Psychopathology 1

AO1-Outline the Two-Process Model for explaining phobias.

• Acquisition (Classical Conditioning): Phobias are learned through association. A neutral stimulus (NS) is paired with an unconditioned stimulus (UCS) that triggers fear (UCR). Eventually, the NS becomes a conditioned stimulus (CS) producing fear (CR). Example: Little Albert associating a white rat with a loud bang.

• Maintenance (Operant Conditioning): Phobias are maintained through negative reinforcement. When an individual avoids the phobic stimulus, their anxiety decreases. This reward (reduction of fear) makes the avoidance behavior more likely to be repeated, preventing extinction.

AO3:Evaluate the behavioral approach to explaining phobias.

• Strength: Real-world application. It explains how phobias are maintained, which led to the development of exposure therapies (like SD). This gives the model high practical value.

• Limitation: Cognitive aspects. The model focuses solely on behavior and ignores irrational beliefs or cognitive distortions associated with phobias (e.g., thinking a spider is "deadly").

• Limitation: Biological Preparedness. Seligman argues we are evolutionarily predisposed to fear things that were dangerous in our evolutionary past (snakes/darkness), which the two-process model doesn't account for.

AO3:Describe and evaluate Systematic Desensitisation (SD).

• AO1 Process: Based on counterconditioning and reciprocal inhibition (fear and relaxation cannot coexist). 1) Anxiety Hierarchy is created; 2) Relaxation techniques are taught; 3) Gradual Exposure from least to most frightening.

• AO3 Strength: Evidence of Effectiveness. Gilroy et al. (2003) followed 42 patients treated for spider phobia; at 3 and 33 months, the SD group was less fearful than a control group.

• AO3 Strength: Suitability. It is often more appropriate than flooding for patients with learning disabilities or high levels of anxiety, as it is less traumatic.

AO1:Describe and evaluate Flooding.

• AO1 Process: Immediate, full-scale exposure to a phobic stimulus without a gradual build-up. It works through extinction—without the option of avoidance, the patient learns the stimulus is harmless as their physical exhaustion leads to a drop in anxiety levels.

• AO3 Strength: Cost-effective. Flooding is highly effective and much quicker than SD (often only one session is needed), making it cheaper for health services like the NHS.

• AO3 Limitation: Traumatic. It is an extremely unpleasant experience. High attrition rates (dropping out) are common, which can be a waste of time and money, and may even make the phobia worse if the session is not completed.

The Cognitive Approach to Explaining Depression

• (AO1): Explain Beck’s Negative Triad and Ellis’s ABC Model.

• Beck: faulty information processing; depressed people focus on negative aspects of a situation, ‘black and white thinking’→ something is all bad or all good

• negative self schema: package of ideas and information developed through experience, mental framework for interpretation of sensory information.self schema= package of information people hold about themselves, negative self schema= interpreting all information about themselves in a negative way

• the negative triad

1)negative view of world, world is cold hard place

2)negative view of future, rhoughts which reduce hopefullness and enhance depression

3)negative view of self, im a failure, enhances existing deoressive feelings as confirms existing emotions of low self esteem

• Ellis’ ABC model: irrational thoughts, illogical or unrealistic that interfere with us being happy or free from pain

• Activating event, external events which trigger irrational thoughts

• Beliefs, irrational e.g utopianism= belief that life is always meant to be fair

• Consequences, emotional and behavioural

Treating Depression (CBT)

• (AO1/AO3): Outline Cognitive Behavioural Therapy (CBT) and evaluate its effectiveness.

• AO1: Aims to identify and challenge irrational/negative thoughts. Includes Beck’s Cognitive Therapy: identifies the negative triad a patient may have, once identified, these thought are challenged, helps patients test the reality of their negative beliefs, patients then set homework to record events of what they enjoyed or if someone was nice to them: patient is the scientist. In future sessions, if patents irrational thoughts return, therapist uses evidence to prove patient is incorrect.

• Ellis’s REBT: rational emotive behavioural therapy. D= dispute, E= effect. Main purpose is to identify and dispute irrational thoughts. empirical argument= disputing whether there is actual evidence to support irrational believe. logical argument= disputing whether irrational thought follows from facts

• AO3 (Strength): Highly effective. March et al. (2007) found that after 36 weeks, 81% of adolescents improved with CBT, the same rate as antidepressants. CBT is brief therapy and cost effective therefore seen as first choice of treatment in public health care systems such as NHHS

• AO3 (Limitation):lack of effectiveness for severe cases and those with learning disabilities. Requires high motivation. Severely depressed patients may struggle to engage with the cognitive work, making drugs a more suitable initial treatment. talking therapy unsuitable for those with learning disablities. therefore cbt only appropiate for specic range of people with depression

• AO3 (Limitation): relapse ratess, concerns over how long benefits last, long term outcomes are not as good as assumed, study assessing depressed patients every month for 12 months while on cbt, clients relapsed after 6 months, means cbt may need to be periodically repeated

The Biological Approach to Explaining OCD

• (AO1): Outline Genetic and Neural explanations for OCD.

• Genetic: OCD is polygenic (up to 230 genes involved, e.g., SERT and COMT). It is aetiologically heterogeneous, meaning different combinations of genes cause it in different people.

• Neural: 1) Neurotransmitters: Low levels of serotonin prevent the transmission of mood-relevant information. 2) Brain Structures: High activity in the orbitofrontal cortex (worry circuit) or abnormalities in the parahippocampal gyrus (processing unpleasant emotions).

Treating OCD (Drug Therapy) (AO1/AO3): Explain SSRIs and evaluate their use for OCD.

• AO1: Selective Serotonin Reuptake Inhibitors (SSRIs) prevent the reabsorption and breakdown of serotonin in the synapse. This increases the concentration of serotonin, allowing it to continue stimulating the post-synaptic neuron.

• AO3 (Strength): Cost-effective and non-disruptive. Drugs are cheaper for the NHS than psychological therapies and require less effort from the patient (they just have to take a pill).

• AO3 (Limitation): Side effects. Some patients experience indigestion, blurred vision, or loss of sex drive. These can lead to attrition (patients stopping their medication), which causes symptoms to return.

Flashcard 1: Statistical Infrequency

• AO1 (Description): Abnormality is defined as any behavior that is statistically rare or "unusual." It relies on a normal distribution curve; those falling at the extreme ends (e.g., an IQ below 70 or above 130) are classified as abnormal.

• AO3 (Evaluation):

  1. Real-world application: It is a useful objective tool in clinical practice to assess the severity of symptoms, such as using the Beck Depression Inventory (BDI) where a score of 30+ indicates severe depression.

  2. Unusual characteristics can be positive: A high IQ over 130 is statistically infrequent but desirable, meaning this definition cannot be used alone to make a diagnosis as it fails to distinguish between desirable and undesirable "abnormal" traits.

  3. Labels can be social stigmata: Being labeled as "statistically abnormal" may negatively impact a person's self-perception or how others treat them, especially if they are already functioning well in life.

Flashcard 2: Deviation from Social Norms

• AO1 (Description): Behavior is abnormal if it violates the unwritten "rules" or collective judgments of a society about what is acceptable. For example, Antisocial Personality Disorder is characterized by a failure to conform to lawful and ethical behavior.

• AO3 (Evaluation):

  1. Real-world application: It has value in clinical settings for diagnosing personality disorders where the key defining characteristic is a failure to conform to social standards.

  2. Cultural and Situational Relativism: Norms vary significantly between cultures (e.g., hearing voices is acceptable in some but a symptom of schizophrenia in others) and situations, making it difficult to apply a universal standard.

  3. Risk of Human Rights Abuses: Historically, this definition has been used to maintain social control over minority groups, such as labeling "drapetomania" (slaves running away) as a mental disorder.

Flashcard 3: Failure to Function Adequately (FFA)

• AO1 (Description): Occurs when someone is unable to cope with the ordinary demands of day-to-day life (e.g., maintaining hygiene or holding a job). Rosenhan and Seligman (1989) suggested signs including personal distress and irrational/dangerous behavior.

• AO3 (Evaluation):

  1. Represents a threshold for help: It provides a sensible criterion for when an individual needs professional intervention because it focuses on the point where their symptoms become life-limiting.

  2. Discrimination and Social Control: It is easy to label non-standard lifestyle choices as "failing to function" (e.g., New Age Travellers or those who practice extreme sports), potentially restricting the freedom of choice for those who live unconventionally.

  3. Subjective experience: While it honors the patient's feelings, a psychiatrist must still make a subjective judgement on whether the distress is "normal" (e.g., after a bereavement) or truly dysfunctional.

Flashcard 4: Deviation from Ideal Mental Health (DIMH)

• AO1 (Description):Rather than looking for what is "wrong," this defines abnormality by looking at what is "missing" from psychological health. Jahoda (1958) criteria include: self-actualisation, high self-esteem, autonomy, and an accurate perception of reality.

• AO3 (Evaluation):

  1. A comprehensive definition: It covers a broad range of criteria for mental health, providing a highly useful checklist for individuals to assess themselves and discuss goals with professionals like humanistic counsellors.

  2. Culture-bound: Jahoda’s criteria are rooted in Western, individualist cultures; concepts like "self-actualisation" are considered indulgent in collectivist cultures that value community over the self.

  3. Extremely high standards: Very few people meet all of Jahoda’s criteria at once or for a long time, which could label the majority of the population as "abnormal" and set an unrealistic bar for recovery.

Flashcard 5: Phobias (Anxiety Disorders)

• Behavioural:

  • Panic: Crying, screaming, or running away.

  • Avoidance: Making a conscious effort to stay away from the stimulus.

  • Endurance: Remaining in the presence of the stimulus but experiencing high levels of anxiety.

• Emotional:

  • Anxiety: An unpleasant state of high arousal.

  • Fear: Immediate and extremely unpleasant response when encountering the stimulus.

  • Unreasonable response: The emotional trigger is disproportionate to the actual danger.

• Cognitive:

  • Selective attention: Inability to look away from the phobic stimulus.

  • Irrational beliefs: Unfounded thoughts (e.g., "If I blush, people will think I'm weak").

  • Cognitive distortions: Perceptions are inaccurate (e.g., seeing a belly button as "disgusting").

Flashcard 6: Depression (Mood Disorders)

• Behavioural:

  • Activity levels: Reduced energy (lethargy) leading to withdrawal, or "psychomotor agitation" (struggling to relax).

  • Disruption to sleep/eating: Insomnia, hypersomnia, or significant weight gain/loss.

  • Aggression: Irritability that may lead to verbal/physical aggression or self-harm.

• Emotional:

  • Lowered mood: Feelings of worthlessness or "emptiness."

  • Anger: Directed at the self or others.

  • Lowered self-esteem: Describing oneself with "self-loathing."

• Cognitive:

  • Poor concentration: Inability to stick to tasks or make decisions.

  • Dwelling on the negative: Ignoring the positive and recalling unhappy events (the "half-empty" glass).

Flashcard 7: Obsessive-Compulsive Disorder (OCD)

• Behavioural:

  • Compulsions: Repetitive actions (e.g., handwashing) performed to reduce anxiety.

  • Avoidance: Avoiding situations that trigger anxiety (e.g., not emptying bins to avoid germs), which can interfere with normal life.

• Emotional:

  • Anxiety and distress: Powerful, unpleasant thoughts (obsessions) that create overwhelming anxiety.

  • Accompanying depression: Low mood and lack of enjoyment in activities.

  • Guilt and disgust: Irrational guilt or disgust directed at the self or something external (like dirt).

• Cognitive:

  • Obsessive thoughts: Recurrent, intrusive thoughts (e.g., fear of contamination) that occur for 90% of sufferers.

  • Cognitive strategies: Using mental "rituals" (like praying or counting) to manage anxiety.