psychopathology full topic (copy)

what is the definition of abnormality

behaviour, thoughts or traits the deviates from the norms of society

what are the 4 types of abnormality

statistical infrequency/deviation

deviation from social norms

failure to function adequately

deviation from ideal mental health

what is the definition of abnormality in the context of statistical infrequency/deviation

when a person’s trait, thinking or behaviour is classified as abnormal if it is rare or statistically unusual

evaluating statistical infrequency/deviation as an explanation for abnormality

strength: real life application - almost always used for clinically diagnosing mental disorders as a comparison with a baseline/normal value

limitation: just because a characteristic is unusual doesn’t make it undesirable eg. having a higher IQ isn’t undesirable

what is the definition of abnormality in the context of failure to function adequately

if a person’s current mental state is preventing them from leading a ‘normal’ life alongside the associated normal levels of motivation and obedience to social norms

evaluating failure to function adequately as an explanation for abnormality

strength: final diagnosis takes the person’s perspective into account (the patients account of symptoms and the psychologists objective opinions are both considered) = more accurate diagnosis’ as they aren’t constrained by statistical limits

limitation: may lead to embarrassing labels such as ‘crazy’ or ‘strange’ and because each person has such a different diagnosis (some hugely minor and other more severe) their quality of life could be ruined by these labels from employers or friends

what is the definition of abnormality in the context of deviation from social norms

the straying away from social norms specific to a certain culture and the behaviour a person portrays is violating the unwritten rules of social groups

evaluating deviation from social norms as an explanation for abnormality

strength: participant characteristics - a person may be mislabelled as not normal but simply disagree with or wish to break the social norms

limitation: no universal agreement over social norms = the line between normal in different cultures changes (eg. hallucinations are normal in Zulu culture) and norms change overtime (eg. drink driving used to be acceptable)

what is the definition of abnormality in the context of deviation from ideal mental health

when a person does not meet a set of criteria for good mental health - such as an inability to self-actualise and having an accurate perception of ourselves

who proposed the failure to function adequately form of abnormality

Rosenhan and Seligman 1989

who proposed the deviation from ideal mental health form of abnormality

Marie Jahoda 1958

what did Jahoda say were the 8 ideal mental health criteria

positive attitude towards one’s self

self-actualisation (fulfilling ones potential)

integration (ability to balance aspects of personality and life experiences)

autonomy (ability to make important decisions and to take control of one’s life)

accurate perception of reality

environmental mastery

positive relationships with others

a sense of purpose in life

evaluating deviation ideal mental health as an explanation for abnormality

strength: real world application - most people with concerning mental health issues, will have some form of diagnosis

limitation: Jahoda may have had an unrealistic expectation of ideal mental health with the vast majority unable to acquire - making it that almost the whole population would be considered not normal = limited method of diagnosing mental health disorders

limitation: cultural bias - this criteria is not inclusive of all cultures but mainly focuses on western culture

what is a phobia

a group of mental health disorders characterised by high levels of anxiety that interferes with normal living, in response to a particular stimulus or group of stimuli

what are behavioural characteristics towards phobias

how we act

what are emotional characteristics towards phobias

how we feel

what are cognitive characteristics towards phobias

how we think

what are some examples of behavioural characteristics towards phobias

avoidance

freezing or fainting (panic)

endurance

what are some examples of emotional characteristics towards phobias

feelings of panic or anxiety

persistent or excessive fear

(all emotions cued by a stimulus or anticipation of stimuli)

what are some examples of cognitive characteristics towards phobias

cognitive distortions - irrational nature of a person’s thinking

irrational beliefs - resisting logical and rational arguments

aware of their unreasonableness

selective attention - the patients focus on the phobic stimuli even when it causes them anxiety (causes irrational beliefs or cognitive distortions)

what is endurance as a behavioural characteristic towards phobias

when a person is exposed to a phobic stimuli for an extended period of time and experiences heightened levels of anxiety throughout this time

what is depression

a mood disorder when people have a low mood for an extended period of time (weeks or months) and that affects daily life

usual symptoms of depression (7)

feeling sad

lacking interest in normal activities

irrational or negative thoughts

lowered activity levels

lowered concentration levels

not eating properly

insomnia

what are some behavioural characteristics of depression (4)

reduced/increased activity levels

tiredness and lack of energy (inability to get up and out of bed in the morning)

agitation and aggression

changes in sleep or eating patterns

what are some emotional characteristics of depression (5)

feeling sad

loss of interest in everyday activities

lowered self-esteem

constant poor mood (lasting up to months)

high anger levels both internal and external (lack of control)

what are some cognitive characteristics of depression (3)

absolutist thinking leading to irrational thoughts (eg. thinking your an absolute failure)

selective attention towards negative events (glass half empty)

poor concentration

what is OCD

an anxiety disorder when anxiety arises from obsessions and compulsions (a response to these obsessions as the individual believes the compulsions will reduce the anxiety)

what are obsessions

persistent and intrusive thoughts - the person is obsessed with this thinking

what are compulsions

the behaviours that are repeated over and over again as the person believes it will help the reduce the anxiety they feel from an obsession

what are some behavioural characteristics of OCD

compulsive behaviours (eg. continuous cleaning)

mental acts

repeated behaviours - not realistically related to the individual beliefs as to what it will prevent

avoidance

what are some emotional characteristics of OCD

anxiety and distress (scale of how intense)

awareness of their excessive behaviours

feelings of disgust and guilt

feeling fear about something that could happen (mostly irrational situations)

what are some cognitive characteristics of OCD

reoccurring, intrusive thoughts and impulses

embarrassment or frightened

acknowledgement of irrational actions and knowning the thoughts are all in their mind

the OCD cycle

→obsessive thought →

→anxiety →

→compulsive behaviour →

→temporary relief →

what is the two-process model for phobias

an explanation for the onset and persistence of disorders that create anxiety, such as phobias.

what are the two processes in the two - process model

classical conditioning for onset

operant conditioning for persistence

who proposed the two - process model

Orval Hobart Mowrer 1960

how do psychologists explain behavioural characteristics of phobias

1. panic

2. avoidance

3. endurance

Who conducted the Little Albert study to see about phobias

John Watson and Rosalie Rayner

what is the Little Albert study

classical conditioning:

exposed Albert to a white rat (NS), producing no response, then paired the white rat with a loud bang (UCS) producing fear (UCR) and through repetition Albert made the association between the rat (CS) and fear (CR)

operant conditioning:

conditioned response occurs in other objects (eg. white fluffy things - rabbits), operant conditioning takes place when a behaviour is rewarded or punished. Once a CR is established towards a CS, people often avoid the stimulus (negative reinforcement) making them more likely to repeat the behaviour, Little Albert avoided the white rats (negative reinforcement) to avoid the fear associated with them

evaluating the behaviourist explanation of phobias

strength: real-world application - led to exposure therapies (eg. systematic desensitisation)

strength: explains the link between acquisition and maintenance of phobias - Little Albert proved how the phobia was acquired and why is was maintained

C/A: not all phobias are acquired through bad experiences and not all bad experiences acquire phobias

limitation: alternate explanation for th acquisition of phobias (Seligman) = alternative theories can explain why some phobias are more frequent that others

Seligman

we are more likely to develop phobias towards ‘prepared stimulus’ = stimulus that have posed a threat to ancestors (eg. fire or deep water) and therefore phobias can be acquired from things that present danger in our evolutionary past

what is systematic desensitisation

a behaviour therapy designed to reduce an unwanted response (eg. anxiety)

involves drawing up a hierarchy of anxiety - provoking situations related to a person’s phobic stimulus

teaches the person to relax then slowly exposes them to more stressful phobic situations (up the hierarchy) while maintaining relaxation

what is flooding

a behavioural therapy in which a person is exposed to an extreme of their phobic stimuli to reduce the anxiety triggered by the stimulus

what is counterconditioning

a learning response used in systematic desensitisation

the person is taught to associate the phobic stimulus with relaxations instead of anxiety (through classical conditioning)

what are the 3 processes of systematic desensitisation

1. anxiety hierarchy

2. relaxation

3. exposure

how does flooding stop the CS producing the CR as fear

avoidance behaviour becomes extinct

a learned response is extinguished when the CS/phobic stimulus is encountered without the UCS/phobia

basically reverses classical conditioning and the effect of it

overall summary of systematic desensitisation

lots of shorter sessions (longer time to complete)

client is gradually exposed to increasingly anxiety-provoking situations

effective but not as much as flooding

overall summary of flooding

1-3 longer sessions (up to 2 or 3 hours)

client is immediately exposed to very high anxiety - proving situations

more traumatic but also more effective if completed (but clients have the choice to withdraw at any point)

evaluating systematic desensitisation

strength: research support - Gilroy et al 2003

strength: can be used to help people with learning disabilities - anxiety disorders are normally accompanied with learning disabilities, and these people are unable to give full cognitive commitment with cognitive behavioural therapy, but they can with behavioural therapy

limitation: more expensive than flooding - more sessions

limitation: people have the right to withdraw consent at any point meaning it can be a very long process if the client is unwilling to cooperate and face their phobias

Gilroy et al 2003

42 people underwent systematic desensitisation for a spider phobia over three 45mins sessions, at 3 months and 33 months the group showed a significant reduce in their sympitns compared to the control group

evaluating the use of VR for exposure therapy

strength: provides exposure while avoiding real dangers (eg. heights)

strength: cost effective - no money spent on sessions and overcoming some fears can be costly (eg. flying)

limitation: may be less effective as it lacks the social and realistic element of life

evaluating flooding

strength: cost -effective - less sessions means less money spent (frequently as little as 1 session can overcome a phobia) meaning they can continue their normal lives soon after

limitation: ethical issues - can be traumatic for the client

limitation: symptom substitution - deals with the anxiety response but doesn’t change the root of he phobia

what are the main cognitive explanations of depression

the disorder is the result of disturbance of thinking

focus of an individuals irrational beliefs, negative thoughts and misinterpretation of events

is it about how you see/ think about a problem that causes depression (not the problem itself)

people can overcome mental disorders by learning to use cognitions that are more appropriate

what did Aaron Beck suggest

there’s a cognitive explanation as to why some people are more vulnerable to depression than others - 3 parts to this cognitive vunerablitity

what are Aaron becks 3 cognitive vulnerability points

faulty information processing - only focusing on negative outcomes of a situation and disregarding positive ones (blowing things out of proportion, thinking in black and white)

negative self schemas - a belief of knowledge (interpreting information about themselves from the world in a negative light, lowering their self confidence) - Weissman and Beck 1978

negative triad - patient suffers from having negative thoughts about the self, the future and the world

Weissman and Beck 1978

aim: investigate the process of depressed people to establish if they were made up of negative self schemas

method: measured by using a dysfunctional attitude scale - asking participants to agree/disagree with statement

results: depressed participants made more negative assessments and concluded that depression does involve negative self schemas

evaluating Beck’s theory

strength: research evidence - weissman and Beck 1978

strength: practical application - forms the basis of cognitive behavioural therapy (CBT) and they can all be challenged in CBT

limitation: doesn’t explain all aspects of depression - only explains the basic symptoms of depression, but its a complex disorder with a range of symptoms not all of which can be explained

Albert Ellis

believed good mental health is a results of rational thinking

argued that people with depression have based their lives off common irrational beliefs that underlie depression

what was Ellis’ ABC theory

A - an activating event triggers

B- an individual’s irrational beliefs

C - a consequence

each steps leads to the next

evaluating Ellis’ ABC model

strength: practical application - led to a successful therapy (REBT - rational emotive behavioural therapy) in which irrational beliefs are challenged to reduce depression symptoms (so irrational beliefs must play a role in depression)

limitation: only offers a partial information - aside from those that have a clear activating event (eg. reactive depression), many suffer from depression without an apparent cause and feel frustrated their concerns/experineces aren’t reflected in this theory

limitation: can’t explain all aspects of depression - only explains the basic symptoms of depression, but its a complex disorder with a range of symptoms not all of which can be explained (eg. hallucinations and delusions)

(limitation: may blame the depressed person for their symptoms)

what is Beck’s cognitive behavioural therapy

a therapy to challenge the negative triad (beliefs) of a client

first they will be assessed to discover the severity of their condition (depression)

the therapist will then establish a baseline/starting point prior to treatment - to monitor the improvement

the therapist makes the client aware of the relationships between thought and emotion (eg. I am stupid → this makes me feel sad → I feel sad so I’m not enjoying myself)

the client is asked to provide information about how they perceive themselves, the future and the world

the therapist challenges the triad by focusing on successions and achievements from the client

clients become aware of their negative views and replace their irrational beliefs with more optimistic and rational ones

Ellis’ Rational Emotive Behavioural therapy (1962)

Ellis extends his model to the ABCDE model

D - dispute (challenges the negative thoughts)

E - effect (see a more beneficial effect on thought and behaviour

central technique for REBT is to identify and dispute the patient’s irrational thoughts

Ellis argues irrational thoughts are the main cause of all types of emotional distress and behaviour disorders, and these irrational thoughts make impossible demands of the individual = anxiety, failure and psychological difficulty

REBT challenges the client to prove these statements (and when this isn’t possible) they are replaced with more reasonable and realistic statements

Newark et al 1973

aim: discover if people with psychological problems have irrational attitudes

method: 2 groups (one with anxiety and a control group) of participants were asked whether they agreed with statements that Ellis identified as irrational

results: 65% of anxious participants agreed with the first statement while 2% agreed from the control group

80% anxious participants agreed with the second statement compared to 25% from the control group

conclusion: people with emotional problems this in irrational ways

evaluating the cognitive approaches (Beck and Ellis’ to treating depression)

strength: research support - John March = CBT is effective

limitation: not effective for all people - some people with severe depression can’t be treated using CBT as they are unable to attend regular sessions due to low mood etc… (only those that are willing to help will be treated successfully with CBT)

limitation: CBT focuses on present life and present challenges, while some depression cases are related to past events (eg. childhood trauma or past deaths of loved ones) and since CBT tells people not to dwell on the past, it isn’t useful for everyone

John March

aim: test the effectiveness of CBT

method: 327 adolescents in 3 groups (one treated with Cat, one with drugs and one with both CBT and drugs)

results: after 36 weeks:

81% of CBT group improved

81% od drugs improved

86% both treatments improved

what are genetic explanations

genes that make up chromosomes which code for our physical (eye colour, hair colour) and psychological (mental disorder, IQ) features

genes are transmitted from parents to offspring

what are neutral explanations

the view that physical and psychological features are determined by the behaviour of the nervous system (mostly the brain - as well as other neurons)

chromosomes and DNA determine behaviour

Aubrey Lewis 1936

observed his OCD patients:

37% had parents with OCD

21% had siblings with OCD

suggests that the vulnerability of having OCD runs in families

what is the diathesis - stress model

a model that suggest that certain genes leave some people more likely to develop a mental disorder (but no for certain), and an environmental stress/experinece is required to trigger the condition

what are candidate genes

genes that researchers have identified as creating vulnerability for OCD

some of these are involved in regulating the development of serotonin

what does the belief in OCD being polygenic mean

OCD is caused by a combination of genetic variations that together cause vulnerability

Steven Taylor 2013

found that 230 different genes may be involved in OCD - some of which relate to dopamine and serotonin

what is dopamine

a neurotransmitter involved in making people happy

what is serotonin

a neurotransmitter involved in making people sad

what does aetiologically heterogeneous mean

origins may vary from one person to another (eg. one set of genetic material may cause the disorder in one person and a different material will cause it for another person)

what are the neural explanations of OCD

the genes associated with OCD are likely to affect the levels of neurotransmitters and the structures of the brain

low levels of serotonin disrupt normal transmission of mood-related information between neurons

what part of the brain is associated with decision-making (ab)normalities

lateral frontal lobes

what part of the brain is associated with processing unpleasant emotions and functions abnormally for people with OCD

left parahippocampal lobes

evaluating genetic explanations of OCD

strength: research support - Nestadt et al 2010 and Marini and Stebnicki 2012

limitation: environmental risk factors - OCD isn’t entirely genetic in origin and environmental risk factors contribute to OCD (Kiara Cromer et al 2007 proves genetic vulnerability only provides a partial explanation for OCD)

limitation: ani

Mal studies - some of our evidence to support genetic causes for repetitive behaviour is based off animals (eg. mice) and although they share some of the same genes, human brain is much more complex

Nestadt et al 2010

reviewed twin studies

found 68% identical twins shared OCD

31% of non-identical twins shared OCD

Marini and Stebnicki 2012

discovered a family member diagnosed with OCD is 4 times more likely to develop it compared to a family without the diagnosis

Kiara Cromer et al 2007

found that half of OCD clients had experienced a past traumatic event and they had the least severe cases of OCD

evaluating neural explanations

strength: research support - drugs that target serotonin levels are effective in reducing OCD symptoms meaning there has to be a link between OCD and serotonin levels

limitation: no unique neural system - the serotonin and OCD link may not be unique to just OCD as most people with OCD also have depression (co-morbidity)and depression is also linked to serotonin levels meaning that serotonin leads to depression which leads to OCD instead of serotonin levels leading to OCD

co-morbidity

when a person has 2 illnesses at the same time - and sometimes one can be a consequence of another (eg. depression and OCD)

what is drug therapy

treatment involving drugs - normally for treating psychological disorders, it affects the nurotransmitters levels

how long does it take SSRI’s to change a person’s behaviour and affect their neurotransmitter levels

3-4 months

what does SSRI stand for

selective serotonin re-uptake inhibitor

what is the standard treatment for OCD

antidepressant drug therapy - SSRI’s

explain the journey serotonin takes in the brain

released by the presynaptic neuron and travels across the synapse to the postsynaptic neutron

it conveys the message from the pre to the postsynaptic neuron

it is then reabsorbed by the presynaptic neuron

how does SSRI’s change the journey of serotonin in the brain

prevents the reabsorbtion/re-uptake by the presynaptic neuron

this means there is a higher level of serotonin in the synapse

meaning the serotonin can continue to affect the postsynaptic neuron

is the dosage of serontonin the same in every SSRI

the dosage of serotonin depends on the SSRI but a typical dose of Prozac (fluoxetine) is 20mg (available as a capsule or liquid)

can drug treatment and oral treatment work alongside each other when treating OCD

yes, SSRI’s and CBT are often used together as drugs reduce the emotional symptoms meaning the person can engage in CBT more successfully

but some people refer to use just one or the other with treatment - but depends on the person

is there alternative drugs to SSRI and if so, why?

yes because SSRI’s can take up to 3 or 4 months to work, so it can be paired with other drugs

Tricyclics (eg. cholmipramine) - acts of the serotonin system but has more severe side effects so its normally a last resort alternative for people who dont have any response to SSRI’s

SNRI’s (serotonin - noradrenaline re-uptake) - increase the levels of serotonin and the levels of the neurotransmitter noradrenaline and is also a second resort for people who don’t suit SSRI’s

evaluating drug therapy

strength: evidence of effectiveness - clear evidence that SSRI’s reduce symptom severity and improve quality of life for people with OCD (Mustafa Soomro et al 2009)

C/A: drug treatments might not be the most effective treatment - Petros Sapkinakis et al 2016

strength: cost-effective and non-disruptive - drugs are easier as they dont intrude in everyday life and routines and are provided for free by the NHS

limitation: serious side effects - SSRi’s can have bad side effects like blurred vision, loss of sex drive and can be distressing (and those taking tricyclic clomipromine have a higher chance of side effects and these can be bad - weight gain, heart-related problems and aggressive behaviour)

limitation: biased research - some believe that evidence for drug effectiveness is biased because some researchers are sponsered by drug companies and may selectively publish positive outcomes, there is a lack of independent studies on drug effectiveness

Petros Sapkinakis et al 2016

concluded that cognitive and behavioural therapies were more effective than SSRI’s

Mustafa Soomro et al 2009

reviewed 17 studies of SSRI' effectiveness compared to a placebo group

found that all SSRI people had better improvement than the placebo group

70% taking SSRI people had reduced symptoms

the remaining 30% could be helped by a combination of drugs or psychological therapies