Psychopathology

Definition

• Numeruically unusual behaviour or characteristic.

Intellectual Disability Disorder

• IQ below 70% is part of the diagnosis of IDD.

Evaluation

Real - Life Application

• Simple means of assing patients.

Unusual Characteristics can be Positive

• Some unusual behaviours don't require treatment.

Not Everyone Unusual Benefits from a Label

• Some people woth low IQ function adequately and don't benefit from being labelled.

Definition - Social judgement about what is acceptable.

Norms are Culture - Specfic - 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 Human Rights Abuses

• The social norm approach maintains control over minority groups, e.g women.

Definition - Failing to cope with demands of everyday life.

When is Someone Failing? - 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's Perspective

Captures experience of people with metal distress problems.

Is It Different From Deviation From Social Norms

Alternatives lifestyles or doing extreme sports may be exampes of both.

Subjective Judgement

Requires a subjective judgement during assessment.

Definition

• Jahoda considered normality rather than abnormality.

What Does It Look Like?

• Includes lack of symptoms, ratrionality, self-actualisation, coping with stress.

Evaluation

Comprehensive Definition

• Includes all the reasons anyone might seek help.

Cultural relativism

• Ideas specific to Western cultures, e.g. self-actualisation.

Universally High Standard Of Mental Health

• Few people achieve all or even most of the ideals.

Behavioural

• Panic
• Avoidance or endurance

Emotional

• Irrational and unreasonable fear and anxiety

Cognitive

• Selective attention
• Irrational beliefs
• Cognitive Distortions

Two Process Model - Mowrer: Two processes of conditioning.

Acquisition by Classical Conditioning - Unconditioned stimulus (UCS) produes a fear response, UCS then associated with neutral stimulus.

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 acquired and maintained.

Alternative Explanation For Avoidance

• May be motvated more by seeking safety rather than anxiety reduction.

Incomplete Explanation of Phobias

• Cannot account for preparedness to acquire phobias of some stimuli and not others.

Anxiety Hierachy - A list of situations ranked for how much anxiety they produce.

Relaxation

• Reciprocal inhibitation.
• Relaxation includes imagery and/or breathing techniques.

Exposure - Exposed to phobic stimulus whiclt relaxed at each level of the anxiety hierachy.

Evaluation

Effective - More effactive than relaxation alone after 33 months (Gilroy et al.)

Diverse Range Of Patients - E.g. appropriate for patients with learning difficulities.

Acceptable to patients - Patienets prefer to flooding so drop-out rates are lower.

Evaluation Extra

• Some phobias don't follow trauma.
• Cognitive aspects of phobias not explained.

What is it? - Exposes patients to a very frightening situation without a build-up.

How does it work? - Works by extinction of the conditioned fear response.

Ethical safeguards - Patients must give informed consent to and be prepared for flooding.

Evaluation

Cost effective - More effective than systematic desensitisation and quicker, therefore cheaper. (Ougrin)

Less effective for some - Less effective for complex phobias like social phobias.

Traumatic treatment - Drop out rate is high so ineffective.

Evaluation extra

• Symptoms substitution.

Behavioural

• Lethargy of agitation.
• Increased or decreased sleeping/eating.
• Aggression and self-harm.

Emotional

• Lowered mood.
• Anger towards self and others.
• Low self-esteem.

Cognitive

• Poor concentration.
• Negative bias.
• Absolutist thinking.

Faulty Information Processing - Attending to the negative aspects of a situation.

Negative self-schemas - Negative information about ourselves is assessed whenever we encounter a self-relevant situation.

The Negative Triad - Negative views of the world, the self and the future.

Evaluation

Supporting evidence

• Solid support for idea that certain cognitions make us vunerable to depression (Clark and Beck).

Practical application in CBT

• Negative thoughts can be identified and challenged by therapists.

Doesn't explain all aspects

• Cannot easily explain extermes of anger or hallucinations and delusions.

Activating event - A negative life event that triggers a response.

Beliefs - Beliefs that lead us to over-react ton the activating event, e.g. that 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 halluncinations and delusions.

Evlautaion extra

• Cognitive primacy.
• Insecure attachments linked to depression.

Beck's CT - Aims to identify negative thoughts and challenge them, including through testing them.

Ellis's REBT - Aims to identify and challenge irrational beliefs by argument.

Behavioural activation - Includes techniques from CT and REBT but also behavioural techniques.

Evaluation

It is effective - Significantly more effective than no treatment (Culipers et al.).

May not work for the most severe cases - Not effective where patients are too depressed to engage in thearpy.

Patient-therapist relationship - All therapies fairly similar (Luborsky et al.).

Evaluation extra

• Some patients want to explore their past.
• Overemphasis of cognitions.

Behavioural

• Compulsions usually decrease anxiety.
• Avoid \situations that trigger anxiety.

Emotional

• Intense anxiety.
• Depression.
• Guilt and disgust.

Cognitive

• Obsessive thoughts.
• Cognitive strategies, e.g. prayer.
• Self-insight.

Candidate genes - Genes that may be involed 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 (Nestadt et al.).

Too many candidate genes

• So many genes incolved means little predictive value.

Environmental risk factors.

• OCD is associated with trauma, so it is clearly not entirely genetic in origin.

Serotonin - Low levels of of serotonin linked to OCD.

Decision-making system - Frontal lobes and parahippocampal gyrus may be malfunctioning.

Evaluation

Supporting evidence -Antidepressants that work on the serotonin system alleviate OCD (Nestadt et al.).

Not clear what mechanisms are involved - All the neural systems associated with OCD are only involved in some cases.

Shouldn't assume neural mechanisms cause OCD - Neural abnormalities may be the result of OCD not the cause.

Evaluation extra

• Serotonin-OCD link may be co-morbidity with depression.
• Twin studies are flawed as genetic evidence.

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 serotonin plus other systems) or SNRIs (noradrenaline).

Evaluation

Effective at tackling symptoms - SSRIs are superior to placebos in treating OCD (Soomro et al.).

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.

Evaluation extra

• Unreliable evidence for drug treatment.
• Some cases of OCD follow trauma.