psychopathology

• what is deviation from social norms?

  - when someone behaves in a way that is not expected

  - social norms refers to society having a collective judgement and expectation about what behaviour is acceptable.

  - E.g. DSM- 5 identifies one symptoms of antisocial personality disorder as 2 the absence of prosocial internal standards". So a psychopaths behaviour is considered abnormal in a wide range of cultures
• What is statistical infrequency?

  - Define behaviours as normal/ abnormal based on the number of times we have observed it.

  - Human characteristics cluster around an average, which is called normal distribution.

  -E.g. average IQ is 100 and 68% of people score between 85-115 . Only 2% of people score below 70 and are classified as "abnormal" with the intellectual disability disorder.
• What is failure to function adequately?

  - When individuals are unable to maintain basic standards and requirements of everyday; or are unable to hold down a job or maintain relationships.

  -Rosenhan and Seligman proposed signs of this: no longer conforming to interpersonal rules, experiencing severe personal distress, behaviour becoming irrational and dangerous.
• What is deviation from ideal mental health?

  -Criteria that we need to follow to be considered normal.

  -Jahoda came up with this criteria which includes: ability to self actualise, cope with stress, have good self esteem, lack guilt and be independent of other people.
• Criticism of statistical infrequency

  -Labelling doesn't always benefit an individual, as it can lead to self-fulfilling prophecy.

  -E.g. if someone has a very low IQ but wasn't distressed and coping with life, then labelling them as abnormal would only have a negative impact.
• Criticism of deviation from social norms

  - Culturally and historically relative.

  -Social norms vary drastically from one culture to another. What we deem as normal and abnormal in the UK in the 21st Century may be very different to the standards of other cultures and generations.

  -E.g. some societies class children out of wedlock as deviation from social norms, whereas others see it as perfectly normal.
• Criticism of failure to function adequately

  - Relies on subjective requirements.

  - Because it relies on classification systems e.g. global assessment functioning scale. This is a criteria which is used by psychiatrists which rely on their subjective interpretations, which can be biased.

  - As a result this definition lacks objectivity.
• Criticism of ideal mental health

  - Sets unrealistically high standards.

  -Very few people would be able to obtain the standards set by Jahoda, so according to this criteria majority of us would be classified as abnormal.

  - However, does give us a mental health to strive towards. So, it is often used in counselling so patients can focus on one aspect at a time, meaning it has real life applications.
• What is the two process model?

  - designed by mowrer.

  - Phobias acquired by classical conditioning and maintained by operant conditioning.
• How are phobias acquired?

  - classical conditioning

  -This is a basic form of learning where a neutral stimulus is repeatedly paired with another stimulus called the unconditioned stimulus. Neutral stimulus becomes associated with the conditioned stimulus and elicits the same response.
• Outline the Little Albert study

  - Before conditioning, rat is the neutral stimulus which creates no response. The loud bang is the unconditioned stimulus which creates an unconditioned response of fear and anxiety.

  - During conditioning, the rat is paired with the loud bang which creates an unconditioned response of fear.

  - After conditioning the rat becomes the conditioned stimulus creating a conditioned response of fear

  - Generalisation of fears occurs when the conditioned response of fear applies to all similar phobic stimuli. E.g. Little Albert is scared of all furry things.
• How are phobias maintained?

  -operant conditioning

  -Once a fear is established, we avoid objects or situations producing fear

  - This reduces anxiety. It also strengthens fear and makes it more likely that this object or situation will be avoided in the future.
• Criticism of the two process model

  - fails to take account of evolutionary factors of phobias.

  - Many people have phobic responses to things that were a source of danger in our past e.g. snakes and the dark.

  -Evolutionary psychologists believe that there were adaptive advantages to fearing such things. Seligman called this biological preparedness, which is an innate predisposition to acquire such fears.

  - However, many people aren't fearful of things such as guns and cars which cause greater danger today. Because they only exist in recent society we have not developed biological preparedness yet.

  - So, two process model is oversimplified.
• Strength of two process model

  - Has real world applications

  - Because its good explanatory power has led to successful treatments e.g. flooding and systematic desensitisation. The idea behind these therapies is that the patient cant practice avoidance and must be exposed to stimuli. So, the phobia cant be negatively reinforced and a new association is learnt.

  - Therefore, this is a strength as it is used in counselling etc.
• Criticism to the two process model


  - There are alternative explanations for avoidance

  -Not all avoidance behaviour is associated with phobias.

  -E.g. in agoraphobia staying in the house is due to feeling safe there, which explains why some people will leave their house with someone else but not alone.

  - Problem for the two process model as it can't account for non-specific phobias such as agoraphobia.
• What are the aims of behavioural treatments for phobias?

  - Aim to reduce phobic anxiety through classical conditioning where a new response to phobic stimuli is paired with relaxation instead of anxiety ( counterconditioning)

  - Aims to reduce phobic anxiety through operant conditioning where there is no option for avoidance behaviour.
• Describe systematic desensitisation


  - Teaches patients a more appropriate association and is designed to reduce unwanted response e.g. anxiety to stimulus

  - Reciprocal inhibition= 2 competing emotions cant occur at the same time, so if fear is replace with relaxation the fear cant continue

  -1st anxiety hierarchy is constructed by patient and therapist. Creates a stepped approach to getting the person to face the object or situation of their phobia from least to most frightening

  - Next the patient is trained in relaxation techniques

  - Finally the patient is exposed to phobic stimuli while practicing relaxation techniques as feelings of anxiety arise

  - Process continues by patient moving up the hierarchy
• Describe flooding


  - Individual's senses are overwhelmed with phobic stimuli , so they realise no harm occurs

  -No relaxation techniques are used and there is no build up. This causes anxiety to reach a peak, meaning it has to come back down. Individuals are exposed repeatedly and in an intensive way, their senses are flooded with thoughts, images and actual experiences of the object of their phobia

  - This stops phobic responses very quickly and without the option for avoidance behaviour , the patient quickly learns that the phobic stimulus is harmless.

  -The learned response is extinguished when the conditioned stimulus is encountered without the unconditioned stimulus.
• Strength of systematic desensitisation

  - It is a simple process that the patient controls.

  - This makes it a suitable form of treatment for patients including children and people with learning difficulties.

  - Other therapies such as flooding would overwhelm these patients and CBT would leave them confused due to discussion of complex cognitive processing.

  -So, systematic desensitisation is an appropriate therapy for the majority of patients.
• Strength of systematic desensitisation

  - Patient can be exposed to phobic stimuli in virtual reality

  - This is cost effective as the client and therapist don't have to leave the consultation room. Also less dangerous as the phobic stimuli cant physically harm them.
• Strength of flooding


  - cost effective

  - Flooding can work in as little as one session as opposed to 10 sessions of systematic desensitisation to achieve the same result.

  -This means more people can be treated at the same cost with flooding than with systematic desensitisation or other techniques.
• Limitation of flooding


  - Is a traumatic experience

  - Confronting one's phobic stimuli in extreme from provokes tremendous anxiety

  - Patients and therapists rated flooding as significantly more stressful than systematic desensitisation

  -Raises an ethical issue for psychologists of knowingly causing stress to their clients

  - Traumatic nature leads to much higher attrition rates than systematic desensitisation, so therapists may avoid this treatment.
• what is faulty information processing in Beck's cognitive explanation for depression?

  - People with depression make fundamental errors in logic. They attend to the negative aspects of a situation and ignore the positive. Have a tendency to blow small problems out of proportion and view themselves as either a success or failure, ignoring the middle ground
• What is negative self schema in Beck's cognitive explanation for depression?

  - self schemas are a package of ideas we have about ourselves

  - People with depression have developed negative self schemas, so interpret all info about themselves in a negative way
• What is the negative triad in Beck's cognitive explanation of depression?

  - Beck built on the idea of maladaptive responses and suggested that people become trapped in a cycle of negative thoughts.

  -Have a tendency to view themselves, the world and the future in negative ways
• What does the A in Ellis' ABC model stand for?

  - Activating event. This is something that happens to or around someone. E.g. Mary breaks up with her boyfriend
• What does the B in Ellis' ABC model stand for?

  -Beliefs

  - The activating event causes someone to have either rational or irrational beliefs.

  - E.g. of rational belief= Mary tells herself that although the breakup is sad they weren't compatible with each other and she will learn from that experience

  -E.g. of irrational belief= Mary tells herself that the breakup is her fault and that she is unlovable and will always fail on her relationships.
• What does C stand for in Ellis' ABC model?

  - Consequence

  - Rational beliefs lead to desirable consequences e.g. Mary is looking forward to forming new healthy relationships and learns from her experience

  - Irrational beliefs lead to undesirable beliefs e.g. mary is deciding not to form new relationships as she will only fail and get hurt
• Strength of Beck's theory of cognitive vulnerabilities

  - Has practical applications in CBT

  -Beck's explanation forms the basis of CBT, as all cognitive aspects of depression can be challenged in CBT

  -Negative self schemas can be challenged as the therapist provides evidence for why these schemas are irrational

  - Useful because research has shown pregnant women who showed cognitive vulnerabilities are more likely to develop post natal depression. This can lead to targeted intervention with particular mothers to help prevent the onset of depression
• Criticism of Beck's theory

  - Doesn't explain all aspects of depression

  -Theory explains basic symptoms of depression, however it is a complex disorder with a range of symptoms , not all of which can be explained. E.g. some people experience extreme anger, hallucinations and delusions. These symptoms require different explanations.

  - Therefore, cognitive vulnerability isn't a particularly good explanation for depressive phenomena
• Strength of Ellis' ABC model

  - Has practical applications in REBT.

  - Ellis' explanation has led to successful therapy, irrational beliefs are challenged and disputed by the therapist.

  - This can help reduce depressive symptoms suggesting that the irrational beliefs had some role in depression
• Limitation of Ellis' ABC model


  - Only offers a partial explanation

  - Some depression, known as reactive depression does occur as a result of an activating event.

  - However, not all depression arises as a result of an obvious cause e.g. endogenous depression are cases of depression which aren't traceable to life events and it is not obvious what leads to a person becoming depressed at a particular time

  - Therefore, this model cant explain all types of depression
• What is CBT?


  - Involves both cognitive and behavioural elements

  -Cognitive element aims to identify irrational and negative thoughts which lead to depression. Aim is to replace these negative thoughts with more positive ones

  - Behavioural element encourages patients to test their beliefs through behavioural experiments and homework.

  - There are 2 strands of CBT based on Beck's and Ellis' ABC model. All CBT starts with an initial assessment where patient and therapist identify problems. They agree on a set of goals and how to achieve these.
• Describe Beck's cognitive therapy

  - Therapist helps the patient identify negative thoughts in relation to the world, themselves and the future, using Beck's negative triad

  -Patient and therapist work together to challenge these irrational thoughts, using reality testing

  - Therapist then sets a homework task to challenge and test the patient's negative thoughts.
• Describe Ellis' rational emotive behavioural therapy


  - ABC model was extended to include D (dispute) and E (effect)

  - Main idea is to challenge irrational thoughts, which is achieved through argument. The therapist disputes patient's irrational beliefs to replace them with effective beliefs and attitudes

  - 2 different types of dispute: logical dispute ( therapist questions the logic of a person's thoughts) or emperical dispute ( therapist seeks evidence of a person's thoughts.
• Strength of CBT


  - Is as effective as antidepressants in treating depression

  -researchers examined 327 adolescents diagnosed with depression and looked at the effectiveness of CBT and antidepressants. After 36 weeks, 81% of the CBT group and 81% of the antidepressant group had significantly improved

  - So, CBT can be seen as an effective and useful form of treatment
• Limitation of CBT


  - Alone, it may not work in the most severe cases.

  - This is because patients with severe depression find it hard to engage with a therapist discussing logical thinking. So, a patient may need to be given medication before engaging with CBT

  - This limits the effectiveness of CBT as a treatment of depression
• Strength of CBT


  - Has a positive impact on the economy

  - World health organisation predicted that by 2020 depression will become the biggest single burden due to lowered productivity and unemployment

  - Psychological research shows that people with depression are less likely to suffer relapse after having CBT. May initially be more expensive but in the long term is more economically sound due to reduced sick pay and time off work.
• Criticism of CBT


  - It's success may not be due to techniques used

  - Methods in CBT and REBT isn't whats effective, its the relationship that's created by the therapist. It can often be found that depressed people have felt isolated with a lack of opportunity to talk without judgement.

  - So, the technique suggested by Beck and Ellis isn't any more effective than client-centred approach to therapy.
• What is the genetic explanation of OCD?

  - Focued on identifying specific candidate genes, which predisposes some individuals to OCD.

  - COMT gene = associated with OCD. Regulates dopamine, variation of this gene can lead to higher levels of dopamine, which is common in OCD patients

  - SERT gene affects transport of serotonin and can cause lower levels of serotonin, which is common in OCD patients.

  - Whether a person OCD is partly due to genes, which explains why patients often have other family members with OCD.