Psychopathology

Question 1

What is ICD-10 v DSM-5

Answer 1

ICD: The international classification system for diseases by World Health Organisation

Is used in Europe

Categorises different disorders on the basis of signs and symptoms

DSM: Diagnostic and statistical manual of mental disorders

International use (American)

Categorises different disorders on the basis of sign and symptoms

Takes account of social and environmental problems that influence disorders (daily life)

Question 2

What are the 4 definitions of abnormality

Answer 2

Statistical Infrequency

Deviation from Social norms

Failure to function adequately

Deviation form ideal mental health

Question 3

Define Deviation from social norms VS Deviation from ideal mental health

Answer 3

Social norms: oncerns behaviour that is different from the accepted standards of behaviour in a community or society.

Mental Health: Occurs when someone does not meet a set of criteria for good mental health.

Question 4

Define Statistical Infrequency and Failure to function adequately

Answer 4

Statistical Infrequency: Occurs when an individual has a less common characteristic to most of the population such as being more depressed or less intelligent.

Failure to function adequately: Occurs when someone is unable to cope with ordinary demands of day-to-day living. (This may include being unable to perform the behaviours for day-to-day living such as maintaining basic hygiene or not holding down a job or relationships with people around them)

Question 5

List the strength and weakness of Statistical Infrequency

Answer 5

+ Real-world application:
Is used in clinical practice both as part of formal diagnosis and as a way to assess the severity of an individual’s symptoms. An example of this used in an assessment tool is the Beck depression inventory (BDI). A score of 30+ is widely interpreted as indicating severe depression. This shows that the value of of the SIC is useful in diagnostic and assessment processes.

— Unusual characteristics can be positive:
If very few people display a characteristic, then the behaviour is statistically infrequent but that doesn’t mean we would call them abnormal as for every person with an IQ below 70 there is another with 130. Yet we would not think of someone as abnormal with a high IQ. This means that although statistical infrequency can form part of assessment and diagnostic procedures, it is never sufficient as the sole basis for defining abnormality.

Question 6

List the strength and weakness of Deviation from social norms

Answer 6

+ Real-world application:
Is used in clinical practice such as the key defining characteristics of antisocial personality disorder is the failure to conform to culturally normal ethical behaviour. Signs of the disorder are all deviations from social norms. Such norms also play a part in the diagnosis of schizoptypal personality disorder. This shows that the deviation from social norms criterion has value in psychiatry.

— Social norms are situationally and culturally relative:
A person from one culture may label someone from another culture as abnormal using their standards rather than the person’s standards. Eg – Hearing voices is socially acceptable in some cultures but would be seen as a sign of abnormality in the UK. This means it is difficult to to judge deviation from social norms from one context to another.

Question 7

List the strength and weakness of Failure to function adequately

Answer 7

+ Represents a threshold for help
Most of us have symptoms of mental disorder to some degree at some time as according to the mental health charity Mind, around 25% of people in the UK will experience a mental health problem in any given year. However, many people press on but when we cease to function adequately people seek or are referred for professional help. This means that the failure to function criterion provides a way to target treatment and services to those who need them most.

— Discrimination and social control
It is hard to distinguish between failure to function and a conscious decision to deviate from social norms. For example, people may choose to live off-grid as part on alternative lifestyle choice or take part in high-risk leisure activities. This means that people who make unusual choices can be labelled abnormal and their freedom of choice restricted.

Question 8

List the strength and weakness of Deviation from ideal mental health

Answer 8

+ A comprehensive definition
Jahoda’s concept of ‘ideal mental health’ includes a range of criteria for distinguishing mental health from illness and covers most of the reasons why we might need help with mental health. This means that mental health can be discussed meaningfully with a range of professionals who might take different theoretical views. Eg – psychiatrist or CBT therapist. Therefore, ideal mental health provides a checklist against which we can assess ourselves and others.

— May be culture-bound
Some of Jahoda’s criteria for IMH are firmly limited in the context of USA and Western Europe as self actualisation is not recognised in most of the world and be dismissed as self-indulgent. Even in Europe there are variations in the value placed on independence (high in Germany, low in Italy). This means that it is very difficult to apply the concept of the ideal mental health from one culture to another.

Question 9

What 3 signs did Rosenhan & Seligman propose that could be used to determine when someone is not coping

Answer 9

1. When a person no longer conforms to standard interpersonal rules such as maintaining eye contact and respecting personal space
2. When a person experiences severe personal distress
3. When a person’s behaviour becomes irrational or dangerous to themselves or others

Question 10

What were Jahoda’s 8 pieces of criteria for ideal mental health

Answer 10

1. We have no symptoms or distress
2. We are rational and perceive ourselves accurately
3. We self-actualise
4. We can cope with stress
5. We have a realistic view of the world
6. We have good self-esteem and lack guilt
7. We are independent of other people
8. We can successfully work, love and enjoy leisure

Question 11

Define phobia, behavioural and cognitive

Answer 11

Phobia – An irrational fear of an object or situation.

Behavioural – Ways in which people act.

Cognitive – Refers to the process of ‘knowing’, including thinking, reasoning, remembering, believing.

Question 12

Define the two-process model and the behaviourist approach

Answer 12

Two-process model: An explanation for the onset and persistence of disorders that create anxiety such as phobias.

Behaviourist Approach: A way of explaining behaviour in terms of what is observable and in terms of learning.

Question 13

Explain classical VS operant conditioning

Answer 13

Classical - Learning by association. Occurs when two stimuli are repeatedly paired together - an unconditioned stimulus and a new neutral stimulus. The neutral stimulus eventually produces the same response that was first produced by the unconditioned stimulus alone.

Operant - A form of learning in which a behaviour is shaped and maintained by it’s consequences. Possible consequences of behaviour include positive reinforcement, negative reinforcement or punishment.

Question 14

What are 3 categories of DSM-5 of phobia

Answer 14

Specific Phobia: Phobia of an object, such as animal, body part or situation such as flying or having an injection.

Social anxiety (social phobia): phobia of a social situation such as public speaking or using a public toilet.

Agoraphobia: Phobia of being outside or in a public place.

Question 15

What are the 3 behavioural categories of phobias

Answer 15

Panic - Such as possibly crying, screaming, running, freezing etc

Avoidance - Unless making a conscious effort to face their fear people can tend to go to a lot of effort to avoid coming in contact with the phobic stimulus

Endurance - Occurs when a person chooses to remain in the presence of the phobic stimulus.

Question 16

What are the 3 emotional characteristics of phobias

Answer 16

Anxiety: Phobias are classed as anxiety disorders as they involve an emotional response of anxiety preventing a person relaxing and makes it very difficult to experience any positive emotion. Anxiety can be long term.

Fear: Is the immediate and extremely unpleasant response we experience when we encounter or think about a phobic stimulus. It is usually more intense but experienced for shorter periods than anxiety.

Emotional response is unreasonable: The anxiety or fear is much greater than is ‘normal’ and disproportionate to any threat posed.

Question 17

What are the 3 cognitive characteristics of phobias

Answer 17

Selective attention to the phobic stimulus: If a person can see the phobic stimulus it is hard to look away from it. Keeping our attention on something really dangerous is a good thing as it gives us the best chance of reacting quickly to a threat but this is not so useful when the fear is irrational.

Irrational beliefs: A person with a phobia may hold unfounded thoughts in relation to phobic stimuli (that can’t be easily explained and don’t have any basis in reality.

Cognitive distortions: The perceptions of a person with a phobia may be inaccurate and unrealistic.

Question 18

What are the 4 DSM-5 categories of depression

Answer 18

Major depressive disorder: Severe but often short-term depression.

Persistent depressive disorder: Long-term or recurring depression including sustained major depression and what used to be called dysthymia

Disruptive mood dysregulation disorder: Childhood temper tantrums

Premenstrual dysphhobic disorder: Disruption to mood prior to and/or during menstruation

Question 19

What are the 3 behavioural characteristics of depression

Answer 19

Activity levels: Have reduced energy levels making them lethargic which can lead to withdrawals from work, education and their social life with severe cases not getting up from bed. Some cases there is an opposite (psychomotor agitation) were agitated individuals struggle to relax and may end up pacing a room.

Disruption to sleep and behaviour: May experience reduced sleep (insomnia) or increased need for sleep (hypersomnia) with appetite increasing or decreasing leading to weight changes

Aggression and self-harm: Can often become irritable and in some cases physically or verbally aggressive leading to things such verbal aggression in leaving relationships or quitting a job. Depression can also lead to physical aggression to the self including self-harm.

Question 20

What are the 3 emotional characteristics of depression

Answer 20

Lowered Mood: This is still a defining emotional element of depression, but it is more pronounced than in the daily kind of experience of feeling lethargic and sad. Often describing themselves as worthless and empty.

Anger: People with depression also frequently experience anger and sometimes extreme anger which is linked to this negative emotion. This can be directed at the self of others with such emotions leading to aggressive or self-harming behaviour.

Lowered self-esteem: People with depression tend to report reduced self-esteem. Can be quite extreme with some describing a self-loathing

Question 21

What are the 3 cognitive characteristics of depression

Answer 21

Poor concentration: Is associated with depression. May find themselves unable to stick with a task as they usually would or find it hard to make straight-forward decisions. Can interfere with work.

Attending to and dwelling on the negative: Experiencing a depressive episode people are inclined to pay more attention to negative aspects of a situation and ignore the positives. See the glass as half empty then half full. Also have a bias to recalling unhappy events rather than happy ones.

Absolutist thinking: Most situations are not all good or all bad but when a person is depressed, they tend to think this way. Called black and white thinking meaning that when a situation is unfortunate, they tend to see it as an absolute disaster.

Question 22

What is OCD

Answer 22

A mental health condition characterised by a person having obsessions and / or compulsive behaviour. Obsessions are cognitive, takes place in the mind whereas compulsions are behavioural, something you do.

Question 23

What are the 4 DSM-5 categories of OCD

Answer 23

• OCD: Characterised by either obsessions (recurring thoughts, images etc) and / or compulsions (repetitive behaviour such as hand washing). Most people with a diagnosis of OCD have both obsessions and compulsions.
• Trichotillomania: Compulsive hair-pulling
• Hoarding disorder: The compulsive gathering of possessions and the inability to part with anything regardless of its value.
• Excoriation disorder: Compulsive skin-picking

Question 24

What are the 3 behavioural characteristics of OCD

Answer 24

Compulsions are repetitive: Typically, people with OCD feel compelled to repeat a behaviour. A common example is handwashing.

Compulsions reduce anxiety: Around 10% of people with OCD show compulsive behaviour alone – they have no obsessions, just a general sense of irrational anxiety. However, for the vast majority, compulsive behaviours are performed in an attempt to manage the anxiety produced by obsessions. (E.g compulsive handwashing is carried out as a response to germs.

Avoidance: The behaviour of people with OCD may also be characterised by their avoidance as they attempt to reduce anxiety by keeping away from situations that trigger it. People with OCD tend to try to manage their OCD by avoiding situations that trigger anxiety.

Question 25

What are the 3 emotional characteristics of OCD

Answer 25

Anxiety and distress: OCD os regarded as a particularly unpleasant emotional experience because of the powerful anxiety that accompanies both obsessions and compulsions. Obsessive thoughts are unpleasant and frightening and the anxiety that goes with these can be overwhelming. The urge to repeat a behaviour (a compulsion) creates anxiety. Accompanying depression: OCD is often accompanied by depression, so anxiety can be accompanied by low mood and lack of enjoyment in activities. Compulsive behaviour tends to bring some relief from anxiety, but this is temporary. Guilt and disgust: As well as anxiety and depression, ICD sometimes involves other negative emotions such as irrational guilt.

Question 26

What are 3 cognitive characteristics of OCD

Answer 26

Obsessive thoughts: For around 90% of people with OCD the major cognitive feature of their condition is obsessive thoughts (i.e. thoughts that occur over and over again). These vary from person to person but are always unpleasant. Cognitive coping strategies: Obsessions are the major cognitive feature of OCD but people also respond by adopting cognitive coping strategies to deal with the obsessions. This may help manage anxiety but can make the person appear abnormal to others and can distract them from everyday tasks. Insight into excessive anxiety: People with OCD are aware that their obsessions and compulsions are not rational. This is actually necessary for a diagnosis of OCD. However, in spite of this insight, people with OCD experience catastrophic thoughts about the worst case scenarios that might result if their anxieties were justified.

Question 27

Define Systematic desensitisation VS Flooding

Answer 27

SD: A behavioral therapy designed to reduce an unwanted response such as anxiety. SD involves drawing up a hierarchy of anxiety-provoking situations related to a persons phobic stimulus, teaching the person to relax and then exposing them to phobic situations. Working their way through the hierarchy whilst maintaining relaxation. Flooding: 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. This takes place across a small number of long therapy sessions.

Question 28

What are the 3 processes involved in SD

Answer 28

The anxiety hierarchy: Is put together by the client and therapist. This is a list of situations related to the phobic stimulus that provoke anxiety, arranged in order from least to most frightening. Relaxation: The therapist teaches the client to relax as deeply as possible. It is impossible to be afraid and relaxed at the same time, so one emotion prevents the other. This is called reciprocal inhibition. Relaxation might involve breathing exercises or mental imagery techniques. Exposure: The client is exposed to the phobic stimulus while in a relaxed state. This takes place across several sessions, starting at the bottom of the anxiety hierarchy. When the client can stay relaxed at lower levels, they move up the hierarchy. Treatment is successful when the client remains relaxed in high-anxiety situations.

Question 29

How does flooding work

Answer 29

Flooding stops phobic responses quickly, possibly because the client learns that the phobic stimulus is harmless when avoidance is not an option. In classical conditioning terms, this is called extinction. A learned response is extinguished when the conditioned stimulus (e.g., a dog) is encountered without the unconditioned stimulus (e.g., being bitten), so the conditioned stimulus no longer produces fear. In some cases, the client may relax simply because they become exhausted by their fear response.

Question 30

What is the cognitive aproach

Answer 30

The term ‘cognitive’ has come to mean ‘mental processes’ so this approach is focused on how our mental processes (E.g thoughts, perceptions and attention) affect behaviour.

Question 31

What is the negative triad and ABC model

Answer 31

NT: Beck proposed that there are three kinds of negative thinking that contribute to becoming depressed: negative views of the world, the future and the self. Such negative views lead a person to interpret their experiences in a negative way and so make them more vulnerable to depression. ABC: Ellis proposed that depression occurs when an activating event (A) triggers an irrational belief (B) which in turn produces a consequence (C), i.e. an emotional response like depression. The key to this process is the irrational belief.

Question 32

In Beck’s negative triad what is faulty information processing and negative self-schema

Answer 32

Faulty information processing: When depressed people attend to the negative aspects of a situation and ignore positives. People may also tend to blow small problems out of proportion and think in ‘black-and-white’ terms. Negative self-schema: A ‘schema’ is a package of ideas and information developed through experience. They act as a mental framework for the interpretation of sensory information. A self-schema is the package of information people have about themselves. People use schemas to interpret the world so if a person has a negative self-schema they interpret all information about themselves in a negative way.

Question 33

What is the negative triad and it’s three elements

Answer 33

Beck suggested that a person develops a dysfunctional view of themselves because of three types of negative thinking that occur automatically, regardless of the reality of what is happening at the time. These three elements are called the negative triad: A.) Negative view of the world - creating the impression that there is no hope B.) Negative view of the future - thoughts that reduce any hopefulness and enhance depression C.) Negative view of the self - thoughts enhance any existing depressive feelings because they confirm the existing emotions of low self-esteem.

Question 34

What are the 3 parts of Ellis' ABC model

Answer 34

A - Activating event: According to Ellis we get depressed when we experience negative events and these trigger irrational beliefs. B - Beliefs: He called the belief that we must always succeed or achieve perfection 'musturbation'. I-can't-stand-it-itis' is the belief that it is a major disaster whenever something does not go smoothly. Utopianism is the belief that life is always meant to be fair. C - Consequences: When an activating event triggers irrational beliefs there are emotional and behavioural consequences.

Question 35

What is cognitive behaviour therapy (CBT) and it's 2 elements

Answer 35

A method for treating mental disorders based on both cognitive and behavioural techniques. From the cognitive viewpoint the therapy aims to deal with thinking such as challenging negative thoughts. The therapy also includes behavioural techniques such as behavioural activation. Cognitive: CBT begins with an assessment in which the client and the cognitive behaviour therapist work together to clarify the client's problems. Jointly identify goals for the therapy and put together a plan. Behaviour: CBT then involves working to change negative and irrational thoughts and finally put more effective behaviours into place.

Question 36

What is Beck's cognitive therapy

Answer 36

The idea behind cognitive therapy is to identify automatic thoughts about the world, the self and the future - the negative triad. As well as challenging these thoughts directly, CT aims to help clients test the reality of their negative beliefs such as being set HW which is referred to as the 'client as scientist'.

Question 37

What is Ellis's rational emotive behaviour therapy (REBT)

Answer 37

REBT extends the ABC model to an ABCDE model - D stands for dispute and E for effect. The central technique of REBT is to identify and dispute irrational thoughts.

Question 38

What is behavioural activation

Answer 38

The goal of behavioural activation is to work with depressed individuals to gradually decrease their avoidance and isolation, and increase their engagement in activities that have been shown to improve mood.

Question 39

What is the biological approach

Answer 39

A perspective that emphasises the importance of physical processes in the body such as genetic inheritance and neural function.

Question 40

What is the genetic VS neural explanations

Answer 40

Genetic: Genes make up chromosomes and consist of DNA which codes the physical features of an organism (such as eye colour & height) and psychological features (such as intelligence). Genes are transmitted from parents to offspring Neural: The view that physical and psychological characteristics are determined by the behaviour of the nervous system, in particular the brain as well as individual neurons.