Psychopathology

Question 1

What is depression?

Answer 1

Depression is a mood disorder in which a person experiences extreme sadness.
To be diagnosed with depression, an individual must experience low mood and/or lack of interest in activities they usually enjoy, for at leat two weeks. They also must have at least 3/4 (five in total) of the other following characteristics

Question 2

What are the emotional characteristics of depression?

Answer 2

Extreme low mood- depressed individuals will experience overwhelming sadness, which surpasses what it is normal to feel on a daily basis

Loss of interest in activities which they usually enjoy- depressed individuals will no longer find enjoyment in their hobbies, work or social interactions, which can often lead to withdrawal

Worthlessness- depressed people may question their value, have low self worth, and may have thoughts such as “I’m not good enough”

Question 3

What are the cognitive characteristics of depression?

Answer 3

Reduced concentration- a depressed person may have reduced concentration, memory and decision making ability, this is likely to interfere with a persons work
Suicidal thoughts- a depressed person may consider ending their own life
Negative beliefs about self- a depressed person may have persistent negative views about their abilities, attractiveness, may believe they are unlikeable or won’t be successful in the future

Question 4

what are the behavioural characteristics of depresssion?

Answer 4

changes in activity levels- depressed individuals are likely to be lethargic and easily fatigued, however some may suffer from the psychomotor effect and become restless
Change in eating or sleeping habits- a significant weight change (5%) or a significant change in sleeping patterns (could be an increase or decrease) could indicate that an individual is suffering from depression
Social impairment- depressed person may withdraw themself from loved ones or may behave differently to how they did previously

Question 5

Describe Beck’s negative triad

Answer 5

Beck believed depression is caused by faulty and irrational thinking

Beck’s negative triad explains that depressed people have negative views about themselves, the future and the world, regardless of what their reality is
Beck also believed that depressed people have negative self schemas and negative cognitive biases. A self schema is a packet of knowledge that someone has about themself, negative self schemas means that someone views themself in a negative way, this is often the result of childhood traumas such as parental rejection or bullying

He also believed that depressed people have a tendency to overgeneralise negative events, for example they may perform poorly on a test and believe they won’t achieve anything in life

Question 6

Describe Ellis’ ABC model

Answer 6

Ellis theorised that while depressives believe that life events are the cause of their unhappiness, it is actually their interpretation of events
Activating event (any unpleasant event, for example the breakdown of a relationship)
Belief( how the person interprets the event, for example it was all my fault no one loves me and no one ever will)
Consequence (either an emotion or an action that the person carries out in response to the belief, for example either feelings of worthlessness or making no attempt to meet other romantic partners)
He believed that people become depressed because they interpret events in excessively negative or threatening ways

Question 7

Evaluation of the cognitive explanation of depression- supporting research

Answer 7

Koster displayed positive, negative and neutral words to a group of depression patients and a control group who did not have depression. He found that the depressed group spent more time looking at the negative words than the control group.
This supports the idea that depressed people have negative cognitive biases
Hammer and Krantz found that depressed women made more errors in logic when interpreting written material than a control group
These pieces of research show a correlation between irrational thinking and depression, however, it does not prove cause and effect

Question 8

Evaluation of the cognitive explanation of depression- practical applications

Answer 8

The cognitive explanation has led to the development of many treatments for depression, such as CBT which targets irrational thinking (changing irrational, negative thoughts into positive, helpful thoughts) The general success of CBT is strong evidence that depression is at least somewhat caused by irrational thinking.

Question 9

Evaluation of the cognitive explanation of depression- symptom not cause

Answer 9

One limitation of the cognitive explanation of depression is that by using it to develop treatments we could be treating a symptom instead of the cause of the disorder. For example, people could have thoughts such as “other people don’t like me” because they are depressed, rather than the other way round. This means that if irrational thoughts are treated, symptom substitution could happen, which is when the same underlying disorder manifests in a different way. This means that a more holistic approach, accounting for biological and psychological theories may be a much better way of treating such a complex disorder

Question 10

Describe Ellis ABCDE model as a method for treating depression (rational emotive behavioural therapy REBT)

Answer 10

D - disputing
E - effective feelings
Ellis’ ABCDE model works by disputing the clients negative thoughts and changing them into effective feelings, he which would allow the patients to think more positively about their every day experiences. It is also designed to help the client’s self-worth to increase. He outlined three types of disputing, all designed to create argument
Logical disputing- asking the patient to evaluate whether the conclusion they have drawn logically follows on from the information given
Empirical disputing- arguing that there is no evidence for the assumption the patient has made
Pragmatic disputing- arguing that the assumption made is not useful to the patient

Question 11

Describe Beck’s cognitive behavioural therapy (CBT) emotional strategies

Answer 11

Based on Beck’s negative triad, which outlines that people with depression have negative thoughts about themselves, their world and their future CBT works by the client and therapist identifying the clients negative thoughts together, and the therapist setting homework for the client to learn to change their negative faulty thoughts into positive rational thoughts

Some strategies used were
Thought catching: client has to record events which caused negative thinking within their week, it is the therapists role to discuss this with them and think of ways in which they could interpret this event more positively
Client as scientist/ reality testing: Client would be asked to record either times when they enjoyed an event or an activity or times when someone was nice to them, the therapist can use this as evidence against negative thinking if the client overgeneralises by being negative about their entire life in the future
Cognitive reconstruction: changes the way in which the patient thinks, for example by asking them to sign up for dating sights, this changes negative thoughts such as “I’m unattractive” into positive thoughts such as “someone thinks I’m attractive”

Question 12

Describe behavioural activation within CBT

Answer 12

This is useful as many people with depression no longer enjoy activities which they did previously. The therapist and client will work together to identify potentially enjoyable activities, and the client will be set graded homework assignments such as “go for a walk for 15 minutes”

Question 13

Evaluation of CBT- effectiveness

Answer 13

There have been numerous studies indicating that CBT is highly effective, for example March found that CBT and antidepressants were both 81% effective in preventing relapse of depression, and 86% effective when combined. However, people who receive CBT are likely to have a larger increase in wellbeing as it teaches skills which last long term, which gives the patient a stronger sense of personal atonomy

Question 14

Evaluation of CBT- depends on the competence of therapist

Answer 14

Kuyken found that there was a 15% variance in the effectiveness of CBT depending on competence of the therapist. Other factors which could affect effectiveness are relationship with therapist, patients expectation of outcome and participants willingness and effort

Question 15

Evaluation of CBT for treating depression- applicable in many contexts

Answer 15

CBT can be carried out both online and in person, and has been found to be effective in people with both mild and severe depression. However, some participants are unable to respond well to CBT as their depression may be so severe they may be unable to pay attention to what is happening or unable to motivate themselves to engage in the homework activities.
Additionally, Simmons found that CBT is not effective for people who are resistant to change. This means that alternative therapies are necessary for some people

Question 16

Evaluation of CBT- expensive

Answer 16

Hiring trained personnel is extremely expensive for the NHS, and when CBT is ineffective this money is wasted. It could be argued that antidepressants are a better alternative as they are much cheaper. However, CBT may be better in the long run as antidepressants do not teach skills so may have to be taken for ever while CBT only lasts for a few months

Question 17

What is OCD (obsessive compulsive disorder)

Answer 17

OCD is an anxiety characterised by having both obsessions and compulsions
Obsessions are repetitive, unwanted intrusive thoughts which are usually about a perceived threat
Compulsions are repetitive behaviours e.g tapping or mental ads such as counting which are designed to reduce the chance of the perceived harm in the obsession happening

Question 18

Emotional characteristics of OCD

Answer 18

Recurrent and persistent thoughts- these thoughts are obsessive, uncontrollable and distressing
Insight into obsessive anxiety- OCD sufferers are aware that their anxiety is excessive and irrational- this is necessary for a diagnosis
Catastrophic thoughts- OCD sufferers have a tendency to think of the worst case scenario situations

Question 19

Behavioural characteristics of OCD

Answer 19

Compulsions reduce anxiety- for example, repeatedly checking that a door is locked could reduce the feeling of anxiety that the house may be broken into
Repetitive behaviour behaviour- for example repeatedly tapping or turning a light switch on and off, this is done in response to obsessions

Question 20

Cognitive characteristics of OCD

Answer 20

Guilt- often experience extreme guilt over moral issues, for example, they may believe their own actions may lead to something awful happening
Anxiety- anxiety in OCD sufferers is often extreme and overwhelming

Question 21

Describe the genetic explanation of OCD

Answer 21

Family studies have shown that people with a first degree relative with OCD have a higher chance of suffering with OCD themselves. For example Pauls et al found that people with a first degree relative have a 10% chance of suffering with OCD, while the rate in the general population is around 2%

Candidate genes are genes with create a vulnerability for OCD. One example is the SERT gene, which means that less seretonin is transferred. This means that there is less connection between the deeper structures of the brain and the prefrontal cortex, which triggers OCD.

Another example is the COMT gene, which means there is more transmission of dopamine. This is associated with the formation of repetitive behaviours as high dopamine levels cause anticipation of reward

Question 22

Evaluation of the genetic explanation of OCD-research support

Answer 22

One strength of the genetic explanation of OCD is that there is research support. For example Paul’s et al found that people were five times more likely to be diagnosed with OCD than if they had a first degree relative. This is a significant increase, which shows it is likely there is at least some genetic component in the development of OCD.

Question 23

Evaluation of the genetic explanation of OCD- further research needed

Answer 23

Pato suggested that more research is required as few details about OCD are understood. For example, there may be different genetics contributing to the subtypes, for example, early onset, tic-related and hoarding related. Hemmings found that a gene for dopamine was much less common in early onset than late onset OCD

Question 24

Limitation of the genetic explanation of OCD- nature vs nurture

Answer 24

It is very difficult to separate nature and nurture, as the majority of people learn behaviours from their biological parents. For example, children may see their parents carrying out compulsions and copy this behaviour themselves. Furthermore, research has found that over 50% of OCD patients had at least one trauma and OCD is more severe in those with more than one trauma. This suggests OCD may be genetic in origin but environmental stressors may influence its development

Question 25

Evaluation of the genetic explanation of OCD- inconsistency in the research

Answer 25

Pauls found that OCD was 5 times more common in people with a first degree relative, while Marini and Stebnicki found that it was 4 times more common for people with a close family member. This means that the research in inconsistent therefore it is difficult to understand the true extent of genetic influence on OCD

Question 26

Neural explanation for OCD- abnormally low rates of seretonin

Answer 26

Transmission of serotonin is lower in people with OCD, and it is likely that this is because serotonin has a role in stopping the repetition of tasks, if this is not present, compulsions can be formed. Pigott found that OCD symptoms were reduced in patients who had antidepressants which targeted serotonin much more than patients who received antidepressants which had less effect on serotonin.

Question 27

Neural explanations for OCD- abnormal brain circuits

Answer 27

The caudate nucleus, which is located in the basal ganglia, usually suppresses worry signals from the orbitofrontal cortex. When the caudate nucleus is damaged, it fails to suppress the worry signal and the thalamus is alerted. It confirms the worry signal and a worry circuit is created. This could result in an obsession being formed

Question 28

Evaluation of neural explanations for OCD- supporting evidence

Answer 28

Paul et al found excessive activity in the caudate neucles in OCD sufferers PET scans taken while the symptoms are active e.g someone with a germ obsession holding a dirty cloth, found excessive activity in the orbitofrontal cortex Seretonin levels were compared in 169 OCD sufferers and 253 non-sufferers, and rates of seretonin were found to be much lower in sufferers Empirical evidence, objective not subjective shows a correlation between abnormal brain activity and OCD

Question 29

Evaluation of neural explanation of OCD- symptom not cause

Answer 29

A persons brain circuits or seretonin levels may be different because they have OCD, meaning it may be a symptom rather than a cause. This means that if this symptom is treated rather than the underlying issue, symptom substitution may happen and the disorder may manifest itself as something else

Question 30

Evaluation of neural explanation of OCD- reductionist

Answer 30

Ignores cognitive and psychological explanations, for example OCD may be the result of conditioning. There is strong evidence for the psychological explanation within the success of CBT

Question 31

Evaluation for the neural explanation of OCD- mixed success of antidepressants

Answer 31

Basanti found that in some patients, increasing the levels of seretonin can actually make OCD worse. It is not clear whether OCD is caused by problems with the transmission of particular neurotransmitters or by issue with how several neurotransmitters interact. As symptoms vary so much between sufferers, it is unlikely OCD is caused by low transmission of serotonin alone

Question 32

What are the four different definitions of abnormality?

Answer 32

Deviation from social norms Statistical infrequency Deviation from ideal mental health Failure to function adequately

Question 33

Describe deviation from social norms

Answer 33

Deviation from social norms refers to people who do not fit the unwritten rules of our society, for example they may talk to themselves in public or wear a swimming costume to work A mental disorder associated with this is antisocial personality disorder. People with APD are aggressive and irrational, and do not follow our moral standards

Question 34

Evaluation of deviation from social norms- face validity

Answer 34

This definition has face validity, as this is how most people would define abnormality. Additionally, it is helpful for diagnosis as most people with a mental disorder will also fit this definition. For example, social phobics have an extreme fear of social situation so will avoid these and appear withdrawn, which is considered abnormal. People with anorexia will avoid eating which is also considered abnormal ect

Question 35

Evaluation of deviation from social norms definition- social norms will change over time

Answer 35

In the past, homosexuality was considered abnormal, it was considered a mental disorder until the 1970s and is now a celebrated part of society. There may be other behaviours which are considered abnormal now which will grow to be normalised in the future. This means that under this definition abnormality is difficult to measure as it is re,entice to the time period

Question 36

Evaluation of deviation to social norms definition- cultural relativity

Answer 36

Hearing voices would be a sign of a mental disorder such as schizophrenia in the UK, however in some cultures it would be considered a sign of spirituality and would be celebrated. This interferes in the categorisation of people who have moved between cultures where social norms vary significantly

Question 37

Describe the failure to function adequately definition

Answer 37

People who fail to function adequately are those who fail to cope with the demand of every day life, for example employment or personal hygiene. They also fail to conduct satisfying relationships and may also fail to experience a normal range of emotions or behaviours, for example, they may have extreme highs and lows or a flat affect. The main example of this is severe depression, which may cause people to lose interest in things the usually enjoy and eventually the motivation to do anything altogether, these people may fail to get out of bed in the morning or self-isolate. Rosenham and Seligman also characterised people who fail to function adequately as maladaptive (behaviour which prevents them from reaching their goals, and causing observer discomfort)

Question 38

Evaluation of failure to function adequately- real life application

Question 39

Limitation of failure to function adequately - subjective judgement

Answer 39

Different people may have different beliefs about what is adequate functioning. For example, people with schizophrenia may feel they are functioning adequately but may display erratic behaviour which could cause observer discomfort, which is part of the definition according to Seligman and Rosenham) As the definition is subjective this means it is unscientific

Question 40

Limitation of failure to function adequately- oversimplified

Answer 40

Not all people who are abnormal fit into this definition. For example, Harold Shipman murdered over 200 of his patients over a 23 year period but was seen as a respectable doctor and behaved typically. This means that having failure to function adequately alone as a definition for abnormality would be oversimplified.

Question 41

What is statistical infrequency?

Answer 41

Statistical infrequency is anyone who strays far from the average and is usually around 5% of the population, for example, abnormally high IQ or abnormally low IQ. Another example are rare mental disorders, any which affect less than 5% of the population

Question 42

Strength of statistical infrequency- objectivity + usefulness

Answer 42

Statistical infrequency is a scientific way of measuring abnormality as doctors can agree on a cut off point and a way of collecting data. They can also measure severity of symptoms against averages in order to measure abnormality, which means that those who need help can be identified and receive it. Anyone in the range of 85-115 IQ is considered normal, and anyone with an IQ under 70 can be diagnosed as having IDD. This means that statistical infrequency has practical applications as it is a useful part of clinical assessment

Question 43

Limitation of statistical infrequency- desirability of characteristics

Answer 43

One limitation of the statistical infrequency definition of abnormality is that it does not focus on the desirability of features. For example, having a high IQ 150+ is statistically infrequent, therefore these people would be classed as abnormal, however, we should not suggest that this characteristic is undesirable. Furthermore, those diagnosed with depression or anxiety would not be statistically infrequent as these disorders are fairly common, which means that if we purely relied on this definition the wrong people may be offered help. This means that the definition is unable to separate desirability and frequency of characteristics.

Question 44

Limitation of statistical infrequency- cultural variation

Answer 44

Diagnosis rates of different disorders vary between cultures, for example, in Asian cultures diagnosis of depression is much lower than in Western cultures. The generally accepted idea is that in collectivist cultures, there is much more community support for people who may be struggling, therefore people require professional help much less. However, Rack suggested that it may be due to social stigma within these communities as they do not see emotional distress as the responsibility of a doctor. Therefore, statistical infrequency reflects the likelihood of seeking diagnosis and professional help, rather than the actual prevalence of a mental health disorder

Question 45

Describe the deviation from ideal mental health definition

Answer 45

This definition outlines that in an absence of any of the six criteria, a person is abnormal, it was outlined by Jahoda Personal autonomy- emotional and physical independence from others Environmental mastery- being able to fit into and thrive in new places Resistance to stress- having no strong or irrational reaction to stressful situations Self-actualisation and personal growth - having the willingness and ability to become the best version of yourself Positive attitudes about the self- having self-respect and positive self-concepts Accurate perception of reality- perceiving the world in a non-distorted fashion, having an objective and realistic view of the world

Question 46

Example of deviation from ideal mental health in psychology?

Answer 46

A person with anorexia nervosa may have an inaccurate view of the world as they see their body in a distorted way. They are also likely to have negative self-concepts therefore do not have positive attitude about the self

Question 47

Strength of the deviation from ideal mental health definition- positive approach

Answer 47

This definition focuses on what a person should be aiming for rather than what shouldn’t be present, which can help individuals strive to improve. Additionally, since it covers such a broad range of issues, most problems people seek help for will be listed, therefore it is a good tool for identifying mental health issues. It also has practical applications as it has been used for the positive psychology movement in the humanistic approach

Question 48

Limitation of the deviation from ideal mental health definition of abnormality- unrealistic

Answer 48

It is very unlikely that a person will meet all six criteria at all points in their lives. For example, feeling high levels of stress are very normal during a traumatic event such as a bereavement. This means that the definition sets unrealistically high expectations for mental health, so if it was followed strictly most people would be classed as abnormal. It is better to consider the criteria as a goal to aim towards, rather than a minimum standard which must be achieved in order to not be abnormal

Question 49

Limitation of the deviation from ideal mental health definition of abnormality- cultural relativism

Answer 49

The ideas proposed by Jahoda very much fit the standards of Western, individualist cultures, and therefore may be considered ethnocentric. For example, self-actualisation and personal growth may be considered unimportant or even selfish in collectivist cultures which focus on a goal of achieving the best for the whole community. For example, elders may plan the marriages or career paths of young people, which may also mean there is much less of a need for personal autonomy.

Question 50

What are phobias?

Answer 50

Phobias are classed as an anxiety disorder, in which a person feels irrational fear in response to an object or situation. The three types of fears are: Specific phobias- including animal phobias or situation phobias for example lifts Social phobia- and excessive fear of social situations for example an extreme fear of eating in public Agoraphobia- and excessive extreme fear of public spaces, this is thought of as the most severe of all phobias

Question 51

What are the behavioural characteristics of a phobia?

Answer 51

Panic - could be shown in a variety of ways such as crying or screaming Avoidance- people with phobias will generally go to extreme effort to avoid their phobic stimulus, for example driving long distances to avoid flying Endurance- the alternative to avoidance, the person will remain in the presence of the phobic stimulus, but may experience high levels of fear and anxiety

Question 52

What are the emotional characteristics of a phobia

Answer 52

Emotional responses are disproportionate to the situation- emotional responses are too extreme for the level of threat posed by the phobic stimuli Anxiety- prevents the sufferer relaxing and makes it difficult to feel any positive emotion. Fear is the immediate and extremely unpleasant response we experience when we encounter or think about the phobic stimulus

Question 53

What are the cognitive characteristics of a phobia?

Answer 53

Irrational beliefs- the person with a phobia may have beliefs such as “the spiders are going to come and find me” Reduced concentration- if a person is in close contact with their phobic stimulus, they are unlikely to be able to complete any other task

Question 54

Explain the acquisition of phobias

Answer 54

Part of the two process model proposed by Mowrer (1960) Before conditioning: A fear of being bitten is natural as this causes pain, therefore this is the unconditioned stimulus, this causes the unconditioned response of fear During conditioning: The unconditioned stimulus of being bitten is paired with the neutral stimulus of a dog, together they create the unconditioned response of fear After conditioning: The dog is now the conditioned stimulus, this alone creates the conditioned response of fear