Psychopathology

• Definitions of Abnormality

  
  

  
  

  There are 4 ways to identify abnormality:

  1. Deviation from social norms
  2. Deviation from ideal mental health
  3. Failure to function adequately
  4. Statistical infrequency
• Definitions of Abnormality

  
  

  Strengths of "Deviation from Social Norms Definition":

  1. Considers how our behavior affects other people (helps minimize harm to others
  2. Distinguishes between normal and abnormal - This definition has a clear indication of what is considered normal and abnormal as most of us understand and are aware of social norms in our own culture
• Definitions of Abnormality

  
  

  Disadvantage of "Deviation from Social Norms Definition":

  • Social norms vary across cultures, societies, and historical periods. What may be considered abnormal in one culture or time period might be perfectly normal in another.
  • Ethnocentric - This definition is based on western societal norms and reflects the majority, which is a white population
• Definitions of Abnormality

  
  

  Deviation from social norms refers to behavior that significantly deviates from what is considered typical, acceptable, or appropriate within a particular society or cultural context.
• Definitions of Abnormality

  
  

  Failure to function adequately defintion of abnormality states individuals are abnormal when they are unable to cope with every day life
• Behavioural Characteristics of Depression:

  
  

  
  

  Behavioural characteristics

  • Affected sleep: This can be an increase in the need to sleep and stay in bed or a decrease where they suffer from insomnia or premature waking
  • Affected appetite: Again, this can be an increase, where the person eats more and more to comfort eat, or, a decrease, where the person cannot eat and struggles to eat meals
  • Aggression and self-harm: Depression can lead the individual to be aggressive with themselves and cause self-harm, such as cutting and suicide attempts
• Emotional Characteristics of Depression:

  
  

  
  

  Emotional characteristics

  • Sadness: The lowered mood is a key defining emotion of depression and can lead the person to feel hopeless
  • Anger: People with depression often have angry outbursts; this can be directed at themself or others
  • This emotion comes under behavioural characteristics as well as they can cause harm to themselves and others 
  • Loss of interests: The person suffering from depression may lose all interest in activities or hobbies that once brought them joy, so giving them a lack of control
• Cognitive Characteristics of Depression:

  
  

  
  

  Cognitive characteristics

  • Negative views of the world: The person suffering from depression is likely to think that everything will turn out badly and there is no hope 
  • Irrational thoughts: Their thoughts and beliefs are not rational and the person suffering from depression will see the world negatively, their thoughts do not accurately reflect reality 
  • Poor concentration: The person suffering from depression can have poor levels of concentration, where they are unable to stick with a specific task or they find it hard to make decisions

• Cognitive Explanations of Depression:

  
  

  Beck’s Negative Triad

  Beck suggested there were 3 parts to cognitive vulnerability( the way they think):

  • Faulty information processing
  • Negative self-schema
  • The negative triad
• Cognitive Explanations of Depression: Beck's Negative Triad

  1. Beck's 1st part to cognitive vulnerability (explaining depression)

  Faulty information processing

  • When depressed the person tends to ignore the positives in their lives and only focus on the negatives
  • The depressed person will blow small problems out of proportion
  • These cognitive biases cause the depressed person to constantly see themselves as worthless and useless
• 2) Beck's 2nd part to cognitive vulnerability (explaining depression)

  
  

  Negative Self Schema

  
  

  • When depressed, the person will have a negative self-schema, which means they interpret all of the information about or around themselves negatively
  • A schema is a shortcut that acts as a mental framework for the individual
  • A self-schema is the framework of information they have about themselves
  • For example, they could have an ineptness schema, in which they believe they will fail, and/or a negative self-evaluation schema, where they constantly remind themselves of their worthlessness

• Cognitive Explanations of Depression: Strengths of Beck's Negative Triad :

  • Personal life events are taken into account and are recognised as a starting point for the person's depression.
  • Real-world applications: Due to the findings of both Beck and following psychologists, it has allowed psychologists and therapists to understand cognitive vulnerability and apply it in treatments such as CBT (Cognitive Behavioural Therapy).
• 3) Beck's 3rd part to cognitive vulnerability (depression)

  Beck's negative triad

  
  

  •  Regardless of the reality, due to the person having depression and having both cognitive biases and negative self-schemas, the depressed person develops a dysfunctional view of themselves
  • Beck suggests that a depressed person has three elements of negative thinking and these are called the negative triad:
  • Negative view of the self: I am worthless/ unimportant/ useless/ a waste of time
  • Negative view of the world: Everyone is against me
  • Negative view of the future: I am never going to amount to anything

  

• Cognitive Explanations of Depression: Limitation of Beck's negative triad:

  • It does not explain the symptoms of depression, such as why different depressed people may experience different feelings, E.g. Feeling extreme anger, hallucinations, or extreme exhaustion.
  • Another limitation of Beck's negative triad is that it doesn't account for the role of cultural differences in shaping individuals' cognitive patterns and depressive symptoms.
• • Cognitive Explanations of Depression: Ellis's ABC Model

  
  

  • Albert Ellis (1962) had a slightly different view to Beck and suggested depression is caused by irrational thoughts and that rational thoughts cause good mental health.
  • Ellis stated that these irrational thoughts interfere with happiness and cause the person to be unhappy.
  • Ellis defined irrational thoughts as not logical or realistic thoughts. 
• Ellis's ABC Model

  • Ellis developed the ABC model to explain how irrational thoughts affect individuals: 
  • A: Activating event. This is a negative event that triggers the irrational thoughts, E.g. Losing your job 
  • B: Beliefs. The thoughts which the person associates with the event, and why it happened:
  • C: Consequences. Rational beliefs lead to health consequences (new job or job searching), Irrational beliefs lead to unhealthy consequences
• Cognitive Treatments of Depression:CBT

  • The most commonly used psychological treatment used to treat depression is Cognitive Behaviour Therapy (CBT).
• Cognitive Treatments of Depression: CBT

  
  

  CBT (Cognitive Behavioral Therapy) helps treat depression by helping individuals identify and change negative thought patterns and behaviors. It teaches skills to challenge distorted thinking, cope with stress, and develop healthier ways of coping, leading to improved mood and functioning.
• Cognitive Treatments of Depression: REBT

  
  

  Ellis's Rational Emotive Behaviour (REBT) 

  • REBT extends Ellis's ABC model to ABCDE (D is for Dispute and E is for Effect)
  • The main technique for REBT is to identify and challenge irrational thoughts 
• Cognitive Treatments of Depression: REBT

  • The therapist will dispute the patient’s irrational beliefs, to replace their irrational beliefs with effective beliefs and attitudes. There are different types of dispute which can be used, including: logical dispute – where the therapist questions the logic of a person’s thoughts, for example: ‘does the way you think about that situation make any sense?’ Or empirical dispute – where the therapists seeks evidence for a person’s thoughts, for example: ‘where is the evidence that your beliefs are true?’
• Cognitive Treatments of Depression: Strengths of CBT and REBT

  • CBT and REBT are quicker treatments than other therapies:
  • CBT is very effective in treating mild depression and stopping it from progressing into severe depression.
  • It teaches the client skills that they could apply to other areas in their life.
• Cognitive Treatments of Depression: Limitations of CBT and REBT

  
  

  • CBT has been criticised for blaming the client as the whole focus is on their irrational thoughts.
  • CBT as with all 'talking therapies' is not very good for those clients who do not like to take or express themselves or lack the verbal skills to do so.
• Cognitive Treatments of Depression:

  
  

  Difference between CBT and REBT

  • CBT focuses on identifying and challenging negative thoughts and behaviors, aiming to replace them with more realistic and adaptive ones.
  • REBT emphasizes identifying and disputing irrational beliefs that lead to emotional distress, aiming to replace them with rational beliefs.
• Behavioural Characteristics of OCD

  • Compulsions: Compulsions are repetitive and time-consuming, they can stop the person suffering from OCD from continuing their daily life
  • Avoidance:
  • The person suffering from OCD is likely to try and avoid situations that would cause them to show their compulsions
• Emotional Characteristics of OCD

  • Extreme anxiety: The person suffering from OCD is likely to suffer from extreme levels of anxiety, obsessive thoughts (which are often frightening and overwhelming) and the compulsions that cause the sufferer anxiety and distress
  • Guilt: Often those suffering from OCD, can also have other negative emotions against themselves, such as feeling guilt over a situation or being disgusted with themselves
• Cognitive Characteristics of OCD

  • Obsessive thoughts: The majority of people suffering from OCD have obsessive thoughts
  • Obsessive actions: The person suffering from OCD will often have to perform these obsessive actions to allow them to continue with their day
  • Excessive anxiety: The sufferer of OCD understands that these thoughts and actions are irrational but they cannot stop them, however, even though they understand they are irrational
• Behavioural Treatments of Phobias: Systematic desensitisation

  • This is the main behavioural therapy to treat phobias and it is designed to slowly reduce the anxiety caused by the phobia using classical conditioning.
• Behavioural Treatments of Phobias: Systematic desensitisation

  
  

  The three process involved in systematic desensitisation are: 

  Anxiety hiearchy

  • The patient and therapist work together to construct an anxiety hierarchy

  Relaxation

  • This could be in the form of breathing exercises or using imaging techniques, where the patient imagines themselves in a relaxing environment
  • Reciprocal Inhibition: One emotion prevents the other (cannot have 2 emotions at the same time)

  Exposure

  • the patient is exposed to the phobic stimulus starting at the bottom of the hierarchy
• Behavioural Treatment of Phobias: Advantages Of Systematic Desensitisation

  • Proven to be successful with a range of phobias and effective on different types of people 
  • Systematic desensitisation is a fast treatment and requires less effort than most other psychotherapies
• Behavioural Treatment of Phobias: Limitation of Systematic Desensiastion

  • It is less effective for evolutionary therapies 
  • Systematic desensitisation doesn't treat the cause of the phobia, only the behaviour it causes
• • Biological Explanations of OCD

  
  

  • Researchers have identified Candidate genes as genes that create vulnerability to OCD 
  • OCD seems to be polygenic; this means OCD is not caused by one single gene but by a combination of genetic variations that together cause significantly increased vulnerability
• Evaluation of Biological Explanations of OCD

  Strengths:

  • Nestadt et al. (2010) reviewed evidence that 68% of identical twins will both have OCD compared to 31% of non-identical twins

  -This is a significant link to show that genetics play an important role in the development of OCD

  • A person with a family member who has OCD is 4 times more likely to be diagnosed with OCD themselves
• Evaluation of Biological Explanations of OCD: Limitations

  
  

  • Ignores environmental factors which play a part in the development of OCD
• Behavioural Approach to Explaining phobias

  • The acquisition of the phobia by classical conditioning:
  • Phobic objects are at first a neutral stimulus (NS) and do not produce a phobic response 
  • However, if it is then presented with an unconditioned stimulus (UCS), that produces an unconditioned response (UCR) then, the NS will become associated with the UCS and then the fear (phobia), will occur whenever the NS is there
  • This means the NS becomes a conditioned stimulus (CS) and the UCR becomes the conditioned response (CR)
  • This conditioning is then generalised to similar objects
• Biological Approach to Treating OCD

   The main biological treatment is the use of drug treatments, which affect the functioning of the brain and neurotransmitter levels. 
• Biological Approach to Treating OCD

  SSRIs (Selective Serotonin Reuptake Inhibitors)

  • The work solely on the neurotransmitter serotonin which is associated with OCD 
  • They inhibit/ prevent the re-uptake/ absorption of serotonin, which happens too fast in people with OCD 
  • By preventing the reabsorption of and breakdown of serotonin, SSRIs effectively increase levels of serotonin in the synapse, which results in the neurotransmitter remaining active in influencing the post-synaptic neuron 
  • The average time for SSRIs to take effect is 4 months, before they impact on symptoms
• Biological Approach to Treating OCD: Strengths

  • Evidence of Effectiveness, although drug therapy doesn't 'cure' OCD, it allows for a significant improvement i.n the suffering life, reducing OCD behaviours.
  • Drug therapy is cost-effective as they are cheaper than other psychological treatments, which is preferred for health services that have a budget they must adhere to. 
• Biological Approach to Treating OCD:Limitations

  • Side-effects: Drug therapies can have potentially serious side effects: With SSRIs, these side effects can include; blurred vision, loss of sexual appetite, irritability, indigestion, and sleep pattern disruption.
  • High relapse rates once patients stop taking the drug.
  • Publication bias has been shown that positive results are more likely to be published than not,
• Exam

  Drug therapy 

  SSRIs (Selective Serotonin Reuptake Inhibitors)

  • The work solely on the neurotransmitter serotonin which is associated with OCD 
  • They inhibit/prevent  the re-uptake/ absorption of serotonin, which happens too fast in people with OCD 
  • By preventing the reabsorption of and breakdown of serotonin, SSRIs effectively increase levels of serotonin in the synapse, which results in the neurotransmitter remaining active in influencing the post-synaptic neuron 
  • The average time for SSRIs to take effect is 4 months, before they impact on symptoms