Psychopathology Flashcards
(114 cards)
1
Q
deviation from social norms
A
-straying away from what society deems as normal
-deviant behaviour –> that which is considered anti social or undesirable by the majority of society
-The standards of acceptable behaviour are set by the social group and are adhered to by group members
-violation of unwritten social class
e.g anti social behaviour
2
Q
strengths of deviation from social norms
A
Real life application in diagnosis of ASD –> According to DSM-5 one important symptom of ASD is absence of prosocial internal standards
helps society –> Adhering to social norms means that society is ordered and predictable. This is argued to be advantageous.
3
Q
Limitations of deviation from social norms
A
-Not a sole explanation –> other factors that contribute to deviation of social norms / abnormality
-Cultural relativism –> social norms vary between communities e.g hearing voices is normal in some cultures but is abnormal in the UK and would be classed as mental illness
-Can lead to systematic abuse of human rights
-lacks temporal validity
4
Q
statistical infrequency
A
-A person’s trait, thinking or behaviour is classified as abnormal if its rare of statistically unusual
e.g IQ –> less than 2.2% of the population have an IQ lover than 70 (statistically rare)
extreme side of distribution curve
5
Q
strengths of statistical infrequency
A
-Real life application in diagnosis of intellectual disability disorder –> statistical infrequency is a useful part of clinical assessment
-doctors can very quickly and easily determine abnormality
-definition is more objective than other explanations for abnormality
6
Q
Limitations of statistical infrequency
A
-Unusual characteristics can be positive –> IQ scores above 130 can be seen as superintelligent rather than abnormal even though both 70 and 130 is unusual and statistically infrequent. Cannot be used alone to make a diagnosis
-Be labelled is not a benefit –> Labelling may have a negative way on the way the person and other’s perceive themselves
7
Q
Deviation from ideal mental health
A
-Occurs when someone does not meet set criteria for good mental health
-Mental illness can be diagnosed the same as physical health
e.g bipolar disorder
Marie Jahoda suggested that one has ideal mental health if they…..
-self actualize
-are rational
-can perceive themselves naturally
-can cope with stress
-are independent of other people
8
Q
strengths of deviation from mental health
A
-Comprehensive definition –> covers a broad range of criteria
-This definition focuses on what is helpful and desirable for the individual, rather than the other way round
-A strength is that this definition allows for an individual who is struggling to have targeted intervention if their behaviour is not ‘normal’. For example, their distorted thinking could be addressed to help their behaviour become normal, as if their thinking is biased then their behaviour will be too.
9
Q
Limitations of deviation from mental health
A
-Cultural relativism –> Jahoda’s classification of ideal mental health are specific to Western and American cultures (individualistic cultures)
-Unrealistically high standard for mental health
-Jahoda’s criteria is difficult to measure objectivity and is overdemanding
10
Q
Failure to function adequately
A
-Abnormal behaviour is when an individual is not able to cope with everyday life. It acknowledges that people may act differently but if they have a basic inability to manage in everyday life their behaviour is abnormal
David Rosehan and Martin Seligman determined signs when someone is not coping
-irrationality –> behaviours are aggressive or hard to understand
-personal distress –> depression and anxiety disorders
-violation of moral standards –> goes against societies moral standards
-no longer conform to rules
11
Q
strengths of failure to function adequately
A
-Patients perspective –> includes subjective experience of the individual. Useful criteria
-easy to observe and measure so can be diagnosed
12
Q
Limitations of failure to function adequately
A
-Deterministic
-Subjective
-not all maldaptive behaviour is a sign of mental disorder
-people may still suffer with mental disorder but can cope well with everyday life
-issues of individual differences
13
Q
define a phobia
A
anxiety disorder which interferes with daily living, It Is an instance of irrational fear that produces a conscious avoidance of the feared object or situation
-2% in UK have diagnosis of phobia according to DSM-5
-marked and persistent fear of a specific object or situation for more than 6 months
14
Q
characteristics of a phobia
A
emotional, behavioural, cognitive
-persistent fear of phobic stimulus
-irrational beliefs about the phobic stimulus
-avoidance of the phobic stimulus
-ONLY ONE SPECIFIC STIMULUS
15
Q
emotional reponse to phobias
A
-anxiety disorder –> unpleasant state of high arousal
-unreasonable emotions –> response is irrational
-fear and irrationality
16
Q
behavioural response to phobias
A
-panic –> the patient suffers from heightened physiological arousal upon exposure to the phobic stimulus, caused by the hypothalamus triggering increased levels of activity in the sympathetic branch of the autonomic nervous system.
-avoidance –> avoidance behaviour is negatively reinforced (in classical conditioning terms) because it is carried out to avoid the unpleasant consequence of exposure to the phobic stimulus. Therefore, avoidance severely impacts the patient’s ability to continue with their day to day lives.
-endurance –> this occurs when the patient remains exposed to the phobic stimulus for an extended period of time, but also experiences heightened levels of anxiety during this time
17
Q
cognitive characteristics of a phobia
A
-selective attention to phobic stimulus –> this means that the patient remains focused on the phobic stimulus, even when it is causing them severe anxiety. This may be the result of irrational beliefs or cognitive distortions.
-irrational beliefs –> this may be the cause of unreasonable responses of anxiety towards the phobic stimulus, due to the patient’s incorrect perception as to what the danger posed actually is.
-cognitive distortion –> the patient does not perceive the phobic stimulus accurately. Therefore, it may often appear grossly distorted or irrational e.g. mycophobia (a phobia of mushrooms) and rectaphobia (a phobia of bottoms).
18
Q
3 categories of phobias
A
specific, social, agoraphobia
19
Q
specific phobias
A
-most common
-sufferers are anxious in the presence of a particular stimulus
20
Q
social phobia
A
-sufferers experience inappropriate anxiety in social situations. Even just thinking about them can cause anxiety. This leads to avoidance
-usually starts in adolescence with no trigger
21
Q
agoraphobia
A
-least common
-sufferers are anxious in a situation they cant easily leave e.g crowds
-They are avoidant and anxious
-most cases begin in early/mid 20s and can happen without warning
22
Q
assumptions (behavioural)
A
-only behaviour is important
-abnormal behaviour is learned by social events or through conditioning
-environment can reinforce maladaptive behaviour
-tabula rassa
-classical and operant conditioning
23
Q
two model process
A
-Hobart Mowrer
-states that phobias are acquired by classical conditioning (association) and maintained due to operant conditioning (negative reinforcement)
24
Q
acquisition by classical conditioning
A
-Watson and Rayner
-association of a fearful event with a certain stimulus elicits phobic response
-NS becomes conditioned
-Little Albert
25
maintenance by operant conditioning
-behaviour is reinforced or punished
-negative reinforcement occurs in phobias
-whenever we avoid the phobic stimulus we are successful in escape of fear and anxiety
26
Little Albert - Watson and Rayner
Aim --> to see if we form and association/fear that riggers a response
Procedure:
-Waston and Rayner created a phobia in a 9 month old baby
-NS = rat
-UCS = loud noise
-UCR = fear of noise
-CS = rat
-CR = fear of rat
Results:
-albert had a phobia of the white rat due to association of a loud, frightening noise
Conclusion:
-stimulus generalization
27
strengths - behavioural approach to phobias
-Good explanatory power --> 2 process model = important implication for therapies = real life application
-Research support --> Little Albert study = valid and credible explanation
-Treatment (practical application) --> systematic desensitzation and flooding = reliability
28
limitations - behavioural approach to phobias
-Alternative explanation for avoidant behaviour --> not all phobias result from anxiety and may be due to feeling of saftey etc
-An incomplete explanation of phobia --> only relevant to social phobia
-Doesn’t take biological/innate phobias into account --> e.g fear of snakes (ophidiophobia)
29
systematic desensitastion
-Systematic desensitisation is based upon the principle of classical conditioning. It involves a counter-conditioning procedure whereby a fear response to an object or situation is replaced with a relaxation response in a series of progressively increasing fear-arousing steps --> Wolpe (1958) - cannot experience fear and relaxation at same time
30
steps for systematic desensitisation
Anxiety hierarchy --> relaxation ---> exposure
31
anxiety heirachy
-constructed by the patient as therapist
-this is a stepped approach to getting the person to face the object or situation of their phobia from least to most frightening
32
relaxation
-the therapist teaches the patient to relax as deeply as possible e.g breathing exercises of mental imagery techniques, meditation or drugs such as valium
-reciprocal inhibition
33
exposure
-finally the patient is exposed to phobic stimulus while in a relaxed state.
-this takes place across several sessions starting at the bottom of the anxiety heriachy
-treatment is successful when the patient can stay relaxed
34
relaxation
-At each stage of systematic desensitization a relaxation technique is used
35
flooding
-stops phobic responses more quickly and more effectively
-Involves overwhelming the individuals senses with the item of simulation that causes anxiety till that person realises no harm will occur
-No relaxation or step by step build up. Individual is exposed repeatedly and in an intensive way.
-patients must give informed consent before continuing with this treatment
36
extinction
Extinction --> when patient learns quickly that the phobic stimulus is harmless
37
Similarities of flooding and SD
-Direct expose to phobic stimulus
-get to process of extinction
-done in controlled settings
-based on principle of behaviourist approach
38
Differences between flooding and SD
-flooding is faster and more effective than SD
-flooding doesn’t involve relaxation techniques
-flooding has higher attrition (drop out) rate
39
evaluating therapies
When evaluation therapies we always want to consider their effectiveness and appropriateness
-appropriateness --> right for persons situation
-effectiveness --> how well it works
40
strengths of systematic desensitization
-+ Supporting evidence = Gilroy et al. followed up 42 patients treated in three sessions of systematic desensitisation for a spider phobia. Their progress was compared to a control group of 50 patients who learnt only relaxation techniques. The extent of such phobias was measured using the Spider Questionnaire and through observation. At both 3 and 33 months, the systematic desensitisation group showed a reduction in their symptoms as compared to the control group, and so has been used as evidence supporting the effectiveness of flooding.
+ Systematic desensitisation is suitable for many patients, including those with learning difficulties = Anxiety disorders are often accompanied with learning disabilities meaning that such patients may not be able to make the full cognitive commitment associated with cognitive behavioural therapy, or have the ability to evaluate their own thoughts. Therefore, systematic desensitisation would be a particularly suitable alternative for them.
+ More acceptable to patients, as shown by low refusal and attrition rates. = This idea also has economical implications because it increases the likelihood that the patient will agree to start and continue with the therapy, as opposed to getting ‘cold feet’ and wasting the time and effort of the therapist!
41
limitations of systematic desensitisation
-takes more time so perhaps will be more expensive (3 processes involved)
-only treats observable and measurable symptoms of a phobia
42
strengths of flooding
-Quicker and more effective
-useful for specific phobias
-+ = Cost-effective - Ougrin compared flooding to cognitive therapies and found it to be cheaper. This is because the patient’s phobia will typically be cured in one session, thus freeing them of their symptoms and allowing them to continue living a normal life.
43
limitations of flooding
-— = Less effective for complex phobias. Social phobias involve both anxiety and a cognitive aspect i.e. thinking unpleasant thoughts about a situation. Thus, in such cases, cognitive therapy may be more appropriate because this therapy can target the distal causes of the phobia, as opposed to the mere proximal (indirect) causes. This suggests that alternatives may be more effective
-may be traumatic and therefore lead to attrition
44
depression
-Depression is a mood disorder. It involves prolonged and fundamental disturbance of mood and emotion (low mood and low energy)
-depressive disorders are the most common of all the psychopathological disorders.
-In Britian it is estimated that 20% of adults suffer from depressive illness at any one time
-There are no laboratory tests to diagnose depression
45
diagnosis of depression
-In order to be suffering from clinical depression a person should have experienced at least five of the following symptoms and a persistent low mood over at least 2 weeks
46
symptoms of depression
-poor appetite or weight gain --> behavioural
-sleep difficulty or sleeping too much --> behavioural
-loss of energy/tiredness --> behavioural
-body slowed down or agitated --> behavioural
-loss of interest or pleasure in usual activities --> behavioural/emotional
-feelings of guilt --> emotional
-inability to concentrate --> cognitive
-suicidal behaviour --> cognitive
47
emotional characteristics of depression
-lowered mood --> empty + worthless
-anger --> aggressive/self harming
-lowered self esteem --> self loathing
48
behavioural characteristics of depression
-reduced levels of energy --> lethargic
-disruption to sleep and eating behaviour
-aggression and self harm
49
cognitive characteristics of depression
-poor concentration
-dwelling on the negative (half empty or poor mindset)
-absolutist thinking (absolute disaster)
50
cognitive psychologists
Cognitive psychologists draw inference from expression of internal feelings through behaviour
51
becks cognitive theory of depression
-American psychologist Beck suggested a cognitive approach to explaining why some people are more vulnerable to depression than others
-in particular it is a persons cognitions that create this vulnerability (Beck suggested 3 parts)
Faulty information processing --> negative self schemas --> negative triad
52
faulty information processing
-this type of thinking can lead individuals to pay more attention to the negative aspects of situations and ignore the positive
-Glass is always "half empty" and can be difficult for individuals to break out of this pattern of negative thinking
-blow small things out of proportion --> black and white terms
53
negative self schema
-a schema is a package of ideas and information developed through experience
-they act as mental framework for the interpretation of sensory information
-a self schema is the package of information we have abt ourselves.
-if we have a negative schema then we interpret all information about us in a negative way e.g "Im not good enough"
54
negative triad
-a person develops a dysfunctional view of themselves because three different types of negative thinking that occur automatically, regardless of the reality of what is happening at the time
1) Negative view of the self (incompetent + undeserving)
2) Negative view of the world (hostile place)
3) Negative view of the future (problems will not disappear)
This pessimistic view becomes a self-fulfilling prophecy and leads to cognitive bias. Depressed people tend to focus on the negative aspects of their lives and ignore the positive ones
Beck conducted a questionnaire to assist healthcare conditions in the diagnosis of depression
55
Elli's ABC model
-Ellis focuses on irrational beliefs as the source of depression. It is not what happens to someone that causes depression but how they deal with it
-He proposed that good mental health is the result of rational thinking
-Conditions like anxiety and depression result from irrational thoughts
ABC model explains how irrational thoughts affect our behaviour and emotional state
56
irrational thinking (ellis)
-Negative event --> rational belief --> healthy negative emotion
-Negative event --> irrational belief --> unhealthy negative emotion
57
A, B, C
A = activating event = irrational thoughts are triggered by external events. We get depressed when we experience negative events that trigger irrational thoughts
B = belief = there are a range of irrational beliefs e.g musturbation --> must always achieve success, I-cant-stand-it-it is --> major disaster, utopianism = fairness
C = emotional and behavioural consequences as a result of irrational belief
58
correlation
Correlation between negative thoughts and depression rather than a cause and effect relationship
59
strengths of Beck's theory
-Supporting research evidence - Grazioli and Terry’s evaluation of 65 pregnant women for cognitive vulnerability and depression before and after birth. The researchers found a positive correlation between an increased cognitive vulnerability and an increased likelihood of acquiring depression after birth. This supports the link between faulty cognition and depression, which is in line with the predictions made by Beck’s cognitive theory, thus increasing the validity of this theory.
Practical application in CBT = An increased understanding of the cognitive basis of depression translates to more effective treatments i.e. elements of the cognitive triad can be easily identified by a therapist and challenged as irrational thoughts on the patient’s part. Thus, it translates well into a successful therapy and the consequent effectiveness of CBT (as discussed later on) is merit to the accuracy of Beck’s cognitive theory as an explanation for depression.
60
limitation of becks theory
-Doesn’t explain all aspects of depression --> Becks questionnaire is limited to and only explains basic symptoms of depression. Depression is a complex mental illness that is expressed differently in different people. For example, some sufferers of depression suffer hallucinations and bizzare beliefs that Becks questionnaire doesn’t underscore. Lacks generalisability
Furthermore, there are alternative explanations which suggest that depression is a biological condition, caused by genes and neurotransmitters. Research has focused on the role of the neurotransmitter serotonin and found lower levels in patients with depression. In addition, drug therapies, including SSRIs (selective serotonin reuptake inhibiters), which increase the level of serotonin, are found to be effective in the treatment of depression, which provide further support for the role of neurotransmitters, in the development of depression.
61
strengths of ellis theory
-Practical application to CBT --> + = The ABC model shares the same advantage as Beck’s cognitive theory in that it provides a practical application in CBT. The effectiveness of CBT suggests that identifying and challenging irrational beliefs are at the core of ‘curing’ depression, which in turn supports the theoretical basis of the ABC model, through a specific focus on the role of faulty cognitions in the development of depression and specifically, in the interpretation of an activating event.
62
limitation of ellis theory
-Questionnaire method is subjective and not descriptive
-— = Ellis’ ABC model cannot explain all types of depression, apart from those which clearly have an activating event i.e. reactive depression. However, many suffer from depression without an apparent cause, and may feel frustrated that their concerns/experiences are not reflected in this theory. Therefore, this suggests that the ABC model is limited at best. Both the ABC model and Beck’s cognitive theory of depression share the same disadvantage in that they cannot explain all aspects of depression e.g. hallucinations, anger, Cotard Syndrome. This poses a particularly difficult practical issue in that patients may become frustrated that their symptoms cannot be explained according to this theory and therefore cannot be addressed in therapy.
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alternative explanations for depression other than cognitive
-Biological approach --> depression is caused as a result of chemical imbalance in the brain
-Psychodynamic approach --> depression is caused of repressed trauma in childhood during psychosexual stages
64
CBT
-CBT can help break the vicious cycle of maladaptive thinking, feelings and behaviour. This includes behavioural techniques such as behavioural activation
-Based on both behavioural and cognitive techniques
-can help people change how they think and what they did. These changes can help them feel better
-meet w a therapist between 5-20 times and each session lasts 30-60 minutes
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steps for CBT
Assessment --> formulation/goals --> treatment --> homework/monitoring --> treatment complete
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Becks cognitive theory in relation to CBT
Patient + therapist work together --> Identify automatic thoughts about the world, self and future known as the negative triad. Formulate goals and struggles
Challenge the negative thoughts --> Once thoughts are recognised the patient and therapist must work together to remove them. Test reality of negative beliefs so may be set HW and are checked upon. (reality testing)
The patient as a scientist --> Patients might be sent homework to do e.g record and event when someone was nice to them to investigate the reality of their negative beliefs
67
Elli's REBT (rational emotive behavioural therapy)
A = activation event
B = beliefs
C = consequences
D = dispute
E = effect
REBT extends Elli's ABC model to identify dispute and challenge irrational thoughts
A --> B --> c --> D --> E
-challenge and replaced thoughts with more rational beliefs
68
types of disputing
-empirical argument --> disputing whether there is actual evidence to support the negative belief
-logical argument --> disputing whether negative thoughts logically follows from the facts
69
research example using CBT
-March et al followed a group of 372 adolescents with a main diagnosis of depression
-After 36 weeks 81% and 81% and 86% were respective improvement rates for each 3 experimental conditions
Condition 1 --> CBT only
Condition 2 --> antidepressants
Condition 3 --> CBT and antidepressants
70
strengths of CBT cognitive therapy
-is effective (research support) --> March et al --> CBT is beneficial and is just as effective as antidepressants
-practical applications (DIY that breaks poor habits) --> can be done by patient at home and work on techniques to reduce negative thoughts. Limit impacts long term
71
limitations of CBT cognitive therapy
-CBT may not work for most severe cases --> patients cannot motivate themselves to engage with the hard cognitive work of CBT. Perhaps medication is better
-overemphasis on cognition and ignores other factors e.g trauma can impact depression --> minimise importance of circumstances e.g McCisker et al --> patient living in poverty of abuse may cause them to have depression. Inappropriate CBT techniques can demotivate people to change their situation
-not long term 42% relapsed
-more effective when combined with antidepressants (March et al)
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define obsessions
intrusive thoughts, impulses or images
73
define compulsions
repetitive/ritualistic behaviour or mental acts
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define OCD
OCD is a mental health condition where a person has obsessive thoughts and compulsive activity
-Some people with OCD may spend an hour or so a day engaged in obsessive-compulsive thinking behaviour but for others the condition can completely take over their life.
75
DSM-5 characteristics of OCD
OCD --> characterized by either obsessions (recurring thoughts) and/or compulsions (repetitive behaviour)
Hoarding disorder --> compulsive gathering of possessions and the inability to part with anything regardless of its value
Trichotillomania --> compulsive hair pulling
Excoriation disorder --> compulsive skin picking
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behavioural characteristics of OCD
-compulsions are repetitive e.g hand washing which reduce anxiety
-avoidance --> to reduce anxiety by keeping away from situations that trigger OCD
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emotional characteristics of OCD
-Anxiety and distress --> unpleasant and emotional experience because of the powerful anxiety that accompanies obsessions and compulsions. Thoughts are unpleasant and frightening and anxiety can be overwhelming
-accompanying depression --> OCD is often accompanied by depression e.g low mood or lack of enjoyment
-Guilt and disgust --> other negative emotions such as irrational guilt can arise alongside OCD other than anxiety or depression
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cognitive characteristics of OCD
-90% with OCD experience obsessive thoughts --> always unpleasant e.g impulses to hurt someone
-"uncontrollable urges"
-excessive anxiety --> irrational thoughts --> catastrophic thoughts about worst case scenarios that might result in anxiety
-hypervigilant (constant alterness)
79
OCD cycle
obsessions --> anxiety --> compulsions --> relief
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biological approach to explaining OCD
-biological approach --> emphasises the importance of physical processes in the body
-genetic explanations --> specific genes increase vulnerability for OCD --> genetics inherited by our parents
-neural explanations --> genes associated with OCD are likely to affect the levels of key neurotransmitters as well as the structures of the brain
81
genetic explanations to OCD
-genes are involved in how vulnerable we may be to OCD
-Lewis (1936) observed his OCD patients and found 37% had parents with OCD and 21% has siblings iwht OCD
-OCD is inherited and individuals have specific genes which predispose it
82
diathesis stress model
certain genes leave some people more likely to suffer a mental disorder. Environmental stress may trigger the condition
83
candidate genes
genes which create vulnerability for OCD. Genes involved in regulating development of serotonin system e.g 5HTI-D beta gene involves the transport of serotonin across synapses
84
OCD is polygenic
OCD is polygenic --> OCD is not caused by one single gene but that several genes are involved.
COMT gene = dopamine and neurotransmitters
SERT gene = serotonin and neurotransmitters
Taylor analysed findings of previous studies and found 230 genes involved in OCD (too many to have predictive power)
85
neural explanations to OCD
-The genes associated with OCD are likely to affect the levels of key neurotransmitters as well as structure of the brain called neural explanations
86
role of serotonin and dopamine
Role of serotonin --> regulate mood and lower levels associated with SERT gene. Low levels may affect mood and mental processes. Drugs which increase level of serotonin are effective in treating patients with OCD
High levels of dopamine --> increase symptoms of OCD
87
decision making systems (OCD)
some cases of OCD in particular hoarding disorder seem to be associated with impaired decision making. Abnormal functioning frontal lobes which are responsible for logical thinking and making decisions
-Max et al (1994) found that when the basial ganglia (coordination of movement) is disconnected from the frontal cortex then OCD symptoms are reduced
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strengths to biological explanations to OCD
-Nestadt et al. reviewed previous twin studies of OCD and found that 68% of identical twins, compared to 31% of non-identical twins, share OCD. This strongly suggests that there is a genetic basis for this disease because identical twins share 100% of their genes with each other, whilst dizygotic twins only share 50% of genes with each other. However, it is important not to be deterministic - just because an individual has a particular combination of candidate genes does not mean that the individual is ‘doomed’ to develop OCD, but rather that this genetic vulnerability must be paired with an environmental stressor to result in OCD, as dictated through the diathesis-stress model. (strong influences of genetics on OCD)
-There is evidence to support the role of some neural mechanisms in OCD. E.g antidepressants work purely on the serotonin system, increasing levels of neurotransmitter. Such drugs are effective in reducing OCD symptoms
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Limitations of biological explanations to OCD
-Lacks predictive power --> Twin studies suggest that OCD is largely under genetic control, but psychologists havent been so successful at pinning down all the genes involved
-Lacks reliability --> Environmental factors can also trigger the risk of developing OCD (diathesis stress model) e.g Cromer et al found half of OCD patients in their sample had a traumatic event in their past and that OCD was more severe in those with more than one trauma
-— = Too many candidate genes = With over 230 candidate genes each individually coding for an increased risk of OCD, then this poses a practical issue in that it is difficult to assess which candidate genes have the greatest influence and so which genes drug treatments should target. Thus, such an explanation is likely to have little predictive value in the future.
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Marie Jahoda - 6 criteria
-positive self attitude
-behaving independently
-self actualisation
-resistance to stress
-accurate perception of reality
-environmental mastery - flexibility/ control in one's own environment
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diathesis stress
-need combination of genes and environment for OCD
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co-morbidity
having 2 disorders at the same time
93
neuron and neurotansmitter
neuron - nerve cells that send messages
neurotransmitter - responsible for relaying information from one neuron to another
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assumptions of biological approach
-the biological approach assumes that psychopathology is caused by physical factors therefore altering these physical factors should help treat psychopathology
-For OCD drug therapy is commonly used
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drug therapy for OCD
-Treatments for OCD are based on the assumption that it is a chemical imbalance (neurotransmitters) which cause abnormality
-drugs can increase and decrease levels of neurotransmitters
-most common drug therapy for OCD is use of selective serotonin reuptake inhibitors (SSRIs) which increase serotonin levels
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steps for SSRI's
1) Serotonin is released by presynaptic neurons in the brain and travels across the synapse to receptor sites on the post-synaptic neurons
2) serotonin which is not absorbed into the post-synaptic neuron is reabsorbed into the sending cell (pre synaptic neuron)
3) SSRI's increase the level of serotonin avaliable in the synapse by preventing it from being reabsorbed into the sending cell
4) This increases the level of serotnin in the synapse and results in more serotonin being received by the receiving cell (post-synaptic neuron)
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other drugs in the treatment of OCD
-Tricyclics (older type of antidepressant) --> e.g cliomirpamine -> same effect on serotonin as SSRI's but has more severe side effects so usually reserved for patients who don’t respond to SSRI's
-SNRI's (serotonin-nor adrenaline reputake inhibitors) --> 2nd line of defence for patients who don’t respond to SSRI's. Increase levels of serotonin as well as other neurotransmitter noradrenaline
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research evidence to support biological treatment
-double blind trial
-G.Mustafa Soomro et al (2009) reviewed 17 studies that compared SSRI's to placebos in the treatment of OCD.
-All 17 studies showed significantly better outcomes for SSRI's than for the placebo conditions
-typically symptoms reduce around 70% of people taking SSRI's
-For remaining 30% most can be helped by alternative drugs of psychological therapies
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strengths of biological treatment to OCD
-supporting research evidence = valid and effective = double blind trial (Soomro et al) = real life applications
-drugs are cost effective + easy improvements than psychological treatments = easy for people to administer themselves = non-disruptive to patients lives unlike psychological therapies which require motivation = more willing to receive treatment
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limitations of biological treatment to OCD
-research uses small samples
-most effective when combined with other psychological treatments
-drugs have side effects e.g blurred vision e.g for those talking clomipramine side effects are more common and can be more serious e.g more than 1 in 10 patients suffer tremors and weight gain = reduced effectivness
-unreliable evidence for drug treatments = Goldacre discovered that research is bias and drug companies don’t resport all the evidence
101
mood vs anxiety disorder
mood = depression
anxiety = phobias and OCD
102
what is OCD (3 marks)
OCD is an anxiety disorder where sufferes have obsessions and compulsions. Obsessions are recurring intrusive thoughts and compulsions are repetitive actions that the sufferer feels they must complete in order to stop the obsessions
103
Ellis =
reactive rather than endogenous depression
reactive = as the result of a stressor
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Ao1 = cognitive approach to treating depression
general rationale of cognitive therapies – to change / modify negative schema /
irrational thoughts and so alleviate the depression
* Beck’s cognitive behaviour therapy (CBT) – steps involved: identification of irrational
thoughts/negative triad (‘thought-catching’); ‘patient as scientist’ – generate
hypotheses to test validity of irrational thoughts; homework tasks; reinforcement of
positive thoughts; cognitive restructuring
* Ellis’ rational emotive behaviour therapy (REBT) – ABCDE model; rational
confrontation / dispute; empirical and logical arguments; challenging automatic
negative thoughts; behavioural activation; shame-attacking exercises
105
16 marker = statistical infrequency and deviation from social norms
Statistical infrequency:
* abnormality is defined as behaviour or characteristics that are rare/uncommon/unusual
* occupies the extreme ends of a normal distribution curve, eg low IQ defined as intellectual disability
disorder
* relies on the use of up-to-date statistics.
Deviation from social norms:
* all societies make collective judgments about what counts as ‘normal’/usual/typical behaviour
* any behaviour that does not conform to accepted/expected standards is abnormal
* norms vary from culture to culture.
Possible discussion:
* many diagnoses of illness involve some reference to statistics
* difficult to know where the line is between statistically normal and abnormal/subjective interpretation
* some statistically infrequent behaviour is desirable/highly regarded, eg high IQ
* not all behaviour that deviates from social norms is a sign of illness, eg speeding
* norms are culturally relative so difficult to determine universal signs of illness
* social norms definition could be used/abused as an instrument of social control
* social norms change over time (lack of temporal validity)
* neither definition is satisfactory on its own – comparison with alternatives, eg failure to function,
deviation from ideal mental health.
106
2 emotional characteristics of OCD
low mood
self loathing
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disturbed communication in basal ganglia
accounts for repetitive and ritualistic behaviour
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reciprocal inhibition
reciprocal inhibition refers to the principle that two opposing emotions, like fear and relaxation, cannot be experienced simultaneously. This concept is central to the behavioral therapy technique of systematic desensitization, which aims to replace phobic anxiety with relaxatio
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OCD =
aetiologically heterogenous condition
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extra psychopathology information
Patients need to give informed consent before they take part as it is traumatic
Volk- concept of reciprocal inhibition - cannot experience fear and relaxation at the same time
Flooding - no option of avoidance etc so patient quickly realises the phobic stimulus is harmless - leads to extinction
Example of SSRI = fluoxetine
Combination of drug therapy in OCD to treat OCD - drug therapy treats emotional characteristics while CBT allows patients to engage cognitively and behaviours
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SERT and COMT gene
SERT = lower serotonin levels = anxiety that feels overwhelming, malfunctioning in the OFC
COMT = higher dopamine levels, cant suppress intrusive thoughts, compulsions ingrained
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drugs to treat OCD
-overall aim = reduce anxiety, accompanying depression etc
alternatives to SSRI's used if they are ineffective
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evaluation = definitions of abnormality
There is also no definite cut-off point where normal behaviour becomes abnormal behaviour. Finally, some behaviours that are considered psychologically abnormal are quite common, e.g. mild depression. Hassett and White (1989) argue that you cannot use statistical infrequency to define abnormality because of this. Using the statistical infrequency idea, some disorders would not be classed as anything unusual.
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PEEL paragraph for failure to function adqueatly eval
A weakness of the Failure to Function Adequately definition is its individual differences. For example, someone with OCD may have excessive rituals that prevent them from functioning adequately, therefore causing them to miss work. However, another person may suffer from the same from the same problem but find time to complete their rituals and make work on time. This therefore questions the validity of this definition. Definitions of abnormality typically take a nomothetic approach and try to identify a list of factors, or symptoms, that can be used to diagnose abnormal behaviour. However, some psychologists, would argue that this approach ignores individual differences and therefore a different approach to defining abnormality might be more appropriate
