Psychopathology

Question 1

What is psychopathology?

Answer 1

The study of mental illnesses

Question 2

How can we decide if a persons behaviour or psychological state are sufficiently unusual to justify diagnosing and treating them?

Answer 2

Definitions:
1. Deviation from social norms
2. Statistical infrequency
3. Failure to function adequately
4. Deviation from ideal mental health

Question 3

What ids meant by deviation from social norms as a definition of abnormality?

Answer 3

A person is seen as abnormal if a persons behaviour or thinking violates unwritten rules (social norms) about what is acceptable in society.

Question 4

Give an example of deviation from social norms

Answer 4

Running around naked -

Question 5

Limitations for deviation from social norms:

1- Cultural relativism - social norms differ between cultures

2- Relies on the context of behaviour - may not be abnormal but deviant behaviour.

Answer 5

One issue with the deviation from social norms as a definition for abnormality is that social norms are culturally relative/specific to a certain culture. This is because social norms differ between different cultures and different things are considered normal and in other countries abnormal. For example drinking alcohol in Saudi vs the uk. therefore this is a limitation as our perception of abnormality/social norms must be adapted to specific cultures.

Another issue of this definition is that it relies on the context of the behaviour .if someone breaks a social norm this may not be deviant behaviour but only in certain situations this may be considered evidence of psychological disturbance. For example shouting in a football match but then shouting in public. This could possibly be an indication of a underlying health condition. As a consequence this definition fails to offer an alternative explanation related to degree and context of one’s behaviour

Another issue is that overtime social norms change so things that were seen as deviant before may not bee seen as deviant now for example homosexuality was illegal until1973.

Question 6

Strength for deviation from social norms
1- Keeps society orderly

Answer 6

Strength = can keep society orderly. This means that social norms in society inform people of what to do and what not do do - what is acceptable therefore maintaining Oder in scoiety by preventing chaos and dysfunction n

Question 7

What is meant by statistical infrequency as a definition of abnormality?

Answer 7

A mathematical way of testing abnormality by looking at someone’s behaviour to see if its statistically uncommon or common.

Question 8

Give an example of statistical infrequency

Answer 8

Average IQ can be represented on a normal distribution. If two standard deviations away from the mean then you are considered abnormal. so this is behaviour that is not seen very often.

Question 9

Weakness of statistical infrequency:

1- Could lead to labelling

2- Statistically infrequent behaviour = labelled as abnormal could in fact be desirable characteristics

Answer 9

One problem of this definition of abnormality is that it could be an invite to labelling. This is because statistical infrequency can label individuals as abnormal which could be hinder our to an individuals life. For example those with a low IQ could face discrimination based upon the definition and set drawbacks in their life such as poor self-image etc

Another problem with this definition for abnormality is that statistically infrequent behaviours labelled as abnormal could in fact be desirable traits. for example a high IQ would be unusual yet be hugely celebrated so called genius those without this desirable trait would be seen as less. therefore has a negative impact on society.

Question 10

evaluation (strengths) for statistical infrequency?

1- Real world Application

Answer 10

one strength of statistical infrequency is that it has real world application as it can be used in clinicians to diagnose a patient. for example intellectual disability we can measure the IQ of an individual if its below for example 60 it could justify their need for help

Question 11

what is meant by failure to function adequately as a definition of abnormality?

Answer 11

a person is considered abnormal when they are unable to cope with demands of everyday life and live independently in society. Their behaviour also causes stress and discomfort to family and friends

Question 12

how to know if someone lies upon the definition of failure to function adequately according to Rosenhan and Seligman (1989)?

Answer 12

the global assessmment of functional scale:
unpredictability - impulsive, uncontrollable
maldaptiveness - going against acceptable standards
personal distress - excessive emotional responses
irrationality - unreasonable thinking/impulses
observer discomfort - to others

Question 13

Weakness for failure to function adequately:

1- Individual Differences play a role

2- Confusing distinguishing failure to function adequately and deviation form social norms.

Answer 13

one limitation of this definition is that individual differences play a role. for example a person with OCD may exhibit rituals that may prevent them from functioning adequately, as they constantly miss work or school whereas another person may suffer from the same excessive rituals but find time to complete and come on time to work. therefore we need to take into account how individual differences.

another limitation of this definition is that it can often be confusing when distinguishing between failure to function adequately and deviation from social norms. For example, a behaviour which appears to be failure to function adequately, such as not being able to go to work, may in fact be a deviation from the social norm should that person be choosing to live an alternative lifestyle out of the common system for that society. It is therefore difficult to ascertain if this behaviour should be considered maladaptive. By labelling individuals who make such choices as ‘failing’, personal freedom is being squashed.

Question 14

evaluation (strengths) foir failure to function adequately?

Answer 14

one strength of failure to function adequately is that it considers the subjective personal experiences of the partient. this definition considers the thoughts and feelings of the person experiencing the issue and does not simply make a judgement withought taking the personal viewpoint of the sufferer into consideration. this suggests that failure to function adequately ia auseful model for assessing psychopathological behaviour.

One strength of failure to function criterion is that it represents a sensible threshold for when people need profession help. Most of us have symptoms of mental disorders to some degree ant some time. Factually, around 25% of people in the Uk will experience mental health problems in any given year. People can be referred for help by others or notice themselves. This means that the treatment and services can be targeted to those who need them.

Question 15

what is mneant by deviation from ideal mental health as a definition for abnormality?

Answer 15

Jahoda (1958) suggested that abnormnal behaviour is defined when there is an abscence of particular and ideal characteristics. so behqaviours which move away from ideal mental health.

Question 16

what are the 6 principles of ideal mental health?

Answer 16

• having a high self-esteem and strong sence of identity
• capable of person growth and self-actualisation
• being independent of others and self-regulatiung
• having an accurate view of reality
• being able to integrate and resist stress
• being able to master your environment

Question 17

eva;uation (weaknesses) of deviation from ifdeal mental health as a definition for abnormality?

Answer 17

one ;limitation of this definition is that the criteria is unrealistic as proposed by Jahoda. this is because at times everyone will experience stress and negativity for once in their life for examploe when a loved one passes away. however when we put this definition into this context the individual would be considered abnormal irrespective of the circumstances out of their control. therefore a weakness of this definition as a defintion for abnormality as it has set too much of a high stabndard and does not tkae into account little or major setbacks which infintely have an impact on anyones life.

another issue with this definition for explaining abnormality is that cultural relativism. Jahoda does not take intoi accountb how this definitiuon may differ in certain coun tries. for example personal growth may be seen as overly self-centered in countries which favour collectivist ideas. thus this definition is culture bound.

another issue with this definition it that mental illnesses could have an effect on whether or not an individual is able to cover this criteria. for example those with schizophrenia will struggle to form an accurate view of reality.

Question 18

evaluation (strengths) of devioatioon from ideal mental health as a definition for abnormality?

Answer 18

one strength of Jahoda’s definition is that it takes a positive approach in defining abnormality rather than considering the negative and undesirable behaviours. this could help aid a persons’s determination to become and to strive to become a beter person. Also this takes into account multiple factors that can affect an individuals health and wellbeing. So thius shows that the defintion of ideal mental health is comprehensive and covers a broad range of criteria.

Question 19

phobias

Question 20

what is a phobia?

Answer 20

a phobia is an anxiety disorder which causes an irrational fear of a particular object or situation

Question 21

what are the 3 categories of phobias?

Answer 21

• simple (specific) phobias
• social phobias
• Agorophobia

Question 22

what is a simple phobias?

Answer 22

this is the most common type of phobia and this is where a person fears a specific object

Question 23

simple phobias are then divided into a further 4 categories what are they?

Answer 23

• animal, injury, situational, natural

Question 24

what is a social phobia?

Answer 24

social phobias involve feelings of anxiety in social situations

Question 25

what 3 categories is social phobias further divided into?

Answer 25

- performance, interaction, generalised

Question 26

what is agoraphobia?

Answer 26

fear of being in open, outside or in a public space

Question 27

what can agoraphobia be caused by?

Answer 27

can be caused by simple phobias or social phobias e.g fear of contamination (mysophobia)

Question 28

what are behavioural characteristics of phobias?

Answer 28

Avoidance and panic

Question 29

What is Avoidance and Panic?

Answer 29

IF a person is presented with their phobia, their immediate response is to avoid it. However, not all people are able to avoid their fears and thus panic, causing high levels of stress and anxiety. Sometimes the fear is so intense that they freeze.

Question 30

what are emotional characteristics of phobias?

Answer 30

excessive and unreasonable fear and anxiety when in the presence of the phobia. This can be displayed by emotional expressions such as screaming, crying upon seeing the phobia.

Question 31

what are cognitive characteristics of phobias?

Answer 31

selective attention and irrational beleifs

Question 32

what is selective attention?

Answer 32

where a person becomes fixated upon the object they fear and find it difficult to direct their attention elsewhere.

Question 33

what s irrational beleifs?

Answer 33

a person belives the object they fear is dangerous and deadly or poses a threat to them

Question 34

Depression

Question 35

what is the DSM 5 categories of depression?

Answer 35

- major depressive disorder - severe but often short-term depression - persistent depressive disorder - long - term or recuring depression including sustained major depression - disruptive mood dysregulation disorder - childhood temper tantrums - pre-menstrual dysphoric disorder - distruption to mood prior to and or during menstruation

Question 36

what is depression?

Answer 36

a mood disorder characterized by low mood and low energy

Question 37

what two categories is depression divided into?

Answer 37

unipolar and bipolar

Question 38

how is a diagnosis for depression made?

Answer 38

sufferers are required to experience at least 5 symptoms, everyday for at least 2 weeks

Question 39

what are the behavioural characteristics for depression?

Answer 39

loss of energy, sleep disturbance, changes in appetite

Question 40

what are the emotional characteristics of depression?

Answer 40

depressed mood and feelings of worthlessness and sadness , lack of interest in activities

Question 41

what are the cognitive characteristics of depression?

Answer 41

diminished ability to concentrate and tend to focus on the negative

Question 42

what is OCD?

Answer 42

An anxiety disorder where anxiety arises from obsessions and compulsions. Compulsions are a response to obsessions. The individual believes the compulsions will reduce anxiety.

Question 43

what are obsessions?

Answer 43

Persistent and intrusive thoughts. The person is obsessed with this thinking. The thoughts are always there.

Question 44

what are compulsions?

Answer 44

Compulsions are the behaviours that are repeated over and over again. The person thinks they will help the anxiety, or make things better. They feel like they have carry out this behaviour or ritual. They have no choice.

Question 45

what are the behavioural characteristics of OCD?

Answer 45

Compulsive behaviours e.g. non-stop cleaning. Repetitive behaviours Unconcealed behaviours Can be mental acts (praying) Behaviours are not realistically connected to what the individual believes they will to prevent.

Question 46

what are the emotional characteristics of OCD?

Answer 46

- severe anxiety and distress because of obsessive thoughts and ideas - depression

Question 47

what are the cognitive characteristics of OCD?

Answer 47

obsessive thoughts which reoccur all the time

Question 48

behavioural approach to explaining phobias

Question 49

what is meant by the behavioural approach?

Answer 49

a way of explaining in terms of what is observable and in terms of learning

Question 50

who came up with the two process model?

Answer 50

Mowrer (1947)

Question 51

what did the two-process model suggest?

Answer 51

a way to explain how phobias are learned and formed as well as maintained

Question 52

how are phobias formed/learnt?

Answer 52

through classical conditioning

Question 53

what is classical conditioning?

Answer 53

Classical conditioning involves learning to associate something of which we initially have no fear (NS) with something that already triggers a fear response (UCS).

Question 54

explain how phobias are formed through classical conditioning?

Answer 54

a person forms an association to the thing they fear (neutral stimulus) with something bad could be a bad thought (unconditioned stimulus). hence the thing they fear is now conditioned (conditioned stimulus) and produces a fear/panic response (conditioned response). a phobia has now developed.

Question 55

explain how phobias are maintained?

Answer 55

through operant conditioning

Question 56

explain how using operant conditioning phobias are maintained?

Answer 56

for example, when a person avoids their phobia, it reduces their feelings of anxiety and so negatively reinforces their behaviour, making the person more likely to avoid this fear to feel relief maintaining their fears

Question 57

KEY STUDY: WATSON AND RAYNER (1920s) study?

Answer 57

how a fear response could be learned through classical conditioning

Question 58

describe the method used by Watson and Rayner?

Answer 58

- 11 month old participant named 'little albert' - showed him various objects and found that there was no particular response but to a white rat. - so whenever the white rat came near 'little albert' they struck a metal bar with a hammer behind little alberts head (loud noise) which startled him. they did this 3 times

Question 59

results?

Answer 59

little alber began to cry when the white rat approached him

Question 60

conclusion?

Answer 60

showed that through classical conditioning phobias are made by inducing a fear response in an individual. this experiment also showed that little albert generalised his fear to other white furry objects

Question 61

evaluation (strengths) for the two-process model as an explanation for phobias

Answer 61

research evidence supports that a part of the two-process model for the behavioural explanations of phobias. Watson and Rayner illustrated how the process of classical conditioning can induce a phobia. he used a little boy named albert who was conditioned to fear white rats. this led him to generalise this fear to other white fluffy objects. this study is supportive of the idea that humans learn by classical conditioning and we can also generalise our fear to other phobic stimuli. therefore the two-way process explains why we fear and why we fear similar things another strength of the two-process model is its application to real life. because of behaviourist's ideas people have produced therapy treatments for phobias. such as systematic desensitisation and flooding. these methods have been proven to be effective in the treatment of phobias. for example systematic desensitisation helps people unlearn their fears and flooding ensures that people no longer avoid their fears and prevents negative reinforcemnt from taking place. therefore this supports the two-way process as it was useful in helping to treat and cure phobias

Question 62

Limitation of the two-way process as an explanation for phobias

Answer 62

however a limitation of the two-way process is that when it comes to explaining phobias it ignores the role of cognition. many people are irrational thinkers, so their phobias are a result of their cognitive thinking. however the two-way process does not take into consideration the irrational thoughts so can not successfully explain why these thoughts give rise to phobias. However using the cognitive approach, treatments such as CBT have become more successful than behavioural treatments

Question 63

behavioural approach to treating phobias

Question 64

what are the two types of treatments for phobias?

Answer 64

flooding and systematic desensitisation

Question 65

what is systematic desensitisation?

Answer 65

Gradually reduce phobic anxiety through classical conditioning. The person must learn to relax in front of phobia. this is called counter-conditioning

Question 66

what are the 3 critical components to systematic desensitisation?

Answer 66

- fear hierarchy - client and therapist rank phobic situations from least to most terrifying - relaxation training - individual is taught relaxation techniques - exposure/reciprocal inhibition - exposing the individual to their phobia. so relaxation takes over fear. the patient gradually moves up the hierarchy until they are completely relaxed then progress on to next level

Question 67

what is the reciprocal inhibition theory?

Answer 67

two emotional states can not exist at the same time. therefore a person is unable to be both anxious and relaxed at the same time and relaxation should overtake fear

Question 68

evaluation (strengths) of systematic desensitisation McGrath et al (1990) Gilroy et al (2002)

Answer 68

effective - shown by research evidence. McGrath et al (1990) found that 75% of patients with phobias were successfully treated using systematic desensitisation. this was especially true when the patient came into direct contact with the feared stimulus (in vivo) then simply imagining (in vitro) further support by Gilroy et al (2002) - who examined 42 patients with arachnophobia. each patient was treated using 3 45-minute sessions. when examined 3 months and 33 months later, the systematic desensitisation group were less fearful than a control group (who were taught only relaxation techniques). this provides further support that systematic desensitisation is effective and in the long run. systematic desensitisation is often favoured over flooding because of its ethical nature. patients report a preference over systematic desensitisation over flooding because of the high levels of anxiety faced that can occur when placed in a position with their feared stimulus. therefore more appropriate for those with learning disabilities or suffer from sever anxiety disorders as the relaxation techniques could be a positive and pleasant experience

Question 69

Evaluation (weaknesses) for systematic desensitisation

Answer 69

however systematic desensitisation is not effective in treating all phobias. patients with phobias which have not developed through personal experience are not treated effectively by systematic desensitisation. some psychologists believe that certain phobias have an evolutionary survival benefit and are not the result of learning. so a weakness is that its unable to treat evolutionary phobias which are innate

Question 70

what is flooding?

Answer 70

This involves exposing someone to their phobia but without a gradual build up (anxiety hierarchy). It is immediate exposure to a very frightening situation. Done in a safe and controlled manner Sessions are longer, but clients may only require one.

Question 71

explain how flooding works?

Answer 71

a person is unable to avoid (negatively reinforce) their phobia and through continuous exposure, anxiety levels eventually decrease. since the option of avoidant behaviour is removed, extinction will soon occur since fear time is a limited response to a situation which eventually subsides. as exhaustion sets in for an individual they may begin to feel a sense of calm and relief which creates a new positive association to the stimulus

Question 72

strengths of flooding? Ougrin (2011)

Answer 72

cost effective - research suggested that flooding is equally effective as other treatments such as systematic desensitisation. and cognitive therapies. Ougrin (2011) but takes much less time in acheiving these results. therefore a strength a patients cure their phobias more quickly and more cost effective for companies such as the NHS

Question 73

a weakness of flooding. Wolpe (1969)

Answer 73

a weakness of flooding is that it can be highly traumatic for patients since it purposefully elicits high levels of anxiety within the individual. Wolpe (1969) recalled a case with a patient becoming so anxious that she required hospitalisation. although it is not unethical as patients provide full consent many do not complete the full treatment as it is so stressful. therefore can be a waste of time and money if patients do not engage fully with the session.

Question 74

Cognitive approach to explaning depression

Question 75

what was Beck's cognitive theory?

Answer 75

Beck explained why some people are more vulnerable to depression than others. In particular it is a person's cognitions that create this vulnerability. Beck suggested three parts to this cognitive vulnerability: Faulty information processing Negative self-schema The negative triad

Question 76

what is the cognitive negative triad?

Answer 76

a negative and irrational view of ourselves, our future and the world around us. for sufferers of depression, these thoughts occur automatically and are symptomatic of depressed people

Question 77

what maintains the cognitive triad?

Answer 77

negative self-schemas

Question 78

what are negative self-schemas?

Answer 78

a schema is a 'package' of knowledge which stores information and ideas about our self and the world around us. these schemas were developed in childhood and depressed people form negative self -schemas from negative experiences such as from criticism from parents peers or even teachers.

Question 79

what is meant by the term Faulty information processing or Cognitive bias (process) ?

Answer 79

Depressed people attend to the negative aspects of a situation and ignore the positives. Many depressed people also have the tendency to overgeneralise and catastrophise the situation for example ''ive failed one of my exams so im going to fail all of my exams''

Question 80

what is the negative triad?

Answer 80

negative views about oneself the world and the future

Question 81

Strengths for the Beck's cognitive triad: 1- RESEARCH SUPPORT Clark and Beck (1999) AND Cohen et al (2019) 2- REAL WORLD APPLICATION - Cohen et al

Answer 81

supporting research - 'cognitive vulnerability refers to ways of thinking that may predispose a person to becoming depressed. in a review Clark and Beck (1999) found that not only were cognitive vulnerabilities more common in depressed individuals but they come before depression. this was also found out by a recent study Cohen et al (2019). they tracked the development of 473 adolescents, regularly measuring cognitive vulnerability. they found that cognitive vulnerability predicted later depression. this shows that a persons negative -slef schemas about onself can initiate depression in individuals so we can come up with treatments for those who develp this way becks cognitive triad also has real life applicatio in screening and treating depression. Cohen et al concluded that using assesing cognitive vulnerability allow 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 therapy works by altering the negative self schemas causing depression, making them more resilient to negative life events. this is useful as we can prevent depression occuring in more young adults who can go on to become more successful and acheive what they want and offering other individuals to do better

Question 82

explain how Ellis explained depression?

Answer 82

Ellis came wup with the ABC model to explain how irrational thoughts could lead to depression

Question 83

describe and explain the stages of the ABC model

Answer 83

A = Activating event - e.g you pass a friend in the hallway and say hello but they did not reply back B = Beliefs - this belief could either be irrational or rational interpretation rational - friend didn't hear you irrational - friend dislikes you C = consequences - irrational beliefs lead to unhealthy outcomes such as depression ' deletes friend and thinks llowley of themselves 'and rational beleifs lead to healthy outcomes

Question 84

(strengths of Ellis ABC model

Answer 84

- application to therapy. Ellis approach to cognitive therapy is called REBT rational emotional behavioural therapy. this idea of therapy is by disputing with a depressed individual and altering and disproving their irrational thoughts that are making them unhappy. useful as it helps people overcome depression

Question 85

limitation of Ellis ABC model?

Answer 85

only explain reactive depression and not endogenous depression. there seems to be no doubt that depression is caused by negative life events which is known as reactive depression and we respond to negative events also seems to be partly the result of our beliefs. however many cases of depression are not traceable to real life events and it is not obvious as to what has caused the individual to become depressed. this is called endogenous depression. so this suggests that Ellis ABC model can not be used to treat all types of depression and mainly focuses on reactive depression caused by an event in the patients life

Question 86

the cognitive approach to treating depression.

Question 87

what are the main components to CBT?

Answer 87

- Initial assessment – patient and therapist identify patients problem - Goal setting – both therapist and client agree on a set of goals and how to achieve them - Identifying negative/irrational thoughts and challenging them - Set homework – person is able to identify their own negative thoughts and challenge them

Question 88

how does Ellis rational emotive behaviour therapy (REBT) differ to CBT?

Answer 88

- Same first procedures as CBT but there is more of a focus of disputing, therefore She added D and E to ABC model to suggest a way of treating depression - focusing more on disputing and challenging these negative thoughts whereas Becks CBT focuses on discussing evidence for and against the irrational thoughts and identifying them through Becks cognitive triad

Question 89

what two main elements were added on to Ellis ABC model

Answer 89

D = Dispute to challenge irrational beliefs E = Effective new beliefs to replace irrational ones

Question 90

what are the 2 different types of dispute that can be used in REBT?

Answer 90

logical dispute - where the therapist questions the logic of the persons irrational thoughts empirical dispute - where the therapist seeks evidence for the irrational thoughts

Question 91

what is the main idea of the therapist setting homework?

Answer 91

- so the patient identifies their own irrational thoughts and proves them wrong. as a result their beliefs begin to change

Question 92

strengths of the cognitive approach to treating depression: 1- FOUND TO BE EFFECTIVE - MARCH ET AL (2007) 2- COST EFFECTIVE - BRIEF THERAPY

Answer 92

Effective – research evidence -> March et al (2007) – found CBT effective as antidepressants – researched 327 adolescents with depression and looked at effectiveness of CBT, antidepressants and both of them together. After 36 weeks 81% of the of the antidepressant group and the Cbt group improved by 81% and the group using both increased by 86% -> shows both effective but when combined may be more effective. Cost effective – a very brief therapy requiring only 6-12 sessions. Seen as first choice in NHS – helps people become better – go back to work – increase the economy

Question 93

weaknesses of the cognitive approach to treating depression

Answer 93

Requires Motivation – depression can be severe which makes people lack motivation -> find it difficult to attend sessions or unable to engage with sessions making the treatment ineffective. Those with disability will find it difficult -> Sturney (2005) suggests that psychotherapy is not suitable for people with learning disabilities due to the hard cognitive work it requires. -> not suitable for everyone HOWEVER Counter point : a review by Lewis and Lewis (2016) concluded that CBT was as effective as antidepressant drugs and behavioural therapies for severe depression. Taylor et al (2008) when used appropriately is effective for people with disabilities Benefits are not long lasting? – recent evidence – long term outcomes = not good. Ali et al (2017) assessed depression in 439 clients every month for twelve months following a course of CBT. -> 42% of the clients relapsed into depression within six months of ending treatment. 53% relapsed within a year. -> CBT does not have lasting effects on everyone, clients relapse so we could increase sessions of CBT or follow up every so often to ensure individuals do not relapse again

Question 94

Biological approach to explaining OCD

Question 95

what is meant by the biological approach?

Answer 95

The approach assumes all human behaviour has a biological origin.

Question 96

what is the genetic explanation for OCD

Answer 96

suggests that OCD is inherited and that individuals receive specific genes (candidate) from their parents and these genes determine whether or not they have OCD

Question 97

what are Candidate genes?

Answer 97

genes that make you more vulnerable to OCD

Question 98

OCD is believed to be a polygenic condition. what is meant by this?

Answer 98

several genes are involved and contribute to the disorder

Question 99

evidence for OCD as a polygenic condition?

Answer 99

Taylor (2003) suggests that as many as 230 genes may be involved in the condition and perhaps different genetic variations contribute to different types of OCD.

Question 100

what are two genes that have been said to be linked with OCD?

Answer 100

- COMT gene - SERT gene

Question 101

what does the COMT gene do?

Answer 101

The COMT gene regulates the neurotransmitter dopamine.

Question 102

one variation of the COMT gene does what..?

Answer 102

One variation of the COMT gene results in higher levels of dopamine and this variation is more common in patients with OCD compared to people without OCD.

Question 103

what is the SERT gene?

Answer 103

affects the transport of the neurotransmitter serotonin

Question 104

explain how transportation issues of serotonin can explain OCD?

Answer 104

Transportation issues cause lower levels of serotonin to be active within the brain and are associated with OCD.

Question 105

what study can back this claim?

Answer 105

Ozaki et al., (2003) published results from a study of two unrelated families who both had mutations of the SERT gene. It coincided with 6 out of 7 of the family members having OCD.

Question 106

Strength of the genetic explanation: 1- RESEARCH SUPPORT FROM FAMILY STUDIES - Nestadt et al (2000) 2- RESEARCH SUPPORT FROM TWIN STUDIES - BILLET ET AL 3-

Answer 106

family studies support. Lewis (1936) examined patients with OCD and found that 37% of patients with OCD had parents with the disorder and 21% had siblings who suffered. Nestadt et al (2000) takes this point further and suggest that thoswe with a first-degree relative are five times more likely to inherit OCD. twin study research - Billet et al - conducted a meta-analysis of 14 twin studies investigating the genetic inheritance rate of OCD. it waa concluded that MZ twins had double the risk of developing OCD compared to DZ twins if one of the pair had the disorder. Since concordance rates are never 100%, it suggests that the diathesis-model would be a better explanation whereby a genetic vulnerability is inherited and triggered by a stressor in the environment.

Question 107

Limitation of the genetic explanation for OCD: 1- DOES NOT TELL US EVERYTHING - Cromer et al (2007) - LINK TO DETERMINISM!

Answer 107

However a limitation of this is that it does not tell us everything about OCD. for example environmental factors can also trigger or increase the risk of developing OCD (diathesis-stress model) for example Cromer et al (2007) found that over half the OCD patients in their sample had a traumatic event in their past, and that the OCD was more sever in those who had more than one traumatic experience. This suggest that genetic vulnerability is only one part of an explanation into OCD

Question 108

what is meant by the neural explanation for OCD

Answer 108

Suggest that abnormal levels of neurotransmitters and certain regions of the brain are implicated In OCD.

Question 109

What is the role of serotonin?

Answer 109

Regulates mood so reduced levels of serotonin is associated with mood disorders including depression

Question 110

Where does evidence for the role of serotonin in OCD come from?

Answer 110

Research examining antidepressants. Pig got eat al (1990) found that drugs which increase the level of serotonin in the synaptic gap are effective in treating patients with OCD

Question 111

What causes low levels of serotonin?

Answer 111

Likely due to serotonin being removed too quickly from the synapse before it has been able to transmit it’s signal/ influence to the postsypnaptic cell

Question 112

What process happens a lot with people in OCD?

Answer 112

Uptake

Question 113

Explain the uptake process?

Answer 113

Pre-synaptic neurons release neurotransmitters and receptors on the postsypnaptic neuron detect these, if the signal is strong enough, then the message is passed on, the neurotransmitter detach from the receptors and are taken back to the presypnaptic neurone through a process called uptake.

Question 114

Because of studying the brain, what in the brain causes OCD

Answer 114

- several regions in the frontal lobes of the brain have abnormal brain circuits in patients with OCD

Question 115

What are the two brain regions specifically in OCD??

Answer 115

Basal ganglia - cluster of neurones at the base of the forebrain orbitofrontal cortex- converts sensory information into thoughts and actions

Question 116

What is the worry circuit?

Answer 116

A set of brain structures including the Orbitofrontal cortex, basal ganglia, caudate nucleus, and thalamus. Communication between these structures is often seen in people who have OCD

Question 117

Explain how the obsessive thoughts work using the worry circuit?

Answer 117

In normal functioning, The basal ganglia filter out minor worries coming from the OFC BUT if this area is hyperactive, even small worries get to the thalamus, which is then passed back to the OFC forming a loop (reoccurring obsessive thoughts)

Question 118

How do compulsions try to stop reoccurring obsessive thoughts?

Answer 118

Repetitive motor functions (compulsions) are an attempt to break the loop. While carrying out the compulsion may give temporary relief but the hyperactive basal ganglia will soon resume the worry circuit

Question 119

Strength of the Neural explanation: 1- Real World Application - led to the development of SSRI's

Question 120

Issues for the neural explanation for OCD

Answer 120

There is an issue with understanding neural mechanisms involved in OCD. Whilst there is evidence which suggest that certain neural systems do not function normally in patients suffering with from OCD, such as the basal ganglia and the OFC, research has also identified other areas of the brain that are occasionally involved as well. This means that there is no brain system which has been found to consistently play a role in OCD. So although, there is evidence to suggest that neurotransmitters and brain structures are implicated, it must not be concluded that there is a cause and effect relationship since it is difficult to ascertain whether the biological abnormalities seen are the case of OCD or the result of having the disorder.

Question 121

What is an alternative explanation for the neural explanation for OCD?

Answer 121

The two process model can be implemented to describe how learning plays a role in the disorder. So initial learning of the feared stimulus could occur through classical conditioning e.g dirt paired with anxiety. And the way this behaviour s maintained is through operant conditioning and negative reinforcement whereby the stimulus is avoided so anxiety is removed. This could result in an obsession forming which is linked to the development of a compulsions.g washing hands which serves to reduce the anxiety felt. Support for this Albutcher et al (1998) - success of behavioural treatments for OCD where symptoms of patients are improved for 60-90% of adults

Question 122

Treating OCD

Question 123

What is the aim of biological treatments?

Answer 123

To restore chemical imbalances in the brain

Question 124

What are the two types of drug therapy used to react OCD?

Answer 124

- antidepressant drugs (SSRI’S) - anti-anxiety drugs (BZ’s)

Question 125

Give a type of SSRI?

Answer 125

Prozac (selective serotonin reuptake inhibitors)

Question 126

Explain how SSRI’S work?

Answer 126

When serotonin is released from the pre-synaptic cell into the synapse, it travels to the receptor sites on the post-synaptic neuron. Serotonin which is not absorbed into the post synaptic is reabsorbed into the pres-synaptic neuron. SSRIs increase the level of serotonin in the synapse from preventing it from reabsorbed by the pre-synaptic cell.

Question 127

Give a type of anti-anxiety drugs?

Answer 127

Benzodiazepines (BZ’s), diazepam, Valium

Question 128

Explain how Anti-anxiety drugs work?

Answer 128

BZ’s work by enhancing the action of GABA. GABA tells the neurons in the brain to slow down and around 40% of the neurons in the brain respond to GABA. So overall BZ’s have a quietening influence on the brain so reduce anxiety. Which is a result of obsessive thoughts.

Question 129

Explain how GABA receptors help to reduce anxiety?

Answer 129

Some neurons have GABA receptors sites at the synapse and when GABA locks into one of these, the flow of the chloride ions into the neuron is increased. The chloride ions make it more difficult for the receiveving neuron to be stimulated by further neurotransmitters. Thus the nervous system is slowed down making the patient feel more relaxed.

Question 130

Strength of biological treatments for OCD

Answer 130

Drugs are effective. Research done by Soomro et al (2008) showed the effectiveness of SSRIs by comparing them with a drug with no pharmacological sentiment. He conducted a review of research examining the ffectiveness of SSRIs and found that they were significantly more effective than placebos in the treatment of OCD across 17 different trials. However these studies are criticised for only concluding short-term effects Another advantage to drugs to treat OCD is their cost effectiveness compared to psychological treatments like CBT. Many doctors actually prefer using drugs over psychological treatments as they are more cost-effective for treating OCD which is beneficial for health providers. In addition CBT needs patients to be motivated whereas drugs are non-disruptive to everyday life. So more successful for those who lack motivation.

Question 131

Limitation of biological treatments for OCD

Answer 131

One limitation of treating OCD is side effects. Although drugs like SSRIs are effective in treating OCD, some patients experience mild indigestion while other might experience more serious side effects like hallucinations, errection problems and raised blood pressure. BZ’s are renowned for being highly addictive and also cause increased aggression and long- term memory impairment. As a result BZ’s are recommended for short term treatment only of up to 4 weeks according to Ashton (1997). Consequently side effects diminish the effectiveness of drug treatments as patients will stop taking meds if they experience these neg effects Drug treatments are also criticised for treating the symptoms but not the disorder. Although SSRIs work by increasing the level of serotonin and reducing anxiety levels by minimising the symptoms of OCD, it does not treat the underlying cause of OCD. Furthermore when a patient stops taking the medication they are prone to relapse. Koran et al (2007) suggested that psychological treatments such as CBT are more effective long term solution as they provide a more lasting treatment and potential cure.

Question 132

DONE!!!