AQA Psychology- Psychopathology

Psychopathology

Psychopathology

What are the definitions of abnormality?

-Statistical Infrequency

-Deviation of social norms

-Failure to Function adequately

-Deviation from ideal mental health

What is statistical infrequency?

Describes behaviour as normal or not based on the number of times we observe it.

If the persons scores cluster around the average then they are considered 'normal' for that category.

On either side of the average people are attain the normal distribution therefore counting as abnormal. .

What are the positives for statistical infrequency?

Objective- A cut off point is agreed

No value judgements- doesn't view homosexuals as abnormal because they are wrong just because they are infrequent to heterosexuals.

Appropriate- In many cases it can define abnormality.

What are the negative points for statistical infrequency?

Inappropriate- 130+ IQ would be considered abnormal but people with high-intelligence don't need treatment

Labelling those who are living happily as abnormal if they satisfy the criteria for statistical infrequency

Cultural factors are not considered- something that may be normal in one country may be abnormal in another

What are deviation from social norms?

When a persons behaviour is different from what we would expect it to be. Offends the sense of what is acceptable. As a society makes a collective about what is right. Social norms vary by age, gender, culture so universal norms are rare.

A person with anti-social disorder (psychopathy) is impulsive, aggressive and irresponsible. DSM-5 says that we make the social judgement that psychopaths are abnormal because they don't conform to moral standards.

What are the characteristics of people with psychopathy?

Impulsive

Aggressive

Irresponsible

What are the positive points for deviation from social norms?

Establishes developmental and situational norms e.g- filling a nappy at age 2 (Normal). Walking around naked at 40 (Abnormal)

Protects society from the effects of an individuals abnormal behaviour can have on others

What are negative points for deviation from social norms?

Subjective- social norms are no real and objective. Based on opinions of society. Social norms are used control those seen as a threat to social order

Social norms change over time

Cultural relativism

What is failure to function adequately?

When a person can no longer cope with the demands of every day life.

e.g unable to maintain basic standards of nutrition; can't hold down a job or relationship.

What are Rosenhan and Seligman's points for failure to function adequately?

-Person no longer conforms to standard interpersonal rules e.g eye contact

-Person experiences serve personal distress

-Person's behaviour becomes irrational or dangerous to themselves and/or others.

What are the positive evaluation points for failure to function adequately?

Attempts to include the subjective experience of the individual and views it as important- captures the experience of many people who need help. Useful criteria.

Checklist- practical checklist allows individual assessment of abnormality level.

What are the negative points for failure to function adequately?

Normal abnormality- sometimes it is normal to suffer personal distress (after death of loved one)

Cultural relativism- varies in different cultures.

Risk of discrimination and limiting personal freedom- If taken literally, the definition sees people who participate in extreme sports, or have religious/supernatural beliefs.

What is deviation from ideal mental health?

A picture/idea is created of what is psychologically healthy, and then those who do not match these ideals are abnormal.

Who created criteria for ideal mental health?

Jahoda

What are Jahoda's criteria for ideal mental health?

Positive attitude towards oneself- (Self respect and self-concept)

Self actualisation- motivated and full of potential (personal growth and development)

Autonomy- Independent, self reliant and sufficient. Able to make their own decisions.

Resisting Stress- have effective coping strategies and every day anxiety

Accurate perception of reality- perceive the world in a non-distorted manner

Environmental mastery- competence in all aspects of life; ability to meet demands of any situation.

What are the positive points for deviation of ideal mental health?

-Focuses on what is desirable - positive approach to mental health

-Checklist/criteria- allows targeting of which areas to work on when treating abnormality

-Holistic- considers an individual as a whole person rather than focusing on individual areas of their behaviour.

What are the negative points for deviation of ideal mental health?

-Cultural relativism- differs from culture to culture

-Sets high standards for mental health- even the majority of people will not meet all of the criteria.

-Subjective- criteria is vague and difficult to measure objectively (relies on self-report_

What does the criteria for deviation of ideal mental health rely on?

Self reports- they are subjective.

What is a phobia?

An irrational fear of an object or situation.

An anxiety disorder characterised as uncontrollable and extreme irrational and involve anxiety levels out of proportion to any actual risk.

Where do phobias originate from?

Childhood

However they do usually lessen in strength during adulthood

What are the DSM-5 sub-types of phobias?

-Simple/Specific- phobia of specific thing or environment: animals, injuries, situations, natural environment.

-Social- Over-anxiety in social situations; perception of self-inadequacy and being judged; sufferers have difficulty conducting meaningful relationships: performance, interaction, generalised.

-Agoraphobia- fear of being outside or in open spaces- leads to anxiety/ panic attacks when leaving the home or a safe place. Natural response= stay at home.

What is simple/specific phobias?

-Simple/Specific- phobia of specific thing or environment: animals, injuries, situations, natural environment.

(Phobia of an object like an animal or body part)

What are Social phobias?

-Social- Over-anxiety in social situations; perception of self-inadequacy and being judged; sufferers have difficulty conducting meaningful relationships:

performance

interaction

generalised.

(Phobia of a social situation like public peaking)

What is Agoraphobia?

Agoraphobia- fear of being outside or in open spaces- leads to anxiety/ panic attacks when leaving the home or a safe place. Natural response= stay at home.

(Phobia of being outside or in a public place.)

What is the natural response for people with Agoraphobia?

Stay at home

What are the behavioural characteristics for phobias?

-Avoidance: make an effort to avoid contact with phobic stimulus

-Endurance- sufferers remain in the presence of phobic stimulus but with high anxiety levels continuing

-Panic- crying, screaming, running away

What are the emotional characteristics for phobias?

Excessive fear: high levels of anxiety due to presence of feared stimulus.

What are the cognitive characteristics for phobias?

Recognition of irrationality- sufferers are consciously aware that their fear is overstated. But can't control it.

Social phobias only- holding irrational beliefs

What is the behavioural explanation for phobias?

Two-process model

What is the two process model?

1. Acquisition(onset) of phobias occurs through classical conditioning. (indirectly through SLT or traumatic event)

2. Maintain phobias through operant conditioning- avoidance of stimulus acts as negative reinforcer (reward=reduction of anxiety), this then reinforces the avoidance response.

What is an example of the two process model?

Little Albert- Watson and Rayner created a phobia of rats for Albert,

Iron bar noise (UCS) =Fear (UCR)

UCS=Rat (NS) repeatedly paired

Rat (CS)= Fear (CR)- which was generalised to all white fluffy objects.

What are the positive evaluation points of the two process model?

It has practical applications- Hold important implications for therapies as the knowledge of how phobias are maintained explains why patients need to be exposed to phobic stimulus in order to eliminate phobia.

What are the negative evaluation points for the two process model?

Suggests avoidance responses are motivated by anxiety reduction but:

Buck suggests they are just as much motivated by the safety factor. where agoraphobics tried to leave the house they could do it with low levels of anxiety if they were with a trusted person.

Seligmen identified biological preparedness as its the innate predisposition to acquire certain fears- evolutionary factor.

What are the two behavioural approaches for phobias?

Systematic Desensitisation

Flooding

What is Systematic Desensitisation?

A behavioural therapy designed to reduce phobic anxiety through the principle of Classical conditioning. Suffers are cured if they learn to relax in presence of phobic stimulus.

It is impossible to be afraid and relaxed at the same time (counter-conditioning)

What are the steps for Systematic Desensitisation?

1. Anxiety hierarchy

2. Relaxation techniques

3. Exposure

What is an Anxiety Hierarchy in terms of Systematic Desensitisation?

Put together by therapist and patient.

A list of situations related to phobic stimulus that provoke anxiety in ascending order.

Starts- Sufferer imagines scenario

End- Suffer in contact with scenario

What is Relaxation Techniques in terms of Systematic Desensitisation?

Therapist teaches sufferer how to relax deeply. Can be breathing or mental imagery techniques. Drugs like Valium may also be used. As well as mediation.

What is Exposure in terms of Systematic Desensitisation?

While in a relaxed state the patient is exposed to phobic stimulus ; occurs over several sessions. When they can stay relaxed at a step they move up the hierarchy.

What are the positive points for Systematic Desensitisation?

It is effective in reducing anxiety experienced in the presence of phobic stimulus.

Effects can be long-lasting (Gilroy)

Suitable for a wide range of patients and is more commonly accepted by patients rather than other treatments. Less trauma and stress involved.

What are the negative points for Systematic Desensitisation?

It takes a very long time. Usually done over a month

Expensive- takes several sessions

Waiting list for NHS

What is Flooding?

Exposing patients to their phobic stimulus straight away. Immediate exposure and v.scary.

Why is flooding effective?

No option of avoidance behaviour so the patient quickly learns that the phobic stimulus is harmless.

What must the patient provide if they are undergo flooding?

Fully informed consent with the choice of Systematic Desensitisation or flooding for ethical considerations.

What is the positive point for flooding?

Cost-effective- Compared to other treatments flooding is more cost effective.

Quickest method.

Patients are free of their symptoms sooner so it is cheaper.

What is a negative point for flooding?

Highly traumatic experience- patients often unwilling to see it through (money and time wasted)

What is Depression?

An effective mood disorder that involves lengthy disturbance of emotions.

What percentage of people suffer from depression at some point?

20%

Who are more likely to suffer from depression?

Women are twice as likely to suffer from depression (Particualrly in adolescence due to low self-esteem)

How do doctors diagnose depression?

No lab tests

Diagnose from behaviour and from what the patient tells them this make it difficult to distinguish the least severe from the most severe cases.

What needs to be shown for depression to be diagnosed?

PERSISTENTLY LOW MOOD FOR AT LEAST TWO WEEKS AND HAVE AT LEAST 5 OF THE SYMPTOMS.

What are the behavioural characteristics for depression?

Poor appetite and weight loss or opposite

Reduced sleep or opposite

Reduced energy levels (lethargic) or Psychomotor agitation (struggle to relax)

Poor personal hygiene

What are the emotional characteristics of depression?

Lack of enthusiasm/interest/ pleasure in usual activities

Sadness

Self-directed anger

Feelings of worthlessness/ self-reproach. Excessive and Inappropriate guilt

What are the Cognitive characteristics of depression?

Reduced concentration

Poor memory

Negative and irrational thoughts

What are the Cognitive explanations for depression?

Focuses on how thinking shapes out behaviour. depression is seen as being caused by negative and irrational thought processes and so to cure depression this must be reversed.

Beck's Negative Triad

Ellis' ABC Model.

What what is Beck's Negative Triad?

-Negative views about world

'Everyone hates me because im worthless'

-Negative views about the future

'I'll never be good at anything because everyone hates me'

-Negative Views about Oneself

'I am worthless'

What is Becks Negative Triad based on the concept of?

Schemata-

These Schemas dominate thinking and are triggered in situations that are similar to those in which the Negative schemas were learned.

this is along with cognitive biases. The pessimistic view of depressives becomes self-fulfilling prophecy and lead to cognitive bias.

What are the positive evaluation points of Becks Negative Triad?

Evidence to support-

Boury et al- monitored students negative thoughts with Becks depression Inventory, finding that depressive misinterpret facts and experiences in a negative way and feel hopeless for the future.

Formed the Basis of CBT- has practical applications- translates well into a successful therapy where all the Cognitive explanations can be identified.

What are the Negative Evaluation points about depression?

Depression thought to be more complex than just basic symptoms that the negative triad identifies. Doesn't explain cases of extreme anger or hallucinations.

What is Ellis' ABC model?

A-Activating event- something happens in the environment around you

B-Beliefs- irrational or rational which you hold about the situation

C-Consequence- either a healthy or unhealthy negative emotions which is the response to belief.

What does the ABC model explain about depression?

This is not what causes depression but how they deal with it.

'Must' thinking a term coined by ellis to describe absolutist thinking is the kind of thinking.

This gives rise to extreme frustration/anger/depression.

This 'must' thinking leads to irrational thinking.

What are examples of 'must' thinking?

I must be approached of

I must do well or succeed.

I must be happy, else I die

Positive points of ABC Ellis model?

Practical applications- in CBT which supports this which challenges irrational negative beliefs can lead to reduction of depression.

Negative Evaluation points of Ellis' ABC Model?

Only explains reactive depression and when there is only an obvious cause= limited.

Doesn't explain all aspects- It doesn't explain the anger associated with it or some cases of hallucinations.

What are the cognitive treatments for depression?

Cognitive Behavioural therapy (CBT)

Rational emotive behavioural therapy (REBT)

What are the aims of these therapies?

Aims to change the way a client thinks.

(Turn negative to positive)

Challenges irrational and maladaptive thought processes.

Should lead to a change in behaviour as a response on new thinking patterns.

What does the Cognitive treatments for depression focus on?

Affect- feelings of the client

Behaviour- actions of client

Cognition- thoughts of client

What is CBT?

Application of Beck's cognitive theory

Most commonly used for psychological treatment of depression.

Not an easy option- time consuming and expensive

Relies on a good relationship between client and therapist.

Client and therapist put a list together of goals they wish to receive on the therapy and work to reach them.

Therapists often use CBT and REBT to remove negative clients.

Why isnt CBT and easy option?

Time consuming and Expensive

What does CBT rely on between therapist and client?

Good relationship and motivation to do well.

What is involved in CBT?

Challenges thoughts directly to change them to positive.

They put a list of goals they wish to achieve.

What is CBT thought of in terms as a therapy?

An umbrella for other therapies including REBT

What's Beck's cognitive Theory?

Application of the Negative Triad to identify about world self and future.

Wants to challenge and eliminate them.

Therapists question patients and test their reality of negative beliefs. -Helps them realise the irrationality of them.

Homework is often set.

What is Ellis' REBT?

Extension of the ABC model.

D- disrupting irrational thoughts- encouraged to create alternative positive thoughts

E- effects of the new beliefs and attitudes that emerge

F- feelings and emotional response that arises.

Involves homework tasks

Puts them in situations they wish to avoid

To become more active and take part in a pleasurable activity

What study looked at CBT?

Embling

What was the Aim of Emblings study?

Explore relationship between emotions and depression

What type of Sample was Embling study?

Opportunity sample of 38 depressives- both given anti-depressant and CBT.

Control- 19- only receiving anti depressants

What was the method of the study?

Patients recorded dysfunctional thoughts to monitor mood changes using 1 to 100 scale. (Only done in treatment group)

Used BDI to assess depression levels pre-study then at 1 week intervals.

What were the results of Emblings study?

Treatment groups scored decreased over time.

Control- Stayed the same.

CBT combined with drug therapy works better than drugs alone.

Where was best improvement seen in Emblings study?

Those with internal LOC, high autonomy levels, low sociotropy levels and self orientated perfectionism

Positive points of Embling's study?

CBT is effective. Stops Mild depression turning extreme.

Research- William and Whitfield:

CBT had strongest research base for effectiveness. Recognised problem with NHS to be able to deliver face to face sessions. Instead use self help method. Involves SPIRIT. this teaches core cognition behavioural skills using self help material.

High Controls- replicable

Negative Evaluation points of Emblings study?

A lack of expression may be factor of depression or an effect od being depressed.

Improvement in condition group may be that they were seen more frequently and were allowed to share more than the control.

Depressed patients should be psychologically mensured for suitability of CBT.- not appropriate for everyone

Positive Evaluation points for CBT?

It's effective

Research- March et al

Compared effects of CBT with drugs and a combination of the two. 86% of both significantly improved. - First choice for NH S

Better therapist = better treatment.

Effective for mild depression from becoming serve.

Negative Evaluation point of CBT?

Not appropriate for everyone- severe cases- can't engage if no.motivation.

CBT is difficult to evaluate- found that use of measurement scales to assess CBT produced different measures of improvement amount patients.

Not suitable for patients who cant talk about their Feelings.

What is OCD?

An anxiety disorder with which sufferers experience persistent intrusive thoughts.

What are obsessions?

Forbidden or inappropriate ideas and visual images aren't based in reality.

What are Compulsions?

Intense uncontrollable urges to repetitively performs tasks and behaviours. attempts to reduce distress or prevent the feared events.

What are the behavioural characteristics of OCD?

Compulsions- Responses to the obsessions- repetitive to reduce anxiety

Avoidance- attempt to reduce anxiety by keeping away from situations that trigger it- can interfere with Normal life.

Social impairment- Anxiety level limit the ability to conduct meaningful relationship.

Emotional characteristics of OCD?

Extreme anxiety/distress- Obsessive thoughts are unpleasant and frightening- compulsions create anxiety

Depression- low moods with temporary relief from compulsions

Guilt and disgust- feels bad for themselves or are angry at their inability to do things

Cognitive characteristics of OCD?

Obsessions- reoccurring and unpleasant

Coping strategies- developed by sufferers to deal with stress to achieve relief

Recognition that OCD is irrational

Hypervigillance-attention focus on potential hazards; constant alertness

What is the Biological approach for explanations for depression?

-Genetic

-Neural

Why are genetics involved in OCD?

Increased vulnerability

Lewis- observed that 37% of his patients had parents with OCD and 21% had siblings with OCD. Suggesting that OCD runs in families. More as vulnerability due to lack of 100% concordance rate.

What does the diathesis-stress model state about OCD?

Genes leave some people more likely to suffer a mental disorder from environmental experiences (stressors) are necessary to trigger the condition.

Candidates genes create vulnerability to OCD.

What is the COMT gene?

Regulates the production of dopamine

What has COMT genes got to do with OCD?

One allele of the COMT gene has been found more common in OCD patients

Tukel et al:

Lower levels of COMT gene activity leads to higher levels of dopamine- associated with stereotyped movements which manifest themselves into OCD.

What is the SERT gene?

Transport of serotonin across the synaptic cleft. Creates lower levels of serotonin. - implicated in OCD

What did Taylor discover in his meta-analysis?

Found evidence to suggest that up to 230 genes are involved in OCD

Also, different gene groups cause OCD in different people.

Positive Evaluation points of Explanations for OCD?

Empirical studies:

Nestadt et al- Twin studies

68% of identical twins shared OCD as opposed to non-identical twins at 31% Strongly suggests genetic influence of OCD

Negative Evaluation points of explanations for OCD?

Concordance rates in studies are never 100%- therefore other environmental factors. Diathesis stress model is better explanation.

(Cromer at al- over half the OCD patients had suffered a trauma and the OCD was more severe in them)

Too many candidate genes- Can't pin down the genes involved. This is because several genes are involved- each genetic variation only increases the rick of OCD by a fraction. Only provides little critical value.

Reductionist/ determinant review- Not feasible to suggest that one gene might be the cause for a complex disorder like OCD as it is polygenic