Psychopathology (P1) Flashcards

Question

What are emotional characteristics of depression? | Depression

Answer 1

1. Lowered mood 2. Anger 3. Lowered self-esteem ## Footnote **1. Lowered mood** * more pronouned than in daily experience of feeling lethargic and sad * Often describe themselves as worthless and empty **2. Anger** * Can frequently experience anger/extreme anger * Directed at self or others * Emotion can lead to aggressive or self-harming behaviour **3. Lowered self-esteem** * Emotional experience of how much we like ourselves * Depression = likes themselves less than others * Can be extreme and described as self-loathing

Answer 2

1. Poor concentration 2. Attending to and dwelling on the negative 3. Absolutist thinking ## Footnote **1. Poor concentration** * Unable to stick with a task they usually would * Hard to make decisions they would normally find straightfoward * Intereferes with daily lfie **2. Attending to and dwelling on the negative** * Pay more attention to negative aspects of a situation and ignore the positives * Bias towards recalling unhappy events rather than happy ones **3. Absolutist thinking** * Black and white thinking * When a situation is unfortunate tend to be seen as an absolute disaster

Answer 3

Obsessive Compulsive Disorder is a condition characterised by obsessions and/or compulsive behaviour ## Footnote Obsessions = cognitive Compulsions = behavioural

Answer 4

1. Compulsions are repetitive 2. Compulsions reduce anxiety 3. Avoidance ## Footnote **1. Compulsions are repetitive** * Compelled to repeat a behaviour * Examples = counting, handwashing etc **2. Compulsions reduce anxiety** * 10% of OCD people show compulsive behaviour alone * Compulsive behaviours are performed in an attempt to manage the anxiety produced by obsessions **3. Avoidance** * Avoidance as they attempt to reduce anxiety by staying away from situations that trigger it

Answer 5

1. Anxiety and distress 2. Accompanying depression 3. Guilt and disgust ## Footnote **1. Anxiety and distress** * powerful anxiety accompanies obsessions and compulsions * Obsessive thoughts are unpleasant and increase anxiety * Urge to repeat a behaviour (compulsion) creates anxiety **2. Accompanying depression** * Accompanied by low mood and lack of enjoyment in activities **3. Guilt and disgust** * Irrational guilt e.g. over minor moral issues * Disgust may be direct against something external like dirt or at the self

Answer 6

1. Obsessive thoughts 2. Cognitive coping strategies 3. Insight into excessive anxiety ## Footnote 1. Obsessive thoughts * 90% of people with OCD the major cognitive feature of their condition is obsessive thoughts * Vary from person to person but always unpleasant 2. Cognitive coping strategies * To deal with obsessions * May help manage anxiety * May distract from everyday tasks * May make the person appear abnormal to others 3. Insight into excessive anxiety * Aware their obsessions and compulsions aren't rational * People with OCD experience catostrophic thoughts about worst case scenarios that may result if their anxieties were justified * Tend to be hypervigilant

Answer 7

The two-process model

Answer 8

* Acquisition by classical conditioning * Maintenance by operant conditioning

Answer 9

* Operant conditioning takes place when behaviour is reinforced or punished * Reinforcement tends to increase frequency of a behaviour (true for both negative and positive reinforcement) * Negative reinfocement - avoiding a phobic stimulus results in a desirable consequency (avoiding anxiety). Reduction in fear reinforcces the avoidance of behaviour and so the phobia is maintained

Answer 10

1. Real-world application 2. Phobia and traumatic experiences ## Footnote 1. Real-world application * Exposure therapies (e.g. systematic desensitisation) * Idea that phobias are maintained by avoidance of the phobic stimulus is important in explaining why people with phobais benefit from being exposed to the phobic stimulus * Once avoidance behaviour is prevented it ceases to be reinforced by experience of anxiety reduction and avoidance declines * Valuable, identifies a means of treating phobias 2. Phobias and traumatic experiences * Little albert study COUNTERPOINT * Not all phobias appear after experiencing a bad experience * Not all frightening experiences lead to phobias * Limited explanation

Answer 11

* Cognitive aspects of phobias ## Footnote * Doesn't account for cognitive aspects of phobias * Explain behaviour * Phobias the key behaviour is avoidance of the phobic stimulus * However we know that phobias aren't simply avoidance resonses - they also have a significant cognitive component * Does not offer an adequate explanation for phobic cognitions * Doesn't fully explain symptoms of phobias

Answer 12

A behavioural therapy designed to reduce an unwanted response e.g. anxiety. Involves drawing up a hierarchy of anxiety provoking situations related to a person's phobic stimulus, teaching the person to relax and then exposing them to phobic situations. The person works through the hierarchy whilst maintaining relaxation

Answer 13

1. Evidence of effectiveness 2. People with learning disabilites ## Footnote 1. Gilroy et al (2003) * Followed up 42 people who had SD for spider phobia in 3 5-minute sessions * At 3 and 33 monthss the SD group were less fearful than a control group treated by relaxation without exposure * SD is likely to be helpful for people with phobias 2. Learning disabilites * Can be used to treat those with learning disabilities * Main alternatives to SD not suitable * Often struggle with cognitive therapies that require a high level of rational thought * Flooding may make them feel confused and distressed * SD is most appropiate for treating those with learning disabilites and phobias

Answer 14

Flooding is quicker and cheaper

Answer 15

A behavioural therapy in which a person with a phobia is exposed to an extreme form of a phobic stimulus in order to reduce anxiety triggered by that stimulus. Takes place across a small number of long therapy sessions

Answer 16

* Stops phobic responses quickly * Without option of avoidance behaviour client learns phobic stimulus is harmless * Process is called extinction * A learned response is extuingished when the conditioned stimulus (dog) is ecountered without the unconditional stimuls (being bitten) resuling in conditioned stimulus no longer producing conditioned response (fear) * Client may achieve relaxation in presence of phobic stimulus due to exhaustion from fear response ## Footnote It is not unethical as it is not done until informed consent is collected from the client

Answer 17

Highly cost-effective ## Footnote * Cost-effective as it is clinically effective and not expensive * Flooding can work in 1 session whereas SD may take 10 sessions for the same results * More can people treated at the same cost with flooding than with other therapies

Answer 18

Traumatic ## Footnote * Highly unpleasant experience * Confronting a phobic stimulus in an extreme form provokes tremendous anxiety * Schumacher et al (2015) found that participants and therapists rated flooding as significantly more stressful than SD * Ethical issues of knowingly causing stress to clients although they obtain informed consent * Traumatic nature meants that attrition (dropout) rates are higher than for SD * Overall therapists may avoid this treatment

Answer 19

* Faulty information processing * Negative self-schema * The negative triad

Answer 20

* Depressed people attend to negative aspects of a situation * Ignore positives * Absolutist thinking

Answer 21

* Schema is a package of ideas and information developed through experience * Act as a mental framework for the interpretation of sensory information * Self-schema is package of information about themselves * If a person has a negative self-chema they interpret all information about themselves negatively

Answer 22

* Person develops dysfunctional view of themselves because of 3 types of negative thinking that occur automatically 1. Negative view of the world - Creates impression is no hope anywhere 2. Negative view of the future - Thoughts reduce any hopefulness and enhance depression 3. Negative view of the self - Thoughts enhance any existing depressive feeling as they confirm existing emotions of low self-esteem

Answer 23

1. Research support 2. Real-world application ## Footnote **1. Clark and Beck (1999)** * Review concluded that not only were these cognitive vulnerabilities more common in depressed people but they preceed the depression **Cohen et al (2019)** * Prospective study * Tracked the development of 473 adolescents regularly measuring cogntive vulnerability * Found that showing cognitive vulnerability predicted later depression * Association between cognitive vulnerability and depression 2 . Applications in screening and treatment of depression * Cohen et al * Concluded that assessing cognitive vulnerability allows psychologists to screen young people identifiying those most at risk of developing depression in the future and monitoring them * Understanding cognitive vulnerability can be applied in CBT * Therapies work by altering the kinds of cognitions that make people vulnerable to depression making them more resilient to negative life events * Understanding of cognitive vulnerability useful in clinical practices

Answer 24

A partial explanation ## Footnote * Doesn't explain why some may experience hallucinations or delusions

Answer 25

* Activating event - Get depressed when experience negative events and these trigger irrational beliefs * Beliefs - Range of irrational beliefs. Musturbationn (must always achieve perfection), Utopianism (life is always meant to be fair) * Consequences - When an activating event triggers irrational beliefs there are emotional and behavioural consequences

Answer 26

Real-world application ## Footnote * Psychological treatment of depression * Ellis' approach to cognitive therapy is called Rational Emotive Behaviour Therapy * By vigorously arguing with a depressed person the therapist can alter the irrational beliefs that are making them unhappy * Some evidence to support the idea that REBT can change negative beliefs and relieve symptoms of depression (David et al 2018)

Answer 27

Reactive and endogenous depression ## Footnote * Only explains reactive depression and not endogenous * Many cases of depression are not traceable to life events and it is not obvious what leads the person to become depressed at that particular time * ABC model less useful for explaining endogenous depression * ABC model can only explain some cases of depression * Partial explanation

Answer 28

A method for treating mental disorders based on cognitive and behavioural techniques. Therapy aims to deal with thinking e.g. challenging negative thoughts. Also includes behavioural techniques such as behavioural activation ## Footnote * Most commonly used for treatment of depression

Answer 29

* Begins with an assessment where the client and therapist work together to clarify issues * Jointly identiy goals and put together a plan to achieve them * One of the central tasks is to identify where there might be an irrational thought that will benefit from challenge

Answer 30

* Involves working to change negative and irrational thoughts * Put more effective behaviours into place

Answer 31

* Identify automatic thoughts about the negative triad and challenge them * Helps client test the reality of their negative beliefs * Client may be set homework referres to as the client as scientist investigating the reality of their negative beliefs like a scientist * Homework can be used as evidence to challenge irrational negative beliefs

Answer 32

* ABCDE model * D - Dispute * E - Effect * identify and dispute irrational thoughts * Intended effect is to change the irrational belief so break the link between negative life events and depression * Ellis identified different methods of disputing such as empircal argument (involves disputing whether there is evident to support the negative belief), Logical argument (involves disputing whether the negative thought logically follows from facts)

Answer 33

* When depressed they tend to increasingly avoid difficult situations and become isolated which worsens/maintains symptoms * Goal of behavioural activation is to work with depressed people to gradually decrease their avoidance and isolation and increase their engagement in activies that have been shown to improve mood e.g. exercise * Aims to reinforce such activity

Answer 34

Evidence of effectiveness ## Footnote March et al (2007) * Compared CBT to antidepressant drugs and a combination of both when treating 327 participants * After 36 weeks 81% of CBT group, 81% of antidepressant group and 86% of combined group were significantly improved * CBT was just as effective when used on its own and more so when combined with antidepressants * Farily brief therapy (10-12 sessions) so cost-effective * CBT widely seen as first choice of treatment in public healthcare systems

Answer 35

1. Suitability for diverse clients 2. Relapse rates ## Footnote 1. Suitability * In some cases depression can be so sevre that clients cannot motivate themselves to engage with CBT * May not be able to pay attention to what is happening in a session * Likely hard cognitive work in CBT makes it unsuitable for treating those with lerning disabilites * **Sturmy (2005)** - any form of psychotherapy is not suitable for those with learning disabilites * CBT only suitable for a specific range of people with disabilites COUNTERPOINT * **Lewis and Lewis (2016)** * Their review concluded that CBT was as effective as antidepressant drugs and behavioural therapies for severe depression * **Taylor et al (2008)'s** review concluded that when used appropiately CBT is effective for those with learning disabilities 2. Relapse rates * CBT has high relapse rates * CBT is quite effective but there is concerns over how long benefits last * Relatively few early studies of CBT for depression looking at long-term effectiveness * **Shehzad Ali et al (2017)** assessed depression in 439 clients every month for 12 months following a course of CBT. 42% of clients relapsed in 6 months of ending treatment and 53% within a year * CBT needs to be repeated periodically

Answer 36

Genes make up chromosones and consist of DNA which codes the physical features of an organism (such as eye colour, height) and psychological features (e.g. mental disorder, intelligence). Genes are transmitted from parents to offspring i.e. inherited

Answer 37

* Genes which create vulnerability for OCD * Some of these are involved in regulating the development if the serotonin system * Gene 5HT1-D beta is implicated in the transport of serotonin across synapses

Answer 38

* OCD is caused by a combination of genetic variations that together significantly increase vulnerability * Taylor et al analyed findings of previous studies and found that up to 230 different genes may be involved in OCD * Genes include those associated with action of dopamine as well as serotonin both neurotransmitters believed to have a role in regulating mood

Answer 39

* One group of genes may cause OCD in one person byt a different group of genes may cause OCD in another person * Term to describe this is aetiologically heterogenous meaning that the origins (ertiology) of OCD vary from one person to another (heterogenous) * Some evidence suggest different genetic variations may cause different types of OCD

Answer 40

Research support ## Footnote Nestadt et al (2010) * Reviewd twin studies * Found 68% of monozygotic twins shared OCD as oppossed to 31% of dizygotic twins Marini and Stebnicki (2012) * Found that a person with a family member diagnosed with OCD is around 4x more likely to develop it as someone without * Genetic influence on development of OCD is demonstrated

Answer 41

Environmental risk factors ## Footnote * There are environmental risk factors * Strong evidnce for idea that genetic variation can make a person more/less vulnerable to OCD however it seems that environmental risk factors can also trigger or increase the risk of developing OCD * Cromer et al (2007) found over half the OCD clients in their sample had experienced a traumatic event * OCD was also more severe in those with 1+ traumas * Genetic vulnerability only provides partial explanation

Answer 42

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 43

* Neurotransmitter serotonin is believed to help regulate mood * Neurotransmitters are responsible for relaying information from one neuron to another * Low levels of serotonin means normal transmission of mood-relevant information doesn't take place aand a person may experience low moods (other mental processes may be affected) * Some cases of OCD may be explained by a reduction in functioning of serotonin system in the brain

Answer 44

* Some cases of OCD (especially hoarding disorder) seem to be associated with impaired decision making * May be associated with abnormal functioning of the lateral of the frontal lobes of the brain * Frontal lobes responsbile for logical thinking and making decisions * Parahippocampal gyrus associated with processig unpleasant emotions functions abnormally in OCD

Answer 45

Research support ## Footnote * Antidepressants that work purely on serotonin are effective in reducing OCD symptoms and this suggests serotonin may be involved in OCD * OCD symptoms form part of condtions that are known to be biological in origin such as degenerative brain disorder, Parkinson's disease which causes muscle tremours and paralysis (Nestadt et al) * If a biological disoder produces OCD symptoms we may assume biological processes underlie OCD * Biological factors may be responsible for OCD

Answer 46

No unique nerual system ## Footnote * Serotonin-OCD link may not be unique to OCD * Many people with OCD also experience clinical depression (co-morbidity) * This depression likely involves disruption to the action of serotonin * Could be that serotonin is disrupted in people with OCD as they are also depressed * Serotonin may not be relevant to OCD symptoms

Answer 47

Treatment involving drugs i.e. chemicals that have a particular effect on the functioning of a body system. In context of psychological disorders such drugs usually affect neurotransmitter levels

Answer 48

* Antidepressant * Selective Serotonin Reuptake Inhibitor * Serotonin is released by certain neurons in the brain * Released by presynapic neuron and travels across a synapse * Neurotransmitter chemically conveys the signal from the presynaptic neuron where it is broken down and reused * By preventing reabsorption and breakdwon SSRIs effectively increase levels of serotonin in the synape and continue to stimulate the postsynaptic neruon ## Footnote * Available as capsules or liquid * 3-4 months of daily use for SSRIs h=ti have an impact on symptoms

Answer 49

20mg ## Footnote * SSRI

Answer 50

* Often used alongside Cognitive Behaviour Therapy to treat OCD * Drugs reduce a person's emotional symptoms e.g. feeling anxious or depressed * People with OCD can engage more effectively with the CBT * Occasionally other drugs are prescibed alongside SSRIs ## Footnote * In practice some respond best to CBt whole others benefit more when additionally usind drugs e.g. fluoxetine

Answer 51

* Tricylics * SNRIs

Answer 52

* Older type of antidepressant * Example, clomipramine * Acts on avrious systems including serotonin system where it has same effect as SSRIs * Clomipramine has more severe side-effects than SSRIS * Genuinely kept in reserve for those who don't respond to SSRIs

Answer 53

* Serotonin-Noradrenaline Reuptake Inhibitors * More recently used to treat OCD * Reserve for those who don't respond to SSRIs * SNRIs increase levels of serotonin as wel as noradrenaline

Answer 54

1. Evidence of effectiveness 2. Cost-effective and non-disruptive ## Footnote 1. Soomro et al (2009) * Reviewed 17 studies that compared SSRIs to placebos in the treatment of OCD * All studies showed significantly better outcomes for SSRIs than for placebo conditions * Typically symptoms reduce for around 70% of people taking SSRIs * Remaining 30% most can be helped by other alternative drugs or combinations of drugs and psychological therapies * Drugs appear to be helpful for most people with OCD COUNTERPOINT * Evidence suggests that even if drug treatments are helpful for most people with OCD they may not be the most effective treatments available * Skapinakis et al (2016) carried out a systematic review of outcome studies and concluded both cognitive and behavioural (exposure) therapies were more effective than SSRIs in treatment of OCD 2. Cost-effective and non-disruptive * Drug treatments in general are cheap compared to psychological treatments became many thousands of tablets or liquid doses can be manufactured in the time it takes to conduct a session of psychological therapy * Using drugs is good value for public health systems and is a good use of limited funds * Non-disruptive to people's lives as psychological therapy involves time spent in sessions

Answer 55

Serious side-effects ## Footnote * Drugs can have potentially serious side-effects * A small minority will get no benefit * Some may experience side-effects e.g. indigestion, blurred vision * Usually temporary * Can be distressing for minority that are long-lasting * For those taking tricyclic clomipramine side effects are more common and serious. More than 1 in 10 people experience weight gain. 1 in 100 become more aggressive and have heart problems * Some have reduced quality of life as a result of taking drugs * May stop taking altogether reducing effectiveness

Psychopathology (P1) Flashcards

(79 cards)