Unit 1: Psychopathology Flashcards
1
Q
What are the definitions of abnormality :
A
- deviation from social norms
- statistical infrequency
- failure to function adequately
- deviation from ideal mental health
2
Q
Why do deviations from social norms change ?
A
norms may be different for different generations/cultures
few behaviours would be considered universally abnormal
3
Q
Evaluations of statistical infrequency as a definition of abnormality :
A
+ real life application - is a useful part of clinical assessment for abnormalities
- unusual characteristics can be positive - high intelligence is abnormal however we wouldn’t see it a thing that needs treatment. Serious limitation as it means that it would never be used alone to make a diagnosis
- not everyone unusual benefits from a label - if someone is living a fulfilled life there is no benefit to them being labelled regardless of how abnormal they are as it may have a negative effect on how others view them or how they view themselves
4
Q
Evaluations of deviation from social norms as a definition of abnormality:
A
+ it has real life application in the diagnosis of anti social personality disorder
- never the sole reason for defining abnormality
- cultural relativism - social norms vary from generations and communities creating a problem for people living in a different cultural group to their own
- can lead to human right abuses - to much reliance on this can lead to an abuse of human rights. Historically used to maintain control over minority ethnic groups and women.
Classification may seem ridiculous now but only because social norms have changed
5
Q
Who proposed signs to tell when someone is failing to function adequately ?
A
Rosenhan and Seligman (1989)
- no longer conforms to standard interpersonal rules
- severe personal distress
- behaviour becomes irrational or dangerous
6
Q
Who suggested a criteria of good mental health and what was it ?
A
Jahoda (1958) created a criteria of good mental health :
- no symptoms or distress
- rational and can perceive others accurately
- self actualisation
- can cope with stress
- realistic view of world
- good self esteem and lack of guilt
- independent of others
- successfully works, loves and enjoys leisure
7
Q
Evaluation of failure to function adequately as a definition of abnormality :
A
+ patient’s perspective - it does attempt to include the subjective experience of the individual and sees this as important
- is it simply a deviation from social norms - if we treat these behaviours as ‘failures’ to function we risk limiting personal freedom and discriminating against minority groups
- subjective judgements - to decide someone has to decide whether a patient is distressed and someone else has the right to make this judgement
8
Q
Evaluations of deviation from ideal mental health as a definition of abnormality :
A
+ comprehensive definition - covers a broad range of criteria for mental health making it a good tool for thinking about mental health
- cultural relativism - Jahoda’s criteria are specific to Western European and north american cultures - culturally bound
- it sets an unrealistically high standard for mental health
9
Q
What does the latest DSM recognise as categories of phobias and related anxiety disorders :
A
- specific phobia
- social anxiety
- agoraphobia
10
Q
What are the behavioural characteristics of phobias :
A
- Panic
- Avoidance
- Endurance
11
Q
Emotional characteristics of phobias:
A
- anxiety
- unreasonable emotional responses
12
Q
Cognitive characteristics of phobias:
A
- selective attention to the phobic stimulus
- irrational beliefs
- cognitive distortions
13
Q
What categories of depression does the latest DSM recognise ?
A
- major depressive disorder
- persistent depressive disorder
- disruptive mood dysregulation disorder
- premenstrual dysphoric disorder
14
Q
Behavioural characteristics of depression ?
A
- activity levels reduced
- disruption to sleep or eating behaviour
- aggression or self-harm
15
Q
What is it called when depression leads to an increase in activity levels?
A
psychomotor agitation
16
Q
Emotional characteristics of depression :
A
- lowered mood
- anger
- lowered self esteem
17
Q
Cognitive characteristics of depression :
A
- poor concentration
- attending to and dwelling on the negative
- absolutist thinking
18
Q
What categories of OCD does DSM-5 recognise :
A
- OCD
- Trichotillomania
- hoarding disorder
- excoriation disorder
19
Q
Behavioural characteristics of OCD :
A
- compulsions ( repetitive and reduce anxiety )
- avoidance
20
Q
Emotional characteristics of OCD :
A
- anxiety and distress
- accompanying depression
- guilt and disgust
21
Q
Cognitive characteristics of OCD :
A
- obsessive thoughts
- cognitive strategies to deal with obsessions ( meditating )
- insight into excessive anxiety
22
Q
Who proposed the two-process model ?
A
Mowrer (1960)
23
Q
What is the two-process model based on ?
A
the behavioural approach to explaining phobias
24
Q
What does the two-process model state ?
A
phobias are acquired by classical conditioning and then continue because of operant conditioning
25
Who did the little albert case study ?
Watson and Rayner (1920)
26
'Little Albert' case study explanation :
he showed no previous anxiety
then whenever a rat was presented they made a loud bang close to his ear. noise is an unconditioned stimulus which creates an unconditioned response of fear. When the ns the rat and ucs are encountered together the ns becomes associated with the ucs and now both produce a fear response. rat is now a conditioned stimulus which produces a cr
27
What does Little Albert support ?
the two process model - that phobias are acquired by classical conditioning
28
Why does Mowrer state phobias don't fade ?
operant conditioning
29
How does Mowrer state operant conditioning maintains phobias ?
he suggests that whenever we avoid a public stimulus we successfully escape the anxiety and fear we would have suffered if we had remained. This reduction in fear reinforces avoidant behaviour and so the phobia is maintained.
30
Evaluations of the two-processes model as a behavioural approach to explaining phobias :
- how about when people have phobias and they are not aware of having a bad experience with what their phobic towards
+ the two process model is a definite step forward from Watson and Rayners concept of classical conditioning - explains how phobias are maintained over time - this can be applied to therapies as it explains why patients need to be exposed to the fear stimulus
- not all avoidance behaviours associated with phobias seems to be the result of anxiety reduction some avoidance behaviour seems to be motivated by positive feelings of safety. This is a problem for the two-process model which suggests that avoidance is motivated by anxiety reduction
31
What is systematic desensitisation ?
a behavioural therapy designed to gradually reduce phobic anxiety through the principle of classical conditioning
32
What is reciprocal inhibition ?
when two feelings like being afraid and relaxed can't happen at the same time so one emotion prevents the other
33
What are the three processes involved in systematic desensitisation :
- anxiety hierarchy
- relaxation
- exposure
34
What does Flooding entail ?
immediate exposure to a patients phobic stimulus
35
How does flooding work ?
it stops phobic responses very quickly
may be because without the option of avoidance the patient learns the phobic stimulus is harmless ( extinction ) --- conditioned stimulus can no longer produce the conditioned response of fear
another reason is that patients may experience relaxation because they become exhausted with their own fear response
36
Ethical safeguards for flooding ?
as it is an unpleasant experience it is important the patients give fully informed consent
37
Evaluations of systematic desensitisation :
+ Gilroy et al (2003) followed up 42 patients who had been treated for spider phobia in three 45 minute sessions of systematic desensitisation. Phobias assessed on several methods such as the Spider Questionnaire - control group was treated by relaxation without exposure - at both three and 33 months systematic desensitisation group was less fearful than relaxation group -- shows that sd is helpful in reducing the anxiety in spider phobia and that effects are long lasting
+ not well suited to all patients - for example some sufferers of anxiety disorders like phobias also have learning difficulties - learning difficulties can make it hard to understand what is happening during flooding or to engage in cognitive therapies that require the ability to reflect
+ patients prefer it because it does not cause the sae degree of trauma as flooding - it may also be because relaxation procedures in systematic desensitisation are actually pleasant and it also has low attrition rates
38
Evaluations of flooding :
+ studies comparing flooding to cognitive therapies have found that flooding is highly effective and quicker than alternatives - quick effect is a strength as it means that patients are free of their symptoms as soon as possible making the treatment cheaper
- effective for simple phobias but less so for complex social phobias - may be because it cognitive aspects - a sufferer of a social phobia does not simply experience an anxiety response but thinks unpleasant thoughts about the social situation - may benefit more from cognitive therapies
- highly traumatic - patients are often unwilling to see it through to end so time and money sometimes wasted preparing patients only to have them refuse to start or complete treatment
39
What does Beck (1967) suggest ?
a cognitive approach to explaining why some people are more vulnerable to depression than others
40
What is Faulty information processing ?
attending to the negative aspects of a situation and ignoring the positive
41
What is a schema ?
a 'package' of ideas and info developed through experience
42
What three types of negative thinking result in a person developing a dsyfunctional view of themselves regardless of their reality ?
- negative view of the world
- negative view of the future
- negative view of the self
43
Evaluations of Beck's negative triad ?
+ Clark and Beck (1999)
reviewed research on this topic and concluded that there was solid support for all these cognitive vulnerability factors - critically these cognitions can be seen before depression developed - suggesting Beck may be right about cognition causing depression in some cases
+ forms the basis of CBT were cognitive aspects of depression can be identified and challenged
- it explains all the basic symptoms but not complex ones - Jarrett 2013 states some can suffer from Cotard syndromes -------------- and some are angrey or hallucinate or have bizzare beliefs
44
What did Ellis suggest in 1962 ?
a different cognitive explanation of depression than Beck
45
What is the ABC model :
- A - activating event
- B - beliefs
- C - consequences
46
Evaluations of Ellis's ABC model :
- some cases of depression follow an activating event - reactive depression
but some depression arises without a cause meaning Ellis's explanation only applies to some kinds of depression and is therefore only a partial explanation for depression
+ led to successful therapy - REBT ( rational emotive behavioural therapy)
- Ellis explains why some people appear to be more vulnerable to depression than others as a result of their cognitions --- it doesn't easily explain the anger associated with depression or the fact that some patients suffer hallucinations and delusions
47
What does CBT entail ?
- assessment where patient and therapist work together to clarify patients problems
- then they identify goals for the therapy and put together a plan
- identify negative or irrational thoughts
48
What is the idea behind cognitive therapy ?
to identify automatic thoughts about the world, the self and the future (negative triad)
49
What is the central component behind Beck's therapy ?
challenge negative thoughts
50
How does cognitive therapy help patients to challenge negative beliefs ?
set homework such as to record when people were nice to them or they enjoyed something
in future sessions if the patient states no one is nice to them for example, the therapist can produce the evidence to prove the patients statement incorrect
51
What does the REBT extend the ABC model to ?
the ABCDE model
- D stands for dispute
- E for effect
52
What is the central technique of REBT ?
to identify and dispute irrational thoughts
53
Who created Rational Emotive behavioural therapy ?
Ellis
54
What does an REBT therapist do ?
challenge irrational beliefs
this would involve an argument which intends to challenge the irrational belief and break the link between the negative life event and depression
55
What different methods of disputing did Ellis identify ?
- empirical argument ( disputing whether there is actual evidence supporting the negative belief )
- logical argument ( disputing whether the negative thought logically follows from the facts )
56
What is behavioural activation ?
CBT therapist encouraging a depressed patient to be more active and engage in enjoyable activities
more evidence for disputing irrational beliefs
57
Criticisms of CBT :
- one of the basic principles of CBT is exploring the present and future - some can find this frustrating as they want to explore their past
- there is a risk of minimising the importance of the circumstance in which a patient is living - as a patient who is being abused or living in poverty needs to change there circumstance - any therapy that only focuses on cognitive factors can miss this
- in some cases depression can be so severe that patients cannot motivate themselves to engage - where this is the case it is possible to treat with anti depressants and commence CBT when they are motivated - limitation as CBT cannot be used as the sole treatment for all cases of depression
58
Support for CBT :
+ March ( 2007) compared the effects of CBT with antidepressant drugs and a combination of the two with 327 adolescents with a main diagnosis of depression --- found after 36 weeks 81% of just CBT and just anti depressant group and 86% of combined were significantly improved
59
What are the forms of biological explanations to OCD :
- neural
- genetic
60
How did Lewis (1936) research a genetic vulnerability to OCD ?
he observed that of his patients 37% had parents with OCD and 21% had siblings with it
61
What are candidate genes in OCD ?
genes which create a vulnerability to OCD
some involved in regulating development of the serotonin system
62
What is the 5HT1-D beta gene implicated in ?
the efficiency of transport of serotonin across the synapse
63
How many genes cause OCD ?
it is polygenic
64
How did Taylor (2013) investigate the polygenic nature of OCD ?
he analysed findings of previous studies and found evidence that up to 230 different genes may be involved in OCD
65
What does aetiologically heterogeneous mean ?
One group of genes may cause OCD in one person but a different group in another
origin has different causes
66
What is there evidence to suggest different types of OCD is caused by ?
different genetic variations
67
What are neural explanations ?
when genes associated with OCD are likely to affect the levels of key neurotransmitters as well as structures of the brain
68
What is serotonin believed to do ?
regulate mood
69
What happens when a person has low levels of serotonin ?
normal transmission of mood-relevant messages are not recieved and mood and mental processes are effected
70
What can OCD be associated with ?
impaired decision making
71
What is impaired decision making associated with ?
abnormal functioning in the lateral bits of the frontal lobe
72
What is there evidence to show the left parahippocampal gyrus is associated with ?
processing unpleasant emotions, functions abnormally in OCD patients
72
Supports of the genetic explanation for OCD :
+ Nestadt (2010) reviewed twin studies and found that 68% of identical twins shared OCS as opposed to 31% of non-identical twins - strongly suggests a genetic influence of OCD
73
Criticisms of the genetic explanation for OCD :
- several genes are involved and each genetic variation only increases the risk of OCD by a faction --- consequence is that a genetic explanation is unlikely to ever by very useful as it provides little predictive value
- environmental factors can also trigger it - Cromer et al (2007) over half of patients had a traumatic event in there past and OCD was more extreme in patients with more than one trauma
73
Support of the neural explanation for OCD :
- anti depressant drugs work solely on the serotonin system
74
Criticisms of the neural explanations for OCD :
- studies of decision making have shown that these neural systems are the same systems that function abnormally in OCD (Cavedini 2002) ----- however research also identifies other brain systems that may be involved sometimes but no system has been seen to always play a role --- we cannot therefore claim to understand the neural mechanisms involved in OCD
- there is evidence to suggest that various neurotransmitters and structures in the brain do not function normally in patients with OCD But these biological abnormalities could be a result of OCD rather than a cause
75
Support of drug therapies :
+ cheap compared to psychological treatments - good value for public health system ---- they are also non disruptive to a patients life
76
Criticisms for drug therapies :
- side effects
- minority will get no benefit
- some suffer blurred vision, indigestion and a lack of sex drive -- usually temporary
- in Clomipramine they are more serious and more common
this reduced the effectiveness as people stop taking them
- controversy as some psychologists believe the evidence favouring drug treatments is biased because the research is sponsored by drug companies and they do no report all of the evidence ( Goldacre 2013 )
77
What do drug therapies aim to do ?
increase or decrease levels of neurotransmitters in the brain or to increase or decrease their activity
78
How do SSRI's help treat depression ?
they prevent the re-absorption of serotonin into the pre-synaptic neuron and from it breaking down effectively increasing its levels in the synapse and thus continuing to stimulate the post synaptic neuron
79
How long does it take for SSRI's to have an impact on symptoms ?
3 to 4 months
80
What are drugs usually used alongside ?
CBT
81
What happens if SSRI's aren't effective after 3 to 4 months ?
dose can be increased or it can be combined with other drugs
82
Examples of other drugs you can combine SSRIs with ?
- Tricyclics
- SNRIs
83
Example of a tricyclic ?
clomipramine
84
Side effects of tricyclics ?
more severe side effects than SSRIs - why it is kept in reserve for patients who don't respond to SSRIs
85
How do tricyclics work ?
they have the same effect on the serotonin system as SSRIs
86
What are SNRIs ?
second line of defence for those who don't respond to SSRIs
87
How do SNRIs work ?
they increase levels of serotonin as well as noradrenaline
