Psychopathology

List the 4 definitions of abnormality

1. Statistical infrequency

2. Deviation from social norms

3. Failure to function adequately

4. Deviation from ideal mental health

define ‘statistical infrequency’ as a definition of abnormality

Any behaviour that strays from the statistical norm - for example, only a small amount of people will have an IQ below 60, we therefore consider it abnormal.

Define ‘Deviation from social norms’ as a definition of abnormality

Those who subvert the expectations for traditional social behaviour/ interactions. defined by the majority - culturally specific.

Define ‘Failure to function adequately’ as a definition of abnormality

Someone may be considered abnormal when they can no longer cope with everyday life. This may include struggling to maintain personal hygiene or being unable to conform to interpersonal rules of conversation such as making eye contact.

Define ‘deviation from ideal mental health’ as a definition of abnormality

Someone may be considered abnormal when they fail to meet our standards for the norm of psychological health. If someone does not meet the 8 criteria for good mental health, they may be considered abnormal.

Give one strength and two weaknesses of Statistical infrequency as a definition of abnormality.

strength: Has real life applications in diagnosing mental illness

weakness: does not consider the desirability of the characteristic - some unusual things can be positive

weakness: Not everyone unusual benefits from a label, sometimes those who are ‘statistically deviant’ are living happily without negative effects and a label of abnormality will only negatively effect their life.

Give 3 weaknesses of deviation from social norms as a definition of abnormality

1. Not a sole explanation - cannot be used independently as a diagnosis tool, at least one other definition has to be used

2. Culturally relative - Social norms are different in every society, someone from a different country may be completely ‘normal’ at home but when abroad be viewed as extremely abnormal

3. Can lead to human rights abuses - Has historically been used as a way to single out and persecute those who have opposing views to a ruling dictatorship or other form of power.

Give 1 strength and 2 weaknesses of ‘failure to function adequately’ as a definition of abnormality

strength: attempts to include the experience of the individual, acknowledges that their experience is important to the diagnosis and treatment.

weakness: Hard to differentiate between failure to function and deviation from norms. Treating behaviour that is simply socially abnormal as failure to function runs the risk of discriminating against minorities.

weakness: Judgements of whether or not someone is failing to function can be subjective. It’s hard to accurately and definitively state whether someone is suffering or not without completely understanding their experience.

Give one strength and two weaknesses of 'Deviation from ideal mental health’ as a definition of abnormality

strength: comprehensive definition - broad range of criteria effectively covers all bases of mental health

weakness: unrealistic standards for mental health - very few individuals actually reach all 8 criteria.

Weakness: Culturally specific - standards for mental health are considered differently in different cultures, we all view different things as important

What are the 8 criteria for good mental health and who came up with them

Jahoda (1958)

1. We have no symptoms or distress

2. We are rational and perceive ourselves accurately

3. We self actualise

4. We can cope with stress

5. We have a realistic view of the world

6. We have good self esteem - lack guilt

7. We are independent of other people

8. We can successfully work, love and enjoy our lesiure

Define ‘phobia’

an irrational fear of an object or situation

What are the three types of phobia

.Specific phobia

.Social phobia

.Agoraphobia

What are the 3 behavioural characteristics of a phobia

1. Panic

2. Avoidance

3. Endurance

Define panic as a behavioural characteristic of phobia

A phobic person may respond to the phobic stimulus by panicking, this can involve many behaviours such as screaming, crying and shouting.

Define avoidance as a behavioural characteristic of a phobia

A phobic individual may make a deliberate effort and go out of their way to avoid coming into contact with the phobic stimulus. This can effect the way they go about daily life.

Define endurance as a behavioural characteristic of a phobia

The alternative to avoidance, a sufferer remains in the presence of the phobic stimulus but continues to have high levels of anxiety. This may occur in unavoidable situations such as flying.

What are the two emotional responses of a phobia ?

1. Anxiety

2. Unreasonable emotional response

Define anxiety as an emotional response of a phobia

sufferer experiences uncomfortable state of anxious psychological arousal - anxiety and fear.

Define unreasonable emotional response as an emotional response to phobia

The emotional responses a sufferer feels in relation to phobic stimuli go beyond what is reasonable. Screaming and crying because you have seen a spider is wildly disproportionate to the actual danger posed by it.

What are the three cognitive characteristics of a phobia ?

1. Selective attention to the phobic stimulus

2. Irrational beliefs

3. Cognitive distortions

Define selective attention as a cognitive response to a phobia.

if a sufferer can see the phobic stimulus, it can be very hard for them to focus on anything else. Should the phobic stimulus be actually dangerous this is effective as a safety strategy but if the phobia is non-dangerous it is just an inconvenient distraction.

Define irrational beliefs as a cognitive response to a phobia

A phobic may hold irrational beliefs in relation to the phobic stimulus - for example, an arachnophobic may think ‘it’s going to bite and kill me’ when they see a common house spider.

Define Cognitive distortion as a cognitive response to phobia

a phobic’s perception of the phobic stimulus may be distorted. They may see the phobia as disgusting and revolting when to non-phobics it’s not.

How many behavioural, emotional and cognitive characteristics does a person need to possess to be diagnosed with a phobia?

One behavioural, one emotional and one cognitive.

the two process model:

1. what psychological perspective is it from

2. who theorised it and in what year

1. Behaviourist

2. Mowrer - 1960

What are the two parts of the two process model?

1. Acquisition - classical conditioning

2. Maintenance - operant conditioning

Explain acquisition by classical conditioning

Learning by associating a neutral stimulus ( the future phobia) with an unconditioned stimulus (the experience that teaches us to be afraid). These two produce an unconditioned response - fear. eventually the neutral stimulus becomes a conditioned stimulus ( phobia) and interacting with it produces a conditioned response ( behavioural, emotional and cognitive)

What research demonstrated acquisition of a phobia by classical conditioning ?

Who did it and in what year?

The little Albert experiments

Watson and Rayner - (1920)

Explain maintenance of a phobia by operant conditioning

responses gained from classical conditioning tend to decline overtime, a phobia is prevented from fading by maintenance through operant conditioning. Operant conditioning takes place when our behaviour is reinforced, positively or negatively.

define positive reinforcement

define negative reinforcement

Continuing a behaviour as we learn that it rewards us.

Continuing a behaviour as we learn that it helps us avoid negative consequences. Ex: a phobic avoiding their phobic stimulus as they learn it stops them from being afraid.

What research supports operant conditioning?

Who did it?

Skinner’s box

Skinner

Give a strength of the two process model

Good explanatory power - Was a step forward in understanding phobias, explained how they’re maintained over time - had important implications for therapies and treatments.

Give 3 weaknesses of the two process model

Alternate explanations for avoidant behaviour - evidence to suggest that when sufferers avoid the phobic stimulus, it’s not to get away from the fear but is instead to get to a point of safety

Incomplete explanation - Ignores the fact that evolutionary factors probably have a role in causing phobias, it is more common to have a fear of things that have always been a danger to humans such as snakes ( this is adaptive) but very few of us have a phobia of relatively new but actually more dangerous things such as guns

Some phobias don’t follow trauma - people can develop phobias of things that they’ve never even seen. Two process model fails to acknowledge the findings of social learning theory that individuals learn to be afraid of things by observing other’s fear.

What are the two behaviourist treatments for a phobia

1. Systematic desensitisation

2. Flooding

Explain the idea of systematic desensitisation as a treatment of phobia

Designed to gradually reduce phobic anxiety through classical conditioning and exposure. If the phobic can learn to relax in the presence of the phobic stimulus, they will be cured.

What are the 3 stages of systematic desensitisation and how do they work.

1. The anxiety hierarchy - patient encouraged to list situations relating to the phobic stimulus from least to most scary

2. Relaxation - the phobic learns relaxation techniques to help them feel calm

3. Exposure - the phobic is exposed to the situation at the bottom of their anxiety hierarchy and are encouraged to use relaxation techniques to calm down. Once they can cope with that, they move up the anxiety hierarchy until they can cope with the scary situation.

Give 3 strengths and one weakness of Systematic desensitisation as a treatment of phobia

1. Effective - Gilroy’s research into arachnophobics showed that those who had had systematic desensitisation treatment were less fearful than the control group both 3 and 33 months after the treatment, it is effective and long lasting.

2. Suitable for a diverse range of patients - this treatment is appropriate for pretty much everyone (those with learning disabilities may struggle with the alternative options)

3. Acceptable to patients - Patients prefer it to the alternative options, Low refusal rates and low drop out rates

4. Symptom subscription - When one phobia disappears or is cured, it may be replaced with another one ( however the evidence for this is limited and mixed)

Explain the idea of Flooding as a treatment of phobia

Exposing sufferers to their phobic stimulus without a build up. Immediate exposure to a very frightening situation (an arachnophobic may have a spider crawl on their face)

How does Flooding work?

Flooding stops phobic responses very quickly, this could be because without the option of avoidant behaviour, the patient learns there is nothing to be afraid of. This is called **extinction** - to erase a learned response of fear, the conditioned stimulus (the phobia) must be presented without the unconditioned (the fear of what the phobia will do). The patient can sometimes relax because they are simply exhausted by their fear response. This process can be traumatic, **informed** consent must be received.

Give 1 strength and 3 weaknesses of Flooding as a treatment of phobias

1. Cost-effective - flooding is very effective, very quickly. Sometime only 1 session is needed to cure the phobia so it often costs patients less

2. Less effective for some types of phobia - flooding is useful for treating specific phobias but is less effective for more complex phobias such as social phobias as they often involve irrational thinking and may be better treated by cognitive therapies

3. Treatment is traumatic for patients - highly traumatic experience and patients often refuse to start or finish treatment which can lead to a waste of time and money

4. Symptom substitution - when one phobia is cured, it can be replaced by another (although the evidence for this is mixed)

What are the 3 behavioural characteristics of depression?

1. Change in activity levels

2. Disruption to sleep and eating

3. Aggression or self harm

Explain change in activity levels as a behavioural characteristic of depression.

Sufferers often become lethargic and withdrawn. This has a knock on effect on social life, or the opposite happens - this is called psychomotor agitation

Explain disruption to sleep and eating behaviour as a behavioural characteristic of depression

Sufferers often suffer from insomnia ( particularly early waking) or hypersomnia. Appetite can also increase or decrease causing weight gain or loss

Explain aggression and self harm as a behavioural characteristic of depression

Sufferers can often become verbally or physically aggressive to others or to themselves ( this may lead to self harm.)

What are the 3 emotional characteristics of depression

1. lowered mood

2. low self esteem

3. anger

Explain lowered mood as an emotional characteristic of depression

Sufferers can often feel sad, empty, worthless and lethargic

Explain anger as an emotional characteristic of depression

Sufferers often feel predominately negative emotions, one of these being anger. High levels of anger can lead to aggressive behaviour

Explain lowered self esteem as an emotional characteristic of depression

Sufferers regularly report not liking themselves, feelings of self loathing and not feeling good enough.

What are the 3 cognitive characteristics of depression

1. focusing on the negative

2. absolutist thinking

3. poor concentration

Explain focusing on the negative as a cognitive characteristic of depression

Sufferers of depression are likely to view the glass as ‘half empty’. They are also more likely to recall bad memories than happy ones

Explain absolutist thinking as a cognitive characteristic of depression

people with depression are likely to view situations as all good or all bad and fail to see the nuance - black and white thinking.

Explain poor concentration as a cognitive characteristic of depression

sufferers may struggle to focus on simple tasks or make decisions they would normally find easy.

What are the two cognitive explanations of depression

. Beck’s cognitive theory

. Ellis’ ABC model

What are the three parts of cognitive vulnerability that Beck identifies

. Faulty information processing

. Negative self schemas

. Negative triad

Explain faulty information processing as an element of Beck’s cognitive theory

Information is interpreted negatively, ignoring the positive aspects of a situation and only thinking about how awful it is or how it could be better

Explain negative self schemas as an element of Beck’s cognitive theory

Mental framework of the self is structured negatively, this means we interpret all information about the self in a negative light

What are the three components of the negative triad (an element of Beck’s cognitive theory)

• Negative view of the self

• Negative view of the future

• Negative view of the world

How does Becks CBT test the reality of the patient’s beliefs

Patients are encouraged to collect information about their lives themselves, usually positive events, when they express faulty thinking, the therapist can challenge it with evidence from their life.

What does Ellis’ theory focus on?

Irrational thoughts

What do A,B&C stand for in the ABC model

Activating event

Belief

Consequence

How does Ellis’ REBT challenge patient’s irrational beliefs

Therapist engages in argument with the patient, either empirical or logical - disputing evidence or facts

Give 3 evaluations of Beck’s cognitive theory

• Supporting evidence - Beck’s theory is supported by Grazioli’s research into mothers

• Practical application in CBT

• Doesn’t explain all factors of depression such as hallucination and extreme anger

Give 3 evaluations of Ellis’ ABC theory

• Practical application in CBT

• Not all depression is reactive

• Doesn’t explain more complex cases of depression

Give 3 evaluations for CBT (both Beck’s and REBT)

• May be due to therapist-patient relationship

• At least as effective as antidepressants

• May be too hard for depressed person to engage with

What are the behavioural characteristics of OCD

• Compulsions - repetitive and anxiety reducing

• Avoidance

Explain compulsions as a behavioural characteristic of OCD

Compulsions are urges to perform actions that are driven by intrusive thoughts. These actions are usually performed by the sufferer to reduce the anxiety that intrusive thoughts cause. They are also almost always repetitive.

Explain avoidance as a behavioural characteristic of OCD

Sufferers will often go out of their way to avoid anything that may trigger an obsessive thought

What are the emotional characteristics of OCD

• Accompanying depression

• Anxiety and distress

• Guilt and disgust

What are the cognitive characteristics of OCD

• obsessive or intrusive thoughts

• Insight into anxiety

• cognitive strategies

Explain obsessive/intrusive thoughts as a cognitive characteristic of OCD

sufferers often suffer from obsessive or intrusive thoughts which are repetitive thoughts that are always of unpleasant things, they often drive compulsions or avoidance to ‘stop’ their occurrence

Explain insight into anxiety as a cognitive characteristic of OCD

Sufferers of OCD have to be aware that their anxiety and intrusive thoughts are unreasonable and unlikely to actually occur, if they believe them to be real, they’re more likely to be suffering from a form of psychosis

Explain cognitive strategies as a cognitive characteristic of OCD

Sufferers often develop methods to deal with the anxiety caused by OCD and intrusive thoughts

What is the genetic explanation for OCD

OCD is hereditary, it is passed down from parents

• Polygenic - caused by groups of genes

• Candidate genes

• Different groups of genes cause OCD in different people

What is the neural explanation for OCD?

• Serotonin being reabsorbed by the presynaptic nerve faster than it can be produced, therefore not enough is transmitted to the post synaptic nerve to give it effect.

• Impaired decision making systems - parahippocampalgyrus and lateral frontal lobes often show signs of damage

Give 3 evaluations of the genetic explanation of OCD

• Supporting evidence - Nesdadt 61% of identical twins with OCD share it their twin - 31% for non - identical twins.

• Too many candidate genes - psychologists have not yet pinpointed specific ones

• environmental risk factors- environment does play a part in acquisition of OCD

Give evaluations of the neural explanation for OCD

• environmental risk factors play a part

• Nesdadt - supporting evidence

• Logical fallacy - what’s to say that the damage to parahippocampalgyrus and lateral frontal lobe isn’t caused by OCD rather than causing the OCD - correlation doesn’t equal causation.

Explain the biological treatment for OCD

Drugs called SSRIs (selective serotonin reuptake inhibitors) reduce the reabsorption of serotonin by blocking open vesicles in the presynaptic nerve. should be taken in 20mg daily doses and can be paired with other drugs and therapies to make it more effective.

Give evaluations for the use of SSRIs to treat OCD

• Effective

• Causes side effects

• Non disruptive to patients life and cheap.

Name 5 side effects of SSRIs

• blurred vision

• heart murmurs

• aggression

• loss of sex drive

• heightened blood pressure

Explain why the use of SSRIs is non-disruptive to a patient’s life

patients with OCD may struggle to leave the house and go into new spaces so taking drugs at home minimises discomfort