Psychopathology Flashcards
(192 cards)
1
Q
What is statistical infrequency
A
occurs when an individual has a less common characteristic for example being more depressed or less inteligent than most of the population .
2
Q
deviation from social norms
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concerns behaviour that is different from the accepted standards of behaviour in a community or society .
3
Q
example ; IQ and intellectual disability disorder
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the statistical approach comes into its own when we are dealing with characteristics that can be reliably measured for example intelligence .
-We know that , in any human characteristic , the majority of people’s scores will cluster around the average /
-Further we go , fewer people will attain that score . this is NORMAL DISTRIBUTUION .
4
Q
What is IDD (intellectual disability disorder )
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Used to be known as mental retardation , individuals who score below 70 , unusual or abnormal .
5
Q
Do people notice deviation from social norm ?
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When a person behaves in a way that is different from how we expect people to behave . Defined on what is i norm behaviour , we make a collective judgement as a society about what is right .
6
Q
How are norms specific to the culture we live in
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for example , some behaviour that are universally abnormal , on the basis that they BREACH social norms .
-homosexuality as illegal in 2019 until new laws were made , before sex between men was punishable .
7
Q
example anti social personality disorder
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a person with this is impulsive , aggressive and irresponsible .
-according to the manual used by psychiatrists to diagnose mental disorders DSM-5 .
-One important symptom of antisocial personality disorder is an absence of prosocial internal standards associated with failure to conform to lawful and culturally normative ethical behaviour .
8
Q
what are disorders aka
A
in other words , we are making the social judgement that psychopaths are abnormal because they don’t conform to our moral standards . Psychopathic behaviour would be considered abnormal in a very wide range of cultures .
9
Q
EVALUATION - one strength of statistically infrequency
example used intellectual disability disorder
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the usefulness of statistical infrequency .
-Statistically infrequency is used in clinical practice , both as part of formal diagnosis and as a way to assess the severity of an individual’s symptoms .
-intellectual disability disorder requires an IQ of below 70 .
-an example of statistical infrequency criterion tool s beck repression inventory BDI .
-a score of 30+ is widely interpreted as severe depression
10
Q
EVALUATION -limitation - unusual characteristics can be positive
A
one limitation of statistical infrequency is that infrequent characteristics can be positive as well negative .
-you would not think someone as having an high IQ as abnormal .
-Meaning that although statistical infrequency can form part of assessment and diagnostic procedures it is nevermsufficent as the sole basis for defining abnormality .
11
Q
evaluation extra - benefit verus problems
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some unusual people benefit from being classed as abnormal .
For example , somewhere who ahs a very low IQ , and is diagnosed with intellectual disability can then access support services or someone with a very high BDI score is likely to benefit from therapy .
-On the other hand , not all statistically unusual people benefit from labels . Someone with a low IQ who can cope with their chosen lifestyles would not benefit from a label . Their is a SOCIAL STIGMA , attached to such labels .
12
Q
Evaluation - Real-world application
A
One strength of deviation from social norms is its usefulness .
-Deviation from social norms is used in clinical practice .
For example , the key defining characteristic of antisocial personality disorders , is the failure to conform to culturally normal ethical behaviour (recklessness , aggression violating the rights of others and deceitfulness .)
13
Q
Evaluation - Real world application
A
deviation from social norms is used in clinical practice .
-For example , the key defining characteristic of antisocial personality disorder is the failure to conform to culturally normal ethical behaviour (i.e recklessness( aggression , violating the rights of others and deceitfulness .
14
Q
what are these disorders deviations from social norms ?
A
such norms also plays a part in the diagnosis of schizotypal personality disorder ,w here the term (strange ) is used to hcracterisixcise , the thinking behaviour and appearance of people with the disorder - showing us that deviation from social norms criterion has value in psychiatrist .
15
Q
EVALUATION - cultural and situational relativism
A
one limitation of deviation from social norms is the variability between social norms in different cultures and different situations .
-A person from one cultural group may label someone from another group as abnormal using their standards rather than the person’s standards .
-For example , hearing voices , normal in some cultures which is seen as abnormal in the UK .
16
Q
Cultural and Situational Relativism
A
Also even with ne cultural context ,m social norms differ from one situation to another . Aggressive and deceitful behaviour in the context of family life is more socially unacceptable than in he context of corporate deal-making .
-This means that it is difficult to judge deviation from social norms across different situations and cultures .
17
Q
Failure to function adequately
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occurs when someone is unable to cope with ordinary demands of day to day living .
18
Q
deviation from ideal mental health
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occurs when someone vdoes not meet a set of criteria for good mental health .
19
Q
How do we decide if someone is not functioning adequately ?
A
If they are unable to maintain basic standards of nutrition and hygiene .
-We might also consider that they are no longer functioning adequately if they cannot hold down a job or maintain relationships around them .
20
Q
What is the three criteria to someone failing to function adequately .
A
David Rosenhan and Martin Seligman proposes some additional signs to show that someone is not coping .
-When a person no longer conforms to standard interpersonal rules , for example maintaining eye contact / respecting personal space .
-When a person experiences severe personal distress .
-When a person’s behaviour become irrational or dangerous to themselves or others .
21
Q
Example ; intellectual disability disorder
A
on the previous spread we looked at the example of intellectual disability disorder and we saw that before low iq , and individual must be failing to function adequately , BEFORE a diagnosis is given .
22
Q
Deviation from ideal mental health - what is the alternative way to look at mental health ?
A
a very different way to look at normality and abnormality is to ignore the issue of what makes someone abnormal but instead think about what makes anyone normal .
then we can identify who deviates from the ideal mental health .
23
Q
What does ideal mental health look like ?
Marie Jahoda
A
Suggested we have to meet the following criteria /
-We have no symptoms or distress .
-We are rational and can perceive ourselves accurately .
-We can self-actualise (strive to reach our potential )
-we can cope with stress
-we have a realistic view of the world
*-we have good self-esteem and lack guilt
-we are independent of other people .
-we can successfully work love and enjoy our leisure .
24
Q
Marie Jahoda
A
Inevitably , there is some overlap between what we might call deviation between what we might call deviation from ideal mental health and what we might call failure to function adequately .
-so we can think of someone’s inability to keep a job as either a failure to cope with t he help reassures of work or as a deviation from the ideal of successfully working .
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Evaluation - represents a threshold for help
One strength of the failure to function criterion is that it represents a sensible threshold for when people need professional help .
-Most of us have symptoms of mental disorder to some degree at some time . In fact , according to the mental health charity mind , around 25% of people in he uK will experience mental health problem in any given year .
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Many people press on in the face of fairly severe symptoms .
It tends to be at the point that we cease to function adequately that people seek professional help or are notices and referred for help by others . This criterion means that treatment and services can be targeted to those who need them most .
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EVALUATION - discrimination and social control
one limitation of failure to function is that it is easy to label non=standard lifestyle choices as abnormal .
-in practice , it can be very hard to say when someone is really failing to function and when they have simply chosen to deviate from social norms .
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EVALUATION - discrimination and social control part 2
not having a job or permanent address might seem like failing to function and for some people it would be .
-However , people with alternative lifestyles choose to live off grid .
-similarly those who favour high-risk leisure activities or unusual spiritual practices could be classed , unreasonably as irrational and perhaps a danger to self .
-This means , that people who make unusual choices are at risk of being labelled as abnormal and their freedom of choice may be restircited .
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evaluation - failure to function can be normal
There are some circumstances in which most of us fail to cope for a time e.g bereavement it may be unfair to give someone a label that may cause them future problems just because they react to difficult circumstances .
-On the other hand , the failure to function is no less rea just , because the causes clear .
-Also , some people need professional help to adjust to circumstances like bereavement .
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EVALUATION - a comprehensive definition
one strength of the ideal mental health criterion is that it is highly comprehensive .
-Jahoda's concept of ideal mental health includes a range of criteria for distinguishig me
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evaluation - may be culuture bound
-one limitation of the ideal mental health criterion is that its different elements are no equally applicable across a range of cultures .
-Some of Jahoda;s crtiera for idel mental health are firmly locted int he context of USA and Western Europe .
-In particualr , the concept of self-actualistion would proably be dismiessed as self induglent in mch of the world .
--Even
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evaluatione xtra - extremely high standards
very few of us attin all of jahoda's crtiera for mental health , and proably none of us achieve all of hem at the same time or keep them up for ber long .
-it can be disherterning to see an impsosibl se of standards to liv eup to .
-on the otehr hands , havign sucha c omprehensieve set of crtieria fo rmental helath to work towrds mgiht be prtical value to someoen wanting to undersand and improve their mental health .
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evaluation maybe culture bound - wesern europe
-even western europe ther eis quite a bit of varaition int he lave placed in much of the world .
-even with wesern europe , there is quite a bit of variation int he vlue placed on personal indepndence -e.g high germanly , low in ital .
-furthermore wha defines success ino ur working ,s ocial ,a nd love-lives is verdifferent in dkfferentcultures .
-THIS MEANS , tht it is difficult ot applyt he concept of ideal mental health from on culture to aother .
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what is a phobia ?
an irrational fear of an object or situation .
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meaning of behaviorual ?
ways in which people act
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meaning of emotional ?
related to a person's feelings or mdood .
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meaning of cognitive ?
refers to the process of knwoing , inclduing thinkign , resoning , remembering believing .
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there are three ctegoires of phobi and related to anxiety disorder :
...
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specific phobia
phobia of an object such as an animal or bod aprt , or a situation such as flying or having an injection .
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social anxiety (social phobi )
phobia of a social situation such as opublic speaking or using a public toilet .
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agoraphobia
phoia of beingo utside or ina public place .
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behaviorual charcaterstics of phobia
-the fear resposnes in phoias are the ame as we expereicne for any other fear or vene if the levels of fer is irrarional - out of all proprtion to the phobic stimulus .
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an example of a behaviorual charcaterstc - PANIC - explain
-A person with a phobia , may panic in resposne to the presence of the phobic stiulus .
-paic may involve a range of behaviours including crying , creaming , or running away .
--children may react slightl diffeeny for example , by freezzing , ccligning or having a tantrum .
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behavioural chracterstics of phobia - voidnce - explailn
unless the person is mking a conscious effort to face thier fear they tend to go to a lot of effort to prevent coming into contact with the phoic timulus , This cn make mskr i hsd to go about daily life .
-for example someone with a ear of publiv toielts may hae to limit the time they spend outisde the home in relation to show long they can lst without a toielt .
-this in turn can intefere with work , eduction and soicl life .
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behviorual characterstics of phooias - endurance
the alternative behaviorual reposne to avoidance is endurance . This occus whent he person choose to remian in the presence of the phobic stimuuls .
-For example , a person with arachnohpia , reman in a room wih spider on ceiling and keep eye contact w it .
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one emotioanl characeristic of phobias - anxiety
phobias are classed as anxiety disroders . Byd efenition then they invovle an emotioanl reponse of anxiety . s an unpelasnt sta eof high rusal .
-This present a person relaxing and makes it very difficult to experience any postiie emotional . Anxiety can be long term .
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emotional chracteristics of phobias - fear
althogh in everyday speech we mmight use the term 'anxiety' and 'fear' as interchangebaly , they have disnitc meanings .
-FEAR is the immeediate an extremely nplesant respone we extremel unplrasnt resposne we experience when we ecnounte or think about phbc stiumuls .
-it is usuallymore intense but experienced for shore periods han anxiety .
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emotional charcatersics of phobia - emotional resposne is unreasonable
the nxiety or fear is much greater than is ' normal' and disportopin to any threat posed .
-for example a person whcih arachnopha will hev a strong emotional reposne to tin sprea - most peole would repsond in a less anxious way even to a pisnous spider .
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cognitive characteristics of phobia
-the cognitive element is concerned with the wyas in which peole propcess informaiton .
-people with phobias process information aout phobic stimuli different from toher objects or situations .
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one cognitive charcaractertis of phobias = selectie attnetion to the phobic stimulus
if a person can see the phobic stimulus it is hard to look away dfrom it . Keeping our attnetion on something really dageorus is a good thing as it gives us the best chance of reacting wuicklt o threat ,but this is not useful when the fer is irrional .
-A oersin with pgonophobia will struggle to centrate on what theya re doing if there is soemone witha beard in the room .
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another congitive characteristics of phobias - irrational beleifs.
a person with a phobia mayy hold unfoudned thorughs in relation to pghoc stimuli - thst can;t be easily explained and dn't have any basicis inreality
-for example social phobias can ivovle beliefs like i must aleys sound intellgien , this kin of beleifs INCREASE HT EPRESSURE NON THE PERSON TO PERFORM WELL IN SOCIL SITUATIONS .
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cogntiviee charcateistics of phobi -cognitie didstortions
the percpetions of a person with a phbia may be inaccurae and unrelaistic . so , for exampel , soemone with mycoohpbia sees mushroom as disgusitng .
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What is the dsm ?
these are the numbers of stems for classifying and diagnosisng mental helath probels
-this stnds dor diagnositic statisicla mnual of mental disordr and is punlsihed in america .
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what is depression
a mental health disordder characterised by low mood and low energy levels .
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the dsmdsm recognisesognises four types of depression .
...
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first type of depression - major depressive disorder
severe but often short-term depression
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second type of ddepression - persistent depressive disorder
long term or recurring depression , inlcuding sutained mjor depression and what used to be called systhmia .
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dispurpitive mood dysregulation disorder
childhood temperer tnanturms .
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premenustural dysphorc disord
disurption to mood prior to and / o r during mensturation .
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behaviour charcatersitics of depression - disprution to sleep eand eting hebaiour
depression is assoicated ,w ith chnges to sleeping heaviour a person may pexperience reduced sleep (inosminia ) , particualrly premture waking , or an increaed need for sleep (hypersonmia ) .
-similr appetitie and eting may increase or decrease leading to weight gain or loss . le[ pnt os that such hebaours are disputed by depression .
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behaviorual charactersitics of depression -activity levels
typicll people with dperession have reduced levels of energy , making hte lethrgic . This has a knock-oneffect , with people tending to withdraw from work , education and social lie . In extreme cases this can be so severe
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aggresion and self-harm
people with depression are often irritable , nad in some areas they can become verbally or phsicallya ggrssive This can haeve a seiorus knock on effect on a number of apsects of their lfie , For exampe ,, someoen epxperiencing dperession might dispay verbal aggresion by ending relationship or quitting a job .
-depression can alo lead to physcial aggression directed agaisnt the self . This inclues selfharm often int he form of cutting and sucidie attempts .
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emotional charactertisics of depression - lowered mood
when we use the wrod de[ressed in everydya life , we are usually dwcribing having LOWRED MOOD , N OTHER WORDS SAD , THER EIS MORE TO clincial depressION THAN THIS ,
-LOWERED MOO DIS STILL A DEINNG EMOTIONAL ELEMENT OF DEPRESSION BUT IS MORE PORNOUNCED THAN IN THE DAILY KIN DOF EXPERIENCE OF DFEELING , LETHARGIC AND SF , epEOPLE WITH DEPRESSION OFTEN DESCRIBE THEMELVES AS WROTHLESS AND EMPTY .
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Emotional chrcateristic depression - anger
although people with depressio n tend to experience more negative emotions and fewer positive ones duirng epsiodies of depression , this expereinc eof negtive emotion is not limtied to sadness .
-people with depression also freqnuentl expression anger , soemtimes extrem anger .
-This canbe directed at the sle for others . On occasion such emoitons
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emotional charactersiitcs -lowered self esteem
self - esteem is the emotional expeirn eof how muchw e like our seles, people with epresion ten dto have a low self esteem . evena hting themseves
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gongitive charactertiscs of depression 0 poor cocnentration
depression is associaited with poor elvels of cocnentration , the uperosn may find themselves unabel to stick witha task as they wusualyw oudl or they mgith amke it hard to mke decisions htey would nromall find straightforward . Poor concentration and poor deiciosn making are liekl to infere with an indivisuals work .
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cogntive charactersitcs of depression - attending to and dwelling ont he negative to and dwelling on the negatie
when expereicnign a dperessive epsiode people re inclined to pay more attention engative aspects of ss and ignore the positives in other words , they stend to se a glss as half empty rather than half ufll .
-people with dperession also ahe a bias toeards reclling unahppt events rather than happy ones .
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cognitive characteristics of depression - absolutist thinking
-Most situations are not all-good or all-bad , but when a person is depressed , they tend to think in these terms .
-This is sometimes called black and white thinking . This means that when a situation is unfortunate , they tend to see it as an absolute disaster .
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What is OCD (obsessive compulsive disorder)
A condition , characterised by obsessions by and/ or compulsive behaviour .
Obsessions are cognitive whereas compulsions ar ebehavioural .
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DSM-5 Categories of OCD THERE ARE five types
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OCD
Characterised by either obsessions (recurring thoughts , images etc) . And/ or compulsions - repetitive behaviours such as hand-washings .)
-Most people with a diagnosis of OCD have both obsessions and compulsions .
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Trichotillomania
Compulsive hair pulling .
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Hoarding disorder
the compulsive gathering of possessions and the inabilti8y to part with anything , regardless of its value .
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excoriation disorder
compulsive skin picking
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one behavioural characteristic of OCD - compulsions are repetitive
typically , people with OCD , feel compelled to repeat a behaviour . A common example is hand-washing .
-Other common compulsive repetitions include counting , praying , and tidying / preordering groups pf objects such as CD collections (for those who have them ) or containers in a food cupboard .
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another behavioural characteristic of OCD - Compulsions reduce anxiety
Around 10 % of people with oCD , show compulsive behaviour alone - they have no obsessions , just a general sense of irrational anxiety . HOwever , for the vast majority , compulsive behaviours are performed in an attempt to manage the anxiety produced by obsessions .
-For example , compulsive hand-washing is carried out as a response to an obsessive fear of germs . Compulsive checking for example that a door is locked or a gas appliance is switched off is in response to the obsessive thought that it might have been left unsecured .
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final behavioural characteristic of OCD -avoidance
The behaviour of people with OCD , may also be characterised by their avoidance , as they attempt to reduce anxiety by keeping away from situations that trigger the anxiety .
-People with OCD , tend to try to manage their OCD , by avoiding situations that trigger it .
-For example .
compulsive hand-washing , is carried out as a RESPONSE to an obsessive fear of germs . Compulsive checking for example that the door is locked or a gas appliance is switched off is in repose to the obsessive thought that it might have been left unsecured .
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emotional characteristics of OCD - anxiety and distress
OCD , is regarded as particularly unpleasant emotional experience because of the powerful anxiety that accompanies both obsessions and compulsions .
-Obsessive thoughts are unpleasant and frightening , and the anxiety that goes with these can be overwhelming , The urge to repeat a behaviour (A COMPULSION) creates anxiety .
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Emotional characteristic of OCD - accompanying depression
OCD - is often accompanied by depression - so anxiety can be accompanied by low mood and lack of enjoyment in activities . Compulsive behaviour tends to bring some relief from anxiety but this is temporary .
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emotional characteristics of ocd - guilt and disgust
as well as anxiety and depression , OCD , sometimes involve other negative emotions such as irrational guilt . For example , over minor moral issues , or disgust , which may be directed against something extern like dirt or the self .
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cognitive characteristics of OCD - Obsessive thoughts
For around 90% , PEOPLE WITH ocd THE MAJOR cognitive feature of their condition is obsessive thoughts , i.e. , the thoughts that recur over and over again .
-These vary considerably from person to person but are always unpleasant .
-Examples , of recurring thoughts are worried of being contaminated by dirt and germs , or certainty that a door has been left
unlocked so intruders will come in.
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cognitive characteristics of OCD - cognitive coping strategies
obsessions are the major cognitive aspect of OCD , but people also respond by adopting cognitive coping strategies , to deal with the obsessions . For example a religous person tormented by obsessive guilt may respond by praying or meditating . This may help manage anxiety but make the person appear abnormal to others a and can distract them from everyday tasks .
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cognitive characteristics of OCD - insight into excessive anxiety
people with ocd are aware that their obsessions and compulsions are not rational , In fact this is necessary for a diagnosis of OCD .
-If someone really believed their obsessive thoughts were based on reality , that would be a symptom of quiet a different form of mental disorder .
-However , in spite of this insight , people with OCD , experience catastrophic thoughts about the worst case scenarios that might result if their anxieties were justified . They also , tend to be hypervigilant )maintain constant alertness and keep attention focused on potential hazards _ .
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behavioural (behaviourist approach )
a way of explaining behaviour in terms of what is observable in terms of learning .
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what is the two - process model
an explanation for the onset and persistence , of disorders that create anxiety , such as phobias . The two processes are classical conditioning for onset and operant conditioning for persistence .
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classical conditioning
learning by association . Occurs when , two stimuli are repeatedly paired together , an unconditioned (unlearned stimulus ) AND AN NEW NETURAL STIMULUS . tHE NEW STIMULUS then eventually produces the same response that was first produced by unconditioned stimulus alone .
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operant conditioning
A form of learning in which behaviour is shaped and maintained by its consequences . Possible consequences of behaviour include positive reinforcement , negative reinforcement or punishment .
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acquisition by classical conditionign part 1
-classical conditioning involves learning to associate something weinitally have no fear for with something we do have a fear for .
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classical conditioning - study (1)
JOhn Watson created a phobia in a 9 month old baby called LIttle Albert .
-Albert showed no unusual anxiety at the start of the study , When shown a white rat , the tried to paly with it .
-BUt then whenever the rat was presented , the researchers made a loud noise banging an iron bar close to albert;s ear.
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Classical conditioning study - (2)
The noise is an unconditioned stimulus (UCS) WHICH THN CREATES AN UCresposne FEAR .
-RAT WHICH WA SA NAETURAL STIMULUS AND THE UCS ENOCUNTERED CLOSE TOGHETHER , THE NS IS ASSOCAITED WITH the ucs ,a dn both now produce fear .
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classical conditioning study 3
Albert displayed fear , when he saw a rat NS . The rat is now a learned or conditioned stimulus that produces a conditioned response .
This conditioning is then generalised to similar objects . They tested Lbert , by showing him other furry objects sucha s a non-white rabbit ,a fur coat and Watson wearing a Santa Claus beard made out of cotton balls , little albert was distressed by all of these .
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maintenance by operant conditioning (1)
responses acquired by classical conditioning usually tend to decline over time . However , phobias are often long - lasting . Mowrer has explained this as the result of operant conditioning .
-OPerant conditionign takes place when our behaviour is reinforced (rewarded) or punished .
-Reinofrcement , tend to increase the frequency of a behaviour .
-This is ture of both negative reiinforcement and positive reinforecment .
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maintenance by operant conditioning (2)
In , the case of negative reinforcement an individual avoids a situation that is unpleasant .
-Such behaviour results in a desirable consequence means the behaviour will be repeated .
-Mowrer suggested that whenever . we avoid a phobic stimulus we successfully escape the fear an anxiety that we would have experienced if we had remained there .
-This reduction in fear reinforces the avoidance behaviour and so the phobia is maintained .
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Evaluation of ocd - real world applications
One strength of the two process model is its real - world application is exposure therapies (such as systematic desensitization , ) .
-THe distinctive element of the two - process model is the idea that phobias are maintained by avoidance of the phobic stimulus . This is important in expalining why poeple with phobias benefit from being exposed to the phobic stimulkus .
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evaluation - real - world application part 2
once the avoidance behaviour is prevented , it ceases to be reinforced by the experience of anxiety reduction and avoidance therefore declines .
-In behavioural terms , the phobia is the avoidance behaviour so when this avoidance is prevented the phobia is cured .
-This shows the value of the two - process approach because it identifies a means of treating phobias .
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evaluation - cognitive aspects of phobias
one limitation of the two process model is that id does not account for the cognitive aspects of phobias .
-Behavioural explanations - including the two - process model , are geared towards explaining behaviour . In the case of phobias the key behaviour is avoidance of the phobic stimulus .
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evaluation - phobias and traumatic experiences - counterpoint
Not all phobias appear following a bad experience .
-In fact , some common phobias such as snake phobias occur in populations where very few people have any experience of snakes let alone traumatic experiences .
-Also , considering the other direction not all frightening experiences lead to phobias .
-This means that the association between phobia and frightening experiences is not as strong as we would expect if behavioural theories provided a complete explanation .
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evaluation of the cognitive aspects of phobias
however , we know that phobias are not simply avoidance responses - they also have a significant cognitive component for example holding irrational beliefs about the cognitive stimulus .
-The two process model , explains avoidance behaviour but domes not offer an adequate explanation for phobic cognitions . This means that the two process model does not completely explain the symptoms of phobias .
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evaluation -phobias and traumatic experiences
A further strength of the two - process model is evidence for a link between bad experiences and phobias .
-The little Albert Study illustrates how a frightening experience involving a stimulus can lead to a phobia of that stimulus .
-more systematic evidence comes from a study by Ad De Jongh who found that 73% of people with a fear of dental treatment had experience a traumatic experience , compared to control group people with low dental anxiety only 21% experienced a traumatic event conforming the association between stimulus and a unconditioned response pain leading to the development of the phobias .
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evaluation extra - learning and evolution
behavioural models of phobias , such as the two - process model , provide credible individual explanations i.e. they can explain how a particualr person develops and maintains a particular phobia .
-However , there are othe rmore general aspects to phobias that may be better explained by evolutionary theory . For example , we tend to acquire our phobias of things that have presented a danger in our evolutionary past aka the dark . This is called preparedness .
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What is systematic desensitization
A behavioural therapy designed to reduce an unwanted response such as anxiety .
-SD , involved drawing up a hierarchy of anxiety - provoking situations related to a person's phobic stimulus , teaching the person to relax , and then exposing them to phobic situations . THe person works their way tho
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meaning of flooding
a behavioural therapy in which a person with a phobia is exposed to an extreme form of a phobic stimulus in order to reduce anxiety triggered by that stimulus . This takes place across a small number of long therapy sessions .
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sd is known as
counterconditioning .
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there are three processes involved in SD .
first process - THE ANXIETY HIERARCHY
Is put together by a client with phobia and therapist . This is a list of situations related to the phobic stimulus that provoke anxiety arranged in order from least to most frightening .
-For example , A PERSON with arachnophobia might identify a picture of a small spider a slow on their anxiety .HIERACHY AND HOLDING A TARANTULAR as top of the hierachy .
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second process in SD - RELAXATION
The therapist teaches the client to relax as deeply . It is impossible to be afraid and relaxed at the same time , so one emotion prevents the other . This is called reciprocal inhibition . The relaxation might involve breathing excelsis or alternatively the client migth learn mental imagery techniques .
-Clients can be taught to imagine themselves in relaxing situations ( such as imagining lying on a beach ) or they might learn meditation . Alternatively relaxation can be achieved using drugs such as Valium .
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third process in SD - Exposure
Finally , the client is exposed to the phobic stimulus , while in a relaxed state . This takes place across several sessions , starting at the bottom of the anxiety hierarchy when the client can stay relaxed in the presence of the lower levels of the phobic stimulus whent hey move up the hierarchy . Treatment is successful whent he client can stay relaxed in situations high on the anxiety hierarchy .
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HOw does flooding work ?
Flooding stops phobic responses very quickly . This may be because without the option of avoidance behaviour , the client quickly learns that the phobic stimulus is harmless .
-this process is known as extinction .
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how does flooding work (2)
a learned response is extinguished when the conditioned stimulus is encountered with the unconditioned stimulus . The result is that the conditioned stimulus no longer produces the conditioned response fear .
-in some cases, the client , may achieve relaxation in the presence of the phobic stimulus simply because they become exhausted by their own fear response .
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ethical safe guards to flooding
flooding is not unethical per se , but it is an unpleasant experience so it is important clients give informed consent to this traumatic procedure and that they are fully prepared before the flooding session . A cline would normally be given the choice of systematic desensitization or flooding .
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evaluation of sd - evidence of effectivines
One strength of systematic desensitization SD is the evidence base for its effectiveness . Lisa gilroy followed up 42 people who has SD for spider phobia in 3 45 mins sessions . ar 3 and 33 months sd group are less fearful than a control group treated by relaxation without exposure .
-sd is helpful for phobias .
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evaluation - strength of sd - people with learning disabilities
-a further strength of sd is that it can be used toto treat people with learning disabilities . Some people requiring treatment for phobias also have a learning disability . However , the main alternatives to SD are not suitable . People with learning disabilities often struggle with cognitive therapies that require a high level of rational thought .
-People with learning diabetes may also feel confused and distressed by traumatic experience of flooding . This means that SD is often the most appropriate treatment for people withh learning diffuclties who have phobias .
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Evaluation Extra -SD in virtual reality
traditional sd , involves exposure to the phobic sti mulus , in a real world setting .However , there are advantages to conducting the exposure part of SD , in virtual reality . Exposrue thgouh VR , can be used to avooid dangerous situations likje heights an is cost effective because the psycholist anfd client need not to leave the consulting room .
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evaluation - cost effective flooding
one strength of flooding is that it is highly cost effective .
-Clinical effectiveness means how effective a therapy is at tackling symptoms . However , when we provide therapies in health systems like the NHS , we also need to think about how much they cost . A therapy is cost - effective if it is clinically effective and not expensive .
-Flooding can work in as little as one session as opposed to say , ten sessions for SD to achieve the same result . Even allowing for a longer session perhaps three hours , making flooding more cost-effective . This means than more people can be treated at the same cost with flooding than with sd or other therapies .
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evaluation - traumatic - flooding
-one limitation of flooding is that it is a highly unpleasant experience . Confronting one's phobic stimulus in an extreme provokes tremendous anxiety . Sarah Schumacher found that participants and therapists rasted flooding as significantly more stressful than SD .
-This raises the ethical issue for psychologists of knowlignlyc ausing stress to their clients ,a lthoguh this is not a serious issue provided they obtain informed consent , more seriousl y , the traumatic neuter of flooding means the DROPOUT RATERS are higher than for sd so therapists maya foid using this treatment .
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evaluation extra -symptom substitution
A limitation , of behavioural therapies , including flooding , is that they only mask symptoms and do not tackle the underlying cause of phobias (symptom substitution) for example Jacqueline persons reported the case of a woman with a phobia of death who was treated using flooding .
-Her fear of death , declined , but her fear of being criticised got worse . HOwever , the only evidence for symptom substitution comes in the form of case studies which , in this case , may only generalise to the phobias in the study (e.g phobia of death may be different from a phobia of heights . )
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What is the cognitive approach ?
The term 'cognitive' has come to mean 'mental processes' so this approach is focused on how our mental processes )e.g thoughts , perceptions , attention ) affect behaviour .
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Negative Triad
Beck proposed that there are three kinds of negative thinking that contribute to becoming depressed . Negative views of the world , the future and the self .
-Such negative views lead a person to interpret their experiences in a negative way and so make them more vulnerable to depression .
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ABC model
Ellis proposed that depression occurs when an activating event (A) TRIGGERS AN IRRATIONAL BELEIF (b) WHICH IN TURN PORDUCES A CONSEQUENCE (C) , I.E AN EMOTIONAL response like depression .
-The key to this process is an irrational belief .
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What is faulty information processing
When depressed people attend to the negative aspects of a situation and IGNORE , the positives .
-People also tend to blow small problems out of proportion and think in 'black and white' terms .
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What is negative self schema ?
A schema is a package of ideas and information developed through experience .
-They act as a mental framework for the interpretation of sensory information .
-A self schema is the package of information people have about themselves .
-People use schema to interpret the world , so if a person has a NEGATIVE schema , they interpret all information about themselves in a negative way .
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According to Beck , what is the reason why people develop a dysfunctional view of themselves . (1)
There are three elements that are called the negative triad . When a person is depressed , negative thoughts about the future , and oneslef are uppermost .
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Negative triad , first element - negative view of the world
this creates the impression there is no hope anywhere .
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negative triad , second element - negative view of the future
such thoughts reduce any hopefulness and enhance depression .
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negative triad , third element - negative view of the self
such thoughts enhance any existing depressive feelings because they confirm the existing emotions of low self-esteem .
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Ellis's ABC model
-He proposed a different cognitive explanation for depression .
-He proposed that good mental health is the result of rational thinking , defined as thinking in ways that allow people to be happy and free from pain .
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Ellis's ABC Model (2)
To Ellis , conditions like anxiety and depression (poor mental health ) , result from irrational thoughts . Ellis , defined as irrational thoughts , not as illogical or unrealistic thoughts , but as any thoughts that interfere with us being happy and free from pain .
-Ellis used the ABC model to explain how irrational thoughts affect our behaviour and emotional state .
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A - Activating event - explain
Ellis , focused on situations in which irrational thoughts are triggered by external events . According to Ellis , we get depressed when we experience negative events and these trigger irrational beliefs .
-Events like failing an important test or ending a relationship might trigger irrational beliefs .
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B - beliefs
Ellis identified a range of irrational beliefs .He called the belief that we must always succeed or achive perfection musturbatopn is the beleif that isd is a major disaster whenever something does not go smoothly . Utopianism is the belief hat life is always meant to be fair .
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C - Consequences
When an activating event triggers irrational beliefs , there are emotional and behavioural consequences .For example , if a person believes they must always succeed but then fails this can lead to depression
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Evaluation - Research support for Beck
One strength of Beck's cognitive model of depression is the existence of of supporting research . 'Cognitive vulnerability' refers to ways of thinking that may predispose a person to becoming depressed , for example faulty information processing , negative self schema and the cognitive triad .
-In a review David Clark and Aaron Beck concluded that not only were these cognitive vulnerabilities more common in depressed people , but they preceded the depression .
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evaluation - research support (2)
This was confirmed in a more recent prospective study by Joseph Cohen . They tracked the development of 473 adolescents , regular measuring cognitive vulnerability . it was found that showing cognitive vulnerability . It was found that showing cognitive vulnerability predicted later depression . This shows that there is an association between cognitive vulnerability and depression .
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Evaluation - real world application strength of beck
A further strength of Beck's cognitive model of depression is its applications is screening and treatment for depression .
-Cohen et al - conduced that assessing cognitive vulnerability allows psychologist's to screen young people , identifying those most at risk of developing depression in the future and monitoring them .
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Evaluation - real world application strength of beck (2)
-Understanding cognitive vulnerability , can be also applied in cognitive behaviour therapy (CBT) , . tHESE THERAPIES work by altering the kind of cognitions that make people vulnerable to depression , making them more resilient to negative life events .
-This means than an understanding of cognitive vulnerability is useful in more than one aspect of clinical practice .
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Evaluation Extra -A partial explanation
There seems to be no doubt that depressed people show particular patterns of cognitio , and that these can be seen before the onset of depression . If therefores appears that Beck's suggestion of cognitive vulnerabilities is at least a partial explanation for depression
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Evaluation - Real - world application of Ellis's ABC model
One strength of Ellis's ABC model , IS ITS REAL - WORLD application in the psychological treatment of depression .
-Eliis;s approach to cognitive therapy , is called rational emotive behaviour REBT , for short .
-The idea of REBT , is that by vigorously arguing with a depressed people the therapist , can alter , the irrational belief that are ,making them unhappy .
-There is some evidence to support the ide that REBT , can both change negative beliefs , and relieve the symptoms of depression meaning REBT , has real - world value .
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Evaluation - reactive and endogenous depression - limitation to Elis's ABC model
One limitation of Ellis's ABC model of depression is that it only explains reactive depression and not endogenous depression .
-There seems to be no doubt that depression is often triggered by life events - WHat Ellis would call activating events . Such cases are sometimes called reactive depression . how we respond to negative life events also seem to be at least partly result of our beliefs .
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Evaluation - reactive and endogenous depression - limitation to Elis's ABC model (2)
However , many cases of depression are not traceable to life events and it is nt obvious what leads the person to become depressed at a particular time . This type of depression is sometimes called endogenous depression .
-Ellis's ABC model is less useful for explaining endogenous depression . This means That Ellis's model can only explain some cases off depression and is therefore only a partial explanation .
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Evaluation extra - ethical issues of abc model
The ABC model of depression is controversial because it locates responsibility for depression purely with the depressed person . Critics say this is effectively blaming the depressed person , which would be unfair .
-On the other hand , provided it is used appropriately and sensitively , the application of the ABC model in REBT (discussed on the next spread ) , does appear to make at least some depressed achieve more resilience and feel better.
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Cognitive Behaviour Therapy
A method for treating mental disorders based on both cognitive and behavioural cognitives . From the cognitive viewpoint the therapy aims to deal with thinking , such challenges negative thoughts , the therapy also includes behavioural techniques such as behavioural activation .
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Irrational thoughts
Also called a dysfunctional thoughts . In Ellis's model and therapy , these are defines as thoughts that are likely to interfere with a person's happiness .
-Such dysfunctional thoughts lead to mental disorders such as depression .
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cognitive element of CBT
CBT begins with an assessment in which the client and the cognitive behaviour therapists work together clarify the client's problems . They jointly identify goals for the therapy and put together a plan to achieve them . One of the central tasks , is to identify where there might be negative or irrational thoughts that will benefit from challenge .
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behaviour element of CBT
CBT , then involves working to a change negative and irrational thoughts and finally put more effective behaviours into place .
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Beck's cognitive therapy (1)
Cognitive therapy is the application of Beck's cognitive theory of depression . The idea behind cognitive therapy is to identify automatic thoughts about the world the self and future - this is the negative triad . Once identified , these thoughts must be challenges . This is the central component of the therapy.
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Beck's cognitive therapy (2)
As well as challenging these thoughts directly , cognitive therapy aims to help clients test the reality of their negative beliefs .
-They might therefore be set homework such as to record when they enjoyed an event or when people were nice to them .
-This is sometimes referred to as the client as scientists investigating the reality of their negative belief's ina way scienits owuld .
-Im future sessions if a client say that no one is nice of them or no point in going opt events , the therapist can be producer this evidence and use this to prove the client's statements are incorrect .
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Ellis's rational emotive behaviour therapy (1)
Rational Emotive behavioural therapy REBT - extends to the ABCDE model - D STANDS FOR Dispute , and E for effect .
-The central technique of REBT is to identify and sipute (challenge ) irrational thoughts .
-For example , a client might talk about about how unlucky they have been or how unfair things seem . An REBT therapist would identify these as examples of utopianisms and challenge this as an irrational belief and so break the link between negative life events and depression .
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Ellis's rational emotive behaviour therapy (2)
The vigorous argument is the hallmark of REBT . eLLIS IDENTIFIEED DIFFERENT METHOD OF DISPUTING . fOR EXAMPLE , EMPIRICAL ARGUMENT INVOVLES DISPUTING WHETGHERE THERE IS ACTUAL EVIDENCE TO SUIPPORT THE NEGATIVE BELEIF . lOGICAL ARGUMENT INVOVLES DISPUTIN WHETHER THE NEGATIVE LOGICALLY FOLLOWS fromt he facts .
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Behavioural activation
As individuals become depressed , they tend to increasingly avoid difficult situations and become isolated which maintains or worsens symptoms .
-THE GOAL of behavioural activation is to work with depressed individuals to gradually decrease their avoidance and isolation and increase their engagement ina ctivities that have been shown to improve mood e.g exercising going out for dinner - therapist aim's to reinforce sucha ctivity .
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Evaluation - evidence for effectiveness - strength of CBT
One strength of CBT , is the large body of evidence supporting its effectiveness for treating depression .
-Many studies show that CBT WORKS . For example , john March compared CBT to antidepressant drugs and also to a combination of both treatments when treasting 327 adolescents .
-After , 36 weeks , 81% of the CBT plus antidepressant group were significantly improved . So CBT , was just as effective when used on its own and more so when used alongside antidepressants .
-CBT , is usually a fairly brief therapy requiring 6-12 sessions so it also cost effective , meaning cbt is widely seen as the first choice of treatment in public healthcare systems such as the national health service .
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EVALUATION - SUSTAINAIBILITY for diverse clients .
One limitation of CBT , for depression is the lack of effectiveness for severe cases and for clients with learning disabilities . In some cases , depression can be so severe cases for clients with learning disabilities . In some cases , depression can be so severe that clients cannot motivate themselves to engage with the cognitive work of CBT . They may not even be able to pay attention to what is happening in a session . It is also seems likely that the hard cognitive work involved in CBT makes it unsuitable for treating depression in clients with learning disabilities . This suggets that CBT may only be approopriate for a specific range of people with depression .
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Suitability for diverse clients counterpoint
A;though , the conventional wisdom has been CBT , is unsuitable for very depressed people and for clients with learning disabilities . There is now some more recent evidence that challenges this . A review by Gemma Lewis and Glyn Lewis concluded that CBT was as affective as antidepressant drugs and behavioural therapies for severe depression . Another review by John Taylor concluded that when used appropriately CBT is effective for people with learning disabilities . Meaning CBT may be suitable for a wider range of people than it was once thought .
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EVALUATION - limitation - relapse rates
A further limitation of CBT FOR THE TREATMENT of depression is its high relapse rates .
-Although CBT , is quite effective , in tackling the symptoms of depression , there are some concerns over how long the benefits lasts .
-Re;atove;u few early studies of CBT for depression looked at long term effectiveness .
-SOME HOW MORE RECENT STUDIES SUGGEST THAT LONG - TERM OUTCOMES ARE NOT AS GOOD AS HAD BEEN ASSUMED .
-aFTER ASSESING DPERESSION OF 439 CLIENTS , 42% of clients relapse into depression within 6 months of ending treatment sand 53% relapsed within a year .
-,meaning CBT , need to be repeated periodically .
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EVALUATION EXTRA - client preference
CBT for depression focuses on identifying and changing unhelpful patterns of thinking and behaviour .
-There is a large body of evidence to show that , when used with appropriate clients , this is highly effective at least in the short term , in tackling symptoms of depression .
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EVALUATION EXTRA - client preference (2)
owever , not all clients want to tackle depression this ay ,s ome people just want their symptoms to go as quickly and easily as possible and prefer medication . Clothes for example , survivors of trump wish to explore the origins of their symptoms in a study of client preference, depressed people rated CBT as their LEAST PREFFERRED psychotically happy .
-so doe4s it really matter what depressed people want form a psychological therapy if it is effective .
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biological approach
a perspective that emphasises the importance of physical processes in body such sas genetic inheritance and neural function
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genetic explanations
genes make up chromosomes and consist of DNA WHICH CODES of dna which does the physical features of an organism (such as eye colour , height ) , and psychological features of an organism such as mental disorder intelligence . Genes are transmitted from parent to offspring i.e inherited
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neural explanations
the view that physical an psychological characteristics are determined by the behaviour of the nervous systems ,
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genetic explanations
some mental disorders appear to have a stronger biological components than others , and OCD is a good example of a condition that may be largely understood as biological in nature . One form of biological explanation is the genetic explanation .
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What are candidate genes
Researchers have identified genes which create vulnerability for OCD , called candidate genes . SOme of these genes are invovled in regulating the development of the serotonin sytem .
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How are genes invovled in OCD ?
Genes are involved in individual vulnerability to OCD . In a classic study , AUbrey Lewis (1936) observed that of his OCD patients , 37% had parents with OCD and % had siblings with OCD .
-Suggesting OCD , runs in families , although what is probably passed on from one generation to the next in genetic vulnerability not the certainty of OCD .
-According to the diathesis stress model , certain genes leave some people more likely to develop a mental disorder but it is not certain .Some environmental stress (EXPEREICNE ) is necessary to trigger the condition .
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Is OCD polygenic ?
-OCD , seems to be polygenic , this means that OCD is not caused by one single gene , but by a combination of genetic variations that together significantly increase vulnerability .
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Ocd being polygenic ? - study
Steven Taylor has analysed findings findings of previous studies and found evidence that up to 230 different genes may be involved in OCD . Genes that have been studied in relation to OCD , include those associated with the action of the dopamine as well as serotonin , both neurotransmitters believed to have a role in regulating mood .
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different types of OCD
One group of genes may cause OCD , in one person but a different group of genes may cause the disorder in another person . The term used to describe this , is aetiologically heterogenous meaning that the origins (aetiology ) of OCD VARY from one person to another (heterogenous ) .
-There is also some evidence to suggest that different types of OCD , may be the result of particular genetic variations such as hoarding disorder and religious obsession .
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What is the role of serotonin in terms of OCD ?
One explanation of OCD , concerns the role of the neurotransmitter serotonin , which is believed to help regulate mood .
-Neurotransmitters , are responsible for relaying information from one neuron to another .
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What does it mean if a person has low levels of serotonin ?
Then normal transmission of mood - relevant information does not take place an a person may experience low moods (and other mental processes may also be affected ) . At least some cases of OCD , May be explained by a reduction in the functioning of the serotonin system in the brain .
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Decision - making sytems in OCD
Some cases pf PCD , and in particular , hoarding disorder , seem to be associated with impaired , decision-making . This in turn may be associated with abnormal functioning of the lateral (side bits ) of the frontal lobes of the brain .
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What is the frontal lobe , as well as other parts of the brain ?
The frontal lobes are the front part of the brain , (behind your forehead ) . that are responsible for logical thinking and making decisions . There is also evidence to suggets than area called th parahippocampal gyrus associated with processing unpleasant emotions , functions abnormally in OCD .
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Evaluation - Research support for OCD
-One strength of the genetic explanation for OCD , is the strong evidence base to OCD , as a result of their genetic makeup .
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Evaluation - Research support for OCD - twins studies
In one study with NEstadt , reviewed in (210) found that 68% of identical twins MZ , SHARED ocd , AS OPPOSED TO 31% OF NON IDENTICAL dz TWINS .
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Evaluation - Research support for OCD - FAMILY STUDIES
Research has found that a person with a family member diagnose dwith OCD , is around four times as likely to develop it as someone without .
-These research studies suggest that there must be some genetic influence on the development of OCD .
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evaluation - environmental risk factors
One limitation of the genetic model , of OCD , is that there are also environmental risk factors .
-There is strong evidence for the idea that genetic variation can make a person more or less vulnerable to OCD .
-hoWEVER , ocd , DOES NOT APPEAR to be entirely genetic in origina nd it seems that environemntal risk factors can also trigger or increase the risk of developing oCD .
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evaluation - environmental risk factors - case STUDY
In one study for example , Kiara Cromer found that over half the OCD clines in their sample had experienced a traumatic event in their past . OCD was also more severe in those with one or more traumas . Meaning genetic vulnerability only provides a partial explanation for OCD .
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Evaluation Extra - animal studies
It has proved difficult to find candidate genes genetic variations that are possible causes of OECD . There is evidence though from animal studies , showing that particular genes are associated with repetitive in other species for example miCe . However , although mice and humans share most gene s, the human mind and brain are much more complex , and it may not be possible to generalise from animal repetitive behaviour to human OCD .
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evaluation - Research support for the neural model for OCD
One strength of the neural model of OCD , is the existence of some supporting evidence . Antidepressants that work purely on serotonin are effective in reducing OCD , symptoms , and this suggests that serotonin may be invovled in OCD .
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evaluation - Research support for the neural model for OCD - Parkinson's disease
-ALSO , ocd symptoms , form part of conditions that are known to be biological in origin , such as the degenerative brain disorder , Parkinson's disease which causes muscle tremors and paralysis .
-If a biological disorder produces OCD symptoms , then we may assume that biological uerlie OCD.
This suggests that biological factors (e.g serotonin and the processes underlying certain disorders ) MAY ALSO BE RESPONSIBLE FOR ocd .
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Evaluation - no unique neural system - limitation of the neural model
One limitation of the neural model is that serotonin - ocd link may not be unique to OCD . Many people with OCD , also experience clinical depression . Having two disorders together is called comorbidity .
-This depression probably , involves (though is not necessarily caused by ) disruption to the action of serotonin .
-This leaves , us with a logical problem when it comes to serotonin as a possible basis of OCD . It could be simply be that serotonin activity is disrupted in many people with OCD because they are depressed as well .
-Meaning serotonin may not be relevant to OCD symptoms .
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EVALUATION EXTRA - correlation and causality of OCD
There is evidence to show that some neural systems (such as serotonin ) do not work normally in people with OCD . According to the biological model of mental disorder , this is most easily explained by brain dysfunction causing the OCD .
-However , this is simply a correlation between neural abnormality and OCD and such correlations do not necessarily indicate a casual relationship .
-It is quite possible that the OCD causes the abnormal brain functioning or both are influences by a third factor .
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What is drug therapy ?
Treatment involving drugs , i.e chemicals that have a particular effect on the functioning of the brain or some other body system .
-In the case of psychological disorders such drugs usally affect neurotransmitter levels .
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What are SSRIs part one
The standard medical treatment used to tackle the symptoms of OCD , involve a particular type of antidepressant drug called a selective serotonin reuptake inhibitor .
SSRIs work on the serotonin system in the brain .
-Serotonin is released by certain neurons , in the brain . in particular is released by the presynaptic neurons and travels across a synapse .
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SSRIs part two
The neurotransmitter chemically conveys the signal from t he presynaptic neuron to the postsynaptic neuron and then it is reabsorbed by the presynaptic neuron where it is broken down and reused .
-By preventing the reabsorption and breakdown , SSRIs effectively increase levels of serotonin in the synapse and thus continue to stimulate the postsynaptic neuron . This compensated for whatever is wrong with the serotonin system in OCD .
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SSRIs part three
dosage and other advice vary according to which SSRI , is prescribed . A typical daily dose of fluxetine , is 20 mg , this may be increased if it is not benefitting the epton .
-liquid or tablet form can be take , takes 3 -4 months to have much impact on the symptoms .
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Combining SSRIs with other treatment
Drugs are often used alongside cognitive behaviour therapy , to treat OCD . The drugs reduce , a person's emotional symptoms such as feeling anxious and depressed . This means that people with OCD can engage more effectively with the CBT .
-In practice some people respond best CBT alone whilst other benefit more when additionally using drugs like fluoxetine . Occasionally other drugs are prescribed alongside SSRIs .
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Alternatives to SSRIs
When an SSRI , is not effective after three or four months , the dose can be increased , or it can be combined with other drugs . Sometimes different antidepressants are tried . People respond best to CBT alone whilst others benefit more when additionally using drugs like fluoxetine . Occasionally other drugs are prescribed alongside SSRIS .
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alternative to SSRIs - tricyclics
(an older type of antidepressant ) , are sometimes sued such as clomipramine . This acts on various systems including the serotonin system where it has the same effect as SSRIs .
-Clomipramine has more severe side- effects than SSRIs so it is generally kept in reserve for people who do not respond to SSRIs .
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Alternative to SSRIS - SNRIS
(serotonin - noradrenaline reuptake inhibitors ) , have more recently been used to treat OCD .
-These are different class of antidepressant drugs and like , clomipramine , are a second line of defence for people who don't respond to SSRIs .
-SNRIs , increase levels of serotonin as wella s another different neurotransmitter - noradrenaline .
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Evaluation - Evidence for effectiveness
One strength of drug treatment for OCD is good evidence for its effectiveness . There is clear evidence to show that SSRIs reduce symptom severity and improve the quality of life for people with OCD . For example G mustasfa , reviewed 17 studies that compared SSRIS to placebos in the treatment of OCD .
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Evaluation - Evidence for effectiveness - studies
-aLL 17 STUDIES showed significantly better outcomes with SSRIS .
Symptoms reduced for about 70% of people taking SSRIS .
FOr the remaining 305 , MOST CAN BE EITHER helped by drug combinations or alternative drug meanign drugs appear to be HELPFUL with most people that have OCDS .
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Evaluation - Evidence for effectiveness - counterpoint .
there is some evidence to suggest that even if drug treatments are helpful for most people with OCD , they may not be the most effective treatments available .
-Carried out a systematic review of outcomes more effective than SSRIS i the treatment of OCD . tHIS MEANS DRUGS may not be the optimum treatment of ocd .
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Evaluation - cost-effective and non-disruptive - drug therapy
One strength of drugs is that they are cost effectiv eand non- disruptive to people's lives .
-A strength of drug treatment for psychological treatments because many thousands of tablets or liquids doses can be manufactured int he time it take to conduct one session of psychological therapy .
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Evaluation - cost-effective and non-disruptive - drug therapy (2)
Using drugs to treat OCD , is therefore , good value for public health systems like the NHS , and represent a good use of limited funds . As compared to psychological therapies , SSRIs are also non-disruptive to people's lives .
-IF UYOU WISH YOU CAN SIMPLY TAKE UNTIL YOUR SYMPTOMS DECLINE . tHIS IS QUITE DIFFERENT FORM PSYCHOLOGICAL therapy which involves time spent attending therapy sessions . This means that drugs are popular with many people with OCD and their doctors .
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evaluation serious side effects
one limitation of drug treatments for OCD , is that drugs can have potentially serious side - effects .
-Although , drugs such as SSRIs help most people , a small minority will get no benefit . Some people also experience side-effects such as indigestion , blurred vision and loss of sex drive .
-These side-effects are usually temporary , however , they can be quite distressing . for people and for a minority they are long lasting .
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evaluation serious side effects (2)
For those taking , the tryicyclic clomipramine , side-effects are more common and can be more serious for example more than 1 in 10 peole e xperience erection prboelkms and weight gain in 1 in 100 become aggressive and heart related problems .
-This means that some people have a reduced quality of life as a result of taking drugs and may stop taking them altogether meaning the drugs cease to be effective .
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EVALUATION extra - biased evidence
There is always some controversy over the evidence for the effectiveness of drugs . Some psychologists believe that the evidence for drug effectiveness is biased because researchers are sponsored by drug companies and may selectively publish positive outcomes for the drugs they sponsor are selling .
-On the other hand , there is a lack of independent studies of drug effectivenes sand also research on psychological therapies may be biased . The best evidence available is supportive of the usefulness of drugs for OCD .
