Topic 3: Alternatives to the Medical Model

Question 1

Explain the classical conditioning explanation of phobias.

Answer 1

• Learning by association.
• Watson and Raynor outlined the case of Little Albert, who was made phobic of rats, despite previously having no fear of them.
• This was done by repeated pairings of a loud noise with a white rat.
• This was generalised to other white things like rabbits or Father Christmas’s beard.

Question 2

Explain the operant conditioning explanation of phobias.

Answer 2

Reinforcers to shape behaviour.

Negative reinforcement: removal of an unpleasant experience (avoiding their phobia).

Positive reinforcement: Children may fear dogs, so they may receive comfort/attention from a parent as a reward.

Question 3

Explain the social learning theory explanation of phobias.

Answer 3

Observation & imitation of a behaviour. If a child sees a significant adult with a phobia they might imitate this behaviour.

Question 4

Explain the cognitive explanation of mental illness.

Answer 4

The assumption that people with mental illness have faulty thinking.
- Cognitive distortions happen automatically.
- It can be caused by childhood experiences.

Question 5

State the 3 main dysfunctional beliefs in
people with depression which form a
cognitive triad, as suggested by Aaron Beck.

Answer 5

1. I am worthless or flawed.
2. Everything I do results in failure.
3. The future is hopeless.

Question 5

State the cognitive triad.

Answer 5

1. Negative views about the world → “Everyone is against me because I’m worthless”
2. Negative views about the future → “I’ll never be good at anything”
3. Negative views about oneself → “I’m worthless and inadequate”

Question 6

Define overgeneralisation.

Answer 6

When a person becomes depressed, then they would seek out information to confirm their negative beliefs.

Question 7

State the key principles of CBT.

Answer 7

• Create realistic thoughts, NOT change negative ones to positive.
• Focuses on the interpretation/meaning attached to an event, not the event itself.
• Tackles dysfunctional core beliefs.
• Tackles catastrophic misinterpretation of physical symptoms.
• Structured, time-limited, collaborative.

Question 8

What do treatments based on the cognitive approach aim to do?

Answer 8

Challenge core negative beliefs.

Question 9

Cognitive Neuroscience Explanation: What does this explanation link to?

Answer 9

Impact of memory to areas of the brain to identify abnormalities, which will enhance the predictability of behaviours.

Question 10

Cognitive Neuroscience Explanation: What does brain-imaging techniques allow?

Answer 10

Identification of altered areas of the brain for people with a diagnosis. This allows us to identify cognitive processes involved in the disorder.

Question 11

Cognitive Neuroscience Explanation: There is no evidence for cause and effect, but…

Answer 11

…more understanding of why symptoms occur due to better knowledge of neural deficiencies in disorders.

Question 12

Cognitive Neuroscience Explanation: What are neurotrophic factors essential for?

Answer 12

Growth, survival, and maintenance of neurones.

Question 13

Cognitive Neuroscience Explanation: What is the most common neurotrophic factor in adults?

Answer 13

BDNF: brain-derived neurotrophic factor

Question 14

Cognitive Neuroscience Explanation: State the result of a decrease in BDNF in the hippocampus.

Answer 14

Induces stress which reduces neural cell development.

Question 15

Cognitive Neuroscience Explanation: What system controls stress and hence serotonin levels.

Answer 15

Hypothalamic-pituitary-adrenal system (HPA)

Question 16

Cognitive Neuroscience Explanation: What are the consequences of neurological malfunction?

Answer 16

• Impacts cognitive areas in the hippocampus.
• Behavioural outcome of depression (HPA can’t cope, decrease in serotonin levels).

Question 17

Cognitive Neuroscience Explanation: What is cognitive neuroscience research limited?

Answer 17

• Recent development
• Research is mainly carried out on animals

Question 18

Cognitive Neuroscience Explanation: Outline Shraynae (2002) research conclusions.

Answer 18

Increasing BDNF levels in the hippocampus produced an effect that mimicked antidepressants for mice with learned helplessness.

Question 19

Cognitive Neuroscience Explanation: Outline De Raedt & Koster (2010) research conclusions.

Answer 19

• Reduced prefrontal neural activity linked to depression.
• Serotonin metabolism, influenced by the HPA axis, mediates this reduction.
• Impaired control of negative schemas (cognitive blueprints) results.
• Increased vulnerability to depression is the outcome.

Question 20

Cognitive Neuroscience Explanation: Outline Barch (2005) research conclusions.

Answer 20

Suggested that the cognitive deficits associated with schizophrenia, such as disturbances in memory, can be explained by neural deficiency.

Question 21

Cognitive Neuroscience Explanation: What might a likely treatment be?

Answer 21

Brain imaging to identify altered areas of the brain and increase/decrease of hormones.

Question 22

Szasz (2011): What did Szasz challenge on his essay, and what image did he reject?

Answer 22

The medical model of mental illness. He rejected the image of patients as passive victims of biological events.

Question 23

Szasz (2011): What did Szasz believe, regarding mental illness.

Answer 23

Mental illnesses that are found to have physical causes are undiagnosed physical illnesses.

Question 24

Szasz (2011): What does Szasz believe that the term 'mental illness' refers to?

Answer 24

The judgement of some people about the disturbing or socially unacceptable behaviours of other people whom are labelled as 'mentally ill'.

Question 25

Szasz (2011): What does Szasz challenge regarding law and mental illness?

Answer 25

He challenges the insanity defences used by defendants, as he believes that assuming all people are inherently good, and bad actions are a result of mental illness, has implications for human freedom.

Question 26

Szasz (2011): What does Szasz compare psychiatrists to?

Answer 26

Jailers: imprisoning people in a system and denying them their right to seek, accept and reject medical diagnosis and treatment.

Question 27

Szasz (2011): State Szasz's 3 conclusions.

Answer 27

1. The medicalisation and politicisation of psychiatry over the past 50 years have led to a dehumanised model of care. 2. Mental illness should be regarded as a metaphor, a myth. 3. The moral legitimacy of psychiatry should be rejected as it involves violating human liberty.

Question 28

Non-biological treatment: Behaviourist: Explain 'systematic desensitisation'.

Answer 28

1. Fear Hierarchy: The patient and therapist create a list of their fears, ranked from least to most frightening. 2. Relaxation Training: The patient learns relaxation techniques like deep breathing or imagery to manage anxiety. 3. Gradual Exposure: The patient is gradually exposed to the feared situations or objects, starting with the least frightening. 4. Counterconditioning: Relaxation techniques are used during exposure to associate the feared object or situation with relaxation instead of fear. 5. Real-Life Application: The patient applies these learned responses to real-life situations to overcome the phobia.

Question 29

Non-biological treatment: Behaviourist: Explain 'flooding'.

Answer 29

- Direct exposure aims for quicker treatment. - Adrenaline-fueled fear is temporary and subsides. - Calm can be linked to the feared object. - However, this can trigger panic and worsen the phobia.

Question 30

Non-biological treatment: Cognitive: Explain 'Rational Emotive Therapy'.

Answer 30

RET is looking for beliefs/thoughts which are irrational or unhelpful to us. May be seen in the way they speak e.g. 'awfulizing'.