Psychology a level - psychopathology

definitions and treatments AO1 and AO3

what are the 4 definitions of abnormality

deviation from social norms, failure to function adequately, deviation from ideal mental health, statistical infrequency

what is deviation from social norms? give an example and evaluate

not adhering to standards constructed by society

e.g. Antisocial Personality Disorder, characterised by impulsivity and aggression

strength - based on observable behaviours

limitation - culture-bound

what is failure to function adequately? give an example and evaluate

being unable to cope with the ordinary demands of day-to-day living

e.g. someone may be unable to get out of bed in the morning due to their depression

strength - prioritises help for those who need it most

limitations - social control, does not consider the patient’s perspective

what is deviation from ideal mental health? evaluate

having a poor mentality, the criteria for which was proposed by Jahoda

strength - comprehensive

limitation - culture-bound

what is statistical infrequency? give an example

occurs when an individual has a less common characteristic, shown through a numerical comparison of a whole population

e.g. those with an IQ under 70 are thought to have an intellectual disability

strength - subjective which is useful in diagnosis

limitation - reductionist

list 3 of Jahoda’s criteria for good mental health (there are 7 total )

no symptoms of distress, independence, rational and accurate perception of reality

what is a phobia

a high level of anxiety in response to a particular stimulus or situation, where the extent of fear is irrational and disproportionate

give 2 behavioural characteristics of phobias

avoidance, panic

give 2 cognitive characteristics of phobias

irrational beliefs, recognition of overexaggerated anxiety

give 2 emotional characteristics of phobias

persistent and excessive fear, disproportionate levels of anxiety

what is depression

a mental disorder characterised by low mood and low energy levels

2 behavioural characteristics of depression

loss of energy, disruption to eating and sleeping behaviour

2 cognitive characteristics of depression

thoughts of death, dwelling on the negative

2 emotional characteristics of depression

worthlessness, constant low mood

what is OCD

a mental disorder where anxiety arises from obsessions and compulsions are carried out to reduce anxiety

2 behavioural characteristics of OCD

avoidance, repetitive compulsions

2 cognitive characteristics of OCD

obsessive thoughts, insight into irrationality

2 emotional characteristics of OCD

distress, embarrassment and shame

which approach is used to explain and treat phobias

behaviourism

how are phobias learnt and maintained, according to behaviourism

learnt through classical conditioning, maintained through operant conditioning: two-process model

which case study supports that phobias are learnt through classical conditioning

little albert and the white rat

which two treatments does behaviourism use for phobias

systematic desensitisation, flooding

what kinds of phobias is systematic desensitisation not helpful in treating

complex, social phobias

two strengths of systematic desensitisation

ethical, supported by research

two limitations of systematic desensitisation

expensive, long process

2 strengths of flooding

quick process and cost effective, Wolpe: research support girl forced to drive 4 hours

two limitations of flooding

unethical and only suitable for patients in good physical health

arguably leads to symptom substitution rather than treating the cause of phobias

which approach is used to explain and treat depression

cognitive

what are the 3 parts of Beck’s negative triad

themselves, the world, the future

what is Ellis’ ABC model

argues that interpretations of events if what causes a persons unhappiness

Activating event e.g. failing a test

Belief e.g. utopianism: the belief that life is always meant to be fair

Consequence e.g. behavioural symptoms of depression

lead to the development of REBT

what kind of therapy is used to treat depression

Cognitive behavioural therapy

which 3 kinds of disputing are used in REBT

logical, empirical, pragmatic

2 strengths of CBT

research support, suitable for depression as it challenges cognitions and less dangerous than REBT

2 limitations of CBT

effectiveness depends on the skills of the therapist, not all beliefs of a depressed person are irrational

which approach is used to explain OCD

biological

which two explanations does bio approach give for OCD

genetic, neural

how does bio approach treat OCD

drug therapy

how does Lewis’ study support genetic cause of OCD

37% OCD patients had parents with OCD, 21% had siblings with OCD

what is the incidence of OCD in the general population

1-2%

twin study on OCD

Nestadt et al (2010) found 68% concordance MZ twins and 31% DZ

What does the diathesis stress model show

predispositions and life stressors both play a role in whether an individual reaches the threshold of having a disorder

why is OCD polygenic

up to 230 genes may be responsible

what does aetiologically heterogenous mean

OCD has different causes in different people

what did Cromer find regarding the link between trauma and OCD

over 50% of OCD clients had experienced a traumatic event and OCD was more severe in those who had suffered 1+ traumas

what have PET scans showed about the frontal lobe and OCD

OCD patients have higher levels of activity in the orbital frontal cortex

why is the caudate nucleus thought to be damaged in OCD patients

normally suppresses signals of worry from the OFC to the thalamus, but in people with OCD this doesn’t happen; they worry more

known as the ‘worry circuit’

is serotonin high or low in OCD patients

low - due to the SERT gene

is dopamine high or low in OCD patients

high - due to COMT gene

evidence from study on rats to support neural explanation of OCD

rats given a drug to increase dopamine production produced compulsive checking behaviours

what does SSRI stand for

Selective serotonin reuptake inhibitors

give the name of the most common SSRI

Prozac

how long do SSRIs take to impact OCD symptoms

3-4 months

why should SSRIs be used alongside CBT

drugs reduce emotional symptoms so clients can benefit more from CBT, cognitive therapy may better fix the root cause of the disorder in a long term way

what is an alternative drug to SSRIs

tricyclic antidepressants, SNRIs, which block the reabsorption of both serotonin and noradrenaline. these have more side effects, however

how do placebo studies support the use of drug therapies for OCD

review of 17 studies found that SSRIs has significantly better outcomes in treating OCD than placebos

symptoms reduced for around 70% of people taking SSRIs

3 limitations of drug therapy

side effects

review done in 2016 found that CBT more effective than SSRIs

Simpson et al: 45% OCD patients relapse after stopping SSRIs, 12% after therapy

give a strength and a counterpoint of drug therapy

cost effective HOWEVER more long term than CBT

2 pieces of research support for Beck’s negative triad

Review by Clark and Beck concluded cognitive vulnerabilities precede depression

Recent prospective study by Cohen et al tracked development of 473 adolescents and found cognitive vulnerability predicted later depression

real world application of Ellis’ ABC model

application in rational emotive behavioural therapy (REBT) where the therapist vigorously argues with the depressed patient

David et al found REBT relieves symptoms and challenges beliefs

does Ellis’ ABC model explain reactive depression, endogenous depression, or both

only reactive: a limitation of the model

describe research support for systematic desensitisation

Gilroy et al (2003) followed up on 42 people who had SD for spider phobia across 3 45min sessions

after both 3 and 33 months they were less fearful than a control group treated with relaxation but no exposure

research that shows flooding is traumatic

Schumacher et al (2015) found p’s and therapists rated flooding as significantly more stressful than SD

research support for effectiveness of CBT

March et al (2007) compared CBT to antidepressant drugs and a combination of both in 327 depressed adolescents

after 36 weeks, 81% CBT group, 81% antidepressant group, and 86% combined group had significantly improved

research support REBT

David et al found REBT more effective after 14 weeks than SSRIs after 6 months

2 elements of Beck’s approach other than the negative triad

cognitive bias (mentally distorting information) including over-generalisation and catastrophising

negative self-schema

what is symptom substitution (limitation of flooding)

behavioural therapies only mask or shift symptoms rather than treating the underlying cause of phobias

Persons (1986) reported case study of a woman with a phobia of death which was replaced by flooding with a phobia of being criticized

what is the ABCDE model

extension of the ABC model including the use of REBT

D = disputing irrational belief

E = effective new belief

key difference between styles of REBT and CBT

confrontational vs collaborative

strength of the two-process model

study found 60% dog phobias link it back to a traumatic experience

research support cognitive basis post-natal depression

65 mothers with a cognitive vulnerability more likely to have postnatal depression after giving birth

Ozaki et al

2 random families used as p’s

6/7 of them with OCD had mutated SERT gene