psychopathology Flashcards
(91 cards)
1
Q
what are the different definitions of abnormality?
A
1) statistical infrequency (SI)
2) deviation from social norms (DSN)
3) failure to function adequately
4) deviation from ideal mental health
2
Q
define abnormality in terms of statistical infrequency.
A
- these are rare behaviours often considered to be ‘abnormal’ e.g. intelligence
- IQ is normally distributed (see physical drawing) and the average score is 100+ or - 15
- a normal IQ is between 85 to 115 and only 2% score below 70 signifying they are statistically abnormal and are diagnosed with intellectual disability disorder
3
Q
what is a positive evaluation of statistical infrequency?
A
P- one strength is that statistical infrequency has real world application
E- an IQ of below 70 (bottom 2%) is used to diagnose intellectual disability disorder (IDD)
E- this creates consistency in the diagnosis of mental health disorders and allows psychologists to make accurate assessments and treatments of patients
4
Q
what is a limitation of statistical infrequency?
A
P- a limitation is that unusual characteristics can also be a positive
E- if very people display a characteristic, then the behaviour is statistically infrequent but does not mean we would call them abnormal
- IQ scores above 130 are just as unusual as those below 70, but not regarded as undesirable or needing treatment
E- this means that although statistical infrequency can be part of defining abnormality it is not accurate enough to diagnose a mental health problem/abnormality
5
Q
define deviation from social norms in terms of abnormality.
A
- this is when a person behaves in a way that is different from how they are expected to behave they may be defined as abnormal (a collective judgement as a society about what behaviour is ‘normal)
- there are relatively few behaviours that would be considered universally abnormal therefore definitions are related to cultural context e.g. homosexuality is viewed as abnormal in some cultures but not others and was considered abnormal in our society in the past
example: anti-social personality disorder (psychopathy) and is a failure to conform to ‘lawful and culturally normative ethical behaviour’ and they are abnormal because they deviate from social norms and standards e.g. lacking empathy
6
Q
what is a positive evaluation of deviation from social norms?
A
P- one strength of deviation from social norms is it’s real-life application
E- deviation from social norms is useful in the diagnosis of antisocial personality disorder as this requires failure to conform to ethical standards
E- this means that treatment opportunities can be developed and used to reduce symptoms as well as being useful in psychiatric diagnosis
7
Q
what is a limitation of deviation from social norms?
A
P- one limitation is that the definition may be defined as ethnocentric
E- A person from one culture may label someone from another culture as abnormal using their standards rather than the persons standards e.g. hearing voices is socially acceptable in some cultures but would be seen as a sign of abnormality in the UK
E- this means it is difficult to judge deviation from social norms from one context to another
8
Q
what is another limitation of deviation from social norms?
A
P- another limitation is that the definition fails to distinguish between deviance and psychological abnormality
E- for example, a drink-driver has broken a societal rule (and the law) but psychologists would not class them as psychologically abnormal
E- this means that according to the deviation from social norms definition is invalid
9
Q
define failure to function adequately in terms of abnormality.
A
- this is the inability to cope with everyday life e.g. not being able to maintain basic standards of nutrition and hygiene, hold down a job or maintain relationships
example: intellectual disability disorder - having a low IQ is a statistical infrequency but diagnosis would not be made on this basis alone as there would have to be clear signs that the person was not able to cope with the demands of everyday living
10
Q
what researchers came up with signs that portrayed failure to function adequately?
A
- Rosenhan and Seligman (1989) defined some signs for spotting FTFA:
- no longer conforms to interpersonal norms e.g. maintaining personal space
- they experience severe personal distress
- they behave in a way that is irrational or dangerous
11
Q
what is a positive evaluation of failure to function adequately?
A
P- one strength is that it considers the patients perspective
E- By considering the subjective experience of the patient, we are arguably looking at the important aspect of someone’s mental health-their own experience
E- therefore, using failure to function arguably captures more important aspects of mental health than for example, statistical infrequency
12
Q
what is a limitation of failure to function adequately?
A
P- one limitation is that the defintion can lead to discrimination / social control
E- it is hard to distinguish between failure to function and a conscious decision to deviate from social norms e.g. people may choose to live off-grid as part of an alternative lifestyle choice or taken part in high risk leisure activities
E- this means that people who make unusual choices can be labelled abnormal and their freedom of choice restricted
13
Q
what is another limitation of failure to function?
A
P- another limitation is that failure to function can be normal
E- in some circumstances most of us cannot cope but on the other hand it is real and a person may just need professional help to adjust to it
E- this means it is hard to known when to base a judgement of abnormality on failure to function
14
Q
define deviation from ideal mental health in terms of abnormality and who created a criteria for it?
A
- this is a different way to look at normality and abnormality and with this we can identify anyone who deviated from this ideal
- Jahoda (1985) identified the following criteria for ideal mental health ]:
1) we have no symptoms of distress
2) we are rational and perceive ourselves accurately
3) we self-actualise (reach our potential)
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 our leisure
example: depression would be classes as abnormal by this defintion as it causes a person to have low self-esteem and hold a negative view of the world so the person may struggle with self-attitudes, self-actualisation and autonomy
15
Q
what is a positive evaluation of deviation from ideal mental health?
A
P- one strength of the ideal mental health approach is being comprehensive
E- Jahoda’s criteria provides an extensive view of ideal mental health and it 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 professional
E- therefore, the range of factors discussed makes it a useful tool for discussing mental health problems
16
Q
what is a limitation of deviation from ideal mental health?
A
P- one limitation is that the definition may be culture-bound
E- some criteria for ideal mental health are limited e.g. self-actualisation is not recognised in most of the world
E- this means that it is very difficult to apply the concept of ideal mental health from one culture to another
17
Q
what is another limitation of deviation from ideal mental health?
A
P- another limitation is that it has very high standards of mental health
E- none of us achieve all of Jahoda’s criteria for mental health, and none of us maintain them for long, so these criteria’s could see us all as abnormal
E- therefore, it is of no benefit when deciding who may need treatment who does not want it
18
Q
what is meant by the term phobia and what are the different types?
A
- all phobias are characterised by excessive fear and anxiety, triggered by an object, place or situation
1) specific phobia- phobia of an object such as an animal or body part, or a situation such as flying or having an injection
2) social anxiety (social phobia)- phobia of a social situation such as public speaking or using a public toilet
3) agoraphobia- phobia of being outside or in a public place
19
Q
what are the behavioural characteristics of phobias?
A
1) panic- a person with a phobia may panic in response to the presence of the phobic stimulus, panic may involve a range of behaviours including crying, screaming or running away or children may freeze, cling or have a tantrum
2) avoidance- considerable effort to prevent contact with the phobic stimulus, this can make it hard to go about everyday life
3) endurance- an alternative behaviour to avoidance, involves remaining with the phobic stimulus and continuing to experience anxiety
20
Q
what are the emotional characteristics of phobias?
A
1) anxiety- an unpleasant state of high arousal that prevents an individual relaxing and makes it very difficult to experience positive emotion
2) fear- the immediate response we experience when we encounter or think about a phobic stimulus
3) emotional response is unreasonable- disproportionate to the threat posed e.g. a person with a phobia finds it hard to look away from a phobic stimulus
21
Q
what are the cognitive characteristics of phobias?
A
1) selective attention to the phobic stimulus- a person with a phobia finds it hard to look away from the phobic stimulus
2) irrational beliefs- phobias may involve beliefs e.g. ‘if I blush people will think I am weak’
3) cognitive distortions- unrealistic thinking e.g. belly buttons appear ugly
22
Q
what is meant by the term depression and what are the different types?
A
- all forms of depression and depressive disorders are characterised by changes to mood
1) major depressive disorder- severe but often short-term
2) persistent depressive disorder- long-term or recurring depression, including sustained major depression
3) disruptive mood dysregulation disorder- childhood temper tantrums
4) premenstrual dysphoric disorder- disruption to mood prior to and/or during menstruation
23
Q
what are the behavioural characteristics of depression?
A
1) activity levels- people with depression have reduced levels of energy making them lethargic e.g. cannot get out of bed
2) disruption to sleep and eating behaviour- reduced sleep (insomnia) or increased (hypersomnia), appetite and weight may increase or decrease
3) aggression and self-harm- depression is associated with irrationality and this may extent to aggression and self-harm
24
Q
what are the emotional characteristics of depression?
A
1) lowered mood- people with depression describe themselves as ‘worthless’ or ‘empty’
2) anger- such emotions lead to aggression or self-harming behaviour
3) lowered self-esteem- the person likes themselves less, even self-loathing
25
what are the cognitive characteristics of depression?
1) poor concentration- the person may find themselves unable to stick with a task, or might find simple decision-making difficult
2) attention to the negative- depressed people have a bias towards focusing on negative aspects of current situations and recalling unhappy memories
3) absolutist thinking- 'black and white thinking' when a situation is unfortunate it is seen as an absolute disaster
26
what is meant by the term OCD and what are the different types?
- OCD is characterised by either obsessions (recurring thoughts, images etc) and/or compulsions (repetitive behaviours such as hand washing)
1) trichotillomania- compulsive hair-pulling
2) hoarding disorder- the compulsive gathering of possessions and the inability to part with anything
3) excoriation disorder- compulsive skin-picking
27
what are the behavioural characteristics of OCD?
1) compulsions are repetitive- actions carried out repeatedly in a ritualistic way
2) compulsions reduce anxiety- anxiety may be created by obsessions or anxiety
3) avoidance- OCD is managed by avoiding situations that trigger anxiety
28
what are the emotional characteristics of OCD?
1) anxiety and distress- obsessive thoughts are unpleasant and frightening, and the anxiety that goes with these can be overwhelming
2) depression- low mood and lack of enjoyment
3) guilt and disgust- irrational guilt e.g. over a minor moral issue, or disgust which is directed towards oneself or something external
29
what are the cognitive characteristics of OCD?
1) obsessive thoughts- about 90% of people with OCD have recurring intrusive thoughts
2) cognitive coping strategies- some people with OCD use strategies to cope e.g. meditation
3) insight into excessive anxiety- awareness that thoughts and behaviour are irrational, may have catastrophic thoughts and be hypervigilant
30
what is meant by classical conditioning in terms of a phobia?
- this is acquiring a phobia through association
- Mowrer (1960) argued that phobias are learnt by classical conditioning and then maintained by operant conditioning e.g. the two process model
31
give an example of how classical conditioning creates a conditioned response.
- Little Albert (conditioned fear)
Watson and Rayner (1920) showed how a fear of rats could be conditioned in 'Little Albert'
1) before conditioning- UCS (clang) created an UCR of fear
2) before conditioning- NS (rat) created a NR (fear)
3) during conditioning- UCS (clang) paired with the NS (rat) created an UCR (fear)
4) after conditioning- CS (rat) created the CR (fear)
- little albert then showed generalisation of fear to other stimuli such as white furry objects e.g. a fur coat or Santa Claus beard
32
what is meant by operant conditioning in terms of a phobia?
- operant conditioning takes place when out behaviour is reinforced or punished
negative reinforcement- an individual produces behaviour that avoids something unpleasant
- when a person with a phobia avoids a phobic stimulus they escape the anxiety they would have received
- this reduction in fear negatively reinforces the avoidance and the phobia is maintained rather than confronted
33
give an example of how negative reinforcement works.
- if someone has a fear of clowns they will avoid circuses and other situations where they may encounter clowns
- the relied from avoiding clowns negatively reinforces the phobia and ensures it is maintained rather than confronted
34
what is a strength of the two-process model?
P- one strength of the two-process model is it's real life application
E- the idea that phobias are maintained by avoidance is important in explaining why people with phobias benefit from exposure therapies e.g. SD
- once avoidance behaviour is prevented it ceases to be reinforced by anxiety and avoidance behaviour therefore declines
E- this shows the value of the two-process approach because it identifies a means of treating phobias
35
what is another strength of the two-process model?
P- one limitation is the inability to explain cognitive aspects of phobias
E- behavioural explanations like the two-process model are geared towards explaining behaviour-in this case avoidance of the phobic stimulus
- however, we know that phobias also have a significant cognitive component e.g. people hold irrational beliefs about the phobic stimulus
E- this means that the two-process model does not fully explain the symptoms of phobias
36
what is a limitation of the two-process model?
P- there is supporting evidence from Little Albert
E- he gains his phobia through classical conditioning as Albert eventually shows a feared response (CR) every time he came into contact with the rate (CS)
E- this suggests that the two-process model provides a credible explanation for how a person might develop and maintain a particular phobia
37
what are the two types of methods to treating a phobia?
1) systematic desensitisation
2) flooding
38
what is systematic desensitisation and what does it consist of?
- this is a therapy based on classical conditioning, counterconditioning and reciprocal inhibition
- the therapy aims to gradually reduce anxiety through counterconditioning e.g. phobia is learned through so that phobic stimulus (CS) produces fear (CR), CS is paired with relaxation and this becomes the new CR
- this therapy can take up to 10 sessions as patient starts at the bottom of the hierarchy and treatment is only successful when the person can stay relaxed in a high-anxiety situation
39
what is meant by reciprocal inhibition?
- not possible to be afraid and relaxed at the same time, so one emotion prevents the other
40
what are the 3 steps of systematic desensitisation?
1) the anxiety hierarchy- client and therapist design an anxiety hierarchy - fearful stimuli arranged in order from least to most frightening
- e.g. 1) hold the spider (2) touch the spider (3) opening the container (4) being in the same room as caged spider (5) looking at picture of spider
2) relaxation- person with phobia is first taught relaxation techniques such as deep breathing and/or meditation
3) exposure- patient is exposed to the phobic stimulus while in a relaxed state
- person then works through the anxiety hierarchy and after each stage of patient being exposed to phobic stimulus they are put back into a relaxed state
41
what is one positive evaluation of systematic desensitisation as a way of treating phobias?
P- one strength is that SD is proven to be long-lasting and effective
E- Gilray et al (2003) followed up 42 people who had SD for spider phobia and at the follow up they were less scared 3 months and 33 months post treatment than a control group
E- this means that SD is a more reliable option of therapy and is likely to be helpful for people with phobias
42
what is another positive evaluation of systematic desensitisation as a way of treating phobias?
P- another strength is that it can be useful for people with learning disabilities
E- the main alternative to SD are unsuitable for people with learning disabilities e.g. cognitive therapies require a high level of rational thought and flooding is distressing
- SD, on the other hand, does nor require understanding or engagement on cognitive level and provides relaxation techniques that reduce traumatic experiences
E- this means that SD is often the most appropriate treatment for some people
43
what is one negative evaluation of systematic desensitisation as a way of treating phobias?
P- one limitation is that it is more expensive than flooding
E- this is because it requires multiple sessions as it is only successful when the person can stay relaxed in a high-anxiety situation
E- this suggests that alternative treatments e.g. flooding are more suitable for treating phobias
44
what is meant by flooding and what does it involve?
- flooding involves exposing a person with a phobia to the phobic object without a gradual build-up e.g. a person with arachnophobia receiving flooding treatment may have a large spider crawl over their hands until they can relax fully
- without the option of avoidance behaviour, the person quickly learns that the object is harmless through the exhaustion of their fear response as the conditioned stimulus is faced without the unconditioned stimulus, this is known as extinction
- flooding is not unethical but it is an unpleasant experience so it is important that people being treated give informed consent as they must be fully prepared and know what to expect
45
what is one strength of flooding as a way of treating phobias?
P- one strength of flooding is that it is cost effective
E- for example, even though the sessions can be longer it usually only takes one
E- this means that more people can be treated at the same cost by flooding than by SD or other therapies
46
what is one limitation of flooding as a way of treating phobias?
P- one limitation is that it is less effective against certain types of phobias
E- flooding may not work for more complex phobias such as social anxiety, which have cognitive elements and goes beyond anxiety
E- therefore, this type of phobia may benefit from cognitive therapies and not flooding
47
what is another limitation of flooding as a way of treating phobias?
P- another limitation is that treatment can be traumatic
E-Schumacher et al (2015) found that bother ppts and therapists rated flooding as more stressful compared to SD
- for example, there are ethical concerns about flooding causing stress and the traumatic nature of flooding also leading to higher attrition rates than for SD (patient not seeing the treatment out to the end)
E- this suggests that overall, therapists may avoid using this type of treatment and time and money can sometimes be wasted on it
48
what are the two explanations for depression?
- becks negative triad
- Ellis's ABC method
49
what did Becks explanation suggest about depression?
- the American psychiatrist Beck (1967) took a cognitive approach to explaining why some people are more vulnerable to depression than others and in particular it is a person's cognitions that create this vulnerability
50
what are the 3 parts of Becks cognitive vulnerability?
1) faulty information processing- when people are depressed people attend to the negative aspects of a situation and ignore positives, they also tend to blow small problems out of proportion and think in 'black and white' (something is all bad or all good)
2) negative self-schema- a schema is a package of ideas and information developed through experience and they act as a mental framework for the interpretation of sensory information
- a self-schema is the package of information about ourselves and if we have a negative schema people interpret all information about themselves in a negative way
3) the negative triad- there are 3 elements to the negative triad:
negative view of the world e.g. 'there isn't much change that the economy will get any better'
negative view of the world e.g. 'the world is a cold hard place'
negative view of the self e.g. thinking 'I am a failure' and this negatively impacts upon self-esteem
51
what is one positive evaluation of Becks model as a way of explaining depression?
P- one strength of Beck's model is supporting research
E- Clark and Beck (1999) concluded that cognitive vulnerabilities are more common in depressed people
- for example, a recent prospective study by Cohen et al (2019) tracked 473 adolescent's development and found that early cognitive vulnerability predicted later depression
E- this shows that there is an association between cognitive vulnerability and depression
52
what is another strength of Becks model?
P- another strength is that is has real-world application to screening for depression
E- assessing cognitive vulnerability in young people most at risk developing depression means they can be monitored
- understanding cognitive vulnerability is applied in CBT to alter cognitions, underlying depression, making a person more resilient to life events
E- this means that the idea of cognitive vulnerability is useful in clinical practice
53
what is a limitation of Becks model?
P- one limitation is it lacks validity
E- for example, the supporting research for Becks study uses 473 adolescent's to track their early cognitive vulnerability
E- therefore, the findings cannot be generalised to any other age categories so lacks population validity
as well as this, depressed people show particular patterns of cognition and these can be seen before the onset of depression so Becks theory of cognitive vulnerabilities can be a partial explanation, however, there are some aspects such as extreme anger and hallucinations that cannot be explained by cognitive explanations
54
what did Ellis's explanation suggest about depression?
- the American psychiatrist (1962) suggested that good mental health is the result of rational thinking, defined as thinking in ways that allow people to be happy and free from pain
- conditions such as anxiety and depression (poor mental health) result from irrational thoughts, which he defined as thoughts that interfere with us being happy and free from pain
- Ellis used the ABC model to explain how irrational thoughts affect our behaviour and emotional state
55
what does the ABC model consist of?
A- activating event, where Ellis focused on situations in which irrational thoughts are triggered by external events e.g. we get depressed when we experience negative events and these trigger irrational beliefs such as failing an important test or ending a relationship
B- beliefs, suggesting negative events trigger irrational beliefs
-Ellis called the belief that we must always succeed 'musterbation' and the belief that the world must always be fair and just 'utopianism'
C- consequences, when an activating event triggers irrational beliefs there are emotional and behavioural consequences e.g. if a person believes that they must always success and then fails at something this can trigger depression
56
give an example of the ABC model.
A- failing an exam
B- musterbation (always succeed)
C- depressive symptoms e.g. low self-esteem and no motivation
57
what is one strength of Ellis's model as an explanation of depression?
P- one strength is it's real life application in treating depression
E- Ellis applied the ABC model to treat depression (rational emotive behaviour theory REBT)
- evidence that REBT can both change negative beliefs and relive the symptoms of depression
E- this means that the theory has real world value
58
what is a limitation of Ellis's model?
P- one limitation is that his model only explains reactive depression
E- reactive depression describes a form of depression in which is triggered by negative activating events
- however, in many cases it is not obvious what triggers depression, described as endogenous depression which Ellis's model is less useful in explaining this
E- this means that Ellis's model can only explain some cases of depression
59
what is another limitation of Ellis's model?
P- another limitation of the ABC model as an explanation of depression is that there are alternative explanations of depression
E- for example, the biological approach considers genetic analysis which suggest that depression can run in families and links to inherited biological factors
E- therefore, the ABC model can be a limited explanation of depression
60
what are the 2 psychological treatments used to treat depression?
1) Becks negative triad- cognitive behaviour therapy (CBT)
2) Ellis's ABC model- rational emotive behaviour therapy (REBT)
61
what is cognitive behaviour therapy and what aspects does it consist of?
- CBT is the most common type of treatment for depression and is an example of the cognitive approach to treatment, though it also includes cognitive and behavioural elements:
cognitive element- CBT begins with an assessment in which the client and the therapist work together to clarify the clients problems, they jointly identify goals for the therapy and put together a plan to achieve them e.g. where there might be negative or irrational thoughts that will benefit from challenge
behaviour element- CBT then involves working to change negative and irrational thoughts and finally put more effective behaviour
62
what is aim of CBT?
- the aim is to identify negative thoughts about the self, world and future which is the negative triad
- these thoughts are then challenged directly and clients can be set homework, such as to record when they enjoyed an event, and this can be used by the therapist as evidence against the irrational thoughts e.g. when the client says nothing enjoyable happens in their life
63
what is a positive evaluation of the cognitive behaviour as a treatment for depression?
P- one strength is that there is evidence of effectiveness
E- for example, March et al (2007) compared the effects of CBT with antidepressant drugs and a combination of the two 327 depressed adolescents
- after 36 weeks 81% improved with CBT and 86% improved when CBT was paired with drug therapy suggesting that CBT is just as effective without drug therapy
E- this means that this is widely used as a first choice of the NHS
64
what is another small positive of CBT?
- CBT only usually requires around 6-12 sessions so it can be seen as cost-effective
65
what is a limitation of CBT as a treatment for depression?
P- one limitation is it does not work on a diverse range of clients
E- for example, those with severs depression who lack motivation and also clients with learning disabilities cannot use CBT as it requires complex rational thinking
- as well as this, in severe cases depressed clients may not be able to motivate themselves to take part in the sessions or engage with the cognitive work
E- this means that CBT may only be appropriate for a specific range of clients and alternatives such as antidepressants could be more suitable as they do not require the same level of motivation as CBT
66
what is another limitation of CBT as a treatment for depression?
P- another limitation of CBT is it's high relapse rate
E- few early studies looked at long-term effectiveness and recent studies suggest that relapse is common
- Ali et al (2017) assessed depression for 12 months following s course of CBT and found that 42% relapsed withing 6 months of ending treatment and 53% withing a year
E- this means that CBT may need to be repeated periodically
67
what is REBT and what does it consist of?
- REBT extends the ABC model to an ABCDE model where D stands for dispute and E stands for effect and the central technique of REBT is to identify and dispute (challenge) irrational thoughts
68
how would a REBT therapist tackle depression?
- a cline might talk about how unlucky they have been or how unfair things seem, so a REBT therapist would identify these examples as utopianism or musterbation and challenge these irrational beliefs by creating a vigorous argument (D)
- Ellis created 2 methods of disputing:
1) empirical argument- involves disputing whether there is actual evidence to support the negative belief
2) logical argument- involves disputing whether the negative thought logically follows from the facts
69
what is behavioural activation (E)?
- as individuals become depressed, they tend to increasingly avoid difficult situations and become isolated, which maintains or worsens symptoms
- the goal of behavioural activation is to work with depressed people to gradually decrease their avoidance and isolation, and increase their engagement in activities that have been shown to improve mood
70
what are the key terms involved in the biological approach to explaining OCD and what do they mean?
1) genetic explanation- certain traits or characteristics passed down by parents and are used to explain certain behaviours
2) diathesis stress- a disorder developed due to a vulnerability combined with stressful life events
3) co-morbidity- a situation where a person has 2 or more mental disorders at the same time
4) serotonin- a neurotransmitter that regulates mood
5) neurotransmitters- chemical messenger that sends messages between neurons
6) polygenetic- characteristics or a disorder caused by more than one gene
7) neuron- a nerve cell that sends messages around the body
8) neural explanation- how the structure of the brain and neural chemistry affect behaviour
71
what are the 2 forms of explanation for OCD?
1) genetic explanations
2) neural explanations
72
what is meant by the genetic explanation of OCD and what does it consist of?
- this is where genes are involved in the individual vulnerability to OCD and is said to have a stronger biological influence
- in a study, Aubrey Lewis (1936), observed that of his OCD patients and 37% had parents with OCD and 21% had siblings with OCD
73
how does the diathesis-stress model link to OCD?
- as according to the model, certain genes leave some people more likely to develop a mental disorder as an environmental stressor e.g. a stressful life event, is likely to trigger these conditions
74
what is a candidate gene and what does it suggest about OCD?
- these are genes that have been identified by researchers and are said to create vulnerability for OCD
- some of these genes are involved in regulating the development of the serotonin system e.g. the gene 5HT1-D beta is implicated in the transport of serotonin across synapses
75
why is OCD seen as polygenetic?
- polygenetic suggests that OCD is not caused by a single gene but by a combination of genetic variations that together significantly increase vulnerability to symptoms
- for example, Steven Taylor (2013) has analysed findings of previous studied and found evidence that up to 230 different genes may be involved in OCD and can be seen to affect both serotonin and dopamine which regulate mood
76
what is meant by aetiologically heterogenous and how does it link to OCD?
- this term means that one group of genes may cause OCD in one person but a different group of genes may cause the disorder in another person suggesting that the origins (aetiology) of OCD vary from one person to another (heterogenous)
- for example, things such as hoarding and religious obsessions can be evidence that different types of OCD may be the result of particualr genetic variations
77
what is one strength of the genetic explanation of OCD?
P- one strength is evidence for the genetic explanation of OCD
E- Nestadt et al (2010) reviewed twin studies and found that 68% of identical twins (MZ's) shard OCD as opposed to 31$ of non-identical (DZ) twins
- also, Marini and Stebnicki (2012) found that a person with a family member with OCD is around 4 times as likely to develop it as someone without
E- this means that people who are genetically similar are more likely to share OCD supporting a role for genetic vulnerability
78
what is one limitation of the genetic explanation of OCD?
P- one limitation is the existence of environmental risk factors
E- genetic variation affects vulnerability to OCD, but there are also environmental risk factors that trigger or increase the risk of OCD
- Cromer et al (2007) found in one sample over half of people with OCD experienced a traumatic event, OCD severity correlated positively with the number of traumas
E- this means that genetic vulnerability and the biological explanation only provides a partial explanation for OCD
79
what is meant by the neural explanation of OCD and what does it consist of?
- this explanation suggests that the genes associated with OCD are likely to affect the levels of key neurotransmitters as well as structure of the brain
80
how does the role of serotonin link to OCD?
- one explanation for OCD concerns the role of the neurotransmitters serotonin, which is believed to help regulate mood
- neurotransmitters are responsible for relaying information from one neuron to another e.g. if a person has low levels of serotonin then normal transmission of mood-relevant information does not take place and a person may experience low moods and therefore some cases of OCD may be explained by a reduction in the functioning of the serotonin system in the brain
81
how does decision-making systems link to OCD?
- some cases of OCD, and in particualr hoarding disorder, seem to be associated with impaired decision-making
- this may be associated with abnormal functioning of the lateral (side bits) of the frontal lobes of the brain and the frontal lobes are responsible for logical thinking and making decisions
- there is also evidence to suggest that an area called the left Para hippocampal gyrus, associated with processing unpleasant emotions, functions abnormally in OCD
82
what is one strength of the neural explanation of OCD?
P- one strength of the neural model is supporting evidence
E- antidepressants that work on serotonin reduce OCD symptoms, this suggests that serotonin may be involved in OCD
- also OCD symptoms form part of conditions that are known to be biological in origin e.g. Parkinson's disease
E- this means that biological factors e.g. serotonin and processes underlying Parkinson's disease are likely to be involved in OCD
83
what is one limitation of the neural explanation of OCD?
P- one limitation is that the serotonin-OCD link is not unique to OCD
E- many people with OCD also experience depression, this depression probably involves disruption to the action of serotonin
- it could simply be that serotonin activity is disrupted in many people with OCD because they are depressed as well
E- this means that serotonin may not be relevant to OCD symptoms
84
what is drug therapy?
- drug therapy for mental disorders aims to increase or decrease levels of neurotransmitters in the brain or to increase/decrease their activity e.g. increase the level of serotonin in the brain
85
what standard medical treatment is used to tackle symptoms of OCD?
- SSRI (selective serotonin re-uptake inhibitor) or fluoxetine is a type of antidepressant drug that works on the serotonin system in the brain
- typical dosage of fluoxetine is 20mg although this may be increased if it is not benefitting the person and the drug is available as a capsule or a liquid as well as taking four months of daily use for it to have much impact on symptoms
86
how does the SSRI increase levels of serotonin in the synapse?
- serotonin is released by the presynaptic neuron and travels across a synapse
- the neurotransmitter chemically conveys the signal from the presynaptic neuron to the postsynaptic neuron and then it is reabsorbed by the presynaptic neuron where it is broken down and reused
- by preventing the reabsorption and breakdown, SSRI's effectively increase levels of serotonin in the synapse and thus continue to stimulate the postsynaptic neuron and compensates for whatever is wrong with the serotonin system in OCD
87
how can SSRI be combined with other treatments to treat OCD?
- SSRI can be used alongside cognitive behaviour therapy (CBT) to treat OCD
- the drug reduces a persons emotional symptoms, such as feeling anxious or depressed
- this means that people with OCD can engage more effectively with the CBT
88
what alternative drugs can be given to a patient if SSRI is not effective after 3/4 months?
- firstly if after 3/4 months SSRI is not effective the dose can be increased (up to 60mg a day) or it can be combined with another drug:
1) tricyclics- this acts on various systems including the serotonin system where it has the same effect as SSRI's but the side effects are more severe so is only used when SSRI is not working
2) SNRI'S (serotonin-noradrenaline reuptake inhibitors) are a different class of antidepressant drug and is a second line of defence for people who do not respond to SSRI's
- SNRI's increase levles of serotonin as well as another different neurotransmitter- noradrenaline that regulates cognitive functions and stress reactions
89
what is a positive evaluation of drug therapy as a way of treating OCD?
P- one strength of drug therapy is it's effectiveness
E- Soomro et al (2009) reviewed 17 studies of SSRI's for the treatment of OCD, all 17 studies showed better outcomes following SSRI's than placebos
- typically OCD symptoms reduce for around 70% of people taking SSRI's
E- this means that drugs can be of help to most people with OCD
90
what is another positive evaluation of drug therapy as a way of treating OCD?
P- another strength is that drugs are cost-effective and non-disruptive
E- drug treatment is cheaper compared to psychological treatments, so using drugs to treat OCD is therefore good value for the NHS
- as compared to psychological therapies, SSRI's are also non-disruptive to people's lives as they can be taken as any time of the day rather than spending time going to therapy sessions
E- this means that many doctors and people with OCD prefer drug treatments
91
what is a negative evaluation of drug therapy as a way of treating OCD?
P- one limitation is that drugs can have serious side-effects
E- a minority of people taking SSRI's get no benefit and experience side effects such as indigestion, blurred vision and loss of sex drive
- although they are temporary side effects it can be distressing and sometimes long-lasting as well as more than 1 in 10 gain weight and erection problems and 1 in 100 have heart-related problems
E- this means that peoples quality of life is poor and the outcome is they may altogether stop taking the drugs, reducing the effectiveness of the treatment
