Psychopathology Flashcards
(72 cards)
1
Q
what are the 4 definitions of abnormality?
A
- statistical infrequency
- deviation from social norms
- failure to function adequately
- deviation from ideal mental health
2
Q
what is deviation from social norms?
A
behaviours that are atypical to the accepted standards of behaviour in society
3
Q
what is a strength of the deviation from social norms definition of abnormality?
A
it is a more appropriate definition compared to ‘statistical infrequency’
this is because whilst deviation from social norms distinguishes between desirable and undesirable behaviour and the effect it has on others, the statistical infrequency definition classes behaviour as abnormal if it falls out of the ‘range’ for most people. this is a strength as it may be a more appropriate definition of abnormal behaviour
4
Q
what are the weaknesses of the deviation from social norms definition of abnormality
A
- social norms vary as times change. this is because what is socially acceptable now may not have been socially acceptable 50 years ago. for example, today homosexuality is acceptable but in the past it was deemed a psychological concern by the DSM. this is a weakness as the lack of consistency reduces the validity of this definition
- also, norms differ between cultures (culturally relative). for example, hearing voices is deemed socially deviant in western cultures, but in others it is accepted. this s a problem as the definition should be consistent between cultures, and since it isnt it can be described as ethnocentric
- lastly, it can be criticised for terming people as deviant when they are just trying to express their individuality. for example, just because people dont conform to what is deemed ‘normal’ by society, doesnt mean that they are psychologically abnormal. this is a weakness as this definition can be damaging to certain people in society.
5
Q
what is failure to function adequatley?
A
behaviour that entails somebody being unable to cope with everyday life or engage in everyday behaviours
6
Q
what is the accronym to remember the 5 features of failure to function adequately proposed by researchers? also define the features
A
MUSIC
- maladaptive = when someone is stopping themselves from progressing
- unconventional = abnormal behaviour
- suffering = struggling to cope
- irrational = acting in a way that people do not understand
- control (lost) = acting in an unpredictable and inappropriate manner
7
Q
what is a strength of the failure to function adequately definition of abnormaltity?
A
- it includes the patients perspective. this is because it allows us to view the mental disorder from the point of view of the person experiencing it. for example, the level of distress experienced by a patient is considered when determining whether their behaviour is abnormal or not. this is a strength as the definition provides useful criterion, which allows patients to self assess themselves and their own level of functioning
8
Q
what are the weaknesses of the failure to function adequately definition of abnormality?
A
- abnormality is not always accompanied with disfunction, as people with dangerous personality disorders can still appear normal. for example, harold shipman, a GP that murdered 215 of his patients over a 23 year period seemed to be a respectable doctor. therefore, this is a weakness as using this definition may not be appropriate in all cases.
- also, this definition is limited by cultural relativism. for example, long periods of grief after bereavement are more acceptable in some cultures than others. this means whilst behaviour may be be seen as failure to function in one place, it may be completely normal in another. this is a weakness as the definition is not consistent within cultures.
9
Q
what is statistical infrequency?
A
when behaviour is classed as abnormal because it falls out of the typical range on a normal distribution curve and is infrequent in the population (two+ standard deviations from the mean)
10
Q
what is a strength of the statistical infrequency definition of abnormality?
A
- its an objective way to define abnormality, as a clear cut off point has been agreed. this makes it easier to decide who meets the criteria to be labelled as abnormal in comparison to other definitions. therefore this definition is seen as less subjective as the other definitions
11
Q
what are the weaknesses of the statistical infrequency definition of abnormality?
A
- the are many abnormal behaviours that are actually desirable. for example, very few people have an IQ above 150, yet it would not be suggested that having an IQ above 150 makes somebody abnormal. this is a weakness as only undesirable behaviours need to be identified, so the definition cannot be used alone when making a diagnosis
- statistical infrequency may also be culturally biased, as there are behaviours that are statistically infrequent in some cultures, but more frequent in others. this is a problem as the definition would class these people as abnormal, despite their behaviour being deemed normal where they are from.
12
Q
what is deviation from ideal mental health as defined by jahoda? what is the accronym for this?
A
people who lack all the following characteristics for optimal living:
- an accurate perception of reality
- a resistance to stress (being able to cope in stressful situations)
- self attitudes that are positive (such as high self esteem and a strong sense of identity)
- autonomy (functioning independently)
- self actualisation (being focused on the future and fulfilling their potential)
- mastery of environment (ability to adjust to new situations)
RAAP SAMS
r = reality (accurate)
a = autonomy
ap = attitudes of self = positive
sa = self actualisation
m = mastery of environment
s = stress = resistance
13
Q
what is a strength of the deviation from ideal mental health definition of abnormality?
A
it offers an alternative perspective on mental disorders. this is because the definition focuses on the positives rather than the negatives. therefore, jahodas ideas are in accordance with the humanistic approach, which also focus on the positive nature of humanity
14
Q
what are the weaknesses of the deviation from ideal mental health definition of abnormality?
A
- definition is ethnocentric. this is because the ideals of mental health are not applicable to all cultures. for example, the criterion of self-actualisation is relevant to members of individualistic cultures but not collectivist cultures, where individuals strive for the greater good of the community, rather than just themselves. this is a problem as for the definition to be classed as reliable, the same behaviour should be viewed consistently between cultures.
- also, it is unclear how many of the criterion need to be absent before someone can be classed as deviating from ideal mental health. for example, it is unknown whether all 6 need to be lacking in the individual, or whether they could lack only one or two before being classed. this makes way for subjectivity during diagnosis, which may differ between individual psychiatrists, leading to inconsistency. this is a weakness because the lack of objectivity means that this definition is rarely used in the real world
15
Q
what is a phobia?
A
an irrational fear of an object or situation, that is out of proportion to the phobic stimulus
16
Q
what is a common source used to diagnose mental health problems?
A
the DSM-5
17
Q
what are the three categories of phobias detailed by the DSM-5
A
- specific phobias
- social phobias
- agoraphobia
18
Q
what is a specific phobia?
A
a fear of an object or a situation
19
Q
what is a social phobia?
A
a fear of a social situation such as public speaking or using a public toilet
20
Q
what is agoraphobia?
A
a fear of leaving the house or a safe place. can be characterised by having a fear of being outside or in a public place
21
Q
what are the behavioural characteristics of phobias? describe them
A
panic = can be in the form of crying, screaming or freezing
avoidance = as anxiety increases when being close to the feared situation, the situation is avoided
disruption of functioning = when anxiety and avoidance responses are so extreme that they interfere with the ability to conduct everyday functioning
22
Q
what are the emotional characteristics of phobias?
A
anxiety = long term
fear = unreasonable
23
Q
what are the cognitive characteristics of phobias?
A
irrational beliefs = hold irrational beliefs about the phobic stimuli, and are very resistant to rational arguments
selective attention = sufferers will look intently at the phobic stimuli and find it very hard to look away from it
24
Q
what is the behavioural approach?
A
a way of explaining behaviour in terms of what is observable and in terms of learning
25
what is classical conditioning?
when we learn by association. occurs when two stimuli are repeatedly placed together at the same time (the neutral stimulus and the unconditioned stimulus), and the neutral stimulus alone eventually produces the same response as the unconditioned stimulus did, thus becoming the conditioned stimulus.
26
what is operant conditioning?
a form of learning through reinforcement. maintaining a behaviour because of rewards or in order to avoid a negative outcome.
27
what does the two process model believe?
describe the two process model.
according to the two process model, phobias are acquired through classical conditioning, and maintained because of operant conditioning
classical conditioning: the sufferer learns to associate a neutral stimulus (such as a dog) with a negative outcome, the unconditioned response (eg after watching someone get bitten by a dog). so the dog becomes a conditioned stimulus and induces the unconditioned response of fear.
operant conditioning: with negative reinforcement. the individual avoids the phobic stimulus (the dog) and by avoiding it, they escape the fear and anxiety they would have suffered if they hadnt. this reduction of fear is what maintains the phobia
28
what are the strengths of the behavioural two process model to explaining phobias?
- a strength is that it can be tested in an objective way. for example, one researcher tested the model by pairing a buzzer sound with an electric shock with rats. through the use of negative reinforcement, rats were trained to escape the shock by jumping over a barrier when the buzzer sounded. this is a strength as it increases the scientific validity of the behaviourist explanation for phobias.
- has practical applications. for example, there are several behavioural therapies that use the principles of conditioning to successfully treat phobias, such as systematic desensitisation, which uses classical conditioning to unlearn the previously learnt phobias. evidence comes from a researcher that found 75% of phobic patients showed an improvement in their symptoms after treatment. the success of these treatments strengthens the validity of the behaviourist explanation for phobias
29
what are the weaknesses of the behaviourist two process model for explaining phobias?
- it has been argued that this explanation is incomplete as it fails to explain the role evolution plays in many peoples fears. for example, researchers have found that we are innately predisposed to fear things such as snakes and sharks, even though we may have never experienced or encountered these phobic stimuli. therefore, the two process model may be too simplistic, and there may be more to acquiring a phobia than simply conditioning.
- explanation has also been criticised as it fails to explain the cognitive aspects of a phobia. for example, irrational thoughts themselves can create extreme anxiety and may trigger a phobia. this is a weakness of the behavioural explanation as it doesnt explain a vital component of phobias.
30
what are the two behavioural methods to treating phobias?
- systematic desensitisation
- flooding
31
what is systematic desensitisation?
a behavioural therapy designed to gradually reduce phobic anxiety through the principles of classical conditioning. a new response to the phobic stimulus is learnt by pairing it with relaxation in a process called counterconditioning
32
what are the three processes involved in systematic desensitisation?
- anxiety hierarchy
- relaxation
- exposure
33
what is an anxiety hierarchy?
when the phobic patient works with a therapist to create a list of situations related to the phobic stimulus, starting with the least fearful situation t the bottom, and the most fearful at the top.
34
what does the relaxation component of systematic desensitisation entail?
it is impossible to be afraid and relaxed at the same time, as one emotion would prevent the other. this is called reciprocal inhibition. therefore, teaching relaxation techniques, such as deep breathing, mindfulness and visualisation are key parts of systematic desensitisation .
35
what does the exposure component of systematic desensitisation entail?
when the patient is exposed to the phobic stimulus whilst in a relaxed state. the patient will start at the bottom of the anxiety hierarchy, and when they can maintain relaxation at that level, they move onto the next level.
exposure can be done in two ways:
- in vitro = the client imagines the exposure to the phobic stimulus (doesnt actually experience it)
- in vivo = when the client is actually exposed to the phobic stimulus
36
what are the strengths of systematic desensitisation as a behaviourist method of treating phobias?
- it has been proven to be effective. for example, one researcher found that 75% of his patients showed an improvement in their symptoms after systematic desensitisation. this is a strength as it shows the treatment can be used to treat many sufferers.
- another strength is that sufferers tend to prefer it to the alternative behavioural therapy of 'flooding'. this is largely because it does not cause the same degree of trauma as flooding does, which is supported by the fact that SD has lower attrition rates, which means less people drop out of the treatment. this is a strength because it means SD is able to treat a higher number of patients than flooding.
- another strength is that it has economic benefits. this is because it is very cost effective for most phobias and is therefore cheaper to deliver to sufferers compared to other therapies. it is estimated that mental health issues cost the English economy £22.5 billon a year. thus, this treatment is a strength as it means cost effective therapies can have a more widespread impact on peoples lives
37
what is a weakness of the behavioural treatment of systematic desensitisation as a treatment of phobias?
it is not an effective treatment for all phobias. for example, researchers suggest that SD may not be effective in treating phobias that have an evolutionary component, such as a fear of heights or dangerous animals. this reduces the usefulness of the treatment.
38
what is flooding?
when phobic patients are immediately exposed to their phobic stimulus without the gradual progression seen in systematic desensitisation.
39
what is a strength of the behaviourist treatment of flooding as a treatment for phobias?
it is a cost effective treatment of phobias. research has shown that this treatment is just as cost effective as systematic desensitisation, however it is significantly quicker. this is a strength as patients can be free of their symptoms as soon as possible, making the treatment quicker than systematic desensitisation.
40
what are the weaknesses of the behaviourist treatment of flooding as a treatment of phobias?
- one weakness is that it is a highly traumatic experience for patients. the problem is not that it is unethical, as patients give their consent prior to the treatment, but that it has a very high attrition rate, which means that many patients are often unwilling to see it through to the end. this is a weakness of flooding because time and money are sometimes wasted preparing patients only to have them refuse to start or complete the treatment.
- another weakness is that whilst flooding may be effective for specific phobias, it is less effective for other types of phobias such as social phobias and agoraphobia. this is because behavioural treatments are unable to treat the irrational thinking that is often associated with these more complex phobias. this suggests that other types of treatment, such as CBT may be more effective to treating all types of phobias. this is a weakness as it suggests flooding is restricted in its usefulness to just specific phobias
41
what is depression?
a mental disorder characterised by low mood and low energy levels
42
how does the dsm-5 distinguish between the different types of depression?
- major depressive disorder = severe but short term
- persistent depressive disorder = longer term and recurring
43
what are the behavioural characteristics of depression ?
- disruption of sleep and eating
- loss of energy, resulting in fatigue, lethargy (decrease in consciousness/prolonged drowsiness), and high levels of inactivity eg. struggling to get out of bed
44
what are the emotional characteristics of depression?
sadness= feeling empty, worthless, hopeless and experiencing low self esteem
anger = negative emotions directed as aggression towards oneself in the form of self harm for example, or towards others close to the individual.
45
what are the cognitive characteristics of depression
focusing on the negative = viewing the world, the future and themselves in a pessimistic way that does not reflect reality. individuals may also show bias towards the recollection of unhappy events in their lives, instead of reporting the happy ones.
poor concentration = unable to stick to tasks and make decisions for themselves. this is likely to interfere with the sufferers work and their ability to communicate
46
what are the two cognitve explanations for depression?
- Ellis' ABC model
- Beck's negative triad
47
how does the ABC model explain depression?
A - activating event, such as getting sacked at work, failing an important test or ending a relationship, which might trigger irrational beliefs
B - beliefs. may be rational or irrational. (eg. the 'company was overstaffed' or 'theyve always had it in for me'). according to ellis, the source of irrational beliefs lies in mustabatory thinking, which is is the belief that we must always succeed or achieve perfection.
C - consequences. rational beliefs lead to healthy emotions like perfection, whereas irrational beliefs lead to unhealthy emotions, including depression
48
how does beck explain depression? (not negative triad)
believes that depressed individuals feel as they do because their thinking is biased towards negative interpretations of the world.
depressed individuals have a negative self schema about themselves during childhood, as a result of parental and/or peer rejection and criticism. this leads to the development of cognitive biases (eg. minimisation which is downplaying the importance of a positive thought or event, personalisation which is upholding personal responsibility for events out of a persons control, and selective abstraction which is drawing conclusions based on one of many elements of a situation)
49
how does becks negative triad explain depression?
three types of negative thinking that occur automatically regardless of what the reality is:
- the self = self depreciating thoughts such as 'i am boring' which enhance any existing feelings because they confirm the existing emotions of low self esteem
- the world = pessimistic thoughts such as 'everyone is against me' which create the impression that theres no hope anywhere
- the future = pessimistic thoughts about the future such as 'i will always be on my own' which reduce hopefulness and enhance depression
50
what is a strength of becks theory of the negative triad in explaining depression?
A range of evidence supports the idea that depression is due to negative thinking For example, Grazioli and Terry (2000) assessed 65 pregnant women before and after birth. They found that those who had a high number of cognitive biases were more likely to suffer post-natal depression. Importantly, these cognitive biases were present BEFORE the depression developed. Additionally, Clark and Beck (1999) carried out a meta- analysis of research into this area and found strong support for Beck’s cognitive theory. This evidence suggests that Beck’s theory is a valid explanation of depression.
51
what is a weakness of ellis abc model in explaining depression?
×The ABC model cannot explain all types of depression because not all cases of depression are triggered by an activating event. For example, endogenous depression is caused by chemical and/or genetic factors, rather than an activating life event. This means that the ABC explanation only applies to some kinds of depression (e.g. reactive depression) and is therefore an invalid explanation of depression.
52
what is a strength of the cognitive explanation for depression?
A strength of the cognitive explanation is that it has been applied to ‘Cognitive-Behavioural Therapy’ (CBT). CBT is consistently found to be the best treatment for depression (Cuijpers, 2013). The success of the treatment lends support to the cognitive explanation. If depression is alleviated by challenging irrational thinking then this suggests such thoughts had a role in the depression in the first place. This increases the validity of the cognitive explanations.
53
what are the weaknesses of the cognitive explanation for depression?
However, the cognitive approach appears to blame the patient for their depression. The approach suggests depression is the result of the way a person thinks, and that recovery is only possible by changing a person’s thought processes. This places a large burden of blame on a person already prone to negative thinking. Additionally, this stance may lead the client or therapist to overlook how life events or family problems may be contributing to the depression. In such cases, changing the situation may be more important than focussing on cognitive factors.
X The biological approach provides an alternative explanation for depression. It argues that depression is caused by low levels of the neurotransmitter, serotonin. The success of anti-depressants, which increase serotonin levels, supports the view that biological factors play a part in the disorder. For this reason, the diathesis-stress approach is usually adopted by psychologists. This suggests that individuals with a genetic vulnerability for depression are more prone to stressful life events, which then leads to negative thinking.
54
what is the cognitive treatment for depression?
cognitive behavioural therapy (cbt)
55
what is the aim of cbt?
to replace irrational, negative thoughts experienced by depressed patients with more rational, positive ones, leading to more constructive emotional and behavioural responses
56
how does cbt work?
1. begins with an initial assessment in which the patient and the therapist identify the patients depressive symptoms, outline their current challenges and agree on a set of goals.
2. The therapist helps the individual identify negative or irrational thoughts that may be contributing to their problems.
These thoughts are challenged through a variety of techniques, such as:
Cognitive restructuring: Rephrasing negative thoughts into more positive or realistic ones.
Guided discovery: Questioning the evidence for and against the thought.
Socratic questioning: Asking probing questions to help the individual examine their thoughts and beliefs.
Thought diaries: Recording thoughts, feelings, and behaviors to identify patterns and triggers (patient is set homework)
3. Behavioral Experiments and Activities:
In addition to cognitive techniques, CBT may involve behavioral experiments to test the validity of thoughts and beliefs.
Individuals may be encouraged to engage in activities they have been avoiding or to try new behaviors to gain new experiences and challenge their assumptions.
4. Developing Coping Skills:
CBT aims to equip individuals with practical skills to manage their thoughts, feelings, and behaviors.
This may include techniques like relaxation, mindfulness, and problem-solving.
5. Relapse Prevention:
CBT often includes strategies to help individuals prevent relapse and maintain gains made during therapy.
This may involve practicing skills learned in therapy and identifying potential triggers or situations that might lead to a relapse.
57
describe ellis' rational emotive behavioural therapy (REBT) in explaining depression
- REBT extends the ABC model to ABCDE, with the D standing for 'Disputing irrational beliefs' and the E standing for 'Effects of disputing the irrational beliefs'
- REBT focuses on challenging or disputing irrational beliefs and replacing them with effective, more rational ones, for example, using logical disputing = realising that self defeating beliefs do not follow logically from the information available, using empirical disputing = realising the self defeating beliefs may not be consistent with reality, and using pragmatic disputing = emphasising the lack of usefulness of the self defeating beliefs.
- the Effect of challenging these irrational thoughts is that the patient ill develop more rational beliefs, and in turn become less depressed, leading to more constructive behaviours.
| (LD PD ED)
58
what are the strengths of cbt?
One strength of CBT is that it has proven to be effective in treating depression. For example March et al (2007) compared CBT with drug therapy (antidepressants). After 36 weeks they found 81% of patients showed improvement in both groups. This is a strength because it shows that CBT is just as effective as drug therapy at treating depression but without the unpleasant side effects that most people experience whilst taking anti-depressants.
ü CBT has clear economic benefits. It is estimated that mental health issues cost the English economy around £22.5 billion per year. CBT has proven to be an effective treatment (see March’s study above) therefore, it reduces unnecessary healthcare costs on treatments that are ineffective and also enables people to return to work, thus helping the economy.
CA) However, it should be noted that CBT is not the preferred method of treatment for most patients. Unlike CBT, drug therapy requires little effort and is just as effective at treating depression. Additionally drug therapy is less expensive as it does not require trained therapists. Thus, drug therapy may prove to be more beneficial to the economy than CBT.
59
what is a weakness of cbt?
One issue with using CBT as a treatment for depression is that it may not work for all sufferers. This is because CBT requires patients to commit to attending regular sessions with a therapist, completing homework and putting into practice the techniques learnt. This is more disruptive to patients’ lives than just taking medication. Additionally, many patients lack the motivation to engage successfully in these programme. This is especially true for those who are severely depressed, suggesting that this method of treatment is not suitable for all sufferers.
60
what is ocd?
an anxiety disorder characterised by two main components: recurring thoughts or obsessions, and repetitive behaviours.
61
what are the behavioural characteristics of ocd?
- compulsive behaviours: sufferers may feel compelled to repeat certain behaviours in order to reduce anxiety.
- avoidance: sufferers may also avoid situations which trigger their anxiety, the aim being to reduce their anxiety through avoidance. for example, sufferers who compulsively wash their hands may avoid coming into contact with germs.
62
what are the emotional characteristics of ocd?
- anxiety and distress = both the obsessions and compulsions are a source of anxiety and distress. anxious feelings are reduced by carrying out the compulsive behaviours.
- shame/disgust = sufferers are aware their behaviour is excessive and atypical, which causes feelings of embarrasment and shame. irrational levels of disgust are also felt about germs/dirt/mess
63
what are the cognitive characteristics of ocd?
obsessions = the major cognitive symptom for 90% of sufferers. obsessions are persistent, recurring internal thoughts that often drive anxious feelings. obsessions can be ideas, doubts, impulses, or images, which are seen as uncontrollable, thus indcing anxiety
awareness of excess anxiety = the person is aware that their obsessions and compulsions are irrational.
64
what is the genetic explanation for ocd?
- the genes we inherit from our parents can predispose us to ocd. for example, lewis (1936) found that 37% of his OCD patients had parents with the disorder, suggesting that specific genes are related to the onset of OCD.
- the COMT gene (an enzyme that regulates dopamine) is mutated in people with OCD, preventing the regulation of dopamine levels, thus causing high levels of dopamine seen in patients with OCD.
- the SERT gene is involved in the transportation of seratonin, an inibitory neurotransmitter. when seratonin levels are low, a person is more likely to get OCD. in people with OCD, the SERT gene mutates, causing lower levels of seratonin.
- OCD is polygenic, meaning its not caused by one single gene but that several genes are involved, including SERT and COMT.
65
what is the neural explanation for OCD?
+ describe the worry circuit
- genes associated with OCD affect the level of certain neurotransmitters, as well as particular structures in the brain.
- low levels of seratonin linked to depression and anxiety disorders such as ocd. support comes from the fact that drugs which increase seratonin levels are effective in treating OCD. dopamine linked to the development of compulsive behaviours.
- worry circuit = The orbital prefrontal cortex (OFC) is a region in the brain which converts sensory information into thoughts and actions. The OFC sends signals about potential hazards (e.g. concerns about harmful germs after using a dirty toilet) to the thalamus. However, if these ‘worry signals’ are not serious, they will be suppressed by the caudate nucleus, preventing them from reaching the thalamus. When the caudate nucleus is damaged (like in people with OCD), it fails to suppress minor or unimportant ‘worry’ signals. Thus, unnecessary thoughts and impulses are allowed to alert the thalamus. These signals are then sent back to the OFC, reinforcing the belief that these unnecessary thoughts and impulses are a major concern that need an immediate and powerful response.
66
what are the strengths of the biological explanations for OCD?
The biological explanation for OCD has a great deal of supporting evidence. E.g., Nestadt et al (2010) carried out a meta-analysis of twin studies and found that MZ (identical) twins had an overall concordance rate of 68% compared to only 31%in DZ (non-identical) twins. This supports the link between genetics and OCD. However it should be noted that concordances rates are never 100%, which means that environmental factors must also play a part.
Additional supporting evidence comes from family studies. E.g., Nestadt et al (2000) found that people with a first-degree relative with OCD (e.g. parents, sibling) were five times more likely to develop the illness themselves, compared to the general population. This evidence further increases the validity of the biological explanation of OCD.
ü Support for the biological explanation of OCD comes from the use of anti-depressants. Anti-depressants typically work by increasing the levels of the neurotransmitter serotonin. Thus, the effectiveness of these drugs at reducing the symptoms of OCD provides support for the neural explanation of OCD. For example, Soomro et al (2009) found that SSRIs were significantly more effective than placebos in treating OCD. This supports the view that abnormal neurotransmitter levels must be contributing to the cause of OCD.
✓ Research evidence supports the role of the OFC in OCD. Menzies (2007) conducted MRI scans on OCD patients and their immediate family members without OCD, and also a healthy control group. He found that OCD patients and their immediate close family members had reduced grey matter in the OFC, supporting the view that differences in this brain region are inherited and may be contributing to the disorder. However, researchers have been unable to successfully identify which genes are causing this reduction in grey matter. The consequence is that a genetic explanation is unlikely to ever be very useful because it provides little predictive value. For example, it is unable to predict which relatives with the reduction in grey matter will develop OCD.
67
what is a weakness of the biological explanation for ocd?
The diathesis-stress model may be better at explaining the cause of OCD than the biological explanation. This is because it acknowledges that both genes and the environmental play a role in OCD. It suggests that individual genes could cause vulnerability for OCD but whether the illness develops depends on environmental factors. For example, Cromer et al (2007) found that over half of their OCD patients had experienced a traumatic life event and that OCD was more severe in patients who had experienced more than one traumatic event. This supports the diathesis-stress model and the view that genes alone cannot predictive who is likely to develop OCD.
68
what is a counter argument for the neural explanation for ocd?
reverse causation = Reverse causation in the context of neural explanations for OCD can mean that observed brain differences in individuals with OCD might be a consequence of the disorder, rather than its cause. This is because OCD-related behaviors and cognitions (obsessions and compulsions) can lead to changes in brain structure and function over time. For example, the constant activation of certain brain circuits during compulsions might lead to their structural or functional modification, making it difficult to determine if those changes were present before or during the onset of OCD.
69
how can the biological approach be used to treat ocd in terms of antidepressants?
- use of antidepressants called SSRI's (seletive seratonin reuptake inhibitors) as low levels of seratonin are associated with OCD, preventing the reuptake by the pre-synaptic neurone means more seratonin remains in the synapse for longer, and so is more likely to bind to the post synaptic neurone and stimulate it. [typical daily dose of an ssri such as fluoxetine (prozac) is 20mg, and it takes 3-4 months of daily use to have an effect on symptoms
70
how can the biological approach be used to treat ocd in terms of anti-anxiety drugs?
Benzodiazepines (e.g., Valium) are commonly used to reduce anxiety. Benzodiazepines work by increasing the activity of the neurotransmitter GABA. GABA has a quietening effect on neurons in the brain and therefore, helps to slow down brain activity.
How GABA works:
· GABA is released into the synapse by the presynaptic neuron.
· It locks onto receptors on the postsynaptic neuron
· This opens a channel that increases the flow of chloride ions into the neuron.
· Chloride ions make it harder for the neuron to be stimulated by other neurotransmitters, thus slowing down its activity, reduces the anxiety
experienced due to obsessions and makes the person with OCD feel more relaxed.
other drugs that are used are...
SNRIs (Serotonin Noradrenaline Reuptake Inhibitors).
These drugs work by preventing the reuptake mechanism of both serotonin and noradrenaline, thus increasing the levels of both of these neurotransmitters and reducing anxiety.
- Tricyclics
These are an older drug which work in the same manner as SNRIs, but have more severe side effects.
71
what are the strengths of drug therapy as a biological treatment for ocd?
There is clear evidence for the effectiveness of drug therapy in reducing the symptoms of OCD. For example, Soomro et al (2009) reviewed studies comparing SSRIs to placebos in the treatment of OCD. They found that SSRIs were significantly more effective than placebos in treating OCD. Additionally, Kahn et al (1986) compared placebos and Benzodiazepine (BZs) in 250 patients. They found that BZs were significantly superior to placebos in treating anxiety. This is a strength because drug therapy enables sufferers to cope with their symptoms, such as anxiety, thereby improving the quality of their lives.
ü A further strength of drug therapy as a treatment for OCD is that they are cost-effective compared to psychological treatments. For example, they do not require a trained therapist and are less disruptive to the patients’ lives. Drugs allow patients to reduce their symptoms without having to engage with much of the hard work needed by psychological therapies such as CBT. For these reasons, drug therapies are the preferred method of treatment for many doctors and patients. They enable people to control their symptoms with minimal effort, saving time and money. Additionally, drug therapy combines well with CBT by reducing a patient’s anxiety, thereby enabling them to engage more successful with the techniques.
72
what are the weaknesses of drug therapy as a biological treatment for ocd?
Although drug therapies are more commonly used to treat OCD, in a comprehensive review of treatments for the disorder, Koran (2007) argued that psychotherapies such as CBT should be tried first. This is because drugs only treat the symptoms of OCD rather than the root cause. Whilst drug therapy is effective in the short-term by placing a ‘chemical mask’ on symptoms, they are not a lasting cure. For example, patients normally relapse within a few weeks after medication is stopped. This is an issue as alternative therapies such as CBT or a combined approach of drugs and CBT, may be seen as more appropriate in the long-term.
X A major weakness of drug therapy are the side effects that most patients experience. Common side effects of SSRIs include blurred vision, indigestion and loss of sex drive. These may not seem that terrible but often are enough to make a patient prefer not to take the drug. Some patients also experience more serious side effects like hallucinations, erection problems and raised blood pressure.
BZs are renowned for being highly addictive and can also cause increased aggression and long-term memory impairments. As a result, BZs are usually only prescribed for short-term treatment. Consequently, these side effect diminish the effectiveness of drug treatments, as patients will often stop taking medication if they experience these side effects.
