psychopathology

Definitions of abnormality

Statistical infrequency
Deviation from social norms
Failure to function adequately
Deviation from ideal mental health

Statistical infrequency

Behaviour that is statistically rare, for example, high IQ

AO3 of Statistical infrequency:

+ Can be more appropriate than other definitions, depending on the situation.
- Abnormal can be good (high IQ)
- Normal can be bad (depression)
- Cut off point is subjective and hard to decide.

Deviation from social norms

Violating what is viewed as right socially, for example, homosexuality in the past.

AO3 of deviation from social norms

+ Changes with the times
+ Distinguishes between what is desirable and undesirable
+ Considers effects on others.
- Means those who transgress are more likely to be diagnosed as mentally ill.
- Behaviour is dependent on context and degree.

Failure to function adequately

The inability to go about everyday life, for example, someone with severe OCD

AO3 of failure to function adequately

+ Some people benefit from their failure to function
+ Easy to objectively judge
- Who judges? A person may not realise their behaviour, or may be the only one who does.

Deviation from ideal mental health

Lacking at least one of the six key qualities:
Self-attitudes,
Self-actualisation,
Integration, autonomy,
Perception of reality,
Environmental mastery

AO3 of deviation from ideal mental health

+ Focuses on what a person can do, not what they can't
- Criteria is unrealistic and hard to measure
- Mental illness isn't visible

Definition of a phobia

A group of mental disorders, characterised by high anxiety as a reaction to certain stimuli and interferes with normal life.

Emotional characteristics of phobias

Persistent and excessive fear, also feelings of anxiety and panic.

Behavioural characteristics of phobias

Avoidance, freezing or fainting.

Cognitive characteristics of phobias

Irrational nature of thoughts, inability to rationalise.

Behavioural approach to explaining phobias

Dual process model: classical conditioning causes the fears, whilst operant conditioning maintains it.

Classical conditioning

Before:
NS > Neutral response
UCS > UCR
During:
UCS + NS > UCR
After:
CS > CR

AO3 of classical conditioning

+ Some people do not recall a triggering event, implies some fears may be a result of others processes, for example, social learning.
- Diathesis stress model may be seen as more fitting, as it says we inherit a vulnerability to developing mental disorders.
- the dual process model ignores cognitive elements, such as the idea that phobias are a result of irrational thinking, as the thought triggers high anxiety, which may cause anxiety.

Operant conditioning

+ Reinforcement: positive behaviour causes a positive consequence.
- Reinforcement: behaviour causes the removal of unpleasant stimulus
Punishment: being near a stimulus reinforces the fear.

AO3 of operant conditioning

+ Bandura and rosenthal (1966) found that when a model acted injured when a buzzer sounded, PPT's later showed a fear response to the noise.
- Ignores other theories such as the theory of preparedness, which states we are genetically programmed to associate danger and fear to survive.

Behavioural approach to treating phobias

flooding and systematic desensitisation

Flooding:

Exposing a client to an extreme form of their fear under relaxed conditions until the anxiety is extinguished.
Taught relaxation techniques before.
In vitro (Virtual) or in vivo (real life).

AO3 of flooding

+ Choy et al found that it was more successful than systematic desensitisation, Craske et al found that they were equally effective.
- Can be highly traumatic, which causes clients to withdraw, which may worsen the phobia.

Systematic desensitisation:

Exposing clients to an extreme form of their fear gradually under relaxed conditions until the anxiety is extinguished.
Taught relaxation techniques and used between stages, known as the 'hierarchy of fears'

AO3 of systematic desensitisation

+ McGrath et al found that 75% of clients responded to it positively.
+ Fast, requires less insight and can be self administered.
- Not good for fears with an underlying evolutionary element.

Emotional characteristics of depression

sadness, loss of interest in everyday activities, feelings of emptiness and worthlessness, feeling a lack of control, anger.

Behavioural characteristics of depression

shift in activity levels, sleeping patterns and appetites.

Cognitive characteristics of depression

negative thoughts, views of things and irrational thoughts.

Cognitive approach to explaining depression

Ellis' ABC model, musturbatory thinking and Beck's negative triad (1967)

Ellis' ABC model

A = activating event
B = belief
C = consequence

Musturbatory thinking

Depressed people are more likely to think like this, thinking certain ideas must be true for an individual to be happy:
'I must be approved of or accepted by people i find important'
'I must do well or I am worthless'
'the world must give me happiness or i will die'

Becks negative triad

depressed people acquire a negative schema during childhood (tendency to be pessimistic), caused by many factors, such as peer rejection and criticism from teachers. the schemas are activated in new situations similar to when the schema was created.

AO3 of cognitive approach to explaining depression

+ Support for role of irrational thinking
Hammen & Krantz found than depressed people made more mistakes in logic when interpreting written material
Bates et al found that depressed PPTs given negative statements became more depressed.
+ Blames the client, so they are given the power to change things.
+ Useful because they have direct implications for the success of therapies
- Irrational beliefs aren't realistic
Alloy and Abrahmson found depressive realists see things for what they truly are, as they gave more accurate estimates of the likelihood of disaster

Cognitive approach to treating depression

CBT, which involves the Ellis' ABC model becoming the ABCDEF model, disputing, homework, behavioural activation and unconditional positive regard.

Ellis' ABC model becoming the ABCDEF model

D = disputing irrationla thoughts and beliefs.
E = effect of D and effective attitude.
F = new feelings produced.

AO3 of ABCDEF model

+ Ellis claimed a success rate of 90%.
+ Cuijpers et al found that 75% of studies show CBT is better than no treatment.
- 15% of outcome is down to who the therapist is and their attitueds

Disputing:

Logical: does thinking like this make sense?
Empirical: where's the proof that this is accurate?
Pragmatic: How does this belief help me?

Homework

Vital in testing irrational beliefs against reality

Behavioural activation

CBT encourages those with depression to exercise more.

AO3 of Behavioural activation

Babyak et al: 156 people with depression were either prescribed four months of exercise, meditation or both.
The best result after the four months was from the group who exercised.

Unconditional postive regard

if a therapist provides respect regardless of what a client says, it can change beliefs, and cause attitudes to be facilitated.

AO3 of cognitive approach to treating depression

Individual differences:
- CBT is less suitable for rigid thinkers who don't like change.
- Some don't want direct advice and just want to vent
Other treatments:
>Drug therapy is good for those who can't put in much effort.
Dodo bird effect:
>All are equally effective.

OCD

Stands for obsessive compulsive disorder.

Emotional characteristics of OCD

Obsessions and compulsions cause stress and anxiety, sufferers are aware that their behaviours are excessive so it causes embarrassment and shame.

Cognitive characteristics of OCD

Obsessions are recurring, intrusive thoughts and impulses are seen as inappropriate or forbidden so they may be scary or embarrassing, causing the person to be reluctant to share. Worries are uncontrollable.

Behavioural characteristics of OCD

Behaviours are performed to reduce anxiety, may be repetitive and unconcealed, but may just be mental acts.

Biological explanations for OCD

Genetic explanations: COMT gene and SERT gene, diathesis-stress model.
Neural explanations: Abnormal levels of neurotransmitters, abnormal brain circuits.

COMT gene

Involved in the production of Catechol-O-methyltransferase (COMT), which regulates dopamine. One mutation of the COMT gene is common in those with OCD, as it produces less COMT and more dopamine (Tukel et al).

SERT gene

Also called 5-HTT, affects the transport of serotonin, a common mutation found in those with OCD causes less to be transferred.
Ozaki et al found a mutation of SERT gene in two unrelated families where six or seven members had OCD.

Diathesis stress

The idea of a link between OCD and a gene is unlikely, so possibly, each individual gene creates a vulnerability for OCD and stressors cause it to develop.

AO3 of biological explanations for OCD: genetic explanations

+ Family twin studies:
Nestadt et al found 80 patients with OCD and 343 close relative then compared them with control patients. People with close relative with OCD had a five times greater risk of having it too.
Meta-analysis of 14 twin studies found identical twins were more than twice as likely to develop OCD if their twin had.
+ Research support
Menzies et al used MRI to look at brain activity on OCD patients and their close family. OCD family members had reduced grey matter in key parts of the brain, like the OFC
+ Real world applications
mapping of the human genome has led to the hope that a gene can be linked to specific disorder. Where a parent has the COMT gene, the mother an screen the eggs so they can abort any with it.
- Tourettes and other disorders.
Pauls and Leckman studied patient with tourettes and their families. OCD is a form of expression of the gene that causes tourettes.
Obsessional behaviour is also common in autism and anorexia nervosa

Abnormal levels of neurotransmitters

People with OCD have high dopamine levels - based on animal studies:
> High doses of dopamine causes OCD characteristics (Szechtman et al).
People with OCD have low serotonin levels - anti depressants that increase these hormone levels help with OCD symptoms (Pigott et al)

Abnormal brain circuits

some areas of the frontal lobe are abnormal in those with OCD.
The caudate nucleus (CN) should suppress signals from the orbitofrontal cortex (OFC).
in turn, the OFC sends signals to the thalamus about things that are worrying.
When the CN is damaged, it can't supress minor worry signals, so the thalamus is altered and sends signals back to the OFC, creating response.
> Supported by PET scans.
> Serotonin and dopamine levels are linked tot these areas.

Biological approach to treating OCD

Drug therpies including SSRI's, tricyclics and anti anxiety drugs.

SSRI's (Selective serotonin reuptake inhibitors)

These increase levels of serotonin, which helps regulate mood and anxiety. As seratonin is released into the synaptic gap, SSRI's stop any unabsorbed cells being reabsorbed by the releasing neuron, so it increases levels of serotonin at the synapse

Tricyclics

These block the transporter mechanism that reabsorbs seratonin and noradrenaline into a presynaptic cell after transmission.
More neurotransmitters are left in the synapse, prolonging their activity and easing transmission of the next impulse.

Anti-anxiety drugs

Benzodiazepines (BZs) slow activity of the central nervous system by enhancing the activity of gamma-aminobutyric acid (GABA) which calms neurones in the brain.
these react with special sites on the outside of receiving neurones and opens a channel to increase the flow of chloride ions into the neuron.
this makes it harder for other neurotransmitters to stimulate the neurons, which means its activity is slowed.

AO3 of biological approach to treating OCD

+ Effectiveness
> A randomly controlled trial is often used to compare the effectiveness of the drugs as some are given a placebo without knowing.
> Soomro et al reviewed seventenn studies on the use of SSRI's abd found that the drugs were more effective than the use of placebos.
+ Preferred to other treatments
> drug therapies are favoured as they require little effort and time.
- Side effects
> Drug therapies can have numerous side effects which can cause people to prefer not to use them