Psychopathology Flashcards
(28 cards)
Outline and evaluate ‘deviation from social norms’ as an definition of abnormality
a person is seen as abnormal if their thoughts/behaviour violate unwritten rules of what is acceptable in society
Evaluation:
limitation - abnormality is not standardised
-what may be abnormal in one country may be seen as normal in another
-e.g. homosexuality is illegal in about 75 countries, so it is seen as abnormal
-however, the rest of the world thinks homosexuality is normal
-hence lacks cultural relativism
limitation - fails to offer a complete explanation in its own right
-mediated by the degree of severity and context
-e.g. deviating from a social norm once may not be an issue, but persistent repetition may be a cause for concern
limitation - hindsight bias
-social norms change over time
-e.g. homosexuality was illegal in the UK until 1973, but is now viewed as normal
-means that historically, there may have been violations of human rights due to institutionalisation of people
-Szas (1974) suggests that diagnoses upon those grounds may have been given as a form of social control over minority groups
-e.g. excluding those that do not conform to society
Outline and evaluate ‘failure to function adequately’ as an definition of abnormality
person is considered abnormal if they are unable to cope with the demands of everyday life and live independently in society
may cause personal suffering and distress but also may cause discomfort for other people
Evaluation:
limitation - stems from individual differences
-e.g. one person with OCD may exhibit excessive rituals and be ate to work
-another person with OCD could be punctual as they find time to exhibit excessive rituals
-therefore, despite the same behavioural symptoms, each person would be diagnosed differently according to this definition
-reduces validity of the definition
strength - considers the subjective personal experiences of the patient
-considers thoughts and feelings of the person displaying symptoms
-takes into account personal viewpoints of the sufferer
-hence it is a useful model for assessing psychopathological behaviour
limitation
-difficult to distinguish between failure to function adequately and deviation from social norms, if a symptom can be applicable to both
-limits personal freedom
-difficult to ascertain whether this behaviour should be considered maladaptive
Outline and evaluate ‘statistical infrequency’ as an definition of abnormality
behaviour is seen as abnormal if it’s statistically uncommon or not seen often in society
determined by looking at the distribution of that behaviour across society
e.g. the average IQ is approximately 100
95% of the population have an IQ between 70-130
a small % of the population (around 5%) have an IQ above 130 or below 70, and this would be seen as abnormal due to not being commonly seen in society
Evaluation:
limitation - some statistically infrequent behaviour may be seen as desirable traits
-e.g. an extremely high IQ would be classified as abnormal due to being uncommon in society, but it would still be hugely celebrated
-conversely, depression is very common in society, but not desirable
-therefore, this definition needs to identify those behaviours which are both infrequent and undesirable
limitation - labelling as abnormal can be unhelpful
-e.g. someone with a low IQ may be able to live quite happily without causing distress to anyone
-however, the label of ‘abnormal’ may be an invitation to discrimination or create a poor self-image
-therefore, being labelled as statistically infrequent may cause more distress than the condition itself
limitation - misdiagnosis
-e.g. 10% of people experience depression at some point in their lives so it considered ‘normal’ although it is a disorder
-conversely, people with a high IQ are considered abnormal because it is uncommon, despite it being a desirable trait
Outline and evaluate ‘deviation from ideal mental health’ as an definition of abnormality
Jahoda (1958) suggested that abnormality should be determined by the absence of 6 certain characteristics.
-accurate perception of reality
-self-actualisation
-resistance to stress
-positive attitude towards self
-autonomy
-environmental mastery
Therefore if an individual does not demonstrate one of these criteria, they are considered abnormal
Evaluations:
limitation - different cultures have different views of what should be the criteria for ideal mental health
-e.g. emphasis on personal growth may be seen as too self-centred in countries that value community over individuality
-however, independence within collectivist cultures is not fostered, making the definition culture bound
-suffers from cultural relativism
limitation - unrealistic criteria
-there are times where everyone experiences stress and negativity
-according to this definition, they are considered abnormal, irrespective of their circumstances
-how many must be absent for diagnosis to occur must also be questioned
strength - takes a positive and holistic stance
-definition focuses on desirable behaviours
-comprehensive
-covers a broad range of characteristics that may affect health and well-being
Outline the behavioural, emotional and cognitive characteristics of phobias
behavioural:
-avoiding the stimulus
-sometimes, person comes face to face with phobia, and they experience panic
-sometimes, they may experience freezing’ if the fear is so intense, which is part of the fight or flight response
emotional:
-excessive and unreasonable fear, anxiety or panic
-triggered by the presence or anticipation of the specific stimulus
cognitive:
-person’s selective attention makes them fixated on the object
-they will find it difficult to direct their attention elsewhere
-may have irrational thinking
Outline the behavioural, emotional and cognitive characteristics of depression
behavioural:
-reduction in energy and constantly feeling tired
-disturbed sleep pattern
-changes in appetite
emotional:
-feeling worthless
-lack of interest in everyday activities
cognitive:
-less able to concentrate
-tend to focus on the negative
Outline the behavioural, emotional and cognitive characteristics of OCD
behavioural:
-repetitive compulsions used to manage anxiety
emotional:
-anxiety and depression caused by the interruption to daily life
cognitive:
-obsessive thoughts
-selective attention directed towards the anxiety-generating stimuli
Explain the different types of phobias
simple/specific: when a person fears a certain object in the environment
categories: animal phobias, injury phobias, situational phobias and natural phobias
social phobias: person feels anxiety in social situations, e.g. giving speeches, as the sufferer may feel as thought they are inadequate and will be judged
categories: generalised phobias, interaction phobias and performance phobias
agoraphobia: fear of public spaces and sufferers may experience panic attacks
Outline and evaluate the behavioural approach to explaining phobias, through the two-process model
-proposed by Mowrer (1947)
-acquisition of phobias is through classical conditioning
-maintenance of phobias is through operant conditioning
Classical conditioning:
-process of learning by associating two stimuli with each other to condition a response
-explains how we associate a neutral stimulus (something we do not fear) with an unconditioned stimulus (something that triggers a response)
e.g. people don’t fear lifts, but they fear being trapped, so they develop a phobia of lifts, following a single incident of being trapped in a lift
Watson and Rayner (1920)
-investigates whether a fear response could be learned through classical conditioning in humans
-participant was an 11-month old baby called ‘Little Albert’
-before the experiment, researchers noted that Albert showed no response to various objects, in particular a white rat
-to examine whether a fear response could be induced, Watson and Rayner struck a metal bar with a hammer behind Albert’s head every time he went to reach for the rat
-causes a loud noise that startled him
-did this three times
-thereafter, Little Albert cried whenever he saw the white rat
-demonstrates that a fear response could be induced through the process of classical conditioning in humans
-Little Albert also developed a fear towards similar objects, e.g. a white Santa Claus beard
-shows that he has generalised his fear to other white furry objects
Operant Conditioning:
-classical conditioning explains why we develop phobias, but not why they persist over time
-most phobias are long-term
-explains how phobias are maintained
-phobias can be negatively reinforced, where behaviour is strengthened as the unpleasant consequence is removed
-continuing to avoid lifts and taking stairs will maintain the phobias of lifts
PEEs for the behavioural approach
Strength - research support
-Watson and Rayner (1920) did a study on Little Albert
-findings supported the idea of classical conditioning
-however, as this was a case study, results cannot be generalised to other children or even adults in the initialisation of their phobias
Strength - application to therapy
-behaviourist ideas have been used to develop treatments, e.g. systematic desensitisation and flooding
-these techniques have been successful in treating phobias, so prove the effectiveness of the behavioural approach
Limitation - ignores role of cognition
-phobias can develop due to irrational thinking, not just learning
-furthermore, the cognitive approach has led to development of the CBT
-more successful than behavioural treatments
Limitation - claim that it is not a complete explanation of phobias
-Bounton (2007) suggests that evolutionary factors could play a role in phobias
-e.g. avoidance of stimulus like snakes were a survival strategy for our ancestors to prevent pain/death
-consequently, some phobias may not be learned, but are innate due to biological preparedness
What are the two behavioural treatments for phobias
flooding
Systematic desensitisation
Outline systematic desensitisation as a behavioural treatment for phobias
-counter-conditioning to unlearn the maladaptive response to a situation/object, by eliciting a different response (relaxation)
-has 3 critical components
-fear hierarchy
-relaxation training
-reciprocal inhibition
-first the client and therapist form a fear hierarchy by ranking different situations involving the phobia from least to most terrifying
-client is then taught relaxation techniques, e.g. breathing techniques, progressive muscle relaxation techniques or mental imagery techniques
-final stage is where they are exposed to the phobic situation while relaxed
-according to the theory of reciprocal inhibition, two emotional states cannot exist at the same time, so the client cannot be both anxious and relaxed
-relaxation will overtake fear
-client starts at bottom of fear hierarchy and works their way up
-when they are completely relaxed in the most feared situation, the systematic desensitisation has been successful, as a new response to the stimulus has been learned, replacing the phobia
Evaluate systematic desensitisation as a behavioural treatment for phobias
Strength - research evidence
-McGrath et al. (1990) found that 75% of patients with phobias were successfully treated using systematic desensitisation
-particularly true when using in vivo techniques in which the patient came into direct contact with the feared stimulus, rather than simply imagining (in vitro)
Strength - research evidence
-Gilroy et al. (2002) examined 42 patients with arachnophobia
-each patient was treated using three 45-minute long systematic desensitisation sessions
-when examined 3 months and 33 months later, the systematic desensitisation group was less fearful than the control group (who were only taught relaxation techniques)
-proves that systematic desensitisation is effective for phobias in the long-term
Strength - more ethical than flooding as it causes less distress
-being gradually exposed to a fear-inducing stimulus leads to less psychological harm
-reflected in the high number of patients who persist with SD providing low attrition rates
-furthermore, considered a more appropriate technique for people with learning difficulties or suffer from severe anxiety disorders
-learning the relaxation techniques can be a positive and pleasant experience for them
Limitation - not effective for all types of phobias
-can be difficult to unlearn phobias through SD if they are not developed through personal experiences
-certain phobias are not learned, and have an evolutionary survival benefit
-hence SD is ineffective in treating phobias that have an innate basis
Outline flooding as a behavioural treatment for phobias
-immediate exposure to the fear-inducing stimulus
-done in safe and controlled manner over an extended period of time
-person is unable to avoid (negatively reinforce) stimulus
-fear is a time-limited response, so eventually it will subside
-anxiety eventually decreases due to continuous exposure
-may begin to feel a calm sense of relief as a new positive association to the stimulus is created
Evaluate flooding as a behavioural treatment for phobias
Strength - cost-effective compared to SD
-Ougrin (2011) found it’s just as effective as systematic desensitisation and cognition therapies
-takes much less time to achieve the same results
-patients cure phobias quickly = health-service providers do not have to fund longer options
Limitation - often highly traumatic
-purposefully elicits a high level of anxiety
-Wolpe (1969) recalled a case where patient required hospitalisation due to intense anxiety
-hence initiating flooding treatment may be a waste of time/money
-as many patients are too afraid of the experience to finish treatment
-however, it’s not unethical, as patients give fully informed consent, despite feeling stressed partway through the course of treatment
Limitation - ineffective in treating all phobias
-e.g. social phobias are caused by irrational thinking
-not caused by unpleasant experiences or learned through classical conditioning
-hence, more complex phobias may be more responsive to other forms of treatment, e.g. CBT rather than behavioural approaches
Limitation - criticised for symptom substitution
-although one phobia may be removed through counter-conditioning, another may replace it
-even if symptoms are treated, underlying cause may remain and resurface
-furthermore, environmentally reductionist
-reduces human behaviour to a simple stimulus-response association
-e.g. not every person bitten by a dog will develop a phobia of dogs
-hence other processes must play a role, e.g. cognition
Another name for irrational thinking
cognitive distortions
What are the two key cognitive theories that attempt to explain depression?
Beck’s Cognitive Triad
Ellis’s Irrational Thinking (ABC) Model
Outline Beck’s Cognitive Triad as a cognitive approach to explaining depression
-Beck claimed that depression is caused by negative self-schemas maintaining the cognitve triad: having a negative view of ourselves, our future and the world around us
-these thoughts occur automatically and are symptomatic to depression sufferers
-schema = package of knowledge
-stores information and ideas about ourselves and the world around us
-these schemas are developed during childhood
-according to Beck, depressed people possess negative self-schemas, which may come from negative experiences
Cognitive biases:
-Beck suggests that depressed people are more likely to focus on negative aspects and ignore the positives
-this distortion of information is known as a cognitive bias
-two examples of this include:
-overgeneralisations: person makes a sweeping conclusion based on a single incident
-catastrophising: person exaggerates a minor setback and believe that it is a complete disaster
Outline Ellis’s Irrational Thinking (ABC) Model a cognitive approach to explaining depression
-Ellis suggests good mental health is having rational thinking
-allows the person to be happy and painfree
-but bad mental health is due to irrational thinking
-prevents the person from being happy and pain free
three-stage model suggests how irrational thinking could lead to depression
A = Activation event:
-trigger event occurs
B = Beliefs:
-interpretation of the event can either be rational or rrational
C = Consequences:
-rational beliefs lead to healthy emotional outcomes
-irrational beliefs lead to unhealthy emotional outcomes including depression
Evaluate cognitive approaches to explaining depression
Strength - application to therapy
-cognitive approaches have been used to develop effective treatments for depression, like Cognitive Behavioural Therapy (CBT) and Rational Emotive Behaviour Therapy (REBT), which was developed from Ellis’s ABC Model
-these attempt to identify/challenge negative/irrational thoughts
-successfully been used to treat depression
Strength - research support
-Boury et al. (2001) found that patients with depression are more likely to misinterpret information negatively (cognitive bias)
-feel hopeless about ther future (cognitive triad)
-furthermore, Bates et al. (1999) gave depressed patients negative statements to read
-found that depression symptoms became worse
-these findings support different components of Beck’s theory and that negative thinking plays a role in depression
Limitation - fails to explain origin of irrational thoughts
-most of the research in this area is correlational
-hence psychologists are unable to determine whether negative, irrational thoughts cause depression
-or whether a person’s depression leads to this negative mindset
-furthermore, possible that other factors, e.g. genes and neurotransmitters can cause depression
-hence may have genetic vulnerability that is triggered by environmental stressor (diathesis-stress model)
Limitation - alternative explanations suggest it is a biological condition
-caused by genes and neurotransmitters
-research has found that patients with depression have lower levels of serotonin
-casts doubt on faulty cognition being the sole cause of depression
-furthermore, drug therapies, e.g. SSRIs (Selective Serotonin Reuptake Inhibitors), have been found to be effective too
-this provides further support for the role of neurotransmitters in the development of depression
Explain what Cognitive Behavioural Therapy (CBT) is and how it treats depression
-based on the assumption that faulty thought processes make someone vulnerable to depression
-involves both cognitive and behavioural elements
-cognitive element aims to identify negative and irrational thoughts and replace these with more positive/rational ones
-behavioural element of CBT encourages patients to test their beliefs through behavioural experiments and homework
-CBT has various components including:
1) initial assessment
2) goal setting
3)identifying and challenging negative, irrational thoughts using either Beck’s cognitive therapy or Ellis’s REBT
4)homework
Step 1 and 2 are common for all patients undergoing CBT to treat depression
Beck’s cognitive Behavioural Therapy:
-therapist uses Beck’s cognitive triad to identify patient’s negative views about their self, world and future
-patient and therapist work together to challenge these views, by discussing evidence for and against them
-patient will be set homework to test validity of their negative thoughts
Ellis’s REBT:
-Ellis developed his ABC model to include Dispute and Effect
-therapist will dispute the irrational thoughts to replace them with more effective beliefs and attitudes
-logical dispute could be used, where therapist questions logic of patient’s thoughts
-empirical dispute could be used, where therapist seeks evidence for patient’s irrational beliefs
Evaluate the cognitive approach to treating depression
Strength - research support
-March et al. (2007) examined 327 adolescents who had depression
-treated them with either CBT, antidepressants or both
-after 36 weeks, 81% of the antidepressant group and 81% of the CBT group had improved
-suggests that both treatments are equally effective
-however, 86% of the combination of CBT and antidepressants group had improved
-suggests that combination may be the most effective treatment
Limitation - some aspects require patients to be motivated
-e.g. homework
-people with depression tend to lack motivation
-hence may not engage with CBT or never attend sessions
-reduces effectiveness of the therapy
-however, there are alternative treatments like antidepressants that require less motivation
-therefore, more useful for severely depressed patients
Limitation - criticised for overemphasis on role of cognition
-fails to take into account other factors, e.g. social circumstances
e.g. someone who is a victim of domestic violence does not need to change their negative views, but rather their circumstances
-therefore, CBT would be ineffective in treating patient until circumstances have changed
Limitation - success of CBT is not entirely down to Beck and Ellis’s techniques
-Rosenzweig (1936) argued that the client and therapist relationship plays a huge role in the success of a psychological therapy
-evident in Luborsky et al (2002) comparison study showing little difference between different methods of psychotherapy
Outline genetic explanations to OCD
-polygenic condition
-Taylor (2003) suggests that around 230 genes are involved
-perhaps different genetic variations contribute to different types of OCD (e.g. hoarding or obsession with religion)
COMT gene:
-associated with production of catechol-O-methyltransferase
-requires the neurotransmitter dopamine
-one variation of the COMT gene results in higher dopamine levels
-this variation is more common in patients with OCD compared to without
SERT gene:
-aka S-HTT gene
-linked to serotonin and affects the transport of it
-transportation issues causes less serotonin to be active in the brain
-this is associated with OCD (and depression)
-Ozaki et al. (2003) published results from a study about two unrelated families
-both had mutations of the SERT gene, coinciding with six out of seven family members having OCD
Evaluate the biological approach to OCD
strength - research support from family studies
-Lewis (1936) examined patients with OCD
-37% of OCD patients had parents with it
-21% of OCD patients had siblings with it
-provides support for a genetic explanation for OCD, although it does not rule out any environmental factors
-furthermore, Nestadt et al. (2000) proposes that people with a first-degree relative with OCD are up to five times more likely to develop it in their lifetime
strength - further research support from twin studies
-Billett et al. (1998) conducted a meta-analysis of 14 twin studies investigating the genetic inheritance rates of OCD
-concluded that monozygotic (MZ) twins had double the risk of developing OCD than dizgotic (DZ) twins if one of the pair had the disorder
-provides strong evidence for genetic links
-however, concordance rates in twin studies are never 100%
-suggests that the diathesis-stress model may be a better explanation
-a genetic vulnerability is inherited and triggered by a stressor in the environment
limitation - issue with understanding neural mechanisms in OCD
-some evidence suggests certain neural systems do not function normally in OCD patients
-e.g. the basal ganglia and orbitofrontal cortex
-but other brain regions that are occasionally involved have also been identified
-hence no brain system has been found to consistently play a role in OCD
-therefore, despite evidence of involvement of neurotransmitters and brain structure, it cannot be concluded that there is a cause and effect relationship
-furthermore, it is difficult to ascertain whether biological abnormalities are a cause of OCD or as a result of it
limitation - credible alternative explanations
-e.g. behaviourists proposed the two-process model
-suggests that learning could play a crucial role in the disorder
-initial learning of the feared stimulus could be through classical conditioning (associative process)
-this behaviour pattern is maintained by operant conditioning and negative reinforcement (stimulus is avoided so anxiety is removed)
-could result in an obsession forming which is linked to the development of compulsion.
-furthermore, support for this alternative explanation is found in the success of behavioural treatments for OCD
-symptoms improved for 60-90% of adult patients (Albucher et al.,1998)
Outline a neural explanation to OCD, in relation to neurotransmitters
-serotonin regulates mood, so lower serotonin levels can lead to mood disorders
-role of serotonin in OCD is supported by research on antidepressants (SSRIs)
-Pigott et al. (1990) found that drugs that increase serotonin levels in the synaptic gap, are also effective in treating OCD
-high dopamine levels have been associated with OCD, especially compulsive behaviour
