Psychopathology evaluation Flashcards
Statistical infrequency evaluation
some abnormal behaviour is desirable such as having a high IQ other normal behaviors are undesirable, for example it is quite common to experience depression this makes it hard to distinguish between desirable and undesirable behaviors
need to be able to decide where to separate normality from abnormality also depends on how you see the data
in some situations it is appropriate to use a statistical criterion for example intellectual disability is defined in terms of the normal distribution more than two standard deviations below the mean then it is judged as having a mental disorder
Evaluation of Deviation from social norms
it does distinguish between desirable and undesirable, takes in effect it has on others
- abnormal behavior is behavior that damages others
- statistical infrequent behaviors may be more frequent in another culture for example hearing voices
- social norms are defined by culture as well, classification systems such as DSM are based on western culture there are no universal standards or rules for labeling a behavior as abnormal
relate to the context or degree of behavior for example wearing a bikini to the beach is normal but at a funeral it is not
Evaluation of failure to function adequately
may be the individual that experiences the distress and recognizes that they cannot cope
the individual may be content with the situation or not aware that they are not coping so will judge their behavior as abnormal
depends on whose making the judgement
some dysfunctional behaviors can be adaptive and functional for the individual
for example not eating gains attention this can be rewarding and functional for the disorder
recognizes the subjective experience of the patient allowing use to view the mental disorders from the point of view of the patient
- easy to judge objectively as we can list behaviors and thus judge abnormality objectively
Evaluation of ideal metal health
according to criteria mist of us abnormal as no one can ever meet them all at once
how many have to be lacking before a person is classed as abnormal?
Mental illnesses are not as easy to diagnose and threat consequences of persons life experiences
offers alternative perspective and focus on the desirable
Evaluation of behavioural approach to explaining phobias
Most people with phobias recall a specific incident when their phobia appeared sue et at) - 1994 but not everyone can remember that incident (öst 1987)
- sue et al - phobias may result of different processes for example agoraphobics are likely to be specific whereas arachnophobias are likely to be modeled
according to the two process model on association between a neutral stimuli and a fearful experience will result in a phobia this is not true and explained by the diathesis- stress model
- we inherit a genetic vulnerability for developing mental disorders which are triggered by a life event
Bandura and Rosenthal- 1966 - supported social learning theory in an experiment
a model acted in pain everytime a buzzer was pressed later on the patients who had seen this showed fear to the buzzer
Martian Seligman 1970 argued that animals are genetically programmed to learn association between life threatening situations and fear these are referred as ancient fears from our envoluntary past, explains why we don’t fear modern objects
- bregman 1934 failed to condition 8-16 months by pairing a loud bell with a wooden block this suggests behavioural approach cannot explain
- cognitive approach suggests that phobias may develop as a result of irrational thinking this is not the way that behaviourists would suggest that it come about
Behavioural approach to treating phobias evaluation flooding
- not for every patient
- highly traumatic
- may quit during the process rendering useless
- those who stick with it, it is quick and effective
- Choy et al - flooding was more effective
- one the other hand Craske et al 2008 - both equally effective
- the success of both is due to the exposure than relaxation
- klein et al 1983 - compared SD with supportive psychotherapy for patients with either social or specific phobias - found no difference in effectiveness
- behavioural therapies may not work as symptoms are only the tip of the iceberg - if the symptoms are removed the cause still remains and the symptoms could still resurface
- Freud 1909 - recorded the case of little hans - his fear was removed when he accepted his feelings about his father
behavioural approach to treating phobias evaluation systematic desensitization
-SD was found successful for a range of phobic disorders
- McGrath et al 1990 - reported that 75% of patients with phobias respond to SD
Choy et al 2007 - have to have actual exposure as it is more effective therefore in vivo more effective
- Comer 2002 - modelling is also effective
Ohman et al 1975 - SD may not be effective in treating phobias that have an underlying evolutionary survival component, then treating phobias which are personal
- generally fast
- less effort on patients half
- lack of thinking is also useful for patients who lack insight into their motivations or emotions and for people with learning difficulties
- self-administered - cheaper
Evaluation of the cognitive approach to explaining depression
supported by research
- Hammen and Krantz 1976, found that depressed participants made more errors in logic when asked to interpret written materials than non-depressed participants
- Bates et al 1999 - found that depressed people who were given negative automatic-though statements become more and more depressed
on the other hand
- just because there is a link between negative thoughts and depression it does not mean that negative thoughts cause depression - an individual may adopt negative views due to their depression
- genetic predisposition may make them more susceptible to negative thoughts and depression
- cognitive approach suggests that it is clients that are responsible for their disorder - good as the client can change that
- however there are disadvantages for this - people may overlook situational effects - these could lead to depression
- changing other aspects on the clients life may remove the depression
- helped developed CBT - cognitive behavioural therapy
- consistently doung to be best treatment for depression especially used with drug treatments - Cuijpers et al 2013 supports this
- if depression is relived by getting rid of negative thoughts then it proves that these caused and played a role in causing the depression in the first place
- not all irrational beliefs are irrational - they may seem irrational
- Alloy and Abrahmson in 1979 suggest that depressive realists tend to see things for what they are, gave a more accurate estimate of the likelihood of a disaster
- biological approach suggests that genes and neurotransmitters may cause depression
- Zhang et al 2005 - found that the role of the neurotransmitter serotonin has low levels in depressed people, also found a gene that is 10x more common in depressed people
- a diathesis-stress approach is advisable as individuals with a genetic vulnerability for depression are more prone to living in a negative environment
the cognitive approach to treating depression evaluation
Ellis 1957 - claimed 90% success rate for REBT taking 27 sessions to complete the treatment
Ellis 2001 - recognised that the therapy was not always effective and suggested this was because clients did not put revised beliefs into action
- REBT and CBT - positive outcomes
- Cuijpers et al 2013 - 75 studies found that CBT was superior to no treatment
- Kuyken and Tsivrikos 2009 - conclude that as much as 15% of the variance in outcome may be attributable to therapist competence
CBT less suitable for those who have high levels of irrational beliefs that are rigid and resistant to change - Elkin et al 1985
- Simons et al 1995 - CBT not suitable in situations where high levels of stress in the individual reflect realistic stressors in the persons life that therapy cannot resolve
- some individuals do not get involved in the cognitive effort that is associated with recovery - they prefer to just discuss there problems with a therapist
- Babyak et al 2000 - studied 156 adult volunteers with major depressive disorder- were assigned a fourmont course of aerobic exercise, drug treatment or both, all showed significant improvement by the end of the four months. Six months after the exercise group showed less relapses that the medication group
use of antidepressants such as SSRI’s most popular treatment
- drug therapies require less effort on patients behalf
- could also be used in conjuction with CBT
- most effective when being used with CBT - Cuijpers et al
Saul Rosenzweig 1936 - all methods of treatment for mental disorder were pretty much equally effective - called it the Dodo bird effect
- Luborsky et al 1975, 2002, studied 100 different studies that compared different therapies and found little difference between them - Rosenzwig argued there was a lack of difference because there was so many common factors in the various different treatments
- Sloane et al 1975 - most common being able to talk to a sympathetic person this will enhance self-esteem and have an opportunity to express one thoughts
Evaluation of biological approach to treating OCD
- Nestadt et al 2000 - identified 80 patients with OCD and 343 of their first degree relatives and compared them with 73 control patients without a mental illness and 300 of their relatives
- found that people with a first degree relative with OCD had a five times greater risk of having the illness themselves at some point in their lives compared to the general population
- Billet et al 1998 - meta analysis of 14 twin studies of OCD found that monozygotic twins (identical) were more than twice as likely to develop OCD is their co-twin had the disorder then dizygotic twins
- concordance rates are never 100% - environmental factors must also play a role too
- Pauls and Leckman 1986 - studied patients with Tourette’s syndrome and their families - concluded that OCD is one form of expression of the same gene that determines Tourette’s
- also found in children with autisms
- obsessive behaviour is typical of anorexia nervosa and is one of the characteristics distinguishing individuals with anorexia from individuals with bulimia
- Rasumussen and Eisen 1992 - reported that two out of three patients with OCD experience at least one episode of depression
- supports view that there is not one specific gene or genes unique to DNA
Menzies et al 2007 - Used MRI to produce images of brain activity in OCD patients and their immediate family members without OCD and a group of healthy unrelated people
- OCD patients and their family members had reduced grey matter in key regions of the brain including the OFC this support the view that anatomical differences are inherited and these may lead to OCD
- mapping of the human genome led to the hope that specific genes could be linked to particular mental and physical disorders
- could abort an unborn child with the COMT gene
- ethically wrong - may lead to designer babies
- gene therapy could turn these genes off
- assumes that there is a simple relationship between a disorder and genes - not as simple as that
Two process model could be used to explain OCD
- neutral stimuli such as dirt is associated with anxiety and the anxiety is maintained as the stimulus is avoided and an obsession is formed
- this is supported by success of a treatment for OCD called exposure response prevention (ERP) this is similar to SD - patients experience these stimulus but prevented from carrying out there compulsion
- Albucher et al 1998 - report that between 60 - 90% of adults with OCD have improved considerably using ERP
Evaluation to biological approach to treating OCD
- Soomro et al 2008 – reviewed 17 studie of the use of SSRIs with OCD patietns and found them to be more effective than using placebos in reducing OCD up to three months after treatment so good in the short term
- Koran et al – one problem with placebo studies is they are only for three to four months duration therefore there is no long-term data
- Requires little effort from the user
- Less time than other therapies such as CBT – attend sessions and put thought into what there doing
- Cheaper
- Require little monitoring
- May benefit from just talking with a doctor during a consultation
- All drugs have side effects some more serve than others
- Nausea, headache, insomnia are all side effects of SSRIs – Soomro et al
- Tricyclic antidepressants have more side effects – hallucinations and irregular heartbeats – only used when SSRIs not effective
- BZs cause people to be aggressive and have long-term impairment of memory, also addictive so can only be used for 4 months
- Koran et al 2007 – in a review of treatments for OCD he suggested that although drug therapies are more common, psychotherapies such as CBT should be tried first as it can be more long term
- Patients are more likely to relapse after a couple of weeks of not taking the cure
Turner et al 2008 – claimed that there is evidence of a publication bias towards studies that show a positive outcome of drug therapy and exaggerates the benefits of antidepressant drugs
- Published papers which showed a non-positive outcome were often published in a way that seemed positive
- Drug companies also have a strong interest
- Selective publication can also lead doctors to make an inappropriate treatment decision not in the best interest of their patients
