Psychopathology

• Biological approach to explaining OCD- Brain structure

  PET scans reveal high activity in the ORBITAL PREFRONTAL CORTEX when carrying out tasks that activate OCD symptoms.

  Explanation- the caudate nucleus is designed to suppress minor worry signals reaching the thalamus from the frontal lobes (OFC) is damaged=a "worry circuit".

  The increased activity also prevents patients from stopping their behaviour.
• Brain Structure AO3


  Should be evident in all cases of OCD but it is not. If everyone has it, it's not the cause. Does not appear in all individuals.

  Also, because a structure is not active does not mean to say it does that thing-it is a correlate. The pathway not the structure is causing them.

  Finally, underactive could be a result of having OCD for a long time rather than the cause.
• Serotonin


  Serotonin is a transmitter that calms us down and stops us from repeating tasks. It is a chemical neurotransmitter (messenger)

  Researchers know that OCD is triggered by communication problems between the brain's deeper structures and the front part of the brain. These parts of the brain primarily use serotonin to communicate.

  SEROTONIN IS NOT AVAILABLE TO CALM OBSESSIONS AND ANXIETY CAUSED BY IT.
• Serotonin AO3


  Hu (2006) compared serotonin activity in 169 OCD sufferers and 253 non-sufferers, finding serotonin levels to be lower in OCD patients, which supports the idea of low levels of serotonin being associated with the onset of the disorder.

  SSRI's (anti-depressants that affect serotonin activity) have been found to lower OCD symptoms.
• Biological Approach to explaining OCD- Genetics


  hSERT- OCD may be associated with a rare combination of two mutations within the human serotonin transporter gene (hSERT).

  This causes increased reuptake of serotonin in those neuronal synapses.

  hSERT works too fast, and may collect all the serotonin before the next cell has even heard the signal to absorb the transmitter.

  Decreasing the amount of serotonin available in the synapse for signalling leading to less serotonin being available for neuronal communication.
• Research into Genetics (OCD)

  Billet- MZ twins (68%) are more than twice as likely than DZ twins of suffering (31%).

  MZ twins share 100% of DNA whereas DZ are non-identical.

  Nestadt- Found that you are 5x more likely than the general population if a first degree relative suffers.
• Genetic explanations for OCD

  • Poor predictive validity
  • Too many candidate genes involved
  • Difficult to isolate OCD to one specific gene, more likely to be polygenic
  • The gene doesn't just affect OCD (relationship/vulnerability)
  • Consequence- genetics are unlikely to be a useful explanation in explaining the onset of OCD
• Biological Reductionism


  One weakness of the biological explanation for OCD is that it ignores other factors and is reductionist
• The biological approach does not take into account cognitions (thinking) and learning
• How OCD may be learnt and maintained

  1. Classical conditioning: Dirt stimulus is associated with anxiety

  2. Operant conditioning: Person avoids dirt and continually washes their hands, which reduces their anxiety and negatively reinforces their compulsions
• Statistical Deviation


  Normal&Abnormal are described according to the number of times it is observed. Behaviours that are statistically rare are seen as abnormal. What is regarded as statistically rare depends on normal distribution (shows the proportions of people who share the behaviour in question). Any individual who falls outside of normal distribution (2std points from mean) is considered abnormal.
• 😊Strength of Statistical Infrequency

  Real world application-QB test in ADHD- test done across thousands to establish the baseline.

  Can be appropriate in defining abnormality e.g intellectual disability disorder- nearly all diagnosis of mental disorders include some kind of measurement against statistical norms. e.g intellectual disability disorder- have an IQ under 70pts such people are statistically rare.
• ☹️Limitations of statistical infrequency

  Where do we draw the line between abnormal & normal, numbers are too black&white. e.g decreased appetite losing 5% of body weight links to depression but not 4%?

  Some behaviour is rare but desirable, e.g high IQ.

  Not all abnormal behaviours are infrequent, for example 10% of people will be chronically depressed at some point in their life, therefore this is not "abnormal" but still not right.
• Deviation from social norms

  Behaviour that deviates from society's norms must be abnormal. People who go against the norms are labelled as deviants so society therefore can intervene to make their behaviour desirable. Their behaviour may be incomprehensible to others or make others feel threatened/uncomfortable.
• Deviation from social norms

  Characteristics- Temper tantrums, rudeness, aggression, talking to yourself etc.

  One of the diagnostic criteria- absence of prosocial internal standards associated with the failure to conform to lawful or culturally normative behaviour. e.g the Joker

  We as a society decide whether a psychopath is abnormal.
• 😊Strengths of DSN


  Protects society, beneficial that society gives itself the right to intervene when people are unable to help themselves.

  Protects society against the effects individuals abnormal behaviour may have on others e.g police, social services.
• ☹️Limitations of DSN


  Subjective, social norms are not "real" but based on the ideas of the elite.

  Can be used by powerful people as a way of controlling minorities/bringing them into order.

  Cultural relativism, social norms are ok in one culture but not the other.
• Failure to function adequately


  Failing to cope w/the demands of everyday life e.g selfcare, hold down a job, interact meaningfully w/others, make themselves understood etc.

  3 signs someone is failing to cope- inability to deal w/the demands of everyday living, maladaptive or dangerous behaviour, behaviour causes personal distress or distress to others.
• 😊Strengths of FFA


  Patients perspective, not society or numbers. Shows how the experience is important to the patient, they are reporting failing to cope.

  Objective behaviour allows for a "checklist" (GAF scale- global assessment functioning scale). Diminished ability to concentrate or think (either by subjective account or as observed by others)
• ☹️FFA weaknesses


  Abnormality is not always accompanied by dysfunction, psychopaths can appear "normal" e.g Harold Shipman (a doctor) who killed 215 people.

  "Normal" abnormality, e.g grief is psychologically healthy but the definition doesn't consider this.

  Objective measures do not allow for subjective judgements, what is normal for an extrovert can be abnormal for an introvert. Behaviour can cause stress to others but not the individual.
• Deviation from ideal mental health


  We define physical illness by looking for the absence of signs from physical wellness. Work out what ideal mental health is and anyone w/o those qualities are mentally unhealthy.

  Jahoda states we should look at mental health the same way we look at physical health.
• Ideal mental health characteristics

  • Positive attitude towards onself
  • Self-actualisation
  • Autonomy
  • Resisting stress
  • Accurate perception of reality
  • Environmental mastery
• 😊Strengths of DIMH


  Shows which areas to work on when treating abnormality.

  Positive holistic approach to diagnosis

  Emphasises positive achievements rather than distress and stress, focus is on desirable rather than undesirable.
• ☹️Weaknesses of DIMH


  Criteria is too demanding

  Self-actualisation may not actually be desirable

  Doesn't make sense in every situation.
• OCD- Brain structure


  PET Scans reveal high activity in the orbital prefrontal cortex when carrying out tasks that activate OCD symptoms. This is because the caudate nucleus is designed to supress minor worry signals reaching the thalamus from the frontal lobes (OFC) is damaged = worry circuit. This increased activity also prevents patients from stopping their behaviours.
• ☹️Should be evident in all cases of OCD but it's not


  If everyone has it it's not the cause, doesn't appear in all individuals. Also, because a structure is not active does not mean to say that it does that thing- it is a correlate.

  Finally, underactive could be a result of having OCD for a long time-not the cause.
• Serotonin


  A transmitter which calms us down and stops us from repeating tasks. A chemical neurotransmitter (messenger). Researchers know that OCD is triggered by communication problems between the brain's deeper structures and the front part of the brain. These parts of the brain primarily use serotonin to communicate. SEROTONIN IS NOT AVAILABLE TO CALM OBSESSIONS AND ANXIETY CAUSED BY IT.
• Serotonin AO3


  Hu compared serotonin activity in 169 OCD sufferers and 253 non-sufferers, finding serotonin levels to be lower in the OCD patients which supports the idea of low levels of serotonin being associated with the onset disorder. SSRI's have been found to lower OCD symptoms.
• Genetics


  OCD may be associated with a rare combination of two mutations within the human serotonin transporter gene (hSERT). This causes increased reputake of serotonin in those neuronal synapses. hSERT works too fast and may collect all the serotonin before the next cell has even heard to absorb the transmitter. Decreasing the amount of serotonin available in the synapse for signalling leading to less serotonin being available for neuronal communication.
• AO3 Research into genetics

  Billet- MZ twins (identical) are more than twice as likely than DZ (non identical) twins of suffering.

  Nestadt- found 5x more likely than the general population if a first degree relative suffers.
• AO3 of genetics overall

  Genetic explanations have poor predictive validity as there are too many candidate genes involved. It is difficult to isolate OCD to a specific gene, more likely to be polygenic.

  This gene doesn't just affect OCD>Genetics are unlikely to be useful in explaining the onset of OCD.
• Biological Reductionism


  One weakness of the biological explanation of OCD is that it ignores other factors and is reductionist. e.g the biological approach doesn't take into account cognitions (thinking) and learning. Some psychologists suggest that OCD may be learnt through classical conditioning and maintained through operant stimulus as it is associated w/anxiety and it is maintained through operant conditioning. This causes the person to avoid the stimulus e.g dirt and hand washing
• The Diathesis Stress Model


  A simple link between the candidate gene and OCD is unlikely

  Gene=vulnerability

  Environmental stressor affects whether it develops into anything.
• Systematic desensitisation


  A behavioural therapy for treating anxiety disorders in which the sufferer learns relaxation techniques and then faces a progressive hierarchy of exposure to the objects and situations that cause anxiety.
• Systematic desensitisation


  1st-Relaxation techniques e.g meditation, mental imagery, anti-anxiety drugs (beta blocker) in extreme cases.

  2nd-Hierarchy of anxiety provoking situations

  3rd-Exposure to each stage and then relaxing until at the top of hierarchy.
• Flooding


  Involves going to the worst thing on the hierarchy and exposing the patient to it, taking away the option of avoidance. First relax>full exposure.
• Research findings AO3 flooding

  When exposure starts, anxiety rises however over time the association is broken and anxiety lowers.
• 😊Research to support flooding

  Wolpe used flooding to remove a girls phobia of cars by driving her around for 4 hours until her hysteria was eradicated demonstrating the effectiveness of the treatment, concluding flooding can work on phobias.
• ☹️Does not work on all phobias

  May work on more simple phobias such as cotton wool, however social phobias tend to involve cognitive aspects as it is not just anxiety & avoidance but there are also unpleasant thoughts associated w/the phobia.

  Craske&Barlow- at best 1/5 don't improve>high individual diff

  Not long term & better than before treatment.
• Ost... overall conclusion for flooding

  Found that flooding is a rapid treatment that often delivers rapid, immediate improvements, especially when a patient is encouraged to continue self-directed exposure to feared objects and situations outside of therapy sessions.