psychopathology

AQA A Level psychology

state the 4 definitions of abnormality

1) statistical infrequency
2) deviation from social norms
3) failure to function adequately
4) deviations from ideal mental health

[Statistical infrequency]

Occurs when an individual has a less common characteristic, for example being more depressed or less intelligent than most of the population.
- traits, thinking or behaviour is abnormal if it is different to the usual behaviour of society
[behaviours are classes as abnormal if they are statistically rare or unusual (2 standard deviations away from the mean) ]

normal distribution

Eg: IQ
the majority of peoples score cluster around the average at 100, as you get further away, fewer people attain that score
- people 2 standard deviations away from the average are seen to be 'abnormal' or 'unusual'
- only 2% of the population has an IQ below 70

[Deviation from social norms]

Concerns behaviour that is different from the accepted standards of behaviour in a community or society
trait, thinking or behaviours are abnormal if they deviate from societies standard of acceptable behaviour

social norms

rules that regulate behaviour in a particular society

implicit norms

unwritten, generally understood and agreed on, obvious eg: queuing

explicit norms

rules, laws, clearly expressed through regulations

what is the DSM-5

the manual used by psychiatrists to diagnose a mental disorder

Example of deviation from social norms

Antisocial personality disorder
- impulsive, agressive and irresponsible
- dont confom to normal social morals due to a lack of prosocial behaviour so percieved as abnormal

[failure to function adequately]

Rosenhan’s research

Occurs when someone is unable to cope with ordinary demands of day-to-day living eg: holding down a job
- traits, thinking or behaviour is abnormal if it interefers with a persons ability to cope with the standard demands of day to day living
- there are various indicators of failure to function adequately, the more there are, the greater the possibility the person will be diagnosed with a psychological disorder

Rosenham and Seligman

[propose 7 major features that appear in abnormal behaviour opposed to normal behaviour]
(only need to know 2)
1) maladaptivness of behaviour
2) personal distress

Maladaptive behaviour

MALADAPTIVE BEHAVIOUR IS behaviour that interferes with the person's ability to carry out their usual activities in an effective way.

Personal distress

{failure to function adequetely may be due to personal distress which is a sign of a psychological disorder}
most abnormal individuals report that their suffering eg: unable to sleep, tiredness etc..

[deviation from ideal mental health]

occurs when soneone doesnt meet the set criteria for good mental health
this definition attempts to define normality and assumes that the absence of normality indicates abnormality - LINKS TO HUMANIST APPROACH

Jahoda (1958)

identified various factors that were needed for 'optimal living'. absence of these indicate abnormality. presence of them indicate psychological health

name 6 elements of optimal living

1) positive view of self = individuals have high self esteem and self acceptance
2) self-actualisation = this refers to developing talents and abilities to the full
3) autonomy = the ability to act independently and make your own decisions
4) accurate view of reality = seeing the world as it is without distortions
5) resistance to stress = an individual should be able to handle stressful situations competently
6) master of you own environment = normal people can meet demands within different situations and adapt to changing circumstances

What is a phobia?

A phobia is an intense and irrational fear of a specific object, situation, or activity that poses little to no actual danger. It is a type of anxiety disorder and can be debilitating for the individual experiencing it

What are the 3 types of phobias

specific, social, agoraphobia

Describe specific phobia

Fear of a specific object or situation
eg: arachnophobia

Describe Social phobias

Fear of humiliation in public places so try to avoid social activities and situations

Describe agrophobia

This is a fear of public places/shopping malls, public transport etc..
what makes it different is that it is panic attacks where people may feel no one will help them

What are the characteristics of phobias

Behavioural, emotional and cognitive

Outline behavioural characteristics

- panic - a response to phobic stimulus like crying, fight or flight
- avoidance - effort to stay away from the PHOBIC STIMULUS, making it hard to live a normal life

Outline the emotional characteristics of phobias

- Anxiety - an unpleasnt state of arousal, preventing relaxation
- emotional response is disproportional to real threat

Outline 3 cognitive characteristics of phobias

- selective attention to phobic stimulus - cant concentrate on tasks at hand
- irrational thought processed that exaggerates the threat
- failure to respond to rational argument eg: the spider is scared of u

What are the 2 behavioural approaches to phobias?

Classical conditioning and operant conditioning

The dual process model

the idea that phobias are learnt through classical conditioning and maintained through operant conditioning

classical conditioning - LITTLE ALBERT

-Learning by association-
LITTLE ALBERT - Watson and rayner
Albert played with rats happily before untill one day while he was playing with one, one day an experimenter struck a metal bar close to his head with a bang . Albert was frightened by the noise and this was repeated everytime her reached for the rat. He then developed a phobia of rats
(this is how we learn phobias, following a traumatic event)

Operant conditioning

Behaviour is reinforced by some sort of positive outcome or removal of something negative (always negative reinforcement with phobias)
- avoidance of the phobic object or situation is reinforced by the reduction of anxiety
[a person has a fear, goes to great lengths to avoid is (response) and therefore anxiety decreases (consequence)] - negative reinforcement of phobia ---- PHOBIA IS GENERALISED TO SITUATIONS WITH THE PHOBIC STIMULUS

What is extinction of phobia

Can occur when person is exposed continuous to phobic stimulus and realises it is harmless so no longer has the phobia

What are the 2 behavioural approaches to treating phobias

- systematic desensitisation [GRADUAL EXPOSURE]
- flooding [DIRECT EXPOSURE]

Describe systematic desensitisation

-Joseph Wolpe-
step 1: clients tonight relaxation techniques
step 2: clients construct a fear hierarchy with therapist ( of feared situations with phobic stimulus from least to most feared)
step 3: with the therapist, the client works through the hierarchy and confronts each item whilst in a state of relaxation until their unafraid
Step 4: if this works, the client has been counter conditioned (learnt a new response to the stimulus and no longer associate it with fear)

Define reciprocal inhibition

Fear and relaxation cannot be present at the same time

What are the two ways in which clients confront their phobias

In vitro- imagine the situation

in Vivo- are exposed to the situation in real life

Flooding

Direct exposure of clients to objects or situations they fear without gradual build up in anxiety hierarchy . [Eg: fear of heights.. taken to the top of a tower]
EXTINCTION occurs where learned stimulus no longer produces the conditioned response of fear as people get EXHAUSTED because the body cannot stay in panic or fight or flight for too long
—> anxiety levels go down
(habituation) people cannot avoid the phobia so no negative reinforcement of the fear
NEW RESPONSE LEARNED

What is depression

Is a mood or affective disorder involving a prolonged disturbance to mood ( persistent low mood and loss of interest for atleast 2 weeks)

Clinical depression conditions

HAVE TO SUFFER ATLEAST 5 OF THE CHARCATERISITCS FOR 2 WEEKS
1) poor appetite weight loss
2) insomnia or hypersomina
3) loss of energy
4) loss of interest or social contact (anhedonia)
5) body slowing down ( psychomotor agitation)
6) inappropriate guilt
7) inability to concentrate
8) suicidal thought or behaviours

Outline behavioural characteristics of depression

- disruption to sleep - sufferes may experience insominia, reduction in sleep or hypersomnia, sleeping for long amounts
- disruption to eating patterns - eating more or less
- lethargic - lack of energy, impacting their lives eg: not going work

Outline the emotional characteristics of depression

- lowered mood - feeling sad and often describing themselves as 'worthless'
- Anger - sufferers feel many negative emotions, anger can be towards others or self, resulting in self harm

Outline 2 cognitive characteristics of depression

- poor concentration- being unable to focus and stick with tasks as usual. find it hard to make decisions
- absolutist thinking - 'black and white thinking' when sufferers see minor situations as absolute disasters

Describe THE COGNITIVE APPROACH TO EXPLAINING DEPRESSION

Focuses on how thinking shapes out behaviour. Depression is seen as being caused by negative and irrational thought processes (COGNITIVE PRIMACY)

State the 3 parts to cognitive vulnerability suggested by BECK 1967

1) faulty information processing
2) negative self schema
3) the negative triad

Describe faulty information processing

- depressed individuals focus on {negative aspects of a situation}
people who overgeneralise - conclusions based on a single evidence (eg: failed one test so will fail all)
- catastrophising
exaggerating a minor set back to the worst possible outcome
(eg: failed milestone , will fail a levels and be jobless )

Describe negative self schemas

Beliefs about self is that are negative (eg: im worthless)
- depressed individuals tend to use negative self schema to to interpret info about themselves
Schema is a package of knowledge that's developed through experiences
NEGATIVE SELF SCHEMAS CAUSED BY: - physical or emotional abuse, critisim by others

Describe the negative triad

a) negative view of the world
b) negative view of self
c) negative view of the future
Depressed people tend to think negatively and are trapped in a vicious circle of depression

Ellis' ABC model (1962)

Focuses on irrational beliefs as the source of depression. These thoughts interfere with us being happy and free of pain

What is ABC

A = activating event eg: death of family
B = belief (rational: I lost my job because they were over staffed) (irrational: I lost my job because they hated me)
C = consequences of beliefs eg: Rational: positive emotional response
or Irrational: negative emotional response leading to depression

Healthy negative emotion vs unhealthy

Disappointed or being depressed

Describe Irrational beliefs (3 terms)

{Mustubatory thinking}
certain ideas or assumptions must be true in order to be happy eg: I must always achieve perfection, I must do well
{Utopianism}
this is belief that life's always meant to be fair eg: bad things happen to bad people so if it happens to me I'm bad
{catastrophising}
small evens are being made to seem like ultimate failures

what goes into Ellis' ABC MODEL

A- activating event

B- belief

C- consequence as a result of either rational or irrational beliefs, leading to appropriate or inappropriate consequences

The cognitive approach for treating depression

Aims to change the way a client thinks by challenging irrational and negative thought processes
this will lead to a change in behaviour (reconstruction)
however it is time consuming and expensive

Outline CBT method: Beck's cognitive therapy

identify Negative Thoughts – Recognise irrational or unhelpful thinking patterns.

challenge & Replace Thoughts – Test if thoughts are realistic and replace them with balanced ones.

behavioural Experiments – Practice new ways of thinking in real life (e.g., thought diaries, exposure tasks).

relaxation Techniques – Use breathing exercises and mindfulness to manage stress.

gradual Behavioural Change – Modify thoughts and behaviours for long-term improvement.

Ellis Rational emotional behavioural therapy (REBT)

Central technique is to identify and dispute irrational thoughts and then they are subject to vigorous argument (thorough) comes from his ABC model
ABCDE - D= dispuation and E= effect

Similarities between REBT and CBT

Bith set clients homework which involve clients putting themselves into situations which they previously would have avoided or speak to a friends or family member about feelings.
A key element is BEHAVIOURAL ACTIVATION - where client is encouraged to become part of more pleasurable activities increasing happy hormones

OCD definition

Individuals experience frequent, intrusive and unpleasant obsessional thoughts
these are followed by repetitive behaviours that seek to relive anxiety but provide temporary relief

What are obsessions

Unwanted Intrusive thoughts, impulses, or images that are persistent and interfere with the ability function daily
{OCD suffered often realise these thoughts are irrational but believe the only way to deal with them is by performing compulsive behaviours}

Compulsions

Repetitive behaviours or mental acts that are performed over again and again to prevent or reduce anxiety (temporarily)

4 main categories of OCD

1) checking
2) contamination
3) hoarding
4) intrusive thoughts

Outline behavioural characteristics of OCD

- Compulsive behaviour, has 2 elements:
REPETITIVE: sufferers feel compelled to repeat behaviour, e.g. hand washing.
REDUCE ANXIETY: in most people, they are performed to temporarily reduce anxiety produced by obsessions

- Avoidance: sufferers may attempt to reduce anxiety by avoiding situations which trigger it. e.g. avoiding germs. This can impact living a normal life.

Outline emotional characteristics of OCD

- anxiety and distress - obsessive thought and compulsions bring anxiety and distress which can be overwhelming eg: having to give into complusions produces anxiety
- accompaniying depression - anxiety can come with low mood and lack of enjoyment in activites (compulsions may temporarily reduce this)

Outline 2 cognitive characteristics of OCD

- obsessive thoughts:
recurrent and unpleasant but aware they are irrational eg: door unlocked
- cognitive coping strategies:
praying, counting or meditating that may distract them

Example of obsession/intrusive thought and the respective avoidant behaviour

OBSESSION
jump in-front of train
AVOIDANT BEHAVIOUR
avoid trains

Outline the BIOLOGICAL APPROACH TO EXPLAINING OCD

-candidate gene explanation-
[[[COMT gene is responsible for clearing dopamine from the synapse
- Tukel et Al discovered lower levels of activity if COMT gene lead to higher levels of dopamine (less is cleared) this then links compulsions and stereotyped movement]]]
[[[- SERT gene is involved in the transport of serotonin. Low levels of this are implicated in OCD as less is being transported by SERT GENE
- OZAKI found in 2 unrelated families with a mutation in this gene, 6\7 family members had OCD ]]]

Seratonin

Neurotransmitter that Affects mood
- low levels increase anxiety and a feeling of dissatisfaction

What do higher levels of dopamine lead to

Higher levels lead to higher need or anticipation for reward

What are COMT and SERT genes described as

Candidate genes
some of the genes which we know may be liked to causing OCD when mutated
OCD is polygenetic

What does polygenic mean

involving many genes
TAYLOR analysed findings from previous studies and found 230 genes may be involved in OCD As they have been associated with the action of serotonin and dopamine (mood regulating)

genetic vulnerability study

LEWIS observed that of his OCD patients, 37% had parents with OCD suggesting it runs in families

Diathesis stress model of abnormality to explaining OCD

People are born with a vulnerability to a certain illness but life stressors (external factors) influence whether we get them

Outline neural explanations for OCD

There is evidence from PET scans that people with OCD have abnormalities with their brain

Describe the worry circuit

- the orbitofrontal cortex sends a signal to the thalamus about "potential worries" like germs
- these minor worries in normal brains are usually suppressed by the caudate nucleus
- HOWEVER, if the caudate nucleus is too small or damaged, the worry is confirmed and not suppressed creating a worry circuit leading to obsessive thoughts

Outline the biological approach to treating OCD

DRUG THERAPY- GAVA ET AL
- attempts to increase or decrease levels of neurotransmitter in the brain

Describe SSRIs

- SELECTIVE SEROTONIN REUPTAKE INHIBITORS
-increase the neurotransmitter serotonin to relieve anxiety
-block the reuptake sites, increasing the amount of serotonin in the synapse so more to be absorbed by post synaptic receptors
-this reduces intrusive, unpleasant thoughts and decreases anxiety

Example of types of SSRIs

Fluoxetine, zoloc
(may take 3-4 months to work)

Outline other drug treatments, what are drugs often used alongside

(Drugs often used along side CBT)
- side effects of SSRI's include suicidal thoughts - CBT is used to monitor this
ANTIDEPRESANTS:
- TRYCYCLICS - work similarly to SSRI's on seratonin and work on blocking the reuptake of seratonin but have more severe side effects so only used in SSRI's are not responded to
- SNRIs (seratonin noradrenaline reuptake inhibitors ) - increase serotonin and noradrenaline. again used if patients dont respond to SSRI's