Psychopathology

What is Statistical Infrequency

Abnormality is define as those behaviours that are extremely rare, or any behaviour that is found in very few people is regarded as abnormal

What is the normal distribution

The idea that for any human characteristic, the majority of people’s scores will fall on/near the average.

Any individuals that fall outside the ‘normal distribution’ with either extremely low or high scores (top and bottom 2%) are perceived as abnormal

When is this approach useful

When dealing with characteristics that can be reliably measured (eg intelligence)

Strengths of Statistical Infrequency (Definitions of abnormality)

-Objectively Measured: Based on quantitative data, uses reliable scientific measures for characteristics , not based on opinion

Limitations of Statistical Infrequency (Definitions of Abnormalities)

-Unusual characteristics can be positive: IQ scores over 130 are just as unusual as those below 70 but are regarded as desirable and don’t require special treatment. This definition doesn’t take desirability into account

-Not all abnormal behaviours are statistically rare. Up to 10% of adults in England would have experienced depression

-Cut off points are subjective: For example if it cut of IQ at 70 than 71 is considered normal

What is Deviation from social norms

concerns behaviour that is different from the accepted standards of behaviour in a community or society. Abnormal behaviour is seen as a deviation from unstated rules about how one ought to be behave

Examples and Descriptions of Deviation from social norms

All societies make collective judgments about what counts as ‘normal’ behaviours

Any behaviour that does not conform to accepted standards is abnormal

Norms vary across time and cultures

Strengths of Deviation from Social Norms (Definitions of Abnormality)

-Flexible definition: considers context of behaviour rather than applying rigid rules. Does not label behaviour as abnormal in every case- more sophisticated definition

Limitations of Deviation from Social Norms (Definitions of Abnormality)

-Is not always a sign of mental illness: for example speeding while driving deviates from norms but is not a sign of mental illness

-Cultural relativism: (Idea that behaviour can only be understood within cultural context of that behaviour) for example hearing voices in some african cultures is socially accepted because of beliefs but would be seen as abnormal in Uk

-Can lead to human rights abuses: Social norms are set by those in positions of power in society and have been used to justify discrimination and oppression (Drapetomailla- a ‘disorder causing black slaves to run away)

What is failure to function adequately

Occurs when someone is unable to function with ordinary demands of everyday living

Failure to Function adequately descriptions and examples

- Considered abnormal if it prevents an individual from being able to cope with the demands of everyday life, or their behaviour is a danger to themselves or others

-Unable to maintain basic standards of nutrition and hygiene

-Can no longer attend work/ school

What behaviours did Rosenhan and Seligman suggest an individual is unable to function

-Unpredictable

-Dangerous

-Personal distress

-Distress to observers

What is the Global Assessment of Functioning Scale (GAF)

Measures how well individuals function in everyday life

Strengths of Failure to Function Adequately (Definitions of Abnormality)

-An inability to cope can be measured objectivel- helps decide who needs help and who doesn’t

Limitations of Failure to Function Adequately (Definitions of Abnormality)

-Not everyone who is abnormal struggles with everyday life: Shipman murdered over 200 of his patients (abnormal) however still functioned (wife, 4 kids)

-Not everyone who is failing to function is abnormal: New Age Travellers Group do not live in permanent accommodation + don’t work doesn’t mean they’re abnormal

-‘Distressing’ Behaviour is subjective: What one person may find disturbing another may find normal- unreliable

What is Deviation from ideal mental health

Occurs when someone does not meet a set of criteria for good mental health

Deviation From Ideal Mental Health Description and Examples

Behaviour is classified as abnormal if it does not meet the criteria for good mental health

The more less criteria met the more abnormal they are

What was Marie Jahoda’s Criteria for good mental health

• Self actualisation

• Cope with stress

• Good self esteem

• realistic perception of reality

• Environmental mastery

• Independent

Strengths of Deviation from Ideal Mental Health

-Comprehensive Definition: covers a broad range of criteria for mental health, making it a more holistic approach. Gives a wide picture of what mental health might look like

-Positive Approach: Other definitions focus on what’s wrong, whereas this definition focuses on what’s ideal and promotes mental wellbeing. This encourages people to strive for good mental health

Limitations of Deviation from Ideal Mental Health

-Criteria for mental health is too demanding: Very few of us attain all of Jahoda’s criteria for mental health all times. Therefor this approach would classify most people as abnormal which is unrealistic

-Based on western idea of mental health: some of Jahoda’s criteria reflects ideas of an individualist culture. Much of the world is collectivist. Therefore this definition can not be applied universally

What is a Phobia

An irrational fear of an object or situation

What are 3 types of phobias

Specific:Thing or object

Social: Social situations

Agoraphobia: Situations you can’t get out of

What are the 3 categories of Characteristics

-Behavioural

-Emotional

-Cognitve

What are the Behavioural Characteristics of Phobias

-Avoidance

-Panic

-Endurance

What is avoidance

Going into a lot of effort to avoid coming into contact with the phobic stimulus

What is Panic

If a phobic person comes face to face with an object or situation they will panic. This is a state of heightened psychological arousal

What is Endurance

Occurs when a sufferer remains in the presence of the phobic stimulus but continues to experience high levels of anxiety- this is like freezing in the flight, fight or freeze response

What are the emotional characteristics of phobias

-Anxiety/Fear

-Emotional responses are unreasonable

What is Anxiety/Fear

A strong unpleasant emotional response to the anticipation or presence of feared stimulus. This prevents sufferer from relaxing and makes it difficult to experience any positive emotion

What is Emotional responses are unreasonable

The emotional responses we experience in relation to phobic stimuli go beyond what is reasonable

What are the Cognitive Characteristics of phobias

-Selective attention to the phonic stimulus

-Irrational beliefs

-Cognitive Distortions

What is Selective Attention to the phobic stimulus

If a sufferer can see the phobic stimulus it is hard to direct their attention away from it

What are irrational beliefs

A phobic may hold unrealistic illogical beliefs in relation to phobic stimulus

What is cognitive distortions

The phonics perceptions of the phobic stimulus may be distorted

What is Depression

A mental disorder characterised by low mood and low energy

What are the behavioural characteristics of depression

-Changes in activity levels

-Disruption to sleep and eating behaviour

-Aggression and self harm

What is Changes in activity levels

Typically sufferers of depression have reduced levels of energy, making them lethargic. Sufferers tend to withdraw from work education and social life. In extreme cases the sufferer can’t get out of bed. In some cases it can lead to the opposite effect- psychomotor agitation

What is Disruption to sleep and eating behaviour

Sufferers may experience reduced sleep (insomnia) or increased sleep (hypersomnia). Similarly apetite or eating may be increased or decreased

What is Aggression and Self Harm

Sometimes depression can lead to people becoming verbally or physically aggressive. Depression can also lead to physical aggression aimed at themselves. This includes self harm, often cutting or suicide attempts

What are the emotional characteristics of depression

-Lowered mood

-Anger

-Lowered Self esteem

What is lowered mood

feeling of intense sadness or emptiness. A loss of pleasure in activities that used to be enjoyed

What is anger

sufferers of depression also frequently experience feelings of irritability, anger sometimes extreme anger. This can be directed at the self or at others. On occasion such emotions lead to aggressive or self harming behaviour

What is lowered self esteem

Emotional experience of how much we like ourselves. Sufferers of depression tend to have reduced self esteem

What are the Cognitive characteristics of depression

-Poor concentration

-Attending and dwelling on the negatives

-Absolutist thinking

What is poor concentration

The sufferer may find themselves unable to stick with a task as they usually would if they might find it hard to make decisions

What is Attending to and dwelling on the negatives

Depressed people pay much more attention to negative aspects of a situation and ignore the positives

What is Absolutist thinking

Most situations are not all good or all bad, but when a sufferer is depressed they tend to think in these terms

What is OCD

A condition characterised by obsessions (thoughts) and/or compulsive behaviour

What are the Behavioural Characteristics of OCD

-Compulsions

-Avoidance

What are compulsions

-Compulsions are repetitive; for example hand washing

-Compulsions reduce anxiety caused by obsessive thoughts

What is Avoidance

OCD sufferers may attempt to reduce anxiety by keeping away from situations that trigger compulsive thoughts. This can interfere with leading a normal life

What are the Emotional Characteristics of OCD

-Anxiety and Distress

-Accompanying depression

-Guilt and disgust

What is anxiety and distress

obsessive thoughts are unpleasant and frightening. The anxiety that these thoughts cause can be overwhelming

What is Accompanying Depression

Many individuals with OCD may also experience low mood and a loss of interest in activities they used to enjoy

What is Guilt and Disgust

Obsessive thoughts are often about dirt, contamination, sex, morality etc. Guilt may be directed against something external (dirt) or at the self

What are the Cognitive Characteristics of OCD

-Obsessive thoughts

-Understand the irrationality

What are obsessive thoughts

These vary considerably from person to person but are always unpleasant and persistent

What is Understanding the irrationality

People suffering form OCD are aware that their obsessions and compulsions are not rational. This is necessary for a diagnosis of OCD. However this does not stop the obsessions or compulsions from occurring

What is the OCD cycle

-Obsessive thoughts

-anxiety

-Compulsions

-Temporary relief

What is the Two-process model

A theory that explains the two processes that lead to the development of phobias. Phobias are acquired through classical conditioning and maintained through operant conditioning

How are phobias acquired through classical conditioning

Involves learning to associate situation or object which we initially have no fear of (NS) with something (US) that already triggers a fear response (UCR)

How did Watson and Rayner create a phobia in a 9 month baby

Initially when shown a white Rat, Little Albert tried to play with it (NS). Then every time the experimenter presented the rat (NS) to little Albert, they made a loud noise by hitting an iron bar (UCS) which made little Albert frightened (UCR). Overtime, Albert became frightened (CR) when he saw a rat (CS), even without presence of a loud noise.

-This conditioning generalised to similar objects:Non white rabbit, fur coat and Watson wearing a Santa beard

How are phobias maintained through operant conditioning

Avoiding your phobic stimulus negatively reinforces the phobias and therefore is maintained

Strengths of the Behavioural Approach to Explaining phobias

-Practical Applications: Led to development of treatments such as systematic desensitisation this therapy is based directly on the principles of classical conditioning- helps individual learn to associate phobic stimulus with new relaxed response

Limitations of the Behavioural Approach to Explaining Phobias

-Conflicting Evidence: Not everyone who has experienced a traumatic event goes on to develop a phobia and not everyone who has a phobia has had a traumatic event. Di Nardo reported: 56% of dog phobias had an unpleasant encounter with a dog. 50% of non phobics had an unpleasant encounter with a dog

-Alternative explanation: Bounton (2007) explained we have an innate predisposition to develop phobias of certain stimuli that have been a threat to survival on evolutionary past

-Environmentally Reductionist: The behaviourist explaination may oversimplify the complexity of phobias. Ignores biological factors for example irrational beliefs not explained

What is Systematic Desensitisation

A behavioural therapy designed to reduce an unwanted response such as anxiety to a stimulus. SD involves drawing up a hierarchy of anxiety provoking situations related to the phonic stimulus, teaching the patient to relax, and then exposing them to phonic situations

What is Counter Conditioning

Individual with a phobia learns to replace a fear response with a relaxation response. It is impossible to feel fear and relaxation at the same time- called reciprocal inhibition

What is gradual exposure

takes place across several sessions, starting at the bottom of the anxiety hierarchy. Patient uses techniques learnt to remain relaxed at each stage. Treatments are successful when participants can stay relaxed in situations high on the anxiety hierarchy

Strengths of Systematic Desensitisation

-SD is effective: Giltoy et al followed up 42 patients who had been treated for arachnophobia in 3, 45 minute sessions. Their progress was compared to a control group (50 patients) who only learnt relaxation techniques. At both 3+33 months after treatment the SD group showed a greater reduction in fear

Limitations of Systematic Desensitisation

-Time Consuming and more expensive: Patients need to be trained in relaxation techniques and gradual exposure may take time

-Application to real life: Progress therapy may not generalise outside the controlled clinical setting when individual with the phobia must face their fear without support of the therapist

-Treatment may be more successful for specific phobias: may not be appropriate for social phobias where there is no obvious target. It is generally easier to construct anxiety hierarchy or undergo an intense exposure to object phonias

What is flooding

A behavioural therapy in which a phobic patient is exposed to an extreme form of a phobic stimulus in order to reduce anxiety triggered by that stimulus. This takes place across a small number of long therapy sessions

Results of flooding

Avoidance is prevented. Patient learns that the phobic stimulus is harmless. Eventually patient becomes exhausted by their own fear and anxiety subsides

Strengths of Flooding

-Convinient: Faster and cheaper may only need one session

Limitations of Flooding

-Not suitable for all patients. This can be a highly traumatic psychological and physical experience. I’d flooding fails and patient is released before anxiety subsides the phobia is negatively reinforced

-Application to real life: Progress therapy may not generalise outside the controlled clinical setting when individual with the phobia must face their fear without support of the therapist

-Treatment may be more successful for specific phobias: may not be appropriate for social phobias where there is no obvious target. It is generally easier to construct anxiety hierarchy or undergo an intense exposure to object phonias

What is the Negative Triad

Beck proposed that there were three kinds of negative thinking that contributed to being depressed: negative views of the world, the future and the self. Such negative views lead to a person to interpret their experiences in a negative way and so make them more vulnerable to depression

What is the Negative Self Schema

The other part to this cognitive vulnerability.

-If we have a negative self schema we interpret all information about ourselves in a negative way.They reduce our self esteem. Developed in childhood

What is the ABC model

Albert Ellis proposed that depression occurs when an Activating Event triggers an irrational Belief which in turn produces a Consequence ie an emotional response like anxiety

What is Musturbation

The belief that we must always succeed or achieve perfection

Strengths for the Cognitive Approach to Explaining Depression

Practical Application: They form the basis of treatments for depression

-CTD: Cognitive Behavioural Therapy

-ABC model: Rational Emotive Behavioural Therapy (REBT)

Limitations of the Cognitive Approach to Explaining Depression

-Issues with Cause and Effect: Most of the research is correlational, so it is difficult to establish whether irrational thoughts cause depression or depression causes someone to have irrational beliefs

-Alternative Explanations for depression:It is possible that other factors such as low levels of serotonin are the cause of depression and one symptom for depression

-A partial explanation for depression: Some depressed patients are deeply angry or suffer form hallucinations. Cognitive explanations cannot account for these characteristics

-Blames patient for their depression:Focuses on individuals thought processes so may ignore situational factors

What is Cognitve Behaviour Therapy

A method for treating mental disorders based on both cognitive and behavioural techniques. From the cognitive viewpoint the therapy aims to deal with thinking such as challenging negative thoughts. The therapy also includes behavioural techniques such as behavioural activation

Steps of CBT

1)Thought catching

2)Patient as scientist

3)Homework and Behavioural Activation

What is Thought Catching

Patient identifies their negative self schemas and triad. This can be done through keeping a thought diary

What is Patient as Scientist

Patient generates hypotheses to test accuracy of irrational thoughts. Evidence is presented for and against these thoughts

What is Homework and Behavioural activation

Patients are set homework to complete outside of the therapy session. For example to record something good happens to them. This can be used as evidence to challenge future negative automatic thoughts. It also involves encouraging people with depression to be active and engage with enjoyable activities they may have stopped doing

What is Ellis’ Rational Emotive Behavioural Therapy (REBT)

Ellis extends to ABCDE model to treat depression. The aim of REBT is to dispute irrational thoughts

what is the abcDE treatment for depression

-Disputing: The irrational beliefs are challenged. Two methods of disputing: 1) Empirical Argument=is there any evidence to support the negative belief?2)Logical Argument=does the negative thought logically follow from the facts

-Effect: A reduction in irrational beliefs.Positive emotions and behaviours are a result of new rational beliefs

In REBT there is also homework and behavioural activation

Strengths of the Cognitive Approach to Treating Depression

-Effectiveness of cognitive treatments: March et al-327 adolescents with depression. Treatment was either CBT, Antidepressants, or both. After 36 weeks:

-81% of CBT improved

-81% of Antidepressants improved

-86% of both improved

Limitations of the Cognitive Approach to Treating Depression

-Cognitive treatments may not work for the most severe cases of depression: Cognitive treatments require concentration and commitment. Depression can be so severe that the patients may not be able to attend the therapy. They may not pay attention to what’s happening or be motivated to complete tasks

-Cognitive treatments assume that depression has a cognitive cause: REBT and CBT assume it is caused by irrational thinking however negative thoughts maybe a symptom rather than a cause

-Overemphasis on the role of cognitions: CBT and REBT do not take social circumstances or biological causes into account. These individuals need to change their circumstances or balance levels of serotonin meaning CBT will be ineffective

What are Genetic Explainations

Genes make up chromosomes and consist of DNA which codes the physical and psychological features of an organism. Genes are transmitted from parents to offspring i.e inherited

How does inheritance explain OCD

individuals inherit specific genes which create a vulnerability to developing OCD. Evidence suggests you’re more likely to develop OCD if you have a close relative with OCD

What did Nestadt find about OCD in twins

-68% of monozygotic twins both had OCD compared to

-31% of dizygotic twins

What did Taylor (2013) find about OCD genes

OCD is polygenic: Not caused by one single gene

-Taylor found around 230 different genes may be involved in OCD.

-One group of genes may cause OCD in one person but a different group of genes may cause OCD in another

What are Candidate Genes

Create a vulnerability for OCD:

-Abnormal variant COMT gene (regulates dopamine) =high levels of dopamine levels in OCD patients.

-Abnormal variant of SERT gene (regulates serotonin)= low levels of serotonin in OCD patients

What are Neural Explanations

The view that physical and psychological characteristics are determined by the behaviour of the nervous system, in particular the brain as well as individual neurons

What are Neurotransmitters and how are they associated with OCD

Chemicals that communicate information between neurons. High levels of Dopamine are associated with compulsive behaviours. Low levels of Serotonin are associated with OCD and linked to low mood and anxiety

What is the left parahippocampulgyrus responsible for

processions unpleasant emotions. Abnormal functioning here is associated with OCD

What is the Basal Ganglia System

A cluster of structures in the brain responsible for the coordination of movement. Hyperactivity here is associated with compulsive behaviour in OCD

What is Abnormal Functioning of the Orbito-Frontal Cortex related too

Impaired decision making. Individuals with OCD have exaggerated worry signals. For example the brain keeps sending signals that something is wrong even when it isn’t