1 - Psychopatholgy Flashcards
(90 cards)
1
Q
List the 4 definitions of abnormality
A
Statistical infrequency
Deviation from social norms
Failure to function adequately
Deviation from ideal mental health
2
Q
Explain statistical infrequency
A
By examining descriptive statistics (mean, median and mode) we can define what is normal by referring to typical values. By using normal distribution curves we can display the typical values in the centre and the abnormalities lie at each end. If you fall in the top or bottom 2.5% of the population, you would be considered abnormal.
3
Q
Evaluate statistical infrequency
A
+ application - useful as clinical evidence as it’s based on statistics. It looks at deviation from the statistical norm.
- application - not everyone benefits from being called abnormal - eg: if they’ve got a low IQ.
- application- not all applications need treatment - eg: high IQ
4
Q
Explain deviation from social norms
A
Social norms - Created by groups of individuals, “normal behaviour” is deemed because there are adhered to within that social group. The majority of the individuals will partake in the “normal” activity.
Deviation from social norms - going against social norms.
Abnormality comes from deviating from the norms set by a social group.
5
Q
Evaluate deviation from social norms
A
+ takes into account effect behaviour - relates to rest of society - validity
- cultural differences - different cultures have different social norms - validity
- human rights abuse - social norms change over time - segregation/dislike of minority groups/religions - ethics
6
Q
Explain failure to function adequately
A
When someone struggles to cope with the demands of day to day life.
Eg: maintaining hygiene, basic nutrition etc.
Or harder stuff eg: can’t hold a job. This causes distress to themselves or others.
7
Q
What were the 3 signs used to determine if someone is failing to function adequately and who proposed them?
A
Rosenhan and Selingham
1) when a person no longer conforms to the standard interpersonal rules.
2) when a person experiences severe personal distress.
3) when a person’s behaviour becomes irrational or dangerous to themselves or others.
8
Q
Evaluate failure to function adequately
A
+ app - attempts to include patient’s perspectives and experiences and therefore considers individual subjective examples.
+ app - it can be objective is using a criteria eg: WHODAS
- app - culture bias
- app - isn’t it just deviation from social norms. What about those with alternative lifestyles and CHOOSE not to do stuff (have a job etc.) This could be considered to limit personal freedom.
- app - judgements are subjective - therefore it’s someone’s job to decide if an individual is distressed or not. People could be misjudged.
9
Q
What is deviation from ideal mental health?
A
It focuses on how we are deemed “normal” and then looks at people who deviate from this.
10
Q
Who came up with the list of ideals?
A
Marie Jahoda (1958)
11
Q
What are the 8 criteria in deviation from ideal mental health?
A
No symptoms or distress We are rational and perceive ourselves accurately We self-actualise (reach our potential) Can cope with distress We have a realistic view of the world We have good self-esteem and lack guilt We are independent We can successfully work, love and enjoy our leisure
12
Q
Evaluate deviation from ideal mental health
A
+ app - the theory is comprehensive - it considers lots of different criteria regarding normal mental health and covers most reasons people seek help for mental health concerns.
- app - some classification of ideal health may be specific to Western culture. Some points don’t consider collectivist culture where “individual” success is not considered normal, but family is of high importance.
- app - sets unrealistically high standards for mental health - does anyone meet ALL standards all of the time?
+ app - positive approach to defining abnormality - it focuses on designing traits
13
Q
What is the DSM-5?
A
Diagnostic and statistical manual of mental disorders.
The most common manual used by clinicians for diagnosing mental illnesses. It contains all of the possible mental illnesses and the criteria required to be diagnosed.
14
Q
What is a phobia?
A
Extreme and irrational fears of objects or situations.
They are categorised by excessive anxiety and fear towards something, which is out of proportion with the real danger the object of situation presents.
15
Q
What are the 3 categories of phobias?
A
Specific phobia
Social anxiety (social phobia)
Agoraphobia
16
Q
What is a specific phobia? Give an example
A
Fears about a specific object
Eg: literally anything
17
Q
What is agoraphobia?
A
Non-specific phobia.
Where you fear and avoid open spaces/being public that might cause feelings of trapped ness, helplessness or embarrassment.
18
Q
What is a social phobia?
A
Non-specific phobia.
A fear of social situations. The most common form of anxiety.
Eg: going shopping, talking on the phone.
19
Q
What is a fear of spiders called?
A
Arachnophobia
20
Q
What is a fear of school called?
A
School phobia
21
Q
What is a fear of social situations called?
A
Social phobia
22
Q
What is a fear of a lack of phone signal called?
A
Nomophobia
23
Q
What is a fear of heights called?
A
Acrophobia
24
Q
What is a fear of leaving a safe place called?
A
Agoraphobia
25
List 7 symptoms of having a phobia
Shaking, sweating, panic attacks, nausea, dry mouth, hyperventilating, increased heartbeat.
26
What are the 3 types of characteristics?
Behavioural
Cognitive
Emotional
27
List the 3 behavioural characteristics of phobias
Panic - running, screaming, crying etc.
Avoidance - people go out of their way to avoid scenarios
Endurance - enduring the phobia - met with high levels of anxiety for duration of exposure eg: flying
28
List the 2 emotional characteristics of phobias
Anxiety - a negative response with high stress, where sufferers are unable to relax or be positive.
Unreasonable emotional response - responses are often very unreasonable for the situation. This is very disproportionate to the actual danger.
29
List the 3 cognitive characteristics of phobias
Selective attention - people with phobias will focus more intently on phobic stimuli when it is present. This can be good for survival, however prevents individuals from focusing on anything else.
Irrational beliefs - sufferers may have irrational beliefs about the thing they are afraid of.
Cognitive distortions - individuals who have phobias of things are most likely to see those things in a distorted way.
30
Define depression
According to the DSM-V: depression is a mental disorder which is characterised by low mood and low energy levels.
31
List and define the 4 categories for depression, created by the DSM-V
Major depressive disorder - sever but often short-term depression.
Persistent depressive disorder - long-term or recurring depression, including sustained major depression and what used to be called dysthymia.
Disruptive mood dysregulation disorder - childhood temper tantrums.
Premenstrual dysphoric disorder - disruption to mood prior, to and/or during menstruation.
32
What is dysthymia?
Persistent mild depression
33
List the 3 behavioural characteristics of depression
Activity levels - often lower, feel lethargic, sometimes so severe they don’t leave their bed.
Disrupted sleep and eating - they may often be unable to sleep (insomnia) or wake up early. Appetite can be affected, leading to weight gain/loss.
Aggression and self-harm - they sometimes get very angry and may become verbally or physically aggressive, or aggressive to themselves (self-harm.)
34
List the 3 cognitive characteristics of depression
Poor concentration - they struggle to stick to tasks and find it hard to make decisions.
Attending to and dwelling on negatives - people are more inclined to pay attention to negatives when depressed. Also, more likely to recall negative events than healthy people.
Absolutist thinking - depression sufferers think in a black and white manner. They are unable to see that it’s not all good/bad. If something goes slightly wrong they tend to believe it’s a complete disaster.
35
List the 3 emotional characteristics of depression
Lowered mood - feelings of sadness are much stronger than ordinary daily sadness. Individuals often feel worthless and like they are empty inside.
Anger - often people feel irritable, suffer from intense anger which is frequently directed at themselves but may be towards others.
Lower self-esteem - how much you like yourself and in depressed individuals they don’t like themselves as much.
36
Define OCD
A disorder that is characterised by either obsessions and/compulsive behaviour
37
What does OCD stand for?
Obsessive-Compulsive Disorder
38
What are compulsions?
Where individuals feel compelled to perform a particular behaviour. This relieves anxiety caused by obsessions.
39
What are obsessions?
They are associated with continuous intrusive thoughts which are reoccurring
40
List the 3 behavioural characteristics of OCD
Compulsions are repetitive - eg: sorting CD’s, dishwashing.
Compulsions reduce anxiety - these compulsions are in response to the obsessions. Not everyone has these compulsions, but have a general sense of irrational anxiety.
Avoidance - keeping away from situations that trigger OCD. But this can lead to avoiding ordinary situations and can affect lifestyles.
41
List the 3 cognitive characteristics of OCD
Obsessive thoughts - thoughts that reoccur over and over again. Eg: worries of being contaminated but dirt.
Insight into excessive anxiety - they’re aware their obsessions and compulsions are not rational. They tend to be hyper vigilant. ie: maintain constant alertness for potential hazards.
Strategies to deal with obsessions - also respond by adopting cognitive strategies. Eg: religious person tormented by obsessive guilt may pray/meditate.
42
List the 3 emotional characteristics of OCD
Anxiety and distress - OCD is regarded as a particularly unpleasant emotional experience. Obsessive thoughts are unpleasant and frightening. Anxiety can be overwhelming and the urge to repeat a behaviour causes this anxiety.
Accompanying depression - anxiety can be accompanied by low moods and lack of enjoyment in activities. Compulsive behaviour tends to bring some relief from anxiety but it is temporary
Guilt and distress - further negative emotions such as irrational guilt over minor moral issues
43
What approach do we learn about for explaining and treating phobias?
Behavioural
44
What approach do we learn about for explaining and treating depression
Cognitive
45
What approach do we learn about for explaining and treating OCD?
Biological
46
Who proposed the “two-process model” and what are the 2 stages?
Mowrer (1947)
Stage 1: Classical conditioning: initiation
Stage 2: Operant conditioning: maintenance
47
Describe the study of Little Albert
Classical conditioning
Watson and Rayner (1920)
Rat - no response (neutral stimulus)
Loud noise - fear (unconditioned stimulus and response)
Loud noise and rat - fear
Rat - (conditioned stimulus and response)
48
How does operant conditioning maintain a phobia?
In early ages we learn behaviours are reinforced or punished. This increases the frequency of a behaviour. When we avoid a phobic stimulus we successfully escape the fear and anxiety that is rewarding and reinforces the avoidance behaviour and the phobia is maintained.
Don’t refer specifically to positive or negative reinforcement, just reinforcement in general.
49
Evaluate the two-process model and the behavioural explanation to phobias
+ provides a convincing argument for some disorders. Sue et al (‘94) suggested that people with phobias recall specific incidents. This has led to successful therapies eg: systematic desensitisation. This increases application
- ignores the roles of biology. The diathesis-stress model proposes we inherit a genetic vulnerability for developing mental disorders backed up by Di Nardo (‘88). Also - biological preparedness, being scared of things as an adaptation. But cars and guns are more likely to kill us today - we don’t fear them because they have only just been created. Decrease validity.
- the idea of operant conditioning states that we avoid to escape the fear and anxiety. However research (Buck, ‘10) has found that we might avoid to stay in the safe factor rather than escape the fear. Decreases validity.
- it ignores cognitive and emotional contributions ie: irrational thinking. Decreases validity.
50
Explain the 3 main steps in systematic desensitisation
Anxiety hierarchy - there is a list of situations related to the phobia that provoke anxiety in order of most to least scary.
Relaxation - the patient relaxes as deeply as possible. Meditation, breathing etc. or drugs eg: Valium.
Exposure - exposed to phobia while in a relaxed state. This is over several sessions - starting with the lowest nicety situation. When they can stay calm in lower levels of phobia they move up.
51
Explain how flooding therapy works
It involves immediate exposure to a very booky situation. It stops phobic responses very quickly as without the option of avoidance behaviour, the patient learns that it’s harmless. In classical conditioning it’s called “extinction.” A learned response is extinguished when the conditioned stimulus is encountered without the unconditioned stimulus. The result is that the conditioned stimulus no longer produces the conditioned response.
52
Evaluate systematic desensitisation
+ effective and long lasting - Gilroy et al (‘03) followed up 42 patients - half had down S.D - half just relaxation - all for spiders. After 3 months and 33 months, anxiety was lower in S.D group - validity.
+ suitable for diverse range of patients - ie: works for learning difficulties where flooding doesn’t - generalisability.
+ preferable - patients prefer it to flooding - less traumatic - reliability.
- may only test symptoms rather than underlying cause - so it may resurface in another form (symptom distribution) - validity.
- more appropriate with phobias from resonance experience rather than evolutionary/survival based ones (Ohman 1975) - generalisability.
53
Evaluate flooding therapy
+ cost-effective - also really quick - more people can fit it in their schedules - Ougrin (‘11) found it’s highly effective and quicker than alternatives - generalisability.
+ and - in vivo (actual exposure) is more successful at VR due to the need for contact with stimulus - anything.
- traumatic - people get fucked, they don’t see it through to the end, waste time and money - generalisability/reliability - pussies don’t do it.
- doesn’t work for all phobias - only works for objects not social phobias - generalisability.
54
What are the 2 cognitive explanations of depression?
The ABC model
| Cognitive vulnerability
55
Who came up with the ABC model and what is it?
```
Albert Ellis (1962)
An explanation based on the idea that depression stems from irrational beliefs
```
56
Explain the 3 stages in the ABC model
Activating event - irrational thoughts are triggered by an external event. These events which lead to depression tend to be negative in nature.
Belief - irrational beliefs are identified by Ellis. Utopianism is often a result of the activating event and are often negative beliefs.
Consequence - when irrational beliefs are triggered it leads to emotional and behavioural consequences. Individuals respond negatively to a belief which is here behavioural traits of depression come in.
57
Define utopianism
The belief that life is always meant to be fair. This is often a result of the activating event and are often negative thoughts.
58
What is mustabatory thinking?
Thinking in absolutes
59
Evaluate the ABC model
+ practical application - Ellis’ model led to a successful therapy. It challenged irrational beliefs, this reduces depression. This is supported by Lipsky et al. Supports basic theory as shows that irrational beliefs are a part of depression - validity.
- only a partial explanation - Ellis’ model only applies to reactive depression - decrease generalisability.
- aspects of depression - it doesn’t account for all aspects of depression eg: cases where individuals hallucinate - reliability.
60
What is reactive depression?
Depression following activating events
61
Who developed the cognitive vulnerability theory?
Beck (1967)
62
Explain the 3 parts of cognitive vulnerability
Faulty information processing - depressed individuals tend to the negative aspects of a situation more
Negative self-schemas - if we have a negative ‘self-schema’ we have a negative interpretation regarding information about the self
The negative triad - triangle: negative view of the self, the world and of the future
63
Evaluate cognitive vulnerability
+ supporting evidence - Grazioli and Terry (‘00) assessed 65 pregnant women for cognitive vulnerability and depression before and after birth. They found higher CV after birth. Clark and Beck reviewed research and concluded support for CV factors before depression develops, suggesting Beck was right about cognition causing depression, at least in some cases. Those who had high CV before were more likely to have post-natal depression - ext. val/rel.
+ practical application: CBT - it forms the basis of CBT as cognitive aspects can be identified and challenged in CBT. Components like these from the negative tried are easily identifiable and treated by therapists - application.
- aspects of depression - Beck’s theory explains basic symptoms but not complex ones like hallucinations and bizarre beliefs. Jarrell (2013) found that depressed patients sometimes are delusioned to believe they are zombies (unexplainable) - validity
64
What is the most common therapy used for treating mental health problems?
CBT
65
What does CBT stand for?
Cognitive Behavioural Therapy
66
Explain what CBT does
It begins with a consultation in which the therapist works with the patient to clarify the patient’s problems. They look at what goals are to be achieved through therapy, and put together a plan to achieving them. It looks at where an individual might have negative or irrational thoughts. It works to change these thoughts and put more effective behaviours into place.
67
Explain how CBT works
It breaks down the negative triad, identifies negative thoughts and then challenges them.
It also seeks to help patients test negative beliefs. This is often done through setting behavioural homework.
They validate beliefs through testing.
68
What is REBT and what does it stand for stand for?
Rational Emotive Behaviour Therapy
| Created by Ellis - is the other component of CBT treatment.
69
What is the main aim of REBT?
It identifies and challenges irrational thoughts
70
How does REBT carry out its aim?
It usually involves vigorous argument with the intended effect of changing the belief and breaking the link between negative life events and depression.
71
What does the ABCDE model stand for?
```
Activating event
Belief
Consequence
Dispute
Effect
```
72
What is vigorous argument involve?
Empirical argument
| Logical argument
73
What is logical argument?
Disputing whether the negative thought logically follows from the facts
74
What is empirical argument?
Disputing where there is actual evidence to support the negative belief
75
What is behavioural activation?
Encouraging a depressed patient to be more active and engage in enjoyable activities. This will provide more evidence for the irrational nature of beliefs.
76
Evaluate CBT
+ effective - March et al. (‘07) compared CBT with antidepressants and a combo in 327 adolescents who had been diagnosed with depression. After 36 weeks - improvements from 81% of CBT group, 81% of antidepressant group, 86% of both. This shows it’s just as effective as meds - application.
- Mary not work for the most severe cases - some patients cannot motivate themselves to engage - use AD’s first to get their attention - they’re more alert and motivated. CBT cannot be used as the sole treatment for all cases - application.
- therapist-patient relationships - it may be down to this and not the actual treatment. Rosenzweig (‘37) suggested that the differences between methods of psychotherapy can be very small eg: CBT and systematic desensitisation - validity.
- overemphasis on cognition - not changing possible negative environment can stop progress is they only focus on thoughts - validity.
- patients may want to focus on their past - CBT focuses on the present and future, but some patients may know the issue is their past/childhood - application.
77
What are the 2 forms of biological explanation?
Genetic and neural explanations
78
What did Lewis (‘36) observe (regarding genetics)?
He observed his OCD patients and found that 37% of them had parents with OCD and 21% had siblings with OCD.
These findings start to suggest a strong genetic link for OCD as we can see it must run in families.
79
Explain the 3 aspects of the genetic explanation
Candidate genes - suggests that there are several genes which predispose someone to OCD. Some genes are associated with regulating development of the serotonin systems.
OCD is polygenic - OCD has many different genes associated with it. Possibly as many as 230 genes have been associated with it (Taylor, 2013). Genes are suggested to effect dopamine and serotonin.
Different types of OCD - different groups of genes might be different for different individuals with OCD. Therefore the origin of OCD has different causes. The SERT-gene - a gene which is passed down through generations and is associated with transmission of serotonin.
Ozaki - 6/7 family members who had OCD in 2 families all had mutations of this gene.
80
Explain the 2 aspects of the neural explanation
The role of serotonin - one neural explanation suggests that neurotransmitter serotonin plays a role in OCD. It regulates mood. Low serotonin is linked to mood-relevant processes being unable to take place. OCD (in some cases) could be linked to serotonin.
Decision-making system: in some cases, OCD seems to be associated with impaired decision making. Associated with abnormal function of the lateral frontal lobes of the brain. The frontal lobe is responsible for logical thinking and decisions.
81
Evaluate the genetic explanation
+ good supporting evidence - one of the best methods is the use of twin studies. Nestadt et al. (2010) reviewed twin studies, and found 68% of MZ twins shared OCD compared with 31% DZ - reliability.
- too many candidate genes - psychologists can’t pin down the correct genes involved. This is because each of the combinations only increase the likelihood fractionally, proving very little value - application.
- environmental risk factors - these can also trigger or increase OCD development - eg: Cromer et al. (2007) found over half of OCD patients had had a traumatic past event, and OCD is stronger with those with trauma. Genetics may not be the only cause of OCD - maybe focus on environment causes - more able to do something about these - validity.
82
Evaluate the neural explanation
+ supporting evidence - some antidepressants work purely on the serotonin system, increasing levels of it. Such drugs are effecting in reducing OCD symptoms - this suggests the serotonin system is involved in OCD - validity.
- clarity of mechanisms involves - studies of decision making have shown that these neural systems are the same that function abnormally in OCD (Cavedini et al. 2002). However, research has also identified other brain systems that may be involved sometimes but none have been found that always play a role in OCD. We can’t really claim to understand the neural mechanisms involved in OCD - generalisability.
- assumptions about neural mechanisms - we know that there are mechanisms in the brain which do not function in the same way in OCD sufferers. This is not the same as saying that the abnormalities cause OCD. The abnormalities could be caused by schizophrenia (cause and effect) - validity.
83
What is the main biological treatment used treating OCD?
Drug therapy
84
What is the point in drug therapy?
It aims to increase/decrease levels of neurotransmitters in the brain to increase/decrease their activity
85
What does SSRI stand for?
Selective Serotonin Reuptake Inhibitor
86
What do SSRI’s do?
Prevent the re-absorption and breakdown of serotonin in the post-synaptic neuron. This leaves the serotonin in the synapse allowing it to continue stimulating the post-synaptic neuron. As serotonin is linked to OCD through patients not having enough serotonin to stimulate mood regulation, increasing this compensates.
87
How long does it take for SSRI’s to have an impact on symptoms?
3-4 months
88
How can drug therapy and CBT work together?
Drugs reduce emotional symptoms such as severe anxiety which can have a biological basis and then CBT can be used to address cognitive components which may be necessary, for example the obsessions which the person is struggling with.
89
Describe 2 alternative types of drug which may be administered if SSRI’s are ineffective
Tricyclics - first antidepressant to be used for OCD, works same way as SSRI’s but also blocks re-absorption of noradrenaline. It has more severe side-effects.
BZ (anti-anxiety) - slows down the CNS by enhancing the GABA neurotransmitter
90
Evaluate drug treatments
+ effective - Soomro et al. (‘09) reviewed studies comparing SSRI’s to placebos in OCD treatment - all 17 studies showed much better results for SSRI’s. Typically symptoms decline for 70% of patients. 30% decline for alt drugs and psychological treatments. This shows drugs help the majority - application.
+ cost-effective and non-disruptive - cheaper than psychological treatments. This means good validity for the NHS. Non-disruptive/not time consuming/more people can use it - application/generalisability.
- side-effects - a significant minority have no benefits from SSRI’s. Some get side-effects: indigestion, blurred vision, loss of sex drive. More than 1/10 suffer erectile dysfunction, tremors, weight gain. More than 1/100 become aggressive and suffer disruption to blood pressure and heart rhythm.
- unreliable evidence - Goldacre (‘13) Research was sponsored by drug companies who may not report all the evidence - validity/reliability.
- most OCD has biological origin, some from trauma. These patients need psychological treatment, not drugs - generalisability/application.
