PSYCHOPATHOLOGY

• ABNORMALITY?

  DEVIATION FROM SOCIAL NORMS

  + RWA: calculate severity, suggest treatments but misdiagnosis (not obvious)

  -. low temporal validity (norms subject to change, e.g. homosexuality)

  -. abuse against non-conformists

  -. cultural relativism

  FAILURE TO FUNCTION ADEQUATELY (Rosenhan + Seligman)

  + RWA: calculate severity, GAF, diagnosis but misdiagnosis (subjective)

  -. context and individual differences (bereavement, exams)

  STATISTICAL INFREQUENCY

  + measures numerically, objective but cannot decide cut-off

  -. desirable or undesirable so treatment or none?

  -. not all benefit

  DEVIATION FROM IDEAL MENTAL HEALTH (Jahoda)

  + positive outlook on mental health (goals not stigmas)

  + holistic but difficult to meet all at once

  -. cultural relativism

  -. not effective if severe
• BEHAVIOURAL APPROACH TO EXPLAINING PHOBIAS?

  AO1:

  • learned, two-process model (Mowrer)
  • classical conditioning, association
  • operant conditioning, reinforcement (avoidance)

  AO3:

  + WATSON + RAYNER (Little Albert) but unethical

  + RWA: systematic desensitisation, flooding

  -. trauma/ irrational thinking

  -. evolutionary phobias
• BEHAVIOURAL APPROACH TO TREATING PHOBIAS?

  AO1:

  • learned, classical conditioning, operant conditioning
  • reciprocal inhibition (no two incompatible emotional states same time) - relaxed/ frightened
  • in vivo (direct exposure), in vitro (imagination)

  SYSTEMATIC DESENSITISATION (relaxation techniques, hierarchy, new association)

  + RWA: integration

  + LANG + LAZOVIK (snakes)

  + ethical, appropriate for learning disabilities/ children but not appropriate for evolutionary phobias

  -. impractical

  FLOODING (no avoidance, anxiety levels decrease, disconnect, new association)

  + RWA: integration but can worsen

  + WOLPE (cars)

  + practical

  -. not appropriate for learning disabilities/ children
• COGNITIVE APPROACH TO EXPLAINING DEPRESSION?

  AO1:

  • activity levels, sleep/ eating behaviour, aggression/ self-harm, lowered mood, lowered self-esteem, anger, negative bias, poor concentration, absolutist thinking
  • Ellis' ABC model (irrational thinking) - reactive depression (REBT)
  • Beck's negative triad (cognitive bias, negative self-schemas, negative triad, distort/ misinterpret)

  AO3:

  + GRAZIOLI + TERRY (pregnant women)

  + RWA: CBT

  -. explanatory power (cause and effect, serotonin/ genes, diathesis-stress model, anger/ hallucinations)
• COGNITIVE APPROACH TO TREATING DEPRESSION?

  AO1:

  • CBT, psychotherapy, challenge/ overcome cognitive biases, practical strategies to modify behaviour
  • identify irrational thoughts
  • challenge (disputing - logical, pragmatic (not useful), empirical (not realistic))
  • set goals, strategies (role play - practising new ways of thinking in small made-up scenarios/ behavioural activation - setting goals to engage in enjoyable behaviours)

  AO3:

  + MARCH (CBT vs drug therapy)

  + FORMAT (highly structured = motivation) but severe may not engage

  -. fails to consider biological factors (serotonin/ genes) so drug therapy

  -. impractical (expensive, wait)
• BIOLOGICAL APPROACH TO EXPLAINING OCD?

  • repetitive compulsions, avoidance, anxiety, guilt, disgust, intrusive obsessions, hypervigilance, catastrophic thinking, awareness of irrationality

  GENETIC

  • inherited COMT/ SERT genes
  • mutated COMT, less dopamine reabsorption, higher in synapse
  • mutated SERT, more serotonin reabsorption, lower in synapse

  + NESTADT (68%, 31%) but methodological issues, diathesis-stress model as not 100%

  -. individual differences (trauma) so psychodynamic targets cause

  NEURAL

  • higher dopamine, motivation, respond to intrusive obsessions with repetitive compulsions
  • low serotonin, anxiety
  • damage to prefrontal cortex, inappropriate activation, messages of safety not communicated, danger

  + SOOMRO (SSRIs vs placebo) but low explanatory power

  + MENZIES (abnormalities in prefrontal cortex of fMRI)
• BIOLOGICAL APPROACH TO TREATING OCD?

  AO1:

  • drug therapy, SSRIs or tricyclics
  • SSRIs inhibit serotonin reabsorption, decrease anxiety
  • tricyclics block reabsorption of serotonin/ noradrenaline, decrease anxiety

  AO3:

  + SOOMRO (SSRIs vs placebos) but do not cure OCD only treat (relapse so psychological therapy appropriate)

  + practical (non-disruptive, quicker and cost-effective) but side effects, dependency, withdrawal