Psychopathology

Paper 1 – Revision notes


Definitions of Abnormality


deviation from social norm
- SN - socially constructed, implicit
deviation = abnormal
eg - antisocial personality behaviour


Evaluations


1) depends on culture
- abnormal in one culture
eg women driving


2) Time
- SN change over time
- abnormality not fixed
eg - homosexuality


3) lead to abuse
- discrimination
- demonises individual
- promotes conformity


Deviation from Statistical frequency
- extreme behaviour - infrequent
= abnormal
eg - IQ - 70-130
below 70 = intellectual disability


Evaluations


1) Desirability
- negative behaviour - frequent
eg - domestic violence
- positive behaviour - abnormal
eg - high IQ (infrequent)


2) cut off point
- subjectively determined
- strict boundaries
example
- IQ - 71 = normal
- IQ - 69 = abnormal
   = unfair


3) Discrimination
eq - homosexuality - infrequent - abnormal


Failure to function
- inability complete daily tasks
1- cant conform to interpersonal rules
2- personal distress
3- dangerous behaviour


Evaluation


1) some abnormality doesn't prevent function
- serial killer = work, families


2) who judges
- not stressful for person
eg - OCD - washing hands - no stress


3) disorders help function
- eating disorder - model = work


Deviation - ideal mental health
jahoda - SPAAMI
- self esteem
- personal growth
- autonomy
- accurate perception of reality
- mastery of environment
- integration


Evaluations


1) high criteria
- impossible to fit all
- majority viewed - abdnormal


2) Cultrually relative
- collectivist - don't value independence
   - group behaviours


3) cant compare mental + physical
- physical health - objective
- mental health - subjective




Characteristics of Mental Disorder


Phobias


Emotional
- persistent fear
- excessive/unreasonable
- anxiety/panic
- out of proportion - real danger


Behavioural
- avoidance - spiders
- interferes - daily routine


Cognitive
- irrational thoughts
- resist rationality
- recognises irrationality eventually


Depression


Emotional
- sadness - empty, worthless. negative
- loss of interest - despair, lack control
- Anger - at others or self


Behavioural
- reduced activity level
- tiredness
- affect sleep/appetite


Cognitive
- negative self concept
- guilt, worthlessness
- negative view of world


OCD


Emotional- anxiety, distress
- aware of excessive behaviour
  = shame, embarrassment


Behavioural
- intrusive thoughts
  = doubts, images, impilses
- uncontrollable - creates anxiety


Cognitive
- compulsive behaviour - reduce anxiety
- repetitive - handwashing
- unrealistic behaviour


behavioural approach - explaining phobias


classical conditioning - acquire phobia
- association
little albert
NS - white rat
UCS - loud noise, UCR - fear
UCS + NS  = UCR
CS - rat = CR - fear
- generalised phobia - white objects


Operant Conditioning - maintain phobia
- reward
- avoidance = reinforcing(rewarding)
  = negative reinforcement


Social learning
- learning from others (modelling)
- see others fear = we fear


Evaluation


1) Diathesis stress model
- not everyone learns fear
- genetic vulnerability - mental disorder
- triggered - life event


2) Support for social learning
Bandura
- confederate - fake pain buzzer
- ppts - emotional reaction - buzzer
- acquire fear


3) Biological preparedness
- genetically programmed - association
   = life-threatening = fear (ancient fears)
behavioural - not only explanation




Behavioural approach - treating Phobias


Systematic Desensitisation


Counter-conditioning
- Taught new association
  = relaxation
- Reciprocal inhibition - relax inhibits anxiety


Relaxation
- relaxation techniques - breathing - slow
- visualisation - peaceful scene


Desensitisation hierarchy
- gradually introducing phobia
- not overwhelming
- reduces anxiety


Alternative - Flooding
- learn relaxation techniques
- exposed to extreme phobia
- adrenaline decreases
- relaxation


Evaluation


1) successful
- range of phobias
- 75% patients respond to SD
- in vivo - most successful


2) not appropriate for all phobias
- SD - not effective - evolutionary phobias
- SD - effective - personal experience Pho


3) Individual differences
- flooding not for everyone
- highly traumatic
  - can quit during - reduces effectiveness




Cognitive approach - explaining Depression


Ellis ABC model
A - activating event (fired)
B - Beliefs (hated me)
C - Consequence - irrational response
                          - unhealthy emotion
                          = depression
Mustabatory thinking
- irrational beliefs
  eg- must do well or im worthless
- disappointment, depression
failing exam - irrational belief
                     = failed bc im stupid


Becks - Negative triad
depressed ppl have..
Negative schema - negative view of world
 - lead to systematic cognitive biases
Negative triad
pessimistic - irrational views of:
Self - (undesirable)
The world - (prefer other company)
The future - (will be alone)


Evaluation


1) Blames client not situational factors
- gives power to client to change
X - overlooks situation
   = family, environment, lifestyle


2) Applications - Therapy
- CBT - consistent best treatment
  = especially with drug treatment
supports theory - challenging irrationality


3) irrational beliefes - realist
- depressive realist - see things for what
they are
- depressed ppl - accurate estimates of
disasters
(sadder but wiser effect)




Cognitive approach - treating Depression


Cognitive-behaviour Therapy - CBT
REBT
Ellis extends ABC:
Challenging irrational thought
D - disputing irrational thoughts
E - Effective attitude to life
F - Feelings produced
- Logical disputing - illogical thinking
- Empirical disputing - inconsistent with reality
- Pragmatic disputing - usefulness of beliefs
  = effective disputing changes self-defeating
     beliefs


Homework
- assignment
  eg - ask on date - fear rejection
test irrational beliefs against reality
practice rational beliefs


Behavioural Activation
- depressed clients - more active
- more active - more reward
- identify activity - anticipate cognitive obstacles


Unconditional Positive regard
- convince - value
- therapist - respect, value
   = change in beliefs


Evaluations


1) Research support
- 90% success - REBT
- 27 sessions
- 75 studies - some CBT is better than none


2) Individual differences
- CBT - less suitable - high irrationality
                               - rigid/resistant to change
- ppl prefer sharing worries that solving
- exclude cognitive effort


3) Alternative treatments
- Antidepressants - SSRI's
- less effort for client
- used in conjuction to CBT - effective
   = helps to cope


Biological Approach - Explaining OCD


Genetic Explanations
COMT gene
- regulates production - dopamine
- common in OCD - higher level dopamine

SERT gene
- affects serotonin transport
- decreases level
- study - two families -6/7= OCD
  = mutation or SERT gene
Diathesis-stress
- genes creates vulnerability
- other factors - cause OCD - develop
- posses gene - no ill effect.


Neural Explanations
Abnormal levels of Neurotransmitters
- Dopamine - abnormally high
Animal studies - enhance dopamine
                      = stereotyped movements
                      = similar to OCD
- increase serotonin - decrease OCD



Abnormal Brain Circuit
- frontal lobes - abnormal - OCD
damaged caudate nucleaus -
fails to surpress minor worry signals
signals Thalamus - worry - OFC
-PET scans - high OFC activity




Evaluations


1) Research support genes + OFC
- MRI scans
   - OCD patient
   - immediate family - no OCD
   - Unrelated healthy ppl
- relative - reduced grey matter
               - key regions - OFC
          = anatomical differences - inherited
= brain scans - detect OCD risks


2) Alternative explanations
Two-process model
Classical - NS - dirt = anxiety
Operant - maintained - avoiding
- link learned
Treatment
- ERP - exposed to fear
         - prevented from compulsive behaviour
- high success rate




Biological Approach - Treating OCD


Antidepressants - SSRI's
- increases serotonin levels
   - normalises - worry circuit
- reduces anxiety
re-absoption of serotonin is inhibited
  = increase serotonin


Antidepressants - Tricyclics
- blocks transporter mechanism
   = reabsorbs serotonin + noradrenalin
- targets multiple neurotransmitters
X - greater side-effects
 = second line treatment


Anti-anxiety drugs
- BZs reduce anxiety
- Enhance neurotrans - GABA
GABA - reacts - special site
increase chloride ions - slows down activity
  = feel relaxed


Evaluations


1)Drugs are cost effective and non-disruptive:
- cheaper than psychological treatment.
- They are non-disruptive - quicker than
psychological therapies.


2) Drugs have high side-affects:
- indigestion, blurred vision and loss of sex drive
- Tricyclics - more serious


3)Drug therapy is effective at tackling OCD symptoms:
-SRIs work best with psychological treatment- CBT
- symptoms decrease 70% - SSRIs