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Flashcards in Psychological disorders Deck (144)
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1

What criteria are there for abnormality in psychological disorders?

1. Statistical infrequency

2. Unexpectedness of response - e.g. anorexia starves themselves

3. Norms violation

4. Causing personal distress

5. Disabling

Flawed in isolation, useful taken together.

2

Advantages and disadvantages of classifying mental disorder?

Advantages:

- Helps determine clinical features
- Systematises diagnosis
- Shared understandings

Disadvantages:

- Can lead to stigma
- Pigeon holing - everyone is different and so you are just grouping people together even though they may not be exactly the same
- Natural vs constructed categories (I guess these are constructed?)

3

The different models for mental disorder?

Biological
Behavioural
Cognitive
Psychodynamic
Social

4

What is the biological model, what are the advantages and disadvantages?

Central tenet: Psychological disorder is a consequence of physical changes in brain and/or body

Advantages:

- Research into the role of heritability
- Role of Neurotransmitters
- Efficacy of some biological treatments

Problems:

- Passive patient
- Problem is situated with the persons body
- A biological treatment does not necessarily mean a biological cause
- Relapse

5

What is the behavioural model?

Symptoms and behaviour constitute the main features of mental disorder

The origin and persistence of the behavioural symptom can be understood through the science of learning theory

The application of learning theory removes maladaptive behavioural symptoms and in doing so removes the disorder.

6

The three types of learning theory in the behavioural model?

Classical conditioning - learning through association

Operant conditioning - Learning through consequences

Modelling - learning through copying

7

Benefits and problems with the behavioural model?

Advantages:

- Scientific
- Has Clear concepts
- Provides effective treatment (anxiety disorders in particular.

Problems

- Symptom substitution ie being scared of spiders may present in other ways and it may not tackle this as is not tackling cause.,
- Therapies crude and mechanistic e.g. flooding
- Offers poor explanation

8

Central tenets of the cognitive model?

Peoples view of the world is determined by their thinking (cognition)

Cognition influences symptoms, behaviour and attitudes.

Impaired cognition creates mental disorder

Significant changes in mental disorder requires significant changes in cognition

9

Benefits and problems in the cognitive model?

Benefits:

- Clear concepts
- Scientific
- Effective treatment options (particularly in combination with behavioural

Problems:

- Poor explanatory model
- Changed thinking does not necessarily mean changed behaviour (which came first the behaviour or the thinking)
- It is individualistic.

10

Central features of the psychodynamic model?

1. The focus is the pattern of feelings

2. We are unaware of many influential feelings

3. Important feelings manifest in emotional reactions to the therapist - this is known as transference. The therapists reactions to the patient are equally important, know as counter transference.

4. Troubling feelings and emotions are a part of the human condition, it is the imbalance of these negatives (against positives?) that causes mental disorder.

5. Unconscious feelings are important in all relationships and can manifest themselves in symbols such as dreams.

6. Emphasis on childhood experiences.

11

Benefits and problems with the psychodynamic model?

Benefits:

- Enduring contribution (endured for a long time, however not in academic psychology so much)
- Can be effective

Problems:

- Based on anecdotal evidence
- Findings based on small group of middle class viennese
- BIG influence of therapist - inserting own ideas etc.
- Can give insight into problems but this does not neccessarily fix them.

12

Central tenets of the social model?

Mental disorder is often triggered by life events, that appear independent of the disorder

Social forces such as class, occupational status and social role are precepitants of mental disorder

People with Mental disorder often become and remain disordered because of societal influences

13

Benefits and problems with the social model?

Benefit:
- Draws attention to the role of society and traumatic events

Problems:
- Is it the job of mental health professional to fight societal ills?

14

What are the central tenets of the integrated model of mental disorder?

We each have several layers of functioning, when mental disorder develops it can affect on or more levels.

At different times in the course of mental illness the predominant level of disorder may change

Each model links specifically to one level of functioning

Successful treatment involves matching the level of disturbance with the appropriate model

15

What is the stress-vulnerability model?

A predisposition towards mental illness is truggered by life stressors

This predisposition could be at a biological, cognitive and/or emotional level.

16

Major depressive disorder signs symptoms and diagnosis?

Emotional: sadness or emotional numbing, may include anxiety, anger and/or agitation

Cognitive: Negative view of self, guilt and self-blame, belief that the future is hopeless

Motivational: Have trouble getting started, physical inertia, difficulty making decisions

Somatic: Loss of appetite, sleep disturbance, fatigue, loss of libido and hypochondriasis (hypochondria)


At least 5 symptoms nearly everyday for at least 2 weeks and must include daily depressed mood for most of teh day and/or daily diminished pleasure in activities (anhedonia) - may have psychotic features

17

What is persistent depressive disorder (briefly)?

Milder chronic depression for at least 2 years without 2 months remission.

18

What is the aetiology of the behavioural model's approach to depression?

Learned helplessness

- Failure to learn that responding can be successful as it has not been successful in the past.

EVIDENCE: Hiroto (1974) respondents stop trying to stop a loud noise if previous attempts are unsuccessful.

Reduced rewards:

- Negative spiral of social rewards ie. you feel bad, and people find it harder to be around you so you feel worse etc. Constantino (2012)

19

Behavioural approach to treatment of depression?

Operant conditioning:
- Challenge people's preconceptions, learn through consequence

Classical conditioning:
- Learn a new non-depressive association to personal depressive stimuli. e.g. get up and do something enjoyable, eat chocolate

20

What is the aetiology of the cognitive models approach to depression?

Attributional reformation of learned helplessness:

- The expectation of negative events that one can do nothing about causes depression.

Depressive attributions for negative events are:
- Internal (inherent personal failing)
- Stable (persist over time)
- Global (persist in different situations)

21

Cognitive approach to treatment of depression? Typical scheme?

Typically used with behavioural elements

CBT:
- Cognitive elements correct dysfunctional thinking
- Behavioural elements aim to reinforce and reality test

Typically:
Eduction phase: Teach the relationship between cognition, emotion and behaviour
Behavioural activation and pleasant event scheduling: Increases engagement and activity
Cognitive rehearsal: Develop and practice cognitive/behavioural coping strategies
behavioural hypothesis testing: test the validity of negative assumptions (conditioning)

22

Evaluation of the cognitive approach to depression? (3)

Is negative cognition the cause or result of depression:
- High interpersonal stress regardless of negative cognition can predict depression as much as high negative cognitions Carter and Garber (2011)

Are negative cognitions necessarily pathological:
- Depressed people have less illusion of control than non-depressed people Moore and Fresco (2012)

Therapeutic success:
- roughly similar to pharmacological approaches

23

The aetiology of the psychodynamic model for depression?

It is a defence mounted by the ego against intrapsychic conflict Freud (1917):
- A reaction to loss and subsequent regression to oral stage of dependency theory
- unconscious anger turned upon the self

Modern assumptions:
- Rooted in early losses
- Wound reactivation by recent trauma
- Regression to sense of helplessness
- Ambivalent feelings are a central unconscious conflict
- Overly seek self-esteem from others, the dependency can cause depression

24

Psychodynamic approach to treatment of depressive disorders?

Traditional psychoanalysis:

- Uncover childhood roots of depression
- Explore the ambivalent feelings (conflicting feelings) towards 'lost object' through free association, dream analysis and analysis of resistance and transference.

Interpersonal psychotherapy:

- Focuses more on present problems than past problems
- Focuses more on how depression is used in relationships
- Identify core problem and discuss solutions

25

Evaluation of the psychodynamic approach to depression?

Some depressed people are highly dependent, supports.

Poor parenting is a risk factor for depression - consistent with attachment theory

Therapeutic success with depression, cognitive therapy and IPT (integrated psychological therapy) are all effective treatments for acute major depression, no consensus on the best.

26

Social approach to aetiology of depressive disorders?

R/Fs:
- Recent life event
- For women: Unsupportive spousal relationship, no job outside home, 3 or more young children, no religion, loss of mother <11 yrs

27

Treatment of depression according to the social model? and evaluation of it?

Interpersonal psychotherapy

Couples/marital therapy

Evaluation:

Draws attention to social and societal factors, Cannot predict who can actually become depressed.

28

Types of anxiety disorders (in this course?)

GAD
Panic disorder
Phobias: Specific, agoraphobia, SAD

OCD

29

What is diffuse anxiety, what conditions have this and what are there diagnostic factors?

Diffuse anxiety: Anxiety surrounding no specific object or situation, yet still feeling anxious

GAD: Chronic uncontrollable worry >3months, 2 or more activities or events, restlessness/muscle tension, significant distress or impairment

PD: Suddenly repeatedly overwhelmed with brief attacks of terror, >1 month of persistent concerns about attacks and/or significant maladaptive change in behaviour.

30

Social approach to GAD? Aetiology, Treatment and evaluation.

Aetiology: Societal pressure

Evidence: More likely following natural disaster, more likely on low income, higher in run-down communities.

Treatment: Support system and social change (social policy), international aid, civil rights, egalitarianism (all are equal).

Evaluation: why do some develop and some do not under similar social pressure - can't all be down to social factors