4 - psychopathology Flashcards
(86 cards)
1
Q
what are the 2 main books which is full of mental disorders used to diagnose abnormalities?
A
DSM and ICD-11
2
Q
what is statistical infrequency?
A
- behaviours that our found to be rare and uncommon
- statistically low
- two standard deviations or more from the mean
3
Q
AO3 of using statistical infrequency as a definition of abnormality
A
P - the main issue is that lots of abnormal behaviours are quite desirable
E - for example, lots of people have an IQ over 150 but this abnormality is desirable. Equally, some more common behaviours are undesirable for example experiencing depression
E - therefore, using statistical infrequency to describe abnormality means we are unable to distinguish between desirable and undesirable behaviours
4
Q
AO3 of using statistical infrequency as a definition of abnormality
Cultural relativism
A
P - Furthermore, cultural differences aren’t considered
E - behaviours that are statistically infrequent in one culture may be more frequent in another
E - for example, in America, hearing voices isa sign of schizophrenia and commonly seen as a negative thing whereas in Ghana it is more common and often seen to be more of a positive spiritual experience
5
Q
What is deviation from social norms?
A
going against rules that society has about what is acceptable behaviour
- some rules are explicit and if not followed, could be law breaking
- some are implicit / unspoken rules e.g. not standing too close to someone
context is important
6
Q
AO3 for using deviation from social norms as a definition of abnormality
timeliness
A
P - what is socially acceptable now may have been socially unacceptable 50 years ago
E - Fore example, homosexuality is acceptable in most countries at the moment, but it was included in the sexual and gender identity disorders in the DSM
7
Q
what is ‘failing to act adequately?’
what are the list of 5 characteristics and who created it?
PUMIO
A
abnormal if a person is unable to cope with the demands of everyday life - unable to perform behaviours for day-to-day living e.g. self care, work
Rosenhan and Seligman
1. personal distress
2. maladaptiveness
3. irrationality
4. unpredictability
5. observed discomfort
8
Q
AO3 of using ‘fail to act adequately’ as a definition of abnormality
Cultural relativism
A
P - limited by being culturally relative
E - ‘failure to function’ criteria is likely to lead to different criteria in different countries
- may explain why lower classed, non-white people are often diagnosed as they do not fall into the category pf the ‘norm’ from people who made it
9
Q
3 other issues of using ‘fail to act adequately’ as a definition of abnormality
A
- subjective
- personal experiences of the patient
- some disfunctions could be adaptive and functional for patient
10
Q
what is deviation from ideal mental health? who came up with the criteria and what 6 things are on the list?
A
Jahoda - abnormal behaviour is defined by the absence of
1. positive attitude towards themself
2. self actualisation (aiming to be the best version of yourself)
3. resistance to stress / integration
4. autonomy
5. accurate perception of reality
6. environmental mastery
11
Q
AO3 of deviation from ideal mental health as a description of abnormality?
unrealistic criteria
A
P - ideal mental health criteria suggests that most of us are abnormal
E - they are presented as ideal criteria but we need to ask what people were lacking before they were questioned. Furthermore, the criteria are quite hard to measure
E - therefore, it might be an interesting concept but not really usable to identify abnormalities
12
Q
AO3 of deviation from ideal mental health as a description of abnormality?
Cultural relativism
A
P - many of Jahoda’s mental health criteria are culture-bound
E - self actualisation is relevant to individualist cultures but not collectivist cultures where people promote the needs of the group before themselves. People out of Jahoda’s norm will probably find a higher incidence of abnormality
This limits its usefulness
13
Q
what are cognitive features of phobias?
A
- selective attention (focus on fear)
- presented with object they fear
- hard to divert attention
- irrational thinking and cognitive distortions
14
Q
what are behavioural features of phobias?
A
- avoid fears
- panic
- cry, scream, flight, freeze
- could faint
- normal daily tasks are interfered
15
Q
what are emotional features of phobias?
A
- elicit an emotional response of anxiety and panic
- out of proportional response
- immediate and unpleasant response
- excessive and unreasonable
16
Q
what are cognitive features of depression?
A
- feelings of guilt and can’t concentrate
- struggle to make decisions
- negative thoughts and expectations about themselves, future, relationships and the world
- Absolutist
- recalling unhappy events
- black and white thinking
17
Q
what are behavioural features of depression?
A
- changes in activity levels
- low energy / lethargic
- increasingly agitated
- insomnia or hypersomnia
- lose or gain weight
- aggression or self harm
18
Q
what are emotional features of depression?
A
- low mood
- feeling sad/ empty/ worthless
- anger often self directed
- hopelessness
- low self esteem
- loss of interest for normal activities
- anxiety feelings
19
Q
what are cognitive features of OCD?
A
- obsessive thoughts
- repeated and unpleasant thoughts
- cognitive coping strategies
- uncontrollable thoughts / impulses
- understand their obsession is excessive
20
Q
what are behavioural features of OCD?
A
- compulsions are repetitive
- compelled to repeat certain behaviours e.g. handwriting
- managing anxiety through compulsions e.g. handwashing is a direct result of fear of germs
21
Q
what does the two-process model proposed by Mower (1947) explain?
A
- explains the acquisition of phobias using classical conditioning
- explains the maintenance of phobias using operant conditioning
22
Q
how are fears learned by classical conditioning? and an example
A
Little albert
noise -> fear
noise + rat -> fear
rat -> fear
23
Q
what is generalisation?
A
when stimuli similar to the original CS produces the same response.
E.g. scared of a Santa beard because you’re scared of a rat
24
Q
how are fears maintained by operant conditioning?
A
- negative reinforcement - avoiding a situation means you are still scared as you never face your fears
- positive reinforcement - exposure to fear multiple times and doesn’t get better
25
how are phobias acquired through social learning theory?
- people learn phobias by watching people they identify with
- leads to limitation because of the expectation of being rewarded in the same way
1. identifies
2. role model
3. observes
4. imitate
26
what is supporting evidence of using the behavioural approach to explain phobias?
P - one strength of the behaviourist explanation for phobias comes from research evidence
E - for example, the Little Albert case study shows an example of afear being learned through classical conditioning by pairing a rat with a threatening sound
E - this is evidence that phobias can be formed by classical conditioning
However, as this was a case study of a young boy, it is difficult to generalise the findings to adults, or even other children due to the unique aspects of the investigation
27
what is a limitation of using the behavioural approach to explain phobias?
Biological preparedness
P - another limitation of the biological approach is that it fails to explain many phobias which were not caused by traumas
E - Seligman argued that similarly to animals, humans are genetically programmed to associate and learn between life threatening stimuli and fear. For example, a fear of snakes would have been an ancient fear, explaining why we have an innate fear and reason to protect ourselves. And why people do not have many fears of newer creations such as toasters
E - This suggests the behavioural approach cannot explain all behaviours
28
what is a limitation of using the behavioural approach to explain phobias?
Ignores cognitive factors
P - the behaviourist approach is also criticised for being over simplistic
E - often, an individual who has a phobia, also has an awareness of how irrational their fear is yet they can't control it. Fears often stems from irrational thinking rather than experiences. For example, a person in a lift may think they could get trapped in the lift and suffocate. These thoughts create anxiety and may create a phobia
E - furthermore, cognitive approach has also led to cognitive behavioural therapy, a treatment which is said to be more successful than the behaviourist treatments, therefore demonstrating a cognitive aspect.
29
What is systematic desensitisation and who came up with it?
form of exposure therapy
Joseph Wolpe
30
what is recipricol inhibition?
extinguishing an undesirable behaviour by replacing it with a more desirable behaviour of relaxation as we can't feel fear and relaxed at the same time
31
what are the 3 phases of systematic desensitisation?
1. relaxation techniques - e.g. muscle relaxation techniques, or breathing. Important due to reciprocal inhibition
2. establishment of anxiety hierarchy - individual and therapist mutually agree of stages to be included in exposure, provides structure and is collaborative
3. gradual exposure - carry out the hierarchy list. Have to be fully relaxed in between stages to move to a new level
32
evaluation of using systematic desensitisation
effectiveness
P - one strength of SD comes from evidence which demonstrates the effectiveness of this treatment for phobias
E - for example, McGrath reported that about 75% of patients with phobias respond to SD. In vivo techniques are more that just pictures or videos. In vivo, in vitro, and modelling techniques are all used
E - demonstrating the effectiveness and value of using a range of techniques
33
evaluation of using systematic desensitisation
not appropriate for all phobias
P - SD may not be effective against all phobias
E - Ohman et al suggested SD may not be as effective in phobias which have an evolutionary of survival origin (such as heights or the dark) that treating phobias acquired from experience
E - this suggests SD can only be effective in some phobias
34
what is in viva and in vitra
in viva - seeing fear in real life
in vitra - only seeing fears not physically e.g. on a screen
35
How is flooding used to treat phobias?
by exposing a person to their phobia in the highest extent possible. It is their worst setting possible and introduced with no gradual build up
36
Why is flooding used to treat phobias?
so that a person is unable to avoid their fear and has to fully experience it. As the body can't remain in the fight or flight situation forever, eventually anxiety levels will reduce.
37
AO3 of using flooding as a behavioural approach to treat phobias
Effectiveness
P - flooding can be effective for those who stick with it and it is relatively quick
E - for example, choy et al reported that flooding and SD were both effective yet flooding was a more successful treatment
Flooding is also seen to be more effective in terms of its cost, it is cheaper than SD and less time consuming which reduces stress on health services
E - this shows that flooding is an effective therapy option
38
AO3 of using flooding as a behavioural approach to treat phobias
Individual differences
P - flooding is not for everybody, both patient and therapist
E - It can be a highly traumatic procedure. Patients are made aware before hand although failure to complete this therapy successfully could lead to further psychological harm or development of fear
E - individual differences therefore limit the effectiveness
39
AO3 of using flooding as a behavioural approach to treat phobias
Permanent?
flooding may just temporarily reduce phobias and not address the underlying cause. Psychodynamic approach suggests phobias are substituted or suppressed. CBT may be more likely to address a cause.
40
what are cognitive factors of depression?
- disturbance in 'thinking'
- distorted and irrational thinking causes maladaptive behaviour
41
Who came up with the ABC model?
Albert Ellis
42
what is the main claim of Ellis's ABC model?
that good mental health is a result of rational thinking
43
what are the 3 main irrational thoughts of musturbatory thinking?
1 - i must be approved of to be accepted by people i consider to be important
2 - i must do well or i am worthless
3 - the world must give me happiness or i'll die
44
what do ABC stand for?
A activating event
B beliefs
C consequences
basically, if the belief in response to an event is irrational, then it is more likely to cause an unhealthy negative emotion
45
what was Aaron Beck trying to suggest?
Why some people are more vulnerable to depression than others
46
what are the 3 parts to cognitive vulnerability?
1 - faulty information processing
2 - negative self schemas
3 - the negative triad
47
what is faulty information processing?
- fundamental errors in logic
- selectively attend to negative aspects of a situation
- black and white thinking (absolutist)
- no middle ground
48
what is a negative self schema?
- package of ideas/mental representation
- negative self schema is developed in childhood and previous experiences
- interpret information about themselves in a negative way
49
what is the negative triad?
pessimistic view on these 3 things
negative view of self
negative view of the future
negative view of the world (life experiences)
50
give one strength of using the cognitive approach to explain depression
(supporting evidence)
P - one strength of using the cognitive approach to explain depression is that there is lots of supporting evidence for the role of irrational thinking in the development of depression
E - For example, Hammen and Krantz found that depressed participants made more errors in logic when asked to interpret written material. However, the fact that there is a link does not establish that negative thoughts cause depression
E - the negative thinking could just develop due to the depression rather than the other way round
51
give one strength of using the cognitive approach to explain depression
(patient rather than situational factors)
Another benefit is that the cognitive approach blames the patient rather than the situational factors for their disorder. This can be helpful because it gives the patient the power to change how things are, and helps to focus on the client's mind and recovery.
However, a disadvantage to this stance is that it may cause the client or therapist to overlook situational factors for example not considering how life events may have contributed to their mental disorder.
Therefore, the clients background needs to be explored and considered.
52
give one limitation of using the cognitive approach to explain depression
(biological factors)
P - it also fails to take into account biological factors such as genes or neurotransmitters
E - research supports the role of low levels of serotonin in depressed people, and also research has found that a gene related to this is 10 times more common in depressed people. Successful drug therapies suggest that there is a huge importance of these neurotransmitters in depression
E - the existence of alternative approaches and therapies suggest that depression can't be explained by the cognitive approach alone.
53
give one strength of using the cognitive approach to explain depression
(real world application CBT)
P - another strength of the cognitive explanation for depression is that its application to therapies has been very successful
E - cognitive explanations have been used to develop effective treatments such as CBT and REBT which was developed from Ellis's ABC model
E - These therapies tend to identify and challenge negative and irrational thoughts and have been successfully used to treat people with depression
54
What are the 2 elements of CBT?
cognitive - identifies irrational and negative thoughts and aims to replace them with positive ones
behavioural - patients test their beliefs through experiments/ homework
55
what are the stages of CBT?
- initial assessment
- goal setting
- identify negative/ irrational thoughts and challenge these
- either using CBT or REBT
- homework/ experimenting
56
what does using Beck's model do to help patients?
Helps patients to identify negative thoughts to themselves, the world, and their future
Therapist and patient then work together to challenge irrational thoughts by finding evidence against them
Patients are asked to test the validity of their thoughts through homework
57
what is the ABCDE model?
A - activating event
B - belief
C - consequence
D - disputations to challenge beliefs
E - effect or consequence of defeating belief
58
what are the 3 methods of dispute?
Logical - questioning whether thoughts make logical sense, and asking how the patient came to that conclusion
Empirical - questioning whether or not there is any evidence that the belief is accurate
Pragmatic - emphasises the lack of usefulness of self-defeating beliefs
59
What are 2 useful things to add into CBT
Behavioural activating - being active and going out which
Unconditional positive regard
60
give a disadvantage of using the cognitive approach to treat depression
alternative treatments/ motivation
One issue with CBT is that it requires motivation. Patients with severe depression may not engage with CBT, or even attend the sessions and therefore, drug therapy prescriptions of antidepressants such as SSRI are often more effective at the start of treatments to help patients as it does not require motivation, and it means that patients may later find it a lot easier to deal with the sessions of CBT. This does pose a problem for CBT as it can't be the sole treatment of depression.
61
give a disadvantage of using the cognitive approach to treat depression
individual differences
One issue of using CBT as a way of treating depression is individual differences, and that not everybody reacts to treatment in the same way.
People who have less success with CBT often have higher levels of irrational beliefs that are both rigid and resistant to change. It is also harder for some patients to benefit if their high levels of stress come from, or are worsened, by stressors which cannot be resolved easily such as housing.
Alongside this, some patients simply just do not want to change their mindsets and find therapies to forceful.
CBT can be effective for many although not everybody benefits from it due to a variety of personal circumstances
62
give an advantage of using the cognitive approach to treat depression
support for behavioural activation
Stud taken place
156 adult volunteers diagnosed with major depressive disorder
3 conditions in research
4 month course of
1. aerobic excercise
2. drug treatment
3. combination
found that those in the excercise group had significantly lower relapse rates than the medication group after 6 months
63
what is the COMT gene and what is its impact on OCD?
- regulates the production of dopamine
- one particular variation of COMT gene results in higher levels of dopamine
- this variation is more common in people with OCD
64
what is the SERT gene and what impact does it have on OCD?
- affects the transport of serotonin
- transportation issue can lead to lower levels of serotonin and this is associated with OCD
65
what is diathesis-stress and what impact does it have on OCD?
if you ae genetically predisposed to OCD and you are exposed to stressors, you are more vulnerable to develop OCD
66
what is a concordance rate?
a measure of genetic similarity and the probability that a pair of individuals will both have certain characteristics
67
research to support genetic explanations
family and twin studies
One piece of evidence that OCD is largely biological is a study carried out by Ruedstadt et al
They studied 80 patients with OCD and 343 of their first degree relatives and compared them with 73 control patients without mental illness and 300 of their relatives.
People with a first degree relative with OCD were 5x more likely to have it themselves
A further meta-analysis of 14 twin studies of OCD found identical twins were more than twice as likely to develop OCD if their twin had the disorder than non identical twins
Concordance rates never being 100% means environmental factors must play a role
68
what impact do neurotransmitters have on OCD?
- increased dopamine levels are associated with some of the behaviours of OCD, particularly compulsions
- decreased levels of serotonin are linked with OCD, drugs which increase levels of serotonin are effective in treating patients with OCD
69
what does the basal ganglia do?
- controls movements and thinking, filtering the anxious thoughts
70
what does the orbitofrontal cortex do?
integrates sensory information
71
what does the caudate nucleus do?
suppresses the messages from the OFC
72
what does the thallium do?
receives 'worry signals' from the OFC
73
what is the 'worry circuit?'
the OFC sends worry signals to the thalamus. These are normally suppressed by the caudate nucleus but if damaged, the thalamus is alerted and confirms the worry to the OFC
74
supporting evidence that OCD is biological?
fMRI scans have shown an increase of OFC/ basal ganglia in some individuals with OCD.
PET scans of the brain of OCD patients had reduced grey matter, in particular in the OFC
75
what is an SSRI?
a medication designed to increase the amount of serotonin in the synapse by blocking its reabsorption
76
what did Choy and Schneider say about SSRIs?
SSRIs are the preferred treatment option for OCD as they reduce anxiety which improves mood
77
what is the ingredient of anti anxiety pills?
benzodiazepines
78
what do benzodiazepines do?
- enhance the action of the neurotransmitter GABA (which inhibits neuroactivity)
- reduces the anxiety due to a calming and quietening effect
79
what do tricyclic antidepressants do?
- affect serotonin and/ or chemical called noradrenalin
- effective but takes 2-6 weeks for results
- not addictive but have greater side effects that SSRIs
- only used when SSRIs don't make improvements in OCD symptoms
80
what does SSRI stand for?
Selective
Serotonin
Reuptake
Inhibition
81
which goes with which?
benzo diazepam / SSRI
anti depressants / anti anxiety
benzo diazepam - anti anxiety
SSRI - anti depressants
82
AO3 of using the biological approach to treat OCD
effectiveness
P - there is considerable evidence for the effectiveness of drug treatments
E - Soomro et al carried out a randomised frug trial to compare the effectiveness of a real drug and a placebo drug
they reviewed 17 studies of the use of SSRIs with OCD patients and found them to be more effective than the placebos at reducing symptoms of OCD up to 3 months after treatment. Although one issue is that most studies are only 3-4 month durations
E - therefore, whilst the drug treatments have been shown to be effective in short term, lack of long term data is a limitation.
83
AO3 of using the biological approach to treat OCD
side effects
P - a strong limitation of using SSRIs or bz's for OCD is the side effects
E - for example, an SSRI drug such as Prozac may have side effects of nausea, sexual disfunction, or tiredness, and although they are not hugely severe, they can be enough to stop patients from taking a drug.
Also, bz can have side effects which can interfere with daily life and function such as clumsiness, tiredness and confusion and can even cause hallucinations. They also are very addictive so should not be prescribed unless absolutely necessary.
84
AO3 of using the biological approach to treat OCD
Compared to other treatments
P - one of the greatest appeals of using drug therapies is that is requires little input from the user in terms of time and effort
E - whereas therapies such as CBT require the patient to attend regular meetings and put a lot of thought into tackling their problems. Drug therapies are also cheaper because they require little monitoring and cost much less than psychological treatments so therefore are more economical
85
AO3 of using the biological approach to treat OCD
Not a long lasting cure
However, Maina et al found that patients relapse in a few weeks if medication is stopped. Koran et al suggested that although drug therapies may be more commonly used, psychotherapies such as CBT should be tried first.
This suggests drug therapies do not provide a lasting cure due to short term effectiveness little effort
86
common side effects of anti depressants
sexual disfunction
tiredness
nausea
