Psychpathology

What is statistical infrequency?

When an individual has a numerically less common characteristic comapred to the population.

So, statistical infrequency defines abnormality in term of behaviours seen as statistically rare or which deviate from the mean or norm.

What percentage of the population have an IQ less than 70 and what does this mean?

Less than 2.2% and therefore may be described as having an abnormally low IQ (intellectual disability disorder)

AO3 for statistical infrequency: What is its real life application?

It’s helpful/useful in diagnosing disability disorders such as in schools, which can lead to interventations to help. It’s also used in clinical assessments.

AO3 for statistical infrequency: What doesn’t it consider about unusual characteristics?

Unusual characteristics can be positive and desirable in some cases - e.g. having a really high IQ score. But by this definition, they would be diagnosed with having a mental disorder.

AO3 for statistical infrequency: Why do not all statistical infrequencies benefit from a label?

For example, someone with a low IQ who was not distressed and capable of working may be negatively effected by being labelled as abnormal and lead to a self-fulfilling prophecy.

What is the failure to function adequately?

This occurs when someone is unable to cope with the ordinary demands of day-to-day life. This may cause distress to others and themselves

Who put forward the behaviours that contribute to the failing to function adequately and when?

Rosenhan and Seligman, 1989

What behaviours did Rosenhan and Seligman (1989) put forward to constitute to failing to function adequately?

Suffering, maladaptiveness, unpredicitibility, loss of control, irrationality, causes the observer discomfort

AO3 for failure to function adequately: How does it take a patient’s perspective?

It recognises the subjective experience of the individual themselves who may be struggling to function adequately and wish to see intervention. This means that treatment or help can be tailored specifically to them which can help them recover much quicker.

AO3 for failure to function adequately: Is it simply a deviation from social norms?

For example, people who chose not to have jobs may be considered as failing to function adequately but they are instead just living a traveller's lifestyle. This means that some healthy people are being unfairly labelled as failing to function properly when they are instead just deviating from social norms. This is a limitation as it creates unhealthy stigmas surrounding alternative lifestyles.

AO3 for failure to function adequately: How is judging it a problem?

It is subjectice as someone must go and measure it according to their own view.

What is deviation from social norms?

It concerns behaviour that is different from the accepted standards of behaviour in a society. Norms are specific to the culture we live in, though there are also some that aren’t accepted universally.

What mental health condition is highlighted in deviation from social norms and what is it characterised by?

Antisocial personality disorder which is characterised by a pervasive disregard for the rights of others, lack of empathy and impulsive, often criminal behaviour.

AO3 for deviation from social norms: How do social norms change over time?

Some things that are excepted today have previously been considered abnormal or vice versa. For example homosexuality was included as a disorder under the DSM and wasn’t removed until the 1990s, whilst drink driving was considered acceptable but is now socially unacceptable. This means that it lacks temporal validity and behaviour can be defined as normal or abnormal in one era and not another.

AO3 for deviation from social norms: How is it culurally biased?

What may be regarded as abnormal to one culture may be considered normal in another culture - e.g. hearing voices in some cultures is socially acceptable but may be a mental abnormality in the UK.

AO3 for deviation from social norms: How can it lead to human right abuses?

It can be used to unfairly label and control minority groups. For example, in Russia in the late 1950s, anyone who disagreed with the government ran the risk of being diagnosed as insane and placed in a mental institution.

AO3 for deviation from social norms: What is its real life application?

It is useful in diagnosing disorders such as ASPD which can lead to interventions.

What is deviation from ideal mental health?

This occurs when an individual doesn’t meet the set criteria for good mental health.

Who put forward the criteria for ideal mental health and when?

Jahoda in 1958

What was Jahoda’s 1958 set criteria for ideal mental health?

Positive self-attitudes

Personal growth

Autonomy

Accurate perception of reality

Ability to self-actualise.

The more criteria the individual is unable to meet, the more abnormal they are considered

AO3 for deviation from ideal mental health: How is it a comprehensive definition?

It offers a broad range of criteria for mental health and is a good tool for thinking about mental health and in seeing ways people can improve.

AO3 for deviation from ideal mental health: How is it culturally biased?

Jahoda’s criteria meets more of Western culture’s standards. For example, independance may be considered a negative thing in collectivist cultures.

AO3 for deviation from ideal mental health: How is it a unrealistically high standard?

The criteria may see the average person as abnormal and it’s hard to meet all of Jahoda’s criteria.

What is a phobia?

An irrational fear and anxiety of an object, place or situation. The extent of the fear is out of proportion to any real danger.

What are the behavourial characteristics of phobias?

Panic- Crying, screaming, running away, freezing, fainting.

Avoidance - avoid encountering the phobic stimulus

Endurance - the person remains in the presence of the phobic stimulus but experiences high levels of anxiety

What are the emotional characterisitcs of phobias?

Anxiety - unable to relax or feel positive emotions/An unpleasant state of high arousal.

Fear

Unreasonable and disproportionate emotional response to the actual danger presented by the phobic stimulus.

What are the cognitive characteristics of phobias?

Selective attention - become fixated on the phobic stimulus

Irrational beliefs

Cognitive distortions - perception that are distorted and are sistant to rational arguments.

What is depression?

A mental disorder characterised by low mood and low energy levels.

What are the 4 types of depression according to the DSM?

Major depressive disorder - severe but short term

Persistent depressive disorder - long term

Disruptive mood dysregulation disorder - temper tantrums

Premenstrual dysphoric disorder - low mood prior to menstrual cycle.

What are the behavourial characteristics of depression?

Shifts in activity level - either reduced or increased e.g. psychomotor agitation where they may struggle to relax.

Disruption to sleeping and eating - sleeping to much (hypersomnia) or too little (insomnia). Eat too much or too little.

Agression/self harm.

What are the emotional characteristics of depression?

Sadness - feeling empty, worhtless

Loss of interest and pleasure in usual actvities or hobbies

Low self-esteem

Anger - directed towards themselves or others.

What are the cognitive characteristics of depression?

Poor concentration - leads to poor decision making, poor work

Absolutist thinking/black and white thinking - when they see an unfortunate situation, they view it as a complete disaster.

Attending to and dwelling on the negative - most likely to ignore the positives of a situation. They have a negative view of the world.

What is OCD?

A mental disorder assoicated with obsessions and compulsive behaviour.

What are obsessions in OCD?

Internal components such as thoughts and irrational thought processing.

What are compulsions in OCD?

External components such as behaviours or actions that are carried out repeatedly to reduce anxiety.

What are the behavioural characterisics of OCD?

Compulsions - repetitive and reduce anxiety

Avoidance

What are the emotional characterisitcs of OCD?

Anxiety and distress - unpleasant and frightening. Urge to repeat behaviour creates anxiety.

Depression - lack of enjoyment in activites

Guilt and disgust

What are the cognitive charatceristics of OCD?q

Obsessive thoughts - these are recurrent and unpleasant

Cognitive strategies to deal with obsession - praying or meditating

Insight into excessive anxiety - Sufferers are aware that their behaviour is excessive and this causes feelings of embarrassment and shame.

May be hypervigilant to hazards, worst case scenario thinking.

Who proposed the two-process model for explaining phobias?

Mowrer

According to the behavioural approach, how is a phobia acquired?

Classical conditioning - through association.

According to the behavourial approach and two-way model, how is a phobia maintained?

Operant condition

How does negative reinforcement maintain a phobia?

Negative reinforcement is when a behaviour is strengthened because it removes or avoids something unpleasant.

Through avoding the feared object or situation, anxiety is reduced, providing escape from unpleasant situations. This relief feels rewarding and reinforces the avoidance behaviour, making it more likely to happen again in the future. This cycle of avoidance and relief maintains the phobia, preventing recovery.

AO3 for the behavourist explainations to phobias: How has it got good explanatory power?

Explains how phobias are maintained and this led to important implications for therapy as it explains that patients need to be exposed to the feared stimulus. When the patient is prevented from carrying out avoidance behaviour the behaviour isn’t maintained so therefore declines.

AO3 for the behavourist explainations to phobias: How is it reductionist?

Reduces phobias to stimulus-response reactions. However Munjack (1984) conducted a study on pps with and without a driving phobia. He found that only half of those with the phobia had actually experienced a car accident, whilst many pps without the phobia had been in a car accident. These findings challenge the behavioural explanation as they suggest negative experiences alone don’t fully account for phobias. This implies that an alternative explanation is necessary to understand the origins of phobias.

AO3 for the behavourist explainations to phobias: What may be a better factor to explain phobias?

Bounton (2007) argued that evolutionary factors have an important role. This explains why we may have a phobias of snakes and the dark which have been a source of danger in the past and so it was adaptive to acquire these fears. Seligman (1971) called this biological preparedness. This may also explains why we don’t have a phobias of cars or guns as they were recently developed.

AO3 for the behavourist explainations to phobias: How does the two-process model ignore cognitive factors?

The cognitive approach proposes that some phobias may develop due to irrational thinking, such as catastrophic thoughts or distorted perceptions about the feared object or situation. This means the behavourist explanation is environmentally reductionist, as by focusing solely on behavioural factors, it reduces complex psychological phenomena to basic stimulus-response mechanisms. This overlooks the cognitive processes in the development and maintenance of phobias.

What is systematic desensitisation?

A behavioural therapy that aims to gradually reduce phobic anxiety using conditioning.

What process does systematic desensitisation use?

Counterconditioning, where the individual learns to associate the phobic stimulus with a new, more positive response.

What is reciprocal inhibition in systematic desensitisation?

A principle that states it is impossible to experience two conflicting emotions at the same time. In systematic desensitisation, a person cannot feel both anxiety and relaxation simultaneously, so inducing relation helps to inhibit the anxiety response.

What are the steps in systematic desensitisation?

1. The anxiety hierarchy

2. Relaxation

3. Exposure

What is the anxiety hierarchy in systematic desensitisation?

This is a list put together by the patient and therapist that is a list of situations related to the phobic stimulus in order from least to most frightening.

What is the step of relaxation in systematic desensitisation?

The patient is taught relaxation through breathing techniques, meditation or mental imagery techniques. The patient may sometimes be given drugs such as valium.

What is the step of exposure in systematic desensitisation?

The patient follows the anxiety hierarchy over multiple sessions until the patient can stay relaxed in high anxiety situations. Treatment is successful when the patient can stay relaxed in situations high on the hierarchy.

AO3 for systematic desensitisation: Who found if it is effective?

Gilroy et al (2003) followed 42 patients who had been treated for a spider phobia. A control group was treated by relaxation without exposure. After 33 months the systematic desensitisation group was less fearful. It was found to be long last and effective.

AO3 for systematic desensitisation: Why is it suitable for a diverse range of patients?

Unlike flooding or cognitive therapies, which often require a deeper level of self-reflection and the ability to analyse and challenge one’s thoughts, this approach is accessible. It focuses on gradual exposure and the association of relaxation with the phobic stimulus, making it easier for individuals who may struggle with the complex cognitive demands of other treatments. This adaptability enhances its usefulness across different patient groups.

AO3 for systematic desensitisation: Why is it acceptable to patients?

This therapy is generally more acceptable to patients because it’s less traumatic than flooding. Flooding often has high refusal and dropout rates due to the intense nature of the treatment, whereas SD has more lower refusal rates, making it a more patient-friendly option.

What is flooding?

This involves immediate exposure to a very frightening situation regarding the phobic stimulus.

How does flooding work?

It works by preventing the patient from engaging in avoidance behaviours, allowing them to confront the phobic stimulus directly. This leads to extinction, where the body’s initial alarm phase subsides, leaving the patient emotionally drained but no longer afraid. If the feared stimulus remains present, the patient learns to associate it with calmness rather than fear.

How many sessions does flooding include?

It typically involves longer but fewer sessions compared to other therapies, lasting 2-3 hours.

Why and what are the ethical safeguards with flooding?

Flooding has ethical issues due to the unpleasant experience so patients must provide fully informed consent and should be prepared before the flooding session.

AO3 for flooding: How is it cost effective?

Studies comparing flooding to cognitive therapies have found it highly effective and quicker. It tries to make patients free of symptoms quick as possible which means patients don’t have to pay as much compared to other therapies which take longer.

AO3 for flooding: Why is it less effective for some types of phobias?

Flooding is less effective for phobias with significant cognitive components such as social phobias. Individuals with social phobias not only experience anxiety responses but also engage in persistent unpleasant thoughts, such as fear of embarrassment or judgment. These cognitive aspects are better addressed through cognitive therapies, which focus on identifying and challenging irrational thinking rather than solely confronting the feared stimulus.

AO3 for flooding: What is the problem with the treatment being traumatic?

Flooding can be highly distressing, leading some patients to refuse to complete the treatment. This can result in wasted time and money if sessions are abandoned midway. Additionally, there are ethical concerns if proper informed consent is not obtained, as patients must fully understand the intense nature of the therapy before agreeing to undergo it.

Who proposed the negative triad to explaining depression and when?

Beck, 1976

What are the 3 components of faulty information processing?

Selective abstraction - focusing on a single negative detail of a situation while ignoring the broader context or any positive aspects.

Overgeneralisation - drawing definitive conclusions based on a single event (e.g. failing a test leads to “I’ll fail everything)

Minimisation: Downplaying or dismissing achievements and positive outcomes as unimportant or accidental.

What are negative self-schemas?

Schema is a package of ideas and information we develop through experiences and act as a mental framework for interpreting sensory information. Patients with negative self-schemas interpret all information about themselves in a negative way.

When do negative self schemas develop and what do they lead to?

They have developed during childhood. These lead to systematic cognitive biases in thinking.

What are the components of the negative triad?

1. Negative views about the world (everyone is against me)

2. Negative views about the future (I’ll never be good at anything)

3. Negative views about oneself (I’m worthless and inadequate)

AO3 for Beck’s negative triad: What supporting evidence is there?

Terry (2000) assessed 65 pregnant women for cognitive vulnerability and depression before and after birth. Women higher in cognitive vulnerability were more likely to have postnatal depression. This shows poor cognition has an effect on depression.

AO3 for Beck’s negative triad: How has it got practical application in CBT?

Cognitive aspects of depression can be identified and challenged. The patient can be encouraged to test whether their irrational thoughts are true which can translate into successful therapy. This also has positive economic implications.

AO3 for Beck’s negative triad: Why can’t it explain all aspects of depression?

Some individuals with depression experience hallucinations or delusions such as those seen in Cotard syndrome (Jarrett, 2013) where sufferers believed they were like zombies. These symptoms go beyond the scope of Beck’s focus on faulty thinking patterns and suggest that depression may involve other factors, such as biological or neurological influences, which his theory doesn’t address.

Who proposed the ABC model?

Ellis

What does the A in the ABC model mean?

Activating event. Ellis believed that negative events trigger irrational beliefs.

What does the B mean in the ABC model mean?

Beliefs. These are the potential irrational beliefs that arise after the activating event.

What are the 2 types of beliefs that come under B in the ABC model?

Musterbation: The belief that you must always succeed.

Utopianism: The belief that life should always be fair.

What does the C mean in the ABC model?

Consequences. Irrational beliefs lead to unhealthy emotions such as depression or anxiety and other maladaptive behaviours.

AO3 for the ABC Model: Why is it only a partial explanation

The ABC model says an activating event must occur to trigger the depression, however some cases of depression have no obvious case. Thus it has limited application as it cannot account all cases of depression such as endogenous depression.

AO3 for the ABC Model: How has it got practical application in CBT?

The cognitive ideas have been used to develop effective treatments for depression, including CBT and Rational Emotive Behaviour Therapy (REBT). These therapies attempt to identify and challenge negative, irrational thoughts and have been successfully used to treat people with depression.

AO3 for the ABC Model: What are the alternative explanations?

There are alternative explanations which suggest that depression is a biological condition, caused by genes and neurotransmitters. Research has focused on the role of the neurotransmitter serotonin and found lower levels in patients with depression. In addition, drug therapies such as SSRIs are found to be effective in the treatment of depression, which provide further support for the role of neurotransmitters, in the development in depression.

What is involved in Cognitive Behavioural Therapy?

Assessing patients to clarify problems. The therapist and patient identify negative or irrational thoughts, jointly identify goals and plans to achieve them.

What is involved in Beck’s cognitive therapy?

The therapist and patient identify the patient’s negative triad and irrational thoughts challenge them. They modify negative self schema and test the reality of their negative beliefs. They instead reinforce positive thoughts through cognitive restructuring. Sometimes they are given homework making the patient like the scientist to challenge beliefs.

What is Ellis’s rational emotive behaviour therapy (REBT) an extended version of?

It’s an extended version of Ellis’s ABC model, extended to ABCDE.

D- Disrupting irrational thoughts and beliefs.

E- Effects of disrupting and effective attitude to life.

What is involved in REBT?

It involves rigorous arguments to change irrational beliefs, which involves disputing whether there is actual evidence to support negative beliefs. It can also involve disputing whether the negative thoughts logically follow from the facts.

What is behavioural activation in REBT?

The therapist encourages the patient to become more active to provide evidence for the irrational nature of their beliefs. For example if a patient believes they can’t enjoy anything anymore, the therapist encouraged them to go for a walk or meet a friend. Afterward, the patient realises they felt a small sense of enjoyment, providing evidence that their belief is irrational.

How is unconditional positive regard used in REBT?

Ellis emphasised the importance of unconditional positive regard to build trust and acceptance in therapy. By showing genuine warmth or respect, the therapist helps the client feel valued, regardless of their flaws or mistakes. This supportive environment encourages the client to challenge negative beliefs about themselves and fosters personal growth.

AO3 for CBTs: What research support is there for its effectiveness?

March et al (2007) compared effects of CBT with antidepressants and a combination of two in 327 adolescents with depression. 36 weeks after they 81% of the CBT group and antidepressant group showed improvement. This shows that CBT is just as effective as medication.

AO3 for CBTs: Why might it not work for the more severe cases?

CBT may not be effective where individuals are so overwhelmed by their symptoms that they lack the motivation, energy or cognitive capacity to engage with the structured and active nature of CBT. For these patients, antidepressants may be necessary to alleviate the worst symptoms, enabling them to regain some ability to focus and engage with CBT.

AO3 for CBTs: Who suggested that success may be caused by something else?

Rosenzweig (1963) suggested the difference between different methods of therapies like CBT and SD may be small and that it may be the quality of the therapist patient relationship that actually determines success rather than the type of therapy.

AO3 for CBTs: What is a problem with CBT’s focus?

CBT focuses on the present and future, but not the past. Patients may be aware of the link between childhood experiences and depression and want to talk about it. The present focus may be frustrating, suggesting psychotherapy may be better.

What percentage of patients with OCD did Lewis (1936) find to have parents with OCD?

37%.

Is OCD polygenic or not?

OCD is polygenic

How many genes did Taylor (2013) find associated with OCD?

230

What were the 2 genes associated with neurotransmitters found to be implicated with OCD?

SERT (which affects the transport of serotonin) and COMT (which is responsible for clearing dopamine from synapses).

What are candidate genes?

A gene that is believed to be related to a particular trait.

How is OCD aetiologically heterogeneous?

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

What does serotonin regulate?

Mood

What does low levels of serotonin mean?

That the normal transmission mood-relevant information doesn’t take place.

How can low levels of serotonin explain OCD?

Reduced serotonin levels are linked to obsessive thoughts and heightened anxiety.

How does the SERT gene contribute to OCD?

The SERT gene is linked to the neurotransmitter serotonin and affects the transport of it, causing lower levels of serotonin. This is associated with OCD as reduced levels are linked to obsessive thoughts and heightened anxiety.

What symptoms does elevated dopamine levels cause and why?

Elevated dopamine levels are associated with compulsive behaviours as dopamine is linked to the brain’s reward system, reinforcing repetitive actions that temporarily reduce anxiety.