Clinical Psychology and Mental Health.

Depression

A mood disorder that causes sufferers to experience chronic low mood.

Behavioural symptoms of depression

Low activity, sleep/eating disruption, aggravation/self-harm.

Emotional symptoms of depression

Low mood, anger, low self-esteem

Cognitive symptoms of depression

Poor concentration, negative thinking, irrational thoughts.

Ellis' ABC model

An explanation for depression which suggests it is caused fundamentally by irrational beliefs. This cycle causes and perpetuates depression.

A: activating event

B: beliefs

C: consequences

Ellis' ABCDE model of feelings and behaviour

A: activating event

B: beliefs

C: consequences

D: disputing beliefs

E: effects of disputing

Limitation of Ellis' model

Doesn't explain depression without triggers.

Beck's negative triad

A component of Beck's cognitive explanation for depression which suggests negative thoughts in depression broach three categories: the self, the world and the future.

What are cognitive biases?

Errors in thinking: catastrophising, overgeneralisation, minimisation.

Strength of Beck's theory

Supported by evidence; forms basis of CBT.

Cognitive Behavioural Therapy (CBT)

A form of therapy used to help patients with depression that aims to directly combat irrational cognitive biases.

What is the main goal of CBT?

Identifying and challenging irrational thoughts. Focuses on behavioural activity, homework (journaling), and unconditional positive regard.

What is behavioural activation?

Encouraging engagement in activities that improve mood.

Types of distributing in CBT

Logical, empirical, pragmatic.

Logical disputing

Self defeating beliefs do not follow logically from the information available (e.g. does thinking this way make sense?)

Empirical disputing

Self defeating beliefs may not be consistent with reality (e.g. where is the proof that this belief is accurate?)

Pragmatic disputing

This emphasises the lack of usefulness of self defeating beliefs (e.g. how is this belief likely to help me?)

Strength of CBT

Effective and no side effects

Limitation of CBT

Requires motivation; not suitable for severe depression alone.

Deviation from ideal mental health

A definition of abnormality by Jahoda that suggests if a person does not achieve one of the six criteria of ideal mental health, they are acting abnormally.

Deviation from ideal mental health criteria

- Coping with stress

- Self-actualisation

- Sufficient self-esteem

- Autonomy

- Adaptation to new situations

- Accurate idea of the world

Limitation of ideal mental health definition

Unrealistic- few people meet all criteria

Deviation from social norms

A definition of abnormality that suggests if a person deviates from cultural and social rules, they are abnormal.

However, this definition is restricted temporarily and spatially- E.G. homosexuality was viewed as abnormal in the past, and is currently viewed as abnormal in some countries today.

Limitation of deviation from social norms

Cultural relativism (norms vary between cultures).

Failure to function adequately

A definition of abnormality that suggests if a person has abnormal behaviour if they are unable to function in everyday life. This definition encompasses an individual's quality of life as well as their objective behaviour.

List 3 Rosenhan and Seligman criteria

Personal distress, maladaptive behaviour, irrationality, observer discomfort, violation of moral standards.

Limitation of failure to function adequately

Subjective judgments

Statistical infrequency

An explanation for abnormality that suggests abnormalities can be statistically determined. If the behaviour is calculated to fall out of the range of normal distribution, it can be labelled as statistically infrequent and therefore, abnormal.

Give an example of statistical infrequency.

Low IQ (below 70) used when diagnosing intellectual disability disorder.

Strength of statistical infrequency

Objective and based on data.

Limitation of statistical infrequency

Unusual behaviours aren't always undesirable (e.g., high IQ)

Phobia

An intense, irrational fear of a stimulus.

Behavioural characteristics of phobias

Panic, avoidance, endurance

Emotional characteristics of phobias

Anxiety, unreasonable fear

Cognitive characteristics of phobias

Irrational beliefs, distortions, selective attention.

What two processes cause phobias?

Classical conditioning (acquisition) and operant conditioning (maintenance).

How does classical conditioning explain phobias?

Learning through association (e.g., Little Albert).

How does operant conditioning explain phobias?

Negative reinforcement through avoidance reduces anxiety.

Limitation of the two-process model

Cannot explain phobias without trauma; ignores cognition.

Flooding

A form of therapy for phobias wherein a patient is exposed to a huge amount of fear stimuli in order to help the patient associate the stimulus with safety (since in spite of huge amounts of fear, the patient is not actually in any danger).

Flooding (in-vitro)

Behavioural treatment for a phobia which involves imagined exposure to the phobic object/situation without being able to escape.

Flooding (in-vitro)

Behavioural treatment for a phobia which involved actual exposure to the phobic object/situation without being able to escape.

Strength of flooding

Fast and cost-effective

Limitation of flooding

Highly distressing; risk of dropout.

Systematic desensitisation

A form of therapy for phobias that involves establishing a fear hierarchy and teaching patients relaxation techniques. Use of relaxation at every level of the fear hierarchy gradually causes the fear to become instinct.

Key components of systematic desensitisation

Anxiety hierarchy, relaxation, gradual exposure.

What is counterconditioning?

Learning a new association: fear stimulus + relaxation.

Fear hierarchy

An order of situations that expose patients to increasing levels of fear-inducing stimuli.

Reciprocal inihibition

Inhibition of fear by learning to be relaxed, since both responses are not possible at the same time.

Relaxation techniques

Techniques taught to patients to erase uncomfortable emotions of fear arousal, which can help eliminate a fear response in a phobia, as per reciprocal inhibition.

OCD

A disorder characterised by obsessions (intrusive thoughts) and compulsions (repetitive behaviours), either occurring together or alone.

Behavioural characteristics of OCD

Compulsions, avoidance.

Emotional characteristics of OCD

Anxiety, guilt, disgust.

Cognitive characteristics of OCD

Obsessions, catastrophic thoughts, awareness of irrationality.

What is meant by OCD being polygenic?

Caused by multiple genes.

What does aetiologically heterogeneous mean?

Different gene combinations cause different types of OCD.

What neurotransmitter is involved in OCD?

Low serotonin (also dopamine involvement).

COMT gene

A gene which has a variation which results in higher levels of dopamine and this variation is more common in patients with OCD.

What brain areas are linked to OCD?

OFC, basal ganglia, lateral frontal lobes.

Basal ganglia

Region of the brain involved in the coordination of movement that has been linked to OCD

What do SSRIs do?

Increase serotonin by preventing re-uptake.

How long do SSRIs take to work?

3-4 months

Alternative drugs to SSRIs

SSRIs and tricyclics

Why combine SSRIs with CBT?

SSRIs reduce anxiety so patients engage in therapy.

Strength of drug therapy

Effective for most patients and cost-effective.

Limitation of drug therapy.

Side effects and relapse risk.