Psychopathology

4 definitions of abnormality

Failure to function adequately

Deviation from social norms

Deviation from ideal mental health

Statistical infrequency

Describe failure to function adequately and use Rosenham and Soligmans features

They cannot cope with daily life or interact with the world’s challenges

R and S features

• maladaptive behaviour = individuals behave in ways that go against long term interests

• Personal anguish = individual suffers from anxiety and distress

• Observer discomfort = their behaviour causes discomfort to others

• Irrationality = unexpected behaviour

• Unconventionality = behaviour doesn’t match what is expected by society

Deviation from ideal mental health using Marie Jahodas definition

Environmental mastery = ability to adapt + thrive in new situations

Autonomy = act independently and trust ones own abilities

Resistance to stress = internal strength to cope with anxiety caused by daily life

Self - actualisation = teach potential with self growth

Positive attitude to oneself = self respect, accurate perception of reality = see world without distorted bias

Deviation from social norms

Social norm = unwritten expectation of behaviour that can vary from culture to culture

Homosexuality

Hair / face covering

Public displays of emotion

Statistical Infrequency and describe the normal distribution curve

They are mentally abnormal if their mental condition is rare

Rarity is judged using statistics, comparing to rest of population

Normal distribution curve = average spread of specific characteristics with:

Mean, median and mode in highest point (common)

Example low IQ 70 or lower = diagnosis of intellectual disability

Evaluate failure to function adequately for defining abnormality

Positives: respect social individual experience

Negative: the decision if someone is coping is subjective

Only includes people who cant cope in daily life, most psychopaths can function in society in ways that benefit them

Evaluate deviation from ideal mental health for defining abnormality

Limitation = culturally biased, have western perspective as some cultures value familial success instead of autonomy

Strictness of criteria means many people would be defined abnormal

Positive = more constructive approach to mental health

Multiple factors

Evaluate deviation from social norms for defining abnormality

Negatives = inappropriate to define people who move to new culture “abnormal” according to the new cultural standards

Punishing people for expressing themselves and repressing people who don’t conform to the norms of culture

Evaluate statiscal infrequency as a way to define abnormality

Negatives: Psychological community decide the cutoff point for what is statistically rare

Not all statistically rare traits are abnormal like high IQ

Positives = its objective

What is a phobia

Extreme and irrational fear of objects or situations

Behavioural characteristics of phobia

Avoidance = adapting to avoid object

Panic - happens when they see object

Failure to function = difficult taking part in normal activities in life

Emotional characteristics of phobia

Anxiety = uncomfortable state

Fear = intense state when in presence of phobia

Cognitive characteristics of phobia

Irrational thoughts

Reduced cognitive capacity = cannot concentrate on day to day activities, like work due to attention on the phobia

Behavioural characteristics of depression

Reduction in activity level, like personal hygiene

Anhedonia = lack of pleasure usually felt doing enjoyable things

Change in eating behaviour, weight gain or loss

Increase in aggression towards self or others

Emotional characteristics of depression

Low mood

Guilt

Cognitive characteristics of depression

Poor concentration

Negative schemas = negative biases whe thinking ab world, themselves and future

Behavioural characterises of OCD

Compulsions = performed to reduce anxiety, but this is only temporary

Avoidance of phobic object

Social impairment / social withdrawal

Emotional charcacteristics of OCD

Anxiety

Depression = long sense of sadness

Cognitive charcetrics of OCD

Obsessions = intrusive, irrational thoughts

Hyper vigilance - state of alertness where they are looking for the source of their obsessive thoughts

Selective attention = so focused on object connected to obsession they cannot focus on the environment

Main points of the behaviourist approach

Behaviourists believe that behaviour is learned from interacting with the environment

Two process model = phobias are acquired through classical conditioning (learning through association) and they are maintained through operant conditioning (learning from consequence)

Describe the acquisition of a phobia : classical conditioning

A phobic object starts as a neutral stimulus, which causes a neutral response (no response)

UCS (pain of the sting) produces and UCR (fear)

Association is formed when NS is paired with UCS , so bee becomes a CS, producing a CR - fear

Describe maintains a phobia: operant conditioning

Learning by consequence of actions

Person will try to avoid phobic object, which leads to reduction in anxiety = pleasant situation

This reinforcement strengthens phobia, so person is more likely to avoid it in the future

Evaluate the behaviourist approach to explaining behaviours

Positives = Watson and Rayner (1920) = introduced a rat to little Albert, showed no phobic response. Watson paired rat with hitting large pole behind child’s head, making loud noise and scaring child, scaring him

Phobic response formed = showed phobias can be acquired through association

Also showed generalisation = displaying fear response to other similar objects like dogs

Behaviourist theory of phobia acquisition are applied to counter conditions therapies like systematic desensitisation which are effective

Negatives = counter research by Dinardo = conditioning dog bites were common in people with dog phobias but were also common in participants with no dog phobia

So behaviourist approach DOESNT explain all phobias

Humans don’t display phobia responses to knives, which cause harm

Evolutionary theory can explain the phobias, suggest phobias are hereditary

Main points of the behaviourist approach treating phobias

Behaviourist therapies believes phobias are learnt associations, and try to replace the fear association with relaxation

Reciprocal inhibition = fear and relaxation are opposite emotions, so you cant feel both the same time

Describe what systematic desensitisation is

1. Therapist teaches client relaxation techniques like breathing

2. Client creates anxiety hierarchy, list of feared situations from least to most feared

3. Client is exposed to each level of the hierarchy, starting with least feared and MUST relax at each stage to move on to the next

4. When client can hold phobic object without fear, the association is extinct and a new association with relaxation is formed

Describe flooding

Flooding counter conditions phobia by immediate and full exposure to the maximum level of phobic objects

This causes an extreme panic response (cry), therapist prevents client from leaving

Fear response requires enegry, eventuall client is exhausted and calmed down

What happens if the client ends treatment before they calm down in flooding

Anxiety will decrease due to removing stimulus, and the phobia will be reinforced

Evaluating the behaviourist approach to treating phobias

Positives: client controls systematic desensitisation ,more pleasurable experience

Systematic desensitisation applied to VR exposure therapy for spiders and was affective

Negatives : longer process

Effectiveness of both is limited due to controlled enviaremos of therapists office, wont be same as real world

They are both more effective in treating specific phobias than social phobias, easier to set up anxiety i hierarchy with specific phobias

Main points of cognitive approach to explain depression

Depression is due to irrational thoughts

Schema = mental framework based on experience, negative she as means they have a negative cognitive bias

Describe becks negative triad:

Three schemas with a persistent automatic negative bias

Self =

World = thinking people are hostile

Future - thinking things will turn out badly

Leads to avoidance and social withdrawal

What cognitive distortions does the negative triad lead to?

Overgeneralisation = one negative experience results in an assumption that the same thing will always happen

Selective abstraction = mentally filtering out positive experiences and focusing on negative

Describe Ellis ABC model

A = activating event = anything that happens to someone

B = belief = people without depression beliefs are rational, people with depression have irrational beliefs

C = consequence = rational beliefs ;dad tyy positive consequences, and irrational beliefs lead to negative C

What is mustabatory thinking?

Consequence of no accepting that we dont libe in a perfect world

This leads to disappointment

Evaluate the cognitive approach to explain depression

Positives: Grazioli and Teri assessed thinking style of women before and 6 weeks after giving birth

Women with negative thinking styles more likely to develop postpartum depression - supports idea that faulty thinking leads to depression

CBT used to treat depression - shows the underlying cognitive explanations are valid

Negatives

Cognitive theory depends on assumptions that the beliefs are irrational, but some people a=have reasonable response (poverty, homelessness)

Describe Becks CBT to treat depression

Patient as a scientist: patient generates and tests hypotheses about validity of their irrational thoughts

They realise their thoughts don’t match reality and this changes their schemas, and irrational thoughts are discarded

Thought catching = identifying irrational thoughts coming from negative triad of schemas

Homework tasks = keep a diary, to record negative thoughts and identify situations that cause negative thoughts

Behavioural activation = taking part in. Activities that sufferer used to enjoy

Ellis’s RBT for treating depression

Rational emotive behaviour therapy

Developemnt of ABC model

D = dispute = therapist confront clients irrational beliefs

empirical arguments = challenge the client to get evidence for their beliefs and use logical arguments to show that beliefs dont make sense

E = Effect = reduction of irrational thoughts lead to better C in future

describe the shame attacking exercise - REBT

Client performs a behaviour they fear doing infront of others

Shows client can cope with unpleasant behaviour and can survive against disapproval

Difference between CBT and REBT

CBT - patients acts as a scientist ad figure out the irrationality of their beliefs by themselves

REBT = therapist explains irrationality of thoughts directly to patient via disputation

Evaluate the cognitive approach to treating depression

Positives:

March randomly assigned patients to CBT, drug therapy and third was a combination of drug treatment and CBT

After 36 weeks, they had effectiveness 81%

Some people are too depressed to engage with CBT, as it requires motivation, so drug therapy may be used to stabilise patient before treatment

CBT addresses root cause of depression, not reducing symptoms and is effective un long term

Negatives

They are both focused on the present, client my want to discuss trama from past;

CBT is expensive - 16 sessions

What is OCD?

Symptoms are obsessive thoughts and compulsivos behaviours

They are repetitive and provoke anxiety

Compulsions help to reduce anxiety Temporarily

E.g contamination = cleaning hands

Fire - switching power switches off

Genetic explanation to explaining OCD

Analysis found that candidate genes are found in people with OCD more frequently

SERT gene, COMT

Suggests OCD is polygenic = change in OCD requires a range of changes

Evidence of genetic explanation of OCD

Heritability of OCD comes from family and twin studies ]

With OCD, the more genetically related two people are, the higher the concordance rate

Dizygotic twins (non identical twins) = 31%

Monozygotic (idéntica) = 68%

Supports idea that OCD is inherited

Describe how low serotonin levels cause OCD

Low level is due to serotonin being removed too quickly from synapse before it has been able to transmit signal to postsynaptic cell

Presynaptic neuron releases neurotransmitters

Receptors on Postsynaptic neuron these if signal strong enough, then message passed on

Neurotransmitters detach from receptors and taken back to presynaptic neurons = re uptake

This happens too fast in people with OCD, so reduced serotonin levels in synapse

What is the SERT gene responsible for

Serotonin transportation in synapse

Describe the worry circuit - neural structures

basal ganglia filters out minor worries from OFC, but if this area is hyperactive, small worries can get to the thalamus, which is then passed back to the OFC, forming a loop (Obsessive thoughts)

Compulsion try to break this loop, give temporary relief, the hyperactive basal ganglia resumes the worry circuit

What does the parahippocampal gyrus do

Área of cortex close to hippocampus on brains underside

Responsible for regulating and processing unpleasant emotions

Functions abnormally in cases of OCD

Evaluate the biological approach to explain OCD

Positive

Nestadt = shows high concordance rate between close family members with OCD

Dizygotic = 31% and monozygotic = 68%

Negative

Correlation between twin and family studies doesn’t mean genetics

Twins usually share same environments and monozygotitic twins may be treated more similarly because they look alike

Concordance rate for twins is not 100%, so role of environment changes something

Describe how SSRIs work to treat OCD

Antidepressant drugs to control symptoms of OCD

Selective Serotonin Reuptake Inhbitors = they only influence serontin in brain and they inhibit the reuptake processin the synapse

So serotonin is still left in the synaptic cleft ad stimulate the post synaptic neuron

Decreases anxiety by normalising activity of worry circuit

How effective are SSRI’s?

Take 3 to 4 months to reduce symptoms

Dosage can be increases for drug resistant patients or can take drugs to relax patient

What are SNRI’s?

Increase serotonin and noradrenaline, which is effective when SSRIs fail

Work on multiple neurotransmitters, so have more intense side effects

Evaluate the biological approach to treating OCD

Positives:

Drug therapy is cheap and more convenient

It is effective in short term - Soomro meta analysis comparing SSRis to placebo, and found that SSRIs reduced symptoms of OCD

Negatives

Patients prefer CBTas drug therapy can have many side effects