cause of it.
  • Reductionist to assume a complex disorder is solely caused by neural factors. Doesn’t consider environment or genes.
  • Deterministic. This is a setback for sufferers, believing that they are stuck this way and can’t be helped.
62
Q

Treatment for OCD

A

Anti-depressants (SSRI’s)

Anti-anxiety drugs (Benzodiazepines)

Neurosurgery

63
Q

OCD treatment - Anti depressants (SSRI’s)

A

SSRI’s block re-uptake of seretonin. Forces seretoin to bind to receptors meaning there is more of it in the synapse. Its presence means patient has elevated mood and lower anxiety (results in less compulison/obsession).

Seretonin improves function of caudate nucleus meaning OFC and Thalamus become less active, so obsessions and compulsions reduce.

Effective in 50-80% of patients.

64
Q

OCD treatment - Benzodiaphines

A

Reduce anxiety/addictive behaviours by slowing down nervous system and increasing activity of the NT GABA.

GABA locks to receptor sites, so dopamine cannot bind. This means there is less of it in synapse. Calms patient down and reduces motivation to seek pleasure (compulisions).

65
Q

OCD treatment - Neurosurgery

A

Last resort for major OCD (suffering for 10 years with no response to treatment).

Electro Convulsive Therapy - distruction of brain tissue in areas associated with OCD. 35-50% improve.

66
Q

Positives of OCD treatment

A

:) drugs are easy to take which encourages participation
:) unlikely to drop out of treatment
:) drug treatment cheap/reduces pressure on healthcare
:) lead to improved quality of life and economy

67
Q

Negatives of OCD treatment

A

:( Dougherty et al found SSRI’s make symptoms worse for first 6 weeks - could be dangerous for patients with life threatening OCD.
:( drugs treat symptoms, but don’t cure cause. High chance of relapse. Therapy is needed.
:( drugs have unpleasent side effects, makes quality of life worse and stop patients from taking treatment.
:( Simpson et al - 45% SSRI relapse, 12% CBT relapse.

Psychology A Level (8 decks)

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