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Psychopathology revision notes

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Psychology - Psychopathology
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Psychopathology revision notes

  1. 1. Psychopathology Revision PowerPoint
  2. 2. Definitions of abnormality: Statistical deviation  Abnormality- behavior that is numerically unusual or rare when plotted on a standard distribution curve  Abnormal behavior= behavior at either extreme end of the graph
  3. 3. Evaluation of Statistical Deviation  It doesn't’t distinguish between desirable and non-desirable behaviors e.g. IQ  Who can judge the boundary between ‘normal’ and ‘abnormal’  Cultural relativism- something that is statistically rare in one culture could be considered normal in another
  4. 4. Definitions of abnormality: Deviation from social norms  Societies have standards and norms (expected/ appropriate behavior patterns e.g. queuing)  This definition argues that a person who acts in a socially deviant way/ breaks society’s standards= abnormal  It is based on abnormal behavior being viewed as unpredictable and causing the observer discomfort/ violates moral standards  Abnormal thinking is irrational because it differs from common ways of thought
  5. 5. Evaluation of Deviation from social norms  Too dependent on context  Depends on time and culture  Deviance can be good e.g. not conforming to politically repressive regimes  Strength- distinguishes desirable and non-desirable behavior & considers effect on others
  6. 6. Definitions of abnormality: Failure to function adequately  Being unable to manage everyday life e.g. eating regularly  Lack of functioning is abnormal if it causes distress to self/ others  WHODAS used to provide a quantitative measure of functioning
  7. 7. Evaluation of Failure to function adequately  Distress may be judged subjectively  Behavior may be functional- e.g. depression may be rewarding for the individual  Cultural relativism  Strength- recognised subjective experience of individual, can be measured objectively
  8. 8. Definitions of abnormality: Deviation from ideal mental health  Jahoda identified characteristics commonly used when describing competent people  For example, high self-esteem, self-actualization, autononmy, accurate perception of reality, mastery of the environment
  9. 9. Evaluation of Deviation from ideal mental health  Unrealistic criteria- may not be useable because it is too ideal  Views mental and physical health as the same thing- whereas mental disorders tend not to have physical causes  Positive approach- a general part of the humanistic approach
  10. 10. Mental disorders: Phobias  Emotional: excessive fear, anxiety/ panic cued by a specific object or situation  Behavioral: avoidance, faint or freeze. Interferes with everyday life.  Cognitive: not helped by rational argument, unreasonableness of the behavior is recognised
  11. 11. Mental disorders: Depression  Emotional: negative emotions- sadness, loss of interest, anger  Behavioral: reduced or increased activity related to energy levels, sleep or eating  Cognitive: Irrational, negative thoughts and self-beliefs that are self-fulfilling
  12. 12. Mental disorders OCD  Emotional: anxiety and distress, awareness that this is excessive, leading to shame  Cognitive: recurrent, intrusive, uncontrollable thoughts (obsessions), more than everyday worries  Behavioral: compulsive behaviors to reduce obsessive thoughts, not connected in a realistic way
  13. 13. The behavioral approach: Explaining phobias- Two-process model The Two-process model  Classical conditioning- phobia acquired through association between NS and UCR; NS becomes CS, producing fear Little Albert (Watson and Rayner)- developed a fear of a white rat which generalized into a fear of other white furry objects  Operant conditioning- phobia maintained through negative reinforcement (avoidance of fear)  Social Learning- phobic behavior of others modelled
  14. 14. Evaluation of the Behavioral approach to explaining phobias  Classical conditioning- people often report a specific incident but not always, may only apply to some types of phobia (Sue et al)  Diathesis-stress model- not everyone bitten by a dog develops a phobia (di Nardo et al) may depend on having a genetic vulnerability for phobias  Social Learning- fear response acquired through observing reaction to buzzer (Bandura and Rosenthal)  Biological preparedness- phobias more likely with ancient fears, conditioning alone cant explain all phobias (Seligman)  Two-process model ignores cognitive factors- irrational thinking may explain social phobias, which are more successfully treated with cognitive methods (Engels et al)
  15. 15. The behavioral approach to treating phobias: Systematic Desensitization  Counterconditioning- phobic stimulus associated with new response of relaxation  Reciprocal inhibition- the relaxation inhibits the anxiety  Relaxation- deep breathing, focus on peaceful scene, progressive muscle relaxation  Desensitization hierarchy- from least to most fearful, relaxation practiced at every step
  16. 16. Evaluation of SD  Effectiveness- 75% success (McGrath et al), in vivo techniques may work better or a combination (Comer)  Not for all phobias- work less well for ‘ancient fears’ (Ohmen et al)  Strength- behavioral therapies are fast and require less effort than CBT, can be self-administered
  17. 17. The behavioral approach to treating phobias: Flooding  One long session with the most fearful stimulus  Continues until anxiety subsides and relaxation is complete  Can be in vivo or virtual reality
  18. 18. Evaluation of flooding  Individual differences- traumatic, and if patients quit it has failed as a treatment  Effectiveness- research suggests it may be more effective than SD and quicker (Choy et al)  Relaxation may not be necessary- creating a new expectation of copying may matter more (Klein et al)  Symptom substitution- a phobia may be a symptom of an underlying problem (e.g. Little Hans)
  19. 19. The cognitive approach: Explaining Depression Ellis’ ABC Model (1962)  Activating event leads to rational or irrational belief, which then leads to consequences  Mustabatory thinking (e.g. I must be liked)- causes disappointment and depression Beck’s negative triad (1967)  Negative schema- develops in childhood (e.g. parental rejection), leads to cognitive biases  Negative triad- irrational and negative view of self, the world and the future
  20. 20. Evaluation of the cognitive approach to explaining depression  Support for the role of irrational thinking- depressed people make more errors in logic (Hammen and Krantz); however, irrational thinking may not cause depression  Blames the client and ignores situational factors- recovery may depend on recognizing environmental factors  Practical applications to CBT- supports the role of irrational thinking in depression  Irrational beliefs may be realistic- depressed people may be realists (Alloy and Abrahamson)  Alternative explanation- genes may cause low levels of serotonin, predisposing people to develop depression
  21. 21. The cognitive approach: Treating Depression Cognitive Behavioral Therapy (CBT)  Ellis’ ABCDEF model  D is for disputing irrational beliefs, e.g. logical, empirical, pragmatic  E and F for effects of disputing and Feelings that are produced  Homework- trying out new behaviors to test irrational beliefs  Behavioral activation- encouraging, re-engagement with pleasurable activities  Unconditional positive regard- reduces sense of worthlessness
  22. 22. Evaluation of the cognitive approach to treating depression  Research support- generally successful, Ellis estimated 90% success over 27 sessions. May depend on therapist competence (Kuyken and Tsivrikos).  Individual differences- CBT not suitable for those with rigid irrational beliefs, those whose stressors can not be changed and those who don’t want direct advice  Behavioral activation- depressed clients in an exercise group had lower relapse after 6 months (Babyak et al)  Alternative treatments- drug therapy is much easier in time and effort, can be used along side CBT  Dodo bird effect- all treatments equally effective because they share features, e.g. talking to a sympathetic person (Rosenzweig)
  23. 23. The biological approach: Explaining OCD Genetic Explanations  COMPT gene- one allele more common in OCD, creates high levels of dopamine (Tukel et al)  SERT gene- one allele more common in a family with OCD, creates low levels of serotonin (Ozaki et al)  Diathesis-stress- same genes linked to other disorders or no disorder at all, therefore genes create a vulnerability Neural Explanations  Dopamine levels high in OCD- linked to compulsive behavior in animal studies (Szechtman et al)  Serotonin levels low in OCD- antidepressants that increase serotonin most effective  Worry circuit- damaged caudate nucleus doesn’t suppress worry signals from the OFC to thalamus  Serotonin and dopamine linked to activity in these parts of the frontal lobe
  24. 24. Evaluation of the biological approach to explaining OCD  Studies of first- degree relatives- 5 times greater risk of OCD if relative has OCD (Nestadt et al)  Twin studies- twice as likely to have OCD if MZ twins (Billett et al)  Environmental component- concordance rates never 100%, type of OCD is not inherited  Genes are not specific to OCD- also linked to Tourette’s, autism, anorexia i.e. obsessive- type behavior  Research support for genes and OFC- OCD patients and family members (genetic link) more likely to have reduced grey matter in OFC (Menzies et al)  Real world application- genes may be blocked or modified, genetic explanations lull people into thinking there are simple solutions  Alternative explanations- relevance of two-process model supported by success of SD-like therapy called ERP (Albucher et al)
  25. 25. The biological approach: Treating OCD Drug Therapy  Antidepressants increase serotonin  SSRIs- prevent the reuptake of serotonin by pre-synaptic neuron  Tricyclic’s- block re-uptake noradrenaline and serotonin but have more severe side effects, so are second choice treatment  Anti-anxiety drugs- BZs enhance GABA, a neurotransmitter that slows down the nervous system  D-Cycloserine- reduces anxiety (Kushner et al)
  26. 26. Evaluation of the biological approach to treating OCD  Effectiveness- SSRIs better than placebo over short term  Drug therapies are preferred- less time and effort than CBT, and may benefit from interaction with a caring doctor  Side effects- not so severe with SSRIs (e.g. insomnia), more severe with tricyclic’s (e.g. hallucination) and BZs (e.g. addiction)  Not a lasting cure- patients relapse when treatment stops, CBT may be preferable  Publication bias- more studies with positive results published which may bias doctor preferences

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