Y1 Module 5 - Psychopathology Flashcards Preview

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Flashcards in Y1 Module 5 - Psychopathology Deck (66)
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1
Q

Outline statistical infrequency including an example.

A

Anything other than common/usual behaviour is seen as abnormal. Statistical frequencies are used on characteristics that can be reliably measured. With any characteristic, the majority of people are clustered around an average with a few distinctly above or below it. This can be shown with a normal distribution graph.

2
Q

Give an example of how statistical deviation can be used.

A

IQ is one of the measurable characteristics in which 68% of people have a range between 85-115. An intellectual disorder requires an IQ in the bottom 2% of the population.

3
Q

Briefly discuss a strength of statistical infrequency.

A

Real-life application. Application in the diagnosis of intellectual disability disorder. Assessment of patients include measurements of the severity of their symptoms compared to the statistical norms. Means that statistical infrequency is a necessary part of clinical assessment.

4
Q

“Unusual characteristics can be positive”. Briefly discuss why this is a weakness of statistical infrequencies.

A

People with exceptionally high IQ scores are just as unusual as those with low scores but people with a high IQ aren’t seen as having a undesirable characteristic. Just because only a few people display ‘abnormal’ characteristics doesn’t mean treatment is required to return to normal. This is a weakness of SI because it can never be used alone to make a diagnosis.

5
Q

Explain why the fact that not everyone benefits from a label is a weakness of SI.

A

If someone has a low IQ but is living a fulfilled life then there is no benefit for the to be labelled as abnormal regardless of their IQ.

6
Q

Outline what is meant by deviation from social norms including an example.

A

Society makes a collective decision as to what is acceptable. Anything different to this is ‘abnormal’ behaviour. Social norms are different from every generation and culture which means there are very few behaviours considered universally acceptable.
E.g. Antisocial personality disorder, someone with ASPD has the symptom that is an ‘absence of prosocial internal standards associated with failure to conform to lawful or culturally normative ethical behaviour. Psychopaths are seen as abnormal because they don’t conform to society’s moral standards. This is one of few seen as abnormal in a wide range of cultures.

7
Q

Discuss weaknesses of the deviation from social norms explanation.

A
Not always a sole explanation. There is real-life application for the diagnosis of ASPD. Which means it’s is necessary to think about what is normal and abnormal. However other factors need to be considered e.g. the distress to other people resulting from ASPD. Deviation from social norms is never the sole reason for defining abnormality.
Cultural Relativism. Social norms vary from generation, to society a lot. E.g. could lead to people from one society labelling someone as abnormal, and another society labelling them as normal. Creates creates problems for people living in different cultures. 
Can lead to human rights abuse. Too much reliance on this could lead to human right abuse. Looking at historical examples, it is clear that this has been used in the past to maintain control over minorities / women. Drapetomania applied to black slaves and a symptom was running away. Nymphomania applied to women and was characterised by a sexual attraction to working class men.
8
Q

Why is the deviation from social norms explanation better than statistical norms?

A

One strength of deviation from social norms is that it includes the desirability of behaviour. The statistical deviation idea does not.

9
Q

Outline failure to function adequately.

A

Abnormal behaviour obstructs their ability to carry out normal daily behaviours. Decided when someone isn’t able to maintain basic standard levels of nutrition and hygiene. Or able to hold down a job and maintain relationships with people around them.
Rosenhan & Seligman (1989) signs that are used to determine if someone isn’t coping. No longer conforms to standard interpersonal rules, eg. maintaining eye contact, and respecting personal space. Experiences of severe personal distress. Behaviour becomes irrational or dangerous to either themselves or others.
E.g. intellectual disability disorder. Diagnosis isn’t only based on very low IQ an individual would also have to be failing to function adequately before a diagnosis is given.

10
Q

Outline 1 strength of failure to function adequately.

A

Patients perspective. Attempts to take into account subjective experience of patient. May not be entirely useful since it is difficult to measure stress, but still acknowledges that individual experience is important.

11
Q

Outline weaknesses of failure to function adequately.

A

Is it simple deviation from social norms. In practice, it is hard to distinguish between the two. If we label some behaviours as a failure to function adequately, then we could be limiting a person’s personal freedom.
Subjective judgments. When deciding if someone is failing to function adequately, someone has to make the decision to say that they are distressing or in distress.
There are methods for making this as objective as possible, such as using the Global assessment of functioning scale.

12
Q

Outline deviation from ideal mental health.

A

This looks at what ‘normal’ behaviour is. Once we know what it means to be psychologically healthy then we can identify who deviates from this. Jahoda (1958) set criteria for idea mental health e.g. Self-actualise, cope with stress, independence, good self-esteem, lack of guilt.

13
Q

Outline a strength of deviation from ideal mental health.

A

Comprehensive definition. Covers a wide range of mental health Many people would seek health advice for any of these reasons. The sheer range of factors means it gives people a lot to think about.

14
Q

Outline weaknesses of deviation from ideal mental health.

A

Cultural Relativism. Some of the characteristics set by Jahoda are specific to Western European and North America cultures. E.g. Emphasis on personal achievement in the concept of self-actualisation would be considered self-indulgent in collectivist cultures where the focus is often much more on the family or community.
Unrealistically high expectations of mental health. Few of us achieve all of the criteria, and definitely not all at the same time. Therefore this approach would suggest that most, if not all of us are abnormal to some degree.

15
Q

Outline the 3 behavioural characteristics of phobias.

A

Panic. Panic may result in a range of behaviours from crying to running away, children may freeze or have a tantrum.
Avoidance. If a phobia occurs in daily life then daily activities will be disturbed if someone is avoiding going outside for fear of something they would encounter.
Endurance. The opposite of avoidance, we remain in the presence of the stimulus but experiences high levels of anxiety.

16
Q

Give 2 emotional characteristics of phobias.

A

Anxiety. Phobias are classed as anxiety disorders and therefore involve emotional responses of anxiety and fear. Makes it hard for sufferer to relax.
Emotional responses are unreasonable. Disproportionate to the danger posed by the stimulus, eg unreasonable fear of spiders.

17
Q

Give 3 cognitive characteristics of phobias.

A

Selective attention to the stimulus. Can’t take your eyes off the stimulus.
Irrational beliefs. High expectations increases the pressure the sufferer is under to perform well in social situations.
Cognitive distortions. Seeing a relatively normal object as ‘alien’ or ‘ugly’. A distorted view of the stimulus.

18
Q

Outline the two-process model.

A

Acquisition by classical conditioning. US - something that already produces fear. NS - Something that does not produce fear. NS becomes CS when paired with the US. CS produces the CR.
Maintenance by operant conditioning. Avoidance behaviour reinforces the behaviour through negative reinforcement.

19
Q

Evaluate the explanatory power of the two process model.

A

Goes beyond the original concept of classical condition. Explains how phobias are acquired and how they are maintained over time. Has important implications for therapy → explains why people need to be exposed to the stimulus to deal with the phobia.

20
Q

Evaluate the role of avoidance behaviour in the two-process model.

A

Model suggests that the phobias is maintained through avoidance behaviours - avoiding the phobic stimulus. People with complex phobias e.g. agoraphobia, can often face their fear with somebody present. Suggests avoidance behaviour may be more to do with feelings of safety and less to do with avoiding the stimulus.

21
Q

Why is the two-process model an incomplete model?

A

Does not account for evolutionary influences (Bounton, 2007). We more easily acquire phobias of things that have been a source of danger in the past e.g. Snakes & Spiders → Biological preparedness. We very rarely develop phobias of things that are much more dangerous e.g. guns → They have not been present for long enough. Shows there is more to phobias than learning.

22
Q

Why is a the two process model not a full explanation?

A

Model suggests that phobias are acquired to a traumatic experience. Some people have phobias without having had a negative experience with the stimulus. Suggests that other explanations should be considered e.g. SLT.

23
Q

What is systematic desensitisation?

A

A behavioural therapy designed to gradually reduce phobic anxiety in response to a stimulus through the principles of classical conditioning.
Patients create an anxiety hierarchy - a set of situations that provoke an increasing amount of anxiety. Therapist then teaches relaxation techniques (breathing, mental imagery, meditation or drugs e.g. valium).
Finally the patient is exposed, in a relaxed state, to the first level in the hierarchy. When the patient can remain relaxed in the presence of this stimulus they move on to the next level.
This means a new response is learned to the stimulus → counter-conditioning. It is impossible to be afraid and relaxed at the same time → reciprocal inhibition.

24
Q

What is flooding and how does it work?

A

Exposure to the phobic stimulus, without gradual build-up.
Longer than sessions of systematic desensitisation (2-3 hours), but sometimes only 1 session is needed.
Without the option of avoidance the patient learns the stimulus is not harmful. This is known as extinction → a learned response is extinguished when the conditioned stimulus is encountered without the unconditioned stimulus.

25
Q

Give 3 strengths of systematic desensitisation.

A

Effectiveness. Gilroy et al. (2003) followed 42 patients who had been treated for a spider phobia using SD. Compared to a control group of just relaxation. At both 3 and 33 months the experimental group showed a greater reduction in phobic anxiety.
Suitability. Other therapies are not as suitable for some patients e.g. those with learning difficulties. Learning difficulties can make it hard for people to understand what is happening in flooding or to engage with cognitive therapies. SD is a far more appropriate therapy.
Patients prefer it. SD is less traumatic than flooding. It actually includes some pleasant aspects - like the relaxation techniques. This is reflected in low attrition and low refusal rates.

26
Q

What is a strength of flooding?

A

It is cost-effective. The therapy is as effective for specific phobias as SD (Ougrin, 2011) and quicker. Speed is a pro as patients will be symptom free quickly → makes treatment cheaper.

27
Q

Give 2 weaknesses of flooding?

A

Less effective for some phobias. Social phobias are more complex → have cognitive aspects e.g. thinking unpleasant thoughts about the situation. Cognitive therapies may be more appropriate as these tackle irrational thoughts.
Traumatic for patients. Highly traumatic. Not unethical - patients give consent. However patients are often unwilling to see it through. Time and money are sometimes wasted as prep is made, but they refuse to start or quit.

28
Q

What is meant by symptom substitution?

A

A criticism of behavioural approaches is that very often when a phobia is dealt with, another takes it’s place. This is indicative of a deeper rooted issue, rather than something that has been learned. This being the case, behavioural treatments are not always appropriate for phobias.

29
Q

Outline 3 behavioural characteristics of depression.

A

Activity levels. Disruption to sleeping and eating behaviour. Aggression and self-harm.

30
Q

Outline 3 emotional characteristics of depression.

A

Lowered mood. Anger. Lowered self-esteem.

31
Q

Outline 3 cognitive characteristics of depression.

A

Poor concentration. Attending to dwell on the negative. Absolutist thinking.

32
Q

Outline Beck’s cognitive theory of depression.

A

Some people are more vulnerable to depression than others. This is down to their cognitions - the way they think.

33
Q

Outline the three parts to this cognitive vulnerability.

A

Faulty information processing. When depressed be pay more attention to the negative aspects of a situation, blow things out of all proportion and think in ‘black and white’ terms.
Negative self-schemas. A self schema is a package of information we have about ourselves. If we have a negative self-schema, we will interpret all information we have about ourselves in a negative way.
The negative triad. Negative views of the world - creates a view that there is no hope anywhere. Negative views of the future - reduce hopefulness and enhance depression. Negative view of the self - enhance existing depressive feelings because they confirm existing emotions.

34
Q

Outline Ellis’s ABC model.

A

Ellis believed depression to be a result of irrational thoughts. These are not illogical or unrealistic, but they interfere with us being happy and free of pain.
A - Activating event → some negative event we experience.
B - Beliefs → Irraltional beliefs triggers by activating event: Musturbation, I-can’t-stand-it-itis, utopionism.
C - Consequences → emotional, behavioural - depression.

35
Q

Discuss strengths of Beck’s theory of depression.

A

Good supporting evidence. There is good supporting evidence e.g. Grazioli and Terry. 65 pregnant women were assessed for cognitive vulnerability. Those who scored higher were more likely to develop Post-natal depression. Clark & Beck → cognitions appear before depression, supporting the idea that they cause the depression.
Practical application. Forms the basis of CBT, where all cognitive aspects of depression can be identified and challenged. This means the therapist can challenge and encourage the patient to test the reality of cognitions. Strength because it translates well into a successful therapy.

36
Q

Discuss a weakness of Beck’s theory of depression.

A

Doesn’t explain all aspects of depression. The theory explains the basic symptoms of depression. However it does not explain some of the more complex symptoms e.g. anger & hallucinations.

37
Q

Discuss weaknesses of Ellis’ model of depression.

A

Partial explanation. Depression that follows events is known as reactive depression. This is different to depression that arises without an obvious cause. The explanations only applies to some kinds of depression.
Doesn’t explain all aspects of depression. As with Beck’s theory.

38
Q

Discuss a strength of Ellis’ model of depression.

A

Practical application. Like Beck’s explanation, it has lead to a successful therapy. The idea is that through challenging irrational beliefs a person can reduce their depression. It is supported by research evidence (Lipsky et al.) and this in turn supports the theory and the role of irrational beliefs in depression.

39
Q

What is CBT and what does it involve?

A

Most common treatment to depression. Begins with an assessment in which patient works with therapist to clarify the patient’s problem. They jointly identify goals and work to them together. One of the central tasks is to identify where there might be negative or irrational thoughts. Involves working to change negative and irrational thoughts and put more effective behaviours into place.

40
Q

Outline Beck’s Cognitive Therapy.

A

First, identify negative triad. Once identified, must be challenged, central component to this therapy. Helps to test the reality of these beliefs, investigate these beliefs like a scientist would. To do this, the therapist may set homework e.g. recording positive events, which can be used to challenge irrational beliefs.

41
Q

Outline Ellis’ Rational Emotive Behavioral Therapy (REBT).

A

Extends the ABC model, including D and E. D stands for dispute and E stands for effect.
Central idea is to identify and challenge irrational thoughts. Involves vigorous argument, designed to challenge irrational beliefs.
Different methods of disputing: Empirical - disputes weather there is actual evidence to support irrational belief. Logical - disputes weather irrational thoughts follow from facts.

42
Q

What is meant by behavioural activation?

A

Therapists would encourage a depressed patient to be more active and social. This will provide more evidence for the nature of the irrational beliefs.

43
Q

Outline a strength of CBT as a treatment for depression.

A

Its effective - March et al (2007) compared the effects of CBT with antidepressant drugs and a combination of the two in 327 adolescents with a main diagnosis of depression. After 36 weeks, 81 of CBT group, 81% or antidepressant group and 86% of the combo were significantly improved. Suggests that it is just as effective as other treatments → advocate for using CBT as the first choice for public healthcare systems.

44
Q

Outline weaknesses for CBT.

A

May not work for the most severe cases. In some depression cases, the patient cannot motivate themselves to engage with the CBT work. In such cases it is possible to treat patients with antidepressants until they are more receptive to CBT - then run the two side by side. Is a weakness as CBT can sometimes not be a standalone therapy.
Success may be due to patient/therapist relationship. Rosenzweig (1936) suggested that differences between different psychotherapies are small. The thing they all have in common is the quality of patient-therapist relationship. This may the key to the therapy being successful, rather than the therapy itself.
Some patients want to explore their past. One of basic principles of CBT is that you focus on present and future, rather than the past. Patient may however be aware of a link to their depression and then want to explore that. This can cause frustration in patients and be a hindrance to their recovery.

45
Q

Outline 2 behaviour characteristics of OCD.

A

Compulsions (Repetitive, reduce anxiety). Avoidance.

46
Q

Outline 3 emotional characteristics of OCD.

A

Anxiety and distress. Accompanying depression. Guilt and disgust.

47
Q

Outline 3 cognitive characteristics of OCD.

A

Obsessive thoughts. Cognitive strategies to deal with obsessions. Insight into excessive anxiety.

48
Q

Referring to research, what is meant by genetic explanations in OCD?

A

Genes are involved with OCD vulnerability. Lewis found that 37% of patients with OCD had parents with OCD and 21% had siblings with OCD - suggests that OCD runs in families. It is likely that the vulnerability to OCD is passed in rather than the condition itself. Diathesis-stress model → certain genes leave individuals more likely to develop a disorder in response to an environmental trigger.

49
Q

What is meant by candidate genes?

A

Researchers found some genes that link to OCD vulnerability. Some of these genes are linked to regulating the development of serotonin in the body. E.g. 5HT1-D beta is implicated in the movement of serotonin across synapses.

50
Q

What is meant by the statement: OCD is polygenic?

A

Not caused by a single gene, but many. Taylor (2013) analysed findings from previous studies, found that 230 genes could be linked to OCD. These include those that are associated with the actions of dopamine and serotonin, both of which are involved in the regulation of mood.

51
Q

What is meant by the term aetiologically heterogeneous and how does it relate to OCD?

A

Different types of OCD. One group of genes may cause OCD in one person, but another group of genes could cause OCD in another. Aetiologically heterogeneous - meaning that the origins have different causes.

52
Q

What is meant by neural explanations for OCD?

A

Genes associated with OCD are likely to affect neurotransmitters as well as structure in the brain.

53
Q

Outline the role of serotonin in depression.

A

Role of serotonin. Serotonin is believed to regulate mood - it is responsible for relaying information from one neuron to another. If a person has low levels of serotonin, than normal transmission of mood relevant info does not take place and mood and other mental processes are affected. At least some cases of OCD can be explained through a reduction in the functioning of the serotonin system.

54
Q

How does decision making affect OCD?

A

Some cases of OCD seem to be associated with impaired decision making. This may be associated with abnormal functioning in the lateral parts of the frontal lobe (responsible for logical thinking and decision making). Also evidence that an area called parahippocampal gyrus is implicated with processing unpleasant emotions functions abnormally with OCD.

55
Q

Outline a strength of biological explanations.

A

Good supporting evidence. Nestadt et al (2010) reviewed previous twin studies and found that 68% of identical twins shared OCD and 31% of non-identical twins.

56
Q

Outline weaknesses of biological explanations for OCD.

A

Too many candidate genes. Not successful at pinning down which genes are involved with OCD. This is because it appears that many genes are involved with OCD and that each genetic variation only seems to increase risk by a fraction. Means that is is pretty useless as is does not offer any predictive value.
Environmental risk factors. Environmental factors can increase or trigger OCD (diathesis stress model). E.g. Cromer et al found that over half the OCD patients had experienced a traumatic event in the past, and OCD was more severe in cases that had more than one trauma. Shows that OCD may not be entirely biological - perhaps it would be more useful to focus on the environmental factors as these can be influenced more easily.

57
Q

Outline 1 supporting argument for neural Explanations for OCD.

A

Some supporting evidence. For example, some antidepressants that work solely on the serotonin system have a positive effect reducing levels of OCD.

58
Q

Outline 1 or more weakness of neural mechanisms in OCD.

A

Not clear what neural mechanisms are involved. Studies of decision making have shown these neural systems are the same that function abnormally in OCD. But research has also identified other systems that may be involved some of the time - but never a system that is involved all of the time.
We should not assume that neural mechanisms cause OCD. The biological abnormalities in the brain could be as a result of the OCD, rather than its cause.

59
Q

What is Co-morbidity and how does it relate to OCD?

A

Having two disorders together. Many people with OCD also have depression - also involves disruption to the serotonin systems. It could simply be that the serotonin system is disrupted due to the depression rather than the OCD. It is difficult to separate.

60
Q

Why are twin studies flawed as genetic evidence?

A

They make the assumption that MZ are only more similar in terms of genes. However they may also be more similar in terms of environment (may get dressed the same.). They also grow up in the same environment more often than not. The effect of genes can not be isolated.

61
Q

What is the aim of drug therapies for mental illnesses such as OCD?

A

To increase or decrease the levels of neurotransmitters in brain, or to increase / decrease their activity.

62
Q

Outline what SSRI’s are and how they relate to drug therapy.

A

Selective serotonin reuptake inhibitors. Serotonin is released by certain neurons in the brain. Released by presynaptic neuron and travels across synapse. The neurotransmitter chemically conveys signals from the presynaptic neurons to the post synaptic neurons and then is reabsorbed by the presynaptic neuron and broken down and re-used.
People with depression have reduced levels of serotonin in the brain. SSRI’s prevent the reabsorption of the serotonin, blocking the reabsorption site. This increases the levels in the synapse and thus continues to stimulate the postsynaptic neuron, which reduces the symptoms of depression.

63
Q

How can SSRIs be Combined with other treatments?

A

Used alongside CBT. Drugs reduce symptoms, thus enabling patient to more engage with CBT.

64
Q

Are there alternatives to SSRIs?

A

Tricyclics (clomipramine) - same effect as SSRI’s, more severe side effects - (can cause serotonin syndrome). SNRI’s (selective Noradrenaline reuptake inhibitors) - increase levels of serotonin and noradrenaline.

65
Q

GIve 2 strengths of drug therapies for OCD.

A

Drug therapy is effective at tackling OCD symptoms. There is clear evidence that SSRIs are effective in reducing the severity of OCD symptoms and improving quality of life.
Soomro et al (2009) - reviewed studies comparing SSRIs to placebos. All 17 studies, SSRIs showed better results than Placebos. It is most effective when combined with CBT.
Cost effective and non-disruptive. They are cheap compared to psychological therapy, therefore good value for the public health system. Does not disrupt any routine at all and no time needs to be taken away from your day.

66
Q

Give 2 weaknesses of drug therapies for OCD.

A

Are drug therapies also the appropriate treatment for OCD? Some cases of OCD are biological in origin and therefore it makes sense to treat these with drugs.
Some cases of OCD, however, follow a trauma.
In these cases drug therapies may not be the most appropriate treatment. This is a weakness, as in most cases drugs are handed out indiscriminately, despite there being different causes for the condition.
Drugs can have side effects. A significant minority will not experience benefits from drugs like SSRIs. Some will experience side effects such as indigestion, blurred vision and loss of sex drive, these side effects are usually temporary. Some drugs e.g. Clomipramine can have more serious side effects, erection problems, tremors, weight gain, aggression, blood pressure and heart rhythm disruption. Such factors reduce the effectiveness of drug treatments as patients stop taking them.