psychopathology

• Behavioural characteristics of OCD

  • Compulsions=repetitive behaviours that reduce anxiety
  • Rigid behaviour
  • Superstitious behaviour
• Cognitive characteristics of OCD

  • Obsessions= recurrent,intrusive thoughts that cause anxiety
  • Self doubt= leading to constant checking
  • Irrational beliefs
• Emotional characteristics of OCD

  • anxiety
  • Distress
  • worry
  • fear
• Behavioural characteristics for Phobias

  • panic
  • Avoidance
  • Endurance
• Cognitive characteristics of phobias

  • selective attention to phobia stimulus
  • Cognitive distortions
  • Irrational beliefs
• Emotional characteristics of phobias

  • fear
  • anxiety
  • unreasonable emotional response
• Behavioural characteristics of depression

  • suicide attempt
  • disturbed sleep
  • change of appetite
  • loss of energy and poor self care
• Emotional characteristics of depression

  • sadness
  • anxiety
  • irritability
• Cognitive characteristics of depression

  • low self esteem
  • suicidal thoughts
  • negative thoughts
  • guilt
• Deviation from ideal mental health 


  If a person fails to meet at least one of these criteria they are abnormal.

  1. Self attitude= high self esteem
  2. Personal growth= reaching your full potential
  3. Integration= able to cope with stress
  4. Autonomy= not influenced by others
  5. Perception of reality= need to be accurate
  6. Environmental mastery= work/ leisure/ home life should be fulfilling
• Genetic explanations of OCD

  • Candidate genes= specific genes that might cause OCD. For example, SERT gene which creates low levels of serotonin, implicated in OCD.
  • Polygenetic= interaction of genetic vulnerabilities causing OCD. Linked to this is aetiological heterogeneous which means OCD is caused by different genes in different people.
  • Diathesis stress model= A genetic vulnerability to OCD is inherited but it must be triggered by a stressful event ( not reductionist)
• Evaluation for genetic explanations of OCD

  -Able to inform individual if they can inherit OCD but doesn't identify a treatment or way to deal with it. Limited practical usage.

  Studies:

  • Lewis found that those with OCD: 37% had parents with OCD, and 21% had siblings with OCD
  • Marini et al found 4X more likely to be diagnosed with OCD if you have a relative with OCD
• Neural explanation of OCD

  • Neurotransmitters: low levels of serotonin cause OCD. Thought to be because serotonin is a neurotransmitter that regulates moods and with low levels transmission of relevant mood information does not take place.
  • lateral frontal lobe: responsible for logical thinking and decision making. Abnormal functioning can lead to illogical thinking which is seen in OCD sufferers.
• Evaluation of biological (neural) explanations for OCD

  + low serotonin supported by the usage of anti-depressants (increase serotonin) providing relief for OCD patients.

  -influence of cofounding variables: often people with OCD is co-morbid with depression, which is also thought to be caused by low serotonin. Therefore can't be sure that low serotonin causes OCD as well as depression. No real cause and effect

  +Useful practical application= led to development of drug therapy (SSRI)
• Flooding=Exposure to feared phobia with no hierarchy. Negative association with phobia become extinct .
• Systematic desensitisation=gradually being exposed to the phobia by learning relaxation techniques to work through the anxiety hierarchy. It counter conditions postive association to replace negative association of the phobia.

  Process:

  1. Create anxiety hierarchy
  2. Learn relaxation techniques
  3. Work through the hierarchy using relaxation techniques- don't move up until completely calm
• Evaluation of systematic desensitisation (SD)

  +wide application= postive effect with people with learning difficulties since they struggle with cognitive therapy.

  +considered more ethical since it is patient centred= patients are in control of their progressive makes it more effective.

  +research support= Gilroy examined 42 patients with fear of spiders. SD was effective even 33 months later. Support for effectiveness.
• Evaluation of systematic desensitisation: SD

  -Impractical or impossible to access the top level of the hierarchy. E.g. flying a plane. Some patients don't have access
• Evaluation of flooding


  -less ethical: Don't feel like they are protected from harm. Even though people sign a consent form there is a high rate of drop outs becuse it is an unpleasant experince.

  -alternative treatment CBT: successful for social phobias. Flooding just treats the symptoms but don't treat the underling issue which is what CBT tries to do.
• Evaluation of flooding

  +cost effective and quick: only one lesson needed. for patient and health service providers much cheaper. Positive economical implications.

  +Research support: Wolpe treated this a girl's fear of car rides by driving her for 4 hours until she became less hysterical. Phobia disappeared.
• Deviations from social norms 


  Abnormality is going against accepted standard behaviours within a culture and group. Behaviours can be implicit or implicit.

  +Able to maintain a civilized society. Protects society from abnormal behaviours since it is socially made know in a culture.

  -Cultural relativism

  -Social control arising

  -lacks temporal validity e.g. homosexuality not considered abnormal to late 1990
• Statistical infrequency 


  Abnormal behaviour is rare. Has to be two standard deviations away from the mean on a normal distribution curve.

  +objective mathematical measurement

  -cultural relativism

  -inaccurately measures desirable behaviours as undesirable behaviours e.g. high IQ

  -Cut of point of being two standard deviations away is subjective
• Failure to function adequately 


  Abnormal if they are unable to carry out day to day tasks. According to Seligman and Rosenhan 7 criteria show an individual is failing to function adequately e.g. observer discomfort and maladaptive behaviour.

  + Able to recognise who needs help

  -normal to meet some of these criteria e.g. going through a loss

  -culturally relative

  -Subjective ( maladaptive behaviour- Yorkshire serial killer under delusion they protecting themselves and others)
• Deviation from ideal mental health 


  According to Johada this is not meeting all 6 criteria: personal growth, self attitude, integration, accurate perception of reality, environmental mastery, autonomy. Failure to meet one makes an individual abnormal.

  +positive focus: desirable behaviour, motivating as goals can be meet

  -culturally relative- Autonomy not a criteria in collectivist cultures

  -Difficult to measure- Subjective

  -Optimistic and unrealistic to meet every criteria
• Biological approach to treating OCD


  SSRIs are an antidepressant that act on the serotonin system. Aims to increase levels of serotonin because people with OCD have less serotonin being released and more reabsorbed too quickly.

  Process:

  Blocks reuptake of serotonin, increases levels of serotonin in synapse. Post synapse neuron more likely to fire and this compensates for lack of serotonin.
• Evaluation for treatment for OCD 


  -Treats symptoms not the cause of the disorder. Doesn't treat underlying cause of OCD, just reduce anxiety. Easier to relapse since this is a form of short term effectiveness. CBT may be a more effective long term solution for a treatment and cure.
• Evaluation for treatment of OCD


  + More convenient for users and health services. Requires little input from user in terms of effort and time. Therapies such as CBT, require patient to attend regular meeting and face their problems which can cause uncomfortability. Also, it is much cheaper for health services and requires little monitoring. More patients are willing and it has positive economical implications.
• Evaluations for treatment of OCD 


  -Side effects. According to NHS dizziness and nausea are some side effects. Can influence people's decision to take them or not. Also, can cause more health issues that add to health service problems.
• Evaluation of treatment for OCD


  -Ethical concerns: lack of independent studies into the effectiveness. This is a problem since large drug companies sponsor these drugs and this makes patients question the reliability. Also, many doctors in America get paid more commission if they prescribe more drugs. This makes OCD suffers feel like their protection is not harmed.
• Evaluation for treatment of OCD 


  +Research support for effectiveness: Soomro et al found SSRIS more effective than placebo in treatments for OCD across 17 different trials.
• Evaluation of treatment for OCD


  -Alternative treatment=The treatment is called exposure and response prevention (ERP) similar to systematic desensitisation. They experience their feared stimulus while being prevented from performing compulsive behaviour.
• Behavioural approach to explaining phobias 


  The two process model proposed by Mowrer.

  Classical conditioning acquire phobia. A neutral stimulus is associated with something UCS which is something that naturally causes fear. This creates UCR of fear.

  Operant conditioning maintains phobia. The avoidance of the phobic stimulus reduces anxiety. This is negative reinforcement.
• Evaluation of behavioural explanations for phobias 


  +research support: Little Albert study. Fear of white rats learnt through two process model.

  +Practical application: developed effective therapies. Systematic desensitisation and flooding.

  -nurture explanation is focus but alternative explanations :Biological preparedness explains more common phobias like snakes and spiders. Developed because of survival of the fittest.
• Evaluation of behavioural explanation for phobia

  -Reductionist:

  Cognitive explanations for irrational thoughts. Especially for social phobias were CBT is more effective.

  Biological explanation: Diathesis- stress model. Inherit genetic vulnerability for phobic stimulus only triggered in stressful situation. More holistic.
• Ellis' ABC Model

  1. Activating event. An event happens.

  2. Belief. Event triggers a negative belief

  3. Consequence. Stops trying, more failure and develops depression as a result of their low mood
• Beck's negative triad 


  Explains how negative self schemas cause depression.

  Negative views about oneself, the world and the future

  Beck also identified faulty thinking which are self defeating and cause anxiety or depression e.g. magnification and minimisation.
• Evaluation of cognitive explanations of depression

  -blames client not situational factors: focus is on the mind rather than client's life and environment

  -alternative explanation: biological approach, low levels of serotonin causes depression

  +practical application: developed CBT treatments

  +Research support: Alloy et al placed Americans in their early 20s into groups of positive and negative thinking. Able to determine this since he followed them for 6 years. Found after 6 years 1% in positive group developed depression 17% in negative group.
• Evaluation for cognitive treatment of depression 


  + Research support: March et al found CBT just as effective as anti depressants and particularly effective when combined with them.
• Evaluation for cognitive treatment of depression 


  -Time consuming and requires effort: less people willing to do it and if they did high relapse rates since they have to discuss feeling their uncomfortable with.

  -Holistic treatment: doesn't just consider cognitive treatments but also uses behavioural experiments such as HW tasks.

  -Alternative treatment: anti-depressants.

  -Negative economical implication: Health services invest a lot of money into these treatment and may not always work out. Requires constant monitoring.
• CBT-Cognitive behaviour therapy

  Cognitive element: identify irrational and negative beliefs. Replace negative with postive thoughts. Behavioural element: encourage patients to test belief through behavioural experiments and HW.

  Two treatment:

  Ellis' REBT

  Beck's cognitive therapy