Psychopathology Flashcards
(135 cards)
1
Q
Definition of Statistical Infrequency
A
Occurs when an individual has a less common characteristic - either lower or higher than the population average
2
Q
Definition of Deviation From Social Norms
A
Concerns behaviour that is different from the accepted standards of behaviour in a community or society (vary between cultures and generations)
3
Q
Example of Statistical Infrequency - IQ and Intellectual Disability Disorder - 4 Points
A
- Average IQ is 100
- In a normal distribution, 68% of people have an IQ in the range of 85 to 115
- Only 2% have an IQ below 70
- Those below 70 are seen as ‘abnormal’ and are liable to receive a diagnosis of a IDD (intellectual disability disorder)
4
Q
Statistical Infrequency A03 - Real World Application - 2 Points
A
- Useful in diagnostic and assessment procedures
- Used in clinical practice, both as a part of a formal diagnosis and as a way to assess the severity of symptoms
5
Q
Statistical Infrequency A03 - Unusual Characteristics Can Be Positive - 2 Points
A
- In frequent characteristics can be positive as well as negative
- Never sufficient as the sole basis for defining abnormality
6
Q
Statistical Infrequency A03 - Benefits Vs Problems - 5 Points
A
- Some unusual people benefit from being classed as abnormal
- Someone who has a very low IQ and is diagnosed with intellectual disability can then access support services
- Not all statistically unusual people benefit from labels
- Someone with a low IQ who can cope with their chosen lifestyle would not benefit from a label
- Social stigma attached to some labels
7
Q
Example of Deviation from Social Norms - Antisocial Personality Disorder (Psychopathy) - 3 Points
A
- A person with APD is impulsive, aggressive and irresponsible
- According to the DSM-5, one important symptom of APD is an ‘absence of prosocial internal standards associated with failure to conform to lawful and culturally normative ethical behaviour’
- Make the assumptions that psychopaths are abnormal because they don’t conform to our moral standards
8
Q
Deviation from Social Norms A03 - Real World Application - 3 Points
A
- Useful in clinical practice
- Key feature in defining characteristic of APD is the failure to conform to culturally normal ethical behaviour
- Also used in the diagnosis of schizotypal personality disorder
9
Q
Deviation from Social Norms A03 - Cultural and Situational Relativism - 3 Points
A
- Variability between social norms in different cultures and different situations
- Even within one cultural context, social norms differ from one situation to another
- Difficult to judge DFSN across different contexts
10
Q
Deviation from Social Norms A03 - Human Rights Abuse - 2 Points
A
- Carries the risk of unfair labelling and leaving them open to human rights abuses
- Can be argued that we need to be able to use DFSN to diagnose conditions like APD
11
Q
Failure to Function Adequately - 6 Points
A
- No longer conforms to standard interpersonal rules
- Experiences severe personal distress
- Behaviour becomes irrational or dangerous to themselves or others
- Unable to maintain basic standards of hygiene and nutrition
- Cannot hold down a job/university
- Cannot maintain relationships with the people around them
12
Q
Who Proposed the Conditions of Failure to Function Adequately as a Definition of Abnormality?
A
Rosenhan and Seligman
13
Q
Definition of Failure to Function Adequately
A
Occurs when someone is unable to cope with ordinary demands of day to day living
14
Q
Definition of Deviation from Ideal Mental Health
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Occurs when someone doesn’t meet a set of criteria for good mental health
15
Q
Which Definition of Abnormality is the Most Important One for Psychiatric Diagnosis?
A
Failure to function adequately
16
Q
Failure to Function Adequately A03 - Represents a Threshold for Help - 3 Points
A
- Represents a sensible threshold for when people need professional help
- Most of us have symptoms of mental disorder to some degree at different points in our lives
- Means that treatment and services can be targeted to those who need them most
17
Q
Failure to Function Adequately A03 - Discrimination and Social Control - 3 Points
A
- Easy to label no-standard lifestyle choices as abnormal
- In practice, it can be very hard to say when someone is really failing to function and when they have simple chosen to deviate from social norms
- Means people who make unusual choices are at risk of being labelled abnormal and their freedom of choice may be restricted
18
Q
Failure to Function Adequately A03 - Failure to Function Can Be Normal - 3 Points
A
- There are some circumstances in which most of us fail to cope for a time
- May be unfair to give someone a label that may cause them further problems
- FFA is no less real just because the cause is clear
19
Q
Who Proposed the Conditions of Deviation from Ideal Mental Health as a Definition of Abnormality?
A
Jahoda
20
Q
Deviation From Ideal Mental Health - 9 Points
A
- Symptoms of distress
- Irrational and cannot perceive ourselves accurately
- Cannot self-actualise
- Cannot cope with stress
- Have an unrealistic view of the world
- Have low self-esteem and overwhelming guilt
- Dependent on other people
- Cannot successfully work, love and enjoy our leisure
- Unable to adapt to your environment
21
Q
Deviation From Ideal Mental Health A03 - Comprehensive Definition - 4 Points
A
- Highly comprehensive
- Jahoda’s concept of ‘ideal mental health’ covers most of the reasons why we might seek help with mental health
- Means that an individual’s mental health can be discussed meaningfully with a range of professionals who might take different theoretical views
- Means ideal mental health provides a checklist against which we can access ourselves, and discuss psychological issues with a range of professionals
22
Q
Deviation From Ideal Mental Health A03 - May Be Culture Bound - 5 Points
A
- Its different elements are not equally applicable across a range of cultures
- Some of Jahoda’s criteria is firmly located in the context of USA and Western Europe
- The concept of self-actualisation would probably be dismissed as seed-indulgent in the collectivist world
- Even in Western Europe there is quite a bit of variation in the value placed on personal independence
- Means it is difficult to apply the concept of ideal mental health from one culture to another
23
Q
Deviation From Ideal Mental Health A03 - Extremely High Standards - 2 Points
A
- Very few of us attain all of Jahoda’s criteria for mental health, and probably none of us achieve all of them at the sometime or keep them up for very long
- Might be of practical value to someone wanting to understand and improve their mental health
24
Q
3 Behavioural Characteristics of Phobias
A
- Panic
- Avoidance
- Endurance
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Behavioural Characteristics of Phobias - Panic - 3 Points
- In response to the presence of the phobic stimulus
- Crying, screaming or running away
- Children may react differently - freezing, clinging or having a tantrum
26
Behavioural Characteristics of Phobias - Avoidance - 2 Points
- Conscious effort to prevent coming into contact with the phobic stimulus
- Make it hard to go about daily life
27
Behavioural Characteristics of Phobias - Endurance
The person chooses to remain in the presence of the phobic stimulus
28
3 Emotional Characteristics of Phobias
- Anxiety
- Fear
- Unreasonable emotional response
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Emotional Characteristics of Phobias - Anxiety - 4 Points
- Phobias are classed as anxiety disorders
- Involve an emotional response of anxiety
- Prevents a person relaxing and makes it difficult to experience any positive emotions
- Can be long term
30
Emotional Characteristics of Phobias - Fear - 2 Points
- Immediate and extremely unpleasant response we experience when we encounter or think about a phobic stimulus
- Usually more intense, but experience for a shorter periods than anxiety
31
Emotional Characteristics of Phobias - Unreasonable Emotional Response - 2 Points
- Anxiety or fear is much greater than is 'normal'
- Disproportionate to any threat posed
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3 Cognitive Characteristics of Phobias
- Selective attention
- Irrational beliefs
- Cognitive Distortions
33
Cognitive Characteristics of Phobias - Selective Attention - 2 Points
- If a person can see the phobic stimulus it is hard to look away from it
- Keeping our attention on something dangerous as it gives us the best chance of reaction quickly to a threat but this is not useful when the fear is irrational
34
Cognitive Characteristics of Phobias - Irrational Beliefs
May hold unfounded thoughts in relation to phobic stimuli
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Cognitive Characteristics of Phobias - Cognitive Distortions
Perceptions of a person with a phobia may be inaccurate and unrealistic
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How are Phobias Acquired?
Classical conditioning through association
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How are Phobias Maintained?
Operant conditioning through reinforcement
38
Watson and Rayner - Little Albert Study - 7 Points
- Albert showed no unusual anxiety at the begging of the study
- When shown a white rate (NS), he tried to play with it and showed a positive response
- Whenever the rat was presented to Albert, researchers made a loud, frightening noise (UCS) by banging an iron bar near his ear
- This created a response of fear (UCR)
- When the rat (NS) was shown again to Albert he started to cry and show distress (CR)
- Rat became CS
- When Albert was shown other small furry animals, he displayed a similar reaction
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Definition of Classical Conditioning
Learning through association
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Definition of Operant Conditioning
Learning through reinforcement
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Definition of Positive Reinforcement
A stimulus that increases the probability that a behaviour will be repeated because it is pleasurable
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Definition of Negative Reinforcement
A stimulus that increases the probability that a behaviour will be repeated because it leads to escape from an unpleasant situation
43
Di Gallo - 3 Point
- 20% of people who experienced traumatic car accidents become phobic of cars
- Classical conditioning - car (NS) becomes associated with natural fear response
- Operant conditioning - avoiding car journeys reduces worry/anxiety and maintains a feeling of safety
44
Systematic Desensitisation - 3 Points
- Wolpe - developed a progressive hierarchy that patients work through step by step
- Patients learn in stages to replace fear responses with feelings of calm
- Anxiety and relaxation cannot co-exist, so one must replace the other (reciprocal inhibition)
45
3 Process Involved in Systematic Desensitisation
- Anxiety hierarchy
- Relaxation
- Exposure
46
Systematic Desensitisation - Anxiety Hierarchy - 2 Points
- Put together by client and therapist
- List of situations related to the phobic stimulus that provoke anxiety in order from least to most frightening
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Systematic Desensitisation - Relaxation - 3 Points
- Therapist teaches the client to really as deeply as possible
- Based on reciprocal inhibition
- Breathing techniques, mental imagery techniques, meditation or drugs can be used to relax the client
48
Systematic Desensitisation - Exposure - 4 Points
- The client is exposed to the phobic stimulus while in a relaxed state
- Takes place across several sessions, starting at the lowest point of the hierarchy
- When the client can stay relaxed in the presence of the lower levels of the phobic stimulus, they move up the hierarchy
- Treatment is successful when the client can stay relaxed in situations high on the anxiety hierarchy
49
2 Methods to Treat Phobias
- Systematic desensitisation
- Flooding
50
Systematic Desensitisation - 4 Points
- Behavioural therapy for treating phobias
- Includes drawing up a hierarchy of anxiety-provoking situations related to a person's phobic stimulus
- Teaches the person to relax, then exposing them to to phobic situations
- Person works their way through the hierarchy whilst maintaining relaxation
51
Flooding - 3 Points
- Behavioural therapy in which a person with a phobia is exposed to an extreme form of a phobic stimulus in order to reduce anxiety triggered by that stimulus
- Takes place across a small number of long therapy sessions
- Counter-conditions - extinction
52
Definition of Extinction
Learning that the phobic stimulus is harmless
53
Definition of Depression
A mood disorder characterised by low mood and low energy levels
54
5 Behavioural Characteristics of Depression
- Poor appetite or weight loss, or increased appetite and weight gain
- Sleeping difficulty, or sleeping too much
- Body slowed down or agitated (sped up), loss of energy
- Suicidal behaviour
- Aggression, self harm
55
3 Cognitive Characteristics of Depression
- Recurrent thoughts of death or suicide
- Inability to concentrate or think clearly
- Absolutest thinking
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3 Emotional Characteristics of Depression
- Loss of interest or pleasure in usual activities
- Feelings of self-reproach, excessive or inappropriate guilt
- Anger
57
DSM - 4 Categories of Depression
- Major depressive disorder
- Persistent depressive disorder
- Disruptive mood dysregulation disorder
- Pre-menstrual dysphoric disorder
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DSM Categories of Depression - Major Depressive Disorder
Severe, but often short-term depression
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DSM Categories of Depression - Persistent Depressive Disorder
Long term or recurring depression, including sustained major depression
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DSM Categories of Depression - Disruptive Mood Dysregulation Disorder
Childhood temper tantrums
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DSM Categories of Depression - Premenstrual Dysphoric Disorder
Disruption to mood prior to or during menstruation
62
4 Examples of Cognitive Distortion
- Polarised thinking
- Over-generalisation
- Tyranny of 'must', 'should' and 'ought'
- Catastrophizing
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Examples of Cognitive Distortion - Polarised Thinking
Seeing everything in black or white
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Examples of Cognitive Distortion - Over-Generalisation
Making sweeping generalisations
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Examples of Cognitive Distortion - Tyranny of 'Must', 'Should', and 'Ought'
Something must happen
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Examples of Cognitive Distortion - Catastrophizing
Making a mountain out of a molehill
67
Beck's Negative Triad - 4 Points
- Automatic negative thinking is the cause of depression
- Negative views about the world
- Negative views about oneself
- Negative views about the future
68
Ellis's ABC Model
Activating event -> belief -> consequences
69
Evidence to Support Beck - Grazoli and Terry - 2 Points
- Assessed 65 pregnant women for cognitive vulnerability and depression before and after birth
- Found that those women judged to have been high in cognitive vulnerability were more likely to suffer from post-natal depression
70
Evidence to Support Beck - Clarke and Beck - 3 Points
- Meta analysis
- Found solid support for all the cognitive vulnerability factors
- They can be seen before depression develops, suggesting that faulty thinking causes depression
71
Beck's Cognitive Behavioural Therapy - 5 Points
- Challenge irrational and dysfunctional thought processes
- Based on the idea that depression is caused by disordered thought processes
- Therapist and patient work together to identify where there might be negative or emotional thoughts that will benefit from challenge
- CBT then involves working to change these and put more effective behaviours in place
- Rely on a combination of both Beck's and Ellis's theories, but mainly Beck's
72
Definition of Cognitive Behavioural Therapy
A method for treating mental disorders based on both cognitive and behavioural techniques
73
Ellis's Rational Emotive Behavioural Therapy - 6 Points
- Extends the ABC model to the ABCDE model, adding dispute and effect
- Central technique of REBT is to identify and dispute irrational thoughts
- Intended effect is to change the irrational belief and break the link between negative life events and depression
- Ellis identified different methods of disputing
- Empirical argument involves disputing whether there is actual evident to support the negative belief
- Logical argument involves disputing whether the negative thought logically follows from the fact
74
Behavioural Activation - 2 Points
- As individuals become depressed, they tend to increasingly avoid difficult situations and become isolated, which maintains or worsens symptoms
- The goal of behavioural activation is to work with depressed individuals to gradually decrease their avoidance and isolation, and to increase their engagement in activities that have been shown to improve mood
75
Treating Depression A03 - Evidence for Effectiveness - 5 Points
- March et al - compared CBT to antidepressants and a combination of both treatments when treating 327 depressed adolescents
- After 36 weeks, 81% of the CBT group, 81% of the antidepressants group, and 86% of the combined group, were significantly improved
- CBT was just as effective when used on its own, and more so when alongside antidepressants
- Cost effective because it is usually a fairly brief therapy, requiring 6 - 12 sessions
- Means CBT is seen as first choice of treatment in public health care systems
76
Cognitive Approach to Treating Depression A03 - Unsuitability for Diverse Clients - 5 Points
- Lack of effectiveness of CBT in severe cases and for clients with learning disabilities
- In some cases, depression can be so severe that clients cannot motivate themselves to engage with the cognitive work of CBT
- May not be able to pay attention to what is happening in a session
- Hard cognitive work involved in CBT makes it unsuitable for treating depression in clients with learning difficulties
- Sturmey - suggests that any form of psychotherapy is to suitable for people with learning difficulties
77
Cognitive Approach to Treating Depression A03 - Counterpoint - 2 Points
- Lewis and Lewis - review concluded that CBT was as effective as antidepressant drugs and behavioural therapies for severe depression
- Taylor et al - review concluded that when used appropriately, CBT is effective for people with learning difficulties
78
Cognitive Approach to Treating Depression A03 - Relapse Rates - 6 Points
- High relapse rates after finishing CBT
- Few early studies of CBT and depression looked at long term effectiveness
- More recent studies suggest that long term outcomes are not as good as had been assumed
- Ali et al - assessed depression in 439 clients every month for 12 months following a course of CBT
- 42% relapsed within 6 months of treatment ending, and 53% relapse within a year
- Suggests that it may need to be repeated periodically
79
Cognitive Approach to Treating Depression A03 - Client Preference - 5 Points
- When used with appropriate clients, this is highly effective, at least in the short term, for tackling symptoms of depression
- Large body of evidence to support this, but not all clients tackle their depression in this way
- Some people want their symptoms gone as quickly and easily as possible and prefer medication
- Others might wish to explore the origins of their symptoms
- Yondi et al - conducted a study of client preference, and found that depressed people rate CBT as their least preferred psychological treatment
80
Definition of Obsession
Recurring irrational thoughts that lead to extreme anxiety
81
Definition of Compulsion
Intense uncontrollable urges to repeat tasks and behaviours
82
DSM 5 Categories of OCD - 5 Points
- OCD is characterised by obsessions and/or compulsions, with most people with a diagnosis experiencing both
- 3 common types
- Trichotillomania - compulsive hair pulling
- Hoarding disorder - the compulsive gathering of possessions and the inability to part with anything, regard less of its value
- Excoriation disorder - compulsive skin-picking
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3 Behavioural Characteristics of OCD
- Repetitive compulsions
- Compulsions reduce anxiety
- Avoidance
84
Behavioural Characteristics of OCD - Repetitive Compulsions
Feel compelled to repeat a behaviour
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Behavioural Characteristics of OCD - Compulsions Reduce Anxiety
Compulsions are performed in an attempt to manage the anxiety produced by obsessions
86
What % of People with OCD Only Show Compulsions?
10%
87
Behavioural Characteristics of OCD - Avoidance
Attempt to reduce their anxiety by keeping away from situations that trigger it
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3 Emotional Characteristics of OCD
- Anxiety and distress
- Accompanying depression
- Guilt and disgust
89
Emotional Characteristics of OCD - Anxiety and Distress
Obsessive thoughts are unpleasant and frightening, with the anxiety that goes with them sometimes being overwhelming
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Emotional Characteristics of OCD - Accompanying Depression
Anxiety can be accompanied by low mood and lack of enjoyment in activites
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Emotional Characteristics of OCD - Guilt and Disgust
Irrational guilt and disgust, directed at something external or themselves
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3 Cognitive Characteristics of OCD
- Obsessive thoughts
- Cognitive coping strategies
- Insight into excessive anxiety
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Emotional Characteristics of OCD - Obsessive Thoughts
Vary considerably from person to person but are always unpleasant
94
Emotional Characteristics of OCD - Cognitive Coping Strategies
Adopting cognitive coping strategies to deal with the obsessions and help to manage anxiety, but can make them appear abnormal others and distract them from everyday tasks
95
Emotional Characteristics of OCD - Insight into Excessive Anxiety - 3 Points
- People with OCD are aware their obsessions and compulsions are not rational, which is necessary for a diagnosis
- Experience catastrophic thoughts about the worst case scenario that might result if their anxieties were justified
- Tend to be hyper vigilant
96
2 Biological Explanations for OCD
- Genetic explanation
- Neural explanation
97
Definition of Concordance Rates
A measurement of similarity, usually expressed as a percentage, between two individuals or set of individuals on a given trait
98
Nestadt et al - 4 Points
- Research into concordance rates for OCD in twins
- Was a review of previous twin studies
- MZ twins had rates of 68%, whilst DZ twins had rates of 31%
- Suggests their must be some genetical influence in the development of OCD, but cannot be completely because of genetics
99
Genetic Explanation of OCD - 4 Points
- Has been proposed that there is a genetic component to OCD, which predisposes some individuals to the disorder
- 2 candidate genes identified - COMT and SERT
- OCD is polygenic because more than one specific gene has been identified in the onset of OCD
- Taylor - carried out a meta analysis, finding as many as 230 genes implicated in OCD
100
COMT Gene - 3 Points
- Helps to reduce the action of dopamine
- Variation in the COMT gene decreases the amount of COMT available
- Dopamine is not controlled and there is probably too much dopamine
101
SERT Gene - 2 Points
- Effects the transportation of serotonin
- Variation in the SERT gene creates lower levels of serotonin
102
2 Neural Explanations
- Brain Chemistry
- Brain Structure
103
Neural Explanation of OCD - Brain Chemistry - 4 Points
- Role of serotonin, which is believe to help regulate mood
- If a person has low levels of serotonin then normal transmission of mood-relevant information does not take place, and a person may experience low moods
- Other mental processes can be affected as well
- At least some cases of OCD can be explained by a reduction in the functioning of the serotonin system in the brain
104
Neural Explanation of OCD - Brain Structure - 5 Points
- Dysfunction and abnormal functioning in Frontal Lobe and Parahippocampal Gyrus
- Other areas believed to be involved OCD include the orbital frontal complex (OFC)
- OFC is involved in decision making and worry a about social and other behaviour
- This brain area is thought to help initiate activity upon receiving impulses to act and then stop the activity then the impulse lessens
- It may be that those with OCD have difficulty in switching off or ignoring impulse, so that they turn into obsessions and then compulsions
105
What Does SSRI Stand For?
Selective Serotonin Re-uptake Inhibitors
106
SSRIs - Background Information - 3 Points
- Type of anti-depressant
- Fluoxetine is the mosts commonly used SSRI for depression, OCD and bulimia
- 20 mg is given at first for 3-4 weeks, if this is not effective it can be increased to up to 60 mg
107
How Do SSRIs Work? - 6 Points
- Serotonin is released by certain neurons in the brain
- Released by the presynaptic neurons and travels across a synapse
- The neurotransmitter chemically conveys the signal from the presynaptic neuron to the postsynaptic neuron
- it is then reabsorbed by the presynaptic neuron where it is broken down and reused
- By preventing the reabsorption and breakdown, SSRIs effectively increase levels of serotonin in the synapse and thus continues to stimulate the postsynaptic neuron
- Compensates for whatever is wrong with the serotonin system in OCD
108
Alternatives to SSRIs - 5 Points
- Tricyclics - most commonly Clomipromine
- Have the same effect on the serotonin system as SSRIS, but they have more severe side effects, so are only used as a second option if SSRIs don't work
- SNRIs - Serotonin Noradrenaline Re-uptake Inhibitors
- Developed to treat OCD
- Second option to SSRIs and increase serotonin and noradrenaline
109
Behavioural Approach to Explaining Phobias A03 - Real World Application - 5 Points
- Distinctive element of the two-process model is the idea that phobias are maintained by the avoidance of the phobic stimulus
- Important in explaining why people with phobias benefit from being exposed to the phobic stimulus
- Once the avoidance behaviour is prevented it ceases to be reinforced by the experience of anxiety reduction and avoidance therefore declines
- In behavioural terms the phobias is the avoidance behaviour so when this avoidance is prevented the phobia is cured
- Shows the values of the two-process model
110
Behavioural Approach to Explaining Phobias A03 - Cognitive Aspect of Phobias - 5 Points
- Does not account for the cognitive aspects of phobias
- Behavioural explanations are geared towards explain behaviour, with the key behaviour in phobias being avoidance of the phobic stimulus
- We know that phobias are not simply avoidance response, and they also have a significant cognitive component, such as irrational beliefs about the phobic stimulus
- The two process model explains avoidance behaviour but does not offer an adequate explanation for phobic conventions
- Means that the two-process model does not completely explain the symptoms of phobias
111
Behavioural Approach to Explaining Phobias A03 - Phobias and Traumatic Experiences - 5 Points
- Evidence for link between bad experiences and phobias
- Little Albert study shows how a frightening experience involving a stimulus can lead to a phobia of that stimulus
- Jongh et al - found that 75% of people with a fear of dental treatment had experienced a traumatic experience involving dentistry
- Can be compared to a control group of people with low dental anxiety where only 21% had experienced a traumatic event
- Confirms that the association between stimulus and an unconditioned response leads to the development of the phobia
112
Behavioural Approach to Explaining Phobias A03 - Counterpoint - 4 Points
- Not all phobias appear following a bad experience
- Some common phobias occur in populations where very few people have any experience of the phobic stimulus, let alone a traumatic experience
- And not all frightening experiences lead to phobias
- Means that the association between phobias and frightening experiences is not as strong as we would expect if behavioural theories provided a complete explanation
113
Behavioural Approach to Explaining Phobias A03 - Learning and Evolution - 4 Points
- Behavioural models of phobias provide credible individual explanations
- However, there are other more general aspects to phobias that may be better explained by evolutionary theory
- For example, we tend to acquire phobias of things that have presented a danger in our evolutionary past
- Seligman called this preparedness
114
Behavioural Approach to Treating Phobias A03 - Systematic Desensitisation and Evidence of Effectiveness - 4 Points
- Gilroy et al - followed up 42 people who had SD for arachnophobia in three 45 min sessions
- At both 3 and 33 months, the SD group were less fearful than a control group treated by relaxation without exposure
- Wechsler et al - concluded that SD is effective for specific phobias, such as social phobia and agoraphobia
- Means that SD is likely to be helpful for people with phobias
115
Behavioural Approach to Treating Phobias A03 - Systematic Desensitisation and People with Learning Disabilities - 3 Points
- Main alternatives to SD are not suitable for those with learning difficulties, as they often struggle with cognitive therapies that require a high level of rational thought
- People with learning difficulties may also feel confused and distressed by the traumatic experience of flooding
- Means thatSD is often the most appropriate treatment for people with learning difficulties and who have phobias
116
Behavioural Approach to Treating Phobias A03 - Flooding and Cost-effectiveness - 4 Points
- A therapy is cost-effective if it is clinically effective and not expensive
- Flooding can work in as little as one session to achieve the same result as SD
- Even allowing for a longe session makes flooding more cost-effective
- Means that people can be treated at the same cost with flooding than with SD or other therapies
117
Behavioural Approach to Treating Phobias A03 - Flooding and Trauma - 5 Points
- Confronting one's phobic stimulus in an extreme form provokes tremendous anxiety
- Schumacher et al - found that participants and therapists rated flooding as significantly more stressful than SD
- Raises the ethical issue for psychologists of knowing causing stress to their clients, although this is not a serious issue provided they obtain informed consent
- More seriously the traumatic nature of flooding means that drop out rates are higher then for SD
- Suggests that therapists may avoid using this treatment
118
Behavioural Approach to Treating Phobias A03 - Flooding and Symptom Substitution - 4 Points
- Only mask symptoms and do not tackle the underlying causes of phobias
- Persons - reported the case of a woman with a phobia of data who was treated using flooding
- Her fear of death declined, but her fear of being criticised got worse
- The only evidence for symptom substitution comes in the form of case studies which may only generalise to the phobias in the study
119
Beck's Cognitive Approach to Explaining Depression A03 - Research Support - 5 Points
- 'Cognitive vulnerability' refers to ways of thinking that may predispose a person to becoming depressed, such as faulty information processing, negative self-schema and the cognitive triad
- Clark and Beck - review concluded that not only were these cognitive vulnerabilities more common in depressed people, but they preceded the depression
- Cohen et al - tracked the development of 473 adolescents, regularly measuring cognitive vulnerability
- Found that showing cognitive vulnerability predicted later depression
- Shows that there is an association between cognitive vulnerability and depression
120
Beck's Cognitive Approach to Explaining Depression A03 - Real World Application - 4 Points
- Cohen et al - concluded that assessing cognitive vulnerability allows psychologists to screen young people, identifying those most at risk of developing depression in the future and monitoring them
- Understanding cognitive vulnerability can also be applied in CBT
- These therapist work by altering the kind of cognition that make people vulnerable to depression, making them more resilient to negative life events
- Means that an understanding of cognitive vulnerability is useful in more than one aspect of clinical practice
121
Beck's Cognitive Approach to Explaining Depression A03 - A Partial Explanation - 4 Points
- Seems to be doubt that depressed people show regular patterns of cognition and that these can be seen before the onset of depression
- Appears that Beck's suggestion of cognitive vulnerabilities is at least a partial explanation for depression
- Some aspects to depression that are not particularly well explained by cognitive explanations
- For examples, some depressed people feel extreme anger, and experience come hallucinations and delusions
122
Ellis's Cognitive Approach to Explaining Depression A03 - Real World Application - 2 Points
- David et al - some evidence to support the idea that REBT can both change negative beliefs and relive the symptoms of depression
- Means REBT has real world value
123
Ellis's Cognitive Approach to Explaining Depression A03 - Reactive and Endogenous Depression - 3 Points
- Seems to be some doubt that depression is often triggered by life events, known as reactive depression
- Many cases of depression are not to traceable life events and it is not obvious what leads the person to become depressed at a particular time, known as endogenous depression
- This model is less useful for explaining endogenous depression, meaning it can only explain some cases of depression and is therefore only a partial explanation
124
Ellis's Cognitive Approach to Explaining Depression A03 - Ethical Issues - 3 Points
- Controversial because it locates responsibility for depression purely with the depressed person
- Critics say that this is effectively blaming the depressed person, which would be unfair
- Provided it is used appropriately and sensitively, the application of this model in REBT does appear to make at least some depressed people achieve more resilience and feel better
125
Genetic Explanation of OCD A03 - Research Support - 4 Points
- Evidence from a variety of sources which strongly suggest that some people are vulnerable to OCD as a result of their genetic make-up
- Nestadt et al - reviewed twin studies and found that 68% of identical twins shared OCD as opposed to 31% non-identical twins
- Marini and Stebnicki - a conducted a family study involving OCD and found that a person with a family member diagnosed with OCD is 4 times more likely to develop it as someone without
- Suggests that there must be some genetic influence on the development of OCD
126
Genetic Explanation of OCD A03 - Environmental Risk Factors - 4 Points
- Does not appear to be entirely genetic in origin and it seems that environmental risk factors an also trigger or increase the risk of developing OCD
- Cromer et al - found that over half the OCD clients in their sample had experienced a traumatic event in their past
- Was also more severe in those with one or more traumatic experiences
- Means that genetic vulnerability only provides a partial explanation for OCD
127
Genetic Explanation of OCD A03 - Animal Studies - 3 Points
- Difficult to identify candidate genes that are possible causes of OCD
- Ahmari - animal study that showed particular genes associated with repetitive behaviours in mice
- Human brain and mind are more complex, and it may not be possible to generalise from animal repetitive behaviour to human OCD
128
Neural Explanation of OCD A03 - Research Support - 4 Points
- Antidepressants that work purely on serotonin are effective in reducing symptoms, and this suggests that serotonin may be involved in OCD
- OCD symptoms form part of conditions that are known to be biological in origin
- If a biological disorder produces OCD symptoms, then we may assume there are biological processes underlying OCD
- Suggests that biological factors may be responsible for OCD
129
Neural Explanation of OCD A03 - No Unique Neural System - 4 Points
- The serotonin-OCD link may not be unique to OCD
- Many people with OCD also experience depression, which probably involves disruption to the action of serotonin
- Means that serotonin could be a basis for OCD, and it could simply be that serotonin activity is disrupted in many people with OCD because they are depressed as well
- Means that serotonin may not be relevant to OCD symptoms
130
Neural Explanation of OCD A03 - Correlation and Causality - 4 Points
- Evidence to show that some neural systems do not work normally in people with OCD
- According to the biological model of mental disorders this is most easily explained by brain dysfunction causing the OCD
- Simply a correlation between neural abnormality and OCD, which means that there is not necessarily a causal relationship
- Quite possible that OCD cause the abnormal brain function, or that they are both influenced by a third factor
131
Biological Approach to Treating OCD A03 - Evidence for Effectiveness - 5 Points
- Clear evidence to show that SSRIs reduce symptom severity and improve the quality of life for people with OCD
- Soomro et al - reviewed 17 studies that compared SSRIs to placebos in the treatment of OCD
- All 17 studies showed significantly better outcomes for SSRIs than the placebo conditions
- Typically symptoms reduce for around 70% of people taking SSRIs
- For the remaining 30%, most can be helped by either alternative drugs or combinations of drugs and psychological therapies
132
Biological Approach to Treating OCD A03 - Counterpoint - 3 Points
- Some evidence to suggest that even if drug treatments are helpful for most people with OCD, they may not be most effective treatments available
- Skapinakis et al - review of outcome studies and concluded that both cognitive and behavioural therapies were more effective than SSRIS in the treatment of OCD
- Means that drugs may not be the optimum treatment for OCD
133
Biological Approach to Treating OCD A03 - Cost Effective and Non Disruptive - 5 Points
- Drug treatments are cheap compared to psychological treatments because many thousands of tables or liquid does can be manufactured in the time it takes to conduct one session of psychological therapy
- Using drugs to treat OCD is therefore good value for public health systems and represents a good use of limited funds
- SSRIs are non-disruptive to peoples lives, compared to therapies
- Patient can take the drugs until their symptoms decline, which is quite different to time spend attending therapy sessions
- Means that drugs are popular with many people with OCD and their doctors
134
Biological Approach to Treating OCD A03 - Serious Side Effects - 5 Points
- Some people experience side effects such as indigestion, blurred vision and los of sex drive
- These side effects are usually temporary, but they can be quite distressing for people, and a minority experience them for the long term
- For those taking Clomipramine, side effects are more common and can be more serious
- 1 in 10 experience erection problems and issues with weight gain, and 1 in 100 become aggressive and experience heart related problems
- Means that some people have a reduced quality of life as a result of taking drugs and may stop taking them all together, meaning the drugs cease to be effective
135
Biological Approach to Treating OCD A03 - Biased Evidence - 4 Points
- Some controversy over the evidence for effectiveness of drugs
- Goldacre - believes that the evidence for drug effectiveness is biased because researchers are sponsored by drug companies, and may selectively published positive outcomes for the drugs their sponsors are selling
- But there is a lack of independent studies of drug effectiveness, and the research on psychological therapies may be biased
- The best evidence available is supportive of the usefulness of drugs for OCD
