Psychopathology [U4] Flashcards
Statistical frequency in clinical diagnosis
- Uses objective, quantitative data to identify anomalous mental health
- E.g. A 30+ score on the BDI indicates severe depression
- Ensures consistency and reliability in diagnosis, allowing prioritisation of care to be accurate
Statistical infrequency in a positive light
- Alone, SI doesn’t consider the merit of a behaviour, simply its rarity
- Some characteristics are positive, like high creativity or IQ
- Therefore it cannot be used in isolation to define abnormality
DFSN in clinical diagnosis
- Significant deviation from societal norms can be easily witnessed
- E.g. In Schizotypal personality disorder, eccentric thinking, appearance and behaviour often violate norms
DFSN universality
- Norms vary between cultures and generations
- E.g. hearing voices is abnormal in western society, but spiritual in others
- If clinicians fail to account for it, this variability can lead to misdiagnosis or stigma
F2F as a threshold
- Depicts clearly when professional intervention is needed/appropriate
- Gives us a clear criterion for the distribution of professional aid, as those whose daily life is impaired are prioritised
F2F as normal
- Most fail to cope at some point, such as during bereavement or a break-up
- It’s unfair to label this as abnormal, but the F2F is no less real because the cause is clear
- Therefore, context, severity and duration of symptoms need to be considered holistically before labelling a behaviour as abnormal.
IMH as comprehensive
- By outlining specific criteria, you create a framework for assessing psychological states
- Assessments are thorough and balanced as various aspects of psychological functioning are addressed
- The efficacy and precision of intervention and assessment is enhanced as treatments become targeted
IMH and culture
- Independence and self-actualisation are western ideals. Collectivist cultures value interdependence and community
- Could lead to misdiagnosis and demonstrates a limited applicability
Phobia understanding & Therapy
- Two-process model used to develop systematic desensitisation
- SD uses classical counter-conditioning to extinct phobias
- Flooding prevents negative reinforcement to extinct phobias
- Supports effectiveness of theory (But treatment-causation fallacy if need be)
De Jongh et al. on Trauma
- 73% of those with dentistry fears had experienced violent crime or a traumatic dentistry event.
- Compared to low anxiety control, which only 21% of who had had the same experiences
- Confirms the correlation and supports 2-process model
Bounton & Seligman on alt. phobia explanations
- Behavioural exp. is reductionist
- Avoidance of particular stimuli, like snakes, could improve survival chances of ancestors. Thus, role of evolutionary factors (Bounton)
- Evolutionary psychologists argue some phobias are innate, not learned, as survival mechanisms
- This innate set of phobias is called “Biological prearedness” (Seligman)
Gilroy et al. on Phobias
- Studied 42 arachnophobes
- Each underwent 3 x 45 minute SD sessions
- At 3 and 33 months, the experimental group was significantly less fearful than the control group, who were only taught relaxation techniques
Schumacher et al. on Phobias
- Participants and patients rank flooding as significantly more stressful than SD (Schumacher et al.)
- Cost-effective but highly traumatic
- The stress of the experience leads many to not complete their treatment
- Can often be a waste of time and money
Symptom Substitution in phobias
- Behavioural therapies only treat surface symptoms
- If there is a deeper underlying cause, these symptoms can resurface, potentially in another form
- E.g. a fear of death from bereavement can manifest as a fear of leaving the house, entering a car, eating foods etc.
- This limits treatment’s efficacy
Clark & Beck and Cohen et al. on depression
- Cognitive vulnerabilities more common during and before depression development (Clark & Beck)
- Tracked 473 adolescents, frequently measuring cognitive vulnerabilities, and found they were a good predictor of later depression
- Correlation exists between the two
Biological explanation for depression
- Low serotonin levels is linked to depression
- Drug therapies that increase serotonin are affective in treating depression
- Cognitive explanations in isolation are heavily reductionist
Existence of endogenous depression
- Endogenous depression is where there is no cause to the condition
- Ellis’ explanation can only explain reactive depression, as a result of life events and beliefs
- They are only partial explanations
March et al. on CBT for depression
- CBT just as effective as antidepressants
- 327 diagnosed adolescents
- Compared CBT, antideps and combo treatments
- After 36 weeks, 86% of the lattermost condition had significantly improved, compared to 81% of the first two conditions
Sturmey on the Suitability of CBT
- Requires motivation
- Severely depressed lack the motivation and concentration required to engage
- Also requires a lot of hard cognitive work
- Psychotherapy of any kind is unsuitable for those with learning difficulties (Sturmey)
- Only useful in specific range of clients
Ali et al. on Depression Relapse
- At face validity, CBT is effective at treating depression
- Research brings long-term effects into question
- Ali et al. assessed 439 depressed clients once a month for 12 months after a CBT course
- 42% relapsed within 6 months of treatment end
- 53% relapsed within a year
- Suggests treatment needs to be refreshed/repeated
Nestadt et al. and Marini & Stebnicki
- Reviewed previous twin studies, finding 68% of MZ twins shared OCD compared to 31% of DZ twins (Nestadt et al.)
- If you have a family member with OCD, you are 4x as likely to develop the condition (Marini & Stebnicki)
Cromer et al. on OCD
- Over half of OCD patients had experienced a traumatic event in their past
- The more cases of trauma, the worse the OCD
- Environmental factors are important
- Diathesis stress model
Two-process model on OCD
- Neutral stimulus (E.g. dirt) is associated with anxiety
- Compulsions are negatively reinforced through reducing anxiety
Soomro et al. on SSRIs
- Analysed 70 studies
- In 70% of cases, SSRIs reduced OCD symptoms (Significantly better than placebo)
- Other 30% saw efficacy in combo therapies or alternative drugs (Tricyclics / SNRIs)
Skrapinakis et al. on SSRIs
- Suggested that both cognitive and behavioural therapies are both significantly more effective than SSRIs
Why are drug therapies good?
- Low cost of manufacture en-masse
- Easy, less time-consuming and non-disruptive compared to other therapies
- Better for the economy : Masks symptoms to get people back to work