Psychopathology Flashcards
(320 cards)
1
Q
What’s psychopathology
A
Scientific study of mental disorders and abnormality
2
Q
Definitions of abnormality
How many is there
A
Four
3
Q
Definitions of abnormality
What is the statistical definition of abnormality
A
Defining abnormal according to the number of time we observe is and any behaviour which is rare or uncommon is abnormal
4
Q
Definitions of abnormality
What does the statistical definition use
A
The normal distribution curve
5
Q
Definitions of abnormality
Example with the statistical definition
A
IQ and intellectual disability disorder
Average IQ 100
Most have between 85-115
People below 70 and above 130 are abnormal
Those below would b diagnosed with the intellectual disability disorder
6
Q
Definitions of abnormality
2 strengths of the statistical definition
A
Real life application of diagnosis
Definite cut off point
7
Q
Definitions of abnormality
How is the statistical definition used in diagnosis of intellectual disability disorder
A
It’s a useful part of the clinical assessment as the severity of symptoms of those with mental disorders are compared to statistical norms
8
Q
Definitions of abnormality
Why is the statistical definition used in diagnosis a strength
A
Gives a definitive cut off point which is objective therefore taking way the subjectivity of other definitions
9
Q
Definitions of abnormality
How is there no value judgment in the statistical definitions
A
There is a clear cut off point so behaviour is not seen as unacceptable merely less frequent such as homosexuality
10
Q
Definitions of abnormality
Why is ther absence of value judgement a strength for the statistic all definition
A
Statistical evidence that a person has a mental disorder can justify requests for psychiatric assistance
11
Q
Definitions of abnormality
2 weaknesses of the statistical definitions
A
Unusual characteristics can be positive
Ignores cultural factors
12
Q
Definitions of abnormality
Exceptions of unusual characteristics being positive using the statistical definition
A
Requires no treatment such as a high IQ pr exceptional sport skill
Abnormal yes dos to be sued in an negative sense
13
Q
Definitions of abnormality
What can the statistical definition never be used for
A
Can never be used alone to make a diagnosis
14
Q
Definitions of abnormality
What’s the social Norma’s definition of abnormality
A
States that behaviour which conforms to social norms is normals and behaviour that doesn’t is abnormal
15
Q
Definitions of abnormality
What are social norms
A
Standards set by a society according to which is expects its members to behave
Are unwritten rules
16
Q
Definitions of abnormality
What could happen if someone behaves ina. Way that doesn’t conforms to our social norms
A
May feel anxious or threatened by them and will be considered abnormal as long as society accepts it
17
Q
Definitions of abnormality
What is antisocial personality disorder
A
Psychopath
According to DSM-5 people with is are impulsive aggressive and irresponsible
18
Q
Definitions of abnormality
Characteristics of antisocial personality disorder
A
Absence of prosocial internal standards
Failure to conform to lawful or culturally normative ethical behaviour
Social judgement that psychopath is abnormal as they don’t conform to our moral standards
19
Q
Definitions of abnormality
strength of the social norms definition
A
Real life application in diagnosing antisocial personality disorder
20
Q
Definitions of abnormality
Why is diagnosing a strength of this definition
A
Clear set off of the characteristics of APD
21
Q
Definitions of abnormality
Weakness of the social Norms definition
A
Subjective
22
Q
Definitions of abnormality
Why is the social norms definition being subjective
A
a weakness social norms are based on the opinions of those in society and can be used to control others
23
Q
Definitions of abnormality
What is the failure to functions definition
A
Can no longer cope with the demand of everyday life is considered abnormal and often not able to experience the usual range of emotions
Focuses on personal experiences lined with mental disorders
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Q
Definitions of abnormality
Examples of failure to functions
A
Unable to maintain basic standards of nutrition and hygiene or unable to hold down a job
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Definitions of abnormality
When is someone failing to function adequately list
Personal distress
Maladaptive behaviour
Unpredictability
Irrationality
Observer discomfort
Violations of morals standard
Unconventionality
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Definitions of abnormality
What’s the GAF scale
Assesses how well individuals cope with everyday life used by clinicians
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Definitions of abnormality
What does the GAF a scale rate
Level of social occupational and psychological functioning
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Definitions of abnormality
what is a strength of the failur to functions definitions
Degree of abnormality
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Definitions of abnormality
Example for the degree of abnormality for the failure to function definition
GAF is an continuous scale
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Definitions of abnormality
Why is assessing the degree of abnormality a strength of the failure or functioning definition
Can decide whop needs psychiatric help to what degree
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Definitions of abnormality
What is a weakness of the failur to function definition
Abnormality is not always followed by failure to function
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Definitions of abnormality
example for abnormality not always accompanied by failure to function
Harold shipman. Who had a good jib and well paid murdered 215 patients
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Definitions of abnormality
What is the deviation from ideal mental health definition
Absence of jahodas characteristics of ideal mental health
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Definitions of abnormality
What’s re jahodas characteristics for ideal mental health
-positive attitude towards oneself
-self actualisation
-autonomy
-resisting stress
-accurate perception of reality
-environmental mastery
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Definitions of abnormality
What does having a positive attitude towards oneself on jahodas characteristics of ideal mental health mean
Having self respect and a positive self concept
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Definitions of abnormality
What does having self actualisation on jahodas characteristics of ideal mental health mean
Becoming everything one is capable of becoming
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Definitions of abnormality
What does having a autonomy on jahodas characteristics of ideal mental health mean
Being independent self reliant and able to make personal decisions
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Definitions of abnormality
What does having resisting stress on jahodas characteristics of ideal mental health mean
Having effective coping strategies being able to cope with everyday anxiety provoking situations
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Definitions of abnormality
What does having a accurate ;perception of reality on jahodas characteristics of ideal mental health mean
Perceiving the world in a nondistorted fashion having objective ans realistic view of the world
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Definitions of abnormality
What does having a environmental mastery on jahodas characteristics of ideal mental health mean
Being competent in all aspects of life and meeting the demands of every situation being flexible to changing life circumstances
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Definitions of abnormality
What does this definition focus on
Behaviours and characteristics seen as desirable and the more which aren’t the met the more abnormal
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Definitions of abnormality
What is a strength of the ideal mental health definition
Very comprehensive
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Definitions of abnormality
Why is the ideal mental hamlets definition very comprehensive
Covers a broad range of criteria’s for mental health
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Definitions of abnormality
Why is being comprehensive a strength of the ideal mental health definition
Is a useful tool
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Definitions of abnormality
What is a weakness of the ideal mental health definition
Cultural relativism
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Definitions of abnormality
How does the ideal mental health definition have cultural relativism
Some of the ideas in jehodas classification are specific to Western European and North American cultures
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Definitions of abnormality
why is cultural relativism a weakness
Doesn’t include other cultures in definition
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Phobias
What is a phobia
Type of anxiety disorder which can interfere with daily living
49
Phobias
What are phobias characterised by
Excessive uncontrollable extreme fear and anxiety triggered by and object place or situation
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Phobias
What does a phobia produce
A conscious avoidance of the fears object or situation and the fear is out of proportion to nay real danger or risk presented by the phobic stimulus
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Phobias
According to DSM 5 what are the categories of phobia an related anxiety disorder
Specific phobia (phobia of object or situation)
Social anxiety (phobia of social)
Agoraphobia (fear pr being outside )
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characteristics of phobias
What are the three
Emotional
Behavioural;
Cognitive
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characteristics of phobias
What are the emotional characteristics
Anxiety disorders by definition they involve and emotional response of anxiety and fear
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characteristics of phobias
What is anxiety classed by
An unpleasant star of high arousal with feelings of worry or distress in te prescience of the phobic stimulus which prevent a relaxed feel and makes it difficult to experience a positive emotion
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characteristics of phobias
What makes anxiety difference from fear
Can be long term
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characteristics of phobias
What is fear in emotional characteristics
Immediate and extremely unpleasant string response which is experienced when in contact with the phobic stimulus
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characteristics of phobias
What important about emotional characteristics of a phobia
Emotional responses are unreasonable
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characteristics of phobias
What are the behavioural chatracterostics
How we behave when in contact with phobic stimulus
Panic and trying to escape
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characteristics of phobias
What does panic situate as as a part of behavioural characteristics
Crying screaming running away fainting collapsing or vomiting
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characteristics of phobias
How can children react for behavioural characteristics
Freezing clinging to a parent or having a tantrum
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characteristics of phobias]
Two key behavioural characteristics
Avoidance
Endurance
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characteristics of phobias
Avoidance as a behavioural characteristic
Avoiding coming in contact with phobic stimulus so may not be able to go to places and makes is hard to go about daily life
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characteristics of phobias
What can the behavioural characteristic of avoidance affect
Work, education or social life
General day to day life
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characteristics of phobias
Endurance as a behavioural characteristic
Alternative to avoidance as individual remains in prescience of phobic stimulus but continuous to experience its levels of anxiety often frozen still as may be unavoidable
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characteristics of phobias
What’s are cognitive characteristic
Ways in which people process information and think about it
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characteristics of phobias
What are the three cognitive characteristics
Selective attention to phobic stimulus
Irrational beliefs
Cognitive distortions
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characteristics of phobias
Selective attention as a cognitive charteristic
If individual can see phobic stimulus hard to look away from it and all attention is on it
Not useful
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characteristics of phobias
Irrational beliefs as cognitive characteristics
Irrational beliefs in relation to the phobic stimulus
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characteristics of phobias
Cognitive distortions as cognitive characteristics
Phobic perceptions of the phobic stimulus may be disptorted
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Behavioural approach to explain phobias
How can classical conditioning explain phobias
When someone has a phobia they will make an association between an object or situation and fear
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Behavioural approach to explain phobias
How can operant conditioning link to phobias
Negative reinforcement so individual avoids situation that’s unpleasant and result in a desirable consequence of not feeling fear and anxiety
Reduction in fear reinforces the avoidance behaviour
Avoidance behaviour repeated and phobia maintained
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Behavioural approach to explain phobias
Who is the two process model by and what year
Mowrer (1960)
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Behavioural approach to explain phobias
What is the two process model
Based on the behavioural approach to phobias and states phobias are acquired by classical conditioning and then continue because of operant conditioning
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Behavioural approach to explain phobias
Acquisition by classical conditioning according to the two process model using rat and loud noise
Before
Rats (NS) —> no response
Loud noise (UCS) —> fear (UCR)
During
Rats (NS) + loud noise (UCS) —> fear (UCR)
After
Rats (CS) —> Fear (CR)
Then generalised to similar objects
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Behavioural approach to explain phobias
Maintenance by operant conditioning according to the two process model
Negative reinforcement – Individual avoids the phobic stimulus to avoid the fear anxiety they would have suffered
Positive reinforcement – reduction of fear is a desirable consequence
The avoidance behaviour is more likely to be repeated in the future as it has been reinforced
The phobia is therefore maintained
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Behavioural approach to explain phobias
Two strengths of this
Good explanatory power
Effectiveness of behaviourist treatment
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Behavioural approach to explain phobias
Good explanatory ppower\why was a this a step forward
Went beyond just using classical conditioning alone and explained how phobias could be maintained over time
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Behavioural approach to explain phobias
Good explanatory power
What was the implications of this
For therapies explains why patients need to be exposed to the feared stimulus
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Behavioural approach to explain phobias
Good explanatory power
Why is this a strength
Application to therapy means once a patient is prevented from practicing avoidance characteristics the behaviours ceases to be reinforced and declines
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Behavioural approach to explain phobias
Effectiveness of behaviourist treatment
Example
Treatment such as systematic desensitisation in assessing phobic symptoms are effective
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Behavioural approach to explain phobias
Effectiveness of behaviourist treatment
Why is this a strength
Lends support to behaviourist explanations of phobias
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Behavioural approach to explain phobias
2 weaknesses
Alternative explanation for avoidance behaviour
Incomplete expanlantion of phobias
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Behavioural approach to explain phobias
Alternative explanantion for avoidance behaviour
Exception
Not all avoidance seems to be because of anxiety reduction
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Behavioural approach to explain phobias
Alternative explanantion for avoidance behaviour
Example of agoraphobia
Evidence shows that at least some of the avoidance behaviour is for safety reasons rather than avoiding the phobic stimulus which explains why some agoraphobics can leave the house with a trusted person with little anxiety
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Behavioural approach to explain phobias
Alternative explanantion for avoidance behaviour
Why is this a weakness
This is a problem for the two process mode, as it suggests avoidance is motivated by anxiety reduction
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Behavioural approach to explain phobias
Incomplete explanation of phobias
Why is it not enough
Even if except these involved futher explanation is needed such as evolutionary factors
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Behavioural approach to explain phobias
Incomplete explanation of phobias
How are evolutionary factors involved
We easily acquire phobias of things that’s have been a source of danger in our past such as snakes and it is adaptive to acquire such fears
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Behavioural approach to explain phobias
Incomplete explanation of phobias
Why is this a weakness
The two process model fails to account for this and neglect evolution history
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Behavioural approach to treating phobias
What therapies do need to describe and evaluate
Systematic desensitisation
Flooding
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Behavioural approach to treating phobias
What is systematic desensitisation
Designed to reduce an unwanted response eg anxiety to a stimulus and teaching the sufferer to relax in the prescience of the phobic stimulus
Essentially new response to the phobic stimulus is learned
Phobic stimulus is paired with relaxation “counter conditioning “
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Behavioural approach to treating phobias
What is flooding
Phobic patient i exposed to an extreme form of phobic stimulus to rescue anxiety triggered by it
Without option of avoidance quickly learned stimulus is harmless
‘Extinction’ learned response extinguished when CS is encountered without UCS
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Behavioural approach to treating phobias
What are the three steps of systematic desensitisation
1. The anaixety hierarchy
2. Relaxation training
3. Exposure to anxiety hierarchy
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Behavioural approach to treating phobias
What is the anxiety hierarchy and how is it constructed
List of situations put tog ether by patients and therapists related to phobic stimulus that provoke anxiety arranged in order from least such as thinking about phobic stimulus to most frightening such as holding the stimulus
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Behavioural approach to treating phobias
What is relaxation training
Therapist teacher the patient to relax as deeply as possible
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Behavioural approach to treating phobias
What can be taught in relaxation training
Breathing exercises or mental imagery techniques
Imagine in relaxing situations
Meditation
Alternatively drugs such as valium
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Behavioural approach to treating phobias
What is exposure to the anxiety hierarchy
Patient exposed to hierarchy while remaining in a relaxed state over several sessions starting at the bottom and when patient is relaxed in the presence move up the hierarchy
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Behavioural approach to treating phobias
How long can systematic desensitisation take
Up to a month
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Behavioural approach to treating phobias
What is the result if the treatment is successful of systematic desensitisation
Patient can stay relaxed in situation high on the anxiety hierarchy
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Behavioural approach to treating phobias
2 strengths of systematic desensitisation
Suitable for a wide range of patients
Less traumatic
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Behavioural approach to treating phobias
Why are some treatments not suitable for patients
Eg flooding and CBT aren’t suited to some patients
Some people with learning difficulties wont be able to understand what’s happening our engage with the CBT that require you to reflect what ur thinking
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Behavioural approach to treating phobias
Why is being suitable for a wide range of patients a strength
More access of treatment for patients so quality of life improved
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Behavioural approach to treating phobias
What is systematic desensitisation less traumatic then
Flooding
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Behavioural approach to treating phobias
What is pleasant about systematic desensitisation
Includes elements that are pleasant such as learning relaxation techniques
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Behavioural approach to treating phobias
How is systematic desensitisation shown to be less traumatic
Reflected by low refusal rates for starting treatment and low attrition rates
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Behavioural approach to treating phobias
2 weaknesses of systematic desensitisation
Symptom substitution
Ethical considerations
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Behavioural approach to treating phobias
What is symptom substitution
When one phobia disappear another may appear in its place
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Behavioural approach to treating phobias ]
What is the evidence for symptom substitution
Very missed however behavioural therapists tend to not believe it happens at all
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Behavioural approach to treating phobias
Why is symptom substitution a weakness
Disregard the point in the treatment in the first place
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Behavioural approach to treating phobias
What are the ethical considerations
Systematic desensitisation can be psychologically harmful
And the cost benefit analysis may regard long term benefits of eradicating the phobia as outweighing the short term cost distress
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Behavioural approach to treating phobias
Flooding
What is flooding
Involves a exposing phobia patients tot heir phobic stimulus but without gradual build up in an anxiety hierarchy so involves immediate exposure to a very frightening situation
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Behavioural approach to treating phobias
Flooding
How long does it often last
Typically shorter than systematic desensitisation sessions with one session lasting two to three hours
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Behavioural approach to treating phobias
Flooding
What are the three stages
1. Immediate direct exposure
2. Prevention of avoidance
3. Continuance until anxiety has reduced and fear extinguished
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Behavioural approach to treating phobias
Flooding
What is immediate direct full exposure
Presenting the phobic stimulus to the patient directly in comparison to systematic desensitisation where there’s a gradual exposure
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Behavioural approach to treating phobias
Flooding
What’s prevention of avoidance
Flooding stops the phobic response very quickly
This may be because without the option of avoidance behaviour the patient quickly learns that the phobic stimulus is harmless
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Behavioural approach to treating phobias
Flooding
What is continuing until anxiety has receded abd fear extinguished
Learned response extinguished when the conditioned stimulus is encountered without the unconditioned stimulus so CS no longer produced the CR ‘extinction’
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Behavioural approach to treating phobias
Flooding
strength
Cost effective
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Behavioural approach to treating phobias
Flooding
How is being cost effective strength
Studies comparing flooding to cognitive therapies have found that flooding is highly effective and quicker than alternatives
This quick effect is a strength
The patients are free of their symptoms sooner and treatment is therefore cheaper
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Behavioural approach to treating phobias
Flooding
2 weaknesses
Less traumatic
Not suitable for all patients
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Behavioural approach to treating phobias
Flooding
Why is it traumatic
Highly psychologically harmful as being exposed to phobic stimulus and some patients unwilling to see it through to the end
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Behavioural approach to treating phobias
Flooding
Why is it not suitable for all patient
Eg with heart conditions
Extreme levels of anxiety caused by confrontation with the geared object or situation can be harmful on the body
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OCD
How does the DSM characterise OCD
is repetitive behaviour accompanied by obsessive thinking and is characterised by either obsessions and/or compulsions
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OCD
What are obsessions
Internal component of recurring intrusive thoughts, image etc
Things people think about often inappropriate ideas leading to extreme Anxiety
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OCD
What are compulsions
External component of what people do as a result of the obsessions often uncontrollable urges repetitively perform tasks and behaviours
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OCD
Why are compulsions compulsions
Attempt to reduce distress or feared events and only temporary solutions of have no other way of coping so rely on them
Can include avoiding a situation that triggers obsessive ideas
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OCD
What causes high leve;s of anxiety with ocd
Most sufferers realise there obsessions and compulsions are excessive and inappropriate but can’t control them leading to higher anxiety
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OCD
What do symptoms of ocd often overlap with
Other conditions such as Tourette’s and autism
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OCD
How many people have ocd
Around 2% of the populations
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OCD
Gender differences with ocd
No real difference in prevalence
Preoccupation with contamination and cleaning are more common in females
Males focus more on religious and sexual obsessions
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OCD characteristics
What’s are the three
Emotional
Behavioural
Cognitive
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OCD characteristics
What’s re emotional characteristics
How you feel when you have OCD
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OCD characteristics
What are behavioral characteristics
How you act or behave when you have ocd
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OCD characteristics
What are cognitive characteristics
How you think know perceive or believe when you have ocd
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OCD characteristics
What’s re the behavioural characteristics
Compulsions
Avoidance
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OCD characteristics
What are the two elements of compulsions
There repetitive
They reduce anxiety
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OCD characteristics
How are compulsions repetitive, examples
Sufferers feel compelled to repeat a behaviour
Eg hand washing or counting
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OCD characteristics
How would compulsions reduce anxiety, examples
Compulsive behaviours are mostly performed to try and manage the anxiety caused by obsessions
Eg compulsive hand washing as a response to obsessive fear of germs
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OCD characteristics
What does avoidance as a behavioural characteristic attempt to do
Reduce anxiety by keeping away for situations that trigger anxiety
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OCD characteristics
What can avoidance lead to
People to avoid ordinary situations and therefore interfere with leading a normal life
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OCD characteristics
What can be emotional characteristics
Anxiety and distress
Accompanying depression
Guilt and disgust
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OCD characteristics
Anxiety and distress as emotional characteristics
Unpleasant emotional experiences due to anxiety accompanying obsessions and compulsions
Obsessive thoughts are unpleasant and frightening causing anxiety
Urges to repeat behaviour (compulsion ) creates anxiety
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OCD characteristics
Accompanying depression as an emotional characteristic
Anxiety can be accompanies by low mood and lack of enjoyment of activities
Compulsive behaviour tends to bring some relief from anxiety but temporary
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OCD characteristics
Guilt and disgust as emotional characteristics
As well as anxiety and depression other native emotions such as guilt
Disgust may be directed at something external
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OCD characteristics
What aspect of ocd is cognitive characteristics
Obsessive thoughts
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OCD characteristics
Obsessive thoughts as cognitive characteristics
For around 90% of ocd sufferers obsessive thought are the main feature
Thought that recur over and over and vary from person to person but always unpleasant
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OCD characteristics
Why do people with ocd have insight into excessive anxiety and why is this necessary
They are aware of their obsessions and compulsions are not rational which is needed for a diagnosis
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OCD characteristics
What tend to be for ocd sufferers
Experience catastrophic thoughts about worse case scenarios and tend to be hypervigilant and show attentional biasconstant alertness for hazards
Irrational beliefs about what might happen eg to family
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Genetic explanation for OCD
What does this centre OCD around
Being inherited through genetic transmission
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Genetic explanation for OCD
Research for genetic explanation
Originally centred on twin and family studies now DNA profiling and gene mapping comparing OCD sufferers with non sufferers
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Genetic explanation for OCD
What is passed down
Passes genetic vulnerability from one generation to another not the certainty of ocd
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Genetic explanation for OCD
What is the diathesis stress model
Suggests certain genes eave some people more likely to suffer a mental disorder and environmental stress in necessary to trigger the condition
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Genetic explanation for OCD
What is a candidate gene
Genes which create a vulnerability for OCD and some are involved in regulation the development of the serotonin system
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Genetic explanation for OCD
Example of the candidate gene
5HT1-D beta is implicated in the efficiency of transport of serotonin across synapses
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Genetic explanation for OCD
What is polygenic
Means not cause by one single gene rather several genes
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Genetic explanation for OCD
What did Taylor (2013) discover
Up to 230 different genes may be involved in OCD
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Genetic explanation for OCD
What have the genes studied in relation to OCD include
This associated with the action of dopamine and serotonin
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Genetic explanation for OCD
What is aetiologically heterogeneous
One group of genesmay cause OCD in one person but a different group of genes may cause OCD in another person
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Genetic explanation for OCD
Origin of different types of OCD
May be result of particular gene variations
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Genetic explanation for OCD
2 strengths
Supporting evidence of Lewis (1936)
Nestadt et al (2010)
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Genetic explanation for OCD
What was Lewis (1936
Observed that of his OCD patients 37% had parents with OCD and 21% had siblings with OCD
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Genetic explanation for OCD
What did Lewis (1936) suggest
OCD runs in families
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Genetic explanation for OCD
What was Nestadt eat al (2010)
Reviewed previous twin studies and found that 68% of identical twins shared OCD as opposed to 31% of non identical twins
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Genetic explanation for OCD
What does Nestadt eat al (2010) suggest and what is the limitation
A genetic influence on OCD
However if fully genetic would be 100% between identical twins
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Genetic explanation for OCD
2 weaknesses
Too many candidate genes
Environmental Ericka factors
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Genetic explanation for OCD
What os the problem with candidate genes
Twin studies strongly suggest that {CD is largely genetic but pinning down all the gene involved has been less successful
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Genetic explanation for OCD
What makes candidate genes unpredictable and hard to study
Appears several genes are involved and each genetic variation only increases the risk by a fraction
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Genetic explanation for OCD
Why is candidate genes a weakness
Means that genetic explanation is unlikely to ever be useful as it provides little predictive value
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Genetic explanation for OCD
Impact of environmental risk factors
Can also trigger or increase the risk of OCD
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Genetic explanation for OCD
Study proving environmental factors
Found over half OCD patients in their sample had experienced a traumatic event
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Genetic explanation for OCD
Environmental risk factors as a weakness
Suggests ocd may be more productive to focusing the environmental caused as we are more able to do something about these
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Neural explanation for OCD
What is a neural explanation s
Involving neurotransmitters or structures in the brain
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Neural explanation for OCD
What transmitters is key in ocd
Serotonin
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Neural explanation for OCD
What is serotonin believed to do
Help regulate mood
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Neural explanation for OCD
What role does serotonin have in OCD
If a person has low levels of serotonin then normal transmission of mood information doesn’t take place so may be linked to obsessive thoughts and anxiety
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Neural explanation for OCD
Evidence for low levels of serotonin causing ocd
PET scans
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Neural explanation for OCD
What do some cases of OCD seem to be associated with
Impaired decision making
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Neural explanation for OCD
What part of the brain has impact on impaired decision many for ocd
Lateral part of the frontal lobe
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Neural explanation for OCD
What are frontal lobes responsible for
Logical thinking and making decisions and throught to help initiate activity upon receiving impulses to act then stop the activity when the impulse lessens
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Neural explanation for OCD
What have Pet scans shown for the frontal lobes
PCD sufferers have relatively high levels of activity
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Neural explanation for OCD
Impact for ocd if difficulty switching off or ignoring impulses
Turn into obsessions resulting in compulsive behaviour
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Neural explanation for OCD
What area of the brain is associated with processing unpleasant emotions functioning abnormally in OCD
Parahippocampal gyrus
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Neural explanation for OCD
What in the brain may be linked with compulsions
Hyperactivity in the basal ganglia
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Neural explanation for OCD
2 strengths
Supporting evidence
Hu (2006)
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Neural explanation for OCD
Example of evidence to support role of neural mechanisms in OCD
Some antidepressants work purely on the serotonin systems increasing levels of this and can also be effective for reducing OCD symptoms
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Neural explanation for OCD
What does antidepressants also working for ocd suggest
Serotonin system is involved with OCD
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Neural explanation for OCD
What was Hu (2006)
Compared serotonin activity in 169 OCD sufferers and 253 non sufferers and found serotonin levels were lower in OCD patients
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Neural explanation for OCD
What does Hu (2006) support
Idea that low levels of serotonin are associated with the onset of the disorder
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Neural explanation for OCD
2 weaknesses
Not all suffered of OCDrespond positively to serotonin enhancing drugs
Problems with cause and effect
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Neural explanation for OCD
What does serotonin enhancing drugs not always having positive effects lessen support for
Abnormal levels of neurotransmitter being the sole cause of the disorder
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Neural explanation for OCD
Conclusion of not responding positive to serotonin enhancing drugs
Likely another factor such as physiological or environmental
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Neural explanation for OCD
What is the problem with cause and effect
Even thought here is evidence various neurotransmitters function abnormally compared to non sufferers but not the same as saying this abnormal functioning causes the OCD
Biological abnormalities could be as a result of the OCD rather than the cause
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Biological approach to treating OCD
What does drug treatment for mental disorder aim to do
Increase or decrease levels of neurotransmitters in the brain or to increase/decrease their activity
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Biological approach to treating OCD
Drug work for OCD
Since low levels of serotonin are associated with OCD drug work in various ways to increase the level of serotonin in the brain
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Biological approach to treating OCD
What is the standard medical treatment for symptoms of OCD
Selective serotonin reuptake inhibitor (SSRI)
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Biological approach to treating OCD
How do SSRIs work
On serotonin system by preventing the reabsorption of serotonin, to increase the levels of serotonin in the synapse, therefore continues to stimulate the postsynaptic neuron to compensate what’s wrong with the serotonin system in OCD
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Biological approach to treating OCD
Dosage for SSRIs
Vary according to how is prescribed by typical daily dose fluoxetine is 20mg but may be increased if not benefiting the patient
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Biological approach to treating OCD
How are SSRIs available
As capsules or liquid
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Biological approach to treating OCD
How long does it take for SSRIs to have an impact on OCD symptoms
Three to four months
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Biological approach to treating OCD
What are drugs often used alongside with
CBT
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Biological approach to treating OCD
How does CBT work with SSRIs
Drugs reduce patients emotional symptoms eg anxiety and depression so that the patient can engage more effectively with CBT
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Biological approach to treating OCD
What often happens with SSRIs or CBT
In practice some people respond best to CBT alone whilst other benefit more from the dugs like fluoxetine and occasionally other drugs are prescribed alongside SSRIs
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Biological approach to treating OCD
What can be done if SSRIs arent effective
Dose can be increased or could be combined with another drug or sometime different antidepressants are trued
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Biological approach to treating OCD
Why do some alternative work well for some poeple and not others
Patients respond differently to different drugs
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Biological approach to treating OCD
Examples of other possible drugs
Tricyclics
SNRIs
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Biological approach to treating OCD
What are tricyclics
Older type of antidepressants that’s sometimes used eg clomipramine has and effects as SSRIs but more sever side effects
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Biological approach to treating OCD
When are tricyclics prescribed
For those who don’t respond to SSRIs
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Biological approach to treating OCD
What does SNRI stand for
Serotonin noradrenaline reuptake inhibitors
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Biological approach to treating OCD
When are SNRIs used
To treat the last 5 years of OCD or the patient doesn’t respond to SSRIs
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Biological approach to treating OCD
What do SNRIs increase levels of
Serotonin and noradrenaline
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Biological approach to treating OCD
What’s noradrenaline
Neurotransmitter involved in mood regulation
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Biological approach to treating OCD
2 strengths
Drug therapy is effective and backed up by evidence
Cost effective and non disruptive
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Biological approach to treating OCD
What evidence supports SSRIs
Soomro et al (2008)
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Biological approach to treating OCD
What did Soomro et al do
Reviewed 17 studies of SSRIs versus placebo treatments with 3097 patients
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Biological approach to treating OCD
What did Soomro et al find
SSRIs effective in short term in treating OCD and effectiveness greatest when combined. With psychological treatment like CBT
SSRIs effective for 70% of patients
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Biological approach to treating OCD
Conclusion of evidence
Drugs can therefore help most people with OCD
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Biological approach to treating OCD
What is drug treatment cheap compared to
Psychological treatments such as CBT which require a therapist
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Biological approach to treating OCD
Positive for NHS
Good value to use drugs
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Biological approach to treating OCD
How are drugs non disruptive
Dont disrupt patients lives as much as psychological treatments as can take drugs until symptoms decline and not have hard work of psychological therapy
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Biological approach to treating OCD
2 weaknesses
Drugs can have side effects
Unreliable evidence for drug treatment
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Biological approach to treating OCD
What are examples of side effects of SSRIs
Indigestion blurred vision and loss of sex drive
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Biological approach to treating OCD
Down side to clomipramine
More side effects and more serious
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Biological approach to treating OCD
Why are side effects negative
Reduce effectiveness as poeople stop taking the medication as it has more side effects which outweigh the positives
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Biological approach to treating OCD
Why is there unreliable evidence for drug treatment
Some psychologists believe evidence favouring drug treatment is biased because research sponsored by drug companies who don’t report all evidence
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Biological approach to treating OCD
Why is unreliable evidence a weakness
Drugs wont be as effective as it seems to be
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depression
What is it
Mood disorder involving lengthy disturbance of emotions
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depression
What % of people suffer from some form of depression
20
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depression
How long does a depressive episode generally last
Between two to six months
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depression
What is high among depressives
Suicide rate
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depression
What is the average of of onset
Late twenties
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depression
Examples of depression and depressive disorders
Major depressive disorder
Persistent depressive disorder
Disruptive mood dysregulation
Premenstrual dysphoric disorder
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Characteristics of depression
Three emotional characteristics
Lowered mood
Anger
Lowered self esteem
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Characteristics of depression
Lowered mood as an emotional characteristics
Feeling sad worthless and empty
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Characteristics of depression
Anger as an emotional characteristics
Sometimes extreme
Directed at self or others
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Characteristics of depression
Lowered self esteem as an emotional characteristics
How much we like ourselves
Can be extreme-self loathing
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Characteristics of depression
3 behavioural characteristics
Activity levels
Aggression and self harm
Disruption to sleep and eating
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Characteristics of depression
Activity levels as behavioural characteristics
Reduced levels of energy (withdraw from work, eduction, social life)
Reduced movements and speech
Can’t get out of bed
Psychomotor agitation (can’t relax and pacing)
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Characteristics of depression
Aggression and self harm as behavioural characteristics
Irritable verbally/physically aggressive (relationship and employment problems )
Physical aggression directed at self (cutting or suicide)
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Characteristics of depression
Disruption to sleep and eating as a behavioural characteristics
Reduced sleep (insomnia and premature wakening)
Hypersomnia(increased need to sleep)
Appetite variance (weight loss /gain)
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Characteristics of depression
3 cognitive characteristics
Poor concentration
Attending to and dwelling on the negative
Absolutist thinking
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Characteristics of depression
Poor concentration as a cognitive process
Unable to stick to tasks/making decisions difficult
Likely to interfere with work
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Characteristics of depression
Attending to and dwelling on negative as a cognitive characteristic
Ignores positive
Sees the glass half empty not half full
Bias towards unhappy events rather than happy events
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Characteristics of depression
Absolutist thinking as a cognitive charteristic
Black and white thinking
Eg when a situation is unfortunate they see it as an absolute disaster
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Cognitive approach to explaining depression
What are the two ways of explaining depression
Beck’s cognitive theory
Ellis’s ABC model
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Cognitive approach to explaining depression
What did Beck suggest to use to explain depression
Cognitive approach to explain why people are more vulnerable to depression then others
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Cognitive approach to explaining depression
What does Becks theory suggest depression stems from
A persons cognitions that create vulnerability with emphasis on automatic thought
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Cognitive approach to explaining depression
What are the three parts to cognitive vulnerability
1. Faulty information processing
2. Negative self schemas
3. The negative triad
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Cognitive approach to explaining depression
What is the faulty information processing of becks cognitive theory
When depressed we attend to the negative aspects of a situation and ignore the positives and tend to blow small problems out of proportion and think in “black and white’ terms
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Cognitive approach to explaining depression
What are cognitive biases
Where reality is misperceived
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Cognitive approach to explaining depression
What are the four main cognitive bias as in faulty information processing
Arbitrary inference
Selective abstraction
Overgeneralisation
Magnification and minimisation
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Cognitive approach to explaining depression
What is arbitrary inference
Conclusions drawn in the absence of sufficient evidence eg a man concluding he’s worthless because its raining when he hosts an outdoor party
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Cognitive approach to explaining depression
What’s selective abstraction
Conclusions drawn from jut one part of a situation eg a worker feeling worthless when a product doesn’t work even though sevens people made it
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Cognitive approach to explaining depression
What’s overgeneralisation
Sweeping conclusions drawn on the basis of a single event eg a student regarding poor performance one tests as proof of his worthlessness
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Cognitive approach to explaining depression
What magnification and minimisation
Magnification is exaggerations in evaluation of performance eg a man never wanting to drive again because of a tiny scratch
Minimisation eg woman believing she’s worthless deposited many praises
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Cognitive approach to explaining depression
What is a schema
Mental ‘package’ of ideas and information developed through experience and act as a framework for prosesing information
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Cognitive approach to explaining depression
What’s a self schema
Package of information about ourselves
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Cognitive approach to explaining depression
What happens if we have negative self schemas
Interpret all information about ourselves in a negative way
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Cognitive approach to explaining depression
What is a negative triad
Negative schemas and cognitive biases that happen when were depressed
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Cognitive approach to explaining depression
Components of the negative triad
Negative view of the self
Negative view of the work
Negative view of the future
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Cognitive approach to explaining depression
What is negative view of the self
Where the individual sees them as being helpless worthless or inadequate
These thoughts enhance any existing depressive feelings because they confirm the existing emotions of low self esteem
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Cognitive approach to explaining depression
What is negative view of the world
Where obstacles are perceived within ones environment cannot be dealt
This creates the impression that there is no hope anywhere
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Cognitive approach to explaining depression
2 strengths of becks cognitive theory
Good supporting evidence
Practical application in CBT
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Cognitive approach to explaining depression
What supports becks cognitive theory of depression
Range of evidence supports the urea that depression is associated with faulting information processing, negative self schemas and the negative triad
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Cognitive approach to explaining depression
What study supports becks cognitive theory
Boury et al (2001)
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Cognitive approach to explaining depression
What did Boury et al do
Monitored students negative thoughts with the beck depression inventory
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Cognitive approach to explaining depression
What did Boury et al find
Depressives misinterpret facts and experiences in a negative fashion and feel hopeless about the future
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Cognitive approach to explaining depression
Limitation of boury et al
Only students were studied which limits the extent to which can be generalised
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Cognitive approach to explaining depression
What does CBT do
Identifies and challenges cognitive aspects of depression including the components of the negative triad that are easily identifiable
Therapist can challenge them and encourage the patient to test whether theyre true
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Cognitive approach to explaining depression
Why is CBT a strength fir becks cognitive theory
Translates well into successful therapy
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Cognitive approach to explaining depression
2 weaknesses
Doesn’t explain all aspects of depression
Other approaches many explain depression better
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Cognitive approach to explaining depression
What does Becks theory only do
Neatly explain the basic symptoms if depression but depression is complex
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Cognitive approach to explaining depression
What can’t becks theory explain
Why some depressives are deeply angry or why some suffer from hallucinations
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Cognitive approach to explaining depression
What can depressives sometimes suffer from
Cotard syndrome
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Cognitive approach to explaining depression
Why is this a weakness for becks theory
Cannot easily exp;Lina these cases
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Cognitive approach to explaining depression
What other approach may explain depression better
The biological approach with the genetic explaition
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Cognitive approach to explaining depression
What is the genetic explaination
Centres on the idea that vulnerability to depression is inherited
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Cognitive approach to explaining depression
How is the genetic explanation generally researched
Through twin and adoption studies
More recently, gene mapping used to compare genetic material of those with high or low incidences of the disorder
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Cognitive approach to explaining depression
What’s Ellis’ ABC model
Believed depression resulted in irrational thoughts and depressives mistakenly blaming external event for their unhappiness and its their interpretation of these events which are to blame
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Cognitive approach to explaining depression
What is A in ABC
activating event
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Cognitive approach to explaining depression
What is an activating agent
Situations or external events when something happens in the environment around you
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Cognitive approach to explaining depression
What is B in ABC
Beliefs
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Cognitive approach to explaining depression
What are belies
Belief about event or situation may hope a variety of irrational ones such as life should be fair or you must succeed at everything
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Cognitive approach to explaining depression
What is C in ABC
Consequences
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Cognitive approach to explaining depression
What are consequences
Emotional response to your belief
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Cognitive approach to explaining depression
Difference between depressed and not depressed
People who don’t suffer may react differently as belief may be they did their best
Major deference is how they perceive themselves
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Cognitive approach to explaining depression
1 strengths
Practical application to CBT
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Cognitive approach to explaining depression
What has Ellis’ explanation led to
Successful therapy by challenging irrational negative beliefs to reduce depression
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Cognitive approach to explaining depression
Why is this a strength
Poeples symptoms can be treated therefore resulting in a better quality of life
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Cognitive approach to explaining depression
3 weaknesses
Only a partial explanation
Doesn’t explain all aspects of depression
Wonder et al (1986)
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Cognitive approach to explaining depression
What’s reactive depression
When cases of depression follow activating events
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Cognitive approach to explaining depression
Why is reactive depression a weakness for ellis’ explanation
Only applies to some kinds of depression and is therefore only a partial explanations
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Cognitive approach to explaining depression
Why doesn’t ellis’ explanation explain all aspects
Although explain why some people appear to be more vulnerable to depression than others due to cognitions doesn’t explain anger associated or hallucinations and delusional
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Cognitive approach to explaining depression
Why is this bad
Doesn’t fully explain depression
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Cognitive approach to explaining depression
What did wender et al find
Found adopted children who develop depression were roe likely to have a depressed biological parent even though raised in different environments
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Cognitive approach to explaining depression
Why is wender et al a weakness
Implies biological factors are more important that cognitive ones
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Cognitive approach to treating depression
What does the cognitive approach use to treat depression
CBT
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Cognitive approach to treating depression
What is CBT commonly used for
Psychological treatment for depression and other mental health problems
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Cognitive approach to treating depression
What does CBT do
Uses idea that beliefs expectation and cognitive assessments of self and the environment affect how individuals perceive themselves and others which can affect how problems are approached and how successful indivuals are in reaching goals
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Cognitive approach to treating depression
Route for CBT
First an assessment where the patients and therapist identify the problem
Second ide tidy negative or irrational thoughts that will benefit from challenge
Lastly work to change these negative irrational thoughts
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Cognitive approach to treating depression
What do therapists use techniques from in CBT
Some therapists use techniques from Becks cognitive therapy
Some rely on REBT
Most draw on both
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Cognitive approach to treating depression
What is REBT
Ellis’ rational emotive behaviour therapy
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Cognitive approach to treating depression
What does becks cognitive therapy do
Identify automatic thoughts about world self and future (negative triad) then challenge them
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Cognitive approach to treating depression
What can be set in becks cognitive therapy
Patients may be asked to invective the reality of their negative beliefs throng being set homework
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Cognitive approach to treating depression
What is becks cognitive therapy sometimes referred to as
Patient as scientist
Investigating the reality of their negative beliefs as a scientist would
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Cognitive approach to treating depression
What does REBT involve
Making patients irrational and negative thoughts more rational and positive by identifying and disputing or challenging irrational thoughts and beliefs
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Cognitive approach to treating depression
How is the A in the ABC used in REBT
Patient records events leading to disordered thinking
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Cognitive approach to treating depression
How is B in the ABC model used in REBT
Patient records negative thoughts associated with the event
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Cognitive approach to treating depression
How is the C in the ABC model used in REBT
Patient records negative thoughts or behaviours that follow
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Cognitive approach to treating depression
How does REBT use the ABC
Vigorous argument to dispute and change the irrational beliefs and break the link between negative life events and depression
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Cognitive approach to treating depression
What are the methods of disputing in REBT
Empirical arguments (is there any actual evidence to support the negative thoughts )
Logical argument (does negative thought logically follow from the facts)
This is the eduction phase
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Cognitive approach to treating depression
What’s behavioural activation
Introduced after the education phase
Therapist encourages patient to become more active and engaged in positive activities
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Cognitive approach to treating depression
What is the patient given in between sessions
Goals to boost self esteem and hypothesis testing of negative thoughts
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Cognitive approach to treating depression
2 strengths of CBT
Has no side effects
Cost effective
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Cognitive approach to treating depression
What side effects does CBT not gave
Compared to other treatments such as drug theory (antidepressants) which may have side effects such as anxiety insomnias and headaches which is not and issue for CBT
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Cognitive approach to treating depression
Why is having no side effects a strength
Strength of CBT may encourage more people to try it
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Cognitive approach to treating depression
Why is CBT cost effective
Occurs over a relatively short period of time because the techniques involves are usually continually it stops the symptoms repeating
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Cognitive approach to treating depression
Why is being cost effective a strength
Gives patients practical techniques to use long after the CBT has ended making them feel in control
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Cognitive approach to treating depression
CBT 2 weaknesses
May not work for all cases
Ethical concerns
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Cognitive approach to treating depression
Why mayCBT not be for all patients with depression
May not be able to motivate themselves to engage with hard cognitive work of CBT and find concentrating difficult may not be able to get all the benefits
May feel overwhelmed and disappointed with themselves resulting in strengthened depression symptoms
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Cognitive approach to treating depression
Why is this a limitation
Means CBT cannot be used as a sole treatment for all depression and also as CNT is a talking therapy isn’t suitable for those who have difficulties talking about feelings
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Cognitive approach to treating depression
Why is there ethical concerns for CBT
May be too therapist centred as may abuse their power of control over patients forcing them into certain ways of thinking over depressed patients who may be particularly vulnerable and influential
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Cognitive approach to treating depression
What can be as a result of CBT
Patients too dependant on theorists
