Psychopathology

Question 1

what are the four definitions of abnormality

Answer 1

statistical infrequency
deviation from social norms
failure to function adequately
deviation from ideal mental health

Question 2

what is statistical infrequency

Answer 2

occurs when an individual has a less common characteristic, for example being more depressed or less intelligent than most of the population

Question 3

example for statistical infrequency

Answer 3

the normal distribution of iq scores. people with an iq of 100 is seen as normal. however, people with lower than 100 is seen as abnormal and people with over 200 is also seen as abnormal which is also known as intellectual disability disorder.

Question 4

strength of statistical infrequency

Answer 4

usefulness in real world application
as it is used in clinical practice, both as a part of formal diagnosis and as a way to assess the severity of the individuals symptoms
for example, a diagnosis of idd requires an iq of 70%. an example of statistical infrequency used in an assessment tool is the beck depression inventory. a score of 30+ indicates severe depression.
this shows that the value of statistical infrequency criterion is useful in diagnostic and assessment procesw.

Question 5

limitation of statistical infrequency

Answer 5

unusual characteristics can be positive
for people with an iq below 70 there is another with an iq above 130. however we would not think that someone who has a high iq is abnormal. similarly someone with a low depression score on the bdi would also not be seen as abnormal. these examples show that being unusual or being on one end of the spectrum does not necessarily make someone abnormal.
this means that, although statistical infrequency can form a part of assessment and diagnostic procedures, it is never sufficient as the sole basis for defining abnormality.

Question 6

what is deviation from social norms

Answer 6

concerns behaviour that is different from the accepted standards of behaviour in a society
norms are specific to the culture we live in.

Question 7

an example of deviation from social norms

Answer 7

antisocial personality disorder
this is when a person is impulsive, aggressive and irresponsible. according to the dsm-5 one symptom is an absence of prosocial internal standards associated with failure to conform to lawful and culturally normative ethical behaviour.
in other words, a social judgement is made that psychopaths are abnormal as they dont conform to our moral standards.

Question 8

strength of deviation from social norms

Answer 8

usefulness in real life application
this is used in clinical practice
for example the key characteristic of asd is the failure to conform to culturally normal ethical behavior. these signs of the disorder are all deviations from social norms. such norms also play a part in the diagnosis of schizoptypal personality disorder, there the term strange is used to characterize the thinking, behaviour and appearance of people with the disorder.
this shows that the deviation from social norms criterion has value in psychiatry.

Question 9

limitation of deviation from social norms

Answer 9

is the variability between social norms in different cultures and even different situations
a person from one cultural group may label someone as abnormal using their standards only.
for example, hearing voices is the norm in some cultures, but would be seen as a sign of abnormality in the uk. also, even within one cultural context social norms differ from one situation to another.
this means that it is difficult to judge deviation from social norms across different situations and cultures.

Question 10

what is failure to function adequately

Answer 10

when a person may cross the line between normality and abnormality at the point that they cannot deal with the ordinary demands of life.
e.g maintain basic standards of hygiene.

Question 11

signs of failure to function adequately

Answer 11

Rosenham and Seligmans suggested that these were the sign of failure to function adequately
personal distress
observer discomfort
dysfunctional / maladaptive behaviour
unpredictable behaviour
dangerous behaviour

Question 12

an example of failure to function adequately

Answer 12

an example of this is the intellectual disability disorder
one of the criteria for this is having a very low id (statistical infrequency). however, a diagnosis would not only be made by this basis - an individual must also be failing to function adequately before a diagnosis would be given.

Question 13

strength of failure to function adequately

Answer 13

it represents a threshold for help
around 25% of ppl in the uk will experience a mental health problem in an given year. however, 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 noticed and referred fro help by others.
this criterion means that treatment and services can be targeted to those who need them most.

Question 14

limitation of failure to function adequately

Answer 14

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. similarly those who favour high-risk leisure activities could be classed as a danger to themselves. however, it is not.
this means that people who make unusual choices are at risk of being labelled abnormal and their freedom of choice may be restriced.

Question 15

what is deviation from ideal mental health

Answer 15

occurs when someone does not meet the criteria for good mental health

Question 16

what does ideal mental health look like

Answer 16

jahoda suggested that we are in good mental health if we meet the following criteria
*no symptoms or distress
*rational and can perceive ourselves accurately
*self- actualize
*can cope with stress
*have a realistic view of the world
*good self-esteem and lack guilt
*independent of other people
*successfully work, love and enjoy our leisure

Question 17

strength of deviation from ideal mental health

Answer 17

it is highly comprehensive
this definition covers a broad range of criteria for ideal mental health
it provides reasons as to why someone would seek help from mental health services or be referred for help.
this suggests that jahodas criteria is a good tool to assessing mental health

Question 18

limitation of deviation from ideal mental health

Answer 18

it has unrealistically high standards for mental health
very few people will attain all of jahodas criteria for mental health
therefore, this approach will see most of us as abnormal
this shows that the DIMH definition of abnormality is unreasonable in assessing mental health

Question 19

what is a phobia

Answer 19

an irrational fear of an object or situation

Question 20

what is specific phobia

Answer 20

phobia of an object

Question 21

what is social anxiety (social phobia)

Answer 21

phobia of a social situation such as public speaking or using a public toilet

Question 22

what is agraphobia

Answer 22

phobia of being outside or in a public place

Question 23

behavioural characterisitics of phobias

Answer 23

pain, avoidance and endurance

Question 24

emotional characterisitcs of phobias

Answer 24

anixety, fear, emotional response is unreasonable

Question 25

cognitive characterisitcs of phobias

Answer 25

selective attention to the phobic stimulus, irrational beliefs, cognitive distortions

Question 26

what is depression

Answer 26

a mental disorder characterised by low mood and low energy levels

Question 27

behavioual characteristic of depression

Answer 27

activity levels, disruption to sleep and eating behaviour, aggression and self harm

Question 28

emotional characteristic of depression

Answer 28

lowered mood, anger, lowered self-esteem

Question 29

cognitive characteristics of depression

Answer 29

poor concentration, attending to and dwelling on the negative, absolutist thinking

Question 30

what is OCD ( obsessive- ompulsive disorder)

Answer 30

a condition characterised by obsessions and/or compulsive behaviour. obsessions are cognitive whereas compulsions are behavioural

Question 31

behavioural characterisitcs of ocd

Answer 31

compulsions are repetitive, ompulsions reduce anxietry, avoidance

Question 32

emotional characteristics of ocd

Answer 32

anxiety and distress, accompanying depression, guilt and disgust

Question 33

cognitive characteristics of ocd

Answer 33

obsessive thoughts, cognitive coping strategies, insight into excessive anxiety

Question 34

what is the behavioural approach

Answer 34

emphasises the role of learning in the acquisition of behaviour.

Question 35

what is the two process model

Answer 35

mowrer proposed the two process model based on the behavioural approach to phobias. this states that phobias are acquired by classical conditioning and maintained operant conditioning

Question 36

what makes up the two process model

Answer 36

the phobia is learnt by classical conditioning and maintained by operant conditioning

Question 37

what does classical conditioning involve

Answer 37

involves learning to associate something of which we initially have no fear (neutral stimulus) with something that already triggers a fear response (unconditioned stimulus)

Question 38

example of classical conditioning

Answer 38

watson and rayner created a phobia in a 9 month old baby called little albert. he showed no unusual anxiety at the start of the study. when he was shown a rat he tried to play with it. then the experimenters then set out to give albert a phobia. when the rat was presented to him the researchers made a loud, frightening noise by banging an iron bar close to alberts ear. this noise is an unconditioned stimulus which creates an unconditioned response of fear. when the rat (neutral stimulus) and the ucs are encountered close together the ns becomes associated with the ucs and both produce a fear response. this condition then generalised to similar objects.

Question 39

what is operant conditioning

Answer 39

a form of learning in which behaviour is shaped and maintained by its consequences.

Question 40

when does operant conditioning take place

Answer 40

when our behaviour is reinforced (rewarded) or punished. reinforcement tends to increase the frequency of a behaviour.

Question 41

how is the phobia maintained

Answer 41

mowrer suggested whenever we avoid a phobic stimulus we successfully escape the fear and 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

Question 42

strength of the two process model

Answer 42

it is a valid explanation of phobias this model has been used to create effective therapies for people that suffer from phobias these therapies show that if a patient is prevented from practising their avoidance behaviour then phobic behaviour declines this means that it has real life applications in the treatment of phobias

Question 43

a limitation of the two process model

Answer 43

not all bad experiences leads to phobias for example, not all people that are bitten by a dog develop a phobia therefore, we cannot assume that conditioning alone leads to phobias, as some people may be more vulnerable than others due to individual differences this implies that the two process model does not explain the cause of all phobias

Question 44

another limitation of the two process model

Answer 44

it does not consider biological preparedness for example, we easily acquire phobias of things that were a danger in our evolutionary past this could be advantageous as it can help us to survive therefore, the two process model does not consider the many factors involved when acquiring phobias

Question 45

another strength of the two process model

Answer 45

there is evidence between bad experience and phobias a study for ad de jonagh et al found that 73% with a fear of dental treatment had experienced traumatic experience. this can be compared to a control group of people with low dental anxiety where only 21! had experienced a traumatic event. this confirms that the association between stimulus (dentistry) and ucr (pain) does lead to the development of the phobia

Question 46

the behavioural approach to treating phobia includes:

Answer 46

systematic desensitisation and flooding

Question 47

what is systematic desensitisation

Answer 47

is a behavioural therapy designed to gradually reduce phobic anxiety through the principle of classical conditioning.

Question 48

what are the steps of systematic desensitisation

Answer 48

*practice relaxation techniques *create an anxiety hierarchy *exposed to the first stage of anxiety hierarchy in a relaxed state *exposed to the next stage of anxiety hierarchy in a relaxed stage *person is successfully treated when they can remain relaxed in high anxiety situations (top of hierarchy.)

Question 49

strength of systematic desensitisation

Answer 49

it is effective gilroy et al followed a group of 42 patients that received SD for their fear of spiders on the follow ups ( at 3 and 33 months) this group had less fear than the control group (which had no SD for their phobia) this suggests that SD has long term positive benefits for patients in terms of treating phobias

Question 50

another strength of systematic desensitisation

Answer 50

SD is less unpleasant than flooding people with learning disabilities and children maybe distressed by flooding they may also be unable to give informed consent this means that SD is a more appropriate treatment for people with phobias that also have learning disabilities

Question 51

what is flooding

Answer 51

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

Question 52

how does flooding work

Answer 52

flooding involves immediate exposure to a very frightening situation. flooding stops phobic responses very quickly as the client learns that the phobic stimulus is harmless. this process is extinguished when the conditioned stimulus is encountered without the unconditioned stimulus. this results in the condition stimulus no longer producing the conditioned response.

Question 53

is flooding unethical

Answer 53

no it is not, but it is important that clients give fully informed consent.

Question 54

one limitation of flooding

Answer 54

it is less effective for some type of phobias it is less effective at treating social phobias this is because social phobias are more complex and have cognitive aspects. the patient may therefore benefit from cognitive therapy this suggests that flooding cannot treat all types of phobias

Question 55

another limitation of flooding

Answer 55

it is traumatic for patients it not only raises ethical concerns, but it means that patients are not willing to see the treatment through to the end therefore, attrition rates are higher for flooding compared to SD this means that the therapy is not effective, and it can waste NHS resources.

Question 56

what are the two cognitive approaches to explaining depression

Answer 56

becks negative triad and ellis ABC model

Question 57

what is becks negative triad

Answer 57

aaron beck took cognitive approach to explaining why some people are more vulnerable to depression than others. this involves the role of internal mental processes in determining behaviour

Question 58

what 3 kinds of negative thinking did aaron beck think that makes us vulnerable to depression?

Answer 58

-negative self-schema -faulty information processing -the negative triad

Question 59

what is faulty information processing

Answer 59

this is when depressed people attend to the negative aspects of a situation and ignore positives. they think in 'black and white' terms.

Question 60

what is negative self-schema

Answer 60

a schema is a package of ideas and info developed through experience. if a person has negative self-schema they interpret all information about themselves in a negative way

Question 61

what is the negative triad

Answer 61

three elements that make up the negative triad - negative view of the world -negative view of the future -negative view of the self

Question 62

strength of becks negative triad

Answer 62

it has practical applications as a therapy becks theory has helped to create cognitive behavioural therapy the components of the negative triad are challenged by the CBT this suggests that becks theory has enabled us to create a successful therapy for depression

Question 63

another strength of becks negative triad

Answer 63

the existence of supporting research clark and beck concluded that not only were these cognitive vulnerabilities more common in depressed people but they preceded the depression. this was confirmed by Joseph they tracked the development of 473 adolescents, regularly measuring cognitive vulnerability there is an association between cognitive vulnerability and depression

Question 64

a limitation of Becks model

Answer 64

it does not explain all aspects of depression depression is complex, some people who are depressed feel deeply angry, others experience hallucinations some people even have delusion that they are zombies which cannot be explained easily with becks model becks model focuses on just one aspect of the disorder, negative thoughts and is therefore only a partial explanation of depression

Question 65

what is ellis ABC model

Answer 65

elis proposed that depression is a result of irrational thoughts A - negative activating (trigger) events happen B - irrational beliefs/ thoughts C - emotional and behavioural consequences

Question 66

what is activating event

Answer 66

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.

Question 67

what are the irrational beliefs

Answer 67

*we must always succeed - musturbation *major disaster when something does not go smoothly - I-cant-stand-itis *life is always meant to be fair - utopianism

Question 68

what are the consequences

Answer 68

when an activating event triggers irrational beliefs there are emotional and behavioural consequences e.g if a person believes they must always do well in tests and they fail. this will trigger depression

Question 69

a limitation of ellis ABC model

Answer 69

it only has explains reactive depression and not endogenous expression many cases of depression are not traceable to life events and it is not obvious what leads the person to become depressed at a particular time. this type of depression is called endogenous expression this means that ellis model can only explain some cases of depression and is therefore only a partial explanation.

Question 70

strength of eliis ABC model

Answer 70

its real-world application in the psychological treatment of depression ellis approach to cognitive therapy is called rational emotive behaviour therapy. the idea of REBT is that by vigourously arguing with a depressed person the therapist can alter irrational beliefs that are making them unhappy. there is some evidence to support the idea that REBT can both change negative beliefs and relieve the symptoms of depression. this means REBT has real-world value.

Question 71

what is cognitive behaviour therapy

Answer 71

it aims to identify and change the patients faulty cognitions. the idea is that patients learn how to notice negative thoughts when they have them, and test how accurate they are

Question 72

what is the cognitive element

Answer 72

CBT begins with an assessment in which the client and the cognitive behaviour therapist work together to clarify the clients 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.

Question 73

what is the behaviour element

Answer 73

CBT then involves working to change negative and irrational thoughts and finally put more effective behaviours into place.

Question 74

what is becks cognitive therapy

Answer 74

cbt assists clients in identifying their irrational thought from the negative triad. the client is encouraged to challenge irrational thoughts directly with help from the therapist clients are often set homework to record positive events, which can be used in the sessions to help them challenge irrational thoughts. the therapist can directly confront the client with evidence to highlight their irrational thoughts.

Question 75

what is ellis rational emotive behaviour therapy

Answer 75

REBT extends eliis ABC model to ABCDE. d is for dispute and e is for effect.

Question 76

what does REBT aim to do

Answer 76

this aims to help the client to identify and challenge irrational thoughts. example of this is when a therapist presents arguments to dispute this idea.

Question 77

what do the therapist role

Answer 77

the therapists role is to break the link between negative life effects and depression by changing the clients irrational belief.

Question 78

what are the two types of arguments identified by ellis

Answer 78

empirical arguments and logical arguments

Question 79

what are empirical arguments

Answer 79

disputing if there is real evidence to support the irrational belief.

Question 80

what are logical arguments

Answer 80

disputing if negative thoughts follows logically from the facts.

Question 81

strength of cbt

Answer 81

it has alot of research support March et al found that the CBT was just as effective as medication at treating depression. after 36 weeks, 81% of the cbt group were significantly improved March et al also found that the combination of medication and CBT was the most effective this suggest that CBT is successful at treating depression

Question 82

a limitation of cbt

Answer 82

it does not explore the patients past the main focus of cbt is to focus on the patients present and future- not on their past in some cases there are links between childhood experiences and current depression therefore, the present focus of CBT may ignore an important aspect of the patients depression.

Question 83

another limitation of the cbt

Answer 83

there is an overemphasis on cognition cbt minimises the important of the circumstances in which the patient is living in a patient living in poverty/ suffering abuse needs to focus on changing the environment not just their cognition therefore, cbt could demotivate people form changing their situations and risk being ineffective

Question 84

final limitation of cbt

Answer 84

it may not work for severe costs of depression in some cases depression is so severe that patients cannot motivate themselves to take on the hard cognitive work required for cbt. in such cases, it may be more effective to treat patients using antidepressants this suggests that it cannot be used in every case as a sole treatment for depression

Question 85

what are the two biological approaches to explaining ocd

Answer 85

genetic explanations and neural explanations

Question 86

what is the genetic explanation of ocd

Answer 86

assumes that mental illnesses are heritable. the risk of developing ocd is higher for first- degree relatives and the risk of inheriting ocd is higher than in some families

Question 87

what are candidate genes

Answer 87

this creates vulnerability. some of these genes are involved in regulating the development of the serotonin system.

Question 88

ocd is polygenic

Answer 88

this means that ocd is not caused by one single gene but by a combination of genetic variations that together significantly increases vulnerability. taylor found that upto 230 different genes may be involved in ocd. genes that have been studied in relation to ocd include those associated with the action of dopamine as well as serotonin, both neurotransmitters believe to have a role in regulating mood.

Question 89

different types of ocds

Answer 89

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 that is used to describe this is aetiologically hetereogeneous.

Question 90

what are the two neural explanations for OCD

Answer 90

neurotransmitters and brain structures

Question 91

what are neurotransmitters

Answer 91

they are referred as the bodys chemical messengers

Question 92

what are excitatory neurotransmitters

Answer 92

they have excitatory effects on the neuron. this means they increase the likelihood that the neuron will fire an action potential

Question 93

what is the inhibitor neurotransmitters

Answer 93

have inhibitory effects on the neuron. this means they decrease the likelihood that the neuron will fire an action

Question 94

give an example of an inhibitory neurotransmitter

Answer 94

serotonin - stops messages to brain to be anxious

Question 95

neurotransmitters explanation

Answer 95

neurotransmitters pass information from one neuron to another through the process of synaptic transmission one neurotransmitter called serotonin has a role in regulating our mood if a person has low levels of serotonin then they may experience low mood, and this has been found in some people with OCD.

Question 96

how does brain structures explain ocd

Answer 96

some ocd may be due to abnormality in parts of the brain. for example, hoarding disorder could be caused by abnormal functioning of the frontal lobes which are associated with decision making. there is also evidence to suggest that some people with ocd have abnormal functioning of their left para hippocampus gyrus which is associated with processing unpleasant emotion

Question 97

one strength of the genetic explanation to explaining ocd

Answer 97

there is good supporting evidence for the genetic explanation of ocd. nestadt reviewed twin studies and found that 68% of identical twins shared ocd compared to 31% for non-identical twins. this suggests that some people are vulnerable to ocd as a result of their genetic make up this supports the idea that candidate genes can create a vulnerability for ocd.

Question 98

strength of a neural explanation

Answer 98

it has supporting evidence SSRIs that work on the serotonin system are effective in reducing ocd symptoms for about 70% of people. this implies that the serotonin system may be involved in ocd therefore we can assume that the neural explanations is valid at explaining the causes of ocd

Question 99

limitation of both neural and genetic explanation

Answer 99

it does not consider environmental factors cromer found that over half of ocd patients in their sample had a traumatic event in their past and that ocd was more severe in those with one or more traumas this supports the diathesis stress model - which argues that a biological vulnerability needs to be triggered by the environment this implies that the biological exp does not provide a complete account of ocd

Question 100

a limitation for the neural explanation of ocd

Answer 100

the research support dos not prove causation this is because even though some studies find that people with ocd has low levels of serotonin compared to the general population we do not know if the ocd causes the low levels of serotonin or vice versa, or if an unresearched 3rd factor is involved

Question 101

what are the ways in which you can treat ocd

Answer 101

SSRIs combining SSRIs with CBT tricyclics SNRIs

Question 102

what do SSRIs do

Answer 102

they increase levels of serotonin in the brain

Question 103

what does SSRI stand for

Answer 103

selective serotonin reuptake inhibitor

Question 104

name an SSRI

Answer 104

fluoxtine 20 mg / day

Question 105

how do SSRIs work

Answer 105

prevent the reabsorbtion of serotonin in the brain this increases the level of serotonin in the synapse therefore serotonin continues to stimulate the post synaptic neuron

Question 106

why might a person prescribed SSRIs and CBT

Answer 106

the drugs reduce a patients emotional symptoms. this means that the patient can then engage better with CBT

Question 107

what are the alternatives for ssris

Answer 107

tricyclics (an older antidepressant) and snris (serotonin-nora adrenaline reuptake inhibitor)

Question 108

one strength of drug therapy in treating ocd

Answer 108

they are cost-effective and non - disruptive drug treatments are good value for the NHS as they are cheap compared to psychological treatment SSRIs are also non disruptive to the patients lives as a result of this, many doctors and patients prefer this method of treatment

Question 109

another strength of the drug therapy

Answer 109

it is effective at tackling ocd symptoms soomro et al found that 17 studies showed significantly better results with ssris compared to placebos symptoms reduce for around 70% of patients taking ssris this suggests that drug therapy can help most patients that suffer from ocd.

Question 110

a limitation of drug treatment

Answer 110

it can have side effects for example, patients ted to suffer from blurred vision and loss of sex drive such factors mean that the drug lost effectiveness as people stop taking the medication therefore, psychological therapy may be more effective as there are no side effects

Question 111

another limitation of drug therapy

Answer 111

in some cases ocd follows trauma ocd can have a range of different causes. in some cases it occurs in response to a traumatic event it may not be appropriate to use drugs to treat such cases that follow from a trauma as psychological therapies may provide the best option this implies that different treatment options work for different cases of ocd and the biological and the biological approach does not consider this