psychopathology Flashcards
psychopathology
scientific study of mental disorders (such as depression, phobias and obsessive compulsive disorder)
social norms
standards of acceptable behaviour that are created by a social group
define deviation from social norms
abnormal behaviour is that which goes against the unwritten rules in a given society or culture
limitations of deviation from social norms?
- in some instances it can be beneficial to break social norms (suffragettes)
- the social norms of a society change over time (homosexuality)
- deviation does not always heave mental health consequences (eccentric naturists)
define failure to function adequately
abnormal behaviour that causes an inability to cope with everyday life
what are the 7 features of personal dysfunction
personal distress maladaptive behaviour unpredictability irrationality observer discomfort violation of moral standards unconventionality
define personal distress
feeling sad, anxious and scared
define maladaptive behaviour
behaviour stopping individuals from attaining life goals, both socially and occupationally
define unpredictability
displaying unexpected behaviours characterised by the loss of control
define irrationality
displaying behaviours that can’t be explained in a logical way
observer discomfort
displaying behaviour which causes discomfort in others
violation of moral standards
displaying behaviour which violates society’s ethical standards
define unconventionality
displaying behaviour which does not conform to what is generally done in a certain situation
limitations of failure to function adequately?
- abnormality is not always accompanied by dysfunction. (psychopaths can commit murder while seeming normal - harold shipman)
- times where it is normal and psychologically healthy to suffer from personal distress (grief when a loved one dies)
- behaviour may cause distress to other people and be regarded as dysfunctional when the person themselves feels no personal distress
define deviation from ideal mental health
behaviour is abnormal if it fails to meet prescribed criteria for psychological normality
what are the six characteristics of ideal mental health
positive attitude towards oneself self actualisation autonomy resistance to stress accurate perception of reality environmental mastery
positive attitudes towards oneself
having self respect, high self esteem and self confidence
self actualisation
experience personal growth and development
autonomy
being indépendant, self reliant and being able to make personal decisions for oneself
resistance to stress
having effective coping strategies and being able to manage every day stressful situations
accurate perception of reality
perceiving the world in a non distorted fashion and having a realistic view on the world
environmental mastery
Being competent in all aspects of life
ability to meet the demands of any situation
flexibility to adapt to changing life circumstances.
limitations of deviation from ideal mental health?
- criteria is demanding and unrealistic - many people don’t meet all ideals
- many of the criteria such as ‘personal growth’ is vague to measure and is subjective
- criteria is subject to cultural relativism
define statistical infrequency
abnormal behaviour that is statistically rare (behaviour that lies on both extremes of a distribution curve)
limitations of statistical infrequency
- fails to account for behaviour that is statistically rare but desirable (high iq)
- some psychological disorders are not statistically rare (depression)
- many rare behaviours or characteristics have no bearing on abnormality (left handedness)
3 behavioural characteristics of phobias?
panic - crying, running, screaming,fainting, collapsing, or vomiting
avoidance - response is to evade the object or situation
endurance - they remain in the presence of the phobic object often frozen and unable to move
2 emotional characteristics of phobias?
fear - persistent, excessive and unreasonable worry and distress
anxiety - when they encounter their phobic object the person will feel terror and be apprehensive about what is going to happen
2 cognitive characteristics of phobias?
irrational beliefs - the person’s thoughts about their phobia do not make logical sense
selective attention - when the person encounters the phobic stimulus, they will become fixated on it
behavioural approach
all behaviour, including phobias, are learned rather than being innate or inherited from parents
steps of the two process model?
- the phobia is initiated through classical conditioning
2. the phobia is maintained through operant conditioning
classical conditioning is learnt though…?
association. a stimulus produces the same response as another stimulus because they have been constantly presented at the same time
describe the Watson and Raynor (1920) experiment
- gave little albert a phobia of a white rat
- struck a metal bar (unconditioned stimulus) everytime albert reached for the white rat (neutral stimulus)
- this made albert cry (unconditioned response)
- albert starting crying (conditioned response) everytime he saw the white rat (conditioned stimulus)
- this conditioned response of fear can then be generalised to other objects or situations
operant conditioning
learning through reinforcement and the consequences of one’s behaviour
evaluation of the two process model
+ does not label people with the stigma of being mentally ill, perceives phobias as incorrect responses to stimuli that can be corrected
+ King found that children acquire phobias after having traumatic experiences with the phobic object (supports classical conditioning)
- many people who have a traumatic experience do not then go on to develop a phobia.
- study found that 50% of people who have a dog phobia have never had a bad experience involving a dog, so therefore learning cannot be a factor in causing the development of the phobia
- does not take account of biological factors that can cause phobias. some people could have a genetic vulnerability to phobias.
systematic desensitisation
behavioural therapy developed by Wolpe (1958) to reduce phobias by using classical conditioning
what is reciprocal inhibition
it is impossible to experience two opposite emotions at the same time e.g. fear and relaxation
what is counter-conditioning?
if the patient can learn to remain relaxed in the presence of their
phobia, they can be cured
what are the stages of systematic desensitisation
- anxiety hierarchy
- relaxation training
- gradual exposure
what is anxiety hierarchy
hierarchy of fear is constructed by the therapist and the patient. situations involving the phobic object are ranked from least fearful to most fearful
what is relaxation training?
Patients are taught deep muscle relaxation techniques, such as progressive muscular relaxation (PMR) and the relaxation response.
The idea behind PMR is to tense up a group of muscles so that they are as tightly contracted as possible, hold them in a state of extreme tension for a few seconds and then relax the muscles to their previous state.
Finally, consciously relax the muscles even further so that you are as relaxed as possible
what is gradual exposure
the patient is introduced to their phobic object and they work their way up the anxiety hierarchy starting with the least frightening stage.
they use their relaxation technique whilst they are exposed to the phobic object.
eventually through repeated exposure to phobic objects with relaxation and no fear, the phobia is eliminated.
evaluation of systematic desensitisation?
+ Jones (1924) supports the use of SD to eradicate ‘Little Peter’s’ phobia. A white rabbit was presented to Little Peter at gradually closer distances and each time his anxiety levels lessoned
+ Klosko found that 87% of patients were panic free after receiving SD, compared to 50% on medication, 36% on a placebo and 33% receiving no treatment at all.
- behavioural treatments address the symptoms of phobias. some critics claim that underlying causes of the phobia will remain. in the future the symptoms will return or symptom substitution will occur, when other abnormal behaviours replace the ones that have been removed.
what is flooding?
when the patient is directly exposed to their phobic object (has learnt relaxation techniques beforehand).
there is no gradual buildup using the anxiety hierarchy
the patient does not have the option for any avoidance behaviour, and therefore extinction occurs.
why is flooding ethical?
even though it can cause a great deal of initial psychological harm, the patient would have to give their fully informed consent so that they were fully prepared for the flooding session.
evaluation of flooding
+ Wolpe (1960) supports the use of flooding to remove a patient’s phobia of being in cars. The girl was forced into a car and driven around for four hours until her hysteria was eradicated
- A disadvantage of flooding is that it is a highly traumatic experience and many patients might be unwilling to continue with the therapy until the end. it is unsuitable for children
behavioural characteristics of depression?
change in activity levels
disruption to sleep
disruption to eating behaviour
aggression
emotional characteristics of depression
low mood
feelings of worthlessness
anger
cognitive characteristics of depression
negative schema
poor concentration
define anhedonia
when some people with depression experience lethargy and withdrawal from activities that were once enjoyed
define insomnia
having difficulty falling asleep and staying asleep
define hypersomnia
when people require large amounts of sleep and they might oversleep
define negative schema
when people have a negative view on the world, themselves and the future
This leads to the self-fulfilling prophecy whereby if you expect negative things to happen, they will happen because you make them happen.
Positive factors in their life will be ignored.
what is the cognitive explanation of depression
Depression is the result of disturbance in ‘thinking’.
Depression is a consequence of faulty and negative thinking about events and it can be managed by challenging this faulty thinking.
negative schema are activated when…?
a person encounters a new situation that resembles the original conditions in which the schema was learned
negative schemas lead to cognitive biases in thinking
what are overgeneralisations
negative schemas on the basis of one small piece of negative feedback
what is a negative triad
an irrational view of three elements in the person’s belief system
- the self
- the world
- the future
what is the evaluation of the negative triad
+ Terry (2000) assessed 65 pregnant women for cognitive vulnerability and depression before and after they gave birth. It was found that women who had a high cognitive vulnerability were more likely to suffer post-partum depression.
- cause and effect is not clear. Can we say that negative and irrational thoughts cause depression to develop; or could we say that depression develops first
- does not explain how some symptoms of depression might develop. beck’s theory also does not explain the manic phases experienced by patients with bipolar disorder
describe the ABC model
Ellis (1962) proposed that depression is caused by irrational beliefs:
A (activating event) - an incident in someone’s life
B (beliefs) - the thoughts that occur after the activating event. These could be rational or irrational
C (consequences ) - emotions that are caused by these beliefs. rational beliefs are likely to lead to healthy emotions, whereas irrational beliefs are likely to lead to unhealthy emotions
evaluation of the ABC model
+ research support, Bates found that patients who were given negative thought statements became more depressed. Negative thinking helps cause depression
- although it gives the client power to change the situation, it blames the client for depression
what is CBT and it’s aim
Cognitive Behavioural Therapy
challenges negative thoughts
what is the DEF (in the extended ABC model(REBT))
D (disputing irrational thoughts) - the patients irrational thoughts are disputed and challenged by the therapist
E (effects of disputing and effective attitude to life): the new rational thoughts that occur now that the irrational thoughts have been disputed
F (feelings): new feelings and emotions that result from the new rational thoughts and from having a new attitude to life
what are the three types of disputing
logical
empirical
pragmatic
what is logical disputing
when therapists show patients that their self-defeating beliefs do not logically follow from the information available
what is empirical disputing
when therapists show patients that their self-defeating beliefs are not consistent with reality
what is pragmatic disputing
when therapists emphasise to patients the lack of usefulness of self-defeating beliefs
evaluation of rational emotive behavioural therapy
+ David compared 170 patients who had 14 weeks of CBT with patients who were treated with the drug fluoxetine. Later it was found that CBT was a better long-term treatment for depression
+ Ellis claimed a 90% success rate for CBT, taking an average of 27 sessions to complete the treatment
- requires commitment and motivation which may be a problem for depressed patients, especially those suffering from lethargy
- relies in patients self-reporting their thoughts as thoughts cannot be objectively observed or measured (can’t see thoughts/they may lie)
- not suitable for everyone, it does not work when high levels of stress (cannot dispute genuine stress)
what is an obsession
an intrusive, recurring, irrational thought that is perceived as inappropriate or forbidden
they may be frightening or embarrassing and the person might not want to share them with others
these obsessions are not worries about everyday problems; instead they are uncontrollable and cause anxiety
2 behavioural characteristics of ocd?
compulsions, avoidance
whar is an compulsion
a repetitive behaviour that can hinder ones ability to cope with everyday life
they reduce anxiety that is created by obsessions
the person feels they must perform these actions otherwise something dreadful might happen
2 emotional characteristics of ocd?
anxiety, disgust
3 cognitive characteristics of ocd?
obsessions
awareness that behaviour is irrational
catastrophic thinking (scared smth will happen if they don’t carry out the compulsion)
what is the biological approach to explaining ocd?
it assumes that OCD is caused by genetic and biochemical factors
define polygenic
when one single gene is not responsible for the disorder
define candidate gene
genes that might be responsible for causing a disorder
what is the COMT gene and what does it do
- has a role in causing OCD
- regulates the production of a neurotransmitter called dopamine, which in high levels is associated with OCD
- one variation of the COMT gene results in higher levels of dopamine
- this variation has been found to be more common in ocd patients than people who dont have the disorder
what is the SERT gene and what does it do
-gene has been implicated in ocd
affects the transportation of serotonin, causing lower levels of serotonin
- low levels of serotonin has been linked to ocd (and depression)
evaluation of genetic explanation of ocd?
+Nestadt(2000) research support. found that people who had a first degree relative who had ocd were 5 times more likely to get it
+Bilett(1998) supports genetic transmission. he found from meta-analysis of 14 twin studies that ocd is twice as likely to be concordant in identical twins compared to non identical
-concordance rate for ocd in identical twins is not 100%. therefore not caused entirely by genetic factors
what are dopamine and serotonin?
neurotransmitters that affect mood.
abnormal levels of them are associated with abnormal transmission of mood-related information
ocd sufferers have high levels of dopamine…
- research on animals has found that high doses of drugs that enhance depoamine can induce movements that resemble ocd
- high dopamine levels have also been linked to over hyperactivity in the basal ganglia. this causes repetitive motor functions
serotonin plays a key role in operating…
the caudate nucleus in the basal ganglia, and it seems that low levels of serotonin cause the caudate nucleus to malfunction. in particular, low levels of serotonin result in obsessions
evaluation of neural explanations of ocd?
+anti depressant drugs increase serotonin levels, and lead to a reduction in ocd symptoms. there is good evidence to suggest that low levels of serotonin could be a cause for ocd
- neurotransmitters might not cause ocd. instead low levels of serotonin and high levels of dopamine might be a symptom of ocd
how does the biological approach treat ocd?
uses medication to increase or decrease levels of neurotransmitters, or the activity neurotransmitters, in the brain.
the general purpose is to decrease anxiety, lower arousal, and lower blood pressure or decrease heart rate.
what are SSRIs
- anti depressant drugs called
- selective serotonin re-uptake inhibitors
- a method of treating ocd that works on the serotonin system in the brain
SSRIs prevent the…
reabsorption and breakdown of serotonin and so increase the level of serotonin in the synapse, where it continues to stimulate the postsynaptic neuron. the effect of this should be to reduce anxiety
evaluation of serotonin reuptake inhibitors?
+ Soomro (2009) reviewed 17 studies that compared SSRIs to placebo drugs for treating OCD and found that all 17 studies showed that SSRI drugs were more effective than placebos, especially when SSRs were combined with CBT
+70% of patients have experienced a decline in OCD symptoms when taking SSRIs. remaining 30% of patients tend to opt for a combination of SSRIs and psychological therapies
-side effects which might mean that the OCD patients might stop taking the medication. side effects include indigestion, blurred vision and loss of sex drive.
what are benzodiazepines?
- anti anxiety drugs that treat ocd
- slow down the activity of cns by enhancing the activity of the neurotransmitter GABA.
what is GABA?
a neurotransmitter that has an inhibitory effect on neurone
how does GABA work?
reacts with special sites called GABA receptors on the outside of neurons.
when GABA locks into these receptors it opens a channel that increases the flow of chloride ions into the neuron.
chloride ions make it harder for the neuron to be stimulated by other neurotransmitters, which slows down neural activity and making a person feel more relaxed
evaluation of benzodiazepines?
+BZ drugs can begin to reduce anxiety levels and OCD symptoms in a short period of time, especially compared to other treatments like CBT
-if BZ drugs are used long-term then several unwanted side effects (drowsiness, depression, unpredictable interactions with alcohol)
Ashton (1997) found that longterm users of BZ became very dependent on the drug and a sudden withdrawal of the drug leads to a return of high levels of anxiety and OCD symptoms.
tolerance whereby patients need to take larger and larger doses of the drug in order to reduce their OCD symptoms because their body gets used to the drug
