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Psychopathology Flashcards

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1
Q

What are the 4 definitions of abnormality?

A

Statistical infrequency
Deviation from social norms
Failure to function adequately
Deviation from ideal mental health

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2
Q

When is someone abnormal according to the statistical infrequency definition?

A

Someone has a less common characteristic or numerically unusual behaviour

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3
Q

What is an example of abnormality according to the statistical infrequency definition?

A

Average IQ is 100, so most people have between 85 and 115
Only 2% have a score below 70 and are abnormal and diagnosed with a learning disability

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4
Q

What is a strength and weakness of the statistical infrequency definition for abnormality?

A

Real-world application in clinical practice to diagnose
-diagnosis of intellectual disability disorder requires IQ below 70
Value of the criterion useful in diagnosis and assessment procedures

Infrequent characteristics can be positive instead of negative
-2% have an IQ above 130, but this isn’t seen as abnormal
-unusual ≠ abnormal
Not sufficient as sole basis for defining abnormality

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5
Q

When is someone abnormal according to the deviation from social norms definition?

A

Behave differently from expectations/what is acceptable
These social norms are specific to culture/generations

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6
Q

What is an example of abnormality according to the deviation from social norms definition?

A

Psychopaths are abnormal as they don’t conform to standards

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7
Q

What is an example of how abnormality has changed according to the deviation from social norms definition?

A

Homosexuality was abnormal in the past, and is still abnormal in some cultures

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8
Q

What is a strength and weakness of the deviation from social norms definition for abnormality?

A

Real-world application in clinical practice
-key characteristic of anti-social personality disorder is the failure to conform to culturally ethical behaviour
-being reckless + aggressive is deviation from social norms
Criterion has value in psychiatry

Variability between social norms in different cultures/situations
-hearing voices norm for some cultures, not for UK
-deceitfulness unacceptable in family life, not in corporate deal-making
-may get labelled with own standards
Hard to judge deviation across different cultures + situations

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9
Q

When is someone abnormal according to the failure to function adequately definition? Who listed the key signs that one isn’t functioning and when?

A

Failure to cope to the demands of everyday life
Rosenhan and Seligman (1989)

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10
Q

According to Rosenhan and Seligman (1989), what are the 3 key signs that one isn’t functioning?

A
  1. No longer conforms to interpersonal rules (eg: eye contact, personal space)
  2. Severe personal distress
  3. Irrational/dangerous behaviour to themself/others
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11
Q

What is an example of abnormality according to the failure to function adequately definition?

A

Depression- poor hygiene, work, relationships

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12
Q

What is a strength and weakness of the failure to function adequately definition for abnormality?

A

Represents a sensible threshold for when people need professional help
-Mind charity 25% experience a mental health problem
-when people start to fail to function adequately, they’re referred for help
Treatment + services targeted to those who need

Easy to label non-standard life-choices as abnormal
-no home (traveller)
-enjoy high-risk activities (just deviation from social norm)
Freedom of choice limited if labelled abnormal

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13
Q

When is someone abnormal according to the deviation from ideal mental health definition?

A

Ill mental health is the absence of mental health
When doesn’t meet Jahoda’s criteria (1958) for good mental health

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14
Q

What are the 8 things needed for good mental health in Jahoda’s criteria (1958)?

A
  1. No symptoms/distress
  2. Rational + perceive ourself accurately
  3. Self-actualise
  4. Cope with stress
  5. Realistic view of the world
  6. High self-esteem, lack of guilt
  7. Independent of other people
  8. Successfully work, love, enjoy leisure
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15
Q

What is an example of something that would be defined as abnormal using both the failure to function adequately definition and deviation from ideal mental health definition?

A

Can’t keep up job

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16
Q

What is a strength and weakness of the deviation from ideal mental health definition for abnormality?

A

Highly comprehensive
-range of criteria distinguishing mental health from mental disorder
-covers most reasons why people seek help
-different professionals can help depending on need (eg: psychiatrist for symptoms and humanistic counsellor for self-actualisation)
Definition provides checklist to assess and seek correct help

Unrealistic + demanding
-few satisfy all criteria all of the time so most would be considered mentally ill to a degree
Hard to know how many of criterium needed for disorder, can also be disheartening

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17
Q

What is a phobia?

A

An anxiety disorder with an irrational and excessive fear of an object, place or situation that interferes with an individual’s normal living

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18
Q

What is the DSM-5?

A

Diagnostic + statistical manual

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19
Q

What are the 3 types of phobias?

A

Specific phobia
Social anxiety/social phobia
Agoraphobia

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20
Q

What are the 2 emotional characteristics of phobias?

A

Unreasonable + disproportionate anxiety
Unreasonable + disproportionate fear

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21
Q

What is the difference between anxiety and fear?

A

Anxiety- unpleasant state of high arousal, hard to feel positive and may be long-term
Fear- Immediate, extremely unpleasant + intense response when one sees/thinks about phobic stimulus

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22
Q

What are the 3 behavioural characteristics of phobias?

A

Panic
Avoidance
Endurance

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23
Q

What are the 3 cognitive characteristics of phobias?

A

Selective attention
Irrational beliefs
Cognitive distortion

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24
Q

Who proposed the two-process model for explaining phobias?

A

Mowrer (1960)

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25
What is the two-process model?
An explanation for the onset (classical) and persistence (operant) of disorders that creat anxiety (phobias)
26
How are phobias acquired according to classical conditioning?
NS is associated with fear response (UCR) → little Albert white rat CR of fear triggered every time object/situation is seen (even in UCS absence) CR is generalised to similar objects/situation → fur coat, Santa's beard
27
How are phobias maintained according to operant conditioning?
Responses decline over time via classical conditioning, but phobias are long-lasting due to operant conditioning Avoidance of the phobic stimulus reduced unpleasant fear + anxiety Fear reduction negatively reinforces avoidance and phobia maintained
28
What are 2 strengths of the two-process model to explain phobias?
Real-world application in exposure therapies -model suggests maintenance through avoidance -avoidance prevented through exposure and phobia cured -eg: systematic desensitization High value in treating phobias Evidence for link between bad experience and phobia -little Albert frightening experience of stimulus → phobia of stimulus Confirms the association does lead to the development of a phobia
29
What are 2 weaknesses of the two-process model to explain phobias?
Doesn't account for cognitive aspects of phobias -model explains avoidance, not phobic cognitions eg: irrational beliefs Limited in explaining symptoms of phobias Not all traumatic experiences lead to phobia -Di Gallo only 20% in car accident formed car phobia -may be due to genetic vulnerability of developing mental health disorders Limited in explaining phobias
30
What are the 3 types of exposure?
In vivo (actual) In vitro (imagined) Virtual reality
31
What are the 2 types of behavioural therapies used to treat phobias?
Systematic desensitisation Flooding
32
What is systematic desensitisation?
Gradually reducing phobic anxiety by counter-conditioning (pair with relaxation), and if one is relaxed in the presence of the phobia stimulus, the phobia is cured
33
What are the 3 processes involved in systematic desensitisation?
1. Anxiety hierarchy put together by the client and therapist from least to most frightening phobic stimulus 2. Therapist teaches relaxation as can't be afraid/relaxed at the same time (reciprocal inhibition), so one emotion prevents the other eg: breathing, imagery, meditation, or drugs 3. Exposed to phobic stimulus in relaxed state over several sessions, start at bottom of hierarchy, move up when relaxed in lower levels, until relaxed on high level and phobia is extinct
34
What is flooding?
Immediate and extreme exposure for a longer time (2-3hr) over a small number of sessions to reduce anxiety that is triggered by the phobic stimulus
35
How does flooding work?
Person unable to avoid, learns that phobic stimulus is harmless and becomes exhausted by their own fear, so learnt response of fear is extinguished
36
What are important ethics surrounding flooding?
Informed consent needed Often given choice of systematic desensitisation or flooding
37
What are 2 strengths of using systematic desensitisation to treat phobias? (No weaknesses YAY)
Research supporting effectiveness -McGrath et al 75% successfully treated, particularly with in vivo -Wechsler et al effective for all 3 phobias Helpful in treating Appropriate to help those with learning disabilities (and phobias) -struggle with complex cognitive therapies -distressed/traumatised by flooding Most appropriate method to treat those with learning disabilities and phobias
38
What is a strength and a weakness of using flooding to treat phobias?
Highly cost-effective -clinically effective and not expensive -1 session not 10 to achieve same result More treated at the same cost with flooding over other therapies Unpleasant + traumatic -tremendous anxiety, although do give consent -high attrition (dropout) rates Therapists avoid as may be higher cost and result in larger fear from patient
39
What is depression?
A mood disorder characterised by low mood and/or lack of interest and pleasure in usual activities, affecting everyday living
40
According to the DSM5, what are the 4 categories of depression?
Major depressive disorder Persistent depressive disorder Disruptive mood regulation disorder Premenstrual dysphoric disorder
41
What are the 3 emotional characteristics of depression?
Lowered mood Anger Lowered self-esteem
42
What are the 3 behavioural characteristics of depression?
Activity level (lethargic or psychomotor agitation) Disruption to sleep + eating Aggression + self-harm
43
How can sleep and eating be disrupted when one has depression?
Insomnia/hypersomnia Appetite increased/decreased, leading to weight gain/loss
44
What are the 3 cognitive characteristics of depression?
Poor concentration Attending to and dwelling on the negative Absolutist thinking
45
How do depressed people attend to and dwell on the negative?
Focus on negative aspects of situations (pessimistic) Bias to recalling unhappy events
46
How do depressed people think in absolutist thinking?
SItuiations either all good or all bad So, any unfortunate situation is a disaster
47
How does the cognitive approach explain depression?
Focuses on how mediational (cognitive) processes affect behaviour Depression originates and is maintained as irrational thoughts result in irrational feelings
48
What are the 2 explanations to explaining depression?
Beck's negative triad Ellis's ABC model
49
How does Beck's negative triad explain depression?
One's cognitions (way one thinks) creates vulnerability to depression
50
What are the 3 parts to Beck's negative triad?
Faulty information processing Negative self-schema Negative triad
51
What is faulty information processing?
Overgeneralisations Catastrophising/magnification Negativity bias Absolutist thinking
52
What is negative self-schema?
People use schemas to interpret the world, so a negative self-schema interprets all info about the self negatively Schema activated automatically in new situations
53
What are 2 examples of negative self-schemas?
Ineptness schema (expect to fail) Self-blame schema (responsible for misfortune)
54
What is the negative triad?
One develops a dysfunctional view due to 3 types of automatic, negative thinking regardless of reality. They all interact with each other
55
How does Ellis's ABC model explain depression?
Poor mental health results from irrational thoughts that interfere with being happy and free from pain Model explains how the irrational thoughts affect behaviour and emotional state
56
What does A B C stand for in Ellis's model?
A- activating event B- beliefs C- consequences
57
What does the activating event do?
An external negative event triggers irrational belief
58
What are 3 examples of beliefs (irrational) that one with depression may feel (Ellis)?
Musterbation (must always succeed/be perfect) I-can't-stand-it-itis (major disaster when something isn't smooth) Utopianism (life is always meant to be fair)
59
What is the consequence, and where does it derive from according to Ellis?
Emotional/behavioural response (eg: depression) Consequence comes from irrational belief not activating event
60
What is one strength of the cognitive approach to explaining depression?
Provides practical application (treatment) -CBT (thoughts from negative triad identified and challenged) -REBT (identify and challenge irrational thoughts) If depression is alleviated by challenging thoughts, they must have a role in the first place for leading to depression, increasing validity of explanation
61
What are 2 weaknesses of the cognitive approach to explaining depression?
Unable to explain all aspects of depression -some experience hallucinations and delusions not explained by the triad -Ellis only explained reactive not endogenous depression (with no obvious cause) Cognitive explanation is limited and the validity is questioned as a sole explanation for depression Alternative explanation, depression is a biological condition caused by genes + neurotransmitters -low seretonin levels in depressed people related to gene 10x more common in dep people -SSRI (drug therapy) increases seretonin and is an effective treatment, supports role of NTs in development of dep Doubt as sole explanation, diathesis-stress model better
62
How does the cognitive approach to treating depression work?
Based on cognitive and behavioural techniques Cognitive -initial assessment, clarify problems, identify goals and plan -identify and challenge negative schema and irrational thoughts Behavioural -working to change negative schema and irrational thoughts by putting more effective behaviours in place
63
What are the 2 types of cognitive therapies to treat depression?
Beck's cognitive therapy Ellis's rational emotive behavioural therapy
64
What is Beck's cognitive therapy?
Identifying automatic thoughts in a negative triad via 'thought-catching' (as they're quick/auto), then they're challenged
65
How are automatic negative thoughts challenged in Beck's CBT?
Direct argument- therapist and client discuss evidence for/against irrational thoughts, therapist challenges client to think logically Reality testing- set homework to dispute themself, record positive events used to challenge irrational thoughts Client is a 'scientist' to test negative thoughts
66
How does Ellis's REBT work?
ABCDE (dispute, effect) Identify and dispute (challenege) irrational thoughts via vigorous argument, leads to rational thinking
67
What are the 3 types of disputing used in REBT?
Logical disputing- does the negative thought logically follow from fact? Empirical disputing- is there actual evidence to support negative belief? Pragmatic disputing- show irrational belief not useful/helpful
68
What is behavioural activation?
Decrease avoidance/isolation as it worsens symptoms Increase engagement in pleasurable activities as improves mood and helps to challenge irrational thoughts
69
What are 2 strengths of the cognitive approach to treating depression?
Research to support effectiveness, also cost-effective -March et al 81% significantly improved with CBT, same as with antidepressant, 86% for both -also decrease in suicidal ideation with CBT more than drugs Most effective combined, but CBT very effective in dealing with the root cause of depression (irrational thinking) than the symptoms Appropriate for patients who can't see face-to-face -CBT can + is done over the phone -Mohr et al found significant decrease in symptoms in phone CBT Appropriate for busy people --> mentally healthier population, economic importance
70
What are 2 weaknesses of the cognitive approach to treating depression?
Effectiveness as a LT treatment questioned -high relapse rate of 53% within a year To be effective long-term, must be repeated periodically Not appropriate for all cases (severe, learning disability) -requires attention + motivation -if lacking, antidepressants better Not sole treatment for all, only specific range of people, decreasing validity
71
What is obsessive compulsive disorder (OCD)?
An anxiety disorder characterised by obsessions and compulsions
72
What is an obsession?
Recurring intrusive thought Internal component of OCD
73
What is a compulsion?
A repetitive behaviour External component of OCD
74
According to the DSM5, what are the 4 types of OCD?
OCD Trichotillomania Hoardings disorder Excoriation disorder
75
What is the cycle of OCD?
Obsessive thought → Anxiety → Compulsive behaviour → Temporary relief (repeat)
76
What are the 3 emotional characteristics of OCD?
Anxiety and distress Accompanying depression Guilt and disgust
77
What are the 2 behavioural characteristics of OCD?
Compulsions are repetitive and reduce anxiety Avoidance
78
What % of people with OCD experience compulsions alone?
10%
79
What are the 3 cognitive characteristics of OCD?
Obsessive thoughts Cognitive coping strategies Insight into excessive anxiety
80
Obsessive thoughts are the main cognitive feature of OCD for what % of sufferers?
90%
81
How does a biological approach attempt to explain OCD?
Emphasised importance for physical processes
82
What are the 2 biological explanations to explain OCD?
Genetic explanation Neural explanation
83
How do genetics explain OCD?
Polygenetic, up to 230 specific candidate genes involved Aetiologically heterogenous- origins of OCD vary
84
What are 2 candidate genes for OCD?
COMT gene- associated with the production of COMT to regulate the neurotransmitter dopamine. a variation of this gene = higher levels, associated with obsessions and compulsions SERt gene- affects transport of seretonin. mutation results in increased transporter proteins at neuron's membrane increasing reuptake of serotonin, decreasing serotonin in synapse, explains depression and anxiety
85
What is a strength and weakness of a genetic explanation for OCD?
Strong research support - Nestadt et al 68% MZ had OCD, only 31% DZ had OCD Must be some genetic influence over OCD (although not 100%) ... Also environmental risk factors, not entirely genetic - Cromer et al >half ODC patients had traumatic event - OCD also more severe with trauma Genetic vulnerability is a partial explanation, diathesis-stress betetr
86
What are the 2 neural explanations for OCD?
Neurotransmitters Brain structure
87
What is the purpose of neurotransmitters?
Responsible for relaying info from one neuron to another in the brain
88
What happens if neurotransmitter levels are incorrect?
Normal transmission doesn't occur, resulting in dysfunction
89
What are 2 neurotransmitters with a role in OCD?
Serotonin- regulates mood Dopamine- attention, movement, motivation
90
How does brain structure explain OCD?
Cycle of thoughts and actions in OCD may be due to a fault in the worry circuit, a pathway in the brain
91
What are some brain structures that play a role in OCD?
Orbito-frontal cortex Basal ganglia containing caudate nucleus Thalamus
92
What does the orbito-frontal cortex do?
Converts sensory information into thoughts and actions Sends worry signal to thalamus via basal ganglia
93
What is the basal ganglia responsible for?
Motor coordination + movement If not important, worry signal dealt with and filtered out by caudate nucleus
94
What does the caudate nucleus do?
Regulates signal between OFC and thalamus
95
What is the thalamus?
A relay system sending sensory info to other parts of the brain to take action
96
What happens if the caudate nucleus is faulty?
Doesn't end the signal, eventually results in compulsion
97
What is an example of a faulty worry circuit, resulting in a compulsion?
Think hands are dirty Wash hands
98
What is a strength and weakness of the neural explanation for OCD?
Evidence to support role of neural factors - SSRIs that work only on serotonin system effective in reducing OCD symptoms - Somoro et al proved effectiveness, showing disorder has biological basis NTs are involved in OCD Research doesn't show causal relationship - correlation between faulty neural processing and symptoms - questions if OCD caused by abnormal brain function - may be third factor More research needed before it is a valid explanation
99
What is a general weakness for the biological explanation for OCD?
Alternate, non-biological explanation -behaviourist 2-process model - learn feared stimulus via classical conditioning eg dirt associated with anxiety) - maintained via avoidance/operant conditioning - research for success of behavioural treatment Casts doubt on biological factors being sole cause of OCD
100
What does drug therapy do?
Aims to modify levels/activity of NT in brain to reduce symptoms
101
What are 4 examples of drugs used to treat OCD?
Selective serotonin reuptake inhibitors Tricyclics Selective noradrenaline reuptake inhibitors Benzodiazepines
102
How does serotonin usually work?
1. Serotonin released by presynaptic neuron and travels across synapse 2. NT chemically conveys signal to postsynaptic neuron 3. Serotonin reabsorbed by presynapic neuron, broken down and reused
103
How do SSRIs work?
Prevents reabsorption + breakdown Increases serotonin in synapse Serotonin continues to stimulate post-synaptic neuron: increases mood, decreases anxiety, normalises worry circuit
104
When would you use an alternative to SSRIs?
If tried a higher dose of SSRIs and not effective after 3/4 months
105
What are tricyclics?
Older antidepressants with same effect as SSRI, but more severe side effects
106
What are SNRIs?
Second line of defence, increases serotonin and noradrenaline
107
What do anti-anxiety drugs (benzodiazepines) do?
Enhance NT GABA to slow brain activity, increase relaxation and decreases anxiety eg: valium
108
What are 2 strengths of the biological treatment for OCD?
Evidence for effectiveness - Somero et al reviewed 17 studies of SSRIs vs placebo - all in SSRi group had better outcome: 70% reduction in symptoms Helpful to improve quality of life for most Cost-effective + non-disruptive - manufacturing medication cheaper than psychological treatments - good value for public health systems eg: NHS - also less time going to therapy sessions Appropriate to treat wide range of people
109
What are 2 weaknesses of the biological treatment for OCD?
May not be most effective treatment available - systematic review showed cognitive + behavioural therapies more effective than SSRI - possibly as increasing serotonin doesn't treat underlying cause of OCD Drug therapy not optimal to treat Potentially serious side effects - indigestion, blurred vision, loss of sex drive- temporary + distressing - can also be LT: 1% tricyclics heart issues - people stop taking Symptoms return and low quality of life, so not effective treatment

A-level Psychology (11 decks)

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