Week 2 - Models Flashcards
Describe the scientist-practitioner approach to psychopathology (x6)
Research/empiricism guides assessment, diagnosis, treatment - otherwise unethical
Models (representations of real world) used to explain:
o Origins of abnormal behaviour
o How to treat it
o How to prevent it
Research tests/drives hypotheses derived from models
List 6 models of psychopathology
• Biological (physiological, neurochemical factors)
• Psychodynamic (internal unconscious factors)
• Humanistic/existential (internal conscious factors)
• Behavioural (interaction of social & psychological factors)
• Cognitive (cognitions)
Biopsychosocial - multidisciplinary
What does biomedical model see as the primary cause of psych disorders? (x1)
With aetiology as… (x4)
Inherited/acquired brain disorders involving neurotransmitter imbalances/damage to brain structures
Genetics, biochemistry, neuroanatomy, endocrine system
What is the ‘pedigree method’ of studying gene/environment interactions? (x6)
Family incidence method - Proband (first family member affected by genetic disorder) identified
How prevalent is the disorder in their family?
Nature versus nurture?
• Families share environments as well as genes – imperfect method due to inability to disentangle nature, nurture
Describe the use of classical twin studies in investigating gene/environment interactions (x4)
Good method for nature, nurture distinction
Compares concordance (when both twins have it) rates for MZ and DZ twins
• In MZ twins should be 100% if purely genetic, 50% concordance in DZ – but not many disorders like that
• Differ in genetic similarity, but not likelihood of sharing same environment/experiences
How do we use MZ and DZ concordance rates to decide genetic/environment contributions to disorders? (x3)
o If MZ > DZ: genetic contributions
o If MZ = DZ and both show high concordance; shared environmental contributions (family environment etc)
o If MZ = DZ, and both show low concordance; non-shared environment contributions (eg one twin having an ABI)
Describe the use of adoption studies in investigating gene/environment interactions (x2)
Compares concordance of adopted children to biological versus adoptive relatives
o Eg higher rates of alcoholism in adopteds with biological parents who were alcoholic
Describe the use of molecular genetics in investigating gene/environment interactions (x1)
And two types of studies?
Instead of concordance, investigates influence of specific genres
Genetic association studies
Genome-wide association studies
What is involved in genetic association studies?
Plus e.g. of genetic variation/cause found this way
Needs prior identification of candidate gene
• Is one allele of it more frequently seen in people with the disorder than in people without?
ApoE-e4: 37% of people with AD vs. 14% in general population (but many with alzheimers don’t have the variant)
What is involve in genome-wide association studies? (x2)
- Assess common variation across the entire genome
* Try to identify knew genes that are involved
How does the biomedical model look at biochemistry as aetiology of disorders? (x4)
Most drug therapies increase or decrease the activity of specific neurotransmitters
BUT: effects of neurotransmitter activity are very broad
o Many interact with different neurotransmitters too
o So far too simplistic to say that an imbalance is the cause of disorder
Name four neurotransmitter systems
Serotonin
Gamma Amino Butyric Acid
Noradrenalin
Dopamine
What does the serotonin system do? (x1)
With correlational evidence associating it with… (x4)
Which mean that… (x1)
Regulates behaviour, mood & thought processes
• Aggression
• Suicide
• Impulsive overeating
• Hyper-sexual behaviour
(When these are symptoms, drugs get prescribed at target serotonin)
What two classes of drugs primarily affect the serotonin system?
With what tertiary benefit/use? (x1)
Tricyclic antidepressants
Serotonin specific reuptake inhibitors (e.g., Prozac)
Anxiolytics properties – these drugs can also reduce anxiety in some cases, but don’t know why
What does the GABA system do? (x3) With the most common class of medication being? (x1, plus explain x1)
Inhibits a variety of behaviours & emotions
• Seems to reduce overall arousal
Anxiolytic effects
Benzodiazepines - make it easier for GABA molecules to attach themselves to the receptors of specialized neurons
Noradrenalin/norepinephrine is secreted by the… (x1)
With CNS noradrenalin circuits in… (x2, plus function of each)
Adrenal glands
Hindbrain, in area that controls basic bodily functions such as respiration
Another circuit influences emergency reactions/alarm responses (fight, flight, adrenalin rush) to sudden danger
What does the dopamine system do? (x1)
With circuits that… (x1)
Meaning that dopamine… (x1)
Relays messages to control movements, mood and thought processes
Merge/cross with serotonin circuits
Influence many of same behaviours
How does the dopamine system relate to Parkinson’s disease? (x4)
Dopamine-producing cells damaged.
Substantia negra damaged, motor slowing when about 80% damage
Also emotional regusltion and cognitive function issues
(Dopamine also in other mental health problems, but Parkinson’s is primary)
Name 4 areas of the brain (plus function) that may lead to specific disorders if damaged (neuroanatomy as aetiology)
Hindbrain
o Bodily functions involved in sustaining life, regulation of stages of sleep
Midbrain - reticular activating system
o Involved in regulation of some motor activities (fighting & sex), and sleep
Forebrain
o Site of most sensory, emotional, & cognitive functioning
o Limbic system
Orbitofrontal cortex - damage causes disinhibition
What brain regions are thought to control theory of mind? (x2)
Temporoparietal junction
Dorsomedial prefrontal cortex
What brain regions are thought to control empathy? (x2)
Dorsal anterior cingulate cortex
Anterior insula
What brain regions are thought to control social perception? (x3)
Posterior superior temporal sulcus
Fusiform face area
Amygdala
What brain regions are thought to control social behaviour? (x2)
Ventromedial prefrontal cortex
Orbitofrontal cortex
How is the endocrine system involved in the aetiology of disorders?
Endocrine system produces hormones, that travel in bloodstream
And function to:
o Help regulate the body’s physiological processes – eg maturation, internal functions
o Co-ordinate internal bodily processes with external events
Prolonged stress can cause dysfunction - and maybe permanent damage
Top down, what glands/organs are involved in the endocrine system? (x10)
Pineal body Pituitary gland Parathyroid gland Thyroid gland Thymus gland Stomach Adrenal glands Pancreas Kidney Ovaries/testes
How do we understand the stress relationship through the hypothalamic-pituitary-adrenal-cortical (HYPAC) axis? (x5)
Is where hypothalamus and endocrine system interact and controls reactions to stress
o Hypothalamus connects to the adjacent pituitary gland – which is co-ordinator of endocrine system
o Pituitary gland, in turn, may stimulate the cortical (outer part) of the adrenal glands to produce:
• Surges of adrenalin at inappropriate times
• Cortisol (stress hormone)
What are two biological treatments?
Electro-convulsive shock treatment
Pharmacotherapy
What is involved in electro-convulsive shock treatment? (x3)
Which is used to treat? (x3)
Unilateral or bilateral shocks - both produce whole brain seizures
May change metabolism, blood flow in areas of brain associated with disorder
Side effects – short term amnesia, hit largely managed through dosage
Major/unresponsive depression, bipolar psychosis and some suicidal behaviours
How did John Cade discover uses for Lithium? (x1)
Which is now most effect treatment/management for?
Trying to treat TB in animals, found it made them calm/lethargic, so he gave to psych patients - happened across benefits
Bipolar depression - esp manic phase
What are some issues around pharmacotherapy? (x3)
Side effects - feel terrible, non-compliance
Anti-depressant induced suicide
Dangers of over-prescribing for normal ebb/flow of life - up to 25% prescription rate for kids in US summer camps
What claims does Peter Gotzsche make regarding problems in pharmacotherapy/industry? (x3)
Inherent problems in RCTs that mislead us as to efficacy of drugs - few people benefit from medications
Prescription drugs are the 3rd leading cause of death after heart disease and cancer,
Mainly due to dishonest research/marketing, permissive regulation, over-medicalisation, polypharmacy, not understanding harms
How do WHO studies of prescription drug use raise questions over the value of medicalisation? (x3)
In third world/developing countries, 15% of mentally ill on antipsychotics
Developed countries, 60%
Yet those in developing countries doing better on average
What issues are there around taking drugs to fix ‘chemical imbalances’? (x3, and x2)
Treatment or cause?
• Drugs have far reaching effects, not just on one transmitter
• So you throw whole neurotransmitter system out of balance
Cymbalta: many neuropathic pain sensations
• Particular antidepressant withdrawal linked to massive pain
What does the psychodynamic model hold as the primary cause of psych disorders? (x1)
Unconscious conflicts over impulses such as sex and aggression, originating in childhood.
Describe the 5 overlapping stages of psychosexual development under the psychodynamic model
Oral: 0-1.5yrs, sucking, swallowing etc, ego develops
Anal: 1-3yrs, withholding/expelling faeces
Phallic: 2-6yrs, masturbation, superego develops
Latent: 5-12yrs, little/no sexual motivation, social/cognitive focus
Genital: 11-20yrs, intercourse
In the psychodynamic model, what factors may lead to an oral fixation? (x3)
With what adult consequences? (x3)
Forceful feeding
Deprivation
Early weaning
Oral activities, e.g. smoking
Dependency
Aggression
In the psychodynamic model, what factors may lead to an anal fixation? (x2)
With what adult consequences? (x5)
Toilet training too harsh/lax
Obsessiveness Tidiness Meanness Untidiness Generosity
In the psychodynamic model, what factors may lead to an phallic fixation? (x1)
With what adult consequences? (x6)
Abnormal family set-up leading to unusual relationship with mother/father
Vanity Self-obsession Sexual anxiety Inadequacy Inferiority Envy
In the psychodynamic model, what are the three parts to our personality?
Which are often… (x2)
Id
Ego
Superego
In conflict - mental health to extent of harmony
Describe the id (x2)
Motivated by biologically driven instincts
Operates at unconscious level according to pleasure principle and wish fulfilment
Describe the ego (x3)
Motivated by the reality principle
Uses a range of defence mechanisms to ward off unpleasant feelings:
Repression, projection, ….
Describe the superego (x1)
Conscience and ego ideal
How did Jung differ from Freud? (x4)
De-emphasis of biological drives
Collective unconscious and archetypes
• More spiritual focus
Memory traces of past generations and universal ideas we are born with form the basis of personality
How did Erikson differ from Freud? (x2)
Formation of ego identity & psychosocial development
Life-span approach: Eight psychosocial stages of development
According to the psychodynamic model, what are the three stages of symptom formation?
Traumatic childhood experience
Defence mechanisms
Symptoms
According to the psychodynamic model, what are the three stages of symptom removal?
Free association
Recovery of material
Awareness and interpretation
What are the contributions of the psychodynamics? (x5)
Impact of childhood experiences on later development Impact of the unconscious on behaviour Continuity of normality and abnormality Demystified mental illness Defence mechanisms
What are 3 limits of psychodynamics?
Resistance to empirical investigation
Emphasises abnormality rather than psychological health
Hasn’t contributed to prevention or early intervention methods
What does the humanistic model hold as the primary cause of psych disorders? (x3)
Lack of unconditional positive regard
Leads to self deception
And a distorted view of one’s experiences leads to psychological dysfunction/distress
What are the fundamental tenets of humanistic model of psych? (x3)
Explicitly positive view of human nature
Humans born with natural inclination to be friendly, co-operative and constructive and are driven to self-actualise
Free will: we control, choose, and are responsible for our actions
What were the origins of humanistic model of psych disorders? (x5)
Carl Rogers (1940s) - client centred therapy Acceptance; Congruence; Understanding
What does the behavioural model hold as the primary cause of psych disorders? (x1)
Faulty learning
What was involved in the first wave of behavioural therapy (40s and 50s) (x4)
John B. Watson (1878-1958) founder of behavioural movement
Rejection of introspection
Focus on behaviour which could be observed & measured
Learning has the key role in the development of behaviour
Describe the process of Pavlov’s classical conditioning (x3 stages)
Before conditioning:
US = UR
Neutral stimulus = no CR
During conditioning:
Pair neutral and US = UR
After conditioning:
Neutral becomes CS = CR
According to Skinner’s operant conditioning principles… (x2)
Best way to understand behaviour is to look at the causes of an action and its consequences
o Behaviour only exists when it is rewarded
In operant conditioning, reinforcers are… (x3)
Environmental responses that increase likelihood of repeating behaviour
Positive - e.g. getting praise
Negative - removing unpleasant feeling
In operant conditioning, punishers are… (x1)
Environmental responses that decrease likelihood of repeating behaviour
In operant conditioning, extinction is… (x1)
Suppressing behaviour by removing the reinforcers
In operant conditioning, discriminative stimuli are… (x1)
External events that tell organism that if it performs a certain behaviour a certain consequence will follow
Describe extra assumptions/cognitive processes built into conditioning framework to build Bandura’s observational learning/modelling theory (x4)
Observer must attend to the model and understand connection between model’s behaviour and contingent reinforcement
Observer must store what has been learned in memory and recall the information
Observer must be capable of performing the required behaviour
Thus, non-observable processes are necessary to explain modelling
What are 3 classical conditioning techniques (behavioural treatments)?
o Systematic desensitisation
o Aversion therapy
o Exposure therapy: relearning connections
What are 4 operant conditioning techniques (behavioural treatments)?
o Positive reinforcement
o Extinction
o Token economies
o Behavioural activation: reengagement with rewards
What is 1 modelling technique (behavioural treatments)?
o Social skills training (role plays)
What are the advantages of the behavioural model? (x3)
Behavioural theory and treatments can be tested in the laboratory
Laboratory research supports the behavioural model
Many of the techniques remain useful
What are the weaknesses of the behavioural model? (x4)
o No indisputable evidence that abnormal behaviour is due to improper conditioning
o Too simplistic
o Over-emphasis on learning and environmental determinants of behaviour
o Human cognition could not be accounted for
What does the cognitive model hold as the primary cause of psych disorders? (x14)
Irrational or maladaptive thinking about one’s self, life events, and the world in general
Following the cognitive revolution of the 60s/70s, CBT with cognitive model at its core emerged, with the basic tenet that… (x1)
A (event) leads to B (belief) leads to C (consequence)
Give 2 egs of Ellis’ irrational beliefs (cognitive theory)
o I must be loved, or at least liked, and approved by every significant person I meet.
o I must be completely competent, make no mistakes, and achieve in every possible way, if I am to be worthwhile.
Give 4 egs of Beck’s automative negative thoughts (cognitive theory)
o Arbitrary Inference
o Overgeneralizing
o Dichotomous thinking
o Magnification & Minimisation
What are 2 benefits of the cognitive model?
o Amenable to empirical enquiry
o Complements behavioural strategies
What are 5 weaknesses of the cognitive model?
o Precise role of cognitions in psychopathology unspecified
o Narrowness of scope
o No link between cognitive therapy and cognitive science
o Lack of evidence that cognitive therapy added to behavior therapy
o Lack of evidence supporting hypothesized mediators of change in CBT
What was involved in the second wave of behavioural therapy (60-80s) (x2)
Cognitive theory
Ellis
Beck
What was involved in the third wave of behavioural therapy (90s on) (x4)
1990s
o Dialectical Behavior Therapy (DBT; Linehan)
o Mindfulness Based Stress Reduction (Kabat-Zinn)
1999
Acceptance & Commitment Therapy (ACT)
2000s
o Adaptations of MBSR eg. Mindfulness-Based Cognitive Therapy (MBCT)
What is acceptance and commitment therapy (ACT)? (x1)
Therapy approach that uses acceptance and mindfulness processes to produce greater psychological flexibility
What does ACT hold as the primary cause of psych disorders? (x2)
The way that language and cognition interact with direct contingencies to produce an inability to persist or change behaviour in the service of long-term valued ends
This psychological inflexibility emerges from weak or unhelpful contextual control over language processes
What is ACT based on? (x3)
o Functional Contextualism
o Relational Frame Theory
o Post-Skinnerian contextual theory of language and cognition
What factors lead to psychological rigidity in the ACT hexaflex? (x6)
Dominance of conceptualised past and feared future
Lack of values, clarity or contact
Inaction or disorganised activity
Attachment to conceptualised self
Fusion - with words, gives them unnecessary power
Non-accepting/closed avoidance
According to ACT, what is experiential avoidance? (x1)
Which we can deal with by… (x1)
Moving away from uncomfortable feelings, like anxiety, at the cost of not achieving the things we value, like passing an exam
Cultivating ability to experience difficult thoughts/emotions in service of what matters most – this is psychological flexibility
Under the diathesis-stress model of psych disorders, diatheses include… (x3)
o Genes
o Biological characteristics
o Psychological traits
Under the diathesis-stress model of psych disorders, stressors include… (x4)
o Environmental trauma
o Economic adversity
o Loss of loved ones
o Harsh family background
Under the diathesis-stress model, psych disorders result from… (x1)
The interaction of underlying vulnerabilities and environmental/experiential stressors
