Year 1 Chapter 5 Psychopathology

Question 1

Outline statistical infrequency including an example

Answer 1

• Anything other than common/usual behaviour is seen as abnormal.
  
  • Statistical frequencies are used on characteristics that can be reliably measured.
  • With any characteristic, the majority of people are clustered around an average with a few distinctly above or below it.
    
    • This can be shown with a normal distribution graph.

Question 2

Give an example of how statistical deviation can be used

Answer 2

• IQ is one of the measurable characteristics in which 68% of people have a range between 85-115.
  - An intellectual disorder requires an IQ in the bottom 2% of the population

Question 3

Outline what’s meant by deviation from social norms including an example

Answer 3

• Society makes a collective decision as to what is acceptable
  - Anything different to this is ‘abnormal’ behaviour
  
  • Social norms are different from every generation and culture which means there are very few behaviours considered universally acceptable
  • E.g. Antisocial personality disorder, someone with ASPD has the symptom that is an ‘absence of prosocial internal standards associated with failure to conform to lawful or culturally normative ethical behaviour
    
    • Psychopaths are seen as abnormal because they don’t conform to society’s moral standards
    • This is one of few seen as abnormal in a wide range of cultures

Question 4

Outline failure to function adequately

Answer 4

• Abnormal behaviour obstructs their ability to carry out normal daily behaviours.
  - Decided when someone isn’t able to maintain basic standard levels of nutrition and hygiene.
  - Or able to hold down a job and maintain relationships with people around them.
  
  • Rosenhan & Seligman (1989) signs that are used to determine if someone isn’t coping.
    
    • No longer conforms to standard interpersonal rules, eg. maintaining eye contact, and respecting personal space.
    • Experiences of severe personal distress.
    • Behaviour becomes irrational or dangerous to either themselves or others.
  • Eg. intellectual disability disorder.
    
    • Diagnosis isn’t only based on very low IQ an individual would also have to be failing to function adequately before a diagnosis is given.

Question 5

Outline deviation from ideal mental health

Answer 5

• This looks at what ‘normal’ behaviour is. Once we know what it means to be psychologically healthy then we can identify who deviates from this
  
  • Jahoda (1958) set criteria for idea mental health e.g.
    
    • Self-actualise, cope with stress, independence, good self-esteem, lack of guilt

Question 6

Briefly evaluate a strength of the application of statistical infrequency

Answer 6

• Real-life application
  - Application in the diagnosis of intellectual disability disorder
  - Assessment of patients include measurements of the severity of their symptoms compared to the statistical norms
  
  • Means that statistical infrequency is a necessary part of clinical assessment

Question 7

Briefly evaluate a weakness of statistical infrequencies, why unusual characteristics can be positive

Answer 7

• People with exceptionally high IQ scores are just as unusual as those with low scores but people with a high IQ aren’t seen as having a undesirable characteristic
  
  • Just because only a few people display ‘abnormal’ characteristics doesn’t mean treatment is required to return to normal
    
    • This is a weakness of SI because it can never be used alone to make a diagnosis

Question 8

Explain why the fact that not everyone benefits from a label is a weakness of SI

Answer 8

-If someone has a low IQ but is living a fulfilled life then there is no benefit for the to be labelled as abnormal regardless of their IQ

Question 9

Evaluate why although deviation from social norms has its merits it’s not always a sole explanation

Answer 9

• There is real-life application for the diagnosis of ASPD
  
  • Which means it’s is necessary to think about what is normal and abnormal
    
    • Other factors need to be considered e.g. the distress to other people resulting from ASPD
    • Deviation from social norms is never the sole reason for defining abnormality

Question 10

Explain why cultural relativism is a weakness of deviation from ideal mental health

Answer 10

• Some of the characteristics set by Jahoda are specific to Western European and North America cultures
  - E.g. Emphasis on personal achievement in the concept of self-actualisation would be considered self-indulgent in collectivist cultures where the focus is often much more on the family or community

Question 11

Outline the 3 behavioural characteristics of phobias

Answer 11

• Panic
  - Panic may result in a range of behaviours from crying to running away, children may freeze or have a tantrum
  
  • Avoidance
    
    • If a phobia occurs in daily life then daily activities will be disturbed if someone is avoiding going outside for fear of something they would encounter.
  • Endurance
    
    • The opposite of avoidance, we remain in the presence of the stimulus but experiences high levels of anxiety

Question 12

Give 2 emotional characteristics of phobias

Answer 12

• Anxiety
  - Phobias are classed as anxiety disorders and therefore involve emotional responses of anxiety and fear. Makes it hard for sufferer to relax
  
  • Emotional responses are unreasonable
    
    • Disproportionate to the danger posed by the stimulus, eg unreasonable fear of spiders

Question 13

Give 3 cognitive characteristics of phobias

Answer 13

• Selective attention to the stimulus
  - Can’t take your eyes off the stimulus
  
  • Irrational beliefs
    
    • High expectations increases the pressure the sufferer is under to perform well in social situations.
  • Cognitive distortions
    
    • Seeing a relatively normal object as ‘alien’ or ‘ugly’. A distorted view of the stimulus

Question 14

Outline the two-process model

Answer 14

• Acquisition by classical conditioning
  - US - something that already produces fear
  - NS - Something that does not produce fear
  - NS becomes CS when paired with the US.
  - CS produces the CR.
  
  • Maintenance by operant conditioning
    
    • Avoidance behaviour reinforces the behaviour through negative reinforcement

Question 15

Evaluate the explanatory power of the two process model

Answer 15

-Goes beyond the original concept of classical
condition
-Explains how phobias are acquired and how they are maintained over time
-Has important implications for therapy → explains why people need to be exposed to the stimulus to deal with the phobia

Question 16

Evaluate the role of avoidance behaviour in the two-process model

Answer 16

• Model suggests that the phobias is maintained through avoidance behaviours - avoiding the phobic stimulus
  
  • People with complex phobias e.g. agoraphobia, can often face their fear with somebody present
  • Suggests avoidance behaviour may be more to do with feelings of safety and less to do with avoiding the stimulus

Question 17

Why is the two-process model an incomplete model

Answer 17

• Does not account for evolutionary influences (Bounton, 2007)
  
  • We more easily acquire phobias of things that have been a source of danger in the past e.g. Snakes & Spiders → Biological preparedness
  • We very rarely develop phobias of things that are much more dangerous e.g. guns → They have not been present for long enough
  • Shows there is more to phobias than learning

Question 18

Why is a the two process model not a full explanation

Answer 18

• Model suggests that phobias are acquired to a traumatic experience
  
  • Some people have phobias without having had a negative experience with the stimulus
  • Suggests that other explanations should be considered e.g. SLT

Question 19

Outline what’s meant by systematic desensitisation

Answer 19

• A behavioural therapy designed to gradually reduce phobic anxiety in response to a stimulus through the principles of classical conditioning
  
  • Patients create an anxiety hierarchy - a set of situations that provoke an increasing amount of anxiety
  • Therapist then teaches relaxation techniques (breathing, mental imagery, meditation or drugs e.g. valium)
  • Finally the patient is exposed, in a relaxed state, to the first level in the hierarchy
  • When the patient can remain relaxed in the presence of this stimulus they move on to the next level
  • This means a new response is learned to the stimulus → counter-conditioning
  • It is impossible to be afraid and relaxed at the same time → reciprocal inhibition

Question 20

Outline what is meant by flooding

Answer 20

• Exposure to the phobic stimulus, without gradual build-up.
  
  • Longer than sessions of systematic desensitisation (2-3 hours), but sometimes only 1 session is needed

Question 21

How does flooding work?

Answer 21

• Without the option of avoidance the patient learns the stimulus is not harmful
  
  • This is known as extinction → a learned response is extinguished when the conditioned stimulus is encountered without the unconditioned stimulus

Question 22

Give a strength of systematic desensitisation

Answer 22

• Effectiveness
  - Gilroy et al. (2003) followed 42 patients who had been treated for a spider phobia using SD.
  - Compared to a control group of just relaxation.
  
  • At both 3 and 33 months the experimental group showed a greater reduction in phobic anxiety.
  • Suitability
    
    • Other therapies are not as suitable for some patients e.g. those with learning difficulties.
    • Learning difficulties can make it hard for people to understand what is happening in flooding or to engage with cognitive therapies.
    • SD is a far more appropriate therapy.
  • Patients prefer it
    
    • SD is less traumatic than flooding.
    • It actually includes some pleasant aspects - like the relaxation techniques.
    • This is reflected in low attrition and low refusal rates

Question 23

Outline 3 behavioural characteristics of depression

Answer 23

• Activity levels
  - Disruption to sleeping and eating patterns
  - Aggression and self-harm

Question 24

Outline 3 emotional characteristics of depression

Answer 24

• Lowered mood
  - Anger
  - Lowered self-esteem

Question 25

Outline 3 cognitive characteristics of depression

Answer 25

• Poor concentration
  - Tending to dwell on the negative
  - Absolutist thinking

Question 26

Outline Beck’s theory of depression

Answer 26

• Some people are more vulnerable to depression

- This is down to their cognition - the way they think

Question 27

Outline three parts of cognitive vulnerability

Answer 27

• Faulty information processing
  - Focus more on the negative aspects of situations
  - Thinking in black and white terms
  - Negative self-schemas
  - Self-scheme is a schema about ourselves
  - If someone has a negative self-schema they’ll interpret information about themselves in a negative way
  - The negative triad
  - Negative views of the world
  - Negative views of the future
  - Negative views of self

Question 28

Outline Ellis’s ABC model

Answer 28

• Ellis believed depression to be a result of irrational thoughts
  - These aren’t illogical or unrealistic, but they interfere with us being happy
  - A - activating event (negative event)
  - B - beliefs (Irrational beliefs - Musturabationary beliefs, utopianism)
  - C - consequences (emotional & behavioural)

Question 29

Discuss strengths of Beck’s theory of depression

Answer 29

• Good supporting evidence
  - 65 pregnant women were assessed for cognitive vulnerability
  - Those who scored high more likely to develop postnatal depression
  - Practical application
  - Forms the basis of CBT, where all cognitive aspects of depression can be identified and challenged
  - This means the therapist can challenge and encourage the patient to test the reality of their beliefs
  - Translates well into a successful therapy

Question 30

State a weakness of Beck’s theory of depression

Answer 30

• Doesn’t explain all aspects of depression
  - The theory explains the basics
  - It doesn’t explain some of the more complex parts (e.g. anger and hallucinations)

Question 31

Discuss weaknesses of Ellis’s model of depression

Answer 31

• Partial explanation
  - The type of depression that occurs due to an event is know as reactive depression
  - This is different from depression that arises without an obvious cause
  - The explanation doesn’t apply to all types of depression
  - Doesn’t explain all aspects of depression
  - The theory explains the basics
  - It doesn’t explain some of the more complex parts (e.g. anger and hallucinations)

Question 32

Outline a strength of Ellis’s model of depression

Answer 32

• Practical application

- It’s lead to a successful therapy

Question 33

Describe what CBT is and what it involves

Answer 33

• Most common treatment to depression
  - The patient and therapist assess the patient’s problem
  - They set goals and work together to achieve them
  - They identify where negative or irrational thoughts are
  - Involves changing these and putting more effective behaviour into place

Question 34

Outline Beck’s cognitive therapy

Answer 34

• Identify the negative triad
  - once identified it’s challenged
  - Tests the reality of the patients beliefs
  - Therapist set homework, e.g. record positive events

Question 35

Outline Ellis’s rational emotive behavioural therapy (REBT)

Answer 35

• Extends the ABC model to ABCDE
  - D - dispute
  - E - effect
  - Main idea is to identify and challenge irrational thoughts
  - Two methods of disputing;
  - Empirical - disputes whether or not there is actual evidence to support irrational beliefs
  - Logical - disputes whether the beliefs are actually logical

Question 36

What’s meant by behavioural activation?

Answer 36

• Therapist encourages patient to be more active and social

- Helps to provide more evidence against irrational beliefs

Question 37

Outline a strength of CBT as a treatment for depression

Answer 37

• It’s effectiveness
  - March et al (2007) compared the effectiveness of CBT against drugs and a combination of drug treatment and CBT
  - 327 teens diagnosed as depressed
  - After 36 weeks 81% of the CBT group, 81% of the drug treatment and 86% of the combination group were significantly improved
  - Suggests it’s just as effective as other treatments

Question 38

Outline weaknesses for CBT

Answer 38

• May not work in severe cases
  - In some cases patient cannot motivate themselves to take part in the therapy
  - In these cases it is possible to treat patient with drugs first and then go through with CBT
  - It is a weakness because it cannot be a stand alone therapy
  - Success may be due to patient/therapist relationship
  - Rosenzweig (1936) - differences between difference therapies
  - Patient-therapist relations is what they all have in common
  - This may be the cause of a therapy being successful
  - Some patients want to explore their past
  - CBT focuses on present and the future
  - Patients may however want to focus on what caused their depression
  - CBT not offering this could inhibit a persons recovery

Question 39

Outline behavioural characteristics of OCD

Answer 39

• Repetition of behaviour reduces anxiety

- Avoidance

Question 40

Outline 3 emotional characteristics of OCD

Answer 40

• Anxiety and distress
  - Accompanying depression
  - Guilt and disgust

Question 41

Outline 3 cognitive characteristics of OCD

Answer 41

• Obsessive distress
  - Cognitive strategies to deal with obsessions
  - Insight into excessive anxiety

Question 42

Referring to research, what is the genetic explanation for OCD?

Answer 42

• Some genes make people more vulnerable to OCD
  - Lewis found 37% of people with OCD had parents with OCD and 21% had siblings
  - The vulnerability to the condition is passed on and not the condition itself
  - Diathesis-stress model - some genes leave people more likely to develop a disorder because of an environmental trigger