Clinical Psychology

What does something have to be to be classed as statistically rare?

extreme end of the distribution end (5% of population or 2 s.d’s from the mean)

How might someone deviate from social/cultural norms?

talking to themself

What are the 6 categories assessed by Failure to Function?

Cognition Mobility Self care Getting along Life activities Participation

What is PRAISE in terms of ideal mental health?

Positive attitude towards self Resistance to stress Accurate perception of reality Independence Self actualisation (focus on personal growth and future) Environmental mastery (flexibility)

What are the behavioural characteristics of depression?

Lethargy, Disruption to sleep and eating

What are the emotional characteristics of depression?

lowered mood, anger, low self esteem

What are the cognitive characteristics of depression?

Poor concentration, negative self schemas, absolutist thinking

What are the emotional characteristics of OCD?

Anxiety, distress, depression

What are the cognitive characteristics of OCD?

Obsessive thoughts, Cognitive strategies (mental acts to manage obsessions, Insight into irrational anxiety, Hyper vigilance

What are the behavioural characteristics of OCD?

Compulsions, avoidance

What are the cognitive characteristics of phobias?

Selective attention (focused on stimuli), Irrational beliefs (if I see a spider I will die), Cognitive distortions

What are the emotional characteristics of phobias?

Anxiety, Irrational emotional response

What are the behavioural characteristics of phobias?

Avoidance, panic, endurance (remaining in presence of stimuli but with high anxiety)

What does MDD stand for? What is an example?

MDD - depression

What has to be present to diagnose depression?

According to DSM-5, requires 5 symptoms to be present for at least 2 weeks and must include either depressed mood most the day or anhedonia

What was the NS and UCS in the little albert study?

NS = white rat UCS = loud bang

How are phobias acquired according to the behavioural approach?

Classical conditioning

How are phobias maintained according to the behavioural approach?

Operative conditioning (avoidance)

What does systematic desensitisation involve?

counterconditioning fear with relaxation, cancelling one emotion out (reciprocal inhibition)

What are the two types of exposure in systematic desensitisation?

In vivo (facing phobia IRL) In vitro (imagining phobia)

What are the 3 steps involved in systematic desensitisation?

Anxiety/fear hierarchy, Relaxation training, Gradual exposure

What does flooding prevent?

avoidance

How does flooding work?

fear cant stay high forever, so slowly the fear is extinguished once they realise nothing bad will happen

How long does one flooding session last on average?

2-3 hrs

What did Beck claim depression was a result of?

negative, automatic thoughts and cognitive distortions about the self, the world, and the future

What are examples of Beck’s negative triad

Self = I’m a failure, World = nobody values me, Future = I will never be good at anything

How is Beck’s negative triad maintained?

negative self schemas and cognitive biases

What are cognitive biases?

habitual, faulty ways of thinking such as overgeneralisation and catastrophising

What are negative self schemas?

mental frameworks that shape an individuals self perception, often developing in childhood due to bullying or abuse

What are two negative self schema examples?

Self blame schemas and Ineptness schemas (expectation to fail)

What does ABC stand for in Ellis’ model of depression?

Activating event Beliefs (interpretation of event) Consequences (rational beliefs = positive outcomes Irrational = negative outcomes)

What does REBT stand for?

Rational Emotive Behaviour Therapy

What does D and E mean in terms of the REBT model?

Dispute Exchange (reinterpret)

What are the two types of dispute?

Empirical and Logical

What is an empirical dispute?

asking for evidence to support the negative thought

What is a logical dispute?

questioning whether the belief is logically true

What does REBT try to promote?

healthy thinking patterns

What are the steps of Beck’s CBT?

Identify thoughts

“Thought on trial”

Homework (recording positive events)

Contradict

Behavioural Activation (engaging in positive activities to collect evidence)

What did Nestadt et al find OCD prevalence to be in those with 1st degree relatives with OCD and those without?

1st degree relatives was 11.7% without was 2.7%

What did Gottesman and Carey find the concordance rate to be amongst monozygotic twins and dizygotic twins?

Monozygotic was 87% Dizygotic was 47%

What does the COMT gene do?

involved in the breakdown of dopamine in the brain

What does a variation of the COMT gene do?

lower enzyme activity, dopamine doesn’t break down efficiently, higher levels of dopamine, may overstimulate brain areas involved in reward and habit formation, reinforces compulsive behaviours in OCD

What does the SERT gene do?

responsible for transporting seratonin across synapses

What does a mutation in the SERT gene do?

faster reuptake of seratonin, seratonin removed before impulse is passed, reduced seratonin activity, more vulnerable to obsessive thoughts and increased anxietyWg

What is the role of the Orbitofrontal cortex? What is an example?

processes sensory information from the environment, evaluates this input and turns it into thoughts and behavioural processes, especially if danger is detected. E.g hands feel dirty, worry signal to prompt cleaning

What is the role of the caudate nucleus?

(part of the basal ganglia) it filters out unnecessary or minor worry signals, preventing overreaction to harmless stimuli

What is the the role of the Thalamus?

receives the unchecked worry signals and becomes over-reactive, then amplifies the worry signal, then sends strong signals back to the orbitofrontal cortex, creating a loop of repetitive thoughts and actions reinforcing obsessions and encouraging compulsive action

What has OCD been linked to according to the neural explanation?

abnormal levels of the neurotransmitters seratonin and dopamine

What is the role of seratonin? What may it do in people with OCD?

neurotransmitter responsable for regulating mood and emotional responses - low levels lead to obsessive thoughts and increased anxiety

What is the role of dopamine? What may it do in people with OCD?

plays a key role in reward-seeking behaviour, motivation, and movement. Research suggests that high levels of dopamine may contribute to compulsive behaviours in OCD such as checking or repetitive cleaning.

How does drug therapy work?

targeting neurotransmitter imbalances, especially low levels of seratonin, which are linked to obsessions and anxiety

How do SSRI’s work?

blocks the reuptake of seratonin in the presynaptic neurone, meaning more seratonin remains in the synapse increasing the chance it will bind to receptors on the post-synaptic neurone, leading to greater seratonin activity which has an inhibitory effect on the brain

How do synapses function?

Action potential reaches the end of the nerve axon, triggers the release of NTs from the vesicles, vesicles bond with the nerve membrane and NTs are released into the synaptic cleft, the NTs bind to the receptor sites on the postsynaptic neurone where either an inhibitory or excitatory effect is exhibited. The transmission stops when the NT is reuptaken or broken down.

AO3 Statistical infrequency

Objective - Rigid cut off - NACDOI

AO3 Failure to function

Values the individuals perspective - NACDOI (underlying conditions) - Subjective (lack of consistency between psychologists)

AO3 Deviation from Ideal mental health

Uses a positive holistic approach - Demanding criteria - Culturally biased

AO3 Deviation from social norms

NACDOI (are they actually distressed and not functioning) - Reflects real world concerns (first referral) - Norms differ between cultures (stat)

What is the relationship between people of african caribbean descent and being diagnosed with schizophrenia?

people of african caribbean descent are 7 times more likely to be diagnosed with schizophrenia than the general population

AO3 The behavioural approach to explaining phobias

Watson and Rayner - Alternative explanation (Seligman’s biological preparedness theory) - PRWB (systematic desensitisation and flooding)

AO3 Behavioural approach to treating phobias

Gilroy + Keplan & Tolin - Not suitable for all phobias - Ethical reasons

What did Gilroy say on systematic desinsitisation?

those receiving 3 sessions of SD for a spider phobia showed less fear than a control group who only faced relaxation methods

What did Kaplan and Tolin say on flooding?

65% of those treated with 1 session of flooding no longer showed symptoms, even 4 years later

AO3 The cognitive approach to explaining depression

Cohen et al - Diathesis model - PRWB (CBT)

What did Cohen et al do about the cognitive explanation of depression?

conducted a prospective longitudinal study t.i whether cognitive vulnerability predicted later development of depression.

What did Cohen et al do find out about the cognitive explanation of depression?

adolescents who showed cognitive vulnerabilities such as negative thinking patterns and negative self schemas were more likely to face depressive symptoms in the future

What does the diathesis stress model suggest?

individuals with a genetic predisposition are more likely to develop depression when faced with stressful events, suggesting faulty thinking may be a symptom rather then a cause

AO3 The cognitive approach to treating depression

March et al - Not suitable for all (effort and quality of therapist relationship) - over emphasis on cognitive processes (ignores environmental context)

How many adolescents did March et al investigate?

327

What did March et al find when researching the cognitive approach to treating depression?

after 36 weeks of treatment, 81% receiving CBT and 81% receiving antidepressants improved, 86% for both

AO3 The biological approach to explaining OCD

Objective scientific methods (Gottesman stats) - NACDOIO (Cromer + concordance rates never 100%) - biologically reductionist + treatment

Why is the biological approach to explaining OCD biologically reductionist?

focuses on neurotransmitters but doesn’t consider social influence on OCD, however research into biological factors has led to the informed use of SSRI’s

What did Cromer et al find?

over 50% of OCD sufferers faced traumatic events, with multiple incidents resulting in worse symptoms

AO3 The biological approach to treating OCD

Soomro et al + better for those who cant leave the house - side effects - not suitable long term (Cromer + not adressing root cause)

What did Soomro conduct a meta analysis on?

17 studies comparing SSRI’s and placebos, with SSRI’s being much more effective particularly between 6-13 weeks after starting

What are the side effects of SSRI’s?

headaches, indigestion, raised blood pressure, sexual dysfunction, sleep disturbances, hallucinations