psychopathology Flashcards
(100 cards)
1
Q
What are polygenic conditons?
A
There are many genes that contribute to the condition
2
Q
What is the DSM5 definition?
A
”
OCD is recognised as a disorder of obsessive behaviour,of which there are several:
”
3
Q
3 examples of OCD?
A
”
Trichotillomania – Compulsive hair pulling.
Hoarding Disorder - Compulsion to keep all possession regardless of worth.
Excoriation Disorder – Compulsive skin picking.
”
4
Q
Def OCD?
A
”
Obsessive Compulsive Disorder (OCD) – People experience on a consistent basis both Obsessive and Compulsive Behaviours
”
5
Q
What are the behavioural characteristics?(OCD)
A
”
Compulsions – these are broken down 2 sub types:
Compulsions are Repetitive – the need to repeat even minor actions a set amount of times, this often includes washing, tidying and ordering items.
Compulsions are need to be acted on to Reduce Anxiety – 90% of OCD suffer will need to do things in order to reduce the anxiety that they are feeling. I.e. They must wash their hands regularly in a set way 3 times in order to prevent them being contaminated by germs which would kill them.
Avoidance – OCD sufferer will seek to avoid or reduce their anxiety in by avoiding situations that would trigger their obsessions.
”
6
Q
What are the emotional characteristics? (OCD)
A
”
Anxiety and Distress – Powerful and unpleasant emotions are frequently experienced, ie fear and anxiety around not doing something they feel a compulsion to.
Accompanying Depression – frequently depression will be present as well. Escape from this can often be achieved, if briefly by engaging in compulsions.
Guilt and disgust – frequently targets at themselves or at others.
”
7
Q
What are the cognitive characteristics? (OCD)
A
”
Obsessive Thoughts. – 90% of OCD suffers experience thoughts which they cant shake or stop which cause them significant distress.
Cognitive Strategies – The person develops methods to deal with the thoughts however to others around them they may make them seem odd.
Insight to the Excessive Nature of Their Anxiety – simply put they can know that their actions are irrational and unusual but this does not mean they can stop them.
”
8
Q
What is systematic desensatisation?
A
”
SD is a behavioural therapy designed to gradually reduce phobic anxiety through classical conditioning.
”
9
Q
What are the stages of this therapy?
A
”
- The Anxiety Heirarchy - is put together by patient and the therapist. They create a list of situations related to the phobic stimulus that would frighten them.
- Relaxation - The therapist teaches the patient to relax as deeply as possible then patients are introduced to their stated scenarios and asked to imagine a sense of of calm in these settings.
-
Exposure - The patient is exposed to phobic stimulus while in a relaxed state over several sessions until patients are able to stay calm in high anxiety scenarios.
“
10
Q
How is this an effective treatment?
A
”
It is effective - Systematic desensatisation is effective in the treatment of specific phobias.For example Gilroy et al (2003) followed up with 42 patients who had been treated for anachraphobia in 3 45 minute sessions on SD. Their phobias were assessed through questionaires. The control group was just relaxed instead of being exposed to the stimulus. At 3 months and 33 months later SD was more effective than the control group. Therefore this is a support due to SD being successful at decreasing the level of fear in patients over an extended period of time.
”
11
Q
How can the range of patients support this?
A
”
Suitable for a range of patients - Alternative theories such as flooding/cognitive therapies are not well suited to all patients. Therefore it is more effective for a majority no matter their curcumstances.
”
12
Q
How are the patients more likely to choose this?
A
”
It is acceptable to patients -Most patients will choose this method especially over flooding. This is due to the lack of trauma taking place in order to get rid of the phobia. It can been seen in the low refusal rates and low drop out rates - therefore this demonstrates validity.
”
13
Q
What is flooding?
A
”
This involves exposing patients to phobic stimulus but without a gradual build up. These sessions are usually longer that SD, often around 2-3 hours). Sometimes one session of this can cure the phobia comepletely.
”
14
Q
How does flooding work?
A
”
This stops phobic reactions quickly. In CC this is called extinction where the faulty conditioned response is removed. The condition stimulus (dog) is experienced without the unconditioned stimulus (being bitten). This however can be dangerous because people can have heart attacks, panic attacks or have no PTSD. So patients now have to give their explicit consent.
”
15
Q
How does cost support this?
A
”
It is cost effective - It is just as effective as other treatments for specific phobias and is also quick which lowers the cost of the therapy. Patients are therefore freed from the burden of their phobias without adding a financial one.
”
16
Q
How is its effectiveness an issue?
A
”
It is less effective for some types of phobias - More complex phobias are not as easy to treat with this method, for example social phobias.
”
17
Q
How can trauma be an issue?
A
”
The Treatment is Traumatic for Patients - Flooding is highly traumatic because it creates high levels of stress and anxiety patients are often unwilling to continue or take part in the treatment initially. This is a limitation of flooding because time and money is sometimes wasted preparing patients who eventually refuse the treatment.
”
18
Q
What is the definition+use for Statistical Infrequencies/Deviations?
A
”
- Under this definition a persons actions are classified as abnormal if it is statistically unusual.
- It is necessary to be clear how rare this trait or behaviour is before it is classed as abnormal.
- If we use this definition we would have to class those who are not normal as abnormal and we should be looking for the normal behaviour initially.
- This definition does not distinguish between the positives and negatives that can be found in these abnormalities. Abnormality because of this now has a negative stigma. It also classes rare characteristics as abnormal despite them just being very rarely occuring.
“
19
Q
What is a Strength of this definition? ( statistical infrequency )
A
”
Strengths - It makes it easy to find and diagnose these mental illnesses to give them help. There is therefore room for statistical infrequency as part of the clinical assesment.
”
20
Q
How can unusual characteristics be positive? (stat)
A
”
IQ scores over 130 are just as unusual as those below 70. Howver one is a severely dehabilitating position while the other is just statistically rare, rather than a cause for concern. Her statists fail to define what we class as ‘normal’ effectively. This seriously limits this explanation as it shows that not all statistically infrequent occurences need treatment and should never be the sole definiton used to form a diagnosis.
”
21
Q
How can satatistically infrequent abnormalities have no use?
A
”
Some people live with what would be defined as ‘abnormalities’ through this defininition might be more negatiely impacted by being labeled than going without. Someone with a high IQ recieves no benefit to having an abnormal diagnosis. Therefore the diagnosis of everyone under the definition of statistical infrequency may lead to more harm than good, producing negative views of themselves through an insufficient definition.
”
22
Q
What is the defnition of Deviation from social norms?
A
”
- Here what is classified as abnormal is if it violates the unsaid rules about what is expected and correct in a certain social group.
- Behaviour can been seen as incomprehensible or threatening to others.
“
23
Q
What is the criticism for abuse? (Deviation)
A
”
Can be abused by, for example being used agains gay rights or those of different political views. This leads to minorities being targetted and classsified as abnormal due to their failure to conform to the social or societal norms. Therefore we need to be careful when classifying ‘abnormality’ through this lense as it may have detrimental effects fro the individuals in the minorty.
”
24
Q
What is the criticism for cultural relativism? (deviation)
A
”
A final criticism is how cultural relativism is also relevent as the cultures may see different parts of their own society as natural. For example in Africa it would be acceptible to carry a weapon whereas in the UK this would not be acceptible. This demonstrates how this definition is limited to its use in different cultures and therefore is suffering from cultural relativism.
Weakness implies that they are failing and so become classed under a limited view of mental health. In Caribbeasn comminities we see that those who are classed with schizophenia are often classed by those are white doctors from a middle/upper class background. This means that a limited powerful group are being given power over the medicalisation of mental health. Therefore we need to be careful when giving this power to any particular group.
”
25
***What is the criticism for context? (deviation)***
"
A further criticism is the level of or the context of the situation and the degree of the deviation has to come into account. For example laughing at a funeral would be considered abnormal in that context. This shows we must always consider the violation in a relative light depending on the situation. Therefore this is not as effective as it first seems.
"
26
## Footnote
**What is the definition + characteristics of Fialure to Function Adequately? (R&S)**
"
* If they are unable to cope with the demands of everyday life and perform necessary behaviours that allow themselves to thrive.
***Rosenhan & Selgman (1989)*** ***- Characteristics of Mental Health***
* suffering (**S**eriously?)
* maladaptiveness (Mrs)
* vividness & unconventiallity (Utah)
* unpredictability &loss of control (Loves Cradling)
* Irrationality/Incomprehensability (Irate [and..])
* Causes observer discomfort (Disabled)
* violates moral/social standards (Murder Statistics)
"
27
***How can a lack of subjective opinions support this defninition? (failure)***
"
A strenght of this is that it does not seek to only use subjective opnions of the patient's state. Although distress can be difficult to measure , at leaste here we see a diefinition that acknowledges the patient's experience of the abnormality. Therefore it is a useful definiton to use when assessing useful criteria that can assess abnormality.
"
28
***Adaptiveness or Maladaptiveness? (failure)***
"
Furthermore is this adaptiveness or maladaptiveness? For example a drag queeen takes on the persona of a different identity to do their work and yet they normally have a totally seperate personality - which would usually be classed as abnormal. This shows that sometimes somehting can be adaptive incertian situations and not in others. Therefore context is key when using this definiton as it may lead to missdiagnosis.
"
29
***How is subjectiveness a problem? (failure)***
"
When we have to decide whether someone is either distressed or distressing there is a certain element of external, subjective assessment. Patients may say they are distressed but be judged to be not suffering. There are methods such as the GAFS that seek to lower the level of subjectivity so someone is rationally diagnosed. Therefore we have to realise that a psychiatrist still has the right to diagnose with their expertise over that of a patient.
"
30
## Footnote
**What is the definition + characteristics of Deviation from the Ideal Mental Health?**
"
* Anything that does not fall under this catagorie of promoting positive menthal health, is deemed abnormal.
* Here we need to decide what is necessary for mental health.
***Jahoda***
* Positive view of oneself
* Capability for growth and development
* Autonomy and independence
* Accurate perception of reality
* Positive friendships and relationships
* Environmental mastey of every day situations
"
31
***How si it a positive and pragmatic definition? (ideal)***
"
***Strength*** - Provides a set pf behaviours that should be present and to aim towards.
"
32
***What is the problem with cultural relativism here? (ideal)***
"
Finally cultural relativism suggests that through this definition we should be treated as an individual and yeet in any societies we see the needs of the group being put first. In china we see a collecrivist culture which values the group and codependence as essential. This shows that these criteria fail to recognise cultural relativism therefore providing us a theory that should only be applied to individualist cultures.
"
33
***How is the list of criteria not realisitic? (ideal)***
"
There are such a large amount of criteria on this list that it is not realistic to expect us to meet these all at once. For example if you were fired from your job due to incompetency. In this scenario you cannot possibly be having a positive view of ones self and be capable of growth and development simultaneously. Therefore the definition is not accurate as it tries to cover too many aspects and this means it generates internal conflicts.
"
34
***Should we jsut use physical markers? (ideal)***
"
This definition assumes that the mental conditions are plainly physical and treat them similarely to physical issues. This leads to generic treatments that do not specify to the patient which due to the nature of mental health is not appropriate. Therefore we should seek to note overmedecalization mental health issues by medical establishments.
"
35
## Footnote
**What are drug treatments?**
"
Drugs are careful constructed chemical compounds which are used by people as they have effects which are deemed useful. However there are nearly always other, undesired effects too. These are labelled “side effects as they are not intended effects but they are in truth just effects we don’t want.
"
36
## Footnote
**Whare are SSRIs and how do they treat OCD?**
"
The most common form of drug treatment is to prescribe a specific type of anti depressant called Selective Serotonin Reuptake Inhibitors ( SSRI). These work to cause a build up of serotonin between the pre and the post synaptic neurons.
It does this by preventing the enzymes from breaking down the serotonin. It also prevents the serotonin form being reabsorbed (taken back in) as quickly. Over the period of 3-4 months, these SSRI’s lead to a build up of serotonin, which seem to lead to an elevation of the OCD suffered condition. The normal daily dose is of 20mg in capsules or liquid form.
"
37
## Footnote
***How is treatment a support for SSRIs?***
"
Is effective in treating OCD, Sansone & Sansone (2011) – 70% of OCD suffered show significant improvement in OCD symptoms compared to a placebo treatment.
"
38
## Footnote
***How are side effects limiting?***
"
Side effects often cause people to stop taking them. (eg. headaches, amnesia, taste perversion and delusions). If people stop taking the medecation it will no longer be effective. Therefore this treatment is not effective due to these circumstances.
"
39
## Footnote
***How can the delays be a criticism?***
"
A further criticism of SSRIs is the long delays make people give up on them before they kick in where they will stop taking the pills before the become effective. With OCD patients it can take 3 to 4 months and with the slightest slip they can be forced to start over. Therefore these treatments are not as effective as they seem at first glance.
"
40
## Footnote
***SSRIs are not a cure, how is this a problem?***
"
Another criticism is that the drug treatment is not a cure. Althought the patients are taking this drug (SSRIs), if they were to stop at any point they would return to their premedicated state unlike such treatments as CBT. Therefore it is not an effective long-term solution and patients may only use these as stop gaps so that they can then engage in effective therapy.
"
41
## Footnote
**How can combining treatments with SSRIs be valuable?**
"
Often when offered CBT alone people with OCD are to distressed by the disorder to engage in rational conversations which are a key part of any CBT process. By taking the SSRI’s the suffer can gain enough self control to allow them to engage in the therapy, dealing enabling them to deal with the psychological problems that are behind the disorder.
"
42
## Footnote
**What are the reasons we might use alternative to SSRIs?**
* if they are not working for the patient or they are not suited to their medical history
43
## Footnote
**What are the alternatives to SSRIs?**
"
***Serotonin-noradrenaline reuptake inhibitors (SNRI’s)*** -SNRIs are similar to SSRIs they work by blocking the reuptake of both serotonin and norepinephrine, making them more effective antidepressant than SSRIs.
***Tricyclics antidepressants (TCAs) -*** an older type of antidepressant (first generation). They work by preventing the reabsorption of serotonin and epinephrine back into nerve cells after these chemicals are released into a synapse. They have a stronger, broader effect and can be effective when SSRI’s have failed.
"
44
## Footnote
***What is a criticism for SNRIs?***
"
However, the evidence that SNRIs are more effective is uncertain with people responding unpredictably better or worse them than to SSRIs. Examples of SNRIs include duloxetin (Cymbalta and Yentreve).
"
45
## Footnote
***What si a criticism for tricylics?***
"
However can be more dangerous if an overdose is taken & also cause more unpleasant side effects than SSRIs and SNRIs. Examples include amitriptyline (Tryptizol), clomipramine (Anafranil).
"
46
## Footnote
***Why do they work on some but not others?***
"
***Why do some work on some people but not others?-*** If it is a biological cause then we should all respond or not to the treatments in the same way, yet this if far from the case. This is not helped by the fact, as Goldacre (2013) pointed out that drug companies often don’t publish their studies unless they are successful. Therefore this treatment is not fully effective.
"
47
## Footnote
***How can environmental causes undermine the biological treatment?***
"
***Evironmental causes*** - OCD can be onset by trauma, forcing the recognition that our environment causes OCD to start. This means that the biological theory is not really effective and highlights that the treatment should be recognise other factors than our biology, which these drug treatments fail to do.
"
48
## Footnote
***How is the fight or flight response irrational for phobias?***
"
When we experience a phobic reaction we go into the fight or flight response - however this is dissproportionate to the threat which we are under.
"
49
## Footnote
***Define phobia***
"
Phobia - a fear that is out of proportion and irrational in relation to what the threat it actually intails
"
50
## Footnote
***What are the 3 main forms of Phobia?***
"
1. Specific phobias - Phobia of an objects, animal, body parts or situations
1. Social Phobia - Phobia of a situation eg.public speaking or school
1. Agoraphobia - Fear of being outside or in public spaces
"
51
## Footnote
***Where are phobias classified?***
"
Classified in the DM5
"
52
## Footnote
***What are the 3 behavioural characteristics?***
"
***Panic*** - Range of behaviours including crying, screaming, shaking, sweating or running away.
***Avoidance*** - Seeking to avoid the stimulus wherever posssible. This can have a large impact on day to day life and can become dehabilitating.
***Endurance*** - Where unable to avoid stimulus their anxiety level will rise in comparison to the average person who will quickly lessen in anxiety.
"
53
## Footnote
***What are the 3 emotional characteristics?***
"
***Anxiety*** - The highly unpleasent response that are rapid an extreme when they occur.
***Example : Arachnophobia*** - when a person approaches a place they effect to find spiders they will anticipate this event causeing significant anxiety prior to the actual event.
***Unreasonable Response*** - They suffer an out of proportion response which has increased emotional suffering.
"
54
## Footnote
***What are the 3 cognitive characteristics?***
"
***Selective Attention*** - It is not possible for you to shift yor attention from the source of the phobia itself - usually when the stimulus is present.
***Irrational Beliefs*** - Frequently not in line with a true danger. For example a fear of snakes when there are no poisonous ones in your vecinity.
***Cognitive Distortions*** - The way in which they percieve a phobic stimulus is incredibly different from others. They can even prcieve that others are not affraid but this does not stop them from having the anxiety associated.
"
55
## Footnote
***What si the cognitive approach to phobias?***
"
The Cognitive Approach - You develop your irrational thought process by watching others have a fearful response which leads to your behaviour being an innapropriate response to stimulus. As this continues your thought process becomes more distorted.
"
56
## Footnote
***What is the psychodynamic approach to phobias?***
"
The Psychodynamic Approach -Phobias are caused by unresolved issues often developed at a young age. You displace your fear onto something that is psychologically safe to be scares.
"
57
## Footnote
***What is the neurological explanation?***
"
Obsessive compulsive disorder (OCD) causes problems with the neuro chemicals, in particular Serotonin. It is suggested that the low level of Serotonin seems to prevent the effective communication of mood and emotions. This then results in impaired decision making within the frontal lobes of the brain. It is suggested that it is because of this thought process being so distorted that it leads to the development of obsessive compulsive disorder.
"
58
## Footnote
***How is this leading to an effective treatment?***
"
***Effective Treatment -*** The use of some anti depressants, which increase the presence of Serotonin, and have been noted to as effective in the treatment of OCD. Therefore this provides validity as it can be applied in real life situations.
"
59
## Footnote
***How si this not a whole explanation?***
"
***Not a Whole Explanation*** - A variety of brain areas have been found to be effect OCD, so there is not enough consistency to make it just one or two specific areas as often different people have different areas affected. Therefore the reliability of the NE explanation is called into question.
"
60
## Footnote
***How is cause an effect a problem here?***
"
***Must Avoid Assumptions of Cause and Effect.*** – Just because we observe abnormal levels of neurochemicals in OCD patients brains does not mean it is the cause, instead it may just be a how our brain is made to function due to our distorted thought processes. Therefore the theory may be drawing conclusions from unrelated factors and varibles, limiting its validity.
"
61
## Footnote
***How si there an issue with conformity?***
"
***Issue of*** ***Conformity*** – Abnormal neurochemicals might be due to the depression that is so common with OCD, and nothing to do with the OCD itself. Again this limits the theory as the cause may not actually be linked to the result of abnormal rates of chemicals.
"
62
## Footnote
***What is the genetic explanation for OCD?***
"
The genetic explanation suggest that we have a genetic predisposition to develop OCD. It suggest that certain people have venerability, due to their genetics, which makes them more likely to develop OCD should they experience some form of triggering event.
That there is a environmental ( psychological) trigger to the condition means they are in fact giving a “ diathesis stress model” based explanation. (A diathesis stress model explanation combines psychological and biological elements in order to arrive an effective explanation.)
The cause of OCD is put down to problematic low Serotonin levels or high dopamine levels but the cause of these problematic levels in in fact the effect of faulty genes which have not correctly programed and built the brain. Taylor (2013) showed that 230 genes could be related to development of OCD. The fact that people present differently could be due to a different set of these 230 genes being faulty in each patient.
"
63
## Footnote
***What si the research support for this?***
"
***Research Support***- Twin studies show good support. Nestadt et al (2010) found 68% concordance rate between monozygotic twins compare to 31% dizygotic . Therefore there is a large amount of support for the validityof genes playing a role in the development of OCD (at least some of the time).
"
64
## Footnote
***How does Lewis support this?***
"
***Lewis (1936)-*** Supports this theory by finding that in families where the parent has OCD tendencies the child has a 37% chance of having OCD tendencies as well . Also that when sibling have OCD there was a 21% chance of other siblings having it as well.
"
65
## Footnote
***What does this data alternatively suggest though?***
"
***Flip it*** -However despite the fact that 37% of the children did have OCD it does mean that 63% did not, which makes us have to question why not 100%? This means that there must be other factors that are coming into play which are not explained by the theory, showing that the theory is in fact incomplete.
"
66
## Footnote
***There are too many genes -why is this a problem?***
"
***Too Many Possible Genes*** – Simply for each type of obsessive disorder their seems to be a different set of genes, making the explanation too difficult to use. Therefore this theory is impossible to test in forms of application in studies or in real-life treatments.
"
67
## Footnote
***What role is not considered that ight effect the development of OCD?***
"
***Role of the Environment Needs to Be Considered*** - The Fact that we never reach 100% concordance rate means that other factors have a role to play, which come from our environment. Therefore it is not 100% reliable or valid.
"
68
## Footnote
***How does RM look at the twin studies?***
"
***RM*** – Twin studies are a type of study often used by the biological approach to argue that the cause of something is due to their genetics. The monozygotic twins have the same exactly the same genes and as such if their behaviour is determined by the genes then you should have a high concordance rate, ideally 100% (when twin 1 does so does twin 2).
"
69
## Footnote
**Who proposed the two-process model based on the bahvioural approaches to phobias? (+ expl)**
"
Mowrer (1960)
States that the phobias are created using classical conditioning and are maintained due to operant conditioning.
"
70
## Footnote
**What is the process of classical conditioning? (def+expl)**
"
By forming an innapropriate association where someone can learn to give irrational response to stimulus.
* Unconditioned Stimulus - something we are already responsive to.
* Unconditioned Response - the response we have to the stimulus (eg. fear in the dark)
* Neutral Stimulus - Stimulus we have not yet been conditioned to.
* Conditioned Stimulus - the newly conditioned assosiation to that stimulus when it is present.
* Conditioned Response - the conditioned response to that stimulus.
"
71
## Footnote
**How was this used in the study by Watson and Rayner(1920)?**
"
Classical conditioning was used to make a little boy, Albert, afraid of white rats. They did this by assosiating the white rat with a loud noise that produced the fear response. They did this by banging loadly behind him whenever the rat was present. Therefore over time and through classical conditioning Albert responded to the white rat with fear as it was now a conditioned stimulus.
This proves that fears are learnt - however this did not lead to conditioning directly to the white rat - fears were also now assosiated with all furry animals.
This experiment was ethically dubious and has low inter-rater reliability as it can not be reproduced.
"
72
## Footnote
**What is operant conditioning? (def+expl)**
"
Learning through reinforcement, when children are punished they are less likely to do the same action again as they have learnt the result.
* Reinforcement - every time you do something is can be **positively** or **negatively reinforced.**
* People will continue to repeat the action if they feel they will recieve a positive reaction.
* People will avoid an action if they are going to get a negative reaction.
Mowrer said that when we avoid our phobia it gives us a pleasant feeling that reinforces the behaviour and therefore the phobia stays.
"
73
## Footnote
***How are therapies supporting this study?***
"
***It works as a theory*** - Watson and Rayner proved it correct and two effective therapies have been developed from it. Research has taken place showing that systematic desensatization is an effective treatment for speacific phobias. For example Gilroy et al (2003) treated 42 patients in 45 minute sessions with this method. Even 33 months later this group was still more relaxed than the control group. If this treatments work therefore the theory must be correct to produce effective results that are also long-lasting.
"
74
## Footnote
***What is an alternative theory?***
"
***Alternative theory*** - Classical conditioning, as stated by Buck 2010, only works on anxiety avoidance. Freud also stated that CC only removes the symptoms and does not treat the cause like the psychodynamic approach.
"
75
## Footnote
***What is a biological problem for this?***
"
***Issues of Biological Preparedness*** - Most phobias we have in the past pose a threat to us in some way and yet some logical threats in the modern day cannot be phobic because we have not evolved psychological responses of fear (Bouton 2007). Seligman (1971) called this adaption biological preparedness, which is an innate disposition to aquire certain fears. This explains why we have not biologically adapted to have a phobia of guns themselves. Therefore the two-process method is limited because it only covers phobias developed via conditioning, not through evolutionary means.
"
76
## Footnote
***What about a lack of trauma?***
"
***Not All Phobia have Trauma Attached*** - A person can develop a phobia without a horrific event. For example a child's fear of the dark is not a direct result of a conditioned response. Therefore OC and CC do not provide a complete explanation for the development of phobias.
"
77
## Footnote
***Are thought processes considered?***
"
***Fails Take into Account Our Thought Processes*** - One person may react differently to a situation than another. This is not mentioned in the behaviourist approach beacuse it is not empirical so it annot be measured.
"
78
## Footnote
**What are cognitive behavioural studies?**
"
Cognitive behavioural therapy is a term used to describe any type of therapy that attempts to change a persons problematic behaviours by altering the “irrational thought processes” which are suggested cause the problem through a talkign process.
Often a 16-20 week programme
"
79
## Footnote
**What si Beck's method of CBT?**
"
Beck's method was the first form of CBT and mainly focused around the Negative triad.
* Talks to a patient to find out their main negative thoughts (the ones that reinforce their negative triads)
* Once they have done this are they will then ask the patient challenge them with logical thoughts. eg.past sucess
* They may then be asked to practically look for positive experiences over negtive ones. Spending time with friends or family who value them - giving a positive extenal source.
* May try to ecall times when they have been happy in their past and transposing them onto future events so they will see happy emotions in their future self.
* Part of this is to set them homework , sometimes called “patient as scientist” in which they must test out the new beliefs that they have developed in therapy. Then report them back to the therapist.
* This gives them a chance to test out the beliefs and whether they realistically present themselves in their life, which will allow them to accept challenging their irrational thinking in the future.
"
80
## Footnote
***How is a lack of side effects positive?***
"
***No Side Effects*** - A strength of Beck’s therapy is that it has no side effects and there is evidence that it can be as effective as medication.
"
81
## Footnote
***What is the research support for this?***
"
***Research Support*** - March et al (2007) found that after 36 weeks there was an equal amount of people showing improvement, 81%, in both the medication group and the therapy group, with even higher,86% if 2 are combined.This shows that CBT is an equally effective treatment for depression and as it has no side effects people tend to keep going with it for longer. Therefore CBT may be said to be more effective than medication.
"
82
## Footnote
***It may not be effective for very severe cases?***
"
***It Is Not Effective For All Mental States*** - A weakens of the treatment is that patients have to be mentally capable to engage with the therapy.With the most sever cases of depression they are often not able to engage in therapywith out prior use of medications i.e. antidepressants. This shows that while therapy is effective once they have had their condition stabilised, it is not always effective in stabilising a person when used as the sole treatment method. Therefore we can question the ability for all people to be supported using CBT due to issues of engagement rendering it ineffective for some people.
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83
## Footnote
***How is the therapist-patient relationship a limitation?***
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***A Criticism of REBT & CBT*** - is that it may be more a case of a chance to talk to someone who seems to care, i.e it is the therapist client relationship, that is helpful. Luborsky et al (2002) showed the what ever the type of CBT or talking therapy method being used, it made little difference with recovery rate, remaining being fairly consistent so long as they go to spend time with a therapist. This shows that what the person really needs is some one to talk to and to listen to them, not therapy. Therefore it might be that CBT & REBT true value comes from time with another person rather than the therapy it self.
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84
## Footnote
**What is a negative self-schema?**
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The schema would be a set of ideas that an individual would build in association to specific places, scenarios or people from their previous experiences. A self-schema revolves around all teh information we take in about ourseelves. So if our self-schema is negative then we will interpret all information about ourselves negatively.
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85
## Footnote
**Explain the Negative Triad?**
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This si split into three sections that form a cycle of thought that can leed to developing downward spirals in depressive thoughts:
1. Negative view of the world - They have a lack of hope about anything good ever arriving in their external surroundings.
1. Negative view of the future - They can not see any hope in the future only more potential for failures.
1. Nagative view of the self - The thought that they have failed or any similar negatve thoughts will enhance their depressive state as they confirm their own emotions through a lack of self esteem
This forms a downward spiral because each statement reinforces the next and so it can be hard to escape this reoocurring cycle of depression.
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86
## Footnote
***What is the supporting evidence for this?***
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***Supporting Evidence -*** There is a range of eveidence that shows the smae sfindings as that of Beck that these three factors are the main cause of despression. Grazioli and Terry (2000) assessed 65 pegnant women before the birth as to whether they would suffer from post-natal depression and were able to accurately predict (by finding those with high cognitive vulnerability) who were going to suffer.
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87
## Footnote
***How to practicle applicatons support this?***
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***It has Practicle Applications in CBT -*** This ethod has formed the basis for CBT where all of the cognitive aspects are found and challenged for a patient. This has lead to successful therapy that is effective and lasting, therefore the three suggested factors that lead to depression must play a role.
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88
## Footnote
***How is this not a full explanation?***
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***It does not Explain All Aspects of Depression -*** Depression is incredibly complex and Beck's method only accounts for the simpler aspects. For example it can not explain strong emotions or those who experience hallucinations or bizzare beliefs. A very real example of this is Cotard's Syndrome where patients believe they are Zombies (Jarett 2013). Therefore Beck's theory must not be a complete explanation of the reasons behind developing depression.
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89
## Footnote
***Upbringing alternative?***
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***Attatchment and Depression*** - Attatchment ahs shown that is infants develop an insecure attachment at a young age it may lead to depression in adulthood. Therefore it may be less to do with cognition and more about upbringing as a factor.
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90
Draw out application of operant conditioning
91
What is reciprocal inhibition? (phobias)
**behavior therapy in which the patient is exposed to anxiety-producing stimuli while in a controlled state of relaxation so that the anxiety response is gradually inhibited**.
92
What is the stepped approach to phobias in SD?
The process of slowly acclimatizing them to the phobic stimulus in stages
93
What is the stepped approach to phobias in SD?
The process of slowly acclimatizing them to the phobic stimulus in stages
94
What are the physical explanations for OCD in the neural explanation?
– abnormal functioning in the parahippocampal gyrus which processes unpleasant emotions; hyperactivity in the basal ganglia linked to repetitive actions (compulsions); the orbito-frontal cortex ‘the worry circuit’ – the caudate nucleus-thalamus loop, inability to filter small worries in OCD so worry circuit is overactive
95
How does the COMT gene explain OCD
leads to higher levels of dopamine found in people with OCD
96
How does the SERT gene explain OCD…Who?
creates issues with lower levels of seretonin and found in sufferers of OCD (and depression)
Ozaki et al (2003)
97
What is the diathesis stress model for OCD?
Genes produce a vulnerability that can be triggered by the environment.
98
Who found that antidepressants have a significant effect on OCD
Piggot et al (1990)
99
How does dopamine link to the neural explanation of OCD
higher levels = compulsive behaviours
100
What have PET scans shown about people with OCD
higher activity in the frontal lobe when ‘active’ (their triggers)
