Psychopathology Flashcards

Question

What are the emotional characteristics of depression?

Answer 1

Lowered mood Anger Lowered self-esteem

Answer 2

Poor concentration Attending to and dwelling on the negative Absolutist thinking

Answer 3

Anxiety and distress Accompanying depression Guilt and disgust

Answer 4

Compulsions are repetitive Compulsions reduce anxiety Avoidance

Answer 5

Obsessive thoughts Cognitive coping strategies Insight into excessive anxiety

Answer 6

Mowrer (1947)

Answer 7

Behaviourists propose phobias are learned through experience and association and through classical conditioning phobias are acquired by a stimulus becoming associated with a negative outcome. Phobias are then maintained by operant conditioning which explains why people continue to remain fearful or avoid the object or situation in question. This proposes that behaviour is likely to be repeated if the outcome is rewarding in some way, this is known as positive reinforcement.

Answer 8

A child was in introduced to a loud noise (unconditioned stimulus) which produced the fear response (unconditioned response). A white rat (neutral stimulus) was introduced and paired with this loud noise which over time became paired with the fear response towards this white rat (conditioned response). The rat then becomes a conditioned stimulus as it produces the conditioned response of fear.

Answer 9

Social Learning Theory Explains phobias as having been acquired through modelling behaviours observed from others. An individual may see a phobic response and emulate the reaction as it appears rewarding in some form

Answer 10

Can recall a traumatic or specific event that triggers it. However, a weakness is not everyone is able to link their phobia to a specific event they can recall. This is not to say it never occurred however as Ost (1987) suggests it may have merely been forgotten over time.

Answer 11

A case study by Bagby (1922) lends support for classical conditioning explaining her phobia of running water which caused her extreme distress. The sound of running water had become associated with the fear and distress she experienced demonstrating how the two-process model has validity in some explanations of phobias.

Answer 12

We may not necessarily be able to generalise the findings to the wider population as the circumstances for that phobia developing may lack external validity to other peoples conditions. In addition to this such case studies are time-consuming and almost impossible to replicate to test the reliability of findings to confirm they occurred as patients may describe.

Answer 13

A better explanation as it combines both psychological factors such as the two-process model and combines this with a genetic vulnerability. This suggests that some people may inherit a genetic vulnerability for developing mental disorders such as phobias provided the right environmental stressors trigger this. This would explain why phobias develop in some people but not necessarily others. However again this would be incredibly difficult to validate for certain.

Answer 14

Systematic desensitisation Flooding

Answer 15

Based on the assumption that if phobias are a learned response as classical and operant conditioning suggests, them they can be unlearnt

Answer 16

Anxiety hierarchy Relaxation Exposure

Answer 17

Put together by a client with phobia and therapist List of situations related to phobic stimulus that provoke anxiety arranged in order from least to most frightening For example, a person with arachnophobia might identify a picture a small spider as low on their anxiety hierarchy and holding a tarantula at the top of the hierarchy

Answer 18

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 The relaxation might involve breathing exercises or client learning mental imagery techniques Clients can be taught to imagine themselves in relaxing situations or they might learn meditation Alternatively relaxation can be achieved using drugs such as Valium

Answer 19

Finally 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 in the presence of the lower levels of the phobic stimulus they move up the hierarchy Treatment is successful when the client can stay relaxed in situations high on the anxiety hierarchy

Answer 20

Involves exposing people with a phobia to their phobic stimulus but without a gradual build-up in an anxiety hierarchy Instead flooding involves immediate exposure to a very frightening situation So a person with arachnophobia receiving flooding treatment might have a large spider crawl over them for an extended period Flooding sessions are typically longer than systematic desensitisation sessions, one session often lasting two to three hours Sometimes only one long session is needed to cure a phobia

Answer 21

Flooding stops phobic responses very quickly due to no option of avoidance behaviour so the client quickly learns that the phobic stimulus is harmless In classical conditioning terms this process is called extinction A learned response is extinguished when the conditioned stimulus is encountered without the unconditioned stimulus The result is that the conditioned stimulus no longer produces the conditioned response

Answer 22

Flooding is not unethical but is an unpleasant experience so it is important that clients give fully informed consent tit his traumatic procedure and that they are fully prepared before the flooding session A client would normally be given the choice of systematic desensitisation or flooding

Answer 23

Gilroy followed up 42 people who has SD for spider phobia in three 45-minute sessions At both 3 and 33 months, the SD group were less fearful than a control group treated by relaxation without exposure In a recent review, Theresa Wechsler et al concluded that SD is effective for specific phobia, social phobia and agoraphobia This means SD is likely to be helpful for people with phobias

Answer 24

Some people requiring treatment for phobias also have a learning disability However, the main alternatives to SD are not suitable People with learning disabilities often struggle with cognitive therapies that require more complex or rational thought They may also feel confused and distressed by the traumatic experience of flooding

Answer 25

Can be used to avoid dangerous situations Cost-effective as client and therapist don't need to leave consulting room On the other hand there is some evidence to suggest that VR exposure may be less effective than real exposure for social phobias because it lacks realism

Answer 26

Cost-effective Clinical effectiveness means how effective therapy is at tackling symptoms However when we provide therapies in health systems like the NHS we also need to think about how much they cost A therapy is cost-effective if it is clinically effective and not expensive Flooding can work in as little as one session as opposed to say 10 sessions for SD to achieve the same result Even allowing for a longer session still makes flooding more cost-effective This means that more people can be treated at the same cost with flooding than with SD or other therapies

Answer 27

Confronting one's phobic stimulus in an extreme form provokes tremendous anxiety Schumacher et al found that participants and therapists rated the flooding as significantly more stressful than SD This raises the ethical issue for psychologists of knowingly causing stress to their clients, although this is not a serious issue provided they obtain informed consent More seriously, the traumatic nature of flooding means that attribution rates are higher than for SD This suggests that overall therapists may avoid using this treatment

Answer 28

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

Answer 29

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 schema to interpret the world, so if a person has a negative self-schema they interpret all information about themselves in a negative way

Answer 30

When depressed people attend tot he negative aspects of a situation and ignore positives Black and white thinking

Answer 31

Attempted to explain how disorders such as depression occurred due to irrational thoughts and beliefs Ellis believed that it was interpretation of events by patients that was to blame for their distress and to explain this he referred to his ABC model

Answer 32

Activating event Beliefs Consequences

Answer 33

Irrational thoughts triggered by external events According to Ellis we get depressed when we experience negative events and these trigger irrational beliefs Events like failing an important test might trigger irrational beliefs

Answer 34

Ellis identified a range of irrational beliefs He called the belief that we must always succeed or achieve perfection 'musterbation' 'I can't stand this' 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

Answer 35

When an activating event triggers irrational beliefs there are emotional and behavioural consequences For example, if a person believes that they must always succeed and then fails at something this can trigger depression

Answer 36

'Cognitive vulnerability' refers to ways of thinking that may predispose a person to becoming depressed, for example faulty information processing, negative self-schema and the cognitive triad In a review Clark and Beck concluded that not only were these cognitive vulnerabilities more common in depressed people but they preceded the depression This was confirmed in a more recent prospective study by Cohen et al They tracked the development of 473 adolescents, regularly measuring cognitive vulnerability It was found that showing cognitive vulnerability predicted later depression This shows that there is an association between cognitive vulnerability and depression

Answer 37

Has applications in screening and treatment for depression Cohen et al concluded that assessing cognitive vulnerability allows psychologists to screen young people, identifying those most at risk of developing depression in the future and and monitoring them Understanding cognitive vulnerability can also be applied to CBT These therapies work by altering the kind of cognitions that make people vulnerable to depression, making them more resilient to negative life events This means that an understanding of cognitive vulnerability is useful in more than one aspect if clinical practice

Answer 38

In psychological treatment of depression His approach to cognitive therapy is called rational emotive behaviour therapy The idea of REBT is that by vigorously arguing with a depressed person the therapist can alter the irrational beliefs that are making them unhappy There is some evidence to support the idea that REBT can both change negative beliefs and relieve the symptoms of depression This means REBT has real world value

Answer 39

Only explains reactive depression and not endogenous depression No doubt that depression is triggered by life events - what Ellis would call activating events Such cases are sometimes called reactive depression How we respond to negative life events also seems to be at least partly the result of our beliefs However, many cases of depression are not traceable to life events and it is not obvious what leads the person to become depressed at a particular time This type of depression is sometimes called endogenous depression Ellis's ABC model is less useful for explaining endogenous depression This means that the model can only explain some cases of depression and is therefore only a partial explanation

Answer 40

Cognitive behaviour therapy Beck's cognitive therapy Ellis's rational emotive behaviour therapy Behavioural activation

Answer 41

Cognitive element: CBT begins with an assessment in which the client and the CBT therapist work together to clarify the client's problems. They jointly identify goals for the therapy and put together a plan to achieve them. One of the central tasks is to identify where there might be negative or irrational thoughts that will benefit from challenge. Behaviour element: CBT then involves working to change negative and irrational thoughts and finally put more effective behaviours into place

Answer 42

To identify automatic thoughts about the world, the self and the future - negative triad. Once identified these thoughts must be challenged. As well as directly challenging thoughts, the therapy aims to help clients test the reality of their negative beliefs. They might therefore set homework, such as to record when they enjoyed an event or when people were nice to them. This is 'client as scientist', investigating the reality of their negative beliefs in the way a scientist would. In future sessions if clients say that no one is nice to them or there is no point in going to events, the therapist can then produce this evidence and use it to prove the client's statements are incorrect

Answer 43

REBT extends the ABC model to ABCDE D - dispute E - effect The central technique of REBT is to identify and dispute irrational thoughts. The intended effect is to change the irrational belief and so break the link between negative life events and depression This vigorous argument is the hallmark of REBT. Ellis identified between different methods of disputing e.g. empirical argument involves disputing whether there is actual evidence to support the negative belief Logical argument involves disputing whether the negative thought logically follows from the facts

Answer 44

As individuals become more 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 individuals to gradually decrease their avoidance and isolation, and increase their engagement in activities that have been shown to improve mood, e.g. exercising, going out to dinner, etc. The therapist aims to reform such activity

Answer 45

Evidence for effectiveness. March et al compared CBT to antidepressant drugs and also to a combination of both treatments when treating 327 depressed adolescents. After 36 weeks, 81% of CBT group, 81% of antidepressant group and 86% of the CBT plus antidepressants group were significantly improved. So CBT was just as effective when used on its own and more so when used alongside antidepressants. CBT is usually a fairly brief therapy requiring 6 to 12 sessions so is also cost-effective. This means that CBT is widely seen as first choice of treatment in public health care systems such as NHS.

Answer 46

Lack of effectiveness for severe cases and for clients with learning disabilities. In some cases, depression can be so severe that clients cannot motivate themselves to engage with the cognitive work of CBT. They may not be able to pay attention to what is happening in the session. It also seems likely that the hard cognitive work involved in CBT makes it unsuitable for treating depression in clients with learning disabilities. Sturmey suggests that, in general, any form of psychotherapy is not suitable for people with learning disabilities, and this includes CBT. Suggests that CBT may only be appropriate for a specific range of people with depression.

Answer 47

Recent new evidence that challenges. Review by Lewis concluded that CBT was as effective as antidepressant drugs and behavioural therapies for severe depression. Another review by Taylor et al concluded that, when used appropriately, CBT is effective for people with learning disabilities. This means that CBT may be suitable for a wider range of people than was once thought

Answer 48

Concerns over how long benefits of CBT last. Relatively few early studies of CBT for depression looked at long-term effectiveness. Some more recent studies suggest that long-term outcomes are not as good as had been assumed. Ali et al assessed depression in 439 clients every month for 12 months following a course of CBT. 42% of clients relapsed into depression within 6 months of ending treatment and 53% relapsed within a year. This means that CBT may need to be repeated periodically

Answer 49

Biological approach

Answer 50

Genes are involved in individual vulnerability to OCD. Lewis observed that of his OCD patients, 37% had parents with OCD and 21% had siblings with OCD. This suggests that OCD runs in families, although what is probably passed on from one generation tot he next is genetic vulnerability, not the certainty of OCD. According to the diathesis-stress model certain genes leave some people more likely to develop a mental disorder but it is not certain. Some environmental stress is necessary to trigger the condition

Answer 51

Researchers have identified genes, which create vulnerability for OCD. Some of these genes are involved in regulating the development of the serotonin system. For example, the gene 5HT1-D beta is implicated in the transport of serotonin across synapses.

Answer 52

OCD is not caused by one single gene but by a combination of genetic variations that together significantly increase vulnerability.

Answer 53

Analysed findings from previous studies and found evidence that up to 230 different genes may be involved in OCD. Genes that have been studies in relation to OCD include those associated with the action of dopamine as well as serotonin, both neurotransmitters believed to have a role in regulating mood

Answer 54

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

Answer 55

One explanation for OCD concerns the role of the neurotransmitter serotonin, which is believed to help regulate mood. Neurotransmitters are responsible for relaying information from one neuron to another. 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. At least some cases of OCD may be explained by a reduction in the functioning of the serotonin system in the brain

Answer 56

Some cases of OCD, and in particular hoarding disorder, seem to be associated with impaired decision-making. This in turn may be associated with abnormal functioning of the lateral of the frontal lobes of the brain. There is also evidence to suggest that the left parahippocampal gyrus, associated with processing unpleasant emotions, functions abnormally in OCD

Answer 57

Evidence which strongly suggests that some people are vulnerable to OCD due to genetic make-up. One source of evidence is twin studies. Nestadt et al reviewed twin studies and found that 68% of MZ twins shared OCD as opposed to 31% of DZ twins. Another source of evidence for a genetic influence on OCD is family studies. Research has found that a person with a family member diagnosed with OCD is around four times as likely to develop it as someone without. These research studies suggest that there must be some genetic influence on the development of OCD

Answer 58

Environmental risk factors. There is strong evidence for the idea that genetic variation can make a person more or less vulnerable to OCD. However, OCD does not appear to be entirely genetic in origin and it seams that environmental risk factors can also trigger or increase the risk of developing OCD. In one study for example, Cromer et al found that over half the OCD clients in their sample had experienced a traumatic in their past. OCD was also more severe in those with one or more traumas. This means that genetic vulnerability only provides a partial explanation for OCD.

Answer 59

Supporting evidence. Antidepressants that work purely on serotonin are effective in reducing OCD symptoms and this suggests that serotonin may be involved in OCD. Also, OCD symptoms form part of conditions that are known to be biological in origin, such as the degenerative brain disorder Parkinson's disease, which causes muscle tremors and paralysis. If a biological disorder produces OCD symptoms, then we may assume the biological processes underlie OCD. This suggests that biological factors may also be responsible for OCD.

Answer 60

Serotonin-OCD link may not be unique to OCD. Many people with OCD also experience clinical depression. Having two disorders is called co-morbidity. This depression probably involves disruption to the action of serotonin. This leaves us with a logical problem when it comes to serotonin as a possible basis for OCD. It could simply be that serotonin activity is disrupted in many people with OCD because they are depressed as well.

Answer 61

Treatment involving drugs, i.e. chemicals that have a particular effect on the functioning of the brain or some other body system. In the case of psychological disorders such drugs usually affect neurotransmitter levels.

Answer 62

Type of antidepressant. Serotonin released from presynaptic neurons and travel across synapse. Neurotransmitter chemically conveys signal from presynaptic neuron to postsynaptic neuron and then is reabsorbed by the presynaptic neuron where it is then broken down and reused. By preventing the reabsorption and breakdown, SSRIs effectively increase levels of serotonin in the synapse and thus continue to stimulate the postsynaptic neuron. This compensates for whatever is wrong with the serotonin system in OCD. Dosage and other advice vary according to which SSRI is prescribed. It takes three to four months of daily use for SSRIs to have much impact on symptoms.

Answer 63

Combined with CBT to treat OCD. The drugs reduce a person's emotional symptoms, such as feeling anxious or depressed. This means that people with OCD can engage more effectively with the CBT. In practice some people respond best to CBT alone whilst others benefit more when additionally using drugs. Occasionally other drugs are prescribed alongside SSRIs.

Answer 64

Tricyclics: act on various systems including serotonin system where it has the same effect as SSRIs. Clomipramine has more severe-side effects than SSRIs so it is generally kept in reserve for people who do not respond to SSRIs. SNRIs: a different class of antidepressant drugs and, like clomipramine, are a second line of defence for people who don't respond to SSRIs. SNRIs increase levels of serotonin as well as another neurotransmitter - noradrenaline.

Answer 65

Clear evidence to show that SSRIs reduce symptom severity and improve quality of life for people with OCD. Soomro et al reviewed 17 studies that compared SSRIs to placebos in the treatment of OCD. All 17 studies showed significantly better outcomes for SSRIs than for the placebo conditions. Typically symptoms reduce for around 70% of people taking SSRIs. For the remaining 30%, most can be helped by either alternative drugs or combinations of drugs and psychological therapies. This means that drugs appear to be helpful for most people with OCD.

Answer 66

Some evidence to suggest that even if drug treatments are helpful for most people with OCD they may not be the most effective treatments available. Skapinakis et al carried out a systematic review of outcome studies and concluded that both cognitive and behavioural therapies were more effective than SSRIs in the treatment of OCD. This means that drugs may not be the optimum treatment for OCD.

Answer 67

Cost-effective - many thousands of tablets or liquid doses can be manufactured in the time it takes to conduct one session of a psychological therapy. Therefore good value for public health systems like NHS and represents a good use of limited funds. SSRI's are also non-disruptive in people's lives. If you wish you can take drugs until symptoms decline. This is different from psychological therapy which involves time spent attending therapy sessions. This means that drugs are popular with many people with OCD and their doctors.

Answer 68

Drugs can have potentially serious side-effects. Although drugs such as SSRIs help most people, a small minority will get no benefit, Some people experience side-effects such as indigestion, blurred vision and loss of sex drive. These side-effects are usually temporary, however they can be quite distressing for people and for a minority they are long-lasting. For those taking tricyclic clomipramine, side-effects are more common and can be more serious. For example, more than 1 in 10 people experience erection problems and weight gain, 1 in 100 become aggressive and experience heart-related problems. This means that some people have a reduced quality of life as a result of taking drugs and may stop taking them altogether, meaning the drugs cease to be effective.

Psychopathology Flashcards

(92 cards)