Psychopathology Flashcards
(22 cards)
definitions of abnormality 1
- statistical infrequency
- statistical definition is relatively usual behaviour or characterists are normal and anything different is abnormal
- normal distruction - majority around the average and fewer further above or below the average
evaluation :
1. real world application in clincal practices for formal diagnosis and assessment of severity of symptoms
- example we can use iq for assessing intellecutal disability if its lower than 70 and bdi scale
- unusual characteristics can be positive
- we wouldnt view someone who has a high iq or low bdi as abnromal even though this is the sole basis of abnormality
- can be beneficial sometimes
definitions of abnormality 2
- deviation from social norms
- behaviour whcih is different from expecations
- society collectively has a judgement and anything that offends normal or acceptability is seen as abnromal
- norms are specfific to the culture we live in
- there are very few considered to be universally abnormal
evaluation :
1. real world application in psychiatry for the diagnosis using key clear characteristics
- cultural and situational relativism
- hard to judge norms across cultures and situations as whats normal in one culture may be abnormal in another and therefore it is not fully representative
definitions of abnormality 3
- failure to function adequately
- rosenhan and silgeman came up with signs that determine someone isnt coping
include : - a person does not conform to standard interpersonal rules
- a person experinces sevre personal distress
- a persons behaviour becomes dangerous and irrational to themselves or others
evaluation :
1. represents a sensible threshold for help as it allows us to make a formal diagnosis and not ignore severe symptoms
- allows for treatments and services to be targeted towards those who need it most
- discrimination and social control
- non-standard living can be labelled as abnormal and restrict a persons freedom
- it is hard to determine whether a person is failing to functions adequtely or if they are simply deviating from social norms
definitions of abnormality 4
- deviation from ideal menHtal health
- jahoda came up with criteria for good mental health - no symptoms or distress
- rational and percieve ourselves accurately
- self-actualise
- cope with stress
- realistic view of the world
- good self-esteem and lack guilt
- indpendent from others
- sucessfully work, love and enjoy leisure
evaluation:
1. highly comprehensive as it includes a range of different criteria and acts as a checklist to assess people
- diff psychologists can focus on diff parts of the criteria to make a more in depth and meaningful diagnosis
- culture-bound
- cannot be applicable across cultures due to different ideas and norms
Phobias - Explaining
- two process model
- suggests that we learn a phobia through classical conditioning and we maintain it through operant conditioning - Acquisition by classical conditioning :
- watson and rayner tried to create a phobia in a 9 month old baby called little albert
- he showed no signs of unusual anxiety at the beginning of the study and they tried to make him play with a little white rat (NS)
- researchers then played a loud noise (UCS) near the ear of albert whenever the rat was present which produces a response of fear (UCR)
- through association, whenever the noise was played albert displayed fear (CR) when the white rat was also present (CS)
- conditioning also became generalise to similar objects and alber displayed distress when he saw white, fluffy objects - maintenance by operant conditioning
- responses which are developed through classical conditioning often decline overtime, but with phobias they are more long-lasting because of operant conditioning
- if we try and avoid the phobic stimulus we successfully escape the fear and anxiety, so there is negative reinforcement of avoidance behaviour, however the phobia is then maintained
Phobias - Explaining
Evaluation
- real world application ( exposure therapies )
- can find means of treating phobias through exposure therapies
- the two-process model suggests that phobias are maintained through avoidance
- people who have a phobia will benefit from being exposed to their phobic stimulus
- if avoidance behaviour is prevented then reinforcement will decline
- therefore, if we prevent avoidance then we can cure the phobia - cognitive aspect
- doesnt explain all symptoms of phobias
- behavioural explanations can only explain behaviour
- however, phobias have a huge cognitive component such as irrational thoughts
- therefore it is not a complete explanation as it doesnt account for phobic cognitions - phobias and traumatic experiences
- there is evidence to show a link between phobias and bad experinces
- systematic evidence shows thta 73% of people who have a fear of dental treatment actually had past traumatic experinces related to dentistry
- compared to a control group with low dental anxiety only 21% of them had past trauma
- therefore shows a link between the stimulus and uncodnitioned response which lead to development of the phobia
counterpoint : not all phobias are because of bad experinces
- common phobia such as snake many people have but havent actually encountered one themselves
- therefore not all frightening experiences cause phobias and it is not a complete explanation as there is weak association\
Phobias - Treating ( SD )
- behaviour therapies are designed to gadually decrease phobic anxiety through the principle of classical conditioning
- counterconditioning : learn a different response and associate the PS with relaxation than anxiety
begins with 3 processes
1. anxiety hierachy
- put together with the client and the therapist
- they order situations that are in relation to the phobic stimulus which provoke anxiety from least to most frigtening
- relaxation
- using reciprocal inhibition and ensuring the client is as deeply relaxed as possible
- done using breathing exercises, meditation and mental imagery or even drugs such as valium - exposure
- the client is exposed to the PS in a relaxed state
- takes place across a number of sessions as it works from bottom of anxiety hierachy to the top
- treatment is successful if one remains relaxed even at the highest level anxiety situation
Phobias - Treating ( SD )
Evaluation
- evidence for effectiveness
- Lisa Gilroy followed up 42 people who got SD for their spider phobia is 3 45 min sessions
- found that at both 3 & 33 months they were less fearful than a control group who only got treated w relaxation and not exposure
- shows its effective also in specific, social and agoraphobia - learning disabilities
- people with LD’s often cannot engage in cognitive therapies as they require complex rational thought
- they may become distressed or confused in other therapies such as flooding
- found that SD is the most sutiable alternative for people with LD’s
Phobias - Treating ( Flooding )
- the immediate exposure to the phobic stimulus without gradual build up
- often lasts longer than SD in one session
- it works by stopping the phobic response very quickly as there is no opportunity for avoidance behaviour and the client quickly learns that the PS is harmless
- also uses extinction which is when the learned response is elimated when we encounter the conditioned stimulus without the unconditioned stimulus
- therefore the conditioned stimulus no longer produces the unconditioned response
ethical safeguards must be considered as it is highly unpleasant and people should have an option of SD too and give their fully informed consent
Phobias - Treating ( Flooding )
Evaluation
- cost effective
- clincally effective as well as cost effective
- flooding can work in as little as one session in comparison to 10 in sd, even if 1 session is slightly longer it will work quicker than sd
- so people are treated at the same cost with flooding than with sd - traumatic
- evokes tremendous anxiety
- significantly more stressful than sd
- ethical issues are raised by psychologists
- attrition rates are higher
Depression - Explaining ( Beck )
Becks negative triad / cognitive theory
- basically the idea that some poeple are more cognitvely vulnerable to depression
- includes 3 cognitive vulernabilities such as
1. faulty information processing - this is when a person focuses heavily on the negative and is not able to accept positives and has very black and white or absolutist thinking
2. negative self scheme
- scheme is ideas or information which are devleoped thrugh experinence and a self schema is packages of info that people have about themselves
- they are mental frameworks for the interpretation of sensory info and people use schemas to intepret info, so if its negative they will view everything in a negative way
3. negative triad - creates a dysfunctional view of oneself and is caused by 3 negative thinking that occur automatically
- 1. negative view of the world
- 2. negative view of the future
- 3. negative view of the self
Depression - Explaining ( Beck )
Evaluation
- research support
- research to support the idea that CV are more common in depressed people and precded later depression
- a prospective study by cohen was done which followed development of 473 adolescents, regularly meausring their CV
- those showing CV, predicted later depression
- shows a link between CV and depression - real world application
- in screening and treatments for young people
- if we assess CV then psychologists are able to screen young people and identify and monitor those most at risk
- also can be helped in cbt and can alter cognitions fo those vulerable to depression and create resillience in them to negative life events
- so can be used in clincal practice
Depression - Explaining ( Ellis )
ABC model - good mental health is when we are rational and ABC model explains how irrational thoughts can affect behaviour and emotional state
A - Activating Event
- situations which irrational thoughts can be triggered by external events
- we get depressed wehn we experience a negative event and this causes more irrational thoughts
B - Beliefs
- ‘musturbation’ - feeing like we must achieve and succeed perfection
- ‘i cant stand it itis’ - it is a complete disaster if someone doesnt go smoothly or to plan
- ‘utopianism’ - life should always be fair
C - Consequences
- behavioural and emotional consequences which can trigger depression
Depression - Explaining ( Ellis )
Evaluation
- real world application
- support from REBT which suggests that arguing vigoursly with a depressed person can alter their irrational beliefs
- david et a supports that their negative beliefs can be changed and they can relieve sympotms of depression - reactive vs endogenous depression
- only explains reactive depression not endogenous which is the idea that the depression is not traceable to life events and its not obvious what cause the person to be depressed
- only a partial explanation
Depression - Treating
- CBT
- cognitive element is when the client and the therapist have an assessment to clarify the clients problems
- they then jointly identify goals for the therapy and put a plan in place to achieve them
- identify any negative thoughts that will benefit from challenge - Becks Cognitive Therapy
- identify - automatic thoughts of the world self and future
- immediately challenged
- helps client see the reality of their negative beliefs
- use ‘client as a scientist’ where they write down good experiences to be used as evidence later and prove - thoughts to be incorrect - REBT
- extends Ellis’ ABC model to ABCDE
- d = dispute and e = effect
- therapist identifies an irrational thought and has a vigorous argument w client to try and change this belief and break the link between negative life events and depression
- 2 arguments :
1 - empirical - disputing whether there is evidence to support the negative beliefs - logical - do the negative beliefs follow from facts
- behavioural activation
- working w depressed individuals to gradually decrease their isolation and avoidance which will only worsen their symptoms and increase their engagement in fun activities
Depression - Treating
Evaluation
- evidence for effectiveness
- John March compared CBT to antidepressants and a combination of both when treating 327 depressed adolescents
- found that after 36 weeks 81% of CBT, 81% of AD and 86% of both showed improvement
- shows it is effective by itself but even better when used alongside
- it is also cost effective - suitability for diverse clients
- lack of effectiveness for severe cases and people with LD
- clients cant motivate themselves to engage w the cognitive works of CBT and they arent able to pay attention to what happens during sessions
- also requires complex rational thought which is difficult for those w LD and is not suitable
- any form os psychotherapy is not useful for people w LD
- only a specific range of depressed people benefit from CBT
counterpoint :
- lewis and lewis found that cbt is just as effective as antidepressants or other behavioural therapies in severe cases
- taylor et al found it can be effective for people w LD if used appropriately
- supports wider range of people than we thought - relapse rates
- shehzad ali followed depression in 439 adolescents every month for 12 months following cbt
- found 42% relapsed after 6 months and 53% after 1 year
- not effective long term
- cbt must be repeated periodically
OCD - Explaining ( Genetic )
- genetic explanations are the genes which create vulnerability to OCD
- aubrey lewis found that her ocd patients 37% of their parents and 21% of their siblings had ocd
- suggests that ocd runs in the family and genetic vulnerability can be passed down
- diathesis stress model also states that certain genes are more likely to make some vulnerable to developing a mental disorder and environmental factors also trigger this
candidate genes :
- genes that are involved in ocd vulnerability such as those in the serotonin system
ocd is polygenic :
- there are a number of genetic variations and genes which are involved in ocd rather than just 1 which increases vulnerability significantly
- up to 230 genes involved in ocd
- main ones are those that are neurotransmitters and responsible for regulating mood such as dopamine and serotonin
different types of ocd :
- ocd is aetiologically heterogeneous which means that different combinations of genes causes ocd in 1 person and another variation causes it in another person
- this also causes diff types of ocd for everyone
OCD - Explaining ( Neural )
- genes associated with ocd are more likely to have an affect on key neurotransmitters and brain structure
role of serotonin :
- if a person has low levels of S then the transmission of mood relevant info is not able to take place leading to a decreased mood which explains ocd in some cases
- in other cases it could be because of low functioning in S system
decision-making systems :
- frontal lobes are responsbile for decision making and logical thinking so abnormal functioning of these leads to impaired DM systems
- left parahippocampul gyrus is also responsbile for processing unpleasant emotions and is found to functions abnormally in ocd
OCD - Explaining ( Genetic )
Evaluation
- research to support the idea that some people are more vulnerable to ocd as a result of their genetic make up
- twin studies have found that 68% of MZ twins share ocd as opposed to 31% in DZ twins
- family studies show an individual is 4x more likely to get ocd if a family member has had it - envrionmental risk factors
- these can trigger or increase likelihood of ocd
- cromer’s study found that over half of her ocd clients have had previous traumatic experiences and that it was more severe in those who had more severe ocd aswell
- GV is only a partial explanation
OCD - Explaining ( Neural )
Evaluation
- research to support
- the idea that antidepressants which work solely on the serotonin system have been found to reduce ocd symptoms which suggests serotonin is involved in ocd
- some ocd symtpoms that form part of conditions which are known to be because of biological reasons such as parkinsons
- so if biological disorders produce ocd symptoms we can assume that these biological processes underlie ocd - no unique neural system
- the serotonin/ocd link may not be specific to ocd
- many people who have ocd also have depression known as co-morbidity and depression causes the disruption to the action of serotonin which means that the ocd symptoms may be because of depression instead
OCD - Treating
- drug therapy
- increasing or decreasing the levels of neurotransmitters which could increase levels of serotonin - SSRI’s
- particular type of antidepressant which work on the serotonin system
- serotonin is released by the presynaptic neuron and travels across the synapse and then neurotransmitters chemically convey signals from the pre SN to the post SN and it is reabsorbed by the pre SN
- SSRS’s also prevent the reabsorption and breakdown of serotnin which increases its level in the synapse and can continue stimulating the post SN
- it can take 3-4 months to work on symptoms and dosage varies depending on patient - combining it with other treatments
- often used alongside CBT
- drugs reduce emotional symptoms meaning that people are able to effectively engage in CBT
- CBT can be good alone for some but for others it is better to combine both
- occasionally SSRI’s and other drugs are combined - alternatives to SSRI’s
- when they are not effective after 3-4 months the dosage can be increased or they can combine it with other drugs - tricyclics - older type of antidepressant and has the same effect on the S system as SSRI’s but have more severe side effects
- kept in reserve for people who are not responding to SSRI’s - SNRI’s - another class type of antidepressant
- also works on serotonin system
- increases levels of serotonin and noradrenaline which is another type of neurotransmitter
OCD - Treating
Evaluation
- evidence for effectiveness
- reduce symptom severity and improve quality of life for people with OCD
- a review of 17 studies was done which compared SSRI’s to placebo conditions
- found those had better outcomes taking the SSRI’s than the placebo’s
- 70% of people had reduced symptoms taking the SSRI’s and remaining 30% were helped with alternative drug or combination of psychological treatment too
- drugs are helpful in treating ocd
counterpoint :
- may not be the MOST effective
- review of outcome studies was done and it was found that both behavioural and cognitive exposure therapies may be more effective than SSRI’s
- drugs aren’t the optimum treatment - cost-effective and non disruptive
- cheaper than most psychological therapies, produce same result as 1 session does but much quicker
- cost-effective for nhs and good value of their limited funding
- non disuptive as people dont have to take time to attend therapies, just take the drug until their symptoms decline - serious side effects
- can produce side effects such as blurred vision or indigestion
- tricyclics can produce more severe ones such as weight gain, people becoming more aggressive or suffering disruption to their heart rhythm and blood pressure
- fewer people would take them as they reduce quality of life and so people don’t use it - not effective
