Explaining and Treating Mental Disorders

• What is the behavioural approach to explaining phobias? What is the two process model?


  The behavioural approach to explaining phobias uses Mowrer's two-process model to explain how phobias are learnt.

  
  

  Stage one: Classical conditioning (how phobias are acquired)

  Stage two: Operant conditioning (how phobias are maintained)
• What is classical conditioning with phobias? What was the Little Albert experiment by Watson and Rayner?


  Learning to associate something of which we have no fear of with something that already triggers a fear response.

  
  

  Little Albert:

  - A 9 month old baby with no phobias of animals was presented with a rat, alongside a loud frightening noise

  - Albert then became scared of the rat and showed the same conditioned response to similar furry objects such as fur coats, rabbits, etc.
• What is operant conditioning with phobias?

  Operant conditioning takes place when our behaviour is rewarded (reinforced) or punished. Mowrer suggested that whenever we avoid a phobic stimulus, we successfully escape the fear and anxiety that we would have experienced if we remained there. This reduction in fear reinforces the avoidance behaviour and so the phobia is maintained.
• What are strengths of the two-process model?

  Exposure therapy (systematic desensitisation): since phobias are maintained by avoidant behaviour, it is beneficial to be exposed to the phobic stimulus as it will prevent avoidance and the experience of anxiety reduction will decline. This shows the value of the two-process model as it identifies a means of treating phobias.

  
  

  Supported by research: Sue et al. found that people with phobias often recall a specific incident when their phobia appeared e.g. being bitten by a dog then being scared of dogs, and suggests that different phobias may be the result of different processes like incidents or modelling. This supports the two-process model as phobias could be a result of classical or operant conditioning.
• What is a weakness of the two-process model?

  Seligman argues that not all phobias develop after a traumatic incident, and that all animals are genetically programmed to rapidly learn an association between potentially life threatening stimuli and fear. "Ancient fears" are things that would've been dangerous in our evolutionary past like snakes or heights, and it would've been adaptive to rapidly learn to avoid such stimuli.
• What is systematic desensitisation as a way of treating phobias? What is reciprocal inhibition?


  Systematic desensitisation is a behavioural therapy designed to gradually reduce phobic anxiety through the principle of classical conditioning, teaching the patient a new response to the phobic stimulus by pairing it with relaxation instead of anxiety.

  
  

  Reciprocal inhibition is the idea that one emotion (relaxation) prevents the other (fear) and becomes the response to the phobic stimulus rather than anxiety.
• What is the anxiety hierarchy? What is in vitro and in vivo?


  The anxiety hierarchy is a list put together by the patient and therapist of anxiety-provoking situations arranged from least to most frightening.

  
  

  In vitro: imagination of exposure to phobic stimulus

  In vivo: real-life exposure to phobic stimulus
• What is relaxation and exposure?


  Relaxation: where the patient is taught to relax as deeply as possible, which may involve breathing exercises, mental imagery, meditation or drugs like valium.

  
  

  Exposure: when the patient is exposed to the phobic stimulus at the lowest level of the anxiety hierarchy while in a relaxed state. The treatment is only successful if the patient can move up the hierarchy while staying relaxed, especially the top level
• What are strengths of systematic desensitisation?


  Evidence base for effectiveness: Gilroy et al followed up 42 people who had SD for arachnophobia, and were less fearful of spiders compared to a control group who were only treated with relaxation. Shows the positive effects of SD and is likely to be helpful for people with phobias

  
  

  Learning disabilities: SD is the only treatment suitable for those with learning disabilities as they often struggle with complex cognitive therapies, and may feel distressed by the traumatic experience of flooding. Means that SD is the most appropriate treatment for people who have learning disabilities and phobias
• What is flooding as a treatment for phobias?

  Flooding: being exposed to phobic stimuli WITHOUT a gradual build-up in an anxiety hierarchy.

  - Patients can develop relaxation techniques but are immediately exposed to the phobic stimulus

  - Can only be conducted in vivo

  - Stops phobic responses quickly. Without the option of avoidance the patient quickly learns that the phobic stimulus is harmless a.k.a extinction
• What is a strength of flooding as a treatment for phobias?


  Cost effective: flooding can work in as little as one session as opposed to 10 sessions for SD and will achieve the same result. This means that more people can be treated at the same cost with flooding than with SD or other therapies.
• What are 2 weaknesses of flooding as a treatment for phobias?

  Traumatic experience: confronting one's phobic stimulus in an extreme form provokes tremendous anxiety, participants and therapists rate flooding as significantly more stressful than SD. Raises the ethical issue of psychologists knowingly causing stress to their clients (not serious if they have informed consent) and leads to higher dropout rates. This means that overall, therapists may avoid using this treatment.

  
  

  Symptom substitution: many behavioural therapies (including flooding) only mask symptoms and do not tackle the underlying causes of mental disorders like phobias, meaning as one symptom gets better another appears or gets worse and the underlying cause is still there e.g. when a woman with a phobia of death was treated with flooding her fear of being criticised increased. This means that flooding may be ineffective when it comes to tackling mental disorders as a whole since it only masks symptoms.
• What is the cognitive explanation for depression?


  - Focuses on how irrational thinking and systematic negative biases leads to depression

  - Depressed patients have cognitive abnormalities, meaning their thinking processes are different to clinically normal people
• What are cognitive biases as a part of cognitive vulnerability?


  1. Cognitive biases: those who are depressed pay selective attention to the negative aspects of situations and ignore the positive biases, meaning they make fundamental errors in logic

  e.g. minimisation is the bias towards minimising success in life, limiting the enjoyment one receives from success and leads to low self esteem and surrounds them with negative emotions
• What are negative self-schemas as a part of cognitive vulnerability?


  2. Negative self-schemas: a pessimistic package of information about themselves, leading to them interpreting all information about themselves in a negative way. Mainly formed in childhood through bullying or parental abuse, and leads to faulty information processing
• What is Beck's negative triad as a part of cognitive vulnerability?


  When a person develops a dysfunctional view of themselves because of 3 types of negative thinking: a pessimistic view of themselves ("I am incompetent and undeserving"), of the world, ("It is a hostile and hopeless place") and the future ("My problems will not disappear, there will always be emotional pain"). These thoughts are automatic
• What did Clark and Beck conclude about cognitive vulnerabilities? What are 2 strengths of Beck's negative triad?


  Clark and Beck concluded that not only were cognitive vulnerabilities more common in depressed people but they also existed before the depression (preceded it).

  
  

  1. Research support: Grazzioli and Terry assessed cognitive vulnerabilities and depression in 65 pregnant women before and after birth - found that women with cogn. vuln. were more likely to experience post-natal depression, showing that this explanation is more likely to be accurate

  
  

  2. Practical application: has led to successful therapies such as CBT (cognitive behavioural therapy). Lipsky et al found that challenging irrational negative beliefs can reduce a person's depression. Is also useful for economy due to improving workers' mental health and reducing time off because of this
• What are 2 weaknesses of Beck's negative triad?


  1. Does not explain all aspects of depression: covers basic symptoms but depression is a complex disorder with a range of symptoms such as hallucinations or strange beliefs - not all of which can be explained by Beck's negative triad

  
  

  2. Blames individual for their depression: holds the client responsible for being depressed rather than on the situational factors that may have caused their negative thinking e.g. bereavement
• What is Ellis' ABC model as a cognitive explanation of depression?


  Proposes that depression and anxiety are a results of irrational thoughts that interfere with thinking in ways that allow people to be happy and free from pain. There are common irrational beliefs that underlie much depression

  
  

  A: Activating Event

  B: Beliefs

  C: Consequences
• What is an activating event and what beliefs does this lead to? What are the 3 types of irrational beliefs? What are consequences?


  Activating event: external negative events that trigger irrational beliefs and leads to depression e.g. losing a job

  
  

  Beliefs: an individual's either rational or irrational interpretation of the event.

  1. 'Musturbation': belief that we MUST always succeed or achieve perfection

  2. 'I can't stand it itis': belief that whenever something doesn't go smoothly it is a major disaster

  3. 'Utopianism': belief that life is always meant to be fair

  
  

  Consequences: irrational beliefs lead to unhealthy emotional and behavioural outcomes which can lead to depression. The irrational belief is what leads to the consequence and not the event itself, e.g. failing an exam will lead to irrational beliefs which will lead to not trying/studying for the next exam
• What is a strength of Ellis' ABC model?


  Supporting evidence: Newark et al - one group of people diagnosed with anxiety and another clinically 'normal' group were both asked if they agreed with 2 very irrational statements. 65% anxious 2% normal agreed with first statement, 80% anxious and 0% normal agreed with second statement. From this we can conclude that people with emotional problems think in irrational ways, supporting Ellis' model.

  
  

  However, since it was carried out on those with anxiety and not depression, we cannot fully conclude this supports Ellis' model as it does not account for depression and is only a partial explanation