Psychopathology Flashcards
(123 cards)
1
Q
What are the four definitions of abnormality?
A
- Statistical infrequency/ deviation from statistical norms
- Deviation from social norms
- Failure to function adequately
- Deviation from ideal mental health
2
Q
What is statistical infrequency?
A
This is deciding if a behaviour is abnormal by looking at the number of times we observe it. A statistically rare behaviour would be seen as ‘abnormal’. Any ‘unusual behaviour’ is ‘normal’ and any behaviour that is different is ‘abnormal’. This would be more than a trait that is more than 2 standard deviations from the mean.
3
Q
What are strengths of using statistical infrequency to determine abnormality?
A
- Statistical infrequency is an obvious and relatively quick and easy way to define abnormality
- Real life application - it’s relatively easy to determine abnormality using psychometric tests developed using statistical methods. Most patients with a mental health disorder will undergo a psychometric measurement of their symptoms in comparison to the norm.
4
Q
What are some limitations of using statistical infrequency to determine abnormality?
A
- Desirability of behaviour - Many behaviours are rate but considered high,y desirable (High IQ, great athletic ability). It is difficult to know how far you have to deviate from the average to be considered abnormal.
- Benefits of a label - Someone who is living a happy and fulfilled life may not benefit from a label regardless of how ‘abnormal’ they may be considered. In fact a label of ‘abnormal! Could be detrimental not helpful.
- Some behaviours are statistically very frequent, but still classified as abnormal, for example, depression.
- Cultural and historical relativism - what is statistically frequent and acceptable in one culture and time period is not necessarily the norm in another. For example, arranged marriages are statistically frequent in India, Marijuana smoking is statistically frequent in Jamaica.
5
Q
A
6
Q
What are social norms?
A
Behaviours that society sets up to rule based on a set of moral standards.
7
Q
A
8
Q
Give an example of a deviation from a social norm and suggest why they are considered so
A
Antisocial Personality Disorder (psychopathy)
- Lacks empathy, aggressive, impulsive and irresponsible
- Accoridng to the DSM-V; one important symptom in diagnosing antisocial personality disorder is an ‘absence of pro-social internal standards associated with failure to conform to lawful or culturally normative ethical behaviour’.
9
Q
What is a strength of using deviation from social norm to define abnormality?
A
Has real life application in terms of diagnosis, for example, antisocial personality disorder
10
Q
What are limitations of using deviation from social norms to define abnormality?
A
- Historical issues: Until early 20th century, unmarried women who become pregnant were interred in mental institutions. Until 1967 in the UK homosexual acts were criminal offences. Until 1973 in USA homosexuality was a mental disorder.
- Cultural issues: Russia - a diagnosis of insanity was used to detain political dissidents. Japan - you are deemed insane if you don’t want to work. Western societies - you can plead insanity as a defence - Lorena Babbitt cut off her husband’s penis - pleaded insanity. African/Indian cultures consider it normal to talk to the dead
Social control - This approach has been used as a form of social control, for example, black slaves running away were diagnosed with drapetomania
11
Q
What is the failure to function adequately?
A
An inability to cope with day-to-day life caused by psychological distress or discomfort which may lead to harm of self or others. E.g. someone with depression may only be diagnosed with the disorder if it hinders their normal functioning (work, socialising etc.)
12
Q
How is failure to function adequately used to determine abnormality?
A
Rose ham and Seligman (1989) propose six major features which indicate a person may not be functioning adequately. The more of the features that an individual has, the more likely they are to be considered abnormal.
13
Q
What are the 6 major features which indicate that a person may not be functioning adequately and describe them?
A
- Personal distress - person may get aggressive/angry. They may cry often.
- Maladaptive behaviour - Self harm/suicidal ideology
- Irrationally and incomprehensibility - There appears to be no good reason why the person should choose to heave that way. They don’t listen to reason or common sense. Irrational - doing badly at a test - thinking you will fail all exams in future.
- Unpredictability and loss of control - Behvaiour is often highly unpredictable and inappropriate for the situation. Someone suddenly shouting, showing anger for no apparent reason.
- No longer adheres to interpersonal rules/observer discomfort - Someone invading your personal space when speaking to you
- Violation of morals - Breaking laws, taboos, unwritten social rules
14
Q
What is a strength of using failure to function adequately as a definition of abnormality?
A
Patients perspective - attempts to include the subjective xperience of the individual. Although an individual’s assessment of their own distress may be very subjective,it does at least acknowledge the experience of the patient as important.
15
Q
What are some limitations of using failure to function adequately as a definition of abnormality?
A
- Who decides the acceptable level of functioning? - Deciding whether someone is distressed or something is distressing is subjective. Some patients although they may say that they are distressed may be judged as not suffering.
- Context of the behaviour - Some people engage in behaviours that could be considered maladaptive or harmful to self, but we wouldn’t class them as abnormal. People who have alternative lifestyles may appear to function inadequately, for example, a New Age traveller not having a permanent address, or a base jumper taking part in a sport with a high mortality rate.
- Some people have psychological disorders but still function adequately
- Labelling - a label gives a stigma that may stick around long after the problem has gone. Can affect employment prospects and personal relationships.
16
Q
How can deviation from ideal mental health be judged?
A
Marie Jahoda came up with the PRAISE list of terms that everyone with ideal mental health should have:
Personal Growth (Self actualisation: should reach your potential)
Reality perception (should know what’s real)
Autonomy (should be independent and our ability to make our own decisions)
Integration (should ‘fit in’ with society and be able to cope with stressful situations)
Self-attitudes (should be positive: high self esteem)
Environmental mastery (should cope in your environment, be able to function at work and in relationships, adjust to new situations and solve problems)
17
Q
What is a strength of using the deviation from ideal mental health as a definition of abnormality?
A
- Comprehensive - covers a broad range of criteria. This covers all aspects of mental health and makes us aware of all the different factors which can affect our mental health.
18
Q
What are some limitations of using deviation from ideal mental health as a definition of abnormality?
A
- Cultural relativism - cultural bound - autonomy is valued in Western individualistic cultures but less so in non-western collectivist cultures where community values are more important.
- Difficult, if not impossible to meet all the criteria, therefore is everyone mentally unhealthy - self actualisation - very few people reach full potential. It’s unrealistic.
19
Q
What is a phobia?
A
A phobia is an anxiety disorder, which interferes with daily living. It’s an instance of irrational fear that produces a conscious avoidance of the feared object or situation.
20
Q
How does the DSM-V classify your phobia as being valid?
A
- Marked and persistent fear of a specific object or situation
- Exposure to the phobic stimulus nearly always produces a rapid anxiety response
- Fear of the phobic object or situation is excessive
- The phobic stimulus is either avoided or responded to with great anxiety
- The phobic reactions interfere significantly with the individual’s working or social life, so there’s constant distress about the phobia
21
Q
What is the DSM-V?
A
A reference book used by mental health professionals to diagnose and classify mental disorders.
22
Q
What is a specific phobia?
A
A phobia of a specific object
23
Q
What is social anxiety?
A
A phobia of a social situation such as public speaking
24
Q
What is agoraphobia?
A
Phobia of being outside or in public space
25
What are two emotional reactions to experience of a phobia?
- Anxiety from fear of the phobic stimulus. Emotional response that is negative.
- Unreasonable emotional response, disproportionate to the danger posed
26
What are 3 behavioural reactions that are caused by experience of a phobia?
- Panic - crying, screaming, running away
- Avoidance - take a lot of effort to avoid stimulus which affects day to day life
- Endurance - if you remain in the presence of stimulus, they may experience high anxiety
27
What are 3 cognitive reactions that occur when in distance of a phobia?
- Selective attention - hard to look away from the stimulus
- Irrational beliefs - social phobia - increases pressure on person to perform in social situations
- Cognitive distortions - perceptions of the stimulus are distorted
28
What does the two process model suggest?
Hobart Mowrer (1960) proposed the two process model and he stated that phobias are acquired through classical conditioning and are maintained through operant conditioning
29
How are phobias maintained by operant conditioning?
Reinforcement tends to increase the behaviour whether this is through negative or positive reinforcement. Negative reinforcement is avoiding a situation which is unpleasant. This resu,to in a desirable consequence which means the behaviour will be repeated.
30
Supporting evaluation for phobias: Good explanatory power
- Thw two process model 2as a step forward when it was proposed in 60s. It explains how phobias can be maintained over time and this has important implications for therapies. Once a patient is prevented from practicing their avoidance behaviour, the behaviour ceases to be reinforced and it declines.
31
Negative evaluation for phobias: Alternative explanation for avoidance behaviour
- Not all avoidance behvaiour associated with phobias seems to be the result of anxiety reduction
- Evidence to suggest that at least some avoidance behaviour appears to be motivated more by positive feelings of safety
- Agroaphobia - motivating factor is choosing an action such as not so much in the house is not so much to avoid the phobia stimulus but to stick with the safety factor (Buck,2010)
32
Negative evaluation for phobias: An incomplete explanation of phobias
- Bountin (2007) suggested that evolutionary factors probably have an important role in phobias
- Phobias such as the dark could be acquired by a source of danger in the past
- It is adaptive to acquire such fears
- Seligman (1971) called this biological preparedness- the innate predisposition to acquire certain fears
33
Negative evaluation for phobias: Phobais that don’t follow a trauma
- Where does that fear come from?
- Some people don’t know why they fear something. It can be a result of conditioning but not always
34
Negative evaluation for phobias: What are the cognitive aspects of phobias?
- The behaviourist approach doesn’t take into account the cognitive aspects of
- The two process model explains maintained of phobias in terms of avoidance
But what about how we process emotions?
- Cognitive distortions?
- Irrational beliefs
- Selective attention?
35
What is systematic desensitisation?
This is a behavioural therapy designed to gradually reduce phobic anxiety through the principle of classical conditioning
- If the client can learn to relax in the presence of the phobic stimulus they will be cured
- A new response is learnt - counter conditioning
36
What does systematic desensitisation aim to do?
It aims to extinguish an undesirable behvaiour by replacing it with a more desirable one.
37
What is reciprocal inhibition?
In psychology, it’s when we cannot feel fear and relaxation simultaneously. It’ used in systematic desensitisation.
38
Positive evaluation for systematic desensitisation: It’s effective in reducing phobic behaviour
- Gilroy et al. (2003) - 42 patients treated for a spider phobia in three 45 minute sessions, compared to a control group who were treated by relaxation without exposure
- At three months and 33 months the treatment group were less fearful than the relaxation group
39
What are the steps of systematic desensitisation?
-The client works out a hierarchy of features from least frightening to most frightening (functional analysis)
- Separately, the client learns relaxation techniques and ask him to continually do them
- When the client is fully relaxed, slowly expose them to the phobic stimulus, starting at the least frightening images.
40
Positive evaluation for systematic desensitisation: It’s suitable for a diverse range of phobias
- Some people with anxiety disorders, also have learning disabilities
- It can be difficult for people to understand other therapies such as flooding or CBT that require the ability to reflect on what you are thinking
- Systematic desensitisation is the most appropriate therapy
41
Positive evaluation for systematic desensitisation: It’s acceptable to patients
- Patients prefer systematic desensitisation as it is not as traumatic as flooding. It also includes some elements which are pleasant - relaxation.
- Reflected in low refusal rates and low attrition rates
42
What is flooding?
Invokes immediate exposure to a frightening experience
43
How does flooding work and how does it link to extinction?
The immediate exposure to a frightening experience. There is no option of avoidance and the patient quickly learns that the phobic stimulus is harmless. Sometimes the patient may achieve relaxation in the presence of the phobic stimulus because they become exhausted by their own fear response. This is extinction.
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Negative evaluation of flooding: Ethical safeguards
Flooding is an unpleasant experience so it is important thta patients give fully informed consent. They should be fully prepared before the session.
46
Positive evaluation of flooding: Cost
It’s cost effective
- Flooding is at least as effective as other treatments for specific phobias
- Ougrim (2011) have found that flooding is highly effective and quicker than alternatives
- As it’s quicker this also makes it cheaper
47
Negative evaluation for flooding: It’s less effective for some phobias
- Social phobias and agoraphobia don’t seem to show as much improvement because of complex cognitive aspects, anxiety and unpleasant thoughts, CBT would be more useful
48
Negative evaluation for flooding: trauma
- It can be highly traumatic for the patient and they are often unwilling to see it through until the end
- Time and money are therefore wasted
- It’s very unpleasant so patients need fully informed consent.
49
Negative evaluation for flooding: symptom substitution
- Common criticism for flooding and SD
- One phobia disappears and another replaces it
- Evidence is mixed but Freud suggested that it is said to occur if the unsconscious impulses and conflicts responsible for the original symptoms are not dealt with effectively
50
What is depression and what are its categories?
Depression and depressive disorders can be characterised by changes to mood. DSM-V has the following categories:
- Major depressive disorders can be- severe but short term
- Persistent depressive disorders- long term or recurring depression including sustained major depression
- Disruptive mood dysregulation disorder - childhood temper tantrums
- Premenstrual dysphoric disorder - disruption to mood prior to or during menstruation
51
What is a unipolar disorder?
An episode of depression that can occur suddenly
- Can be reactive - death of a loved one
- Or can be endogenous - neurological factors
52
What is a bipolar disorder?
Manic and depressive episodes
- Change of mood in regular cycles
- Mania: over-activity, rapid speech, and feeling happy or agitated
53
What are some emotional characteristics of depression?
- Lowered mood
- Anger
- Lowered self-esteem
54
What are some behavioural characteristics of depression?
- Reduced energy levels - lethargic
- Disruption to sleep and eating behaviour
- Aggression and self-harm
- Anhedonia - decreased ability to feel pleasure
55
What are some cognitive characteristics of depression?
- Poor concentration
- Attending to and dwelling on the negative
- Absolutist thinking - ‘black and white’
56
What are the key assumptions of the cognitive approach?
- Individuals who suffer from mental health disorders have distorted and irrational thinking - which may cause maladaptive behaviour
- It is the way you think about the problem rather than the problem itself which causes the mental health disorders
- Individuals can overcome mental health disorders by learning to use more appropriate cognitions. If people think more positively, they can be helped to feel better.
57
What did Aaron Beck suggest of depression?
That there’s a cognitive explanation as to why some people are more vulnerable to depression than others. He suggested three parts to this cognitive vulnerability:
- Faulty information processing
- Negative self-schema
- negative triad
58
What did Aaron Beck suggest about Faulty Information processing in depression?
- He believed that people who have depression make fundamental errors in logic
- He proposed that people who have depression tend to selectively attend to the negative aspects of a situation and ignore positive aspects.
- There’s a tendency to blow small problems out of proportion with thinking, in terms of black and white, and ignoring the middle ground.
59
What did Aaron Beck suggest of Negative self-schemas in depression?
He suggested that people who have depression have developed negative self-schemas and therefore they interpret all the information about themselves in a negative way.
60
Weissman and Beck (1978) - Depression experiment
Aim: investigating the thought processes of depressed people to establish if they make use of negative schemas
Method: Thought processes were measured using the Dysfunctional Attitude Scale (DAS). Participants were asked to fill in a questionnaire by ticking whether they agreed or disagreed with a set of statements. E.g. ‘people will probably think less of me if I make a mistake’
Result: they found that participants with depression made more negative assessments than people without depression. When given therapy to challenge and change their negative schemas, there was an improvement in their self-ratings
Conclusions: Depression involves the use of negative schemas
61
What did Aaron Beck propose about the negative triad in depression?
He suggested that people with depression become trapped in a cycle of negative thoughts.
They have a tendency to view themselves, the world and the future in a pessimistic way - the triad of impairments
62
What did Albert Ellis (1962) propose about good mental health?
He proposed that good mental health is the result of rational thinking. Ellis argued that there are common irrational beliefs that underlie much depression (poor mental health), and sufferers have based their lives in these beliefs ‘I must be successful, competent and achieving in everything I do if I am to call myself worthwhile’
63
What is Ellis’ ABC model?
Ellis suggested that
A - an action is affected by
B - an individuals beliefs which results in
C - a consequence
If beliefs are subject to cognitive biases (similarly to Beck’s) then they can cause irrational thinking which produces undesirable behaviours
64
What was the A in Ellis’ ABC model?
Activating event
- Ellis focused on situations in which irrational thoughts are triggered by external events. We have depression when we experience negative events and these events trigger irrational beliefs.
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What does the B in Ellis’ ABC model represent?
Beliefs
- Ellis identified a range of irrational beliefs:
- We must always succeed or achieve perfection ‘musturbation’
- Whenever something does not go smoothly, it is a disaster
- Utopianism - life is always meant to be fair
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What does the C in the ABC model represent?
Consequences.
When an activating event triggers irrational beliefs, there are emotional and behavioural consequences.
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Supporting evidence for Beck: Depression
- Much research has supported the proposal that depression is associated with faulty information processing, negative self-schemas and the triad of impairments
- Grazioli and Terry (2000) assessed 65 pregnant women for cognitive vulnerability and depression before and after birth
- Those high in cognitive vulnerability were more likely to suffer post-natal depression
- Clark and Beck (1999) reviewed research on depression and concluded that there was solid support for all these cognitive vulnerability factors
The cognitions can be seen before depression develops, suggesting that Beck may be right about cognition causing depression
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Supporting evaluation: Practical application for CBT
- Beck’s cognitive explanation forms the basis of cognitive behavioural therapy. All cognitive aspects of depression can be challenged in CBT.
- This includes the components of the negative triad, that are easily identifiable
- This means that a therapist can challenge them and encourage the patient to test whether they are true.
Suggesting that therapy I’ll be more successful
70
Negative evaluation: Beck
- The theory explains the basic symptoms of depression however it’s a complex disorder with a range of symptoms, not all of which can be explained. For example, coated syndrome - delusion that you are a zombie.
71
Negative evaluation: Ellis’ theory
It only offers a partial explanation
- Some depression does occur as a result of an activating event (reactive depression)
- However not all depression arises as a result of an obvious cause
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Positive evaluation: Ellis’ theory - irrational negative beliefs
Ellis’ explanation has led to successful therapy. Irrational negative beliefs are challenged and this can help to reduce depressive symptoms suggesting that the irrational beliefs had some role in the depression.
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Negative evaluation: Ellis’ theory - anger
This explanation doesn’t explain why some individuals experience anger associated with their depression or why some patients suffer hallucinations and delusions
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Positive evaluation: Cognitive primacy - Ellis’ theory
- Cognitive explanations for depression share the idea that cognition causes depression
The idea that emotions are influenced by cognition
Other theories of depression see emotion as stored, similarly to physical energy, to emerge some time after its causal event.
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Positive evaluation: Ellis’ theory - attachment and depression
- Link between insecure attachment to parents and vulnerability to depression in adulthood
- Children who don’t have a secure attachment to their parents are more vulnerable to having depression in adulthood. This could be due to negative feelings of self, the world and the future.
76
What is CBT?
Cognitive Behaviour Therapy is most commonly used psychological treatment for depression, as well as other mental problems. This is a method for treating mental disorders based on both behavioural and cognitive techniques. The therapist aims to make the client aware of the relationship between thought, emotion and actions. CBT can help people to change how they think and what they do. These changes can help them to feel better.
77
What is spoken about in CBT?
- How you think about yourself, the world and other people
- How what you do affects you thoughts and feelings
78
What is behavioural activation in CBT?
encouraging patients to engage in those activities they are avoiding
79
From the cognitive point of view, what does therapy aim to do?
Deal with negative thinking, like challenging negative thoughts
80
What does CBT focus on?
It focuses on the 'here and now' problems and difficulties. Instead of focusing on the causes of distress or symptoms in the past, it looks for ways to improve the state of mind now. CBT aims to get the person to a point where they can 'DIY' and work out their own ways of tackling their problems.
81
What does the process of CBT involve?
Assessment --> Formulation/Goals --> Treatment (by homework and monitoring) --> Treatment complete
The patients meet with the therapist for around 5 and 20 weekly or fortnightly sessions. Each will last 30 to 60 mins. Most draw on techniques by Beck and Ellis.
82
What is CBT 1 (Beck's cognitive therapy)?
It was developed to challenge the negative triad of the client.
The client is first assessed of the severity of their condition. The therapist will establish a baseline, prior to treatment, to help monitor improvement. The client provides information of how they perceive themselves, the world and the future. The therapist uses reality testing e.g. if the client says 'I'm useless and I always fail', they will ask in reality if they have been successful at something. The therapist might ask the client to do something to demonstrate their ability to succeed. Clients are made aware of their negative views and so irrational ideas can be replaced with more optimistic and rational beliefs.
83
What is CBT 2 (Ellis' Rational Emotional Behaviour Therapy (REBT) model)
REBT extends Ellis' ABC model to an ABCDE model. D = Dispute (challenge the thoughts) and E = Effect (see a more beneficial effect on thought and behaviour). Therefore the central technique of REBT is to identify and dispute the patient's irrational thoughts. Ellis believes irrational thoughts are the main cause of all types of emotional distress and behaviour disorder. So, REBT is based on that whenever we become upset, it's not the events taking place in our lives that upset us; it's the beliefs that we hold that cause us to have depression etc. REBT challenges the client to 'prove' the statements said, and then replace them with more reasonable realistic statements (empirical disputing).
84
What is empirical disputing?
A technique used in REBT and CBT where therapists challenge the accuracy of a person's beliefs by seeking evidence to support or refute them. It's about questioning whether the facts of an event or situation align with a person's thoughts and feelings.
85
Newark et al. (1973) - Irrational attitudes
Aim: They wanted to discover if people with psychological problems had irrational attitudes.
Method: Two groups of participants are asked if they agree with the following statements identified by Ellis as irrational:
- It's essential that one be loved or approved of by virtually everyone in the community
- One must be perfectly competent, adequate and achieving in order to consider oneself worthwhile
One group consisted of people who were diagnosed with anxiety. The other group had no psychological problems ('normal').
Result - 65% of the anxious participants agreed with statement a compared to 2% of non-anxious participants. For statement b 80% of anxious participants agreed, compared to 25% of non-anxious participants.
Conclusion: People with emotional problems think in irrational ways
86
Explain how the biological approach is used to explain depression
- Suggests that genes and neurotransmitters may cause depression
- The success of drug therapies for treating depression suggests that neurotransmitter do play an important role; the medication alters the levels of specific neurotransmitters and reduces the symptoms
- A diathesis-stress approach might be advisable, suggesting that individuals with a genetic vulnerability for depression are more prone to the effects of living in a negative environment, which then leads to negative irrational thinking.
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How effective is CBT?
- It reduces symptoms of depression and in preventing relapse and there's a large body of evidence to support this
- March et al. 2007, 327 adolescents: after 36 weeks 81% of both the CBT group and the antidepressant group and 86% of combined treatment showed improved symptoms.
- It's as effective as antidepressants for many types of depressions
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Positive evaluation for CBT and drug treatment
Keller et al. (2000)
- Recovery rates from depression
55% drugs alone
52% CBT alone
85% effective when used together
89
Negative evaluation for CBT - may not work for most severe cases
- In some cases depression may be so severe that patients cannot motivate themselves to engage in the therapy
- In these cases, it's possible to treat the patient with antidepressants and then CBT can commence at a later date
- This is a limitation as it means that CBT cannot be used as the sole treatment in all cases
90
Positive evaluation for CBT - therapist-patient relationship
Success may be due to the therapist-patient relationship (Rosenzweig, 1936)
- Little difference between CBT and other forms of psychotherapy
- It could be the quality of the relationship that makes the differences to the success of the treatment rather than the treatment itself
- Simply having the opportunity to talk to someone who will listen could be what matters most.
91
Negative evaluation: past
Some patients may want to explore their past
- CBT focuses on the 'here and now' however there may be links to childhood experiences and current depression and patients might want to talk about these experiences
- They can find this 'present-focus' very frustrating
92
Negative evaluation: Over-emphasis on cognition
- There's a risk that in focusing on what is happening in the mind of the individual may end up minimising the importance of the circumstances the individual is living in.
- There's thus an ethical issue for cognitive behavioural therapists here, and it's important for therapists to keep in mind that not all problems are in the mind
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What are some implications of psychological research for the economy? (i.e. how knowledge of psychology is of benefit to employers)
- Anything to do with treatment of mental health disorders and people's ability to work and contribute as effective members of society would be relevant - such as, finding Ann effective treatment (for any disorder) would reduce the number of days people have off work sick so productivity improves.
- The world health organisation predicted, in 2020, depression will be the biggest single disease as it is costly to individuals, families, communities and the economy as a whole through lowered productivity, absenteeism and unemployment.
- Therefore, if psychological research shows that people with a disorder like depression are less likely to suffer a relapse after having cognitive therapy then in the long-term it might be more economically sound to offer cognitive therapy as people would have less time off work.
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What is obsession?
A persistent thought, idea, impulse or image that experienced repeatedly, feels intrusive and causes anxiety
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What is compulsion?
A repetitive and rigid behaviour or mental act that a person feels driven to perform in order to prevent or reduce anxiety
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How is OCD and a range of related disorders recognised?
OCD - characterised by obsessions and/or compulsions
Trichotillomania - compulsive hair pulling
Hoarding disorder - compulsive gathering of possessions and the inability to part with anything regardless of its value
Excoriation disorder - compulsive skin picking
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How does the DSM describe the main symptoms of OCD?
- Recurrent obsessions and compulsions
- Recognition by the individual that the obsessions and compulsions are excessive and/or unreasonable
- That the person is distressed or impaired, and daily life is disrupted by the obsessions and compulsions
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What are some behavioural characteristics of OCD?
How a person acts which typically leads to the carrying out of repetitive actions to reduce anxiety. this often leads to avoidance of situations that trigger anxiety.
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What are some emotional characteristics of OCD?
- OCD may feel depressed and/or other negative emotions
- Guilt and disgust
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What are some cognitive factors of OCD?
- OCD sufferers are usually plagued with obsessive thoughts. They also tend to develop cognitive strategies
- Anxiety
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Describe the OCD cycle
Obsessive thought --> anxiety --> compulsive behaviour --> Temporary relief -->
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How can OCD have a biological explanation?
- OCD uses the biological approach as to how its caused.
- It's proposed that there's a genetic component to OCD which predisposes some individuals to the illness
- The genetic explanation suggests that whether a person develops OCD is at least partly due to their genes. This may explain why patients often have family members with OCD.
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What did Billet et al. (1998) and Bellodi et al. (2001) suggest about OCD?
They suggested that genetic factors play a role in the development in OCD. Using evidence from twin studies and family studies, they showed that close relatives are more likely to have the disorder than distant relatives.
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What is a candidate gene?
Candidate genes are ones which have been implicated in the development of OCD. A possible candidate gene is the SERT gene which is involved in regulating serotonin, a neurotransmitter which facilitates message transfer across synapses. Another possible candidate gene is the COMT gene - regulates dopamine (this affects motivation and drive).
105
What does the diathesis-stress model suggest of OCD?
It suggests that people gain a vulnerability towards OCD through genes but an environmental stressor is also required. This could be a stressful event, like a bereavement. OCD is thought to be polygenic - meaning its development is not determined by a single gene but a few - meaning there's little predictive power from this explanation.
106
Positive evaluation: Genetics - OCD
There's some evidence to suggest there's a genetic component to the disorder. One of the best sources of evidence for the importance of genes is twin studies (Nested, 2010)
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3 Negative evaluation: genetics - OCD
- Family studies could also be used to explain environmental influences
- Close relative of OCD sufferers may have observed and imitated the behaviour (SLT)
- It's difficult to untangle the effects of environment and genetic factors
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Positive evaluation: Candidate genes - OCD
Candidate genes are ones which, through research, have implicated in the development of OCD.
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Negative evaluation: Candidate genes - OCD
- There are too many genes involved
- Psychologists have not been successful at pinning down all the genes involved
- Each genetic variation only increases the risk of OCD by a fraction
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Positive evaluation: Diathesis-stress model - OCD
Individuals may gain a vulnerability towards OCD through genes that is then triggered by an environmental stressor
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Negative evaluation: Diathesis-stress model - OCD
Cromer (2007) found that over half the OCD patients in their sample had a traumatic event in the past, and that OCD was more severe in those with more than one trauma
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Negative evaluation - Reductionist approach
- Due to the biological approach no takin into consideration other approaches in psychology, it is reductionist
- There's some evidence of genetics for OCD but it is not the complete picture; for symptoms and causes
- This means that it may be more productive to focus on environmental causes as it seems that not all OCD is entirely genetic in origin
113
What are two neural explanations for OCD?
- There's abnormal levels of certain neurotransmitters
- Certain areas of the brain may not be neurotypical
114
What is the basal ganglia and how does it link to OCD?
This area of the brain is responsible for innate psychomotor functions. Rapoport and Wise (2010) proposed the hypersensitivity of the basal ganglia gives rise to. the repetitive motor seen in OCD, for example, repetitive washing/cleaning/checking
115
What are the two other parts of the brain, other than basal ganglia, are believed to be involved in OCD?
The orbitofrontal cortex and the thalamus. The thalamus is a brain area whose functions include cleaning, checking and other safety behaviours.
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What is the frontal lobe involved in?
Decision making and worrying about social behaviours
117
What would be the result of an overactive thalamus?
Increased motivation to clean or check for safety. If it was overactive the orbitofrontal cortex would become overactive too.
118
What happens if the orbitofrontal cortex becomes overactive?
Results in increased anxiety and increased planning to avoid anxiety
119
What does lower levels of serotonin mean?
It causes normal transmission of mood-relevant information to take place. Lower levels can lead to depression and mood instability. This affects mood and other mental processes
120
positive evaluation - neurotransmitters - OCD
- Allows medication to be developed which helps sufferers
121
3 negative evaluations - neurotransmitters - OCD
- Drugs are not completely effective
- Just because administering SSRIs decreases OCD symptoms, does not mean that lower levels of serotonin are a cause of the OCD
- There is time delay between taking drugs to target the condition and any improvements being made and yet the chemical imbalance is addressed in hours
122
2 positive evaluations - Areas of the brain - OCD
- Advances in technology have allowed researchers to investigate specific areas of the brain more accurately, and OCD sufferers do seem to have excessive activity in the orbital frontal cortex
- Cleaning and checkin behaviours are 'hard-wired' in the thalamus
123
3 negative evaluations - areas of the brain - OCD
- The repetitive acts (compulsions) may be explained by the structural abnormality of the basal ganglia but not necessarily the obsessional thoughts
- There are inconsistencies found in the research as no system has been found that always plays a role in OCD
- These neural changes could be as a result of suffering from the disorder, not necessarily the cause of it.
