Psychopathology - Paper 2 Flashcards
Abnormality - Statistical Infrequency
Implies that a disorder is abnormal if that characteristics is 2 deviations away from the normal rate
Abnormality - When is statistical infrequency used?
- Almost always used in clinical diagnoses and mental health disorders
Abnormality - Statistical Infrequency (How many people in the country suffer with Schizophernia)
1% of the general population
Abnormality - Statistical Infrequency (Negatives)
- Makes the assumption that any abnormal characteristic is negative
Abnormality - Failure to Function Adequately (Who proposed it)
Rosenhan and Seligman 1989
Abnormality - Failure to Function Adequately (What is it)
A persons current mental state is preventing them from leading a normal life
Abnormality - Failure to Function Adequately (What should a person be disobeying to be labelled this)
- Social and interpersonal rules
- Behaviour has been distressed or distressing
- Behaviour has become dangerous
Abnormality - Failure to Function Adequately (STRENGTH)
- It takes in account the patients perspective, and so the final diagnoses will have a subjective reported symptons too.
- Leads to more accurate diagnosis and are not constrained by statistical limits
Abnormality - Failure to Function Adequately (WEAKNESS)
- May lead to labelling some patients as ‘crazy’ or ‘strange’.
- Negative labelling can cause discrimination and prejudices.
Abnormality - Deviation from Social Norms
- Suggests that ‘abnormal behaviour is based upon straying from social norms specific to different cultures
Abnormality - Deviation from Social Norms (APD)
- Antisocial personality disorder
- If they behave agressiveley towards strangers.
- One important sympton of this is the absence of pro-social behaviour
Abnormality - Deviation from Social Norms (19th Century Great Britian)
- Nymohomania
- A mental health disorder given to women who demostrated sexual attractictions to working class men. (DIagronsis was simply made to stop infedelity
Abnormality - Deviation from Social Norms Evaluation (STRENGTH)
- Usefullness
- ## Used in clinical practice
Abnormality - Deviation from Social Norms Evaluation (WEAKNESS)
- Variablity between social norms in different cultures.
- DIfferent culturals may label different things as abnormal
- Example in some culturals hearing voices means you have a strong spiritual connection whereas in others it means your a schizophernic.
Abnormality - Deviation from ideal mental health (who proposed it?)
Proposed by Jahoda (1958)
Abnormality - Deviation from ideal mental health
When someone does not reach seld-actualisation
Abnormality - Deviation from ideal mental health (What is self actualisation)
Reaching our full potential
Abnormality - Deviation from ideal mental health (5 criterias)
- Cannot cope with stress
- Cannot self-actualise
- No/bad self-esteem
- Not independent
- Cannot sucessfully work, love and enjoy our lesuire
Abnormality - Deviation from ideal mental health Evaluation (2 LIMITATION)
- Unrealistic expectation of ideal mental health, with some people being unable to acquire, let alone maintain all criteria listed.
- Culture bound (Located in the context of US and europe) The idea of self actualisation could be seen as self-indulgent (esp. in collectivist cultures)
Abnormality - Deviation from ideal mental health Evaluation (Strength)
Highly comprehensive, has a range of criterias which means it is easy to have a checklist for not only professionals but people to asses themselves next too.
Characteristics of Phobias - Phobia
An irrational fear of an object or situation
Characteristics of Phobias - Behavioural
Ways in which people act
Characteristics of Phobias - Emotional
Related to a persons feelings or mood
Characteristics of Phobias - Cognitive
Refers to the process of ‘knowing’ including and thinking, reasoning, remembering and believing.
Characteristics of Phobias - What is DSM-5
Number of systems for classifying and diagnosing mental health problems
Characteristics of Phobias - three types of phobias
- Specific phobia
- Social anxiety (social phobia)
- Agoraphobia
Characteristics of Phobias - Specific phobia
Phobia of an object, such as an animal or body part
Characteristics of Phobias - Social anxiety
Phobia of a social situation such as public speaking or using a public toilet
Characteristics of Phobias - Agoraphobia
Phobia of being outside or in a public place
Characteristics of Phobias - Three types of behavioural characteristics of phobias
- Panic
- Avoidance
- Endurance
Behavioural Characteristics of Phobias - Panic
Panic may involve a range of behaviours such as crying, screaming or running away
Behavioural Characteristics of Phobias - Avoidance
Negatively reinforced, carried out to avoid the unpleasant consequence. Makes it hard to go by their daily life
Behavioural Characteristics of Phobias - Endurance
- Person chooses to remain in the presence of phobic stimulus.
- Experience heightened levels of anxiety
Emotional Characteristics of Phobias - Three types
- Anxiety
- Fear
- Emotional response is unreasonable
Emotional Characteristics of Phobias - Anxiety
- Unpleasant high state of arousal
- Prevents a person from relaxing and difficult to experience positive emotion
- Can be long term
Emotional Characteristics of Phobias - Fear
- Immediate and extremely unpleasant response when we experience and encounter or think about phobic stimulus
- More extreme and intense
- Shorter period of time
Emotional Characteristics of Phobias - Emotional response is unreasonable
- Anxiety and fear is much greater than normal and disproportionate to any threat posed
Cognitive Characteristics of Phobias - Three types
- Selective attention to the phobic stimulus
- Irrational beliefs
- Cognitive distortions
Cognitive Characteristics of Phobias - Selective attention to the phobic stimulus
- Hard to look away
- Keeping their eye on it as it will give us the best chance to react quickly
- Not useful if threat is irrational
Cognitive Characteristics of Phobias - Irrational beliefs
- Hold incorrect perceptions to the phobic stimulus.
Cognitive Characteristics of Phobias - Cognitive distortions
- Perceptions of person with the phobia may be inaccurate and unrealistic
- May appear grossley distorted or irrational
Characteristics of Depression - DSM-5 categories of depression (there are 4)
- Major depressive disorder
- Persistent depressive disorder
- Disruptive mood dysregulation disorder
- Premenstural dysphoric disorder
Characteristics of Depression - DSM Major depressive disorder
- Severe but often short-term depression
Characteristics of Depression - DSM Persistent depressive disorder
- Long term or recurring depression
- including sustained major depression (Dysthymia)
Characteristics of Depression - DSM Disruptive mood dysregulation disorder
Childhood tempter tantrums
Characteristics of Depression - DSM Premenstrual dysphoric disorder
- Disruption to mood prior to and or during mensturations
Behavioural Characteristics of Depression - Three types
- Activity levels
- Disruption to sleep and eating behaviour
- Aggression and self harm
Behavioural Characteristics of Depression - Activity levels
- Reduced levels of energy which makes them lethargic
- Opposite sometimes (Psychomotor agitation)
Behavioural Characteristics of Depression - Disruption to sleep and eating disorders
- May experience reduced sleep (insomnia)
- Or an increased need for sleep (hypersomnia)
Behavioural Characteristics of Depression - Aggression and Self Harm
- Often irritable, verbally and psychically aggressive
- Depression can lead to physical and verbal aggression
3 types of Emotional Characteristics of Depression
- Lowered mood
- Anger
- Lowered Self-esteem
Emotional Characteristics of Depression - Lowered Mood
-Always being lethargic and sad
Emotional Characteristics of Depression - Anger
- Tend to experience more negative emotions and fewer positive emotions
- Anger can be directed towards themselves or others
Emotional Characteristics of Depression - Lowered self esteem
People with depression tend to have lower self esteem, like themselves less than usual
Three types of Cognitive Characteristics of Depression -
- Poor concentration
- Attending to and dwelling on the negative
- Absolutist thinking
Cognitive Characteristics of Depression - Poor concentration
Unable to stick with a task they usually would or might find it hard to make concentration
Cognitive Characteristics of Depression - Attending to and dwelling the negative
- Depressive episodes people are inclined to pay more attention to negative aspects of a situation and ignore the positives.
Cognitive Characteristics of Depression - Absolutist thinking
Most situations are not all-good ir all-bad but when a person is depressed they tend to think in these terms.
What is OCD (Obsessive compulsive disorder)
A condition characterised by Obsessions and/or compulsive behaviour. Obsessions are cognitive whereas compulsions are behavioural
Four types of DSM categories of OCD
- OCD
- Trichotillomania
- Hoarding disorder
- Excoriation disorder
3 types of Behavioural Characteristics of OCD -
- Compulsions are repetitive
- Compulsions reduce anxiety
- Avoidance
Behavioural Characteristics of OCD - Compulsions are repetitive
Feel compelled to repeat behaviours, common example is repetitive handwashing
Behavioural Characteristics of OCD - Compulsions reduce anxiety
No obsessions just irrational anxiety
For example compulsive handwashing as a response to obsessive fear of germs
Behavioural Characteristics of OCD - Avoidance
To reduce anxiety by avoiding the situation
3 types of Emotional Characteristics of OCD -
- Anxiety and Distress
- Accompanying depression
- Guilt and Disgust
Emotional Characteristics of OCD - Anxiety and Distress
- Obsessive thoughts are unpleasant and compulsions
- Unpleasent experience because of the powerful anxiet
Emotional Characteristics of OCD -
Accompanying depression
- Anxiety is accompanied by depressionn, by low mood and lack of enjoyment in activities.
Emotional Characteristics of OCD - Guilt and disgust
- Sometimes involves other nehative emotions such as irrational guilt, over minor moral issues
3 types of Cognitive Characteristics of OCD -
- Obsessive thoughts
- Cognitive coping strategies
- insight into excessive anxiety
Cognitive Characteristics of OCD - Obsessive thoughts
- Thoughts that recur iver abd iver again
- usually very unpleasant
Cognitive Characteristics of OCD - Cognitive coping strategies
- Major cognitive aspect of OCD, but people also respond by adopting cognitive coping strategies to deal with the obsessions
Cognitive Characteristics of OCD - Insight to excessive anxiety
- Aware that their thoughts are not rational
- If someone believed their obsessive thoughts were based in reality that would be a symptom of a quite different form of mental disorder
The behavioural approach to explaining phobias
A way of explaining behaviour in terms of what is observable and in terms of learning
The behavioural approach to explaining phobias - Two process model
An explanation for the onset and persistence of disorders of disorders that create anxiety, such as phobias.
- Classical conditioning for onset
- Operant conditioning for persistence
The behavioural approach two processes model - Classical Conditioning
Learning by Association
Occurs when two stimuli are repeatedly paired - a neutral stimulus and an unconditioned stimulus
- Neutral stimulus eventually produces the same response that was produced by the unconditioned stimulus alone
The behavioural approach to explaining phobias - Operant conditioning
- A form of learning in which behaviour is shaped and maintained by its consequences. Possible consequences of behaviour include positive reinforcement
The behavioural approach to explaining phobias - Little Albert Experiment
John Watson conditioned a phobia in a 9-month-old baby named ‘little Albert’
Albert showed no unusual anxiety, but by pairing a white rat (Neutral stimulus) with a loud, frightening noise (unconditioned stimulus) . Albert displayed fear when presented with the rat alone, demonstrating classical conditioning.
The behavioural approach to explaining phobias - Conditioning Generalisation
- The tendency for the conditioned response, to be elicited by stimuli similar to the conditioned stimulus. In the little albert experiment fear generalised to similar furry objects such as a fur coat and even watson wearing a santa clause beard.
The behavioural approach to explaining phobias -Operant conditioning Reinforcement
- Reinforcement whether positive or negative, tends to increase the frequency of a behaviour. In the case of negative reinforcement, an individual avoids unpleasant situation, resulting in a desirable consequences.
The behavioural approach to explaining phobias -Operant conditioning (Maintenance of Phobias)
Mower suggested that avoiding a phobic stimulus successfully escapes the fear and anxiety that would have been experienced if exposed to it. The reduction in fear reinforces the avoidance behaviour
The behavioural approach to explaining phobias -Operant conditioning Acquiring and Maintaining a Phobia
- If they constantly avoids situations involving fogs. The act of avoiding the feared stimulus reinforces the avoidance behaviour
Evaluation of Two Process Model - Strengths
Real-World d Application
- In exposure therapies like systematic desensitization. It suggests that Phobias are maintained by avoidance behaviour, and exposure to the phobic stimulus can help overcome the phobias by preventing reinforcement of avoidance behaviour
Link to Traumatic Experiences
- Little Alberts
Evaluation of Two Process Model - Limitations
- Cognitive aspects of phobias
- It explains avoidance behaviour, overlooks cognitive factors such as irrational beliefs aboit the dangers posed by the phobic stimulus
Behavioural Approach to Treating Phobias - Two types
- Systematic desensitation
- Flooding
Behavioural Approach to Treating Phobias - Systematic Desensitisation
- Behavioural therapy aimed at reducing phobic anxiety gradually throughout classic conditioning. It invol ves pairing the phobic stimulus with relaxation instead of anxiety to induce a new response.
Systematic Desensitisation - 3 processes
- Anxiety Hierarchy
- Relaxation
- Exposure
Systematic Desensitisation - 1. Anxiety Hierarchy
The client and therapist make a list, listing the phobic stimulus from least to most frightening
eg. Someone with arachnophobia, may have seen a picture of a small spider will be low on the hierarchy.
Systematic Desensitisation - 2. Relaxation
The therapist teaches the client deep relaxation techniques. Reciprocal inhibition occurs, where relaxation prevents fear. Techniques include breathing exercises, mental imagery, or medication
Systematic Desensitisation - 3. Exposure
The client is gradually exposed to the phobic stimulus in a relaxed state, starting from the bottom of the anxiety hierarchy.
Successful treatment occurs when the client can be relaxed even in situations high on the hierarchy.
Flooding
Flooding is a therapeutic technique involving immediate and intense exposure to the phobic stimulus, without gradual desensitization. Sessions can be lengthy lasting up to three hours. May require only one session to cure a phobia
Flooding - How it works
- Quickly stops the phobic responses by exposing individuals to the feared stimulus without the option of avoidance behaviour.
Extincition in Flooding
- Extinction occurs when the conditioned stimulus (eg. a spider) is encountered without the unconditioned stimulus (eg.harm) leading to the conditioned response (eg.fear)
Client experience in Flooding
- Clients may achieve relaxation in the presence of the phobic stimulus simply because they become exhausted by their own fear response, highlighting the intense nature of flooding sessions
Flooding - Ethical Considerations
- It is crucial for clients to provide fully informed consent due to its traumatic nature. Clients should be given the option between systematic desensitization and flooding
Systematic Desensitisation - Effectiveness
Research Conducted by Liddell et al. 2003 that it is effective for specific phobias, social phobias and agoraphobia
Systematic Desensitisation - Effectiveness with people with Learning Disabilities
As they may struggle with cognitive therapies and find flooding distressing
Strengths in Flooding
- Cost Effective (Achieve results in less than one session)
Limitation in Flooding
Traumatic Nature - Causing significant anxiety,
The Cognitive approach to explaining depression - Negative Triad
- Three kinds of negative thinking contribute to becoming depressed.
- Negative views of the world
- Negative views of the future
- Negative views of the self
Becks Negative Triad - Faulty Information Processing
- Depressed individuals tend to focus on the negative aspects of the situations while ignoring the positives.
- Leads to Black and White Thinking where things are perceived as either bad or good.
Becks Negative triad - Negative Self-Schema
- Mental framework developed through experiences. In depression, individuals possess a negative self-schema, interpreting all information about themselves in a negative manner
Ellis ABC Model
- Is a cognitive framework that explains how irrational thoughts lead to emotional and behavioural consequences.
Ellis ABC Model - Component A
Activating Event
Ellis ABC Model - What is the Activating Event
Refers to the external situations that trigger irritational thoughts. These events, such as failing a test or ending a relationship, can leave to negative emotions
Ellis ABC Model - Component B
Beliefs
Ellis ABC Model - Beliefs
Ellis identified various irrational beliefs, including the belief in the necessity of success or perfection, catastrophizing and utopism.
Ellis ABC Model - C component
Consequences
Ellis ABC Model - Consequences
- When activating events trigger irrational beliefs, they lead to emotional and behavioural consequences.
Strength for Becks Cognitive Model
Beck 1999. supports cognitive model by showing that Cognitive vulnerabilities, such as faulty information processing and nrhative self-schema
Strength for Ellis ABC Model
Has real world application - Applied in the rational emotive behaviour therapy. REBT aims to challenge and change irrational thoughts and beliefs
Limitation of Becks cognitive model
- Offers a partial explanation for depression and only accounts for certain cognitive patters associated with depression.
Cognitive approach to treating depression - CBT
A psychological treatment for depression and other mental health, the client and therapist collaborate to identity the clients problemes and set therapy goals.
Cognitive approach to treating depression - CBT what is targeted
Negative and irrational thoughts
Cognitive approach to treating depression - Behavioral element for CBT
- Involves changing negative thoughts and implementing more effective behaviours. Therapies work with clients to challenge automatic negative thoughts and replace them with more realistic and constructive ones.
Cognitive approach to treating depression - Becks Cognitive Therapy
- Is based on the cognitive theory of depression, discussing on identifying the challenges of negative thoughts and the world, self and future.
Cognitive approach to treating depression - Irrational Thoughts
- Also called Dysfunctional thoughts. In Ellis model and therapy these are defined as thoughts that are likely to interfere with a persons happiness’s.
Cognitive approach to treating depression - What does REBT stand for
Rational Emotive behaviour Therapy
Cognitive approach to treating depression - What is REBT
- Extends Ellis ABC model
- Includes D and E which stands for Disputing irrational thoughts and Examining their effects.
The central technique is to identify and challenge irrational beiefs to break the link between negative life events and depression.
Cognitive approach to treating depression - Disputation in REBT
- Vigorously dispute irrational beliefs such as Utopiansism, by challenging them iwth lofical arguments or emperical evidence.
Cognitive approach to treating depression - Behavioral Activation
Individuals with depression often avoid challenging situations and become isolated which worsen their symptons.
Behavioral Activation involves hradually decreasing avoidance and isolation and increasing engagement in mood-improving activities.
Cognitive approach to treating depression - Goals of Behavioural Activation
- Is to encourage depressed individuals to participate in activities that improve their mood, therefore breaking the cycle of avoidance and isolation
Cognitive approach to treating depression - Role of Therapists in Behavioral Activation
Therapists work with clients to identify enjoyable and meaningfgul activities and reinforce engagement in these activities and reinforce engagement in these activities to improve mood and well-being.
Cognitive approach to treating depression - Evidence for Effectiveness of CBT
- John March Et al (2007) demostrated the effectiveness of CBT in treating depression.
It is often as effective as anti-depressent drugs and combining CBT with medication can yied even better results.
Cognitive approach to treating depression - Limitation of CBT
- High relapse rate. Whilst CBT effectively treats depressive symptons, long term outcome may not be as enduting.
A study such as “Shezad Ali et al (2017) indicated that a significant proportion of clients relapse within 6-12 months after completing CBT.
Genetic Explanation of OCD
OCD may have strong bio component, play a role in individual vulnerability0 Audrey Lewis (1936) found that may OCD patients had relatives with OCD suggesting a family link
Diathesis-Stress Model
According to the diathesis-stress model, certain genes predispose individuals to mental disorders like OCD, but environmental stressors are necessary triggers for the condition to manifest.
Candidate Genes for OCD
Researchers found that candidates with OCD are those regulating the serotonin system
Polygenic Nature of OCD
It is from a combination of different genetic variations rather then a single one. Steven Taylor (2013) suggest that upto 230 genes may be involved In OCD.
Aetiologically Heterogeneous OCD
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Meaning the origins of the disorder of vary among individuals. Different group of genes may cause old In different people, contribute to various types of the disorder.
Neural Explanations for OCD
Genes associated with OCD likely affect neurotransmitter levels and brain structures
Role of Serotonin
Serotonin, a neurotransmitter that regulates mood, may play a role in OCD. Low serotonin levels can disrupt mood regulation, potentially contributing to symptoms of OCD.
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Impaired Decision-Making in OCD
‘OCD, particularly hoarding disorder, may involve impaired decision-making, possibly due to abnormal functioning of the lateral frontal lobes of the brain. These lobes, located behind the forehead, are responsible for logical thinking and decision-making.
Genetic Explanation for OCD: Research Support
Twin studies, such as Nestadt et al. (2010), indicate a significant genetic influence on OCD, with higher concordance rates in identical (MZ) twins compared to non-identical (DZ) twins. Family studies also show increased risk among relatives of OCD patients, as shown by Manni and Stednickl (2012).
Environmental Risk Factors in OCD
Such as traumatic events. Contribute to the development and severely of OCD. Cromer et al. 2007 found that over half of the patients had experienced
Animal Studies and Genetic Basis of OCD -
Animal studies have identified genes associated with repetitive behaviors, possibly related to OCD. However, the complex nature of human cognition and behavior makes it challenging to generalize findings from animal studies to human OCD.
Neural Model of OCD: Research Support
Antidepressants targeting serotonin effectively reduce OCD symptoms, suggesting serotonin involvement in OCD. Additionally, OCD symptoms are observed in conditions like Parkinson’s disease, indicating potential biological underpinnings
Limitation of Serotonin-OCD Link ‘
The serotonin-OCD link may not be unique to OCD, as many individuals with OCD also experience clinical depression. This raises questions about whether disrupted serotonin activity is specific to OCD or a result of comorbid depression.
What does i s SSRI stand for -ocd
Selective serotonin reuptake inhibitors
What is selective serotonin reuptake inhibitors
Medication for treating OCD. They work by increasing serotonin levers in the synapse
Mechanism of Action of SSRIs
. SSRIs prevent the reabsorption and breakdown of serotonin by presynaptic neurons, effectively increasing serotonin levels in the synapse. This allows serotonin to continue stimulating postsynaptic neurons, aiding in the treatment of OCD symptoms
Dosage and Administration of SSRIs
Dosage and administration of SSRIs vary depending on the specific medication prescribed. A typical starting dose of fluoxetine (Prozac) is 20 mg daily, with adjustments based on individual response. It typically takes three to four months of daily use for SSRIs to have a noticeable impact on OCD symptoms.
Alternatives to SSRIs for OCD
. Can be ineffective after three to four months, ‘ several alternatives may be considered. Increasing the SSRI dosage or combining it with other drugs are common approaches. Additionally, alternative antidepressants such as tricyclics and SNRIs may be used, particularly for individuals who do not respond to SSRIs.
Tricyclic Antidepressants for OCD
‘Tricyclic antidepressants like clomipramine are sometimes used to treat OCD. They act on various systems, including the serotonin system, similar to SSRIs. However, tricyclics may have more severe side effects than SSRIs and are typically reserved for individuals who do not respond to SSRIs.
SNRIs for OCD Treatment
Serotonin-noradrenaline reuptake inhibitors (SNRIs) are another class of antidepressants used to treat OCD, particularly for individuals who do not respond to SSRIs. SNRIs increase levels of serotonin as well as other neurotransmitters, offering an alternative treatment option for OCD.
Effectiveness of OCD drug therapy
Good evidence supports the effectiveness of drug treatments for OCD. Studies comparing SSRIs to placebos consistently show better outcomes for SSRIs, with around 70% of individuals experiencing symptom reduction. For the remaining 30%, alternative drugs or combinations with psychological therapies can be helpful.
This suggests that drugs are beneficial for most people with OCD.
Cost effective - drug therapy
Cheaper to manufacture and are less disruptive to individuals’ lives. Unlike therapy, individuals can simply take drugs until symptoms subside, making them more convenient for many people with OCD.
Limitation - side effects of drug therapy
Drugs can have potentially serious side effects, such ‘ as indigestion, blurred vision, loss of sex drive, and more. While temporary for most, these side effects can be distressing and may persist for some individuals. Tricyclic drugs like clomipramine can have more frequent and severe side effects, impacting quality of life and potentially leading individuals to discontinue treatment.
