Psychopathology

• Ellis' ABC Model

  • Activating
  • Beliefs:
  • Any failure = unacceptable when its actually normal
  • Musturbation = idea that we MUST succeed
  • Utopianism = idea life is supposed to be fair
  • Consequences - emotional and behavioural
• Define statistical infrequency

  Behaviour that is numerically unusual in a given population

   

  Assumption is that statistically frequent behaviour = normal whereas infrequent behaviour is abnormal. 

   

  Most human characteristics can be drawn this way.
• AO1 of cognitive approach for treating depression.

  CBT aims to challenge and alter negative thoughts and beliefs that are maintaining depression. Process of thought catching - Client recognises and records negative thoughts and discusses these with the therapist or group. Logic, evidence and pragmatism challenges the client to re-think rationality of beliefs

  Behavioural activation - tasks that are appropriate to their severity of depression. E.g. just going for a 5 minute walk may be enough as a first task. Sense of achievement and they challenge the idea that they cannot achieve anything.
• Evaluation of cognitive approach for treating depression. (TS)

  • One strength of CBT is that it teaches transferable skills which allow clients to continue their own therapy after the programme has ended.
  • Fava claimed that it is better at dealing with the residual symptoms of depression than drugs.
  • However, the focus on the present, may be frustrating for some clients who want to explore their past.
  • Consequently, it can be argued that if clients are experiencing frequent relapse a form of psychoanalysis might be more appropriate.
• Strengths and limitations of deviation from ideal mental health

  • Strengths:
  • Emphasises positivity
  • Can be helpful to identify target areas
  • Holistic approach allows whole person to be assessed
  • Limitation:
  • Demanding criteria
  • Some people would score highly
  • Difficult to define
  • Affected by context
  • Criteria change over time
  • Ignores social and political issues
  • Collecivist societies would reject importance of individual autonomy
• What is a phobia?

  Anxiety disorders characterised by extreme irrational fear that has an impact on life to be diagnosed
• Evaluation of cognitive approach to treating depression. (SR)

  • There is high success rate for CBT
  • March claims that both CBT and antidepressants have success rates of 81%, whilst a combination of both is 86%
  • Because CBT has no side effects compared to drugs and has longer lasting benefits, it should be considered as the best treatment for the majority
  • However, in severe cases where clients are unmotivated it is more appropriate to use it in conjunction with SSRIs to reduce symptoms and allow engagement with CBT. 
• Evaluation of Behavioural Treatments of Phobias (E)

  • SD and Flooding raise major ethical issues.
  • Clients are subjected to their most feared situations
  • Causing some clients to experience very high levels of distress.
  • Clients may not stay in therapy and may actually leave the therapeutic situation in a worse state than when they began due to the potential for high levels of distress.
• Watson and Rayner (1920)


  • Little Albert wasn't scared of anything except the sound of a metal bar being stuck.
  • Albert was shown a rat and a metal bar was struck each time to make him cry.
  • Albert associated the presentation of a rat with a horrible sound and cried when a saw the rat.
  • Albert transferred his fear to other white objects (Cotton wool and rabbits)
  • Criticisms - unethical and Alberts withdrew him from experiment
• Evaluation of biological approach to treating OCD. (SoS)

  • A weakness of SSRIs = 12-16 weeks to show signs of symptoms improving.
  • Low serotonin levels are not the only cause of OCD, and consequently relying on a therapy that raises serotonin activation may not be the best treatment.
  • Some cases of OCD are caused by traumatic events and not biology, and so should not have biological treatments.
  • Use of SSRIs should be limited because the cause of OCD may vary between each client, and it is therefore inappropriate to treat them all with the same biological therapy. 
• SSRIs


  Drugs that raise serotonin levels by blocking serotonin reuptake ports
• How SSRIs work

  1. Serotonin molecules remain in the synaptic cleft

  2. Serotonin can rebind to postsynaptic receptor sites

  3. Serotonin not reabsorbed into presynaptic neuron
• Low serotonin levels


  Have implications in the worry circuit of the brain
• Increasing serotonin concentration


  Can help normalise the worry circuit by increasing serotonin in the nervous system
• Increasing serotonin


  Potentially reduces the anxiety associated with OCD obsessions and the need to complete compulsive behaviours
• Anxiolytics


  Drugs that function by increasing the action of the body's own form of anxiety relief, GABA
• GABA


  An inhibitory neurotransmitter that reduces the ability of other neurotransmitters to activate neurons, having a general quieting effect on the nervous system
• Antipsychotics


  Drugs that temporarily bind to dopamine receptors on the postsynaptic neuron, reducing activation levels
• OCD


  Associated with raised levels of dopamine
• Evaluation of behavioural explanation for phobias. (W)

  • One limitation of the behavioural explanation is that it does not explain why we don’t respond to stimuli in the same way.
  • Di Gallo showed that only 20% of those involved in traumatic car accidents developed phobias of cars.
  • This suggests that some people have a biological predisposition to psychological disorder but it requires a stressor to trigger the disorder and the 80% who did not develop a phobia did not have the biological vulnerability. 
  • Consequently, the diathesis stress model may be a more effective theory.
• AO1 for behavioural explanation for phobias

  Two-process model - CC. Watson and Rayner - Little Albert experienced fear (UR) when he heard metal bar being struck (US). The metal bar was then struck every time he held the rat, associated the sound of the bar with the rat. The rat became the phobic stimulus (CS) as it elicited fear (CR). Phobias maintained by OC. Attention from others acts as positive reinforcement and makes behaviours in response to the stimulus, e.g. screaming, more likely. Avoidance behaviour - negative reinforcement as the sufferer avoids the stimulus and escapes anxiety
• Genetic explanations of OCD

  Genetic explanation:

  • OCD seems to be polygenic - OCD is not caused by one single gene
  • Candidate genes create vulnerability to OCD.
  • Tukel et al.  suggested a variation of the COMT gene may contribute to OCD as it is more common in patients who suffer from OCD than in those that do not. Higher levels of dopamine
  • SERT gene linked with OCD as it affects the levels of serotonin, making them lower
• Neural explanations of OCD

  • Neural explanation:
  • Dopamine levels are thought to be abnormally high in people who suffer from OCD (BASAL GANGLIA REGION)
  • The orbital Frontal Cortex (OFC) - this area of the brain is overactive in people who suffer from OCD.
• Rosenhan and Seligman (1989) criteria

  • Personal distress
  • Maladaptive behaviour
  • Unpredictability
  • Irrationality
  • Observer discomfort
  • Violation of moral and ideal standards
  • Unconventionality
• Characteristics of OCD

  • Behavioural - can hinder everyday functioning and lead to social impairment.
  • Compulsions which are; 
  • Anxiety reducing and repetitive 
  • Avoidance 
  • Emotional:
  • Anxiety = accompanies both obsessions and compulsions and cause distress.
  • Depression = caused by loss of enjoyment in activities
  • Negative emotions e.g guilt + disgust
  • Cognitive:
  • Obsessive thoughts - persistant and intrusive and irrational
  • Cognitive strategies to deal with obsessions and reduce anxiety
  • Insight into condition - awareness of irrationality can make anxiety worse
• Jahoda (1958) identified 6 criteria for mental health, name each one

  • Positive attitude to self
  • Potential for growth and development
  • Autonomy
  • Resistance to stress
  • Accurate perception of reality
  • Environmental mastery
• Evaluation of the genetic explanation for OCD. (LL)

  • Research support for genetic explanation
  • Choy et al. - serotonin causes OCD at low levels
  • Choy et al - tested SSRI's and found that they were successful in most patients
  • There is supporting research for the implication of serotonin in OCD
• Define deviation from social norms

  Behaviour that violates implicit or explicit rules and moral standards of a society
• Becks Negative Triad


  Beck suggested that depressed people make cognitive errors which lead to hopelessness and make them vulnerable to depression, such as focusing on the negative aspects of events and magnifying them, which is a flawed way of thinking. It may originate as a result of life events or critical parenting, leading to low self-esteem and ensuring depression. Beck’s negative triad explores the negative views a depressed person has of themselves, the world, and the future. 

   
• Evaluation of cognitive explanation for depression. (PE)

  • Ellis’ model = partial explanation
  • It explains reactive depression because it generally occurs due to irrational beliefs about an activating event but not all cases of disorder have an activating event.
  • Wender et al = adopted children who were hospitalised for depression= likely to have biological parents with the disorders - cause of depression may be a gene.
  • Therefore, for some it may be a cognitive or biological cause alone, while for others it may be a combination of both, so diathesis-stress would be a better explanation.
• Evaluation of genetic explanations for OCD (FS)


  • RS for family studies
  • Lewis = 37% of the patients with OCD had parents with the disorder and 21% had siblings who suffered.
  • Nestadt - individuals who have a first-degree relative with OCD are up to 5x more likely to develop the disorder
  • Provides support for a genetic explanation for OCD, although it does not rule out other (environmental) factorsplaying a role
• Evaluation of biological approach to treating OCD. (CA)

  s

  • One strength of drug therapies is that they are cheap and accessible compared to CBT
  • However, this could mean that drug therapies are relied upon and overused by healthcare services.
  • Drug therapies are often criticised for treating the symptoms of a disorder but not the cause.
  • Therefore, their increasing use to treat OCD may be problematic as individuals who need psychological help receive drugs instead that may not resolve their disorder, particularly in the long-term.
• AO1 for flooding (behavioural treatments)

  • Flooding consists of one long session where the patient experiences their phobia at its worse. 
  • At the same time, they practise relaxation until their anxiety disappears. The session may last 2-3 hours as fear response has a time limit. 
  • As adrenaline levels naturally decrease, a new stimulus-response link can be learned between feared stimulus and relaxation
• Evaluation of cognitive explanations for depression. (ST)

  • One strength of Beck's triad is that it has contributed to the successful treatments (CBT)
  • Beck claims that CBT has an 80% success rate so it is effective for most people.
  • This is good for the economy as depressed people have the chance to gain a better quality of life and are able to work as a functional member of society.
  • Furthemore, the high success rates also provide supporting evidence which suggest that where there is a negative schema depression is likely to occur, reinforcing cognitive links to the disorder. 
• Evaluation of cognitive explanations for depression. (FN)

  • There is research support for the focus on the negative in depressed people
  • Beevers et al found increased brain activation in response to sad faces rather than happy ones in depressed people compared to non-depressed people.
  • This objective data has broadened our understanding of the disorder and suggests that flawed cognitions may be the origin
  • However, this is only a correlation. We cannot establish a causal connection, so it is unclear as to whether faulty cognitions are the cause or result of depression, so more research is needed.
• AO1 for SD - behavioural treatments

  An individual is taught relaxation techniques, for example breathing techniques. Psychologists then develops an anxiety/desensitisation hierarchy with the client. The final component involves exposing the patient to their phobic situation, while relaxed. According to SD, two emotional states cannot exist at the same time, which is reciprocal inhibition. Therefore, a person is unable to be anxious and relaxed at the same time and the relaxation should overtake the fear.
• Evaluation of behavioural treatments for phobias (E)

  • SD is highly effective.
  • McGrath found that there is a 75% success rate meaning it is appropriate for the majority of people with phobias.
  • However, this treatment is not effective for social phobias, as they can have different causes and involve cognitive elements.
  • Therefore, some clients are in a therapy that is not suited to their phobia, wasting the therapist's time, the client’s money and creating long waiting lists. As a solution, social phobias may be better treated with cognitive behavioural therapy.
• Evaluation of cognitive approach for treating depression. (ENT)

  • One limitation of CBT is that it places too much emphasis on negative thought processes and ignores an individual’s circumstances.
  • For example, negativity may reflect poor housing or social pressures which can create a lot of pressure that will not be alleviated by challenging negative thoughts
  • In these circumstances, more social or financial support may be required for the person.
  • Therefore, CBT would be unhelpful and inappropriate as the client may feel to blame for their condition.
• Strengths and limitations to statistical infrequency


  • Strength:
  • Objective measurements
  • Some behaviours are measure this way eg educational needs
  • Limitations:
  • Abnormal usually has a negative connotation but abnormal intelligence could be desirable
  • Only a system of measurement
  • Some disorders such as depression are statistically common
  • Women more likely to consult doctors than men - only the reported rate
  • Behaviour has to be judged according to the graph for a specific culture
• Evaluation of genetic explanations. (MZ)

  • Research support seen in twin studies.
  • Nestatdt et al (10) = 68% of MZ twins shared OCD as opposed to 31% of DZ twins suggesting genetic component.
  • Since concordance rates in twin studies are never 100%, it suggests that the diathesis-stress model may be a better explanation