psychopathology

• Statistical Infrequency

  Defined as abnormal if behaviour is rare

  
  

  example - fear of buttons = abnormal

  example - fear of heights = normal

  
  

  Strengths: Real Life Application, Objective - clear cutoff point

  
  

  Weaknesses: Doesn't take into account severity of behaviour, Some abnormal behaviours are desireable, Cultrual relativism - behaviours are different in different cultures
• Deviation from social norms

  Behaviour seen as abnormal if behaviour deviates from the rules of society

  explicit norms - refers to rules in a society that are policed by laws - eg wearing no clothes on a nudist beach wouldnt have you arrested but wearing no clothes in central london would

  implicit norms - refers to unwritten rules of society - getting up for a pregnant women if there are no seats

  
  

  Strengths: Distinguises between desirable and undesirable behaviour, helpful when diagnosing mental disorders

  
  

  Weaknesses: Cultral relativism - behaviour in different cultures differs, Social norms = subjective, Social norms vary over time
• Failure to function adequately

  Behaviour is abnormal when their behaviour suggests they cannot cope with the basic demands of everyday life

  3 criterias for this abnormality

  1) a person no longer conforms to interpersonal rules - holding eye contact, respecting personal space

  2) a person experiences severe personal distress

  3) a person behaviour becomes irrational or dangerous to themselves or others

  
  

  Strengths: Includes subjective experiences of the patient

  
  

  Weaknesses: Could just be a deviation from social norms, Requires judgement from external person
• Deviation from Ideal mental health

  Occurs when someone does not meet a set of criteria for good mental health

  1 - Congruence - having high self esteem and a strong sense of identity

  2 - Self-Actualisation - the extent to which a person develops their true capabilities

  3 - Integration - being a functioning member of society, able to cope with stressful situations

  4 - Autonomy - being independent and self reliant

  5 - Accurate perception of reality - having an objective and rational view of the world and yourself

  6 - Mastery of the environment - the ability to love function at work and relationships and enjoy our leisure

  
  

  Strengths: Positive approach, Broad range of criteria, focuses on desirable behaviours rather than individual failures

  
  

  Weaknesses: Cultural relativism - Self-actualisation = Western, Unrealistic standards - very few meet criteria
• Characteristic of Phobias

  Behavioural: Panic - Crying, Screaming, Avoidance

  Cognitive: Irrational beliefs, Selective attention - focusing on stimuli

  Emotional: Anxiety
• Systematic Desensitisation

  Reduces phobias through classical conditioning

  - Counter conditioning, relearning to associate phobic stimulus with relaxation instead of anxiety

  
  

  Anxiety Hierarchy: Patient and therpaist put list of phobic stimulus ranked in order from most to least frightening

  Relaxation: Therapist teaches patient how to relax as deeply as possible - breathing techniques, drugs e.g valium

  Gradual Exposure: Patient exposed to phobia while relaxed, Several sessions, start at bottom and work way up

  
  

  Strengths: Effective, patients prefer it

  Weaknesses: Symptom substitute, one phobia disappears; another takes its place
• Flooding

  Imediate exposure to very frightening situation

  - Patients cannot avoid phobia so cannot be reinforced through negative reinforcement

  
  

  Strengths: Cost effective, quicker than other methods

  Weaknesses: Less effective for complex phobias, traumatic for patients - some unwilling to go through with it
• Characteristics of Depression

  Behavioural: Change in activity levels - withdraw from work, education, social life. Aggression and Self-harm

  Cognitive: Poor concentration, Dwelling on the negative

  Emotional: Anger, Lowered Self-esteem, Low mood
• Beck's Cognitive Theory

  Faulty Information Processing

  - Depressed people have cognitive biases, blow small problems out of proportion

  Negative Self-Schemas

  Low self-esteem
• Beck's Negative Triad
• Ellis' ABC Model

  
• Cognitive Behavioural Therapy (CBT)

  Treatment for depression

  Patient + Therpaist identify irrational thoughts and maladaptive behaviours to replace these with more rational thoughts and coping stratagies
• Rational Emotive Behavioural Therapy

  Extends ABC model(D)ispute irrational thoughts and (E)xchanging these for more rational and balanced ones

  Done through vigorous arguments between patient and therapist
• Characteristics of OCD


  Behavioural: Compulsive to reduce anxiety, Social impairment, hindered everyday function

  Cognitive: Recurrent uncontrolable persistent obsessing thoughts

  Emotional: Extreme anxiety, Guilt, Accompying depression
• Genetic explanations for OCD

  Candidate genes are genes which have been found to create a vulnerability for OCD

  SERT gene: Transport of seratonin across the synapse, producing lower levels of the neurotransmitter

  OCD is polygenetic - (230 genes involved)

  Aetiologically heterogenous - multiple combinations can cause OCD

  Diastheisis-stress model - genes give vulnerability - needs enviromental trigger
• Neutral explanations for OCD

  Role of Seratonin: Neurotransmitters relay information from one neuron to another. Serotonin is an inhibitory neurotransmitter which has a calming effect on the nervous system

  - People with OCD have too little Seratonin in their brain

  - which means they are less likely to feel calm

  
• SSRI drugs

  20mg dosage - 3-4 months to have an effect, Increases level of seratonin in brain. Serotinin is released at the synapse of one neuron to pass a signal on to the next, if not used in the synapse, it goes back to the presynaptic neuron via reuptake pump. In patients with OCD they have less serotinin in areas like the orbitofrontal cortex. Drug works by blocking reuptake pump, giving serotonin more chances to cross the synapse
• Alternative treatments for OCD


  Drugs are often used in conjunction with CBT. Dosage can be upped to 60mg, if no response move to tricyclis. SNRIs another option, increase levels of noradrenaline aswell as serotonin
• PEEL paragraphs for treatments for OCD

  1) Strength = effective at tackling symptoms

  Soomro et al - Meta-analysis of 17 studies of SSRIs. All 17 studies showed bettwen outcomes from SSRIs in comparison to placebos. SSRIs work for around 70% of people

  Cost effective, minimal effort, less disruptive to patients lives

  Combination of CBT + drigs os gp tp

  
  

  2) Weakness = can cause serious side effects

  small minority will get no benefit fro SSRIs, just side effects like indigestion, blurred vision and loss of sex drive

  Positive outcomes short lived, slowly need higher doses - result in dependancy - CBT avoids

  Positive effects of SSRIs biased from big drug companies

  
  

  3) Weakness = not all cases of OCD have a biological origin

  Strong evidence for biological basis of OCD - other unknown causes

  OCD can be limited to trauatic experiences which trigger obsessvie compulsive response as coping mechanism

  Biological treatments are reductionist - treat symptoms not cause