Flashcards in Psychopathology Deck (68):
What are the three different types of depression and explain
Major depression- feelings of sadness, loss, anger or frustration interfere with daily for weeks or longer
Dysthymic depression- bad state of mind, less severe then major depression but the same symptoms
Bipolar depression- serious shifts in mood, energy thinking and behaviour. High to low feelings for days, weeks or months
Outline one cognitive and one emotional characteristic of depression.
Cognitive- reduce concentration
Emotional- lack of motivation
How does the cognitive approach explain depression
Being caused by faulty or irrational thought processes.
What is Becks negative triad (cognitive approach)
Beck believed that people will depression think consistency negatively about themself, the world and the future.
He suggests that this was because during childhood negative self schema develop as a result of authority figures and parents placing unreal demands and being highly critical. They are activated in situations that provide a negative framework for viewing events pessimistically.
In adulthood people will negative schemes share vulnerable to cognitive biases such as overgeneralisation where they make sweeping conclusions based on a single event, magnifying failures and focusing on one aspect of a situation ignoring all others, these cognitive biases. Am taking. The negative triad.
What was Elliis's ABC model
Believed that it was the way in which people interpreted events that led to depression rather than the event itself.
ABC outlined the outline the process
A - activating event
B _ belief of explanation of why it occurred
C - consequence - the feeling the behaviour now causes.
Therefore rational beliefs lead to rational emotions and behaviours whereas irrational beliefs lead to irrational emotion and behaviours. The individual blames the external event for the unhappiness being experienced and fails to realise that it's their perception that causes their response.
How can the negative triad by beck be supported by bates
Bates found that depressed participants who were given negative automatic thought statements become more and more depressed supporting the view that negative thinking leads to depression.
How do Mclntosh and Fischer criticise the cognitive triad by beck
They tested it and found no clear separation of negative thoughts into the three distinct type proposed. Instead they found a single one dimensional negative perception of the self.
How are Becks and Ellis models helpful for depression
They have both been applied to the development of treatment such as CBT, CBT is the most widely used form of psychotherapy and had been found as the best treatment for depression especially when used in conjunction to drug treatments.
What are issues with the cognitive approach to treating depression
It is sometimes accused of blaming the client for there problems. This could result in people being less sympathetic towards them and may impede ( slow down) their recovery as it could fuel their negative schemas.
This is problematic as it ignores any environmental factors that may have contributed to depression such as a dysfunctional relationship. This means they will be overlooked and the focus will be changing the way the client thinks meaning the client doesn't get the support they need and recovery will be limited.
What is an alternative explanation for depression
Biological approach suggests that depression is caused by genes and neurotransmitters for example serotonin is found to be low in people with depression and a gene related to this is ten times more common in people with depression. This alternative explanation is also supported by the fact that drugs which raise serotonin levels are an effective treatment for depression.
What is CBT
Cognitive behavioural therapy
- umbrella term for a number of different therapies that aim to alter the faulty and irrational thoughts of clients to help them engage in more adaptive behaviours.
What is rational emotive behaviour therapy
Aims to turn irrational thoughts into ration ones and help resolve emotional and behavioural problems
How is ABCDEF used in cognitive therapy
Clients are taught to become aware if the irrational nature of their beliefs and to notice the consequences of their beliefs.
The ABC MODEL is used to record their irrational beliefs and reframing is used which involved reinterpreting the activating event in a more rational way. This helps the client recognise that their thoughts have on emotions and behaviour.
ABC model is extended to the DEF
D- disputing irrational thoughts and beliefs
E- effects of disputing and having an effective attitude on life
F - feeling that are produced.
How hare irrational thoughts challenged in CBT
What are the different types
Logical disputing - showing that the belief does not follow logically from the information available
Empirical disputing- using evidence of reality to challenge beliefs
Pragmatic disputing- emphasising the lack of usefulness of self defeating beliefs
What are clients set from CBT sessions and why
Homework- often involves asking them to perform a behaviour that will test their irrational beliefs against reality. These hypothesis testing tasks are only set if the therapist is confident the client Dan achieve them otherwise failure would reinforce their negative beliefs.
What is behaviour activation
Another aspect of CBT- this involves encouraging the client to become more active and engage in activities that they used to find pleasurable. The cognitive barriers that prevent them participating in these activities are challenged. This should serve to increase the amount of positive reinforcement the client receives and assist in them replacing their irrational thoughts with more positive ones.
Who may CBT be inappropriate for
People with learning difficulties
Children - as techniques used challenge their own irrational thoughts
People with severe depression- people with suicidal thoughts need a more fast acting process.
Despite CBT what is another treatment for depression
Anti-depressant drugs- these work by raising the levels of serotonin in the brain. They are significantly more effective than CBT only by a little but drugs have a higher relapse rates than CBT. Therefore overall CBT may be more effective.
Why might some people prefer drugs to receiving CBT
As taking drugs is quicker and not as the consuming
How can the effectiveness of CBT be evaluated
David et Al- student 170 patients who suffered major depression and found that patients treated with 14 weeks of CBT had better outcomes can those treated with drug fluoxetine 6 months after treatment.
Suggesting how CBT may be more effective as it has a more long lasting effect as it teaches clients how to deal with social situations.
It could be said that it depends how good the therapist is to how good your outcome is. Kuyken and tsivikos found a 15% variation depending on the therapist.
Why may Internet types of CBT be preferred compared to face to face
Cheaper, adaptable, allows patients to open up more not as challenging for the patient.
Why might CBT not be suitable for everyone
CBT is less suitable for people who have high levels of irrational beliefs that are rigid as resistant to change.
It's also not suitable in situations where high levels of stress reflect realistic stressors in the personals life that the therapy cannot resolve
How does deviating from social Norms explain abnormality
If they were to violate social norms. Social norms - acceptable and expected within a given society. Shared by members of society. They can be explicit and breaking them could mean breaking the law. Behaviour that deviates from so ail norms is likely to be incomprehensible to others and make them feel threatened.
What are 4 different explanations for abnormality
Deviation from social norms
Failure to function adequately
Deviation from ideal mental health
Pick 2 positive evaluation points for deviation of social norms
-allows us to account for the desirability of behaviour but in terms of for the individual and the good of society- takes into consideration the effect the behaviour has on others.
-the definition takes in to consideration development norms for example a behaviour may be socially acceptable from a 2 year old but not an adult.
Provide 3 criticisms to the deviation from social norms explanation for abnormality
- the explanation is era dependent as the concept of social deviancy is related to moral codes or standards however these change with social attitudes eg- gay rights
- much of the behaviour is context specific and out of context may seen bizarre. For instance being naked on a nudist beach is acceptable but not in public. Therefore it cannot offer a complete definition of abnormality as behaviour is related to context- lacks explanatory power.
- cultural issues must be taken into consideration - in western countries assumption that the White population is the norm and anything that deviates from this is 'abnormal'. This definition is ethnocentric and does not account for ethnic minorities.
Eg- cochrane found that black people were ore likely to be diagnosed with schizophrenia than white people, while the high rates of diagnosis is found in Britain it is not found in countries such as Jamaica were black people are the majority.
How does 'failure to function adequately' describe abnormality
Considers abnormal if they are unable to cope with the demands of everyday life. They may be unable to perform the behaviours for day to day life eg- self care, holding down a job and interacting with others. This may mean the individual guild to achieve a sense of well being, doesn't make larger contribution to social groups and may behave in appropriately to situations.
This definition focus on he individual suffering, drawing attention to personal experiences associated with mental disorders rather than social context.
What did Rosenhan and Seilgman suggest the following features of personal dysfunction were ( name 7, evaluate 3)
- suffering personal distress
-----could be argued that it's normal to suffer in times of our life eg- death of a family member, it would be abnormal not to.
- irrational - others find it difficult to understand why someone would behave in such a way
----- just because others don't understand it it doesn't make it abnormals, people may not have enough information on why they are doing it.
- violates morals - the behaviour is seen as unacceptable
---- behaviour changes across cultures so this is objective
- maladaptiveness - preventing an individual from achieving major life goals.
- vividness and unconventionality- stand out, it is not typical to behaviour in a given situation.
- unpredictable and loss of control
- obverse discomfort
Name 2 positive evaluation points for the failure to function adequately explanation for abnormality
- this explanation gives a practical explanation, the definition provides a check list for the level of abnormality. This concept has been applied to the global assessment of functioning scale which can be used in clinics to rate a persons sociable, occupational and psychological functioning- this is useful in indicating the persons level of risk and need for service.
- this definition does recognise the subjective experience of the individual rather than just the effect the behaviour has on others. In this sense it matches the suffers own perspective as most people seeking clinical help feel that they are suffering and it is impacting on their life.
Name 2 negative evaluation points of the inadequacy to function accurately explanation for abnormality
- behaviour that looks like failure to function adequately may actually represent normal functioning depending on the context. Eg- some political prisoners go in hunger strike as part of their political protest this behaviour is - maladaptive, irrational and unpredictable but it could be considered understandable in the right context. Therefore other 'dysfunctional behaviour' may serve a function to the individual.
- standard patterns of behaviour will vary from culture to culture. So the failure to function inadequately explanation may manifest itself differently depending on which culture you are in. This may lead to misdiagnosis of ethnic minority and could account for the higher proportion of diagnosed mental illnesses among these groups.
How does the statistical infrequency explanation explain abnormality
Suggest that statistically rare behaviour is abnormal. It is based on the notion that many human behaviour and traits follow a normal distribution which can be represented on a graph as a normal distribution curve.
Most people fall in the middle for any given characteristics. The spread of scores can be measured by a statistic called standard deviation. Individuals are normal if they do not deviate too far from the average. People who fall in the bottom and top 5 percent can be considered abnormal.
What is good about the statistical infrequency explanation for abnormality
More objective means of defining abnormality since it relies on quantitate data and does not make any value judgment about the behaviour.
How can the statistically infrequency explanation be negatively criticised
It fails to consider the desirability of that behaviour as having a hight IQ under this explanation would be seen as abnormal but is desirable.
Who decides were the line of abnormality is and how do we draw a line.
How does 'deviating from ideal mental health' explain abnormality
This explanation just explains what is normal and explains how anything that deviates from this is 'abnormal'
Marie Jahoda describes 6 characteristics of good mental health.
- positive view of self
- capability for growth and development
- autonomy and independence
- accurate perception of reality.
- environmental mastery
How can the explanation of deviation from mental health be positively evaluated
- focuses on what is desirably rather than undesirable, therefore a more positive approach to defining abnormality and is in accordance with the positive psychology moment
- focuses on what is desirable provides useful application in the form of goal setting which would facilitate personal growth.
How can the explanation of deviation from mental health be negatively evaluated
-lack objectivity - it isn't clearly operationalised. For example, it is not clear how one would me where environmental mastery- it therefore raises the question
- it could be argued that an accurate perception of reality differs across cultures and overtime. For example talking with an invisible person is considered normal in African culture following bereavement this is not normal in western cultures. Experiencing religious visions could be considered desirable for some groups while others may question the accuracy of perception.
What are phobias
Anxiety disorder. They are characterised by irrational fears that produce a conscience avoidance of the dreaded object or situation.
ROutline one emotion, behavioural and cognitive feature of phobias
Behavioural - avoidance - when faced with an object or situation that causes a fear the individual will try move them selfs away from the situation
Emotional-excessive and unreasonable fear that is marked and persistent
Cognitive- irrational thinking that is resistant to rational arguments
How does the behaviour approach explain and treat phobias
- believes that all behaviour is learnt so phobias are learnt.
Mowrer produced a two process model to explain the acquisition and maintenance of phobias. This model suggests that classical conditioning is involved in the a acquisition of a phobia but that the phobia is maintained though operant conditioning.
How may phobias be acquired through classical conditioning.
How may a phobia be maintained though operant conditioning
A traumatic event can lead to the association of a precipice object leading to a phobia.
Maintained- every time you see the specific object the emotional and psychological experience is refine forced
Getting sympathy from mother may reinforce this phobia.
How can social learning theory explain the acquisition of phobias
Individuals may imitate the phobias displayed by parents. The avoidance behaviour may be vicariously reinforced through observing the reduction of the parents fear or through observing them being rewarded in the form of attention or concern from others.
How does Watson and Reiner explain phobias
Little Albert classical conditioning- classical conditioned little Albert to have a phobia as they made a Big Bang behind his head.
However it doesn't explain why phobias occur in everyday life.
Who supports the two process model and how
Di Gallo- reported that 20% of people experiencing traumatic car accident develop a phobia of card, involving avoiding going places rather than making car journeys. Classical condition - neutral stimulus of the car becomes association with crashing. Void acne of getting in the car is the negative reinforcement.
What is the diathesis stress model?
Suggests we inherit a genetic vulnerability for developing mental disorders but that a disorder will only manifest itself if triggered by a life event. This can explain why some research has found that not everyone bitten by a dog develops a phobia of dogs. The behavioural explanation on its own is not enough to offer a full explanation of the development of phobias, we need combine it with the biological approach in order to account for individual differences.
How can the behavioural explanation be applied to the treatment of phobias
Through systematic desensitisation and flooding. These treatments are based on the principles of classical conditioning and their effectiveness lends credibility to a behavioural explanation of phobias .
What is an alternative explanation for phobias
- believe phobias have an adaptive value and that we are genetically programmed to learn association between potentially life threatening stimuli and fear. This explains why people develop phobias such as spiders and snakes and not card or hair straighteners as modem items were not present during the environment of evolutionary adaptation.
- behavioural explanation do not consider the cognitive processes that may contribute to the development of phobias. For example irrational thoughts such as the plane may suddenly fall from the sky can trigger anxiety. Therapies that address these irrational thoughts such as CBT have been found more effective for treating social phobias which suggest these cognitive processes much be included in a dull explanation of phobias.
What is systematic desensitisation in terms of phobias
Behavioural phobia treatment
Developed by Wolpe. Based on the principles of classical conditioning and aims to replace a faulty association between a conditioned stimulus and conditioned response . The client learns to associate feeling calm with the stimulus that have previous been associated with fear.
Main elements include relaxation, the development of the anxiety hierarchy and gradual exposure.
The therapy is based on the concept of reciprocal inhibition which states that two incompatible emotionally states cannot exists at the same time eg- anxiety and relaxation cannot exist together.
How can the effectiveness of systematic desensitisation be evaluated
Why may they be better than drugs
McGrath reported that about 75% of the patients with phobias respond to SD.
So they can become familiar with the fear having experience with coming across it for the further and knowing how to deal with it.
Tarik al kubaisy
Conducted a randomised control trail with 99 phobic patients who were allocated to three treatment groups - SD working with a therapist, self assessed SD, self administered relaxation.
Self assessed SD was just as effective with SD with a therapist - helping people to overcome a fear independently
What is flooding
Flooding is an alternative behavioural treatment that involved confronting the feared object or scenario, rather than a gradually process it goes straight to the top of the hierarchy. The individual experienced prolonged exposure to the feared object so that their anxiety peaks and then subside, they are unable to make usual avoidance
How effective is flooding
Ost found that flooding is a rapid treatment that delivers improvements especially when the patient is encouraged to continue self directed expose to feared objects and situations outside of the party sessions.
Equally effective as SD but SD is preferred by most patients.
- can cause psychological and physical harm.
General evaluation of behavioural treatments
-work best for simple phobias but are less effective for social phobias suggesting that phobias are less well explained though behavioural concepts
- focus on replacing maladaptive behaviour patterned for more adaptive behaviour. However behaviour therapies do not address underlying causes therefore the symptoms may resurface in another form, this is called symptom substitution.
What does OCD stand for
Obsessive compulsive disorder
What is OCD
And anxiety disorder where anxiety is caused by obsession and compulsions. Obsessions are irrational and persistent thoughts, compulsions are repetitive behaviours that individual perform to reduce anxiety. Therefore obsession could be described as internal symptoms well compulsion external symptoms
What are behavioural characteristics of OCD
Compulsions are behaviours that have are performed to reduce the anxiety caused by the obsession
Compulsions are repeated and excessive they do not connect in a realistic way to what they are designed to prevent or neutralise
Obsessions and compulsions disrupt the individuals ability to perform every day from functions
What are emotional characteristics of OCD
The obsessions and compulsions are a source of considerable anxiety
Individuals may feel shame or embarrassment especially if their experience sexual or religious obsessions
What are cognitive characteristics of OCD
Obsessions are recurrent, intrusive thoughts or impulses that are inappropriate and cause anxiety
Individuals experience attentional bias where their perception is focused on the anxiety generating stimuli
Individuals often engage in catastrophic thinking where they ruminate about a rational worst case scenarios
What are the Neuroanatomical explanations for OCD
People with OCD can to have increased activity in the orbitofrontal cortex this sends will be signals to the basil ganglia ( in normal individuals this will filter out the relevant information but in individuals with OCD these impulses are not inhibited )so the caudate nuclei fails to filter these this triggers the thalamus . The thalamus triggers compulsive behaviours the signals are then sent back to the orbitofrontal cortex.
Given example of OCD in the explanation of neuro anatomical
Someone with OCD may worry that they have not locked the door. These will be signals was not been blocked by the caudate nuclei so there thalamus would be stimulated and it have to import to go back and check the door was locked. The thalamus would also send a signal back to the orbitofrontal cortex which would remain double the circuit.
Name one study that supports and one study that challenges the neuroanatomical explanation for OCD
Coetzer found that orbitofrontal cortex or basil ganglia damage resulting from head injury such as Brain tumours can lead to a OCD
Menzies et al used MRI scan to study the brains of people with OCD, there unaffected first-degree relative's and a group of related healthy controls. They found reduced grey matter in regions of the brain including the orbital frontal cortex in the OCD sufferers and their relatives. This challenges the idea and suggest that there must be some environmental elements as relatives would also have OCD
What is the neurochemical explanation for OCD
OCD is believed to be associated with low levels of the newer transmitter serotonin. However there are some suggestions that serotonin acts as a neuromodulator. Therefore destruction of serotonin has a knock-on effect on regulating other neurotransmitters such as dopamine. Serotonin and these other neurotransmitters are important in the functioning of the orbitofrontal cortex and caudate nuclei.
Name one study that supports the explanation of neurochemical causing OCD
Hu- compared serotonin activity in 169 OCD sufferers and 253 nonsufferers. They found serotonin levels to be lower in the OCD patients. This supports the idea that low serotonin levels are associated with the onset of the disorder
How does the genetic explanation explain OCD
Genetic explanations suggest that OCD could be inherited through genetic transmission. Research suggests that OCD is likely to be caused from a combination of genes that determine an individual's level of vulnerability to the condition.
The COMT gene has been associated with OCD. It is involved in the production of COMT which regulates the production of the neurotransmitter dopamine. One form of the COMT gene has been found to be more common in OCD patients then without the disorder. The variation producers law activity of the COMT Gene and high levels of job.
Name one study that supports the genetic explanation of OCD
Lambert and Kingsley conducted a review of studies and found a 53% concordance rate in and monozygotic twins and a 23% dizygotic twins supporting the genetic explanation however showing that other factors must be involved
How does the biological approach treat OCD
Biological treatments are based on the idea of correcting the biological abnormality is seen as causing a OCD
Antidepressants are used to treat OCD such as SSIR's which Increases levels of serotonin and cars the Orbitofrontal cortex to function at more normal levels.
Types of antidepressants- tricyclics and fluvoxamine.
Auntie anxiety drugs are also used to reduce anxiety their work by slowing down the activity of the central nervous system by enhancing the activity of the neutral transmitter GABA
What is the effectiveness of drug therapy for treating OCD
Julien reported that studies of SSIR's sure that our symptoms do not fully disappear, 50 to 80% of OCD patients improve allowing them to live a fairly normal life.
Why me a joke there a better not be appropriate for all OCD sufferers
Children may not be old enough to take the drugs
Evaluate drug therapy
- cheaper to administer than psychological therapies.
-Koran et al said that CBT should be used first as its a more lasting cure.