Psychopathology

Question 1

What is statistical infrequency?

Answer 1

A disorder is abnormal if its frequency is more than two standard deviations away from the mean incidence rates represented on a normally distributed bell curve.

Question 2

Strength of statistical infrequency

Answer 2

Almost always used in clinical diagnoses of mental health disorders as a comparison with a baseline or normal value. This is used to assess the severity of the disorder. E.g. the idea that schizophrenia only affects 1% of the general population but subtypes are even less frequent.

Question 3

Limitation of statistical infrequency

Answer 3

Statistical infrequency makes the assumption that any abnormal characteristics are automatically negative, whereas this is not always the case. For example, displaying abnormal levels of empathy or having an IQ score above 130 would rarely be looked down upon as negative characteristics which require treatment.

Question 4

What is failure to function adequately?

Answer 4

Proposed by Rosenhan and seligman and suggests that if a person’s current mental state is preventing them from leading a normal life then the individual is considered abnormal. This occurs when the patient does not obey social and interpersonal rules and are in distress or are distressing and their behaviour becomes dangerous.

Question 5

What is a strength of failure to function adequately?

Answer 5

It takes into account the patient’s perspective and so the final diagnosis will be compromised of the patient’s self reported symptoms and the psychiatrists objective opinion. This may lead to more accurate diagnoses of mental health disorders because such diagnoses are not constrained by statistical limits as is the case with statistical infrequency.

Question 6

What is a weakness of failure to function adequately?

Answer 6

The idea that it may lead to the labelling of some patients as strange or crazy which does little to challenge traditional negative stereotypes about mental health disorders. Not everyone with a mental health disorder requires a diagnosis especially if they have a high quality of life and their illness has little impact upon themselves or others. Instead such labelling could lead to discrimination or prejudice faced against them by employers and acquaintances.

Question 7

What is deviation from social norms?

Answer 7

Suggests abnormal behaviour is based upon straying away from the social norms specific to a certain culture. There are general norms, applicable to the vast majority of cultures, as well as culture specific norms.

Question 8

What is a limitation of deviation from social norms?

Answer 8

Mental health diagnoses based on this definition vary so significantly between different cultures has historically led to discrimination as a mechanism for social control. For example, in the 19th century within Great Britain, ‘nymphomania’ described the mental health disorder suffered by women who demonstrated sexual attractions towards working class men. In reality, this diagnosis was simply made to prevent infidelity, cement the differences between social classes and further discriminate against women, thus a reflection of a patriarchal society.

Question 9

What is another limitation of deviation from social norms?

Answer 9

Due to its reliance on subjective social norms, this explanation suffers from cultural relativism. One such example would be hearing of voices which have no basis in reality or ‘hallucinations’. Some Africans and Asian cultures up in particular would look upon this symptom positively, viewing it as a sign of spirituality and a strong connection with ancestors as opposed to a symptom of schizophrenia. This therefore suggests that the use of this definition of abnormality may lead to some discrepancies in the diagnosis of mental health disorders between cultures.

Question 10

What is deviation from ideal mental health?

Answer 10

Proposed by Jahoda. Instead of focusing on abnormality, jahoda looked at what would comprise the ideal mental state of an individual. The criteria include being able to self actualise, having an accurate perception of ourselves, not being distressed, being able to maintain normal levels of motivation to carry out day to day tasks and displaying high self esteem.

Question 11

What is a limitation of deviation from ideal mental health.

Answer 11

Jahoda may have an unrealistic expectation of ideal mental health with the vast majority of people being unable to acquire all of the criteria listed. This means that the majority of the population would be considered abnormal even if they have missed a single criteria. Therefore deviation from ideal mental health may be considered a very limited method of diagnosing mental health disorders.

Question 12

What is another limitation of deviation from ideal mental health?

Answer 12

Suffers from cultural relativism. For example, the concept of self actualisation, which suggests that we must each put ourselves first in order to achieve our full potential, may be viewed as selfish in collectivist cultures where the needs of the group are valued more than the needs of the individual. On the other hand, self actualisation may be a more popular concept in individualistic cultures, where personal achievement is celebrated and the needs of the individual are greater than the needs of the group. This suggests that deviation from ideal mental health would only be accepted as a definition for abnormality in some cultures.

Question 13

What are the behavioural characteristics of phobias?

Answer 13

Panic, avoidance and endurance

Question 14

What is panic?

Answer 14

The patient suffers from heightened physiological arousal upon exposure to the phobic stimulus, caused by the hypothalamus triggering increased levels of activist in the sympathetic branch of the autonomic nervous system.

Question 15

What is avoidance?

Answer 15

Avoidance behaviour is negatively reinforced because it is carried out to avoid the unpleasant consequence of exposure to the phobic stimulus. Therefore avoidance severely impacts the patient’s ability to continue with their day to day lives.

Question 16

What is endurance?

Answer 16

This occurs when the patient remains exposed to the phobic stimulus for an extended period of time but also experienced heightened levels of anxiety during this time.

Question 17

What are the emotional characteristics of phobias?

Answer 17

Anxiety and an unawareness that the anxiety experiences towards the phobic stimulus is irrational.

Question 18

What ar the cognitive characteristics of phobias?

Answer 18

Selective attention, irrational beliefs and cognitive distortions

Question 19

What is selective attention?

Answer 19

The patient remains focused on the phobic stimulus even when it is causing them severe anxiety.

Question 20

What are irrational beliefs?

Answer 20

May be the cause of unreasonable responses of anxiety towards the phobic stimulus due to the patients incorrect perception as to what the danger posed actually is.

Question 21

What are cognitive distortions?

Answer 21

The patient does not perceive the phobic stimulus accurately. Therefore it may appear grossly distorted or irrational.

Question 22

What are the behavioural characteristics of depression?

Answer 22

Changed activity levels, aggression, and changed in sleep patterns or eating.

Question 23

What are the emotional characteristics of depression?

Answer 23

Lowered self esteem, constant poor mood and high levels of anger

Question 24

What are the cognitive characteristics of depression?

Answer 24

Absolutist thinking, selective attention towards negative events and poor concentration.

Question 25

What are the behavioural characteristics of OCD?

Answer 25

Compulsions and avoidance behaviour. This avoidance behaviour is negatively reinforced.

Question 26

What are the emotional characteristics of OCD?

Answer 26

Guilt and disgust, depression and anxiety.

Question 27

What are the cognitive characteristics of OCD?

Answer 27

The patients acknowledgement that their anxiety is excessive and irrational, the development of cognitive strategies to deal with obsessions and obsessive thoughts.

Question 28

What is the behavioural approach to explaining phobias?

Answer 28

Mowrer suggested that phobias are acquired through classical conditioning and then maintained through operant conditioning. Watson and Rayner demonstrated how little Albert associated the fear caused by a loud bang with a white rat. Operant conditioning takes place when a behaviour is rewarded or punished. E.g. phobics practice avoidance behaviours meaning they avoid the phobic stimulus. By avoiding the phobic stimulus they avoid the associated fear. By avoiding such an unpleasant consequence the avoidance behaviour is negatively reinforced and likely to be repeated again hence maintaining the phobia.

Question 30

Strength of behavioural approach to explaining phobias

Answer 30

Good explanatory power- the main advantage of this theory is that it can explain the mechanism behind the acquisition and maintenance of phobias, which classical or operant conditioning alone cannot do. This transfers to practical benefits in systematic desensitisation and flooding. Mowrer emphasises the importance of exposing the patient to the phobic stimulus because this prevents the negative reinforcement of avoidance behaviour. The patient realises that the phobic stimulus is harmless and that their responses are irrational thus translating into successful therapy.

Question 31

Negative of the behavioural approach to explaining phobias

Answer 31

Alternative explanation for avoidance behaviour- Buck suggested safety is a greater motivator for avoidance behaviours meaning they rather than simply avoiding the entirety associated with the phobic stimulus. E.g. he uses the example of social anxiety phobias- such sufferers can venture out into public but only with a trusted friends despot being exposed to hundreds of strangers which could usually trigger their anxiety. This means that Mowrer’s explanation of phobias may be incomplete and only suited for some.

Question 32

Another limitation of the behavioural approach to explaining phobias

Answer 32

Alternative explanation for acquisition of phobias. Seligman suggested that we are more likely to develop phobias towards prepared stimuli. These are stimuli which would have posed a threat to our evolutionary ancestors and so running away from such a stimulus increases the likelihood of survival and reproduction, and so this behaviour has a selective evolutionary advantage. This means that alternative theories can explain why some phobias are much more frequent than other phobias.

Question 33

What is systematic desensitisation as a behavioural approach to treating phobias?

Answer 33

A behavioural therapy designed to reduce phobic anxiety through gradual exposure to the phobic stimulus. It relies upon the principle of counter conditioning. This world due to reciprocal inhibition. The patient and therapist create an anxiety hierarchy made of situations involving the phobic stimulus. The therapist then teaches the patient relaxation techniques. The patient works their way up through the hierarchy only progressing to the next level when they have remained calm in the present level. The phobia is cured when the patient can remain calm at the highest anxiety level.

Question 34

Strength of systematic desensitisation

Answer 34

Supporting evidence- Gilroy et al. Followed up 42 patients treated in three sessions of systematic desensitisation for a spider phobia. Their progress was compared to a control group of 50 patients who learnt only relaxation techniques. The extent to such phobias was measured using the spider questionnaire and through observation. At both 3 and 33 months, the systematic desensitisation group showed a reduction in their symptoms as compared to the control group and so has been used as evidence supporting the effectiveness of flooding.

Question 35

Another strength of systematic desensitisation

Answer 35

It is suitable for many patients, including those with learning difficulties. Anxiety disorders are often accompanied with learning disabilities meaning that such patients may not be able to make the full cognitive commitment associated with cognitive behavioural therapy or have the ability to evaluate their own thoughts. Therefore systematic desensitisation would be a suitable alternative for them.

Question 36

What is flooding as a behavioural approach for treating phobias?

Answer 36

A behavioural therapy designed to reduce phobic anxiety in one session through immediate exposure to the phobic stimulus. This occurs in a secure environment where the patient cannot escape- without the option of practicing avoidance behaviour, such behaviour is not reinforced and so the phobia is not maintained. Thus, in the case of a spider phobia, the patient will instantly be exposed to a room full of spiders which can crawl over them. This relies on the principle that it is physically impossible to maintain a state of heightened anxiety for a long period of time, meaning that eventually the patient will learn that the phobic stimulus is harmless.

Question 37

Strength of flooding

Answer 37

Cost effective- Ougrin compared flooding to cognitive therapies and found it to be cheaper. This is because the patients phobia will typically be cures in one session thus freeing them of their symptoms and allowing them to continue living a normal life.

Question 38

What is a limitation of flooding?

Answer 38

Less effective for complex phobias. Social phobias involve both anxiety and a cognitive aspect. Thus, in these cases cognitive therapy may be more appropriate because this therapy can target the distal causes of the phobia as opposed to the mere proximal causes. This suggests that alternatives may be more effective.

Question 39

What is Beck’s cognitive approach to explaining depression?

Answer 39

Beck proposed that one has a cognitive vulnerability towards developing depression through faulty information processing, negative self schemas and the cognitive triad of automatic negative thoughts. Through faulty information processing the patient blows small problems out of proportion attending to and dwelling on the negative, whilst thinking in black and white terms. Through negative self schemas the patient interprets all information about themselves from the world in a negative light further lowering self confidence. Through the cognitive triad, the patient suffers from negative automatic thoughts about the self, the future and the world.

Question 40

Strength of beck

Answer 40

Supporting research evidence- Grazioli and Terry’s evaluation of 65 pregnant women for cognitive vulnerability and depression before and after birth. The researchers found a positive correlation between an increased cognitive vulnerability and an increased likelihood of acquiring depression after birth. This supports the link between faulty cognition and depression which is in line with the predictions made by Beck’s cognitive theory thus increasing the validity.

Question 41

Another strength of Beck’s cognitive theory

Answer 41

An increased understanding of the cognitive basis of depression translates to more effective treatments. Thus, it translates well into a successful therapy and the consequent effectiveness of CBT is merit to the accuracy of Beck’s cognitive theory as an explanation for depression.

Question 42

What is Ellis’ cognitive theory for depression?

Answer 42

Ellis proposed that an activating event leads to and irrational belief which results in an emotional consequence in the form of depression. The key is the specific interpretation of the irrational belief which is why some people have depression whilst others don’t according to the ABC model.

Question 43

A limitation of Ellis’ ABC model

Answer 43

Ellis’ ABC model cannot explain all types of depression apart from those which clearly have an activating event. However, many suffer from depression without an apparent cause and may feel frustrated that their concerns are not reflected in this theory. Therefore this suggests that the ABC model is limited at best.

Question 44

What is a strength of Ellis’ ABC model?

Answer 44

The ABC model shares the same advantage as Beck’s cognitive theory in that it provides a practical application in CBT. The effectiveness of CBT suggests that identifying and challenging irrational beliefs are at the core of curing depression which in turn supports the theoretical basis of the ABC model through a specific focus on the role of faulty cognitions in the development of depression and specifically in the interpretation of an activating event.

Question 45

What is CBT as a cognitive approach to treating depression?

Answer 45

CBT aims to identify and challenge irrational thoughts, replacing them with more productive behaviours. Beck’s CBT aims on identifying the patients thoughts and challenging them as irrational. This can be guided by the cognitive triad of automotive negative thoughts, faulty info processing and negative self schemas. Cognitive therapy also aims for patients to test the reality of their beliefs. The idea of patient as a scientist.

Question 46

What is Ellis’ rational emotive behaviour therapy as a cognitive approach to treating depression.

Answer 46

Aims to identify the patient’s thoughts and challenge them as irrational, leading to a vigorous argument. This may be a logical argument or an empirical argument. This aims to change the irrational belief and to break the link between negative life events and depression. Through behavioural activation, patients are encouraged to engage in enjoyable activities to provide further counter evidence for their irrational beliefs.

Question 47

What is a strength of the cognitive approach to treating depression?

Answer 47

Supporting research evidence- March followed a group of 327 adolescents with a main diagnosis of depression. After 36 weeks 81%, 81% and 86% were the respective improvement rates for each of the three experimental conditions (CBT, antidepressants, CBT + antidepressants). Therefore, this is compelling evidence for the idea that antidepressants are effective in treating depression and are based on accurate biological explanations of depression.

Question 48

What is a limitation of CBT?

Answer 48

CBT may not be an appropriate treatment for all cases of depression and particularly the most severe cases. This idea could also have been reflected in the evidence provided by March et al, where a combination of CBT and antidepressants is the most effective combination. This is because those with severe depression may not be able to attend the regular CBT sessions due to a lack of motivation and also may feel completely hopeless. This means CBT can’t be used to address all cases of depression and arguably is not suitable for cases which need help the most.

Question 49

What is the biological approach to explaining depression?

Answer 49

The genetic explanation, through the distress stress model suggests that some have a genetic vulnerability towards developing depression. E.g. Lewis et al found that of his OCD patients, 37% had parents with OCD and 21% had siblings with OCD. OCD is polygenic, meaning that up to 230 different genes are involved in its development (Taylor). These are often associated with regulating mood. Researchers have identified candidate genes which increase a person’s vulnerability towards developing OCD. One of these is 5HT1-D beta which is implied in the efficiency of serotonin transport across synapses. OCD is also aetiologically heterogeneous meaning that its origin has many different causes. For example, it has been suggested that hoarding disorder is caused by a particular gene variation.

Question 50

What is a strength of the biological approach to explaining OCD?

Answer 50

Supportive evidence- Nestadt et al reviewed previous twin studies of OCD and found that 68% of identical twins compared to 31% of non identical twins share OCD. This suggests that there is a genetic basis for the disease because identical twins share 100% of their genes with each other whilst dizygotic twins only share 50% of genes with each other. However it is important not to be deterministic- just because an individual has a particular combination of candidate genes does not mean the individual will develop OCD, but rather that this genetic vulnerability must be paired with an environmental stressors to result in OCD shown in the diathermy stress model.

Question 51

What is a limitation of the biological approach to explaining OCD?

Answer 51

Too many candidate genes- with over 230 candidate genes each individually coding for an increased risk of OCD, then this poses a practical issue in that it is difficult to assess which candidate genes have the greatest influence and so which genes drug treatments should target. Thus, such explanation is likely to have little predictive value in the future.

Question 52

What are SSRI’s in the biological approach to treating OCD?

Answer 52

Selective serotonin reuptake inhibitors act on the serotonin system by preventing the reuptake and breaking down of serotonin by the presynaptic neuron. Thus, the concentration of serotonin within the synapse increases causing the post synaptic neuron to be continually stimulated.

Question 53

What are tricyclics in the biological approach to treating OCD?

Answer 53

Reserved for those who do not respond to SSRI’s. Selective noradrenaline reuptake inhibitors increase the concentration of noradrenaline neurotransmitter in the brain.

Question 54

What is a limitation of the biological approach to treating OCD?

Answer 54

A limitation of drug therapy are the serious side effects. For example, those who take Clomipramine, more than one in 10 suffer from erection problems, weight gain and tremors. More than 1 in 100 suffer from increased heart rate and aggressiveness. These side effects can have serious implications on how the patient can go about their everyday lives.

Question 55

What is a strength of the biological explanation to treating OCD?

Answer 55

Increased knowledge about the effectiveness of certain drug treatments for OCD and cognitive treatments can reduce the time people take off work through sick days thus increasing the productivity of he workforce and ensuring that more people are working. This means that more people will be paying taxes. Research into cost effectiveness of treatments for OCD can be the basis of public health survives choosing which treatments they use which can help organisations like the NHS save money.