Psychopathology - Paper 1

Question 1

What is psychopathology?

Answer 1

Refers to either study of mental illnesses or mental distress or manifestation of behaviours and experiences which may be indicative of mental illness or psychological impairment
Concerned with abnormal behaviour
Seeks to define what makes a behaviour abnormal

Question 2

What is statistical infrequency?

Answer 2

Abnormal behaviours are those that are extremely rare, mathematical method for defining abnormality
Human attributes fall into normal distribution within population (bell shaped curve)
Standard deviations inform us how far scores fall on either side from the mean
EXAMPLE
IQ - 68% of population fall within one standard deviation from mean
95% fall within two standard deviations from the mean
Definition states that 5% of population which fall more than two standard deviations from the mean are abnormal
People who scored below 70 and above 130 are abnormal

Question 3

What are deviations from social norms?

Answer 3

Abnormality is when a behaviour doesn’t fit within what is socially acceptable
Dependent on the culture in which the behaviour occurs, what is abnormal in one culture is not defined as abnormal in another
Norm must be deeply embedded into culture for deviations to be seen as abnormal, slight deviations such as changing hair colour may not be seen as abnormal if norm isn’t important to society
EXAMPLES - queuing in a shop, being polite, not laughing at a funeral
Some are also policed by laws such as paedophilia

Question 4

What is failure to function adequately?

Answer 4

When an individual is not able to cope with everyday life, they have the basic inability to manage in everyday life - behaviour is seen as abnormal
Defined by Rosenhan and Seligman into 7 sections - unpredictability, maladaptive behaviour, personal distress, irrationality, observer discomfort, violation of moral standards and unconventionality.
GAF method of measuring this, included 7 sections by Rosenhan and Seligman plus occupational functioning
Schizophrenia defined as abnormal because behaviours are distressing to others even if they’re not personally distressing
However, this definition would not be made if someone with very low IQ on its own. Must have very low IQ which prevents them from daily functioning to be defined as this

Question 5

What is deviation from ideal mental health?

Answer 5

Abnormality defined as deviating from an ideal positive mental health, defined by Jahoda’s criteria of ideal mental health
Absence of criteria indicates abnormality and potential mental disorder
If some are not fulfilled the person would experience difficulties
1. Positive attitude towards self - level of self esteem
2. Self-actualisation - state of contentment, become the best you can be
3. Autonomy - independence and self reliance, function as individual and not depend on others (doesn’t include physical disabilities)
4. Resistance to stress - shouldn’t feel stressed, handle stressful situations competently
5. Environmental mastery - can adapt to new situations and be at ease in all situations in life
6. Accurate perception of reality - should have similar perspective to others, distorted thinking of some people

Question 6

What is a strength of statistical infrequency? Real life application in clinical assessment

Answer 6

Real life application to diagnosis of intellectual disability disorder
Therefore a place for statistical deviation in thinking about what are normal and abnormal behaviours and characteristics
All assessments of patients with mental disorders include some kind of measurement of how severe their symptoms are compared to statistical norms
Useful part of clinical assessment

Question 7

What is a limitation of statistical infrequency? Some abnormal behaviour is desirable

Answer 7

Some abnormal behaviour is desirable
Very few people have IQ over 150 however a lot of people would be liked to be classed as a genius
Definition doesn’t distinguish between desirable and undesirable behaviour
We need a way of identifying behaviours that are both infrequent and undesirable

Question 8

What is a limitation of statistical infrequency? Subjectively determined

Answer 8

The cut off points are subjectively determined
People disagree on what constitutes an abnormal lack of sleep
This is a symptom of depression therefore its important to know where the cut off point lies for there to be a diagnosis to be made
Disagreements about cut off points make it difficult to define abnormality in terms of statistical infrequency

Question 9

What is a limitation of statistical infrequency? Can cause distress, negative view on self

Answer 9

Not everyone unusual benefits from a label
Where someone is living a happy fulfilled life, no benefit from being labelled as abnormal no matter how unusual they are
Someone with low IQ may not be distressed and be capable of working however labelling them with ‘intellectual disability disorder’ would not benefit them
Labelling a person using this definition could have negative self effect on their self view and the way others view them

Question 10

What is a strength of deviation from social norms? Includes issues of desirability of behaviours

Answer 10

Includes those issues
Being a genius is statistically abnormal but we don’t include that in this definition of abnormal behaviour
Narcissism was once viewed as a deviation from social norms however now selfies are a common place
Means that social norms are more useful that other definitions such as statistical norms

Question 11

What is a limitation of deviation from social norms? Social norms vary all the time

Answer 11

Social norms vary all the time
Homosexuality was considered a mental disorder in DSM, it is now considered to be socially acceptable
Definition is based on prevailing social morals and attitudes about what is deemed to be ‘normal’ and ‘abnormal’
Too much reliance on such definitions could lead to systematic abuse of human rights because of attitudes people hold

Question 12

What is a limitation of deviation from social norms? Social norms vary depending on the behaviour’s context

Answer 12

Deviance is related to a behaviour’s context
Eg - wearing few clothes on a beach is normal but abnormal at a formal gathering
Sometimes theres no clear line between abnormal deviation and harmless eccentricity (slightly strange)
Social deviance on its own cannot offer a complete definition of abnormality

Question 13

What is a limitation of deviation from social norms? Cultural differences

Answer 13

Behaviours vary from one community to another
Person from one cultural group may label someone as abnormal from another cultural group based on their own views and standards of ‘normal’ behaviour
Hearing voices is not seen as abnormal in all cultures
Can be problematic to use social norms to define abnormality when diagnosing those from other cultures
Abnormality is culturally relative

Question 14

What is a strength of failure to function adequately? Includes subjective experience of individual and the people around them

Answer 14

Does attempt to include subjective experience of the individual
Acknowledges that experience of individual and people around them is important
Definition captures experience of many people who need help
Useful criterion for assessing abnormality

Question 15

What is a limitation of failure to function adequately? Some abnormal behaviours can be functional

Answer 15

Some apparently abnormal behaviours can be functional
Depression may lead to extra attention for an individual, attention is rewarding and therefore functional even if regarded as abnormal
Incomplete definition as fails to distinguish between behaviours that are dysfunctional and those that have some function for the individual

Question 16

What is a limitation of failure to function adequately? Judgment depends on person diagnosing, can be subjective

Answer 16

Someone needs to decide whether this is actually the case
Sometimes people experience personal distress and recognise their behaviour as undesirable, some may be content with their behaviour and others may be distressed by it
Whether a behaviour is defined as abnormal depends on who is making judgement which may be subjective

Question 17

What is a limitation of failure to function adequately? Limits personal freedom

Answer 17

Hard to say when someone is failing to function adequately or if they’re deviating from social norms
People may think not having a permanent address or job is a sign of failure to function adequately but what can we say about people with alternative lifestyles who choose not to have those things?
Those who practice extreme sports could be accused of being in a maladaptive way, or those with religious or supernatural beliefs could be seen as irrational
If these behaviours are treated as “failures” of adequate functioning, we risk limiting personal freedom and discriminating against minority groups

Question 18

What is a strength of deviation from ideal mental health? Comprehensive definition

Answer 18

Comprehensive definition
Covers a broad range of criteria for mental health, may cover most of the reasons someone would seek help from mental health services or be referred help
Range if factors discussed in Jahoda’s mental health definition make it a good tool for thinking about mental health

Question 19

What is a limitation for deviation from mental health? Cultural differences

Answer 19

Specific to Western European and north Mercian cultures, based on western cultures’ ideals and beliefs
Applying them to non-western members of culture would be inappropriate
Concept of self-actualisation may seem indulgent in many areas around the world
Criteria can only be applied within individualist cultures
Makes findings hard to generalise to the rest of the world

Question 20

What is a limitation of deviation from mental health? Unrealistic, not everyone reaches every point

Answer 20

Criteria are unrealistic
Few people satisfy all criteria all of the time
Everyone would be described as abnormal to a degree
Need to ask how many of Jahoda’s criteria must be absent before someone is judged as abnormal

Question 21

What is a limitation of deviation from mental health? Mental and physical health are not the same

Answer 21

Suggests mental health is the same as physical health
Generally, physical illnesses have physical causes so easy to diagnose, however not all mental disorders have physical causes
Unlikely we can diagnose mental abnormality in the same way we can diagnose physical abnormality

Question 22

What is a specific phobia?

Answer 22

Phobia of an object or a stimulus

Eg - arachnophobia, satanophobia, arithmophobia

Question 23

What is an agoraphobia?

Answer 23

Phobia of being outside or in an open space or public space

Eg - fear of going outside, fear of crowds

Question 24

What is social anxiety?

Answer 24

Phobia of a social situation

Eg - fear of using a public toilet, fear of public speaking, fear of anger

Question 25

What is a phobia?

Answer 25

An anxiety disorder which interferes with daily living It is an irrational, persistent fear of an object or a situation The exposure to the phobic stimulus almost always produces a rapid anxiety response, excessive fear of phobic stimulus Phobia stimulus avoided or responded to with great anxiety

Question 26

What are behavioural characteristics in response to a phobia?

Answer 26

Panic - crying, screaming, running away, freezing, increasing heart rate Avoidance - efforts made to avoid phobia stimulus to reduce anxiety Endurance - remaining in presence of phobic stimulus with high levels of anxiety, some fears may not be completely avoidable

Question 27

What are emotional characteristics of a phobia?

Answer 27

Anxiety - unpleasant state of arousal that prevents relaxation and positive emotion Emotional responses are unreasonable - emotions are disproportionate to the danger posed by the phobic stimulus

Question 28

What are cognitive characteristics of phobias?

Answer 28

Selective attention to the phobic stimulus - attention placed on phobic stimulus once identified Irrational beliefs - unsupported view of phobic stimulus (public speaking - may see more people than are actually there, think they’re stupid if they don’t sound intelligent Cognitive distortions - exaggerated/irrational thought patterns around phobic stimulus, distorted perceptions (spiders - see them as bigger than they are) Recognition of exaggerated anxiety - conscious awareness that anxiety levels experienced are overstated, exaggerated

Question 29

What is behaviourism?

Answer 29

Emphasises role of learning in acquisition of behaviour | Behaviour explained in terms of what is observable

Question 30

What is classical conditioning?

Answer 30

Learning by association Occurs when two stimulus are repeatedly paired together - unconditioned stimulus (UCS) and new neutral stimulus (NS) NS eventually produces same response that was first produced by the UCS alone

Question 31

What is operant conditioning?

Answer 31

Form of learning where behaviour is shaped and maintained by its consequences Consequences include positive reinforcement, negative reinforcement or punishment

Question 32

What is the two process model? Mowrer and spider example

Answer 32

Proposed two process model based on behavioural approach to phobias They’re learnt through classical conditioning and continue/ are maintained because of operant conditioning Person who is scared of spiders is likely to run from one if spotted, escaping and avoiding acts as negative reinforcer, will continue to avoid spiders in the future as reduces anxiety, phobia is maintained When situation and fear is avoided it reinforces the avoidance behaviour, avoidance acts as a pleasant consequence which means behaviour is likely to be repeated - we avoid the fear and anxiety we would have faced if we entered its presence or remained near the phobic stimulus.

Question 33

Little Albert’ study - Watson and Rayner (1920)

Answer 33

Aimed to demonstrate that irrational fears could be induced by use of classical conditioning Used placid boy, Little Albert, who at 9 months showed no fear of a lab white rat At 11 months they carried out procedures to induce fear Whenever rat placed in Albert’s lap, Watson makes loud noise banging two steel bars behind him - total of 7 times Loud noise - unconditioned stimulus Albert’s response (crying) - unconditioned response Before conditioning, rat was a neutral stimulus By third trial, Albert showed fear when showed a white rat Rat now a conditioned stimulus and fear response was a conditioned response

Question 34

What is a strength of the two process model? Good explanatory power

Answer 34

Two process explanation has good explanatory power Explains how phobias can be maintained overtime, important implications to therapy, explains why patients should be exposed to fear stimulus and should prevent patients practicing their avoidance behaviour - behaviour stops being reinforced Application to therapy is a strength of the approach

Question 35

What is a limitation of the two process model? Doesn’t explain development of all phobias/traumatic events did actually happen

Answer 35

Doesn’t explain the development of all phobias People not aware of having experienced an event related to their phobias, can’t remember incident happening that caused phobia to develop Different phobias may be the result of different processes OST says it is possible such traumatic events did happen but phobic has forgotten them

Question 36

What is a limitation of the two process model? May have biological aspects to the phobia rather than negative incidents

Answer 36

Not all phobias are developed from negative incidents, may have biological aspect DiNardo et al found that not everyone bitten by a dog has a phobia of dogs Diathesis stress model says we inherit a genetic vulnerability for developing mental disorders, only manifested by an event to trigger it Dog bite will only lead to a phobia in people with such a vulnerability

Question 37

What is a limitation of the two process model? Phobias have cognitive characteristics, cognitive therapies compared to behavioural treatments

Answer 37

Phobias have cognitive aspects that cannot be explained in traditional behavioural framework Eg - person who thinks they’ll die if trapped in a lift may become extremely anxious and develop a phobia of lifts triggered by this thinking Shows irrational thinking is involved in development of phobias , explains why cognitive therapies can be more successful in treating phobias than behavioural treatments

Question 38

What is a limitation of the two process model? Biological preparedness

Answer 38

Biological preparedness may be better explanation than two process model of how phobias are developed Seligman says - animals more genetically prepared to learn associations between fear and stimuli that were life threatening in our evolutionary past such as snakes Fear is easier to condition to some things (spiders) than others (toasters) even though toasters are more dangerous than spiders Behavioural explanations cannot alone explain the development of phobias

Question 39

What is systematic desensitisation?

Answer 39

Uses classical conditioning to gradually reduce anxiety around the phobic stimulus Aim is to replace feelings of anxiety with relaxation - counter conditioning Impossible to be relaxed and afraid at the same time Relaxation prevents experiencing fear - reciprocal inhibition It follows a three step process - anxiety hierarchy, relaxation and exposure

Question 40

What is the three step process of systematic desensitisation?

Answer 40

Anxiety hierarchy - list put together by patient and therapist of most to least frightening situations that provoke anxiety Relaxation - teaches patient to relax/reduce anxiety as deeply as possible (breathing exercises, meditation, medication if phobia/ anxiety is severe enough Exposure - patient exposed to phobic stimulus whilst in a relaxed state

Question 41

What is flooding?

Answer 41

Involves exposure without gradual build up Immediate exposure of phobic stimulus Don’t have option of avoidance so they learn the phobia is harmless - extinction Conditioned stimulus no longer produces the previously conditioned response of fear \ Must obtain FULL consent - not unethical but it is unpleasant

Question 42

What is extinction?

Answer 42

Patient learns that a phobic stimulus is harmless

Question 43

What is counter conditioning?

Answer 43

Learning a different exposure to the phobic stimulus

Question 44

What is reciprocal inhibition?

Answer 44

Impossible to be afraid and relaxed at the same time - one emotion prevents the other

Question 45

What is a strength of systematic desensitisation? Supporting research evidence (McGrath et al (1990))

Answer 45

Research evidence demonstrates effectiveness of this treatment of phobias McGrath et al (1990) found 75% of patients with phobias were successfully treated using systematic desensitisation - using actual exposure to the phobic stimulus Shows it is effective in treating phobias

Question 46

What is a strength of systematic desensitisation? Further support, Gilroy et al (2002)

Answer 46

Gilroy et al examined 42 patients with arachnophobia Treated using three, 45 mins systematic desensitisation sessions Examined 3 months then 33 months later, systematic group were less fearful than control group (only taught relaxation techniques) Provides further support for SD as a long-term treatment for phobias

Question 47

What is a strength of systematic desensitisation? Suitable for diverse range of individuals, may find it easier to understand than other treatments

Answer 47

Suitable for a diverse range of patients Anxiety disorders often also have learning difficulties - makes it hard for some individuals to understand procedures such as flooding or engage with cognitive therapies that require you to reflect on what you’re thinking Therefore an appropriate treatment for many individuals

Question 48

What is a limitation of systematic desensitisation? Evolutionary survival benefit, not effective in treating all phobias

Answer 48

Not effective in treating all phobias Phobias which aren’t developed from personal experience (classical conditioning), eg - fear of heights not effectively treated using SD Some psychologists believe that certain phobias have evolutionary survival benefits and aren’t a result of personal experience - evolution Ineffective in treating evolutionary phobias

Question 49

What is a limitation of systematic desensitisation? Symptom substitution

Answer 49

When one phobia goes another may appear in its place Phobia of snakes may be replaced with a phobia of trains Suggests its not effective in treating phobias

Question 50

What is a strength of flooding? Cost effective, treated quicker

Answer 50

Cost - effective treatment for phobias Research suggested that flooding is comparable to other treatments (SD and cognitive therapies) of effectiveness - significantly quicker Strength because treated quicker and more cost effective for patient and health service providers

Question 51

What is a limitation of flooding? High levels of anxiety caused

Answer 51

Cost effective but highly traumatic with high levels of anxiety Full consent is obtained but may not complete treatment due to stressful experience Waste of money and time if patients don’t finish treatment

Question 52

What is a limitation of flooding? Irrational thinking instead of unpleasant experience

Answer 52

Highly effective for specific phobias but treatment less effective for social phobia and agoraphobia Social phobias are caused by irrational thinking not by unpleasant experiences More complex phobias can’t be treated by behaviourist treatments and may need to use cognitive behavioural therapy which treats the irrational thinking

Question 53

What is a limitation of flooding? Symptom substitution

Answer 53

When one phobia goes another may appear in its place Phobia of snakes may be replaced with a phobia of trains Suggests its not effective in treating phobias

Question 54

What are the behavioural characteristics of OCD?

Answer 54

- compulsive behaviour - behavioural component of OCD - compulsions are repetitive - compulsions reduce anxiety - 10% of OCD sufferers show compulsive behaviour alone, however for a lot of individuals, compulsions performed to manage anxiety produced by obsessions (recurring thoughts) - avoidance - attempt to reduce anxiety by avoiding situations that trigger OCD

Question 55

What are the emotional characteristics of OCD?

Answer 55

- anxiety and distress - obsessive thoughts are unpleasant and frightening, anxiety can be overwhelming, compulsions also create anxiety - depression - sufferers may have low mood, lack of enjoyment out of activities - irrational guilt - felt over minor moral issues - disgust - directed to something external (dirt) or the self

Question 56

What are the cognitive characteristics of OCD?

Answer 56

- obsessive thoughts - 90% of sufferers have this, thoughts reoccur over and over, vary but are always unpleasant - cognitive strategies - adopted to deal with obsessions and manage anxiety (religious person may meditate or pray) - insight into excessive anxiety - aware obsessions and compulsions aren’t rational, needed for diagnosis

Question 57

What are the two biological explanations of OCD?

Answer 57

Genetic and Neural

Question 58

What is the genetic explanation for OCD?

Answer 58

Focuses on the role that genes play in the development of a mental disorder, genes make up chromosomes and consist of DNA which codes for psychological features Genes transmitted from parent to offspring, therefore inherited

Question 59

How are genes involved in an individual’s vulnerability to OCD? Lewis (1936)

Answer 59

Lewis (1936) observed that 37% of his OCD patients had parents with OCD, 21% had siblings with OCD Suggests that OCD runs in families, however thought that it is the genetic vulnerability rather than a gene(s) Diathesis stress model suggests that certain genes leave some individuals more likely to suffer a mental disorder, need some environmental stress (experience) to trigger the OCD

Question 60

Candidate genes in creating vulnerability of OCD

Answer 60

Researchers have found candidate genes in creating vulnerability of OCD, some of theses genes are involved in regulating development of serotonin system (neurotransmitter involved in OCD) One of the genes thought to be involved in OCD vulnerability is gene 5HTI - D beta (5 huge tits in Dubai) - involved in efficiency of transport of serotonin across synapses

Question 61

OCD is polygenic - Taylor (2013)

Answer 61

Polygenic meaning not caused by one single gene, several genes involved Taylor (2013) analysed findings of pervious studies and found evidence that up to 230 different genes may be involved in OCD Genes thought to be associated with action of dopamine as well as serotonin, both neurotransmitters have role in regulating mood

Question 62

Origin of OCD has different causes

Answer 62

Aetiologically heterogenous, origin has different causes One group of genes may cause OCD in one person and a different group in a different person Some evidence to suggest different types of OCD such as hoarding and religious obsessions may be due to particular genetic variations

Question 63

Strength of the genetic explanation of OCD - evidence support of vulnerability due to genetic makeup - nestadt et al (2010)

Answer 63

Evidence from variety of sources for the idea that some people are vulnerable to OCD as a result of their genetic make-up Nestadt et al (2010) reviewed previous twin studies, found 68% of identical twins shared OCD as opposed to 31% of non-identical Suggests theres a genetic influence on OCD

Question 64

Limitation of genetic explanation of OCD - twin tides flawed, nature vs nurture

Answer 64

Twin studies are flawed as genetic evidence They assume that identical twins are only more similar than non-identical twins due to genes, overlook that identical twins may be similar in terms of shared environment Eg - non-identical twins may be boy and girl so have quite different experiences Reduces value of twin studies, doesn’t separate effects of nature vs nurture on OCD Reduces validity of supporting evidence for genetic explanation of OCD

Question 65

Limitation of genetic explanation of OCD - more than one gene involved, cannot specify

Answer 65

Twin studies suggest OCD is largely genetic but psychologists haven’t been able to identify all of genes involved One reason for this is, there are several genes involved in OCD and each genetic variation only increases risk of OCD by fraction Consequence is that genetic explanation is unlikely to be very useful because it provides little predictive value about whether an individual will develop OCD and if so what type

Question 66

Limitation of genetic explanation of OCD - environmental factors can trigger OCD - Cromer et al (2007)

Answer 66

Evidence that environmental factors can also trigger or increase risk of developing OCD Cromer et al (2007) found over half of OCD patients in their sample had a traumatic event in past and OCD more severe in those who had more than one trauma Suggests that OCD cannot be fully genetic in origin May be more productive to focus on environmental causes because we are more able to do something about the environment

Question 67

What is the neural explanation of OCD?

Answer 67

Explanation which focuses on the structure and function of brain and nervous system in development of mental disorder

Question 68

OCD explained by reduction in functioning of serotonin system in brain

Answer 68

Less serotonin produced in brain, neurotransmitter for regulating mood Low serotonin = normal transmission between neurons doesn’t take place so mood and other processes effected Mutation of SERT gene may lead to this

Question 69

Abnormal levels of dopamine in people with OCD

Answer 69

Dopamine levels abnormally high in people with OCD High doses of dopamine in animals induced stereotyped movements resembling compulsive behaviour found in OCD patients Have to have right balance

Question 70

Decision making takes place in lateral frontal lobe (side bits)

Answer 70

Abnormal functioning in frontal lobes leads to impaired decision making, Thought to be responsible for hoarding disorder

Question 71

Processing unpleasant emotions

Answer 71

Left parahippocampal gyrus may also be involved in OCD Area associated with processing unpleasant emotions Found to function abnormally in those with OCD

Question 72

Evaluating neural explanation of OCD - strength anti-depressants increase serotonin

Answer 72

Evidence for role of serotonin in OCD comes from research examining anti-depressants Found drugs which increase serotonin are effective in treating patients with OCD Suggests serotonin involved in OCD

Question 73

Evaluating neural explanation of OCD - combo whopper co-morbidity, directly involved

Answer 73

Serotonin-OCD link may simply be co-morbidity with depression (having two disorders together) Many with OCD suffer from depression as well, probably involves disruption to serotonin system Could be that individuals with OCD, have their serotonin system disrupted because they’re depressed as well However, fact that anti-depressants with no impact on serotonin don’t work on OCD suggests serotonin directly involved in OCD and not just accompanying depression

Question 74

Evaluating neural explanation of OCD - limitation don’t know actual causes

Answer 74

Shouldn’t be assumed that natural mechanisms cause OCD Evidence to suggest many neurotransmitters in brain don’t function normally in OCD patients Not the same as saying abnormal functioning causes OCD Biological abnormalities could be a result of OCD rather than cause