Psychology - Clinical and mental health

Symptoms of OCD, Behavioural apprach to explain and treat phobias,

Emotional symptoms of OCD

• Anxiety and distress - caused by obsessibe thoughts

• Guilt and disgust - guilt about intrsive thoughts

• Shame and embaressemnt - Know thoights and behaviours are irrational

Behaivoural symptoms of OCD

• Compulsions - repetitive behaviours or mental acts performed to reduce anxiety

• Avoidance - staying away from situations that trigger obbsesions

Cognitive symptoms of OCD

• Obsessive thouhts - inturives, unwanted and repetive thoughts

• Catstrpohising

• Coping mechanisms - help deal with obbsessive thoughts

Behavioural approach to explaining phobias

• argues phobias are a learnt response

• howard mowers 2 process model suggests they are learned through classical conditioing and maintained through operant conditioing

Classical conditioing in terms of phoibas

• learning through assoication

• nuteral stimulus becmes associated with fear

• causes NS to become CS which causes conditioned response of fear (can be genralised to things that look/are the same)

Whatson and Rayner (Little Albert study)

• Used CC to cause Albert to develop a phobia

• Fisrt he showed no fear to a range of stimuli

• paired white rat (NS) with loud noise, loud nosie caused fear

• Alber then assoicated rat with fear

Evaluation of W&R Little Albert study

• Unethical as signficat risk of longterm harm to little Albert

• Only one person was tested so can not be genralised, cant be sure that everyone would react the same way that Albert did

Operant Conditioing in terms of phobias

• phobias tend to be long lasting due to OC

• Specifically negative reinfocment within OC

• People with phobias delibralty avoid their phoibc stimuli as fear and anxiety also avoided

• avoidance is a from of negative reinformcent as it takes away fear and anxiety encouriging the eprson to continually avoid the stimulli

Behaivoural Approach evaluation: Strength

• evidence supporting that phobias are iniated by a negative event event

• eg Ad De Jongh: Found that 73% of people with a dentist phobia had had a negative experince

• this suggests that it develpoped through classical conditioing

Behaivoural Approach evaluation: Strength (Counter point)

• However this does not explain the development of phobias amoung people who cannot identify any activating event which led to contditioned fear response

• however some behavourists argue traumatic events (especially in childhood) could of been forgotten

Behaivoural Approach evaluation: Weakness

• model explain why some phobias are more common than others

• this may be because humans may be biologically prepared for things like snakes and spiders

• This is known as evoulutioanry/biological preparedness

• Even though there was no negative experince, phobia may develop more easily as humans are naturally more sensitive to certain threats.

• these specific phobias are more common because thy were adaptive in out evolutionary past, protecting our ancestors from genuine threats

• This suggets that the behaovural explanation is incomplete as biologiy and evolution also play a role in phoabis

Treating phobias: Systematic desnsitisation

• form of counter conditioing

• attmepts to replace assocation with fear with an association of felling calmed and relaxed

• can be explained by reciprocal inhibition which states that 2 oppisite emotions can not occur at the same time

• SD helps individual feel relaxed so cannot feel fear

Steps of SD

1. Relaxation training - individual learns techniques to help feel calm when faced with phoic stimulus (eg deep breathing)

2. Anxiety heriachy - Indivual and therapist create a list of fear inducing situations realted to phobia from most to least scary

3. Gradual exposure - starting at the bottom of the pyramid, the indivudal slowly faces their fear and doesnt move up until they are calm at the stage

Differnce between in vivo and in vitro

In vivo - exposed to real phobic stimuli

In vitro - exposure in for of imagery

Systematic devation evaluation: Strength

• evidence that is is effective

• Cillory et al followed up 43 participants with spider phobia who has SD.

• At both 3 and 33 months the patients where alot less fearful suggesting it is effective in long term and short term

Systematic devation evaluation: Weakness

• Problem with in vitro method as it reiles on client to imagine fearful situation

• Indiviudals may stuggle to create vivd image

• so some forms of SD limit effectivness

Treating phobias: Flooding

• immediatley bombards patient with phobic stimuli

• effective as i prevents avoiadnace of phocib stimuli

• floodding initally causes huge stress

• but eventually fear response will become exahsted and calm down (known as extinction)

Flooding evaluation: Strength

• evidence taht it is effective

• Choy reported flooding improves sypmtoms of phobias significanlty more than SD of CBT

• However other studies suggests flooding and CBT are equally effective

• This suggests flooding may be a prefferd option as it is much quicker

Flooding evaluation: Weakness

• Flooding is less effective for complex phobias like social phobias

• social phobias have significant cognitve elements (eg persintent negative thoughts about soical situations)

• This means that for social phobias CBT maybe be more effective beacuosue it addresed the engative patterns of thinking

Cognitive apporach to explaining depression

• argues some people are more vunrable to deppresion beacuse of the way they think

• deppresion it due to negative, irrational patterns of thinking including cognitive distrotions

Becks cognitive theroy of depression

• aruges deppresion is due to negative faulty patterns of thinking

• consists of:

1. Cognitive bias

2. negative self scemas

3. the negative triad

Beck’s Cognitive Theory of Depression: 1. Cogntive bias

1. Cognitive bias examples:

• selective thinking: focusing on the negative aspects of a situation and ignoring positives

• Absolutist thinking: thinking in black and white

• Catastrophizing - blowing small problems out of proportion

• Over genrealisation: makeing a sweeping conclusion based in a sigle experince

Beck’s Cognitive Theory of Depression: 2. Negative self schemas

• beck argued that people with depression have a negative self schema (a deeply engrained negative set of beilefs and ideas about themsleves)

• This infulnces how and individual will percive themselves and how they interprat information about themselves

• Negative self schema is also lineked to low self esteem

• he argues a negative self schema is often activated in chilldhood

• For example beacuse of continual parental criticism or rejection by others

Beck’s Cognitive Theory of Depression: 3. The Negative Triad

• With depression, 3 types of negative thinking that occur automatically:

1. Negative feelings about the selves

2. Negative feelings about the future

3. Negative views about world

Beck’s Cognitive Theory of Depression evaluation: Strength

• Evidence depression is linked to cognitive biases, negative self schemas and the negative traid

• Grazioli and terry stuided 65 pregnant women before and after birth

• those showing negative patterns of thinking were more likley to develop post natal depression

• similarly cohen et al tracked development of 473 adolescents and those with negative patterns of thinking were more likley to develop deppresion

• this suggests that negative patterns of thinking do make individuals more vunrable to develop depression

Beck’s Cognitive Theory of Depression evaluation: Wekaness

• ignores biological explanations

• Evidence that biolgoical factors, including genes and depression, may be involved in the development of depression

• There is significant evidence linking low levels of serotonin to depression

• in further support anti depressants like SSRIs (which increase serotonon levels) can be effective in imrpoving deppresion symtoms

• suggesting that Becks CBT is not a complete explanation for depression and needs to be considered alongside biological explnations

Ellis ABC model

• Argues deppresion is a result of negative and irratioanl beliefs triggerd by activating events

• A - Activiating event: event that triggers irrational patterns of thinking

• B - Belifes: triggerd by activating agent and in case of depression are irratioanl and negative, can include:

Musterbatory thinking: holding absolute, unrealsitic demands on oneself, others or the wolrd ‘i must always get As‘ often is beleived that thesse things must be true for the individual to be happy

‘i cant-stand-it-itis’ - when things dont go smoothly is a disaster

‘Utopianism’ - the belief that life is always meant to be fear

• C - Consequnces - Emotional and behavioural consequnces of the beliefs. in the case of depression, irratioanl and negative beliefs typically lead to low mood and harmful behaviours

ABC model evaluation: Strength

• Application to therpay

• ABC model has led to development of rational emotive behavioural therpay (REBT)

• which is shown to through research to be very effective

• REBT aims to identify and chalange negative patterns of thinking, genrally through the use of reailty testing and empirical dispute

• gives validity to thery because it has led to a succesful therapies supporting the idea that irratioanl beilf patterns can cause depression

ABC model evaluation: Weakness

• cognitive appraoch downplays role of situational factors in the cause of depression

• suggests that negative thinking about a situation rather than the situation itself wichi increase vurabeillity to deppresion

• however it is clear that some social situations (extreme poverty of war) could play a significant role in development of depression and chanigng patterns of thinking about thesse situations are unlikley to help

• therefore cognitve appraoch ignores cases of depression which are related more to social circumstances rather than negative irratioanl cognitions

Cognitve Behavioural Therapy (CBT)

• form of talking therapy based on the idea that negative and irratioanl patterns of thinking cause negative emotions and patterns of behaviour

• negative patterns of behaviour then further reinfoce neagtive thinking leading to vicious cycle

• CBT therefore aims to identify and challange irrational and negative patterns of thinking in order to reduce negative emotion and behaviours

Stages of Becks CBT

1. Ideintify irratioanl and negative thoughts causing negative emotions and behaviours, these may be about themslves, the world of the futures (Becks negative triad)

2. Therapist helps client identify common ‘thinking errors’ of cognive distortions (eg black and white, catastrophising)

3. Challangeing irrational thoughts through validity testing - Client taought to recognise when thoughts dont match reality

Can be done through

• Questioing and logical disputing - therpaist asks questions to help the client evalute their thougths

• Considering alternative more likley explnations

• Fact checking - setting client task of collecting evidence as part of homework that can then be used to challange irratioanl thinking

4. Homework tasks: thoughts records/diaries - client asked to keep record of negative throuhts, situations in which they occur, the emotions they trigger, and then practice challangeing and remframing then