Psychopathology Flashcards
(88 cards)
1
Q
What is statistical infrequency?
A
- argues that behaviours that are statistically rare should be seen as abnormal
- any individual who falls outside the normal distribution (about 5%, 2.5% either side) are perceived as abnormal
2
Q
Strengths for statistical infrequency?
A
- clearly appropriate for many mental illnesses where statistical criteria is available (e.g. intellectual disability disorder)
- All assessments with patients with mental disorders includes some
kind of measurement of how severe their symptoms are compared to
statistical norms - This allows for an objective, value-free assessment of the level of
mental disability being experienced
3
Q
Limitations for statistical infrequency?
A
- Not all infrequent behaviours are abnormal, some rare behaviours and characteristics are desirable e.g. high intelligence is statistically rare but desirable.
- Not all abnormal behaviours are infrequent as some statistically
frequent behaviours are abnormal eg depression is
experienced by up to a third of the population which suggests
depression is so common as to not be seen as abnormal under this
definition - The cut-off point is subjectively determined as there needs to be a
decision about where to separate normality and abnormality.
4
Q
What is deviation from social norms?
A
- Each society has norms (or unwritten rules) for what is seen as acceptable behaviour
- Any behaviour that varies from these norms may be seen as abnormal.
- The definition draws a line between socially desirable and undesirable behaviours
- Those who do not adhere to what society deems as acceptable in that community or society are labelled as abnormal.
5
Q
Evaluation of deviation from social norms?
A
strength: practical application
weaknesses: cultural validity, temporal validity, effectiveness
6
Q
What is temporal validity?
A
whether something is true over time
7
Q
What is failure to function adequately?
A
- perceives individuals as abnormal when their behaviour suggests they cannot cope with everyday life.
- e.g. eating regularly, washing clothes, being able to communicate with others and having some degree of control over your life is seen as functioning adequately.
- If a person cannot do this and are also experiencing distress (or others are distressed by their behaviour) then it is considered a sign of
abnormality.
8
Q
What 7 features of abnormality did Rosenhan and Seligman identify for failure to function adequately?
A
- suffering
- maladaptiveness (danger to self)
- vividness and unconventionality (stands out)
- unpredictably and loss of control
- irrationality/ incomprehensibility
- causes observer discomfort
- violates moral/social standards
> the more features shown the more abnormal they are
9
Q
Strengths of failure to function adequately?
A
- takes into consideration the experiences of the patient allowing an assessment to be made from the pov of the person experiencing it
> relatively easy to judge objectively through an assessment of criterion
> therefore can decide who needs psychiatric help
10
Q
Limitation for failure to function adequately?
A
- abnormality is not always accompanied by dysfunction e.g psychopaths can murder and still appear normal
- there is a problem over deciding who has the right to define behaviour as abnormal
11
Q
What is deviation from ideal mental health?
A
- Rather than identifying what is abnormal, Jahoda identified six characteristics of what is to be normal and an absence of these characteristics indicates abnormality
12
Q
What were Jahoda’s 6 characteristics?
A
- positive attitudes towards self
- self- actualisation
- resistance to stress
- autonomy
- accurate perception of reality
- mastery of the environment
- The more of the criteria an individual fails to meet, the further away from normality they are.
13
Q
Evaluation of deviation from ideal mental health?
A
strength: positive approach to mental problems, focus on what is desirable
weaknesses: over demanding criteria, difficult to measure, cultural relativism
14
Q
What is a phobia?
A
a persistent and unreasonable fear of a particular object, activity or situation
15
Q
What are some features of phobias?
A
- Intense, persistent, irrational fear a particular object, event or situation.
- Response is disproportionate and leads to avoidance of phobic object, event or situation.
- Fear is severe enough to interfere with everyday life.
- Condition may or may not be accompanied by PANIC ATTACKS
16
Q
What categories of phobias are recognised by the DSM-5?
A
- SPECIFIC PHOBIAS, of animals, events (flying), bodily (blood), situations (enclosed places).
- SOCIAL PHOBIAS, of social situations, public speaking, parties, meeting new people.
- AGORAPHOBIA, of public crowded places (not open spaces), of leaving safety of home
17
Q
Signs and symptoms of a phobic sufferer (categories) ?
A
- Behavioural: how a person acts (behaves) around the fear
- Emotional: how a person feels when experiencing anxiety
- Cognitive: how a person thinks about phobic stimuli
18
Q
What are the behavioural characteristics of phobias?
A
- panic
- avoidance
- endurance
19
Q
What are the emotional characteristics of phobias?
A
- anxiety
- fear
- unreasonable emotional response
20
Q
What are the cognitive characteristics of phobias?
A
- selective attention to the phobic stimulus
- irrational beliefs
- cognitive distortions - perceptions may be inaccurate and unrealistic
21
Q
What is operant conditioning in psychopathology?
A
changing a behaviour because of a reward or for avoidance
- once a fear is established the individual then avoids the object or situation that produces the fear > reduces anxiety > strengthens the fear and makes it more likely that the object/situation will be avoided in the future
22
Q
What is classical conditioning in psychopathology?
A
A basic form of learning in which a neutral stimulus is repeatedly paired with
another stimulus known as the unconditioned response. The neutral stimulus
becomes associated with the conditioned stimulus and elicits the same
response.
- Conditioning refers to a process of shaping or changing a behaviour
23
Q
What is the two-process model?
A
- Mowrer suggests that phobias are acquired as a result of classical conditioning and is maintained by operant conditioning
e. g. a person who is terrified of spiders is likely to run away when they see one. The escape and consequent reduction of fear acts as a negative reinforcer, increasing the likelihood that they will continue to avoid spiders in the future. The phobia is maintained
24
Q
Evaluation of two process model?
A
support: makes sense and has evidence to support (Little Albert), support from behavioural treatments
weakness: does not explain where all phobias come from, people can develop phobias without having a direct experience with it
25
What are the 2 behavioural treatments for phobias?
flooding
| systematic desensitisation
26
What is systematic desensitisation?
Wolpe (1958) – two competing emotions cannot occur at the same time so if
fear is replaced with relaxation the fear cannot continue
Systematic desensitisation aims to teach a patient to learn a more
appropriate association and is designed to reduce an unwanted response,
such as anxiety, to a stimulus
27
What are the 3 processes involved in SD?
1. anxiety hierarchy created by the therapist and person
2. patient trained in relaxation techniques
3. The patient is then exposed to the phobic stimulus whilst practising the relaxation techniques as feelings of tension and anxiety arise. When this has been achieved the patient continues this process by moving up their hierarchy.
28
Evaluation for SD?
- effective
- suitable for a diverse range of patients
- acceptable to patients - less trauma
29
What is flooding?
- overwhelming the individual’s senses with the item or situation
that causes anxiety so that the person realises that no harm will occur.
- Individual is exposed repeatedly and in an intensive way with their phobia.
- Individual has their senses flooded with thoughts, images and actual
experiences of the object of their phobia.
30
How does flooding work?
- Flooding stops phobic responses very quickly
- Without the option for avoidance behaviour, the patient quickly learns that the phobic stimulus is harmless – this process is called extinction
- A learned response is extinguished when the conditioned stimulus (e.g. a dog) is encountered without the unconditioned stimulus (e.g. being bitten)
- The result is that the conditioned stimulus no longer produces the
conditioned response (fear)
31
Is flooding unethical?
- it is not unethical as patients give informed consent
| - a patient would normally be given the choice of SD or flooding
32
Evaluation for flooding?
- cost-effective
- less effective for some types of phobias (social phobias)
- traumatic for patients
33
What is depression?
- Depression is a mood disorder
- A mood disorder is the term used to explain disorders that affect
the emotional state of those suffering from them, i.e. – the
current emotional mood is distorted or inappropriate to the
circumstances
- Depression is characterised by low mood and low energy levels
34
What are the diagnostic features of depression?
- can affect the thoughts, feelings, behaviour and the physical well-being of an individual.
- Clinical depression is a set of complex symptoms.
- The symptoms must be causing distress or impaired functioning in social and/or occupational roles
35
What are the 4 DSM-5 categories of depression?
- major depressive disorder - severe but often short-term depression.
- persistent depressive disorder - long-term or recurring depression,
including sustained major depression.
- disruptive mood dyregulation disorder - childhood temper tantrums
- premenstrual dysphoric disorder - disruption to mood prior to and/or
during menstruation
36
What are the 3 categories of signs and symptoms of depression?
- behavioural changes
- emotional changes
- cognitive changes
37
What are the behavioural characteristics of depression?
- activity levels (reduced)
- disruption to sleep and eating behaviour
- aggression and self-harm
38
What are the emotional characteristics of depression?
- lowered mood
- anger
- lowered self-esteem
39
What are the cognitive characteristics of depression?
- poor concentration
- attending to and dwelling on the negative
- absolutist thinking
40
What are the key assumptions of the cognitive approach relating to psychopathology?
Individuals who suffer from mental disorders have distorted and irrational
thinking – which may cause maladaptive behaviour.
It is the way you think about the problem rather than the problem itself which
causes the mental disorder.
Individuals can overcome mental disorders by learning to use more appropriate cognitions. If people think in more positive ways, they can be helped to feel better
They focus on an individual’s negative thoughts, irrational beliefs and misinterpretation of events as being the cause of depression.
41
What did Beck suggest?
Beck suggested that there is a cognitive explanation as to why some people are more vulnerable to depression than others.
He suggested three parts to this cognitive vulnerability
1. faulty information processing
2. negative self-schemas
3. the negative triad
42
What is faulty information processing?
- depressed people make errors in logic
- selectively attend to negative aspects and ignore positive aspects
- think in terms of black and white, success or failure, no middle ground
43
What are negative self-schemas?
- packages of ideas we have about ourselves
| - people with depression interpret all information about ourselves in a negative way
44
What is the negative triad?
- become trapped in a cycle of negative thoughts
- tendency to view themselves, the world and the future in pessimistic ways - triad of impairments:
- > negative view of self
- > negative view of world
- > negative view of future
45
What was Weissman and Beck (1978) study and results?
- Aim: to investigate the thought processes of depressed people to establish if
they make use of negative schemas
- Method: thought processes were measured using the dysfunctional attitude
scale (DAS). Ppts were asked to fill in a questionnaire by ticking whether they agreed or disagreed with a set of statements.
- Results: they found that depressed participants made more negative
assessments than non-depressed people. When given some therapy to
challenge and change their negative schemas there was an improvement in
their self-ratings
- Conclusion: Depression involves the use of negative schemas
46
Evaluation of Beck's theory?
- good supporting evidence
- practical application in CBT
- does not explain all aspects of depression
47
What did Albert Ellis propose?
- good mental health is the result of rational thinking
- Ellis argued that there are common irrational beliefs that underlie much depression (poor mental health), and sufferers have based their lives on these beliefs
- ABC model
48
What did Ellis ABC model stand for?
A - an ACTION is affected by
B - an individuals BELIEFS which results in
C - a CONSEQUENCE
49
Evaluation for ABC model?
- only offers a partial explanation - not all depression arises as a result of an obvious cause
- practical application in CBT - has led to successful therapy. Irrational negative
beliefs are challenged and this can help to reduce depressive symptoms suggesting that the irrational beliefs had some role in the depression.
- does not explain all aspects of depression - does not explain why some individuals experience anger associated with their depression or why some patients suffer hallucinations and delusions
50
What is CBT?
- CBT is the most commonly used psychological treatment for depression, as well as other mental health problems (e.g. anxiety, panic, phobias, stress, bulimia, OCD, PTSD, bipolar disorder, etc.)
- This is a method for treating mental disorders based on both behavioural and cognitive techniques
- The therapist aims to make the client aware of the relationship between thought, emotion and actions
- CBT can help people to change how they think (‘cognitive') and what they do (‘behaviour'). These changes can help them to feel better.
- helps to break the vicious circle of maladaptive thinking, feelings and behaviour.
51
What does CBT involve?
- The Sessions: Meet with a therapist for between 5 and 20, weekly, or
fortnightly sessions.
- Each session will last between 30 and 60 minutes.
52
What is CBT 1 (Beck)?
- Beck developed a therapy to challenge the negative triad (beliefs) of the client.
- First, the client will be assessed to discover the severity of their condition.
- The therapist will establish a baseline (or starting point), prior to treatment, to help monitor improvement
- limiting beliefs > lack of action > poor results
- to feel better you must think positively
53
What is CBT 2 (Ellis)?
Ellis’ Rational Emotive Behaviour Therapy
REBT extends the ABC model to an ABCDE model
D = Dispute (challenge the thoughts)
E = Effect (see a more beneficial effect on thought and behaviour)
54
What did Ellis argue in 1962 (REBT)?
- argues that irrational thoughts are the main cause of all types of emotional distress and behaviour disorders.
- REBT is based on the premise that whenever we become upset, it is not the events taking place in our lives that upset us; it is the beliefs that we hold that cause us to become depressed, anxious, enraged,
55
How effective is CBT?
- CBT is effective in reducing symptoms of depression and in preventing relapse and there is a large body of evidence to support this (March et al, 2007)
- It is the most effective psychological treatment for moderate depression.
- It is as effective as antidepressants for many types of depression (Fava et al, 1994). - cheaper, doesn't have to take drugs
- may not work for the most severe cases
- Success may be due to the therapist-patient relationship (rather than treatment itself)
- Some patients may want to explore their past
- An over-emphasis on cognition
56
What were Keller's recovery rates from depression?
55% drugs alone
52% CBT alone
85% when used together.
57
What are the strengths of CBT?
- Client is actively involved in their recovery
- CBT is not physically invasive
- Client learns to help themselves, and can use the skills in new situations.
- CBT works (e.g. Mrach, Fava)
- Particularly when combined with drug treatment (Keller)
58
What are weaknesses of CBT?
- Clients can become dependant on their therapist, or non-cooperative
- CBT is not effective for people with rigid attitudes or resistance to
change
- or for people who have high stress levels in response to genuinely difficult life circumstances (depressive realism)
- CBT is not a quick fix. A therapist is like a personal trainer that advises
and encourages - but cannot 'do' it for the client.
59
What is OCD?
Obsession: a persistent thought, idea, impulse or image that experienced repeatedly, feels intrusive and causes anxiety
Compulsion: a repetitive and rigid behaviour or mental act that a person feels driven to perform in order to prevent or reduce anxiety
60
What are the DSM-5 categories of OCD?
OCD – characterised by obsessions and/or compulsions
TRICHOTILLOMANIA - compulsive hair pulling.
HOARDING DISORDER – the compulsive gathering of
possessions and the inability to part with anything
regardless of its value
EXCORIATION DISORDER - compulsive skin picking.
61
What are the behavioural characteristics of OCD?
- compulsions are repetitive
- compulsions reduce anxiety
- avoidance
62
What are the emotional characteristics of OCD?
- anxiety and distress
- accompanying depression - can be accompanied by a low mood and lack of enjoyment
- guilt and disgust
63
What are the cognitive characteristics of OCD?
- obsessive thoughts
- cognitive coping strategies
- insight into excessive anxiety
64
What is the OCD cycle?
obsessive thoughts > anxiety > compulsive behaviour > temporary relief >
65
What did Bellodi, Mckeon and Murray and Pauls find/ claim ?
that genetic factors play a role in OCD.
Bellodi - Used evidence from twin studies and family studies that showed that close relatives are more likely to have the disorder than more distant relatives.
Mckeon and Murray - patients with OCD are more likely to have first degree
relatives who suffer from anxiety disorders.
Pauls et al - there is a much higher percentage of OCD sufferers in relatives of patients with OCD than in the control group without OCD.
Nestadt:
- Identical twins (68%)
- non-identical twins (31%)
66
What are candidate genes and what are some examples?
genes which have been implicated in the development of OCD.
- SERT gene
- COMT
67
What is the SERT gene responsible for regulating?
involved in regulating serotonin
68
What is the COMT gene responsible for regulating?
regulates production of dopamine (effects motivation and drive)
69
What is the diathesis - stress model?
suggests that people gain a vulnerability towards OCD through genes but an
environmental stressor is also required.
This could be a stressful event, for example a bereavement.
70
What does OCD being polygenic mean?
it means that the development of OCD is not determined by a single gene but a few - means that there is little predictive power from the explanation
71
Evaluation of genetic explanations?
Strengths:
There is evidence to suggest there is a genetic component to the disorder. One of the best sources of evidence for the importance of genes is twin studies (Nestadt – 2010)
Weaknesses:
- Family studies could also be used to explain environmental influences
- Close relatives of OCD sufferers may have observed and imitated the behaviour (SLT)
- It is difficult to untangle the effects of environment and genetic factors
72
Evaluation of candidate genes?
Strengths:
- Candidate genes are ones which, through research, have been implicated in the development of OCD.
Weaknesses:
- There are too many genes involved
- Psychologists have not been successful at pinning down all the genes involved
- Each genetic variation only increases the risk of OCD by a fraction
73
Evaluation of environmental factors affecting OCD?
Strengths:
- Individuals may gain a vulnerability towards OCD through genes that is then triggered by an environmental stressor.
Weaknesses:
- Cromer (2007) found that over half the OCD patients in their sample had a traumatic event in the past, and that OCD was more severe in those with more than one trauma.
- This means that it may be more productive to focus on environmental causes as it seems that not all OCD is entirely genetic in origin
74
What are neurotransmitters?
chemical messenger in the brain e.g. serotonin, dopamine
75
What do neural explanations suggest?
The genes associated with OCD are likely to affect the levels of key neurotransmitters as well as structures of the brain
76
Evaluation of the role of neurotransmitters?
Strengths:
- Allows medication to be developed which helps sufferers.
Weaknesses:
- Drugs are not completely effective
- Just because administering SSRIs decreases OCD symptoms does not mean that this was the cause in the first place
- There is time delay between taking drugs to target the condition and any improvements being made and yet the chemical imbalance is addressed in hours
77
What is the basal ganglia responsible for and what research is there on it?
- responsible for innate psychomotor functions
- Rapport and Wise proposed the hypersensitivity of the basal ganglia gives a rise to the repetitive motor behaviours seen in OCD e.g. repetitive washing/cleaning/checking
78
What areas are thought to be involved in OCD?
- basal ganglia
- Orbit frontal cortex (OFC)
- thalamus
79
What are the functions of the thalamus and orbit frontal cortex and its relation to OCD?
- Thalamus functions include cleaning, checking and other safety behaviours.
- The OFC is involved in decision making and worry about social and other behaviour.
- In OCD the OFC and the thalamus are believed to be overactive.
- An overactive thalamus would result in an increased motivation to clean or check for safety. If the thalamus was overactive the OFC would also become overactive as a result.
An overactive OFC would result in increased anxiety and increased planning to avoid anxiety
80
Evaluation of areas of the brain (OFC, thalamus, basal ganglia)?
Strengths:
- Advances in technology have allowed researchers to investigate specific areas of the brain more accurately, and OCD sufferers do seem to have excessive activity in the orbital frontal cortex
- Cleaning and checking behaviours are "hard-wired" in the thalamus
Weaknesses:
- The repetitive acts (compulsions) may be explained by the structural abnormality of the basal ganglia but not necessarily the obsessional thoughts.
- There are inconsistencies found in the research as no system has been found that always plays a role in OCD
- These neural changes could be as a result of suffering from the disorder, not necessarily the cause of it
81
What are neurons?
- Cells that conduct nerve impulses
- Everything that people think and feel, say and do are caused by communication within and between the neurons that make up the nervous system
82
What is drug therapy?
- The most commonly used biological therapy for anxiety disorders
- This therapy assumes that there is a chemical imbalance in the brain
- This can be corrected by drugs, which either increase or decrease the levels
of neurotransmitters in the brain.
83
What are SSRIs?
- Selective Serotonin Reuptake Inhibitors
- The standard medical treatment used to tackle the symptoms of OCD
- SSRIs work on increasing certain neurotransmitter in the brain by preventing the re-absorption of serotonin.
- By preventing the re-absorption of serotonin, SSRIs effectively increase its levels in the synapse and thus continue to stimulate the post-synaptic neuron
84
What are SSRIs often combined with and why?
- CBT
- The drugs reduce the sufferer’s emotional symptoms, such as anxiety or
depression
- This means that the patient can then engage more effectively with CBT
- Some sufferers may respond best to CBT alone without the need for
medication
85
What alternatives are there to SSRIs?
- SSRIs may not be as effective after 3-4 months teh dose can be increased or it can be combined with other drugs such as:
- SNRIs
- Tricyclics
86
What are tricyclics?
- older type of anti-depressant e.g. clomipramine
- acts on various systems including the serotonin system where it has the same effect as SSRIs
- more severe side effects
87
What are SNRIs?
- Serotonin–norepinephrine reuptake inhibitor
- used to treat OCD
- increase levels of serotonin as well as the neurotransmitter noradrenaline
- used for people who do not respond to SSRIs
88
Evaluations of drug therapy for treating OCD?
- effective at tackling OCD symptoms
- cost-effective and non-disruptive
- side effects - weight gain, dry mouth, loss of memory
- unreliable evidence - drug companies may supress results
- Some cases of OCD follow trauma
