psychopathology evaluation Flashcards
genetic explanation for OCD:
(+)
evidence that some people are vulnerable to OCD as a result of their genetic make-up.
tw: Nestadt et al
Nestadt et al (2010) reviewed previous twin studies and found that 68% of identical twins shared OCD as opposed to 31% of non-identical twins.
This strongly suggests that there is a genetic influence on OCD
genetic explanations for OCD:
twin studies are flawed as genetic evidence
nature vs nurture
They are a standard source of evidence for genetic influences, but they make the assumption that identical twins are only more similar than non-identical twins in terms of their genes. They overlook the fact that identical twins may also be similar in terms of shared environments.
For example, identical twins might be a boy and a girl who have quite different experiences.
This reduces the value of twin studies as the evidence does not separate the effects of nature and nurture on OCD, thus reducing the supporting evidence for the genetic explanation of OCD.
genetic explanations for OCD:
(-)
environmental factors can also trigger, or increase the risk of developing OCD.
tw: Cromer traumatic event
Cromer et al (2007) found that over half the OCD patients in their sample had a traumatic event in their past, and that OCD was more severe in those who had more than one trauma.
This suggests that OCD cannot be entirely genetic in origin.
It may therefore by more productive to focus on environmental causes because we are more able to do something about these.
genetic explanation of ocd
Despite twin studies suggesting that OCD is largely genetic, psychologists have not been successful in identifying all of the genes involved.
tw: predictive value
One reason for this is because there are several genes involved in OCD and each genetic variation only increases the risk of OCD by a fraction.
The consequence is that a genetic explanation is unlikely to be very useful.
This is because it provides little predictive value about whether an individual will develop OCD and if so, what type.
neural explanation:
role of serotonin in OCD +
Evidence for the role of serotonin in OCD comes from research examining anti-depressants.
This research has found that drugs which increase the level of serotonin are effective in treating patients with OCD.
This suggests that serotonin is involved in OCD.
neural explanations:
It should not be assumed that neural mechanisms cause OCD.
tw: biological abnormalities
This is evidence to suggest that various neurotransmitters and brain areas do not function normally in patients with OCD.
This is not the same as saying that this abnormal functioning causes OCD.
These biological abnormalities could be a result of OCD rather than its cause so we cannot establish cause and effect
neural explanations:
The serotonin-OCD link may simply be co-morbidity (having two disorders together) with depression.
The serotonin-OCD link may simply be co-morbidity (having two disorders together) with depression.
Many people who suffer from OCD become depressed. This depression probably involves (though is not necessarily caused by) disruption to the serotonin system.
It could be that in those individuals with OCD, that the serotonin system is disrupted because they are depressed as well.
However, the fact that types of antidepressant that do not work on the serotonin system, have no effect on OCD suggests that serotonin is directly involved in OCD and not just in accompanying depression.
bio treatment for OCD
-clear evidence for the effectiveness of SSRIs in reducing the severity of OCD symptoms
tw: soomro
There is clear evidence for the effectiveness of SSRIs in reducing the severity of OCD symptoms
For example, Soomro et al (2009) found drugs were more effective than placebos in reducing symptoms in 17 studies that were reviewed.
This suggests that drugs can help most patients with OCD.
The impact of this is that it improves the quality of life for patients with OCD
bio treatment
strength of drug therapy is that it requires little input or effort from the user and are cost-effective.
One strength of drug therapy is that it requires little input or effort from the user and are cost-effective. For example, psychological therapies like CBT are time consuming. They also require the person to attend regular meetings and think about tackling their problem.
SSRIs are non-disruptive to patients’ lives in comparison. They also require no therapist and are therefore cheaper.
This means that drug therapies are more economical for the health service and for patients.
bio treatment to OCD
weakness of drug therapy is that all drugs have unpleasant side effects.
One weakness of drug therapy is that all drugs have unpleasant side effects.
For example, SSRIs cause nausea, headaches and insomnia, whilst tricyclics cause hallucinations and an irregular heartbeat.
This can lead to the patient choosing to stop taking the drugs.
This means that side effects, and the possibility of addiction, limit the usefulness of drugs as treatments for OCD.
behavioural approach
two-process explanation of phobias has good explanatory power.
tw-
The two-process explanation of phobias has good explanatory power.
It provides an explanation of how phobias can be maintained over time which has important implications for therapies because it explains why patients need to be exposed to the feared stimulus.
By preventing patients practising their avoidance behaviour their behaviour stops being reinforced therefore helping to treat the phobia.
The impact of this is that it provides individuals with a solution to their phobias thus improving their quality of life.
behavioural
limitation of the two-process model is that it does not explain the development of all phobias.
One limitation of the two-process model is that it does not explain the development of all phobias. Some people cannot remember an incident occurring that led to their phobia developing.
This suggests different phobias may be the result of different processes. However, Ost says it is possible that such traumatic events did actually happen, but the phobic has forgotten them.
behavioural approach:
limitation of the two-process model is that a phobia does not always develop after a traumatic incident
tw: DiNardo et al, dogs
Another limitation of the two-process model is that a phobia does not always develop after a traumatic incident. For example, DiNardo et al. found that not everyone who is bitten by a dog develops a phobia of dogs. The diathesis-stress models says we inherit a genetic vulnerability for developing mental disorders, but a disorder will only manifest itself if triggered by a life event.
This suggests a dog bite will only lead to a phobia in people with such a vulnerability thus limiting the two-process model as we cannot generalise it to all people without a genetic vulnerability
behavioural treatments for phobias:
systemic desensitisation - suitable for a range of patients
Systematic desensitisation is suitable for a diverse range of patients.
A lot of individuals who have anxiety disorders like phobias also have learning difficulties. Learning difficulties can make it very hard for some patients to understand what is happening during the alternatives to systematic desensitisation such as flooding or to engage with cognitive therapies that require the ability to reflect on what you are thinking. Systematic desensitisation is therefore an appropriate treatment for many individuals as well as many different phobias, increasing it’s validity as a treatment.
systemic desensitisation: replacement of phobia
A common criticism of systematic desensitisation is that when one phobia disappears another may appear in its place. For example, a phobia of snakes might be replaced by a phobia of trains. This symptom substitution suggests that systematic desensitisation is not effective at treating phobias. The impact of this is that instead of helping people with their phobias it an make them worse reducing the validity of the treatment.
systematic desensitisation is not effect in treating all phobias
tw:evolutionary phobias
However, systematic desensitisation is not effective in treating all phobias. Patients with phobias which have not developed through a personal experience (classical conditioning) for example, a fear of heights, are not effectively treated using systematic desensitisation. Some psychologists believe that certain phobias, like heights, have an evolutionary survival benefit and are not the result of personal experience, but the result of evolution. These phobias highlight a limitation of systematic desensitisation which is ineffective in treating evolutionary phobias and therefore other treatment options need to be made available.
strength of flooding
-provides a cost-effective treatment for phobias.
One strength of flooding is it provides a cost-effective treatment for phobias.
Research has suggested that flooding is comparable to other treatments. including systematic desensitisation and cognition therapies (Ougrin, 2011) in terms of effectiveness. It is quicker and therefore more cost-effective as you do not need multiple sessions as you would need for systematic desensitisation. The impact of this is that flooding could save already struggling health service providers money that could be used in different areas.
flooding- highly traumatic
Although flooding is considered a cost-effective solution, it is highly traumatic for patients and causes a high level of anxiety. Although patients provide informed consent, many do not complete their treatment because the experience is too stressful and therefore flooding is sometimes a waste of time and money, if patients do not finish their therapy. The impact of this is that it could cost struggling health service providers money which they could use if different heath care areas.
cognitive explanations for depression:
Beck - Grazioli and Terry inc counter evidence
Grazioli and Terry (2000) assessed 65 pregnant women for cognitive vulnerability and depression before and after birth. They found that those women judged to have been high in cognitive vulnerability were more likely to suffer post-natal depression.
This supports the cognitive explanation that depression is due to mental processing.
However, this study only shows support for women so therefore Beck’s theory may not be applied to males.
cognitive approach has useful applications to treating depression.
Beck
The cognitive approach has useful applications to treating depression.
Beck’s explanation has been applied to therapy in the form of cognitive behavioural therepy (CST) where all cognitive aspects of the negative triad for example, can be identified and challenged in CST.
This therapy has consistently been found to be the best treatment for depression.
This suggests that negative thoughts probably have a role in causing depression and therefore increases the validity of the approach
all cases of depression follow an activating event.
Ellis (-)
Not all cases of depression follow an activating event.
For example, some people develop depression without there being a “disaster”.
This means that Ellis’ explanation only applies to some kinds of depression.
Therefore, it is only a partial explanation and explanations for dépression may need to be combined to provide a fully explained approach
ABC model has led to successful therapy.
tw: supports basic explanation
The ABC model has led to successful therapy.
The idea that, by challenging irrational beliefs a person can reduce their depression is supported by evidence such as Lipzky et al. (1980).
This in turn supports the basic theory because it suggests that the irrational beliefs had some role in depression.
Cognitive explanations do not explain all aspects of depression.
Cognitive explanations do not explain all aspects of depression.
Some sufferers of depression experience hallucinations and bizarre beliefs e.g. ‘Cotard Syndrome’- the belief they are zombies.
Beck’s theory explains the basic symptoms of depression, but not the more complex ones. Ellis model explains why some people are more vulnerable than others but again does not explain the anger some individuals feel, or their hallucinations and delusions.
This shows that other explanations may be needed to explain the condition in full, limitimg the original cognitive theories’ validity.
cognitive treatment for depression:
Cognitive Treatment for Depression: 33%
Evaluation
Research shows that CBT is an effective treatment for depression.
March et al. (2007) compared the effect of CBT with antidepressant drugs and a combination of the two in 327 adolescents with a main diagnosis of depression. After 36 weeks 81% of the CBT group, 81% of the antidepressant group and 86% of the combined therapy group were significantly improved.
This shows that CBT is just as effective as medication at treating depression and that the most effective treatment is a combination of biological and cognitive therapies.
Individual differences influence the effectiveness of CBT.
Individual differences influence the effectiveness of CBT.
Elkin et al, found it is less suitable where peoples irrational beliefs are rigid and resistant to change. Also, in some cases of depression, patients can have symptoms so severe that they cannot engage with the therapy which means antidepressants are needed before a patient can begin therapy.
This means that CBT carnot be used as the sole treatment for all coses of depression
The impact of this is that other treatment options need to be considered especially for people who have severe symptoms mesning a more individualised approach may be needed
exercise can be beneficial in alleviating depression.
Research shows that exercise can be beneficial in alleviating depression.
Babyak et al, found that aerobic exercise, anti-depressant drugs or both together treat depression effectively, but there were significantly lower relapse rates for those in the exercise group compared to the drug group.
This shows that exercise used in the behavioural activation part of CBT can be highly effective.
However, not all patients will be able to exercise or have the motivation to do so, so individual differences may affect the effectiveness of the treatment.
statistical infrequency definition of abnormality has real life application.
The statistical infrequency definition of abnormality has real life application.
For example, it is used in the diagnosis of intellectual disability disorder where someone is given this label when their IQ is 69 or below.
Statistical infrequency is therefore a useful part of clinical assessment.
The impact of this is that it increases the validity as a definition of abnormality as it can successfully aid treatment.
The statistical infrequency definition does not distinguish between desirable and undesirable “abnormal” behaviour.
Very few people have an IQ over 130, however, a lot of people would like to be classed as a genius!
This means that we need a way of identifying behaviours that are both infrequent and undesirable in order to give a more accurate definition of abnormal behaviour.
This reduces the validity of the definition as we do not have a set of behaviours that are universally desirable or undesirable
statistical infrequency definition does not distinguish between desirable and undesirable “abnormal” behaviour
The statistical infrequency definition does not distinguish between desirable and undesirable “abnormal” behaviour.
Very few people have an IQ over 130, however, a lot of people would like to be classed as a genius!
This means that we need a way of identifying behaviours that are both infrequent and undesirable in order to give a more accurate definition of abnormal behaviour.
This reduces the validity of the definition as we do not have a set of behaviours that are universally desirable or undesirable
