Psychopathology

• Characteristics of depression

  • about 20% of people will suffer from some sort of depression - women are twice as vulnerable as men
• Characteristics of OCD

  • cognitive = obsessions - repetitive, intrusive and unpleasant thoughts
  • behavioural = compulsions -
  • emotional = extreme anxiety, distress and guilt caused by the obsessions and compulsions
• Behavioural explanations for Phobias - EVAL

  FOR

  • Barlow & Durand (1995) - 50% of people with a phobia for driving could remember a specific incident (car accident) that triggered their fear - shows that phobias are learnt - (Against) HOWEVER, about 50% of people with phobias cannot recall a specific event that triggered the fear.
  • helped develop treatments for phobias - eg systematic desensitisation - shows phobias can be unlearnt
• Behavioural explantaions for phobias - EVAL

  AGAINST

  • phobias don't always start with a traumatic experience for everyone
  • DiNardo (1988) - not everyone who is bitten by a dog develops a fear of dogs. Some phobias can be explained by evolution. It makes sense to be afraid of heights, fire, spiders etc. as they are dangerous and avoiding them helps us survive.
• Cognitive explanations for depression

  Beck's negative triad - pessimistic thoughts about, self, the world and the future

  • depressive-prone people have negative schemas developed from childhood which lie dormant until they are activated stressful or negative life events - means they interpret the world negatively
  • Beck believed that a dysfunctional style of thinking is maintained by cognitive biases, or errors in how we process information about ourselves.
  • This lead us to focus on negative aspects of experiences, interpret things negatively, and block positive memories.
• Cognitive approach to treating depression

  CBT - Beck

  Cognitive therapy is a form of psychotherapy that focuses on how a person’s thoughts lead to feelings of distress. It was developed as an expansion of Beck's theory.

  • The idea behind cognitive therapy is that how you think determines how you feel and act.
  • Cognitive therapists help their clients change dysfunctional thoughts to relieve distress.
  • They help a client see how they misinterpret a situation (cognitive distortion) and how to view situations in a more positive light.
• Cognitive explanations for depression

  • cognitive bias - eg overgeneralisations - making sweeping conclusions based on one single negative events
  • eg if a student gets one bad result on a test they may use this as proof of their worthlessness
• Cognitive approach to treating depression

  Ellis developed an ABC model that can be used in therapy. ABC stands for:

  • Activating event - something that happens in the environment around you that causes the thoughts and feelings
  • Belief - this is the person’s thoughts/ beliefs about the activating event (how they interpret it). In the depressed person, the belief may be irrational.
  • Consequences - the emotional response/ actions to the belief - eg a feeling of worthlessness
• Evaluation of CBT

  Strengths

  • Allows the client to take control – builds self-esteem.
  • Less reliance on drugs than other methods.
  • Does work for many people - Ellis (1957) claimed a 90% success rate for REBT, taking an average of 27 sessions to complete the treatment.

  Limitations

  • Requires Individual motivation.
  • Relies on the competence of the therapist.
  • Works best combined with drugs.
  • Can be expensive and difficult to access (long waiting lists on NHS).
• Evaluation of the cognitive approach

  Strengths

  • It has practical applications. CBT is a successful therapy which challenges irrational beliefs.
  • Beck’s Depression Inventory and Hollon & Kendall’s Automatic Thought Questionnare (ATQ) are effective tools for diagnosing depression.

  Limitations

  • Some types of depression occur with no activating event - reactive depression.
  • Ignores biochemical explanations for depression.
  • Not all patients are able to engage with CBT or find it useful.
• EVAL - studies

  Alternative (Biological) explanations

  • Wender - adopted children that developed depression were more likely to have a depressive biological parent - despite being raised in different environments - shows the importance of biological factors (genes) over environmental ones
  • HOWEVER, concordance rates between Mz twins are not 100% so other factors such as cognitive factors must also play a role in the development of depression
• REBT - Rational Emotive Behavior Therapy - a form of cognitive therapy that focuses on the irrational thoughts that contribute to depression

  • making a patient's negative and irrational thoughts more positive and rational - reframing and challenging negative thoughts
• The Biological Approach to OCD

  Genetic explanations

  Genes make up chromosomes and consist of DNA which codes the physical features of an organism and psychological features. Genes are transmitted from parents to offspring

  Lewis: 37% of his OCD patients had parents with OCD

  21% has siblings with OCD. – Suggests that genetic vulnerability is

  passed on not necessarily as certainty of OCD.

  Diathesis-stress model: Certain genes leave some people more likely to

  suffer a mental disorder, but it is not certain – some environmental

  stress is necessary to trigger a condition
• Biological approach to OCD

  Genetic explanations

  OCD is polygenic

  • OCD is not caused by one single gene but that several genes are involved

  Taylor (2013) – found evidence that up to 230 different genes may be involved in OCD

  • Genes studied include those associated with the action of dopamine as well as serotonin, both neurotransmitters believed to have a role in regulating mood.
• Biological approach to OCD

  Neural explanations

  The genes associated with OCD are likely to affect the levels of key

  neurotransmitters as well as structures of the brain.

  The role of Serotonin

  Serotonin is a neurotransmitter which regulates our mood

  Neurotransmitters are responsible for relaying information from

  one neuron to another.

  If a person has low levels of serotonin, then normal transmission

  of mood relevant information does not take place. – Mood is

  therefore affected

  Some OCD cases can be explained the reduction in functioning of this

  system
• Biological approach to OCD

  Neural explanations - The role of Serotonin

  Hu (2006) - 169 OCD sufferers and 253 non-sufferers

  • found serotonin levels were lower in OCD patients than in the non-sufferers
  • shows that low serotonin levels are associated with the onset of OCD
• Biological explanations for OCD

  Neural explanations

  Decision-Making systems

  Some cases of OCD (hoarding disorder) may be associated with impaired decision making.

  This can also be associated with abnormal functioning of the lateral

  (side bits) of the frontal lobes (front part) of the brain.

  Frontal lobes – responsible for logical thinking and making decisions

  Parahippocampal Gyrus - associated with processing

  unpleasant emotions, functions abnormally in OCD
• Biological approach to treating OCD

  Drug therapy - SSRIs

  Selective serotonin reuptake inhibitors

  synaptic transmission:

  Serotonin (neurotransmitter) is released by the presynaptic neuron and travels across the synapse.

  • The neurotransmitters pass a message from the presynaptic neuron to the postsynaptic neuron
  • Remaining neurotransmitters are then reabsorbed by the presynaptic neuron
  • It is then broken down and reused
  • 
    
  • SSRIs prevent the reabsorption which effectively increases the levels of serotonin in the synapse
  • Therefore, increasing the amount absorbed by the postsynaptic neuron
• Biological approach to treating OCD


  Drug Therapy: Research ev - Soomro et al (2008)

  investigated the effectiveness of SSRIs in the treatment of OCD.

  • reviewed 17 studies on the use of SSRIs with OCD patients vs placebo treatments involving 3,097 patients
  • He found them to be more effective than placebos in reducing the symptoms of OCD up to 3 months after treatment i.e. the short term.
  • SSRIs are an effective treatment for OCD at least in the short term.

  EVAL: large sample and practical applications; side effects - nausea and dizziness
• Biological approach to treating OCD 


  Drug therapy: EVAL

  Strengths

  • research ev - Soomro et al - SSRI's were more effective at reducing OCD symptoms than placebos for up to 3 months
  • cheap - can be used widely and don't need a therapist to administer them

  Weaknesses

  • side effects - vary from person to person - nausea, dizziness, loss of appetite
  • they reduce symptoms but don't actually cure OCD
• Cognitive explanations for depression

  Boury et al

  monitored students’ negative thoughts with the beck’s depression inventory (BDI)

  • found depressed students misinterpret facts and experiences in a negative way and feel hopeless about the future

  supports Beck's theory: negative triad - self, future and world
• deviations from ideal mental health

  Jahoda - 6 criteria FOR OPTIMAL LIVING

  1. if you are not meeting this criteria then
  2. mastery of environment
  3. self-attitudes - high self esteem
  4. personal growth/ self-actualisation
  5. integration - coping with strewssful situations
  6. autonomy - independence
  7. accurate perception of reality
• Definitions of abnormality 


  deviation from ideal mental health - Jahoda - EVAL

  Strengths:

  • positive approach - emphasis on positive achievements rather than failures
  • holistic - considers the person as a whole rather than focusing on the individual areas of their behaviour

  Weaknesses:

  • unrealistic to be able to meet all the criteria
  • culturally varies - different cultures perceive reality differently
• Behavioural approach to phobias

  Systematic desensitisation

  Process:

  • Relaxation training
  • Anxiety hierarchy
  • Gradual exposure to the anxiety hierarchy.