PP condensed flashcards

• Definitions of abnormality- statistical infrequency:

  AO1- number of times it is seen, e.g. intellectual disability disorder, most have an IQ between 85 and 115, those under 70 are statistically abnormal and diagnosed

  AO3- Strength: real-life application, all assessment of patients with mental disorders includes some comparison to statistical norms. Limitation: unusual characteristics can be positive, e.g. IQs over 130 are considered abnormal but not undesirable and requiring treatment, so it should never be used alone
• Definitions of abnormality- deviation from social norms

  AO1- when someone behaves in a way different from how they're expected to, as decided by societies and social groups, e.g. antisocial personality disorder: failure to conform to 'lawful and culturally normative ethical behaviour'

  AO3- Limitation: APD shows there is a place for deviation from social norms in defining abnormality, but there are other factors to consider like distress to others due to APD. Limitation: culturally relative, e.g. hearing voices is acceptable in some cultures but is seen as a sign of abnormality in the UK
• Definitions of abnormality- failure to function adequately:

  • AO1- cannot deal with the demands of everyday life, e.g. personal hygiene or keeping a job, may no longer conform to interpersonal rules or experience personal distress, e.g. intellectual disability disorder, for diagnosis there would have to be clear signs the person is not able to cope with the demands of everyday living
  • AO3- Strength: recognises patient's perspective. Limitation: hard to say someone is really failing to function, people who live alternative lifestyles or do extreme sports may be seen as behaving maladaptively, so we could be limiting freedom
• Definitions of abnormality- deviation from ideal mental health:

  • AO1- what makes someone psychologically healthy, Jahoda's criteria, e.g. realistic view of the world, can successfully work, love and enjoy our leisure and we are rational and perceive ourselves correctly
  • AO3- strength: comprehensive, covers a broad range, good tool for thinking about mental health. Limitation: unrealistic, very few will ever meet all the criteria, meaning they'd be considered abnormal, but does make it clear how people could benefit from seeking mental health
• AO1- Characteristics of phobias:

  • Behavioural- panic (e.g. screaming, running away) and avoidance
  • Emotional- anxiety & fear, and unreasonable responses (widely disproportionate to the threat posed)
  • Cognitive- specific attention to the phobic stimulus and irrational beliefs (e.g. social phobics may think 'I must always sound intelligent)
• AO1- characteristics of OCD:

  • Behavioural- compulsions (actions carried out repeatedly in a ritualistic way to reduce anxiety) and avoidance
  • Emotional- anxiety and distress, and guilt and disgust (e.g. over a minor moral issue or to something external like dirt)
  • Cognitive- obsessive thoughts (90% have obsessive thoughts), and insight into excessive anxiety
• AO1- characteristics of depression:

  • Behavioural- activity levels (reduced levels of energy, making them lethargic) and disruption to sleeping and eating behaviour
  • Emotional- lowered mood (e.g. 'worthless' or 'empty') and anger (e.g. aggression or self-harming behaviour)
  • Cognitive- poor concentration and absolutist thinking ('black and white thinking')
• AO1- behavioural approach to explaining phobias:

  • Mowrer argued phobias learned by classical conditioning and maintained by operant conditioning
  • Watson and Raynor: Little Albert and the white rat, he also showed fear in response to other white furry objects like a fur coat
  • Maintenance by operant conditioning takes placed when behaviour is reinforced or punished- negative reinforcement: when a phobic avoids the phobic stimulus they escape the anxiety they would have experiences
• AO3- behavioural approach to explaining phobias:

  • Strength- two-process model has good explanatory power, went beyond Watson and Reynor's simple classical conditioning of phobias, has important implication for therapy in reducing avoidance behaviour
  • Limitation- not all bad experiences lead to phobias, sometimes they do and it is clear to see how it is the result of conditioning but some done, suggests they must only develop where there is a vulnerability
  • Limitation- ignores cognitive aspects and focuses on behaviour, maintenance of phobias in terms of avoidance ignores cognitive elements of phobias
  • Limitation- more complex behaviour like agoraphobia, evidence that avoidance motivated by positive feelings of safety, explains why some can leave house with trusted friend with little anxiety but not alone
• AO1- behavioural approach to treating phobias:

  • Systematic densensitisation- gradually reduce anxiety through counterconditioning, pairs the CS with relaxation and this become the new CR instead of fear, reciprocal inhibition means it isn't possible to be afraid and relaxed at same time, so one prevents the other, patient and therapist design anxiety hierarchies, individual is taught relaxation techniques and then works through hierarchy, treatment successful when person stays relaxed in situations high on hierarchy
  • Flooding- bombarding phobic with phobic object, without option of avoidance patient quickly learns object is harmless through exhaustion of fear response (extinction), flooding not unethical but unpleasant so patients must give fully informed consent, must be fully prepared and know what to respect
• AO3- behavioural approach to treating phobias:

  • Strength- Gilroy et al. followed up patients who had SD for arachnophobia, at 33 months SD still less fearful than control group with relaxation without exposure, shows it is long-lasting
  • Strength- patients prefer SD as it doesn't cause same degree of trauma as flooding, SD also has elements that are pleasant, e.g. talking with a therapist, reflected in low refusal and attrition rates
  • Limitation- flooding is traumatic, patients unwilling to see it through to the end, means treatment is not effective and time and money are wasted preparing patients for them to refuse to start to complete treatment
  • Limitation- flooding less effective for complex phobias, e.g. social phobias, as social phobias have cognitive aspects (not just anxiety but unpleasant thoughts), this may benefit more from cognitive therapy that tackle the irrational thinking
• AO1- cognitive approach to explaining depression:

  • Beck said some people are prone to depression due to faulty information processing, they ignore positives, blow things out of proportion and think in 'black and white' terms
  • They have negative self schemas- interpret all information about themselves in a negative way
  • Beck's negative triad: negative views of the world, future and self
  • Ellis' ABC model: A- activating event (depression arises from negative events), B- beliefs (e.g. 'musterbation': belief we must always succeed, and 'utopianism': belief world must always be just and fair), and C- consequences (when activating event triggers irrational beliefs there are behavioural and emotional consequences, e.g. if you believe you must always succeed and fail then the consequence is depression)
• AO3- cognitive approach to explaining depression:

  • Strength- Graziosi and Terry assessed pregnant woman for cognitive vulnerability and depression before and after birth, high vulnerability ppts more likely to develop post-natal depression, these cognitions seen before depression develops suggesting Beck may be right about cognition causing depression sometimes
  • Limitation- complex disorder, some are deeply angry, experience hallucinations, or bizarre beliefs like Cotard's syndrome, Beck can't explain this
  • Limitation- psychologists call depression following activating events reactive depression, and see it as different from depression without an obvious cause, means Ellis' explanation only applies to some kinds of depression
  • Strength- Beck's cognitive explanation forms basis of CBT, negative triad can be easily identified and challenged in CBT and can test whether elements of negative triad are true
• AO1- cognitive approach to treating depression

  • Beck's CBT- identify where there is negative or irrational thought that will benefit from challenge (e.g. negative triad self, world and future), 'patient as scientist': encouraged to test reality of their beliefs, set homework tor record when people are nice to them, if they say nobody is nice to them in future sessions therapist can produce evidence to prove them wrong
  • Ellis' REBT- extends to ABCDE model (D- dispute irrational beliefs, E- effect), patient may say how unlucky they are or how unfair life is, REBT therapist would see this as utopianism and challenge: empirical argument (whether there is evidence support) and logical argument (does it follow from the facts), also works to decrease patients avoidance (which increases as individuals become more depressed and worsens depression) and increase engagement in things shown to improve mood e.g. exercising
• AO3- cognitive approach to treating depression:

  • Strength: research support, March et al. 81% improvement in CBT group, 81% of antidepressant group and 86% of CBT+ drugs, shows just as effective as medication and helpful alongside medication
  • Limitation- ignores past, other forms of psychotherapy make links between childhood experiences and current depression, 'present-focus' of CBT may ignore an important aspect of the depressed patient's experience
  • Limitation- overemphasis on cognition, ignores influence on circumstances, e.g. if someone is in poverty or in abuse they need to change that, CBT techniques used inappropriately can demotivate people to change their situation
  • Limitation- may not work for severe cases, patients may not be able to motivate themselves to take on the hard cognitive work for CBT, this is where drugs come in handy, means CBT cannot be used as the sole treatment for all cases of depression
• AO1- biological approach to explaining OCD:

  • Serotonin genes, e.g. 5HT1-D beta, dopamine genes also implicated
  • OCD is polygenic- Taylor et al. found over 230 genes involved in OCD
  • Aetiologically heterogenous- one group of genes may cause it in one person but a different group in another
  • Some types, like hoarding disorder, associated with impaired decision making, may be associated with abnormal functioning of the lateral frontal lobes of the brain (responsible for logical thinking and making decisions)
  • Also evidence to suggest the left parahippocampal gyrus associated with processing unpleasant emotions functions abnormally in OCD
• AO3- biological approach to explaining OCD:

  • Strength- Nestadt et al. 68% of MZ twins shared OCD as opposed to 31% of DZ twins
  • Limitation- psychologists not successful at pinning genes down all genes, appears several genes involved and each only increases risk of OCD by a fraction, unlikely that a genetic explanation will ever be useful as it has little predictive value
  • Strength- antidepressants that work on serotonin system effective on reducing OCD symptoms, suggests serotonin systems involved in OCD. OCD symptoms also form part of biological conditions like Parkinson's disease, suggests biological processes that cause symptoms in these conditions may be responsible for OCD
  • Limitation- co-morbidity, OCD sufferers get depressed, depression involves disruption to serotonin system, logical problem- could be that serotonin system is disrupted in many with OCD because they are depressed as well
• AO1- biological approach to treating OCD:

  • SSRIs- prevent reabsorption and breakdown of serotonin in the brain, increases its levels in synapse so serotonin continues to stimulate postsynaptic neuron- compensates for whatever's wrong with serotonin system in OCD. Typical daily dose of fluoxetime (SSRI) is 20mg, may be increased if not benefitting patient, takes 3-4 months of daily use to impact on symptoms
  • Drugs often used alongside CBT, they reduce emotional symptoms so they can engage more effectively with CBT
  • Tricyclics- older type of antidepressant, same effect on the serotonin system as SSRIs but may have more severe side-effects
  • SNRIs- second line of defence for patients who don't response to SSRI's, increase levels of serotonin as well as nonadrenaline
• AO3- biological approach to treating OCD:

  • Strength- Soomro et al. reviewed studied comparing SSRIs to placebos- all significantly better results for SSRIs, effectiveness greatest when combined with psychological treatment
  • Limitation- controversy attached, some believe evidence favouring drug treatment is biased as it is sponsored by drug companies who dont report all evidence, may suppress evidence that doesn't support effectiveness of certain drugs to maximise their economic gain
  • Limitation- OCD widely believed to be biological, so makes sense treatment should be biological, however is sometimes response to traumatic life events, not appropriate to use drugs when treating cases that follow trauma when psychological therapies may provide best option
  • Strength- drugs cheap compared to psychological treatments, good value for NHS, also non-disruptive to patients' lives, so many doctors and patients like drug treatments for this reason