Psychopathology

definitions of abnormality

Deviation from Social Norms

Statistical infrequency

Failure to function adequately

Deviation from idea mental health

Evaluation Deviation from social norms

+flexible and depends on context. for example being naked in a shop isnt acceptable but bikini on the beach is

-Changes over time - temporal validity. eg homosexuality

-Cultural differences for example some cultures Hallucinations are seen as spiritual

Evaluation of statistical infrequency

+uses objective data

-unusual characteristics are not always undesirable

-not all abnormal behaviours are infrequent. 1 in 4 people suffer from mental health conditions in their life

-what is frequent in one culture may not be the same as another

Failure to Function adequately evaluation

+Considers how the individual feels, and how they are managing everyday life

+measurable - the GAF scales allows for extent of failure to function adequately to be measured

-too much focus on individual. Some abnormal behaviours may not be an issue for the individual but those around them

-abnormality does not always stop someone functioning. they may appear to be fine however have issues

Deviation from Ideal mental health evaluation

+positive and comprehensive. detailed and focuses on factors which are important in life

-unrealistic standards. a lot of us would wrongfully be viewed as abnormal

-culture bias of jahodas criteria

-subjective criteria

Rosenhan and Seligman’s 7 features of dysfunction - failure to function adequately

Suffering

Unpredictability

Irrationality

Maladaptiveness

Observer discomfort - causes distress to others

Vividness & Unconventionality - differs substantially from the way most people behave

Violates moral/social standards

Jahoda’s 6 Categories - ideal mental health

Self attitudes

Personal growth and Self actualisation

Resistance to stress

Autonomy

Perception of Reality

Mastery of the environment

Phobias

anxiety disorders. Fear of something it is not beneficial to be in fear of. It negatively impacts someones everyday life.
Irrational fear of a person, object or situation

Types of phobias

Simple - person fears specific object in environment eg spider

Situational - phobia of a specific scenario eg fliying

Social - involving specific social situations eg giving speech

Characteristics of Phobias

^Behavioural

Avoidance

Panic

^Emotional

Anxiety

Fear

^Cognitive

Irrational beliefs

worries

selective attention

cognitive bias

two process model for phobias - Behaviourist approach

classical and operant conditioning

Evaluation of Behaviourist approach to phobias

-not everyone experiences a traumatic event

+support from behavioural treatments eg flooding or systematic desensitisation

+research support Di Gallo 20% of people in car crash developed phobia of travelling in car. - however only 20%

Behaviourist approach to treating phobias

Systematic Desensitisation

Flooding

Systematic desensitisation

Counter conditioning - learning new response to feared stimulus

Developed by Wolpe 1958

according to theory a person cannot be two emotional states at the same time eg anxious and relaxed. - reciprocal inhibition

1. Relaxation techniques taught

2. Fear hierarchy

3. Therapist confronts client in each step of hierarchy

Evaluation Systematic Desensitisation

+Considered more effective than other therapies. Gilroy found it more effective against spider phobias than just relaxation therapy

-ethical issues - protection from harm +however better than flooding

-Time consuming and expensive, clients may give up

Flooding

Involves exposing patients to feared stimulus without gradual build up.

Immediate exposure to phobic stimulus,

Allowing them exposure to feared stimulus, shows them how there is no basis for their phobia - negative reinforcement.

leads to extinction of fear

in vivo - actual exposure to stimulus

In vitro - imaginary exposure

Evaluation of flooding

+Quick and cost effective only 1-2 sessions needed

-Wolpe one patient became so distressed during therapy they had to go to hospital

-ethical issues

Depression

mood or affective disorder

prolonged and fundamental disturbance of mood and emotion. most common of all psychopathical disorders

unipolar and bipolar despression

Characteristics of Depression

Behavioural

low activity

Disrupted sleep and eating

Aggression and self-harm

Emotional

Low mood

Anger

Low self-esteem

Cognitive

Focus on negative

struggle to focus

Cognitive approach to explaining depression

Becks negative triad

Ellis ABC mode

Ellis ABC model

lies in irrational beliefs

shows how disordered thinking lies in irrational beliefs

Activating event eg sacked from work

Belief eg I was sacked because they never liked me

Consequence eg depression

Becks negative triad

Negative views of the self, the world, the future lead to depression

Evaluation of Cognitive explanation for Depression

-Fails to establish where irrational thoughts come from

+practical application in therapy CBT

-blames client rather than situational factors which could result in depression

-may not be able to explain depression in all sufferers. other approaches may be more appropriate

+research support from Boury et al found patient with depression were more likely to missinterpret information negatively and feel hopeless about the future. - negative triad

the cognitive approach to treating depresion

CBT

Becks ABCDE model

CBT cognitive behavioural therapy

Cognitive - aims to identify irrational and negative thoughts. and the aim is to replace these with positive thoughts

Behavioural - aims for patients to test these negative beliefs

1.initial assessment

2.Goal setting

3.Identifying negative/irrational thoughts

4.Homework - such as mood diary, activity diary to record things you do. or behavioural experiments to test out behaviours and disprove irrational thoughts

Ellis ABCDE model

Dispute and effect

aim is to challenge negative thoughts by disputing them

Challenging irrational thoughts

Logical disputing - does the way you think about this make sense?

Empirical - Is there evidence this is true?

Pragmatic - Are these thoughts helping you?

Cognitive treatment to depression evaluation

-might not work for all pateints. some suffer from severe depression and habe very irrational beliefs so find it hard to engage in set tasks

-Can take time to be affective

-Focuses on thoughts too much, it may be down to living circumstances

+research support, March 2007 shows CBT is 81% affective and 86% alongside drug therapy

+empowers patients, allows them to identify their own negative thoughts and manage them themselves which reduces irrational thoughts, and relapse rates

OCD

anxiety disorder where someone has obsessive thoughts and compulsive activity,

-obsessions is an unwanted or unpleasant thoughts, image or urge that repeatedly enters a persons mind, causing feelings of anxiety disgust or unease

-compulsion is a repetitive behaviour or mental act that someone feels they need to carry out to try to temporarily relieve the unpleasant feelings brought about by the obsessive thoughts.

varies between individuals, some people may only spend an hour or so with obsessive-compulsive thinking whereas others it may take over their whole life

Behavioural characteristics of OCD

compulsions

avoidence

Emotional characteristics of OCR

Anxiety and distress

low mood

Guild and disgust

Cognitive characteristics of OCD

obsessive thoughts

cognitive strategies

selective attention

Biological - Genetic - approach to explaining OCD

Inherited through genetic transmission. Family and twin studies

polygenic, taylor 2013 found 230 different genes may play a role in OCD

COMT gene - associated with the regulation of dopamine. One variation of this gene results in higher dopamine

SERT gene - linked to serotonin, causes lower levels of serotonin also associated with depression

Genetic evaluation

+Nestadt et al 2010 - 68% MZ and 31% DZ share OCD - strong genetic component

-concordance rates are not 100% this means that biological factors are not the only factors responsible for OCD and therefore there must be environmental factors which also contribute towards it

-Genes cannot cause OCD but only increase vulnerability to it, supported by the alternative explanation called a Diathesis stress model, this suggests that Genes predispose certain individuals to the disorder, however an environmental stress is necessary to trigger the condition

Biological -Neural explanation to OCD

The neurotransmitter Serotonin plays a role in regulating our mood, in some cases of OCD there is a reduction in serotonin.

Dopamine levels are also abnormally high in some OCD sufferers. Research has found administering drugs which increase dopamine levels induce compulsive behaviours

Biological - neural - Brain structure explanation for OCD

Orbitofrontal cortex, a region which converts sensory information into thoughts and actions. PET scans have found higher activity in the orbitofrontal cortex in patients with OCD. This can suggest that heightened activity in this region increases the conversion of sensory information to actions, resulting in compulsions. The increased activity also prevents patients from stopping their behaviours.

evaluation of neural explanations and brain structure

-not all patients with OCD have high dopamine levels. This suggests that high dopamine levels don’t always contribute to OCD there could be another cause

+Research evidence. Drugs designed to increase serotonin levels which help reduce OCD symptoms. Shows that low serotonin which causes low mood can be treated lessening OCD symptoms

• Supporting Evidence (Structural): Neuroimaging techniques (e.g., PET scans) have identified high activity in the orbitofrontal cortex and basal ganglia of OCD patients, validating structural abnormalities.

-Correlation not causation for Neurotransmitters and brain structure, we dont know if they are a cause or result of OCD

-Diathesis stress may be more appropriate.

Biological approach to Treating OCD -SSRIs

Drug therapy

SSRIs

the most common treatment for OCD is drugs

antidepressants known as SSRIs(selective serotonin reuptake inhibitors), increase serotonin which in turn affects mood.

Prozac-example of SSRI

SSRIs can take up to 3-4 months to make a noticeable difference

SSRIs block the reuptake of surplus serotonin in the synapse leaving more serotonin to remain in the synapse, increasing activity

Other forms of drug therapy for OCD - other than SSRIs

Tricyclics - block reabsorbtion of both serotonin and noradrenaline, prolonging their activity. They work on more than one neurotransmitter, but this increases side affects so are only used when SSRIs have failed

Benzodiazepines - enhance the affects of GABA - a calming neurotransmitter, which tells neurons to slow down and stop firing, which has a quietening affect on neurons making person relaxed

Evaluation for drug therapy of OCD

+Sansone found SSRIs reduce symptoms for around 70% of patients

+cost affective for NHS compared to psychological treatments

-appropriateness, side affects can occur, such as headaches nausia and insomnia

-not a lasting cure, if patient stops taking drugs they tend to relapse within weeks

+effectiveness increases when paired with psychological treatments such as CBT which shows how it is useful and be used on top of other treatments to cater to specific patients