Psychopathology

  • Created by: Olivia
  • Created on: 20-03-19 16:27
Definitions of abnormality-Statistical deviation
any usual behaviour or characteristics can be thought of as 'normal' + any behaviour that is different is 'abnormal'
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Definitions of abnormality-Statistical deviation-IQ +intellectual disability disorder
Normal distribution-any human characteristic-majority scores will cluster around average+fewer will havea above or below.Average IQ is set at 100 -most 68% have IQ from 85-115.only 2% below 7-'abnormal+r liable receive diagnosis
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what is it
intellectual disability disorder- used to be known as mental retardation
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Definitions of abnormality-Statistical deviation evaluation-real life applications
diagnosis of intellectual disability disorder-place for statistical deviation in thinking bout what r norma+abnormal behaviours+characteristics.-useful part of clinical assessment
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Definitions of abnormality-statistical deviation evaluation-unusual characteristics can be positive
IQ over 130 r just as unusual as below 70-but wouldnt think super intelligence as needed treatment-just cus few display certain behaviours does make statistically abnormal but doesnt mean need require treatment return to normal-limitation
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Definitions of abnormality-Statistical deviation evaluation-not everyone unusual benefits from a label
where someone living happy fulfilled life-no benefit to them being labelled as abnormal-someone very low IQ who not distressed+capable working-wouldnt need diagnosis -if labelled 'abnormal'may have negative effect on how others view them+themselves
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Definitions of abnornmality-Deviation from social norms.
when a persons behaviour in a way is different from how we expect people to behave
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Definitions of abnormality-Deviation from social norms-Norms r specific to culture we live in
social norms may be diff for each generation + every culture so there are few behaviours that would be considered universally abnormal
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Definitions of abnormality-Deviation from social norms-antisocial personality disorder(psychopathy)-judgment psychopathy is abnormal cus dont conform to moral standards
Person with this disorder is impulsive,aggressive+irresponsible.According to DSM-5. 1 important symptom of this disorder is 'absence of prosocial internal standards associated ith failure conform to lawful or culturally normative ethical behaviour'
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Definitions of abnormality-Deviation from social norms evaluation-Not a sole explanation
deviation from social norms- there r other factors to consider,eg distress to others resulting from antisocial personality disorder(failure to function)so not defined sole reason abnormality
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Definitions of abnormality-Deviations from social norms evaluation-cultural relativism
one person from 1 cultural group may label some1 from another culture as behaving abnormally according to their standard-eg hearing voices 1 culture is acceptable but UK not-creates problems for people living with diff cultures groups
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Definitions of abnormality-Deviations from social norms evaluation- can lead to human rights abuses
Black slaves who ran away used to be diagnosed as Drapetomania-clear was used to maintain control.-ridiculous now because our social norms have changed.more radical psychologists suggest some of modern categories mental disorder r abuses
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What are they abuses of
peoples rights to be different
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Definitions of abnormality-Failure to Function adequately
No longer coping with demands of everyday life. Unable maintain basic standards of nutrition+hygiene.also may be if cant hold job down or maintain relationships with people around them
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Definitions of abnormality-Failure to Function-When is someone failing to function adequately?Rosehan+Seligman
when no longer conforms to standard interpersonal rule-eg making eye contact. When experience severe personal distress. Behaviour becomes irrational or dangerous to themselves or others
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Definitions of abnormality-Failure to Function-Intellectual disability disorder
individual must be also failing to function adequately as well as very low IQ before diagnosis given
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Definitions of abnormality-Failure to Function adequatly evaluation-Patients perspective
Acknowlegdes that experience of the patient or others is important. in failure to function definition captures experience of many of the people who need help-suggests failure to func -useful criterion for assessing abnormality
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Definitions of abnormality-Failure to function evaluation-is it simply deviation from social norms?
can be hard say when some1 failing to function+ when deviating from social norms-eg might think not having job is failure to function -if treat these as failures-risk limiting personal freedom+discriminating against minority groups
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Definitions of abnormality-failure to function evaluation-subjective judgments
when deciding if someone failing to function,some1 has judge whether a patient is distressed-some Patients may say r distressed but may be judged as not suffering-these r methods for making such judgments as objective as possible.
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Definitions of abnormality-Deviation from ideal mental health
once picture of how we should be psychologically healthy then we can begin to identify who deviates from this ideal
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Definitions of abnormality-Deviation from ideal mental health.What does ideal mental health look like?Jahoda
no syptoms of distress,rational+can perceive ourselves accurately,self actualise,can cope with stress,realisitc view of world,good self esteem,independent,successfully work,love+enjoy our leisure.
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Definitions of abnormality-Deviation from ideal mental health evaluation-its a comprehensive definition
covers broad range criteria for mental health+in fact covers most reasons some1 would seek help from mental health services or be reffered for help-make it good tool for thinking bout mental health
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Definitions of abnormality-Deviation from ideal mental health evaluation-Cultural relativism
some ideas of Jahoda r specific to Western European+North American cultures-much of world would see independence from others as bad thing.such traits r typical of individualist cultures
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Definitions of abnormality-Deviation from ideal mental health evaluation-It sets an unrealistically high standard for mental health
very few attain all Jahodas criteria for mental health.therefore would see a lot as abnormal-deviation from ideal mental health is probs of no value in thinking bout who might benefit from treatment against their will
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DSM-5 categories of phobia
specific phobia:phobia of object or situation such as having injection.Social anxiety:phobia of social situations.Agoraphobia:phobia of being outside or in public place
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Behavioural charcterisitcs of phobias-respond to things or situations we fear by behaving in particular ways. PANIC
may involve range of behaviours including crying,screaming or running away.children may react diff-freeze,clinging,or tantrum
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Behavioural characteristics of phobias-AVOIDANCE
Tend to go to a lot of effort to avoid coming into contact with the phobic stimulus
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Behavioural characteristics of phobias-ENDURANCE
sufferer remains in presence of phobic stimulus but continues experience high levels of anxiety-may be unavoidable.
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Emotional characteristics of phobias-ANXIETY
Phobias r classified as anxiety disorders.involve emotional response of anxiety+fear.unpleasant state high arousal-prevents sufferer relaxing+makes difficult experience positive emotion-can be long term.
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Emotional characteristics of phobias-example:arachnophobia
fear of spiders-anxiety levels increase whenever enter place associated with spiders-anxiety is general response to situation.when sees spider-experiences fear-very strong emotional response directed towards spider
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Emotional characteristics of phobias-Emotional responses are unreasonable
emotional responses we experience in relation to phobic stimulus go beyond what is reasonable.eg very strong emotional response to tiny spider
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Cognitive characteristics of phobias-people with phobias process info bout phobic stimulus diff from other objects or situations.Selective attention to phobic stimulus
if sufferer can see phobic stimulus-hard to look away- good cus best chance react o threat but can also make struggle to concentrate on what doing
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Cognitive characteristics of phobias-Irrational beliefs
example-people with social phobias may think 'if i blush people will think im weak' -this kinda belief increases pressure on sufferer to perform well in social situations
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Cognitive characteristics of phobias-Cognitive distortions
Phobics perceptions of phobic stimulus may be disorted- someone who phobic to snakes may see them as aggressive looking
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DSM-5 catgeories of depression
Major depressive disorder:severe but often short term depression. Persistent depressive disorder:long term or recurring depression. Disruptive mood dysregulation disorder:childhood temper tantrums. Premenstrual dysphoric disorder:disruption mood
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disruption of mood when
prior to and/or during menstruation
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Behavioural characteristics of depression-Activity levels
typically sufferers have reduced energy-tend withdraw from work,education+social life.extreme-cant get out of bed.some cases can lead-psychomotor agitation-struggle relax+may pace up down a room
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Behavioural characteristics of depression-Disruption to sleep+eating behaviour
sufferes often irritable+some cases can become verbally or physically aggressive-may have knock on effect-eg quitting job.can also lead physical aggresion to themselves-self harm
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Emotional characteristics of depression-Lowered mood
feeling sad. Patients often describe themselves as 'worthless' or 'empty'
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Emotional characteristics of depression-Anger
suffers also frequently experience anger,sometimes extreme anger-can be directed at self or others.
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Emotional characteristics of depression-Lowered self esteem
sufferes tend report reduced self esteem-can be quite extreme-describing as hating themselves
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Cognitive characteristics of depression-Poor concentration
sufferer may find themselves unable stick with a task they usually would or might find hard make decisions that would normally find straight forward.likely interfere with work
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Cognitive characteristics of depression-Attending to +dwelling on the negative
when suffering depressive episode people r inclined pay more attention to negative aspects of situation+ignore positive+also have bias towards recalling unhappy events rather than happy ones
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Cognitive characteristics of depression-Absolutist thinking
sufferers when situation unfortunate they tend to see it as an absolute disaster.'black and white thinking' all good or all bad
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DSM-5 categories of OCD. OCD
obsessions-recurring thoughts, images + compulsions repetitive behaviours such as hand washing.most with diagnosis have both
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DSM-5 categories of OCD
Trichotillomania:compulsive hair pulling. Hoarding disorder:compulsive gathering of possessions+inability part with anything. Excoriation disorder:compulsive skin picking
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Behavioural characteristics of OCD-2 elements-Compulsions are repetitive
feel compelled repeat a behaviour like hand washing. others includ counting,praying,tidying
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2nd element-Compulsions reduce anxiety
10% sufferes have compulsion alone.for vast majority compulsive behaviours r performed attempt manage anxiety produced by obsessions-compulsive hand washin-response obsessive fear if germs
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Behavioural characteristics of OCD-Avoidance
sufferers may be characterised by avoidance as they attempt reduce anxiety by keeping away from situations that trigger it.wash compulsive may avoid germs.
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Emotional characteristic of OCD-Anxiety+distress
obsessive thoughts are unpleasant +frightening+anxiety that goes with it can be overwhelming.urge repeat behaviour creates anxiety
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Emotional characteristic of OCD-Accompanying depression
OCD often accompanied by depression.so anxiety can be accompanied by low mood+lack enjoyment in activies-compulsive tend bring some relief from anxiety but this is temporary
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Emotional characteristics of OCD-Guilt+disgust
OCD sometimes involves other negative emotions such as irrational guilt-for example over minor moral issues or disgust which may be directed against something external like dirt or at the self
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Cognitive characteristics of OCD-Obsessive thoughts
for 90% sufferers major cognitive feature of condition is obsessive thoughts.vary from person to person but always unpleasant.
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Cognitive characteristics of OCD-Cognitive strategies to deal with obsessions
respond by adopting cognitive coping strategies -eg religious person tormentted by guilt may pray.May help manage anxiety but can make person appear abnormal to others+distract them from everyday tasks
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Cognitive characteristics of OCD-Insight into excessive anxiety
sufferers experience catastrophic thoughts about worst case scenarios that might result if their anxieties justified.+tend be hypervigiliant -maintain constant alterness +keep attention focused on potential hazards
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The two process model-Hobart Mowrer-learned classical conditioning+continue cus operant-what is it
the behavioural approach focused on behaviour-what we can see.geared owards explaining rather than cognitive+emotional
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The Two process model-Acquisition by classical conditioning
Watson+Rayner-created phobia in 9month 'Little Albert'-showed no usual anxiety at start study+tried playwithrat.whenever rat presented they made loud noise-unconditioned stimulus-created unconditoned response-fear.
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what happens after loud noise
Rat(neautral stimulus) becomes associated with unconditioned stimulus(noise)-produce fear.rat now conditioned stimulus+produces conditioned response-then showed him others such as white rat-Albert displayed distress
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The Two process model-Maintanance by operant conditioning
phobias long lasting-result of this.when behaviour reinforced or punished.reinforcement tends increase behaviour.true for negative+positive.Negative-avoids situation thats upleasant-results desirable consequence,means behaviour will be repeated.
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The Two Process Model- evaluation-Good explanatory power
step forward-went beyond Watsons+Rayners classical conditioning.explained how phobias maintained over tim+explains why need exposed feared stimulus-once prevented from practising avoidance-reinforced+so declines.strenght
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The Two Process Model-evaluation-Alternative explanation for avoidance behaviour
evidence suggest that at least some avoidance appears motivated by positive feelings of safety-explains why some agoraphobia able leave house with trusted person.-problem as model suggests avoidance motivated anxiety reduction
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The Two Process Model-evaluation-An incomplete explanation of phobias
Bounton points out eg evolutionary factors probs have important role in phobias but model doesnt mention this.-eg fear of snakes that have been source of danger to evolutionary past
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Behavioural approach to treating phobias-Systematic desensistation-what is it
therapy designed gradually reduce phobic anxiety through principle of classical conditoning-if can learn relax in presence phobic stimulus they will be cured-stimulus paired relaxation not anxiety-counterconditioning
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What is reciprocal inhibition
afraid+relaxed at same time-so 1 emotion prevents another
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One process in Systematic desensitisation-The Anxiety Hierachy
put together by patients+therapist.list of situations related to phobic stimulus that provoke anxiety arranged in order from least to most frightening.-eg diff size spiders
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Systematic desensitisation-Relaxation
Therapist teaches to relax as deeply as possible.might involve breathing exercises.Patients can be taught imagine themselves in relaxing situations-eg lying on beach+can also be achieved through drugs-Valium
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System desensitisation-Exposure
finally patient exposed to phobic stimulus while in relaxed state-takes place across several session,starting at bottom of anxiety hierachy.move up when relaxed at lower levels.successful when relaxed at highest
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Systematic desensitisation-evaluation-its effective
Gilroy et al followed up 42 patients who had been treated.the phobia was assessed on several measures+control group treated by relaxation without exposure-at 3m+33monthsafter treatment-SD group less fearful than control-shows its helpful
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Systematic desensitisation-evaluation-its suitable for diverse range of patients
the alternatives-flooding or cognitive therapies not well suited for some patients-learning difficulties make hard for some patients understand whats happening during flooding-SD-most appropiate
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Systematic desensitisation-evaluation-It is acceptable to patients
Patients prefer it.those given choice of SD or flooding tend prefer SD-doesnt cause same level trauma as flooding+cus SD includes relaxation-pleasant.-reflected by low rates number patients dropping out of SD+low refusal rates to start treatment
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Behavioural approach to treating phobias-Flooding-what happens
involves immediate exposure to frightening situation.sessions typically longer lasting than SD-1 session lasting 2-3 hours
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Flooding-how does it work?
Patient quickly learns that Phobic stimulus is harmless-extinction.learned reponse extinguished when conditioned stimulus encountoured with unconditoned stimulus-no longer produces conditioned response of fear.
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Flooding-ethical safeguards
its an unpleasant experience so important patients give fully informed consent so prepared for traumatic procedure
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Flooding-evaluation-it is cost effective
studies comparing flooding to cognitive therapies found flooding is highly effective+quicker than alternatives-strenght-patients free of their phobia quick+makes treatment cheaper
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Flooding-evaluation-its less effective for some types of phobia
less effective for more complex phobias like social phobia-may be cus have cognitive aspects-this type phobia may benefit morw from cognitive therapies cus tackle their irrational thinking
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Flooding-evaluation-treatment is traumatic for patients
Patients often unwilling to see it through to the end.limitating-time+money sometimes wasted preparing patients only have them refuse to start or complete treatment
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Becks Cognitive theory of depression-why some more vulnerable to depression than others-Faulty Info Processing
when depressed attend to the negative aspects of situation and ignore positives +also tend blow small problems out of propotion+think in 'black and white'
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Becks cognitive theory of depression-Negative self schemas
interpret all information about ourselves in a negative way
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Becks cognitive theory of depression-The Negative Triad
person develops dysfunctional view of 3 types negative thinking.1-negative view of world-impression no hope anywhere.2negative view of future-reduce hope+enhance depression.3-negative view of self-enhance depressing feelings-confirm low self esteem
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Becks Cognitive Theory of depression-evaluation-it has good supportive evidence
Grazioli+Terry assessed 65 pregant women for cognitive vulnerability+depression before+after birth.found those judged high in cognitive vulnerability more likely suffer post-natal depression.+clark+beck reviewed this-concluded solid support
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Becks Cognitive Theory of Depression-It had a practical application in CBT
all cognitive aspects of depression can be identified+challenged in CBT-means a therapist can challenge them+encourage the patient test if they r true-strenght of explanation-successful therapy
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Becks Cognitive Theory of Depression-evaluation-it doesnt explain all aspects of depression
some depressed patients are deeply angry+Beck cant easily explain this extreme emotion.some sufferers suffer hallucination-Beck cant explain
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Ellis's ABC Model-explain how irrational thoughts affect our behaviour+emotional state- Activating Event
Get depressed when experience negative events +these trigger irrational beliefs-such as ending relationship
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Eliss's ABC Model-Beliefs
belief we must always succeed or achieve perfection-Musturbation. Icantstandititis-belief its a major disaster whenevr something doesnt go smoothly. Utopianism-belief life is always meant be fair
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Eliss's ABC Model- Consequences
when an Activating Event triggers irrational beliefs there are emotional+behavioural consequences-eg if believe must always succeed+then fail-can trigger depression
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Eliss's ABC Model-evaluation-A Partial Explanation
some cases depression follow activating events-reactive depression-psychologists see as diff kind of depression that arises with obvious cause-means explanation only applies to some kinds depression
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Eliss's ABC Model-evaluation-It Has a Practical Application in CBT
It has led to a successful therapy-challeging irrational beliefs person can reduce their depression.-supports the basic theory-suggests irrational beliefs have some role in depression
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Eliss's ABC Model-evaluation- It Doesnt Explain All Aspects of Depression
Doesnt explain anger associated with depression or fact some patients suffer hallucinations +delusions
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Cognitive Behaviour Therapy- what is it
most common psychology treatment for depression.begins with assessment-patient+therapist work together clarify patients problems+identify goals+put together a plan to achieve them.one task identify irrational thoughts-work change negative+irrational
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Cognitive Behaviour Therapy-Becks Cognitive Therapy
Cognitive therapy is applications of Becks theory of depression.identify negative triad-then challenge+helps test reality of negative beliefs-might be set stuff like record when enjoyed an event 'patient as scientist'
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Cognitive Behaviour Therapy-Eliss's rational emotive behaviour therapy (REBT)
Extends ABC model- to ABCDE- D-dispue+E-effect.-identify+dispute irrational thoughts-eg patient may say how unfair things seem-therapist would identify as utopianism+challenge this as irrational belief
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Cognitive Behaviour Therapy-Behavioural activation
therapist may work encourage depressed patient to be more active +engage in enjoyable activites-will provide more evidence for irrational nature of beliefs
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Cognitive Behaviour Therapy-evaluation-Its effective
March et al-effects CBT+Anti depressent+also combination of both-327 adolesence with a main diagnosis of depression-after 36 weeks-81%cbt+81%antidepressents + 86% combo of both-cbt emerged as just as effective as medication+helpful alongside medicati
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Cognitive Behaviour Therapy-evaluation- CBT may not work for most severe cases
some cases depression can be so severe patients cant motivate themselves engage with hard work of CBT-may not pay attention in session-possible use anti depressents+then begin CBT- but limitation cus CBT not used as sole treatment
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Cognitive Behaviour Therapy-evaluation-success may be due to therapist-patient relationship
may be quality of this relationship that determines success rather than any particular technique that is used-having opportunity to talk to someone who will listen could be what matters most
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Genetic explanations-
some mental disorders have stronger biologocial component than others.lewis observed that of his OCD patients 37% had parents with OCD+21% with siblings-suggests runs in families
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Genetic explanations-Candidate genes
Genes which create vulenrability for OCD. some of these r involved in regulating development of the serotonin system
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Genetic explanations-OCD is polygenic
means its not caused by single gene but several genes r involved. Taylor 2013 analysed findings previous studies+found up to 2030 diff genes may be involved in OCD
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Genetic explanations-Diff types of OCD
aetiolologically heterogeneous- one group genes may cause OCD in 1 person but diff group of genes may cause it in another person.
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Genetic explanations- evaluation- Good supporting evidence
Twin studies-Nestadt et al reviewed previous twin studies+ found 68% of identical twins shared OCD as opposed 31% non identical-strongly suggests of genetic influence on OCD
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Genetic explanations- evaluation-Too Many Candidate Genes
psychlogists havent been majorly successful at pinning down all genes involved- it appears several genes involved+ each genetic variation only increases risk of OCD by a fraction-genetic explanation unlikely be useful-provides little predictive data
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Genetic explanations- evaluation- Enivormental Risk Factors
seems these can also trigger or increase OCD. Cromer et al found over half of OCD patients had traumatic event in their past+ocd more severe those who had more than 1 trauma-suggests cant be entirely genetic
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Neural explanations
Genes associated with OCD r likely affect levels of key neurotransmitters as well as structures of brain
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Neural explanations-the role of serotonin
help regulate mood.if person has low levels serotonin then normal transmission of mood relevant info doesnt take place+mood is affected -some cases OCD may be explained by reduction in functioning of serotoning system in brain
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Neural Explanations-Decision-making systems
some cases OCD seem be associated with impaired decision making.-may be associated with abnormal functioning of the side bits of frontal lobe of brain-responsible logical thinking+making decisions. evidence suggest parahippocampalgyrus
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what is it associated with?
processing unpleasant emotions, functions abnormally in OCD
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Neural Explanations- evaluation-some supporting evidence
some antidepressents work purely on serotoning system-increasing levels neurotransmitter-such drugs effective reducing OCD symptoms+this suggests serotinin system involved OCD.
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Neural Explanations- evaluation- Its Not Clear what Neural Mechanisms are Involved
studies of decision making have shown that neural systems are same systems that function abnormally in OCD+ research also idenfitied other brain systems may be involved sometimes+no system found that always role in OCD-cant claim understand involvmen
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Neural Explanations-evaluation- Shouldnt Assume The Neural Mechanisms Cause OCD
evidence to suggest various neurotransmitters+structures of brain dont function normally in patients with OCD-these biological abnormalities could be result of OCD rather than cause
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Drug Therapy
Aims increase or decrease levels of neurotransmitters in brain or increase/decrease their activity. Drugs work various ways increase levels serotonin in brain
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Drug Therapy-SSRIs- Selective Serotning Reuptake Inhibitor
serotoning released by presynaptic neurons+travel across synapse.Neurotransmitter chemically conveys signal from presynaptic to postsynaptic+then is reabsorbed by presynaptic where broken down+re used
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SSRI-preventing re-absorption+break down of serotnin SSRI effectively?_
icreases its levels in synapse+continue stimulate postsynaptic neuron-comepnstates for whats wrong w serotonin in OCD
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What is the dosage for SSRI
Typical daily dosage of Fluxoetine is 20mg-may be increased if not benefiting paitent. available at capsules or liquid.-takes 3 to 4 months daily use to have impact on systems
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Drug Therapy-Combining SSRI with other treatments
drugs often used alongside CBT to trea OCD. The drugs reduce emotional symptoms -means can engage effectively in CBT
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Drug Therapy-Alternatives to SSRI
Tricyclics-sometimes used-clomipramine-same effect on serotnin as SSRI but have more severe side effects-so kept for those who dont respond to SSRI
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What is the second alternative
SNRI-Serotonin noradrenaline reuptake inhibitor-increase levels serotonin + noradrenaline
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Drug Therapy- evaluation- Drug Therapy is effective at tackling OCD symtpoms
Soomro et al reviewed studies comparing SSRIs to placebos in treatment OCD+concluded all 17 studies showed better results for SSRIs than for placebo conditions+effectiveness greatest when SSRIs r combined with a psychological treatment-usually CBT
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Drug Therapy- evaluation-Drugs r cost effect+non disruptive
cheap compared psychological treatments-therefore good value for public health system like NHS+non disruptive-can take until symptoms decline +not engage with work of therapy
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Drug Therapy-evaluation- Drugs can have side effects
some suffer indigestion,blurred vision+ loss of sex drive-usually temporary.Those taking Clomipramine-more than 1 in ten suffer erection problems,tremors+weight gain +more than 1 in 100 aggressive+disruption blood pressure-people stop taking-
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Definitions of abnormality-Statistical deviation-IQ +intellectual disability disorder

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Normal distribution-any human characteristic-majority scores will cluster around average+fewer will havea above or below.Average IQ is set at 100 -most 68% have IQ from 85-115.only 2% below 7-'abnormal+r liable receive diagnosis

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what is it

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Definitions of abnormality-Statistical deviation evaluation-real life applications

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Definitions of abnormality-statistical deviation evaluation-unusual characteristics can be positive

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