Psyhopatholgy Flashcards
(99 cards)
1
Q
Psychopathology
A
- Study of mental illness/distress
- display of behaviours which suggest a psychological impairment
2
Q
What does psychopathology aim to do
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Study mental health and disorders to determine which behaviour is abnormal
3
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Definitions of abnormality: statistical infrequency
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Abnormal behaviours are those that are extremely rare
4
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Statistical infrequency: what is the central average ?
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Human attributes which can be reliably measured (height) fall into a normal distribution and the rest of the population falls above and below the average
5
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Statistical infrequency: standard deviation
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How far scored fall on either side from the mean
6
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Statistical infrequency: % falls into 1 standard deviation
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68% above and below from the mean
7
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Statistical infrequency: % that falls within 2 standard deviations
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95% above and below the mean
8
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Statistical infrequency: % that fall within 3 standard deviations
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99.7% above and below the mean
9
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Statistical infrequency: % of abnormal population
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5% of the population that fall more than 2 s.d are abnormal
10
Q
Definitions of abnormality: deviation from social norms
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Abnormality is when a behaviour does not fit with what is socially acceptable
11
Q
Deviation from social norms: abnormality within different cultures
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- social norms across societies are not the same and its important to consider how culturally important it is.
12
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Deviation from social norms: types of social norms
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Implicit - you know you shouldn’t do them
Explicit - laws
13
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Definitions of abnormality: failure to function adequately
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- Abnormal behaviour is when an individual is not able to cope with everyday life.
- it acknowledges that people may act differently
14
Q
Failure to function adequately: Rosenhan and Seligman
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Example of sections
- unpredictability
- maladaptive behaviour
- personal distress
- irrationality
15
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Failure to function adequately: GAF
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- Global assessment of functioning scale
- measures how well individuals function in everyday life
16
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Definitions of abnormality: deviation from ideal mental health
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Jahoda defines this as deviating from ideal positive mental health
17
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Deviation from ideal mental heath: Jahodas 6 criteria’s
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- Positive attitude towards self (self-esteem)
- Self actualisation (best)
- Autonomy (independence)
- Resistance to stress
- Environmental mastery (adaptability)
- Accurate perception of reality
18
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Statistical infrequency evaluation: +
A
+ : real life application as its used in the diagnosis of intellectual disability (labelled as have a low IQ below 69).This shows its used as a part of clinical assessment.
19
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Statistical infrequency evaluation: -
A
- : some abnormal behaviour is desirable (high IQ) so the definition doesn’t distinguish between desirable and undesirable.This means we need to identify behaviours which are infrequent and undesirable
- : statistical infrequency involves labelling people based of their rarity however everyone doesn’t benefit from being labelled as they may be coping fine.Label of having an intellectual disability is not useful therefore Labelling them as abnormal may effect self view
20
Q
Deviation from social norms evaluation: +
A
+ : includes issue of the desirability you behaviour e.g. being a genius is statistically abnormal but we wouldn’t include that in the definition of abnormal behaviours + narcissism was seen as a deviation but now selfies are common Social norms are more useful than statistical norms
21
Q
Deviation from social norms evaluation: -
A
- : social norms vary over time e.g homosexuality was considered a mental disorder. This means the definition is based on prevailing social nor as.Too much reliance could lead to systematic abuse of human rights
- : vary from community to community so different groups may label one another as abnormal according to their standards.Problematic to define abnormal behaviour in this way ad abnormality is culturally relative.
22
Q
Failure to function adequately evaluation: +
A
+ : aims to include subjective experience of the individual and why it’s important.mdifficult to measure distress but it captures the experience of people who need help.Failure to function adequately is a useful criterion for assessing abnormality.
23
Q
Failure to function Adequately evaluation : -
A
- : some apparently abnormal behaviours can be functional.e.g depression can lead to extra attention.This shows ftfa is an incomplete definition as it doesn’t distinguish between dysfunctional and functional
- : personal judgment involved when deciding if a patient is distressed.som may see their distress as undesirable whilst some are content but others are distressed by their behaviour.this means it depends who is making the judgment.
24
Q
Deviation from ideal mental health evaluation: +
A
+ : comprehensive as it covers a broad range of criteria’s. Covers most reasons why people soil seek mental health services so its a good tool for thinking about mental health.
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Deviation from ideal mental health evaluation: -
- : specific to western cultures as that’s how Jahoda came up with his criteria’s.Applying them to non western cultures is inappropriate.e.g. Self actualisation could be seen as self indulgent.Only applied to certain individualistic cultures
- : Jahodas criteria’s are unrealistic as only s few satisfy each criteria all the time. Everyone would be described as abnormal to a certain degree.Need to define how many criteria’s must be absent to be defined as abnormal.g
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Phobia
- An irrational fear of an object/situation
| - they’re characterised by excessive fear and anxiety
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Behavioural / emotional / cognitive characteristic
Behavioural: act
Emotional: feel
Cognitive: think
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Behavioural characteristics of phobias
- panic (crying, screaming)
- avoidance
- endurance (high levels of anxiety)
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Emotional characteristics of phobias
- anxiety (high arousal)
| - emotional responses are unreasonable to danger posed by stimulus
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Cognitive characteristics of phobias
- selective attention to phobic stimulus
- irrational beliefs
- cognitive distortions (exaggerated thought pattern about phobic stimulus)
- recognition of exaggerated anxiety
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Behavioural approach to explaining phobias: 2 process model
- phobias are acquired by classical conditioning and they continue because of operant conditioning
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Behavioural approach to explaining phobias: Watson ++rayner
- aimed to demonstrate that irrational fear could be induced by classical conditioning (1920)
- little Albert
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Behavioural approach to explaining phobias: little Albert (first process)
- at 9 months he showed no dear of a white lab rat
- 11 months = placed a rat on his lap and made a loud noise (7 times)
- unconditioned stimulus = loud noise
- unconditioned response = crying
- rat changed from neutral stimulus to conditioned stimulus
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Behavioural approach to explaining phobias: Mowrer second process
- person terrified of spiders is likely to run so escape = negative reinforcer so phobia is maintained
- individual avoids an unpleasant situation = pleasant consequence so the behaviour is likely to be repeated (negative reinforcement)
- avoiding a phobic stimulus reinfect the avoidance behaviour
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Two process model evaluation: +
+ Application to therapy: good explanatory power so it provides an explanation for how to maintain phobias. Important for therapies so patients you can explain why patients need to be exposed to feared stimulus.Behaviour stops being reinforced if avoidance is not practiced.
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Two process model evaluation: -
- phobias don’t always develop after a traumatic event.DiNardo found that everyone bitten by a dog doesn’t develop a phobia.Diathesis stress model says we inherit genetic vulnerability but its triggered by life events.Vulnerable develop phobia.
- biologists preparedness may be better.Seligman says animals are genetically prepared to learn ssociations between fear and a stimuli.E.g fear is easier to condition to spiders than toasters.Behavioural explanations alone cannot explain development of phobias.
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BA to treating phobias: aim
Using principles of classical conditioning to replace a persons phobia with a new response (relaxation)
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BA to treating phobias: systematic desensitisation
- gradually reduces phobic anxiety through classical conditioning
- uses counter conditioning to unlearn a maladaptive response by electing another response = relaxation.
- reciprocal inhibition = relaxation takes over fear
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Systematic desensitisation: 3 processes
1. Client and therapist develop a fear hierarchy and rank the phobic stimulus
2. Individual taught relaxation techniques e.g. breathing
3. Patient exposed to phobic stimulus starting from the bottom and progression up to most feared situation
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Systematic desensitisation: +
E+ research evidence showing effectiveness. McGarth found 75% of patients were successfully treated using in vivo techniques (actual exposure to stimuli)
A+ suitable for a diverse range of patients.A lot of patients have learning difficulties too so they may not be able to engage in cognitive therapies which require reflection.Appropriate treatment for many individuals
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Systematic desensitisation: -
E- not effective for all phobias. Some believe certain phobias, like heights, have an evolutionary benefit so they’re due to evolution.Ineffective for treating evolutionary phobias
E- when one phobia disappears, another may appear.Symptom substitution is not as effective.
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BA to treat phobias: flooding
- person is exposed to the most frightening situation immediately so its more extreme
- unable to negatively reinforce their phobia so as they’re continually exposed , anxiety decreases
- extinction as individual learns phobic stimulus is harmless (learned response).
- conditioned response is no longer fear
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Flooding evaluation: +
+ cost effective. Comparable to other treatments but much quicker.Patients treated quicker and its more cost effective for health services
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Flooding evaluation: -
- cost effective but highly traumatic.Informed consent but many don’t finish treatment.Can be a waste of time and money.
- less effective for other phobias e.g. social phobia as these are caused by irrational thinking not experience. Behaviourist treatments cannot be used for complex phobias
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Depression
A mental disorder characteristic by low mood and energy levels.
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Behavioural characteristics of depression
- low/high activity levels (psychomotor agitation)
- disruption to sleep / eating behaviour
- aggression and self harm no
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Emotional characteristics of depression
- lowered mood (worthless)
- anger (lead to self harm)
- lowered self esteem
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Cognitive characteristics of depression
- poor concentration (decision making and sticking to tasks)
- dwelling on negative aspects (half empty)
- absolutist thinking (situations in b+w)
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2 cognitive approaches to explaining depression
- becks cognitive theory of depression
| - ellis’ ABC model
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Cognitive approach
Approach focused on our mental processes e.g. thoughts and perceptions
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Irrational belief
Thoughts that interfere with us being happy
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Becks cognitive theory of depression
Way people think (cognitions) create a vulnerability for depression
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BCToD: 3 parts to cognitive vulnerability
- faulty information processing
- negative schema
- negative triad
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BCToD: faulty information processing
- focus on negative aspects and blow small problems out of proportion
- see thinks as black and white
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BCToD: schema definition
- mental framework for interpreting information and how we package information we have developed through experience
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BCToD: negative schema
- self-schema is info that we have about ourselves
- use schemas to interpret the world so negative schema = negative interpretation
- maintain the negative trials
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BCToD: negative triad
- negative views of the world, future and self
| - make them more vulnerable to depression
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BCToD: negative views of the world/future =
No hope anywhere/ enhance depression
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BCToD: negative views of self =
Enhance depressive feelings because they confirm emotions of low self esteem
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Ellis’ ABC model
- Depression occurs when an activating event (A) triggers an irrational belief (B) which procures a consequence (C)
- depression is due to irrational thoughts/thinking
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Source of irrational beliefs
Musturbatory thinking “ I must do well”
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BCToD: Evaluation
+ supporting evidence from Grazioli and terry.Assessed 65 pregnant woman for cognitive vulnerability before and after birth and those with high depression were more likely to suffer post natal depression.Depreesion is due to mental processing
+ useful applications for treating depression.Useful for CBT where all cognitive aspects e.g negative triad are identified and challenged.best treatment and thsi means negative thoughts probably have a role in causing defos
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EABC: evaluation
- not all cases follow an activating event.depression can develop without a ‘disaster’ so ellis’ explanation only applies to some kinds of depression(partial explanation)
+ ABC model led to successful therapy.Challenging irrational beliefs can reduce depression e.g. Lipzky et al.Supports basic theory that irrational beliefs play a role in depression.
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Cognitive approach: Evaluation
- depression can be explained by genetic factors/neurotransmitters.E.G gene related to serotonin 10x more common in depressed people.cognitive is not the only explanation.May be better to take a diathesis stress model where the development of depression looks at biological + cognitive together.
- dont explain all aspects of depression.Some experience hallucinations e.g. cotard syndrome (zombies).Becks theory explains basic symptoms and Ellis explains why some re more vulnerable but not the feelings.Other explanations may be needed.
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Cognitive approach to treating depression: types
CBT (beck)
| Ellis’ radial emotive behaviour therapy (REBT)
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Cognitive approach treatment: what is CBT
- method for treating mental disorders based of cog/behavioural techniques
1. begins with an assessment to clarify the patients problem and identify goals.
2. Negative/irrational thoughts identified so they can be challenged and replaced
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Cognitive approach treatment: becks CBT
- Identify automatic thoughts about the world,self and future and then challenge them
- CBT aims to test the reality of negative beliefs so they’re given hw to use in future sessions which can disprove their negative thoughts
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Cognitive approach treatment: REBT
- turn irrational thoughts into rational thoughts an resolve emotional behaviour problems
- Expanded to ABCDEF
- virgorous argument to replace irrational thoughts + produce new feelings
- logical + empirical argument
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Cognitive approach treatment: ABC(DEF)
D: disputing irrational thoughts
E: effects of disputing and effective attitude to life
F: new feelings that are produced
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Cognitive approach treatment: REBT 2 methods
Empirical argument: disputing whether there is actual evidence to support the negative belief.
Logical argument: disputing whether the - thoughts logically follow from facts and if the situation makes sense
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Cognitive approach treatment: what is behavioural activation
- used in CBT
- encouraging a patient to be more active and engage in enjoyable activities.
- Provides more evidence for the irrational nature of beliefs
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CBT: evaluation (+)
E+: research shows its effective.March et al compared the effect of CBT with antidepressant drug in 327 adolescents with depression.81% of CBT and drug group improved but 86% of combined improved.CBT has same effect as drug and a combination of biological + cognitive theories are most effective.
E+: exercise can alleviate depression.Babyak et al found aer exercise and drugs together are effective but there was lower relapse rates in exercise group.Exercise in behavioural activation part of CBT can be highly effective
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CBT: evaluation (-)
A-: Individual differences influence effectiveness.Elkin found it less effective for those with rigid irrational beliefs that are resistant to change.Also some extreme cases where they cannot engage in therapy without antidepressants.CBT cannot be sole treatment.
P-:time consuming and effort.e.g. See therapist once a week for an hour.Homework takes time.
- expensive if not covered by NHS (£55)
- reduces practicality
74
OCD
A condition characterised by obsessions and/or compulsive behaviour
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Behavioural characteristics of OCD
- compulsive behaviours: repetitive (hand washing) and reducing anxiety (hand washing due to fear of germs)
- avoidance (keep away from situations that trigger OCD)
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Emotional characteristics of OCD
- anxiety and distress (urge to repeat a compulsion also creates anxiety)
- depression (low mood)
- irrational guilt usually over minor issues
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Cognitive characteristics of OCD
- obsessive thoughts (for 90% suffers and they’re always unpleasant)
- cognitive strategies (adopted to deal with obsessions and manage anxiety which can distract them)
- insight into excessive anxiety (aware thoughts are not rational)
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Obsessions vs compulsions
- obsessions are are thoughts which continually preoccupy a persons mind and they reoccur (cognitive)
- compulsions are actions involving force so individuals is compelled to do behaviour over and over (behavioural)
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Biological approach to explaining OCD: 2
Genetic and neural explanations
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Explaining OCD: genetic explanation
- Focus on the role of genes in development of a mental disorder as genes make up chromosomes which consist of dna (code for psychological features)
- genes transmitted form parent to offspring (inherited)
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Genetic explanation: Lewis 1936
- 37% of his OCD patients has parents with it and 21% had siblings with it
- OCD runs in families (genetic vulnerability)
- diathesis stress model suggests certain genes make people more/less likely to develop a disorder.Need environmental stress to trigger.
82
Genetic explanation: neurotransmitter involved in OCD
serotonin
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Genetic explanation: candidate genes and named gene
- candidate gene creates vulnerably for OCD and some are involved in regulating the development of the serotonin system.
- 5HT1-D beta involved in the efficiency of transport of serotonin across synapses
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Genetic explanation: polygenic
- OCD is polygenic so several genes are involved
- Taylor found up to 230 different genes
- associated with the action of dopamine as well as serotonin (role in regulating mood)
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Genetic explanation: aetiologically heterogenous
- origin of OCD has different causes
- one group may cause OCD in one person and another group with another person
- hoarding and religious obsessions may be due to particular genetic variations
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Genetic explanation: evaluation
+ evidence that some people are vulnerable to OCD as a result of their genetic make-up.Nestadt et al reviewed twin studies and 68% of identical wins shared OCD whilst 31% for non identical.Shows theirs genetic influence.
- twins studies flawed as genetic evidence.Assume identical are more similar than non identical but overlook that this may be influenced by environment e.g. boy and girls twins are different.Reduces value of twins studies as it doesn’t sep nature and nurture
- environmental factors can increase risk.Cromer found over half suffered a traumatic event and those with more than 1 trauma were more severe.OCD is not entirely genetic.May be more productive to focus on environmental causes as we can do something about these
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Explaining OCD: neural explanations
- Focus on the structure and function of the brain and nervous system in the development of a mental disorder
- abnormalities in neurotransmitters, brain structure and function
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Neural explanations: low serotonin
- reduction in functioning of serotonin system
- normal transmission of mood relevant info doesn’t take place so mood and other processes are affected
- mutation on SERT gene can contribute
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Neural explanations: high dopamine
- abnormally high in OCD sufferers
- high doses of drugs that increase dopamine in animals induce stereotyped movements which resemble those in OCD patients
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Neural explanations: abnormal functioning
- decision making in lateral frontal lobes so if this is abnormal = impaired decision making (hoarding disorder)
- left parahippocampal gyrus associated with processing unpleasant emotions and it functions abnormally in those who have OCD
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Neural explanations: evaluation
+ evidence of role of serotonin from research examining anti-depressants.reserach found that drugs which increase serotonin are effective in treatment.Serotonin involved in OCD.
+/- decision making systems involved in OCD.Cavedini found neural systems that are involved in decision making are abnormal in those with OCD.These areas of the brain are implicated in OCD.However no brain system has been found to always play a role in OCD therefore we do not know which neural mechanisms are involved in the development of OCD
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Biological approach to treating OCD
Drug therapy
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Drug therapy: definition
Aims to increase/decrease levels of neurotransmitters to increase/decrease neurotransmitter activity.
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Drug therapy: serotonin
OCD caused by low levels of serotonin so drug treatment involves increasing levels of serotonin in the brain
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Drug therapy: explain the standard treatment
1. Selective serotonin reuptake inhibitor (antidepressant) used.
2. Work on the serotonin system in the brain by preventing the re-absorption and break down of serotonin by the pre-synaptic neuron.
3. levels of serotonin in synapse increase and continue to stimulate the postsynaptic neuron.
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Drug therapy: dosage
- depends on type fo SSRI
- typical = 20mg fluoxetine as capsule or liquid
- effective after 3-4 months
- if not dosage can be increased / combined
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Drug therapy: other antidepressants
- tricyclics (older) like clomipramine used however they have more severe side effects so its used as a reserve
- Serotonin-noradrenaline reuptake inhibitors (SNRI) increases level of serotonin and noradrenaline.
98
Drug therapy: evaluation (+)
E+ evidence for effectiveness which has improved quality of life.Soomro found drugs were more effective than. Placebos in reducing symptoms in 17 studies.Drugs help lots of patients
P+ little input/effort and they’re cost effective.CBT expensive and require attending regular sessions where SSRI’s are non-disruptive to patients lives and no therapists are required.More economical for health services and patients.
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Drug therapy: evaluation (-)
- side effects.SSRI’s cause nausea, headaches and insomnia and tricyclics can cause hallucinations.Patient may stop taking drugs.Side effects and possibility of addiction limit the usefulness of drugs as treatments for OCD.
- Not a long lasting cure.Effective short term but Marina found that patients relapsed within a week after treatment stopped.Psychological therapies tried before drugs.Drugs many provide a quick solution but psychotherapy is needed for longer lasting effects.
