Psychopathology

  • Created by: ash8642
  • Created on: 21-04-19 14:24

Definitions of Abnormality

Statisical Infrequency

  • Numerically unusual behaviour or characteristic
  • E.g. IQ below 70 is part of the diagnosis of intellectual disability disorder

Evaluation

  • Real-life application - simple means of assessing patients
  • Unusual characteristics can be positive - some unusual behaviours don't require treatment
  • Not everyone unusual benefits from a label - some people with a low IQ function adequately, and don't benefit from being labelled
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Definitions of Abnormality

Deviation from Social Norms

  • Social judgments about what is acceptable
  • What is normal in one culture may not be in another
  • Antisocial personality disorder - impulsive, aggressive, irresponsible behaviour is not socially acceptable

Evaluation

  • Not a sole explanation - other factors matter such as distress to others
  • Cultural relativism - unfair to judge someone from another culture
  • Can lead to some human rights abuses - the social norm approach maintains control over minority groups (e.g. women)
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Definitions of Abnormality

Failure to Function Adequately

  • Failing to cope with demands of everyday life
  • Signs, e.g. not conforming to interpersonal rules, personal distress
  • Intellectual disability disorder - failing to function is part of the diagnosis of IDD as well as low IQ

Evaluation

  • Patient perspective - captures experiences of people with mental distress problems
  • Is it different from 'deviation from social norms'? - Alternative lifestyles or doing extreme sports may be examples of both
  • Subjective judgments - requires a subjective judgment during assessment
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Definitions of Abnormality

Deviation from Ideal Mental Health

  • Jahoda considered normality rather than abnormality
  • Includes lack of symptoms, rationality, self-actualisation, coping with stress

Evaluation

  • Comprehensive definition - includes all reasons anyone might seek help
  • Cultural relativism - ideas specific to Western culture (e.g. self-actualisation)
  • Universally high standards of mental health - few people achieve all or even most of the ideals
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Phobias - Characteristics

Characteristics

  • Behavioural
    • Panic 
    • Avoidance
  • Affective
    • Irrational and unreasonable fear and anxiety
  • Cognitive
    • Selective attention
    • Irrational belief
    • Cognitive distortions
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Phobias - Behavioural Explanation

Behavioural Explanation

  • Mowrer: two processes of conditioning
  • Acquisition by classical conditioning - UCS produces a fear response, UCS then associated with NS
  • Maintenance by operant conditioning - avoidance of phobic stimulus reinforced by anxiety reduction so the phobia is maintained

Evaluation

  • Good explanatory power - explains how phobias can be both aquired and maintained
  • Alternative explanation for avoidance - may be motivated more by seeking safety rather than anxiety reduction
  • Incomplete explanation of phobias - cannot account for preparedness to aquire phobias of some stimuli and not others
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Phobias - Behavioural Treatment

Systematic Desensitisation

  • Anxiety hierarchy - a list of situations ranked for how much anxiety they produce
  • Relaxation - reciprocal inhibition; relaxation includes imagery and/or breathing techniques
  • Exposure - exposed to phobic stimulus whilst relaxed at each level of the anxiety hierarchy

Evaluation

  • Effective - more effective than relaxation alone after 33 months
  • Diverse range of patients - e.g. appropriate for patients with learning difficulties
  • Acceptable to patients - patients prefer it to flooding so drop-out rates are lower
  • Some phobias don't follow trauma
  • Cognitive aspects of phobias not explained
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Phobias - Behavioural Treatment

Flooding

  • Exposes patients to a very frightening situation without a build-up
  • Works by extinction of the conditioned fear response
  • Patients must give informed consent to and be prepared for flooding

Evaluation

  • Cost-effective - more effective than systematic desensitisation and quicker, therefore cheaper
  • Less effective for some - less effective for complex phobias like social phobias
  • Traumatic treatment - drop out rate is high so ineffective
  • Symptom substituation
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Depression - Characteristics

Characteristics

  • Behavioural
    • Lethargy and agitation
    • Increased or decreased sleeping/eating
    • Aggression and self-harm
  • Affective
    • Lowered mood
    • Anger towards self and others
    • Low self-esteem
  • Cognitive
    • Poor concentration
    • Negative bias
    • Absolutist thinking
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Depression - Cognitive Explanation

Beck's Theory

  • Faulty information processing - attending to the negative aspects of a situation
  • Negative self-schemas - negative information about ourselves is accessed whenever we encounter a self-relevent situation
  • Negative triad - negative views of the world, the self, and the future

Evaluation

  • Supporting evidence - solid support for idea that certain cognitions make us vulnerable to depression
  • Practical application in CBT - negative thoughts can be identified and challenged by a therapist
  • Doesn't explain all aspects - cannot easily explain extremes of anger or hallucinations and delusions
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Depression - Cognitive Explanation

Ellis' ABC Model

  • Activating event - a negative life event that triggers a response
  • Beliefs - beliefs that lead us to over-react to the activating event (e.g. life should always be fair)
  • Consequences - depression results when we over-react to negative life events

Evaluation

  • Partial explanation - some cases of depression follow life events, but not all
  • Practical application in CBT - irrational thoughts can be identified and challenged by a therapist
  • Doesn't explain all aspects - cannot easily explain extremes of anger or hallucinations and delusions
  • Cognitive primacy
  • Insecure attachment linked to depression
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Depression - Cognitive Treatment

Cognitive Behavioural Therapy

  • Beck's CT - aims to identify negative thoughts and challenge them, including through testing them
  • Ellis' REBT - aims to identify and challenge irrational beliefs by argument
  • Behavioural activation - includes techniques from CT and REBT but also behavioural techniques

Evaluation

  • Effective - significantly more effective than no treatment
  • May not work for the most severe cases - not effective where patients are too depressed to engage in therapy
  • Patient-therapist relationship - all therapies fairly similar
  • Some patients want to explore their past
  • Overemphasis on cognition
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OCD - Characteristics

Characteristics

  • Behavioural
    • Compulsions usually decrease anxiety
    • Avoid situations that trigger anxiety
  • Affective
    • Intense anxiety
    • Depression
    • Guilt and disgust
  • Cognitive
    • Obsessive thoughts
    • Cognitive strategies (e.g. prayer)
    • Self-insight
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OCD - Biological Explanation

Genetic

  • Candidate genes - genes that may be involved in producing symptoms of OCD (e.g. 5HT1-D beta)
  • OCD is polygenic - different combinations of up to 230 genetic variations
  • Different types of OCD - different combinations of gene variations may cause different kinds of OCD

Evaluation

  • Good supporting evidence - twin studies show OCD is influenced by genes (MZ twins concordance rate = 87% for obsessive symptoms + features vs 47% in DZ twins)
  • Too many candidate genes - so many genes involved means little predictive value
  • Environmental risk factors - OCD is associated with trauma, so it is clearly not entirely genetic in origin; cannot isolate role of nature vs nurture
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OCD - Biological Explanation

Neural

  • Serotonin - low levels of serotonin linked to OCD
  • Decision-making systems - frontal lobes and parahippocampal gyrus may be malfunctioning

Evaluation

  • Supporting evidence - antidepressants that work on the serotonin system alleviate OCD
  • Not clear what mechanisms are involved - all the neural systems associated with OCD are only involved in some cases
  • Shouldn't assume nerural mechanisms cause OCD - neural abnormalities may be the result of OCD, not the cause
  • Serotonin-OCD link may be co-morbidity with depression
  • Twin studies are flawed as genetic evidence
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OCD - Biological Treatment

Drug Therapy

  • SSRIs - antidepressants that increase levels of serotonin at the synapse
  • Combining SSRIs with other treatments - combine with CBT or other drugs
  • Alternatives to SSRIs - clomipramine (acts on the serotonin plus other systems) or SNRIs (noradrenaline)

Evaluation

  • Effective at tackling symptoms - Soomro et al: SSRIs are superior to placebos in treating OCD + reduce symptoms for 70% of patients
  • Cost-effective - compared to psychological treatments, drugs are cheap and non-disruptive
  • Can have side effects - indigestion, blurred vision, and loss of sex drive; worse for clomipramine
  • Unreliable evidence for drug treatments - biased for drug companies benefits
  • Some cases of OCD follow trauma
  • Simpson et al: 45% of drug therapy patients relapsed vs 10% of behavioural therapy patients
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