Psychopathology

Question 1

The definitions of abnormality

Answer 1

Abnormality can be defined via statistic infrequency. If one falls to far away from the normal distribution o has a less common characteristic they are defined as abnormal. Such as IQ, AVG IQ is 100 but 2% show 70IQ - they are abnormal (intellectual disability disorder).

Abnormality can also be defined via Deviation from social norms in which normal and acceptable behaviour is decided by society and if someone doesn’t follow that, they are abnormal. This differs between cultures and one culture may see a behaviour as the social norm whereas another may not. An example is Antisocial personality disorder which is described as impulsive, aggressive and irresponsible. A person with such disorder may fail to follow normative ethical behaviour which is wholly decided by society on what is normal and isn’t

Question 2

Definitions of Abnormality in Statistical infrequency (EVALUATIONS)

Answer 2

One strength of Statistical infrequency is that it has real life application in diagnosing people with intellectual disability disorder.Furthermore it can be used in a clinical assessment and can also determine how severe ones symptoms are. This means there is a place for statistical infrequency.

One limitation for Statistical infrequency is that just because one isn’t normal, it doesn’t mean it is negative. One can be abnormal by having a much higher IQ which is not undesirable. This means that Statistic infrequency can not determine what is behaviourally abnormal and shouldn’t be used alone to make a diagnosis

Another limitation for statistical infrequency is that labelling people as abnormal may not give any benefits and could simply cause them to be stressed and cause family friends and themselves, perceive oneself differently. This means it can have an unnecessary negative effect

Question 3

Definitions of Abnormality in Deviation from Social Norms (EVALUATIONS)

Answer 3

One strength from Deviation form social norms is that it has real life application for the diagnosis of Antisocial personality disorder meaning it does have a place in defining abnormality however a Strong counter argument is that it fails to account for other factors such as Distress or mental health issues and this means deviation of social norms cant completely define abnormality

A limitation of Deviating from social norms is that social norms can vary a lot depending on cultures meaning one person labelled as normal in one community may b very abnormal in another and this creates problems for people living from one culture to another

Another strength of deviation from social norms is that it includes the issue of desirability of a behaviour into account unlike statistical infrequency and this means social norms can be more useful than statistical norms

Question 4

Definitions of Abnormality via Failure to Function adequately and Deviation form ideal mental health

Answer 4

One can also be defined as abnormal due to someone failing to cope with ordinary demands of day-to-day life. This was defined when someone fails to maintain eye contact or respect personal space, experiences severe personal distress and when someone’s behaviour becomes irrational/dangerous for themselves or others

One can also be defined as abnormal when they do not meet a set of criteria for good mental health (Jahoda). The criteria are such as coping with stress, perceiving ourselves accurately or having no symptoms or distress. Deviations from mental health can also overlap with failure to functioning such as losing a job means failure to cope thus abnormal.

Question 5

Definition of abnormality via Failure to function adequately (EVALUATIONS)

Answer 5

ONe strength of Failure to function adequately is that it does include subjective experiences of the individual and acknowledges that the experiences of the patient such as distress is important. This means this explanation is adequate for accessing abnormality but a counter argument is that it is subjective and difficult to asses distress.

One limitation is that it is hard to detect if someone is instead deviating from social norms especially with people with alternative lifestyles such as extreme sports wich may be seen as behaving in a harmful way or religious peoples actions. Treating Behaviours as failures begins to limit personal freedom and discriminate minority groups

Another limitation is that to decide who is failing to function adequately,someone can be distressed but not suffering and ultimately, the principle remains on the Psychiatrist who may be subjective about what is truly happening.

Question 6

Definition of Abnormality via Deviating from ideal mental health (EVALUATIONS)

Answer 6

One strength of deviation from ideal mental health is that it is very comprehensive by covering a broad range of criteria and this means it is good tool in order decide someone’s mental health and if they need mental health services.

One limitation of deviation from ideal mental health is that they are culture bound Ones emphasis on personal achievements may be seen as self indulgent in much of the world since it is about the individual rather than the family or community meaning they only relate to individualist cultures.

Another limitation of Deviation from ideal mental health is that it sets a high standard for mental health that one may not achieve all criteria constantly. This means that since it varies so much, it may have no value in thinking about who may benefit from the treatment against their will. As a counter argument, one could say it does help to determine what ways they could benefit such as seeking treatment or counselling to improve mental health.

Question 7

Phobias (Behavioural + Emotional + Cognitive) Characteristics

Answer 7

Behavioural : One responds to fear in different ways such as..

• > Panic which is crying screaming or even freezing
• > Avoidance which is making conscious efforts to avoid the stimulus altogether
• > Endurance which is when the fear remains and people operative in high levels of anxiety

Emotional characteristics are how people feel towards the phobia, there is

• > Phobias cause anxiety which is an unpleasant state of arousal making it difficult to feel positive emotions
• > Emotional Responses are unreasonable and may lead to phobic stimulus getting out of proportion

Cognitive characteristics are how people think of phobias and include

• > Selective attention meaning its hard to look away sind Exit gives us the best chance of reacting quickly but not good when fear is irrational
• > Irrational beliefs may come from phobias and may put pressure on a person to perform better on social situations
• > cognitive distortions may also arise meaning they may see the phobic stimuli as something worse than it actually is

Question 8

Depression

Answer 8

There are 5 types of depression and they can affect how we act, feel and think about life. Behavioural characteristics of depression are…

• > activity levels drop and sufferers tend to stop being active and could lead to psychomotor agitation which may mean pacing up and down a room
• > it is associated to sleeping disorders and appetite may increase/decrease lading to weight gain/loss
• > sufferers may become physically or verbally aggressive such as ending a job or relationship or self cutting/ suicide attempts

Emotional Characteristics of depression are…

• > Lowered mood can lead to the idea of worthlessness and emptiness
• > Anger may be common and can lead to extreme anger as well which can lead to self harming behaviour
• > Self esteem is reduced and tend to self loathe

Cognitive Characteristics of depression are…

• > poor concentration and making decisions is more difficult which interferes with work
• > People on depressive episodes tend to focus only on negatives and ignore positives and recall unhappy events more than happy ones
• > Depressive symptoms may also see things in black and white blowing things out of proportions

Question 9

Obsessive compulsive disorder OCD

Answer 9

OCD is a condition characterised by obsessions and/or compulsive behaviour. The behavioural characteristics of OCD contain…

• > Compulsions which can be repetitive such as washing hands but compulsions can also reduce anxiety such as making sure the door is cocked etc
• > avoidance may also be common in order to reduce anxiety such as avoiding situations that trigger anxiety which hinder normal life

Emotional Characteristics of OCD include…

• > Anxiety and distress as it is an unpleasant emotional experience and the anxiety may be overwhelming and thus the urge to repeat a behaviour creates anxiety
• > OCD is accompanied by depression but the relief from anxiety is temporary
• > People with OCD may also feel irrational guilt or disgust

Cognitive characteristics of OCD include…

• > Recurring obsessive thoughts which are usually unpleasant and create anxiety
• > people may manage anxiety by strategies such as meditating but may be abnormal
• > people with. OCD are aware of the irrationality yet continue to experience catastrophic thoughts and tend to be hypervigilant

Question 10

Behavioural approach to explaining phobias

Answer 10

The behavioural approach is a way of explaining behaviour in terms of what is observable and in terms of learning Mowrer in 1960 proposed the Two Process model which states that phobias can be acquired through classical or operant conditioning.

In classical conditioning, a study from Watson and Rayner (1920) was conducted in which they created a phobia in Little albert by presenting a rat nearby whilst banging an iron bar close by which scared the baby. Originally, the rat was the neutral stimulus but over time, Albert associated the rat with the banging and this made the rat a conditioned stimulus thus showing classical conditioning forming phobias

It was believed that classical conditioning didn’t explain how phobias were maintained. Thus, Mowrer proposed Operant conditioning in which it is believed that when the phobia is present in the environment, it causes distress and so to people avoid it which means the phobia represents an example of negative reinforcement which is then reinforced as we are avoiding the anxiety meaning the phobia is maintained.

Question 11

Behavioural approach to explaining phobias ( EVALUATIONS)

Answer 11

One strength of the two process model is that it was a sufficient explanation as it went further than Watson and Rayner’s study and explained why it can be maintained thus explaining why people need to be exposed to the phobic stimuli

A limitation of the two process model is that in complex phobias, people may not avoid a stimulus for reducing anxiety but instead may do so to feel safe and could be motivated by positive feelings. Therefore the two process theory fails to account for the fact that avoidance may be for beneficial reasons.

Another limitation is that the two process model also does not account for some phobias we don’t develop through trauma for example, one may e scared of snakes but may have never seen one in real life and this may be due to social learning or fears being displaced which provides another alternate explanation to the model

Question 12

Behavioural Approach to treating Phobias

Answer 12

Systematic desensitisation (SD) is a behavioural therapy designed to reduce phobic anxiety by pairing the stimulus with relaxation rather than anxiety in the process of counter conditioning. One emotion takes over another meaning reciprocal inhibition is shown.

The three processes of SD include

• Anxiety Hierarchy which is ranking a list of situations which causes the least and most anxiety
• Relaxation is then instructed via meditation, deep breathing or even drugs
• The person is then exposed to the phobic stimulus in the relaxed state for several sessions as they move up the hierarchy until they stay relaxed in situations with the stimulus

Another method is Flooding in which people are exposed to an extreme phobic stimulus over long sessions which occurs in the process of extinction meaning a conditioned stimulus (stimulus)is encountered without an unconditioned stimulus (the associated response). Flooding isn’t unethical but one must still make informed consent as it can be a traumatic procedure.

Question 13

Behavioural Approach in treating phobias (SD EVALUATIONS)

Answer 13

One strength of systematic desensitisation is that there is research support from Gilroy (2003) in which 42 patients who previously went under SD for arachnophobia and a control group were given a questionnaire and found that 3 and 33 months in, the SD group showed reduced anxiety for arachnophobia meaning effects are long lasting

Another strength of SD is that flooding may not be suitable for some patients such as people who have a phobia and learning difficulties which can make it hard to understand what happened with therapies that require the ability to reflect meaning SD is appropriate for a diverse range of patients

Another strength of SD is that patients prefer it over flooding since SD causes a smaller degree of trauma and also includes relaxation procedure which can be pleasurable. There are also less refusal rates for SD

Question 14

Behavioural Approach in treating phobias (FLOODING EVALUATIONS)

Answer 14

One strength of Flooding is that it is that studies have found that flooding is highly effective and much quicker than alternatives which also means the treatments are cheaper

A limitation of Flooding is that it may not work with complex phobias such as social phobias because of their cognitive aspects meaning the phobia gives unpleasant thoughts not just anxiety meaning other cognitive therapies are better at tackling irrational thinking

Another limitation is that it is traumatic for patients and it means that patients can sometimes back out and are unwilling to see it through the end which is a limitation due to the time and money wasted to preparing patients only for them to refuse it

Question 15

Beck’s cognitive theory of depression

Answer 15

Beck in 1967 proposed the cognitive approach as an explanation of why one may become depressed due to cognitive vulnerability. One aspect of Becks theory is that someone depressed will see events around them in black and white meaning an event is really bad and have a pessimistic view of the world.

Another aspect of Becks theory is that someone who is depressed develops a negative self-schema. A self schema is the packet of information that we perceive ourselves as and a negative self schema means we interpret information about ourselves in a negative way.

Beck also believed that people depressed will have a negative triad which are 3 elements that change the way we think.This includes the

• > negative view of the world which creates the impression that there is no hope anywhere
• > Negative view of the future meaning they see no future for themselves and thus feel hopeless
• > negative view of the slf which includes thoughts such as being a failure which enhance existing depressive feelings and lower self-esteem

Question 16

Ellis’ ABC model

Answer 16

Albert Ellis (1962) also proposed another cognitive explanation which stated that depression and anxiety arise from irrational (illogical or unrealistic) thoughts which interfere with us from being without pain or happiness. To explain this, Ellis used the ABC model.

A stands for the activating agent which is the idea that we get depressed when we experience negative events which trigger our irrational thoughts and beliefs

B stands for Beliefs which are Irrational such as the belief that if something doesn’t go as planned its a major disaster and one must always be successful or achieve perfection

C stands for consequences which are emotional and behavioural consequences that arise from when an activation agent triggers irrational beliefs.

Question 17

Becks cognitive theory of depression (Evaluation)

Answer 17

One strength of Becks cognitive theory is that it has good supporting evidence since ideas such as negative schemas and faulty information processing is supported by evidence such as when Grazioli and Terry (2000) found that women post natal were high in cognitive vulnerability and thus depression. Research has also been reviewed and its suggested some aspects of the theory are correct

Another strength is that it forms the basis of Cognitive behavioural therapy(CBT) and cognitive aspects of depression can be challenged and identified via CBT meaning patients can be tested with ideas such as the negative triad and this means that the explanation translate into successful therapy

However a limitation of Becks theory is that whilst it can explain basic symptoms of depression, it fails when it comes to extreme emotions such as deep anger aren’t explained and neither is the fact that expression can suffer hallucinations or some suffer from Cotard syndrome

Question 18

Ellis’ ABC model (EVALUATIONS)

Answer 18

One limitation of Ellis’ ABC model is that it is only a partial explanation since Ellis’ model talks about reactive depression when there is an activating agent but does not explain when depression may arise without an obvious case meaning the model can’t completely explain how depression may arise

Another limitation of Ellis’ model is that it doesn’t explain all aspects of depression such as how some people are more vulnerable to depression that others and also has the same problem as Beck’s theory in the fact that it cannot explain extreme anger or hallucinations.

A strength of Ellis’ model is that it does have a practical application in CBT as research support does show that irrational beliefs do play a role in depression and challenging them does also form the basis of CBT.

Question 19

The cognitive approach to treating depression

Answer 19

CBT is a popular way of treating mental health issues such as depression and CBT plays out by assessing the cognitive behaviour and then challenging negative or irrational thoughts that will benefit from CBT. CBT psychologists use a combination of Becks theory and Ellis’ ABC model.

In CBT, Becks theory is used as one needs to identify the thoughts of the future, self and the world of the patient referring to the negative triad. It also challenges the negative beliefs by giving homework to patients to record their beliefs and this can be used as evidence later on if the patient feels irrational thoughts.

CBT also uses Ellis’ model but is built upon making the rational emotive behaviour therapy or the ABCDE model, D standing for Dispute and E sanding for effect. This works by challenging irrational beliefs via vigorous argument to break the link between life events and depression. The vigorous argument is crucial and there are different ways such as an empirical or a logical argument

Finally, patients may also be encouraged to be more active and engage in enjoyable activists which is called Behavioural activation.

Question 20

Cognitive approach for treating depression (EVALUATIONS)

Answer 20

One strength of CBT is that a lot fo evidence shows that CBT is effective. Psychologists who studied the effects of CBT compared to anti-depressants found that 81% of the CBT group and the 81% of the Anti depressants group had significantly improved suggesting that CBT is just as effective as medicine and even more effective with medication suggesting that this is a good first choice treatment

One limitation is that CBT may not be able to treat severe cases of depression which prevent the cognitive work needed to occur meaning anti-depressants must be taken first. This means the medication would have to work as a work around and isn’t always a sole treatment for all cases of depression

Another limitation is that Rosenzweig (1938) argues that psychotherapy such as CBT or SD have little impact and may be due to the therapist-patient relationship which determines the success rather than the technique which is used

Question 21

Biological approach for explaining OCD - Genetic Explanations

Answer 21

OCD is largely understood from a biological aspect as it may be due to a genetic explanation. Lewis (1936) found that 36% of patients had parents with OCD as well and 21% with siblings suggesting it was run through families however now it is believed to be so due genetic vulnerability suggested from the Diathesis-stress model which states that certain genes and some environmental stress causes one to likely suffer a mental disorder

Researchers have identified candidate genes which are genes that are involved in regulating the development of the serotonin system or transport across synapses.

OCD is believed to be polygenic and this was studied by Taylor in which it was found up to 230 genes could be involved with OCD as it relies on the action of dopamine and serotonin, both needed for regulating

There are also different types of OCD wherein 1 group of genes affects a person with OCD but another group of genes affects another which is referred to as aetiologically heterogenous.

Question 22

Biological approach to explaining OCD - Neural explanations

Answer 22

Whilst OCD can be affected by genes, there are also 2 neural explanations.

One neural explanation is that OCD is related to the neurotransmitter Serotonin which helps to regulate the mood. These neurotransmitters send signals from one neurone to another and if there are low levels, the mood relevant information doesn’t take place leading to lower levels of mood and sometimes mental processes meaning OCD can be partially explained via reduction of function from the serotonin system

Another neural explanation is that OCD characteristics like hoarding may be explained from impaired decision making which is associated with abnormal functioning of the lateral frontal lobes which are responsible for logical thinking. There is also evidence suggesting the parahippocampal gyrus is associated with processing unpleasant emotions and doesn’t operate correctly in people with OCD

Question 23

Biological approach to explaining OCD (GENETIC EVALUATIONS)

Answer 23

One strength for genetic explanations for OCD is that there is a a variety of research and sources that support the idea that OCD vulnerability arises from the genome. This is supported by studies such as the Twin Studies which found 68% of twins shared OCD whilst 31% didn’t suggesting that there is a genetic influence on OCD.

One limitation of the genetic explanation for OCD is that there are too many candidate genes that are involved in OCD and researchers can’t inpoint all of them meaning that each genetic variation only plays a small role in increasing the risk of OCD meaning the genetic explanation provides little predictive value.

Another limitation is that there are environmental factors which increase the risk of OCD such as trauma. This was observed in a study done by Cromer (2007) in which over half of the OCD patients previously suffered a traumatic event in their past meaning OCD can’t be entirely genetic in origin and should focus on environmental factors as this is something we can control

Question 24

Biological factor for explaining OCD (NEURAL EVALUATIONS)

Answer 24

One strength is that there is support for neural mechanisms in OCD. An example is anti-depressants which work only on the serotonin system which are also effective in reducing OCD symptoms. Furthermore, some mental diseases like Parkinsons are found to be biological in origin

A limitation of the neural explanations is that whilst the same neural mechanisms fail in OCD, the research finds that other systems may also be involved and so no system has been confidently determined as playing a role in OCD

Another limitation is that the neural explanations are based on the assumptions that neurotransmitters don’t work in patients with OCD however, causality is not determined as the OCD itself may lead to failing neurotransmitters.

Question 25

Biological Approach to treating OCD

Answer 25

SSRI’s are anti depressants which work on the Neurons responsible for the serotonin system. Usually, serotonin is absorbed by a post synaptic neurone and then reabsorbed and broken down by the pre synaptic neurone but SSRIs prevent this meaning it continues to stimulate the post synaptic neurone. Then a specific dosage is administered and symptoms observed.

SSRI’s are usually combined with CBT since reduced emotional symptoms means better cognitive behaviour. However if SSRI’s aren’t effective after 3-4 months, dosage increased or alternatives used such as

• > Tricyclics which are the same as SSRI’s but have more severe side effects
• > SNRI’s are also used to treat OCD and work as a second line of defence if SSRI’s are ineffective and this works by increasing serotonin and noradrenaline levels

Question 26

Biological approach to treating OCD (evaluations)

Answer 26

One strength is that they are cost effective and non disruptive as they don’t affect the patients’ lives and can simply take until symptoms reduce and not engage in psychological therapy.

Another strength is that Drug therapy like SSRI’s is effective tackling OCD symptoms and improving quality of life. Studies also show that compared to a placebo, the results are much better with SSRI’s then a placebo. 70% of typical symptoms decline for patients using SSRI’s and the rest can be controlled using a combination of drugs and psychological treatments

One limitation is that they can have severe side effects such as suicidal thoughts, nausea, seizures and even mania. This means that a significant minority may get no benefit from the treatment and these factors can reduce effectiveness because people stop taking the medication