Psychopathology Flashcards
(90 cards)
1
Q
What is psychopathology
A
- scientific study of mental disorders and abnormalities
- in order to diagnose someone with a mental disorder we must first decide in what way their behaviour differs
2
Q
What are the different abnormality definitions
A
- deviation from social norms
- failure to function adequately
- deviation from ideal mental health
- statistical infrequency
3
Q
What is the deviation from social norms definition
A
- any behaviour that does not follow accepted social patterns or social rules
- such violation of these patterns or rules can be regarded as abnormal behaviour and would be classed as unacceptable
- norms, values, and accepted ways to behave vary from one culture to the next and from one time period to the next
4
Q
What does deviation from social norms consider
A
- looks at impact of an individual’s behaviour upon others
- behaviour displayed is examined in terms of how unstable the behaviour is for the individual and for society as a whole
5
Q
What are social norms
A
- rules in society governing behaviour
- based on moral standards
- can be either explicit or implicit
- explicit => the law
- implicit => codes of conduct
6
Q
How can deviation from social norms be used
A
- help to identify a person who might be suffering from a mental disorder
- if a person is behaving in a strange way that deviates what is expected of them, then we could be concerned enough to think the person might be suffering from a mental disorder
7
Q
What are negative evaluation points for deviation from social norms
A
- odd/eccentric
- context
- temporal validity
- benefits
8
Q
How is odd/eccentric a negative evaluation point for deviation from social norms
A
- definition does not always clearly indicate that a person has a psychological abnormality
- therefore psychologists must be cautious when making judgements as individual may just be odd/eccentric
9
Q
How is context a negative evaluation for deviation from social norms
A
- context must be taken into account
- e.g. wearing no clothes in high street would be odd and deviating from social norms but at a nudist beach would be considered acceptable
10
Q
How is temporal validity a negative evaluation for deviation from social norms
A
- social norms of a society can change over time
- e.g. homosexuality was classed as a mental illness in the ICD until 1990 but is no longer considered an abnormality
11
Q
How is benefits a negative evaluation for deviation from social norms
A
- in some instances, it can be beneficial to break from social norms
- e.g. the suffragettes broke many social norms but this led to women gaining the right to vote
12
Q
What is the failure to function adequately definition
A
- model of abnormality based on the fact that the person is unable to cope with day to day life
- e.g. having a job or interacting with others well
- due to individual experiencing psychological distress and discomfort
- will impact their personal, social and occupational life
- 7 criteria
13
Q
What are the 7 criteria of the failure to function adequately definition
A
- suffering => feeling sad, anxious or scared
- unpredictability => unexpected behaviour characterised by loss of control
- maladaptiveness => behaviour stopping individual from attaining life goals => socially and occupationally
- observer discomfort => behaviour causing discomfort in others
- vividness and unconventionality => behaviour not conforming to what is generally done in a certain situation
- irrationality => illogical behaviours
- violation of moral standard => behaviours violating society’s ethical standards
14
Q
How is the criteria significant for failure to function adequately
A
- more criteria displayed, the more abnormal the individual is
- allows psychologists to see degree of abnormality
15
Q
What are positive evaluation points for the failure to function adequately definition of abnormality
A
- recognises patient’s perspective, e.g. personal distress
- using GAF scale, psychologist can see degree of abnormality
16
Q
What are negative evaluation points for the failure to function adequately definition of abnormality
A
- Harold Shipmen
- normality
- Stephen Gough
- measuring
17
Q
How is Harold Shipman a negative evaluation for the failure to function adequately definition of abnormality
A
- abnormality is not always accompanied by a failure to function
- psychopaths can commit murders while appearing normal
- Harold Shipman was a doctor who murdered 215 patients over 23 years
- maintained outward appearance of a respectable member of his profession, and had a family, the whole time he was committing murders
- no one was aware he was a serial killer
18
Q
How is normality a negative evaluation for the failure to function adequately definition of abnormality
A
- sometimes it is normal and psychologically healthy to suffer from person distress
- e.g. when a loved one dies
- it would be abnormal not to feel distress under these circumstances
19
Q
How is Stephen Gough a negative evaluation for the failure to function adequately definition of abnormality
A
- behaviour may cause distress to other people and be regarded as dysfunctional when person themself feels no distress
- Stephen Gough has been imprisoned for breaching the peace as he insists on hiking naked
- this makes others experience observer discomfort but he feels no distress
20
Q
How is measuring a negative evaluation for the failure to function adequately definition of abnormality
A
- can be difficult to measure and analyse criteria
- needs to be operationalised
- model is subjective and lacks being scientific and objective
21
Q
What is the deviation from ideal mental health definition
A
- stems from humanistic approach
- behaviour is abnormal if it fails to meet prescribed criteria for psychological normality
- devised by Jahoda (1958) under concept of ideal mental health
- identified six characteristics that individuals should exhibit to be considered normal
- absence of characteristics indicates abnormality
- more criteria not met, more abnormal individual is
22
Q
What is the criteria for deviation from ideal mental health
A
- autonomy => being independent, self reliant and able to make personal decisions
- perception of reality => perceiving world in non distorted fashion, having objective and realistic view
- resistance to stress => effective coping strategies and being able to manage everyday anxiety provoking and stressful situations
- integration => having self respect, high self esteem, confidence and positive self concept
- environmental mastery => competent in all aspects of life and ability to meet demands of situations and flexibility to adapt to life changing circumstances
- self actualisation => experience personal growth and development, reaching full potential and feeling fulfilled
23
Q
What are positive evaluation points for the deviation from ideal mental health definition of abnormality
A
- comprehensive, based on similar models for physical health
- positive, holistic, focuses on optimal criteria which all should aim for
- highlights areas individuals should work on
24
Q
What are negative evaluation points for the deviation from ideal mental health definition of abnormality
A
- demanding and unrealistic criteria => not many people reach self actualisation and most people do not meet all criteria at one given moment
- most criteria is vague and difficult to measure => subjective (self actualisation)
- cultural biased, collectivist cultures emphasise communal goals and regard autonomy as undesirable and these people would be seen as abnormal in individualistic cultures
25
What is the statistical infrequency definition to abnormality
- abnormal behaviour is that which is statistically rare
- instances of abnormality would lie at both extremes of a normal distribution
26
Using an example, explain how the statistical infrequency definition works
- looking at IQ scores
- average score is 100
- scores that are significantly higher than 100 (130) or significantly lower than 100 (70) are statistically infrequent
- 2.5% of the population has an above average IQ score and 2.5% has below average, showing infrequency
27
What are positive evaluation points for the statistical infrequency definition
- judgements are based on objective, scientific and unbiased data which helps indicate abnormality and normality
28
What are negative evaluation points for the statistical infrequency definition
- some behaviour can be statistically rare but also desirable such as someone who has above average IQ, they would be highly regarded instead of seen as someone who is abnormal
- some disorders are not statistically rare, such as depression which affects 27% of elderly people
- many rare behaviours or characteristics have no bearing on normality or abnormality, such as being left handed
- there is a subjective cut off point, why is someone who has an IQ of 71 normal but someone with 70 abnormal
29
What are behavioural characteristics of phobias
- avoidance => evade phobic object in presence
- endurance => person may remain in presence of phobic object, frozen and unable to move
- disruption of function => presence of phobic object may interfere with ability to function
- panic => person may panic in presence of phobic object, crying, running, screaming, etc.
30
What are emotional characteristics of phobias
- fear => persistent, excessive, unreasonable worry and distress may be felt in presence of phobic object
- anxiety => person feels terror and might be uncertain and apprehensive when encountering phobic object
31
What are cognitive characteristics of phobias
- irrational => person thinks in irrational manner and resist any rational arguments to counter
- insight => person will know fear is excessive or unreasonable but still find it difficult not to fear
- cognitive distortions => distorted perception of stimulus
- selective attention => becoming fixated on phobic object
32
What are behavioural explanations of phobias
- classical conditioning
- operant conditioning
33
What is classical conditioning
- learning through association
- stimulus produces same response as another stimulus as they have been constantly presented at the same time
- association built between stimuli
34
What is an example of a classical conditioning study
- Little Albert by Watson and Raynor (1920)
- presented Albert with rat, and he showed no fears
- started striking metal bars behind Albert’s head each time he reached for rat
- loud noise startled Albert, making him cry
- both stimuli paired multiple times building association
- started crying each time he saw rat
35
Explain how Little Albert was an example of classical conditioning
- infants are born with certain reflex; stimulus of loud sound is unconditioned stimulus producing reflex of fear as unconditioned response
- white rat is neutral stimulus producing no reflexes
- over time, the white rat became associated with the unconditioned stimulus of a loud noise
- white rat then became conditioned stimulus producing fear as conditioned response
- conditioned response of fear then generalised to other objects or situations; Albert became scared of any white or fluffy objects
36
What is operant conditioning
- learning through consequences of ones behaviour
- positive reinforcement => behaviour adds something pleasant
- negative reinforcement => behaviour removes something pleasant
- punishment => behaviour adds something unpleasant
- avoidance of phobic object reduces fear thus it being reinforced => negative reinfocement
37
What are positive evaluation points for behavioural explanations of phobias
- supported by King (1998)
- reviewed case studies and found children acquire phobias by encountering traumatic experiences with phobic object
38
What are negative evaluation points for behavioural explanations of phobias
- study on Little Albert was unreliable as they have not been repeated so cannot be generalised, study cannot be tested again due to ethical concerns
- some people have traumatic experiences but do not develop phobia, e.g. car crash but still drive. People also build phobias without having traumatic experience, e.g. snakes
- Menzies found only 2% of people with hydrophobia have had bad experience with water, 98% built phobia without classical conditioning so there must be other reasons
- environmentally deterministic/reductionist, does not take into account biological factors such as genetic vulnerability and ignore free will
39
What are behavioural treatments for phobias
- systematic desensitisation (SD)
- flooding
40
What is SD
- developed by Wolpe (1958) to reduce phobias using classical conditioning
- person experience fear and anxiety as behaviour response to phobic object
- SD replaces fear with relaxed response
- impossible to experience two opposite emotions at same time => reciprocal inhibition
- if patient can learn to stay calm they can be cured => counter conditioning
41
What are the different stages of SD
- anxiety hierarchy
- relaxation training
- gradual exposure
42
What is anxiety hierarchy in SD
- hierarchy of fear constructed by therapist and patient
- situations involving phobic object ranked from least to most fearful
43
What is relaxation training in SD
- patients taught deep muscle relaxation, such as progressives muscular relaxation (PMR) and relaxation response
- idea behind PMR is to contract muscles tightly, hold tension for a few seconds then consciously relax muscles even further
44
What is gradual exposure in SD
- patient introduced to phobic object and work way up anxiety hierarchy starting with least frightening
- use relaxation techniques while exposed to phobic object
- when comfortable, they move onto next stage
- eventually, through repeated exposure and relaxation, phobia is eliminated
45
What are positive evaluation points for SD
- Jones (1924) => eradicated Little Peter’s phobia of white rabbit by presenting it closer each time his anxiety reduced
- Klosko et al. (1990) => assessed various therapies for treatment of panic disorders and found 87% were panic free after SD, 50% after medication, 36% on placebo and 33% with no treatment
- less traumatic therapy than compared to flooding, no ethical issues
46
What are negative evaluation points for SD
- behaviour treatments address symptoms of phobias
- some believe that is only tip of iceberg and there are underlying causes
- means symptoms return or symptom substitution occurs when abnormal behaviours replace ones removed
47
What is flooding
- direct exposure to phobic object
- patient taught relaxation techniques but there is no gradual build up
- can be for real or virtual
- stops phobic responses quick as patient has no option for avoidance therefore sees object as harmless and extinction occurs
- patient may achieve relaxation through exhausting themselves out
- ethical even though there is psychological harm as there is informed consent
48
What are cognitive characteristics of depression
- negative schema => negative view of world, themselves and future => self fulfilling prophecy
- poor concentration => difficulty paying/maintaining attention
49
What are emotional characteristics of depression
- low mood => ever present and overwhelming feeling of sadness/hopelessness and feeling empty
- worthlessness => constant feelings of reduced worth, low levels of self esteem
- anger => anger towards others or themselves
50
What are positive evaluation points for flooding
- Wolpe (1960) supports flooding to remove patient’s phobias of cases. Girl forced into car and driven around for 4 hours until hysteria was eradicated
- Ost (1997) states flooding is effective at producing immediate improvements
- cost effective compared to cognitive behaviour therapies
51
What are negative evaluation points for flooding
- highly traumatic experience and many patients may stop therapy => time and money wasted
- less effective for some phobias as they may be more cognitive, social phobias better cured by cognitive therapies
52
What are behavioural characteristics of depression
- changes in activity levels => lethargy and withdrawal from activities previously enjoyable (anhedonia) / high levels of nervous energy, can neglect personal hygiene
- disruption to sleep => insomnia (lack of sleep) or hypersomnia (excess sleep)
- disruption to eating => increased/decreased weight
- aggression => irritable causing aggression to others/self harm
53
What are cognitive explanations of depression
- underlying assumption of cognitive explanation is depression is result of disturbance in thinking
- consequence of faulty and negative thinking about events
- negative triad
- ABC model
54
What is the negative triad
- Beck (1967) believed depressed people acquired negative schema during childhood so have tendency to adopt world in pessimistic view
- schema is cognitive framework helping us organise and interpret information and make sense of new information
- can be caused by parental/peer rejection and criticism from teachers
55
What are negative schemas
- activated when a person encounters a new situation, resembling original conditions in which schema was learned
- lead to cognitive biases in thinking
56
How do negative schemas works
- negative schemas and cognitive biases maintain negative triad
- irrational view of three elements in the persons belief system
57
What are the elements in the negative triad
- the self => there is nothing to like about me, I am boring
- the world => nobody likes me, everyone would prefer someone else’s company
- the future => I am always going to be on my own, nobody will ever love me
58
What are positive evaluation points for the negative triad
- Terry (2000)
- assessed 65 pregnant women for cognitive vulnerability before and after birth
- found women who had high cognitive vulnerability most likely to suffer post partum depression, supporting negative triad
59
What are negative evaluation points for the negative triad
- cause and effect not clear => does depression cause irrational thinking or the other way
- does not explain how some symptoms of depression might develop => many patients are angry and Beck’s theory fails to account for this
60
What is the ABC model
- Ellis (1962) proposed depression caused by irrational beliefs
- devised model to explain how irrational and negative beliefs are formed
61
What are the stages of the ABC model
- Activating Event => incident in someone’s life
- Beliefs => thought after event, could be rational or irrational
- Consequences => emotions caused by beliefs. Rational beliefs lead to healthy emotions whereas irrational beliefs lead to unhealthy emotions
62
What are positive evaluation points for the ABC model
- Bates (1999) found depressed patients who were given negative thought statements become more depressed supporting view that negative thinking leads to depression
63
What are negative evaluation points for the ABC model
- blames patient for depression
- unclear whether depression causes negative thinking or negative thinking causes depression
- Zhang (2005) found there is a gene related to depression making it 10x more likely, thus environmentally deterministic
64
What are cognitive treatments for depression
- aim of cognitive behaviour therapy is to change irrational thoughts and alleviate depression
- Beck’s Cognitive Behavioural Therapy (CBT)
- Rational Emotive Therapy (REBT)
65
What is Beck’s CBT
- identify irrational thoughts => thought catching
- patient then berates hypothesis to test validity of irrational thoughts => patient as scientist
- several strategies used to test hypothesis => patient may gather data and compare evidence, may do homework, may keep diary to record negative thinking situations to target
- when patients report positive thoughts, they are praised by therapist => positive reinforcement
66
What is the aim of Beck’s CBT
- cognitive restructuring
- learning to identify, dispute, and therefore change
67
What is REBT
- Ellis (1994) developed CBT for depression
- therapist uses logical arguments to show patients’ self defeating beliefs are not logical
- also uses empirical arguments to show self defeating beliefs are not consistent with reality
- patients encouraged to engage in behavioural activation => becoming more active and taking part in pleasurable activities, many depressed patients do not engage in activities they use to enjoy
68
What is the aim of REBT
- challenging automatic negative thoughts and replacing them with rational beliefs
69
What are positive evaluation points for CBT
- March et al. (2007) => examined 327 adolescents and compared effectiveness of CBT. 81% of of anti-depressant group and 81% of CBT group significantly improved by 86% of combination group improved, showing combination is most effective
- David (2008) => found CBT better than anti-depressants. Compared 170 patients with 14 weeks of CBT to patients with drug fluoxetine. 6 months later, found CBT patients less likely to relapse
70
What are negative evaluation points for CBT
- requires commitment and motivation, depression patients may not engage/join so CBT will be ineffective. Anti-depressants do not require same level of motivation so are more effective
- suggests irrational thinking is primary cause for depression and ignores other factors, e.g. domestic violence or abuse victims who need to change circumstances and not thinking
- relies on self reporting as thoughts cannot be objectively observed/measured => unreliable
71
What are behavioural characteristics of OCD
- compulsions => repetitive actions that could hinder person’s ability to perform everyday function, compulsive behaviour reduces anxiety created by obsessions, person feels like they must perform action or something bad will happen
- avoidance => sufferers attempt to reduce anxiety by avoiding situations triggering OCD
72
What are emotional characteristics of OCD
- high anxiety => obsessions and compulsions are a source of anxiety, sufferers aware obsessions and compulsive behaviours are excessive causing embarrassment, also aware they cannot consciously control behaviour leading to distress
- disgust => feelings of disgust may be directed against something external
73
What are cognitive characteristics of OCD
- obsessions => recurrent, instructive, irrational thoughts perceived as inappropriate. May be frightening/embarrassing and person may not share them. Uncontrollable and cause anxiety
- awareness => sufferers understand compulsive behaviours and obsessive thoughts are irrational but cannot control/stop them
- catastrophic thinking => scared something terrible will happen if compulsion not carried out
74
What does the biological approach thinking about OCD
- assumes OCD is caused by genetic and biochemical factors
75
How does the SERT gene affect OCD
- affects transportation of serotonin, causing low levels
- low levels of serotonin linked to OCD (and depression)
76
What is the genetic explanation behind OCD
- classed as polygenic => many genes responsible for disorder (230) => candidate genes
77
What are the two main genes that have a role in OCD
- COMT gene
- SERT gene
78
How does the COMT gene affect OCD
- gene regulates production of dopamine
- high levels of dopamine associated with OCD
- one variation of COMT gene results in higher levels of dopamine
- this variation found more common in OCD patients
79
What are positive evaluation points for the genetic explanation to OCD
- Nestadt (2000) => found people who had first degree relatives with OCD were 5x more likely to get disorder
- Billett (1998) -> found from meta analysis of 14 twin studies that OCD twice as concordant in MZ twins than DZ twins
80
What are negative evaluation points for the genetic explanation to OCD
- concordance rate for OCD in MZ twins is not 100% so OCD cannot be caused entirely by genetic factors
81
What is the neural explanation for OCD
- dopamine and serotonin are NTs affecting mood
- abnormal levels of these are associated with abnormal transmissions of mood related information
- OCD suffers have high levels of dopamine => linked to hyperactivity in basal ganglia in brain causing repetitive motor functions => compulsions
- serotonin plays role in operating caudate nucleus’s in basal ganglia of brain => low levels cause caudate nucleus to fall function => obsessions
82
What are positive evaluation points for neural explanations of OCD
- anti depressant drugs increase serotonin levels in OCD leading to reduction in symptoms
83
What are negative evaluation points for neural explanations of OCD
- NTs may not necessarily cause OCD, instead low levels of serotonin and high levels of dopamine might be a symptom of OCD
- no cause and effect, just relationship
84
What are biological treatments for OCD
- biological approach uses medication to increase/decrease levels of NTs or activity of them
- selective serotonin re-uptake inhibitors (SSRIs)
- benzodiazepines (BZ)
85
How do SSRIs work
- work on serotonin system in brain
- serotonin released by presynaptic neurons and travels across synaptic cleft
- chemically conveys signal from presynaptic neuron to postsynaptic neuron then reabsorbed (re-uptake) by presynaptic neuron, where it is broken down and reused
- SSRIs prevent re absorption and breakdown of serotonin, increasing serotonin levels in synapse, where it continues to stimulate postsynaptic neuron => reduces anxiety
86
What are positive evaluation points for SSRIs
- Soomro (2009) => reviewed 17 studies comparing SSRIs to placebo for treating OCD, found all 17 studies showed SSRIs more effective than placebo , especially when combined with CBT
- 70% of patients experienced decline in OCD symptoms when taking SSRIs, other 30% opt for psychological therapies or combination
87
What are negative evaluation points for SSRIs
- side effects => might mean OCD patient stops taking medication => temporary side effects
88
How does BZ work in treating OCD
- anti anxiety drug
- slows down activity of CNS by encasing activity of GABA => has inhibitory effect on neurons
- GABA reacts with GABA receptors on outside of neurons
- when GABA locks into receptors, it opens channel increase flow of chloride ions to neuron
- chloride ions make it harder for neuron to be stimulated by other NTs => slows down neural activity => more relaxed
89
What are positive evaluation points for BZ
- can begin to reduce anxiety levels and OCD symptoms in short period of time, especially compared to CBT, so patient experiences immediate relief
90
What are negative evaluation points for BZ
- if BZ used long-term, several side effects appear, Ashton (1997) found long term users of BZ become dependent on drug and withdrawal leads to high levels of anxiety and OCD symptoms
- issue of tolerance, patients need larger doses in order to reduce symptoms as body becomes used to drug
