Psychopathology Evaluation

Psychopathology: Evaluation

• Definitions of abnormality:
• Statistical infrequency
• Real-life application- diagnosing intellectual disability disorder useful part of clinical assessment- comparing symptoms to statistical norms.
• Unusual characteristics can be positive-IQ scores over 13o just as unusal as below 70 but would not treat this as an undesirable characteristic and so this is a flaw of using statistical infrequency and it should not be used alone
• Not everyone benefits from a label-labelling of someone living normal life can have negative effects: not necessary.
• Deviation from social norms
• Not a sole explanation-other factors to consider such as the distress to other people as a result of psychopathy
• culture relativism- hearing voices is seen as acceptable in some cultures but as mental abnormality in the UK-creates problems for people moving from cultures
• Human-right abuses- maintain control over certain groups by stating they are a deviation from socia norms
• Failure to function adequetly- attempts to consdier subjective experience of the patient, captures experience of many people that need help.
• Simply deviation from social norms- people may not have a job because they choose this not because they are failing to function adequetly but just deviating from social norms. If treated as failures can lead to discrimination.
• Deviation from ideal mental health-
• comprehensive definition- covers broad range of criteria
• Cultural relativism-Some classifications specific to western cultures, traits cover an individualistc culture.
• Unrealistically high standard for mental health- see's most people as abnormal.

Behavioural approach to phobias

• Good explanatory power- Went beyond classical conditioning explaining how phobias can be maintained over time and expressed why patients need to be exposed to feared stimulus in therapy.
• Alternative explanation for avoidance behaviour- suggests avoidance is motivated by anxiety reduction but infact could be due to safety factor, sticking with the safety factor instead of avoiding.
• Incomplete expanation- evolutionary factors, fears of things that have been danger in the past such as snakes. Innate disposition to aquire fear.
• Phobias that don't follow trauma- classical conditioning cannot explain this.

Behavioural to treating phobias

• Systematic desensitisation
• Effective- research has proven its effectiveness: Gilroy followed 42 patients who had been treated for spider phobias in three 45 min SD sessions. Control group had relaxtion without exposure. At 3 months and 33 months SD group less fearful than control gorup-effects long lasting.
• Suitable for diverse range of patients- learning difficulties can make it hard to understand what is happening during flooding so SD more appropriate.
• Acceptable to patients- preferred as less traumatic than flooding. Low refusal and turnover rates.
• Flooding
• -Cost effective- highly effective and quicker than alternatives, patients free of symmptoms asap making treatment cheaper
• Less effective for some types of phobia- social phobias involve cognitive aspect which may benefit more from CBT.
• Trauma- traumatic for patients and many drop out wasting time and money.

Cognitive approach depression

• Becks cognitive theory-
• Good supporting evidence- Terry assessed pregnant women for cognitive vulnerability and depression before and after birth. Those with high CV more likely to gain post-natal depression
• Practical application- forms basis of cognitive behavioural therapy. Componants of negative triad challenged.
• Does not explain all aspects of depression-only covers basic symptoms. Does not explain why peole are angry or suffer from hallucinations etc in more bizzare cases.
• Ellis's ABC model-
• Partial explanation-some forms of depression are reactive depressions (have an acitivating trigger) but some arise without an obvious cause and this is not explained by Ellis' model.
• Practical application- CBT challenging irrational beliefs can reduce depression supporting the idea that irrational beliefs play a role.
• Does not explain all aspects- anger etc as stated above.

Cognitive treatment depression

• Effective- March compared the effects of CBT with anti-depressant drugs and then a combination of the two 327 adolscents with depression. 81% of CBT group, 81% drug group and 86% of both improved. Proves CBT is just as effective as medication.
• May not work for severe cases- patients cannot motivate themselves to engage with the therapy. Have drugs first then when well enough to engage to CBT. Shows CBT is not strong enough as a sole treatment.
• Success may be due to therapist client relationship- talking to someone who listens may be what matters most.

Biological approach to OCD

• Genetic-
• Good supporting evidence- Twin studies: Nestadt reviewed previous twin studies and concluded that 68% of identical twins shared OCD as opposed to 31% non-identical suggesting the genetic influence.
• Too many candidate genes- unsuccessful at pinning down exact genes involved providing little predictive value
• Environmental risk factors- diathesis stress model: Cromer found over half of OCD sufferers in sample had traumatic past and was more severe in those with more than one trauma. - may be more productive to focus on environmental causes.
• Neural explanations-
• Supporting evidence-anti-depressants work purely on the serotonin system and have proved effective in reducing symptoms.
• Should not assume neaural mechanisms causeeee OCD- could be as a result

Biological treating OCD

• Tackling symptoms- Soomro reviewed studies comparing SSRI's to placebos in treatment of OCD and results concluded better results for SSRI's. Most effective combined with CBT. - psychology and the economy
• Drugs cost effective and non-disruptive- cheap compared to CBT and save money for NHS. Not disruptive to patients lives.
• Side effects- people stop taking medication if too bad.