AQA Psychopathology

Definitions of abnormality 1

statistical infrequency

• defining abnormality using numbers

• abnormality = behaviour statistically rare

deviation from social norms

• behaviour goes against social expectations

• related to social and cultural context (eg homosexuality seen as abnormal)

Definitions of abnormality 1 - ao3 strengths

SI - real world application

• diagnosis of intellectual disability disorder (bottom 2%)

DSN - real world application

• diagnosis of antisocial personality disorder/schizotypal personality disorder

Definitions of abnormality 1 - ao3 limitations

SI - unusual does not equal negative

• High IQ considered unusual but positive

DSN - Culture bound

• norms differ in each culture and so hard to decide what behaviours are deviant.

Definitions of abnormalities 2

Failure to function adequately

• inability to cope with everyday living (eg maladaptiveness, personal hygeine)

Deviation from ideal mental health

• Jahoda’s criteria = rationality, accurate self-perception, self actualisation

Definitions of abnormality 2 - ao3 strengths

FFA - threshold

• represents a threshold required for professional help

DIMH - comprehensive definition

• covers most reasons why anyone should seek or be referred for help

Definitions of abnormality 2 - ao3 limitations

FFA - Choice

• Some people willingly engage in maladaptive behaviour (sky-diving)

DIMH - culture bound

• self-actualisation only important in western cultures, to others, it’s more communal-based.

Behavioural approach to phobias

Two-process model (Mowrer) - Phobias learned via CC, maintaned by OC

CC - neutral stimulus becomes conditioned stimulus = conditioned response

OC - avoiding phobia = negative reinforcement, causes relief and decrease in anxiety

Behavioural approach to phobias - ao3 strengths

Real world application

• successfully treating phobia by preventing avoidance (exposure)

Supports idea of past trauma

• 73% people with dental phobia has past trauma related.

Behavioural approach to phobias - ao3 limitations

No cognitive features

• fails to account for cognitive aspects such as irrational beliefs about phobic stimulus

Not all phobias have experience

• not all bad experiences lead to phobias, such as fear of certain animals etc

Behavioural approach to treating phobias

Systematic Desensitisation

1. use of hierarchy ( feared stimuli from least to most frightening)

2. relaxation - techniques practised at each level

   • Reciprocal inhibition - cannot be anxious and calm at same time

3. exposure

Flooding

• immediate exposure, fear extinguished and then becomes extinct (however, ethics)

Behavioural approach to treating phobias - ao3 strengths

SD - effective

• better for spider phobias than relaxation (Gilroy)

SD - inclusive

• suitable for people with learning disabilities, no rational thinking required and no trauma

Flooding - Cheap

• more cost effective than

Behavioural approach to treating phobias - ao3 limitations

Flooding - Traumatic

• immediate and intense exposure leads to high stress compared to SD

SD - Not effective

• Phobias may return as it does not address root of cause, and activities may not reflect real life situations

The cognitive approach to explaining depression

Ellis’s ABC model

• A = activating event

• B = Belief - irrational beliefs / musterbation - unrealistic ‘musts’ on self

• C = Consequence - triggers depression

Beck’s negative triad

• depressed people have faulty processing and negative schema

• Negative triad = negative thoughts about self, world and future

The cognitive approach to explaining depression - ao3 strengths

Ellis - Real-world application

• model lead to REBT model able to challenge and change negative beliefs

Beck - research support

• research shows cognitive vulnerability precedes depression

The cognitive approach to explaining depression - ao3 limitations

Ellis - Only reactive

• fails to explain people developing depression without an activating agent, such as endogenous depression

Beck - Lacks detail

• doesn’t explain all emotions of depression, some experiencing anger to sadness

The cognitive approach to treating depression

Ellis - REBT

• extended ABC model to D = disputing briefs, and E = effect

• challenging beliefs by using empirical and logical arguments, encourages exercise etc

Beck - CBT

• challenge negative thoughts, client given homework

• cog = challenge irrationality, beh = change behaviours

The cognitive approach to treating depression - ao3 strengths

effective

• CBT as effective as antidepressants 81% improvement, but interactionist is best 86% improvement

The cognitive approach to treating depression - ao3 limitations

Not inclusive

• CBT not suitable for those with learning disabilities or severe depression as they do not have the motivation

Relapsing

• only good for short-term, with 42% relapsing after 6 months

Client preference

• not all want to tackle depression, some want it gone fast. a study showed that depressed people rated CBT as lowest preference for therapy

The biological approach to explaining OCD

Genetic

• Polygenic - up to 230 genes (Taylor et al)

• Aetiologically heterogeous

• Candidate genes for serotonin/dopamine = 5HT1-D beta

Neural

• low serotonin lowers mood

• decision-making in frontal lobe impaired

• left parahippocampal gyrus (unpleasant emotions) is abnormal

The biological approach to explaining OCD - ao3 strengths

genetic - twin support

• Nestadt - 68% concordance rate for MZ, 31% DZ twins

neural - support for drugs

• antidepressants reduce OCD by increasing serotonin.

The biological approach to explaining OCD - ao3 limitations

genetic - deterministic

• one sample saw over half of people with OCD also have trauma

neural - Co-morbidity

• OCD linked to depression due to low levels of serotonin, therefore trouble with diagnoses

The biological approach to treating OCD

• SSRI = prevents re-absorption / breakdown of serotonin in brain

  • EG - fluoxetine 20-60mg dose daily

• Interactionist most effective (SSRI + CBT)

• Alternatives =

  • Tricyclics - older and serious side effects

  • SNRI - serotonin noradrenaline reuptake inhibitor (increase serotonin and noradrenaline)

The biological approach to treating OCD - ao3 strengths

effective

• review of 17 studies showed SSRI more effective than placebo (Soomro)

Cost/time-effective

• cheap to manufacture and take, good economic implications and less strain on NHS

The biological approach to treating OCD - ao3 limitations

serious side effects

• erectile dysfunction, weight gain, aggression (Tricyclics), may affect continuation of treatment

not effective

• CBT alone seen to be more effective than drugs for OCD, tackles multiple issues.