psychopathology A03 Flashcards
Deviations from Social Norms (AO3)
criticism - susceptible to abuse
Ev- Muslims in china = abnormal by Chinese Gov + put into re-education camps. Same as homosexuality in victorian times.
Ex- Q’s whether it accurately identifies abnormality that needs treatment or way of Gov’s justifying societal prejudice.
L- but differentiates between normal and abnormal unlike DIMH
criticism - culturally relative
Ev- dependent upon culture e.g. DSM-V uses DSN and is based on white, western cultures but generalises to all.
Ex- so someone = abnormal dependent upon the culture they live in rather than whether it causes them a ‘problem’, like FTF does. Surely if beh abnormal, should be no matter where.
L- but can avoid cultural bias - e.g. DSM-V considers cultural differences when diagnosing abnormality - but is still a subjective measure within each culture.
Criticism- depends upon the context and degree of the DSN
Ev- e.g. wearing a swimming costume on the beach=normal, wearing it in a classroom=abnormal
Ex- if abnormal should be abnormal irrespective of the context or degree of beh
L- but even objective def like statistical infrequency has subjective judgements (e.g. where is the cut off for abnormality- 1%, 5%, 10%?)
all def gave subjective judgement issue.
Failure to Function Adequately (AO3)
criticism- who judges what’s abnormal?
Ev- someone’s deciding what functioning is, subjective, effected by class and ethnicity
Ex- individuals receive different diagnoses of abnormality,e.g. Sz more likely in men, depression women. (male not functioning more serious?)
L- more susceptible to abuse - not correctly diagnose someone. maybe be a beh that psychologist doesn’t like, so says not functioning.
Whereas SI based on data, so not.
criticism- what is defined as functioning/not?
Ev- what the individual seems as functioning may be different to the psychologist (e.g. self harm)
Ex- could be functional to individual, but seems not so observer discomfort.
stopping this beh may lead to more serious consequences like suicide so functional.
L- FTF can be utilised by having more than one psychologist decide abnormality, decreases bias.
strength- considers individuals subjective experience
Ev- allows us to view mental disorder from the view of person with it. How beh is affecting everyday life, so unique to individual.
Ex- not overgeneralising abnormality to all ppl with same beh, unlike DSN. basing abnormality of whether beh is adaptive or not to individuals.
L- looking at beh from neg perspective, as to what person can’t do.
DIMH has more pos outlook oh beh.
Statistical Infrequency (AO3)
strength- objective - based on statistical data
Ev- uses normal distribution and statistical significance to define abnormality -e.g. 1%, 5%, 10% significant difference from normal pop.
Ex- eliminates unconscious bias/human error. Less subjective, more reliable def of abnormality (can be applied consistently to all ppl)
L- still requires judgement of whether to use a 1%,5% or 10% cut off for being abnormal.
criticism - doesn’t distinguish between abnormal being functional or not
Ev - would consider a higher IQ (over 120) to be just as abnormal as a low IQ (below 80- learning disability)
Ex - doesn’t distinguish if infrequency is desirable or not. assumes both high and low IQ needs treatment.
L - does distinguish diff between normal and abnormal, unlike DIMH.
criticism- culturally relative
Ev- depends on which normal population data is being used. normal distribution is culturally specific (e.g. IQ test=western test and normed in USA)
Ex- abnormality is not defined universally so may be invalid to define abnormal from another culture.
L- can ensure gather normal population data from every culture and define within culture data gathered from.
Deviation from Ideal Mental Health (AO3)
strength - positive approach to defining abnormality
Ev - Looks at what’s desirable
rather than undesirable. She accepted that the person is in control of working on themselves to develop in the 6
categories.
Ex - defines normality and not abnormality. Compares people against what it is to be normal, and if does not meet the criteria then abnormal.
L - doesn’t state how many of criteria are needed to be considered normal. so vague definition unlike FTF.
criticism- unrealistic
Ev - criteria hard to measure as vague, e.g. self-actualisation, and accurate perception of reality.
Ex-not effective def of ab - everyone ab as no one meets all criteria, so not useful as no distinct between normal and abnormal.
L- but is positive approach, and humanistic - views everyone as unique and we all need help; as no such thing as ‘normality’.
criticism - compares physical illness to a mental illness
Ev - Physical health is observable and can be felt and measured objectively. Mental health cannot be directly observed or measured.
Ex - criteria for DIMH isn’t observable or easily measurable, e.g., self-actualisation or self- esteem.
L - However, this is a criticism
relevant to all definitions. (and are all culturally relative)
Behavioural Explanation of Phobias (AO3)
strength (research evidence)
Ev- 75% patients responded to SD. Used several exposure techniques- in vivo/vitro, modelling.
Ex- SD = effective in treating phobias.
in vivo/vitro allows gradual exposures and sudden exposures
modelling shows how else to respond
L - but evidence shows in vivo more successful in SD - supports flooding. study found flooding more effective and quicker in treating.
criticism - flooding = unethical
Ev- immediately faced with fear, no right to withdraw, treatment ‘done’ to client.
Ex - causes high level of distress (can harm those with medical conditions). less likely to give consent. very few psychologists conduct due to this. SD better as gradual, at clients pace, so ethical.
L- but flooding does screen for medical condition to avoid harm and one session so aren’t exposed to fear as long as SD
criticism- not effective for all types of phobias
Ev - study found SD and flooding may not be effective against phobias which have underlying evolutionary survival component.
Ex - criticises as not all phobias learned through association + maintained through reinforcement.
Evolutionary - resistant to treatment. (could explain 25% didn’t respond)
L - SD and flooding only treat symptoms not cause, so ‘talking therapies’ could be better
Cognitive approach for explaining
depression
Support: depressed clients have more irrational thinking
- Ev - Depressed patients made more logical errors than non-depressed patients. Depressed patients given more NATs became more depressed.
-Ex - Suggests irrational thinking causes depression, as depressed are more likely to report irrational thinking, such as Mustabatory thinking and NAT’s.
-L - However, not causational. Irrational thinking may be a symptom of depression rather than a cause. People with depression are realists, as gave more accurate estimations of the likelihood of disasters than “non-depressed”. ‘sadder but wiser effect’.
Support: CBT effective in treating depression, hence supports cognitive as cause
-Ev - Study found CBT effective, especially when combined with drug
treatment.
-Ex - This suggests that challenging irrational thinking treats depression. Hence irrational thoughts cause depression. Means that the cognitive explanation is correct in explaining depression.
-L - However, it assumes therapies treat cause of depression (treatment fallacy). Attachment issues may cause depression and alter cognition. E.g., maternal deprivation
Criticism: Ignores biological explanations of depression
-Ev - Research supports correlation – Depressed people 10 times more likely to have gene (5-HTT) mutation.
-Ex - Implies depression is heredited
through genes and that irrational
thinking is a symptom of a biological cause for depression.
-L- Therefore, an interactionist explanation of both biological and cognitive, hence explains why combined drugs and CBT is most effective treatment of depression
Cognitive approach to treating depression (AO3)
Strength - Research support for the effectiveness of CBT
-Ev - Ellis claimed a 90% success rate for REBT, average of 27 sessions.
-Ex - Shows CBT is effective – challenging irrational to rational thoughts through logical and empirical disputing reduces depression. So, REBT is a good treatment for depression.
-Ex - but depends on competence of therapist. The more competent the more successful the outcomes of REBT. It also depends on the motivation of the client.
_ Criticism - individual differences in effectiveness of CBT_
-Ev - CBT = less effective where clients have high levels of stress and realistic stressors they cannot control; high level of irrational beliefs & they are resistant to change.
-Ex - so, REBT does not work
with all people. Due to some being
more resistant to empirical disputing
as in high stress situations. They have
lots of evidence to prove their many
irrational beliefs. Hence more resistant
to change.
_ Criticism – ignores alternative biological treatments for depression_
-Ev - Study found that CBT with anti-
depressants (SSRIs) are more effective
than CBT or drugs alone.
-Ex - The drug therapy reduces the
symptoms of depression to increase the depressed patient’s motivation to attend the 27 sessions and engage actively in the therapy sessions. Thus, reducing the resistance to REBT.
-L - In summary, research suggests that there are small differences in
effectiveness of alternative treatments
for depression. Therefore, they all have
efficacy. So an interactional approach
to treatment is best (drugs & CBT)
Biological approach for explanation of OCD: Genetic (AO3)
Strength - research support for candidate genes causing OCD
-Ev- Meta-analysis of longitudinal twin studies. Found MZ twin = 68% concordance rate; DZ = 31% concordance rate.
-Ex - so, OCD is genetic – SERT & COMT gene.
MZ twins = 100% genes compared to DZ = 50%.
Therefore, the more genetic similarity have the higher the concordance rate for OCD are more similar as they share the same OCD gene. E.g., MZ higher concordance than DZ and have higher genetic similarity.
-L - but, OCD could be env.
MZ twins have higher concordance as have more environmental similarity in how they are reared (e.g., dressed the same, same friends) than DZ (who look different in appearance). Therefore, the meta-analysis does not control enough for the environment and OCD may
therefore not be genetically caused.
Criticism – OCD could be environmentally caused and not biological
-Ev- Study found ½ of OCD patients had experienced a traumatic experience. OCD was more severe in those who had experienced a traumatic event.
-Ex - Study suggests that OCD is due to life experiences (e.g., MZ twins may have experienced the same childhood trauma unlike DZ).
Therefore, OCD is not genetics. Explains why brain may be hypervigilance to future threats, from having past threats.
-L - but, DSM may be a better exp as only 50% of people with OCD had trauma. Could be a genetic predisposition for OCD that is triggered by a traumatic event from the env bringing out the OCD symptoms. Therefore, an interaction of nature &
nurture.
-L - but, the modern DSM argues that the env can switch on or off our genetics (such as the SERT & COMT
gene; epigenetics).
So, is it that people with OCD already have a genetic predisposition that is being triggered by childhood trauma, or is it the childhood trauma that causes the genetic abnormality?
Biological approach for explanation of OCD: Neural (AO3)
Strength – research support for neurochemical explanation of OCD
-Ev - Treatment using SSRIs (selective serotonin reuptake inhibitors – which increases serotonin levels), OCD
symptoms decrease;
various studies range from 50-80% improvement in symptoms of OCD.
-Ex - Suggests that low serotonin causes OCD symptoms, as when serotonin levels are increased by SSRIs that there is a reduced in OCD symptoms.
-L - However, only 50% improve, so 50% of people with OCD taking SSRIs do not improve in their symptoms. Therefore serotonin cannot be the only factor ‘causing’ OCD. If it was the success rate would be closer to 100%; but the results are too mixed, as a large range.
Strength – support for neurophysiological & neurochemistry causing OCD
-Ev - PET scan – found too low serotonin & hypersensitivity in caudate nucleus. Also found an exaggerated response in basal ganglia & OFC.
-Ex - Implies that caudate nucleus has too little serotonin in people with OCD, so does not inhibit the function of the caudate nucleus to detect threats. The OFC and basal ganglia are then overactive and creating compulsions to reduce the anxiety created by the caudate nucleus.
Therefore, OCD is biologically caused by
the function and structure of the brain.
-L - However, correlational, cannot assume that abnormal brain activity in specific areas are the cause of OCD. PET scans does not measure serotonin levels directly.
On the other hand, there is mixed evidence proving the correlation between the basal ganglia and OCD
-Ev - E.g., one study found no
difference between OCD and non-OCD
patients in the structure of the basal
ganglia.
-Ex - If the basal ganglia was linked to OCD there would be a unique difference between those with OCD and without.
Therefore, it appears OCD is not linked to the basal ganglia.
-L - However, there is evidence supporting the basal ganglia. A case study of person who suffered basal ganglia damage due to a head injury, developed OCD.
However, could be the trauma of the
head injury event causing OCD than
biological brain damage
Biological approach to treating OCD (AO3)
Strength - Drugs are effective at treating OCD
Ev - One study found 50-80%
improvement in symptoms using SSRI’s.
Another meta-analysis compared SSRIs
to placebo and all 17 studies found a 70% reduction in OCD symptoms for SSRIs.
Ex_ - Shows robust evidence from
multiple studies that SSRIs are effective
in treating OCD by increasing serotonin
levels.
L - However, drug only treats symptoms not the cause. Study found 90% relapse rate when stopped taking drugs.
Therefore, only works whilst on the
SSRIs, so only a ‘sticking plaster’ and not
treating the cause of OCD.
Criticism - side effects of drugs
Ev - side effects of SSRI’s - Indigestion, sterilisation, dry mouth.
Ex - This a negative compared to other psychological therapies. Effects quality of life of adults, particularly those in intimate relationships as it affects their sexual functioning and can even be fatal (MAOIs). Whereas psychological
therapies have no side effects.
L - However, psychological therapies are more time consuming and expensive.
They require commitment to turn up to
sessions and this may be anxiety provoking for the person with OCD.
Whereas drug therapies require very
little commitment or motivation, can be
taken at home and does not disrupt daily life. Therefore, drug therapies are better practically for OCD.
Criticism - biologically reductionist
Ev - Most treatment uses a combination of CBT and drug therapy. The drugs reduce the symptoms of anxiety and enable to person to access the more committed CBT sessions.
Ex - Therefore, it is reductionist to consider only drug therapy as it is not a long-term solution. However, when
considered through interactional
treatment methods it is more effective
and holistic.
L - Therefore, in summary to reduce long term symptoms of OCD both biological and psychological treatments are needed. One to deal with the neurophysiological and neurochemical changes in the brain and the other to deal with coping strategies and ways of managing their OCD. This gives the best
