What is statistical infrequency?
- Abnormality in terms of statistics/numerically rare.
- Rarely seen behaviour/characteristics are abnormal.
What’s an example of a statistically infrequent characteristic?
An IQ of below 70 or above 130.
What’s a positive evaluation of statistical infrequency?
Real life application: most assessment of mental disorders is compared with statistics, intellectual disability disorder.
Give negative evaluations of statistical infrequency
1) Unusual characteristics can be positive: abnormal but not requiring of treatment, desirable perhaps? e.g. IQ over 130.
2) Not everyone benefits from a label: if someone is living a normal life –> is a negative label needed?
What is deviation from social norms?
- Behaving in a way that is different from the expected way.
- Relatively few behaviours are universally abnormal.
-Some are accepted not but weren’t in the past, culturally dependent.
E.g. Anti-Social Personality Disorder
Evaluate deviation from social norms
1) Social norms culturally relative :( : can’t compare normality across cultures due to differing standards.
2) Could lead to human right abuses? E.g. Drapetomania - black slaves trying to escape is a form of social control.
How does Deviation from Ideal Mental Health differ from all other outlooks of abnormality?
It looks at what makes us normal as opposed to characteristics which make us abnormal.
Who came up with Deviation from Ideal Mental Health?
Give as many of the criteria for Deviation from Ideal Mental Health as possible
1) No symptoms/distress.
4) Cope with stress
5) Realistic view of the world
6) Good self-esteem
8) Successfully work
Evaluate Deviation from Ideal Mental Health
1) Culturally relative?: self-actualisation may be considered self-indulgent in collectivist cultures
2) Unrealistically high standards: few people can meet all criteria –> but it does show how to improve health
What is Failure to Function adequately?
Inability to cope with everyday living, e.g. not maintaining a relationship or holding down a job.
Who came up with Failure to Function adequately?
Rosenhan and Seligman (1989)
Give some criteria for Failure to Function adequately
- No longer conform to interpersonal rules (personal space).
- Experience personal distress.
- Behave irrationally or dangerously.
Evaluate Failure to Function adequately
1) Hard to explicitly see sometimes: Failure to Function adequately or Deviation from social norms? e.g. extreme sports seen as behaving maladaptively?
2) Subjective: distressed but not suffering? Objective by ‘Global Assessment of Functioning Scale’
Give 2 behavioural characteristics of Phobias
1) Panic - e.g. crying, running away from phobic stimulus.
2) Avoidance - of stimulus, affecting everyday living.
Give 2 emotional characteristics of Phobias
1) Anxiety + fear - one leads to the other.
2) Unreasonable responses - e.g. crying to tiny spider
Give 2 cognitive characteristic of Phobias
1) Selective attention to phobic stimulus - hard to look away from stimulus.
2) Irrational beliefs.
Give 2 behavioural characteristic of depression
1) Activity levels - decline –> lethargic, in extreme cases can’t get out of bed.
2) Disruption to sleep and eating behaviour - increase/decline
Give 2 emotional characteristic of depression
1) Lowered mood - worthless or empty.
2) Anger –> aggression or self-harming.
Give 2 cognitive characteristic of depression
1) Poor concentration.
2) Absolutist thinking - unfortunate situation = absolute disaster
Give 2 behavioural characteristic of OCD
1) Compulsions - action carried out repeatedly; ritualistic.
2) Avoidance - of situation that triggers anxiety.
Give 2 emotional characteristic of OCD
1) Anxiety and distress - of unpleasant thoughts and anxiety that comes with it can be overwhelming.
2) Guilt or disgust.
Give 2 cognitive characteristic of OCD
1) Obsessive thoughts - of fear.
2) Insight into excessive anxiety - aware of irrationality, sufferers become overaware of their obsession
What is the name for the behavioural approach to explaining phobias, and who came up with it?
Classical conditioning is also known as learning by ____ ?
Learning by association
Explain the process of acquiring a phobia
1) UCS (being bitten) –> UCR (anxiety)
2) NS (dog) –> No response
3) UCS (being bitten) + NS (dog) –> UCR (anxiety)
4) CS (dog) –> CR (anxiety)
How is the phobia maintained?
By operant conditioning.
What is operant conditioning?
Reinforcing or punishing of particular behaviours.
What type of reinforcement maintains operant conditioning?
- Avoiding behaviour that avoids something unpleasant.
- Reduction in fear from avoiding –> maintained.
Whats an evaluative strength of the two-process model?
Good explanatory power:
- important implications for therapy.
- if they can’t avoid, phobic behaviour declines.
- REAL-LIFE application
Give evaluative limitations of the two-process model?
1) Incomplete explanation:
- easily acquire some phobias that are considered dangerous, e.g. snakes
- biological preparedness = innately prepared to fear some things more than others (Seligman, 1971)
2) DiNardo et al. (1988) not all bad experiences, e.g. being bitten by a dog, lead to phobias being developed. Pre-exisiting vulnerability?
3) Doesn’t consider cognitive aspects:
- explains behaviour but not thoughts about it
- e.g. irrational beliefs
Describe Systematic Desensitisation (SD)
- Aims to gradually reduce anxiety through counter-conditioning; phobia paired with relaxation.
- Formation of anxiety hierarchy: least –> most frightening.
- Relaxation practiced at each level of hierarchy, progress up when successfully relaxed.
What is reciprocal inhibition?
The inability to feel two emotions at the same time, in this case relaxation and anxiety.
Give 2 positive evaluations for Systematic Desensitisation
- Gilroy et al. (2003) followed up 42 patients who had SD for arachnophobia: less fearful than control groups after 3 and 33 months.
2) Suitable for diverse range:
- Alternatives may not be suitable for people with learning difficulties, who may think ‘what’s going on?’
What is flooding?
- Immediate exposure to phobic stimulus
- Patient learn phobia is harmless through exhaustion of their own fear response = extinction.
1) Less effective for some phobias::
e. g. social phobias that may have cognitive aspects like unpleasant thoughts = CBT better?
2) Traumatic for patients:
- not unethical as patients are unwilling to carry on.
- Rate of Attrition high.
- = ineffective, time and money wasted
What is Beck’s cognitive theory of depression? (Without negative triad)
- People are more prone to depression due to faulty information processing i.e. flawed thinking.
- Depressed people have negative self-schemas i.e. interpreting all information about themselves in a negative way
What is the negative triad?
1) Negative views about the world.
2) Negative views about the future.
3) Negative views about the self.
Give 2 evaluative strengths of Beck’s cognitive theory of depression
1) Good supporting evidence:
- Grazioli and Terry (2000) - assessed 65 pregnant women for cognitive vulnerability and depression pre and post natal.
= high in cognitive vulnerability = more likely to suffer post-natal depression –> cognitions before depression.
2) Practical applications in CBT:
- forms basis of it, components of negative triad identified and challenged to see if they’re true or not.
Give 1 evaluative limitation of Beck’s cognitive theory of depression
1) Doesn’t explain all aspects: e.g. extreme anger.
- Jarrett (2013) some suffer delusions, hallucinations or even Cotard Syndrome: belief that one is a zombie.
Describe Ellis’ ABC model
A - activating event; experience of negative events, e.g. losing a job.
A –> B
B- beliefs; how we view the event afterwards, e.g. if you believe you must always succeed, failure is catastrophic.
B –> C
C - consequences; emotional and behavioural.
E.g. if you believe in always in succeeding, and failure happens, along with how you deal with it = depression.
Give 2 evaluative negative of Ellis’ cognitive theory of depression
1) Partial explanation:
- not all cases arise from an event.
- ‘reactive depression’ that arises without an obvious cause.
2) Cognitions may not cause all aspects of depression:
- cognitive primacy: emotions influenced by thoughts.
- some see depression emotions, such as anxiety, as a type of stored energy that’ll emerge at some event.
What is Beck’s contribution to CBT?
- Patient and therapist work together to identify any negative thoughts that’ll benefit from being challenged. (in relation to negative triad).
- Patients as ‘scientists;
= testing the relating of irrational beliefs, e.g. recording events where someone is nice to you.
= if negative views in the future –> prevent evidence.
What is Ellis’ contribution to CBT?
Ellis’ ‘Rational Emotional Behaviour Therapy’ (REBT): extending ABC model to ABCDE model.
D - dispute irrational beliefs.
E - effect.
How would Ellis challenge irrational beliefs?
1) Empirical argument - evidence to support irrational beliefs.
2) Logical argument - whether negative thoughts follow from facts
Describe evidence that indicates CBT is effective?
March et al. (2007) compared effects of (1) CBT (2) Anti-depressants (3) combination of both.
- After 36 weeks.
= the same, or combo is an improvement –> useful?
Give limitations of CBT
1) May not work for severe cases:
- patients may not be motivated to take part in hard work of CBT = antidepressants first to alleviate symptoms.
2) Success due to patient-therapist relationship: - Rosenzweig (1936) - differences between the methods of psychotherapy little.
- Luborksy et al. (2002) supports this.
- Quality of it = success to get better increases
3) Overemphasis on cognition?:
- could be circumstances in which find themselves in e.g. poverty –> hard to change.
What is a candidate gene? (Genetic explanations of OCD)
A specific gene that vulnerability for a condition; in this case of OCD, especially on the dopamine and serotonin systems which regulate mood.
Who said OCD is polygenic? (Genetic explanations of OCD)
Taylor (2013) and he found 230 different genes.
What does aetiologically heterogenous mean? (Genetic explanations of OCD)
(Different types of OCD)
- One group of genes may cause OCD in one person, and another group of genes in another.
What is supporting evidence for genetic explanations of OCD?
Nestadt et al. (2010)
- twin studies.
- found a concordance rate of 68% in MZ twins as opposed to 31% in DZ twins.
Give 2 evaluative limitations of genetic explanations of OCD
1) Too many genes identified:
- can’t precisely pin down genes involves, and each one only increase risk slightly = little predictive value.
2) Environmental risk factors involved:
- Cromer et al. (2007) - found that over 1/2 of the patients in their sample had suffered a traumatic event in their past.
= OCD more severe with trauma
What are neurotransmitters? (Neural explanations of OCD)
Neurotransmitters are responsible for relaying info from one neuron to another, e.g. low levels of serotonin lowers mood and shows fault in transmission.
What examples of OCD can be explained by impaired decision making?
What part of the brain is dysfunctional in OCD, and what does it do?
Left parahippocampal gyrus, responsible for unpleasant thoughts
What is the supporting evidence for neural explanations of OCD?
- Antidepressants working on serotonin system reduced OCD symptoms
- Nestasdt et al. (2010) OCD symptoms form part of biological conditions such as Parkinson’s.
Give an evaluative negative of the neural explanation for OCD
Is the Serotonin-OCD link unique to OCD?
- many people who suffer OCD are also depressed; co-morbidity.
- could be that the serotonin system is disrupted because OCD sufferers are depressed
How do drugs affect neurotransmitters?
- Increase/decrease levels
- Increase/decrease their activity
What do SSRIs do?
Prevent the reabsorption and breakdown of serotonin in the brain; increasing levels in the synapse, stimulating post-synaptic neuron.
What does combining SSRIs with CBT achieve?
Reduces emotional symptoms so one can participate in CBT.
What are the two alternatives to SSRIs?
1) Tricyclics - older type, same effect on serotonin system as SSRIs but more severe side effects.
2) SNRIs - increase levels of noradrenaline and serotonin
= BOTH ARE SECOND LINE OF DEFENCE.
Give 2 evaluative strengths of the biological treatment for OCD
1) Drug therapy is effective:
- Soomro et al. (2009) found significantly better results when comparing SSRIs to placebos in 17 studies.
- CBT + drugs = most effective.
2) Drugs cost-effective and non-disruptive:
- cheap compared to psychological treatments, which is good for the NHS.
- can continue life normally.
What are some of the side effects of drug treatment, give statistics too if necessary.
- No benefits.
- Indigestion problems, blurred vision.
- Those taking a form of tryclic suffer weight gain; around 1/10.
Give 2 evaluative negatives, apart from side effects, of biological treatments of OCD.
1) Evidence unreliable:
- controversy attached.
- Goldacre (2013) would say evidence favouring drugs is bias as not all evidence is reported = all about profit.
2) Some cases follow trauma:
- drugs may not be best appropriate with severe emotional issues of trauma
- psychological treatment best option first?