Psychopathology paper 1

what are the 3 types of phobias?
specific phobia, social anxiety, agoraphobia
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what is a specific phobia?
phobia of an object or single certain thing e.g a spider
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what is social anxiety?
fear concerning social situations e.g public speaking
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what is agoraphobia?
fear of being outside or in public
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what is a phobia?
an anxiety disorder that interferes with daily living. It involves irrational fears that produces a conscious avoidance of the feared object or situation
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what are the three characteristics of phobias?
emotional, behavioural, cognitive
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what are the emotional characteristics of phobias?
anxiety and fear from exposure (immediate fear response due to presentation of object/situation)
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what are the behavioural characteristics of phobias?
panic (distressed behaviour e.g crying), avoidance (efforts made to escape feared object/situation), endurance (remain in presence of phobic stimulus but anxiety still high)
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what are the cognitive characteristics of phobias?
irrational beliefs, cognitive distortions (their perception of the phobic stimulus may be misrepresented), selective attention (find it hard to look away from phobic stimulus)
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what is the behaviourist explanation for phobias? (brief outline) who came up with this explanation?
suggests phobias are acquired through learning, classical conditioning establishes the fear when individual associates neutral stimulus with a fear response (little albert) and are maintained through operant conditioning (pos. and neg. reinforcement)
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How did Mowra explain why phobias are long lasting?
operant conditioning acts as the maintenance for the fear response established by classical conditioning. Without operant conditioning phobias would decline over time as there is no reinforcement involved and insentive to maintain the fear.
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what are the two types of phobia treatment?
systematic desensitisation and flooding
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who established systematic desensitisation? what is the aim of the treatment?
Wolpe, the aim is to gradually reduce anxiety which is achieved by classical conditioning
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explain how classical conditioning works in the systematic desensitisation process?
association of CS & CR that = phobic response replaced, new response to stimulus learned so stimulus associated w/ relaxation not anxiety (counter cond.), impossible to relax & anxious as 1 stops other (reciprocal inhibition), relax w/phobia = cured
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steps to systematic desensitisation?
anxiety hierarchy (8-10 steps), relaxation techniques, gradual exposure (cured when they reach highest level and are relaxed)
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what is an advantage of systematic desensitisation? (supporting research)
gilroy et al - followed 42 patients treated for arachnophobia (spiders) & assessed phobia w/questionnaire and responses to spiders. Found at 3 and 33 months SD group were less fearful than control group. proves effectiveness of SD.
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what is another advantage of SD? (extensive)
suitable for diverse patients, whereas flooding & CBT not suited to all i.e anxiety sufferers or learning difficulties cannot engage during CBT or understand whats happening in flooding. So SD more appropriate.
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what s another advantage of SD? (prefer) but also disadv? (time etc)
patients prefer SD to other therapies i.e flooding as there is less trauma. This is evident in low refusal rates. BUT Sd longer sessions and more expensive.
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what is flooding? who invented it?
Stampf, it is immediate exposure to the phobic stimulus. It involves extinction, which means that the learned response stops when the conditioned stimulus (spider) is encountered without the unconditioned stimulus (being bitten)
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how long does flooding take?
usually 2/3 hours.
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what are the two forms of flooding?
in-vivo (actual exposure) or virtual (imaginary exposure)
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what is an advantage of flooding? (supporting research)
Ougrin - effective for specific phobias, compared flooding with CBT and found highly effective and quicker than CBT. This is adv as means done more quickly and cheaper
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what is a disadv of flooding? (suitable for all phobias?)
Less effective for complex phobias i.e social phobias as they have cognitive aspect. i.e they have anxiety response and unpleasant thoughts about social situ. so CBT may be more effective to tackle irrational thinking.
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what is a disadv of flooding? (pleasant?)
its a traumatic experience, patients often unwilling to complete treatment (attrition rates) and there are high refusal rates. So time and money spent on treatment wasted.
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what is the two-process model explanation of phobias?
Mowra stated phobias are learned by classical cond. and continue due to operant. e.g watson and reynor "little albert" created a phobia of rats in a baby via classical cond. & this conditioning was generalised to similar white fluffy objects
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what is an advantage of behavioural explanations for phobias? (supporting research)
Watson & rayner - found little albert originally showed fear to loud noise & no response w/rat. But when rat paired w/noise he showed fear when exposed to rat on own. Suggest phobias acquired via classical cond. as predicted by 2 process model
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what is another advantage of behavioural explanations for phobias? (app)
2 process model = good explan of how phobias learned/ maintained. explains why patients need exposure to feared stimulus. Used in therapy, once prevented from using avoidance behav. isn't reinforced so declines. Real life app for flooding therapy.
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what is a disadvantage of behavioural explanations for phobias? (limited explan)
ignores cognitions; cog. app.= develop phobias due to irrational thinking i.e claustrophobic may fear bring trapped so get phobia. led to CBT which more effective than behav. treatment. Shows cog. key part in phobias, so limited explan
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what are the behavioural characteristics of depression?
reduced activity levels (no energy, lethargic, withdraw from work/education/social life), disrupted sleep/eating behave. (insomnia and increased need for sleep - hypersomnia) and aggression & self harm (irritable & can be aggressive towards self)
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what are the emotional characteristics of depression?
lowered mood (depressed - more pronounced feeling of lethargic and sadness. feel worthless and empty). lowered self esteem (sufferers describe as self loathing)
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what are the cognitive characteristics of depression?
poor concentration (unable to stick w/a task, hard to make decisions, affects their studies), focuses on negatives (recall bad events rather than pos), absolutist thinking (think situations are all bad 'black and white thinking)
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what is the brief cognitive explanation for depression and who developed it?
Beck suggests a persons cognitions creates a vulnerability to depression i.e the way they think about situations
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what are the 3 parts to cognitive vulnerability?
1) faulty info processing (attend to negative aspects of situ & ignore positives), 2) negative self schema (package of neg ideas/info about us), 3) negative triad (dysfunctional view bc of 3 types of thinking. neg view of world, future and self)
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what is an advantage of the cognitive theory of depression? (supporting research)
Grazioli and Terry - assess 65 pregnant women for cog vuln before n after birth. those w/higher cog vuln more likely to have post natal dep.
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what is another advantage of the cognitive theory of depression? (practical application)
developed CBT as cognitive aspects of depression can be identified during therapy and challenged for likelihood of being true. CBT is successful so suggests cognitions are likely to contribute to depression
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what is a disadvantage of the cognitive explanation? (all symptoms?)
doesn't explain all symptoms i.e some patients suffer Cotard syndrome (delusion they are zombies), Beck cant explain this so its a limited explanation
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what was Ellis' cognitive explanation for depression?
proposed good health is the result of rational thinking, which allows people to be happy and free of pain, therefore depression results from irrational thought (illogical or unrealistic)
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what is Ellis' ABC model?
(A)ctivating event: situation triggers irrat. thought i.e fail exam, (B)eliefs: irrat. beliefs about event i.e musturbation is belief must always achieve perfection, (C)onsequences: emotional/behavioural response to beliefs i.e giving up
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what is an advantage of Ellis' ABC model? (app)
has practical application as helped to develop REBT, i.e neg beliefs challenged resulting in reduced depression. shows irrational beliefs play a role in depression.
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what is a disadvantage of Ellis' ABC model? (all symptoms?)
doesn't explain coward syndrome (as above)
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what is another disadvantage of Ellis' ABC model? (limited)
explains depression following an event (reactive depression) but not depression without an obvious cause. Only applies to some types of depression and so is only a partial explan.
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what are the two cognitive therapies for depression?
REBT and CBT
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what is CBT?
identify negative triad thoughts and challenge them directly by testing likelihood of truth. Set hw to record when they enjoyed an event or ppl nice to them ('patient as scientist') which acts as evidence when therapist challenges their neg. views.
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what is REBT's brief aim and what does it derive from?
Ellis developed REBT as an extension to the ABC model to ABCDE model (dispute and effect). Aim is to identify and dispute irrational thoughts.
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how is REBT carried out?
identify utopianism/mustubatory beliefs (i,e unfair something is/need for success). Methods of disputing: empirical arg. (evid?), logical arg. (facts?) & pragmatic disp. (useful?) = vigorous arg. change irr. belief, break link of neg. events & dep.
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as well as CBT and REBT what would therapists usually encourage patients to do? what is this called?
behavioural activation - encourage patient to be more active & engage in enjoyable activities i.e socialising. Provides evidence for irrationality of beliefs.
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what is an advantage of REBT? (supporting ev)
David et al - patients suffering from depressive disorder and treated w/14 weeks of REBT had better outcomes after 6 months than those treated w/drugs. Shows that REBT is a better long term treatment and is effective
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what is a disadvantage of CBT? (all patients?)
requires motivation so may not work in all cases as cant motivate self to engage w/hard cognitive work i.e cant pay attention to session. In serious cases given drugs so more alert for therapy. Proves CBT cant be used as sole treatment
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what is a disadvantage of CBT? (root cause)
focuses on present and future not past, patients may want to talk about prev. exp. that link to current dep. so may be frutsrated by present focus. Other psy therapies suggests childhood impact = depression. not addressing root cause.
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what is OCD?
an anxiety disorder where sufferers experience obsessions (forbidden/ inappropriate recurring thoughts) and compulsions (repetitive behav. such as hand washing)
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what are the behavioural characteristics of OCD?
Compulsions: compulsions are repetitive and are carried out to reduce anxiety. Avoidance of feared object may reduce anx.
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what are the cognitive characteristics of OCD?
obsessive thoughts: recurrent thoughts. Insight into excessive anxiety: aware obsessions and compulsions not rational but cant control them
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what are the emotional characteristics of OCD?
anxiety and distress: extremely unpleasant and emotional responses. Depression.
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what is the cycle of OCD?
1) obsessive thoughts 2) anxiety 3) compulsive behaviour 4) temporary relief
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what is the genetic explanation of OCD?
OCD runs through families, suggested that a genetic vulnerability to the condition is passed on. Diathesis stress model suggests genes predispose ppl to OCD and stress striggers condition.
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what type of genes have been found to be involved in OCD? who investigated this?
Cand. genes found which create vuln. OCD also polygenic (many genes involved) - 230+ genes accord. to Taylor. These genes assoc. w/serotonin & dopamine (regulate mood). OCD aetiologically heterogeneous (diff combos cause it) explains diff types OCD
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what is an advantage of the genetic explanation of OCD? (supporting research)
Nestadt et al - reviewed prev. twin studies and found 68% MZ twins shared OCD and 31% DZ twins. Suggets genetic influence of OCD as MZ share 100% genes and DZ only 50%
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what is a disadvantage of the supporting evidence for the genetic explanation of OCD? (twin studies)
methodological issues as assume MZ twins only more similar in terms of genes, but may be bc of shared enviro. MZ have more similar enviro as treated more similarly i.e dress alike and share room. Could cause greater likelihood of sharing OCD gene
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what is another disadvantage of the genetic explanation of OCD? (opposing evidence)
Cromer et al - more than half OCD patients had traumatic event in past and those w/ more than one traumatic event had more severe OCD. Suggests OCD not entirely genetic, theres environmental cause.
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what is the neural explanation of OCD in basic terms?
the genes of OCD are likely to affect the levels of key neurotransmitters as well as structures of the brain.
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how is the neurotransmitter serotonin affected in OCD patients?
serotonin is believed to regulate mood and there are low levels of serotonin activity in OCD patients on PET scans. Drugs which inc. serotonin levels found to reduce symptoms suggesting serotonin effected by OCD.
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how can some cases of OCD involving impaired decision making be explained by the neural explanation of OCD?
impaired decision making may be associated w/abnormal functioning of the lateral frontal lobes of brain (role of logical thinking/decision making). Left parahippocampal gyrus functions abnormally & assoc. w/ processing unpleasant emotions.
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what is an advantage of the neural explanations of OCD? (supporting research)
supporting research supports role of neural mechanisms in OCD i.e anti depressants work purely on serotonin system and are effective in treating symptoms so suggests serotonin involved
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what is a disadvantage of the supporting research for neural explanations? (cause and effect)
correlational so biological abnormalities could be a symptom of OCD rather than a cause. cant draw reliable conclusions.
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what is another disadvantage of neural explanation of OCD? (responses to serotonin drugs)
not all sufferers respond positively to serotonin enhancing drugs, if serotonin is the cause we would expect improvement of symptoms in all cases. Lessens support for serotonin being the sole cause of OCD.
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what does the biological treatment of OCD/ drug therapy aim to do?
increase/decrease levels of neurotransmitters in the brain or increase/decrease their activity. In the case of OCD, serotonin is focused on.
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what is the standard drug therapy called and what is the most common type of this? how much is taken and how long does it take to be effective?
SSRI, most common type of this is fluoxetine (prozac), typical take 20mh a day and takes 3/4 months of daily use to impact symptoms
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how is serotonin released in the brain?
it is released by presynaptic neurone and travels across the synapse, it chemically conveys the signal from the pre to post synaptic neurone & is reabsorbed by the presynaptic neurone where its broken down and reused.
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How do SSRIs work?
work on the serotonin system in the brain, prevents the re-absorption and breakdown of serotonin, which increases levels of serotonin in synapse so postsynaptic neurone is stimulated. Normalises the serotonin system in OCD patients.
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why are SSRIs sometimes combined with other treatments?
drugs can be used alongside CBT to treat OCD as the drugs reduce emotional symptoms such as anxiety and depression so allow patients to engage more effectively in the therapy
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if the SSRI is not effective how much is the dosage increased to and after *** long? (maximum)
after 3-4 months if still not effective can be increased to 60mg
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if the SSRI isn't effective at all, which other drugs can patients be prescribed? How do they work?
Tricyclics - same effect on the serotonin system but severe side effects. SNRI - increase serotonin levels but also levels of noradrenaline
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what is an advantage of drug treatment? (cost)
they are cheap; benefit for NHS. also they are less disruptive to patients' lives compared to psychological therapies as patients dont have to engage w/the hard work of psy.therapy. Doctors & patients prefer drugs.
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what is a disadvantage of drug treatment? (side effects)
patients can suffer indigestion, blurred vision and loss of sex drive. Clomipramine causes 1/100 to suffer disruption to blood pressure & heart rhythm, Patients stop taking it & so not effective.
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what is a disadvantage of drug treatment? (cause)
treats symptoms not cause, if patient stops taking the drug they are prone to relapse and so psychological treatments may be a better long term solution.
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what are the 4 definitions of abnormality?
deviation from social norms, statistical infrequency, failure to function adequately, deviation from ideal mental health
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what is 'deviation from social norms' as a definition of abnormality?
society's unwritten rules for accept. behav. & not conformed = abnormal. Norms specific to culture/generation i.e gay in some cultures. Failure to conform to lawful/culturally normative behav. = abnormal. i.e psycho = agg, irrational & irresponsible
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what is an advantage of the deviation from social norms definition?
flexible as takes into account situational and developmental norms i.e bikini on a beach vs on a street, baby having tantrum vs adult.
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what is a disadvantage of the deviation from social norms definition?
social norms vary massively in different generations & cultures.e.g hearing voices considered spiritual but in UK mental abnormality.
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what is statistical infrequency as a definition of abnormality?
statistically influent behav = abnormal. statistics are used to create a normal distribution curve to show the proportions of ppl who share same characteristics/behav. Most will be near the mean. If someone falls outside of the ND (5%) = abnormal
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what is an advantage but also disadvantage of statistical infrequency definition?
it is useful for quantifiable characteristics such as IQ or heigh as theyre objective, so no interpretation needed by doctor. BUT less useful for unquantifiable behav, i.e anxiety
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what is a disadvantage of statistical infrequency?
some behaviours which are considered abnormal are actually frequent in society i.e 10-20% of the population have depression. This suggests that depression is normal and shouldnt be considered a problem.
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what is another disadvantage of statistical infrequency?
doesn't take into account unusual characteristics that could be positive i.e high IQ, we wouldn't consider this abnormal i.e require treatment to make it 'normal' standard.
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what is the failure to function adequately definition of abnormality?
considered abnormal when cant cope w/demands of everyday life. Rosenhan & Seligan signs of abnormality: doesn't conform to interpersonal rules, severe personal distress, maladaptive behav, irrational & unpredictable behav.
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how is failure to function measured?
global assessment of functioning measures how well individuals function in every day life (score 1-100)
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disadvantage of failure to function definition?
sometimes abnormality isn't always accompanied by dysfunction i.e Harold Shipman had a successful job and was married but was a serial killer
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what is another disadvantage of failure to function definition?
hard to say whether someones failing to function or just deviating from social norm i.e travellers do not live in permanent accommodation and dont work. labelling them as abnormal could lead to discrimination against these groups and limiting freedom
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what is the deviation from ideal mental health definition of abnormality?
looks at signs of absence of wellbeing in terms of mental health. Jahoda's criteria for good MH: pos. att, self actualisation, autonomy, resisting stress, acc. perception of reality, enviro mastery
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what is an advantage of the deviation from ideal mental health definition?
it is a holistic interpretation of abnormality as involves a broad range of criteria for mental health.
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what is a disadvantage of the deviation from ideal mental health definition?
unrealistically high standard for mental health as most people dont meet all the ideals i.e few people experience personal growth all the time
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what is an advantage of the deviation from ideal mental health definition?
takes a positive approach to abnormality as emphasis is on positive achievements so allows u to target areas to work on
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