Psychopathology

Mental Disorders
1. Phobias
  1. Emotional - excessive and unreasonable which is coupled with anxiety and panic. Cued by the presence of anticipation of the object or situation
  2. Behavioural - Avoidance, freeze or faint, . It interferes with the person's normal routine.
  3. Cognitive - irrational thinking and resistance to rational arguments. Recognises that the fear is excessive or unreasonable.
2. Depression
  1. Emotional - sadness, loss of interest, low self esteem and anger due to lack of control
  2. Behavioural - increase/decrease in activity levels, insomnia, poor appetite
  3. Cognitive - negative emotions and thoughts, irrational thoughts
3. OCD
  1. Emotional - anxiety and stress, feelings of embarrassment, disgust
  2. Behavioural - repetitive and concealed to perform these actions
  3. Cognitive - seen as uncontrollable, recurrent and intrusive thoughts
Definitions of abnormality
1. Statistical Infrequency
  1. If the behaviours reach either end of the scale it is normally seen as abnormal, however, some may be good
  2. Abnormality is defined as those behaviours that are extremely rare
  3. I; Abnormal can be seen as desirable. J; High IQ could still be seen as desirable. E; Identification between desirable and undesirable has to be found
    1. I; Can be appropriate to use a statistical criterion. J; Can be used for the cut off of abnormality . Two SD or below it is seen as abnormal. E; Shows statistical infrequency may be inappropriate
2. Deviation from social norms
  1. Abnormal behaviour is seen as deviant from unstated rules about how one 'ought' to behave. Anything that violates these rules are seen as abnormal
    1. Rules are based around explicit rules (laws) and implicit rules (personal beliefs made by culture)
      1. An example is homosexuality - once seen as abnormal and were put into mental institutions but now it is seen as a social norm
  2. I; Main difficulty is that it varies as times change. J; E.g homosexuality was once seen as abnormal but now it is a social norm. E; Shows that social morals and attitudes can change
    1. I; Making judgements on deviance is often related to context of behaviour. J; Many cases there is not a clear line between what is abnormal and what is eccentric. E; Means that social deviance cannot make a complete definition for abnormality as it relies on context
3. Failure to Function Adequately
  1. People are judges on their ability to go about daily life.
    1. Could be a situation where the individual is not having any distress but it could be causing distress for others
      1. The DSM and WHODAS - includes understanding and communicating, self care and life activities
        I; Recognises the subjective experience of patients. J; It is relatively easy to judge objectively as we can list behaviours. E; Shows strengths
        I; Someone needs to decide if it actually the case. J; Could be that individual is content but it is that others are uncomfortable and behaviours are abnormal. E; Weakness is that it depends on who is making the judgement
4. Deviation from social norms
  1. Jahoda conducted PRAISE - Personal growth, reality perception, autonomy, integration, self attitudes and environmental mastery.
    1. Absence of this can suggest possible mental disorders and abnormality
      1. I; Has an unrealistic criteria. J; Jahoda presents an ideal criteria but it could be difficult to assess specific criteria. E; Not really useable when comes to abnormality
        I; Mental health is same as physical health. J; Physical is easy to detect whereas mental health is normally a consequence from life experiences. E; Unlikely that mental abnormality is diagnosed is same as physical health.
Behavioural Approach - Explaining Phobias
1. Operant conditioning - avoidance of the phobic stimulus reduces fear and is this reinforcing. This is an example of negative reinforcement. Reward is them not having anxiety
  1. Phobias may also be acquired through modelling behaviour of others
  2. I; Some support for CC. J; Often able to recall when a phobia occurred e.g. being bitten by a dog. E; However, not everyone can do this because the situation has been forgotten.
    1. I; Could be explained by diathesis stress model. J; Individual has genetic vulnerability for developing a mental disorder. E; However, will only occur if there has been a trigger.
      1. I; Phobias don't always develop after a traumatic incident - biological preparedness. J; Animals are scared of ancient fears that would be dangerous in evolutionary past. E; Explains why we are less likely to develop fears of modern objects
Behavioural Approach - Treating Phobias
1. Flooding
  1. Patient experiences their phobia at its worst whilst using relaxation. Finished in one long session. Adrenaline levels decrease, a new association can be made
    1. I; Individual differences. J; Flooding is not for every patient as it could be traumatic for them. E; They may still wait and therapy will not be as effective.
      1. I; Appears flooding can be effective and relatively quick. J; Researchers said both treatments were good but flooding is more effective. E; However, others say both treatments are effective
2. Systematic Desensitation
  1. Counter Conditioning - patient is taught a new association that runs counter to the original association
    1. Relaxation - therapist teaches client new relaxation techniques e.g. slow breathing
      1. Desensitisation Hierarchy - works by gradually introducing patient to feared situation one step at a time
        Step 1 - relax muscles. Step 2 - contrast hierarchy of scenes. Step 3 - patient works through hierarchy. Step 4 - Patient mastered one step and moves to next. Step 5 - patient eventually mastered the fear
        I; Found SD is successful of phobias. J; 75% patients respond to SD and actual contact is most beneficial with stimulus E; Shows there is some effectiveness with SD.
        I; Generally relatively fast and requires less effort on patients part. J; E.g - CBT requires lot of willpower from patient to understand. E; Lack of thinking is useful for people with lack of insight into motivations.
Cognitive Approach - Explaining Depression
1. Mustabatory Thinking - thinking that certain ideas or assumptions must be true in order for an individual to be happy
  1. An individual who holds these is likely to be disappointed or at worst depressed
2. Negative schema - likely that depressed people have developed a negative schema in childhood, this could be caused by factors such as peers. Biased towards negative interpretations and lack of control
3. I; Depression is linked with irrational behaviour. J; Hammen and Krantz found depressed p's made more errors in logic when asked to interpret written material. E; However, doesn't mean that negative thoughts cause depression
  1. I; Blames client for behaviour. J; Gives clients power to change their ways. E; However, may lead to client/therapist to overlook situational factors
    1. I; Led to practical applications in therapy. J; Both models have been applied to CBT as it found to be best treatment for depression. E; If depression is alleviated then it suggests that irrational thinking has a role in depression.
Cognitive Approach - Treating Depression
1. CBT - combination of cognitive and behavioural therapy to turn irrational thoughts into rational ones (REBT)
  1. Ellis extended ABC to ABCDEF - disputing thoughts, effects of disputing and feelings. Logical disputing, empirical disputing and pragmatic disputing
    1. Clients are often asked to complete assignments to challenge and test the irrational beliefs that they believe in
      1. CBT involves specific focus on encouraging depressed clients to become more active. Therapists and client can identify pleasurable activities and deal with cognitive barriers
2. I; Research to support CBT. J; Ellis claimed 90% success rates, on average 27 sessions to complete. E; However, may not be as effective as beliefs aren't put into action.
  1. I; CBT may be less suitable to people with high irrational beliefs. J; Found a possible lack of success for suitability as direct advice is not always taken. E; Shows individual differences
    1. I; Alleviate depression through exercise. J; Major depressive disorder - end of 6 months exercise group had lower relapse rates than medication groups. E; Shows some support for behavioural activation
Biological Approach - Explaining Depression
1. COMT Gene; involved in the production of COMT, regulates the production of the neurotransmitter dopamine that has been implicated in OCD, one form of the gene has been found to be common in OCD, produces lower activity of COMT gene and higher levels of dopamine
  1. SERT Gene; affects the transport of serotonin, creating low levels of this neurotransmitter. One study found a mutation of this gene in two unrelated families where 6/7 had OCD.
    1. Diathesis-stress model; genes are implicated in a number of disorders such as depression and post traumatic stress disorder, it suggests that each individual gene creates vulnerability for OCD. Other factors (stressors) affect what the condition developed but some may possess the gene but not suffer any illness as there is no trigger
2. Abnormal levels of neurotransmitters; dopamine levels are thought to be abnormally high in people with OCD, lower levels of serotonin associated with OCD, antidepressants increase serotonin levels and reduce symptoms OCD.
  1. Abnormal brain circuits; caudate nucleus - signals from OFC - signals to thalamus. When nucleus is damaged - thalamus is alerted - signals back to OFC = WORRY CIRCUIT. Supported from PET scans, serotonin plays key role in OCD.
3. I; There have been twin studies to show evidence for the biological approach. J; A meta analysis on OCD found that identical twins were more than twice as likely to develop OCD if their co-twin did. E; However, concordance rates are not 100% as some environmental factors must have a role also
  1. I; There has been research for Tourette's syndrome and disorders. J; Researchers found that OCD is one form of expression if the same gene that determines Tourettes and was also found the same gene that determines Tourettes and was also found that both symptoms are in autistic children.
    1. I; There has been research to support OFC and genes. J; Researchers used MRI to find brain activity in OCD patients, families without OCD and unrelated people finding that OCD does affect the OFC. E; This supports the view that differences may lead to OCD in individuals.
Biological Approach - Treating OCD
1. SSRIs; block the re-uptake of serotonin at the presynaptic membrane, increasing serotonin concentration at receptor sites on the post synaptic membrane. E.g Proza to increase levels of neurotransmitter serotonin to regulate mood and anxiety
  1. Tricyclics; block the transporter mechanism that reabsorbs with serotonin and noradrenaline. As a result, more of these neurotransmitters are left in the synapse, prolonging the activity. Due to them having more side effects they are used as a second line treatment for when SSRI is not effective
    1. Anti-anxiety drugs; benzodiazepines are commonly used to reduce anxiety e.g. Diazepam. Slows down anxiety of CNS by increasing activity of GABA. GABA is released from neutron as it travels across the gap and locks onto one of the rector sites. Increases the flow of chloride ions and slowing down the neuron and CNS - relaxing the patient
      1. GABA regulates excitement in the central nervous system and acting as a natural form of anxiety reducer
2. I; There is considerable evidence for the effectiveness of drug treatments. J; Researchers found SSRIs were more effective than placebos in reducing the symptoms of OCD up to 3 months after treatment. E; However, as studies are only a short duration there is only very little long term data
  1. I; A strength is that drug therapies are preferred to other treatments such as CBT. J; From the point of the health service they are also cheaper as they require little monitoring and are cheap compared to psychological treatments. E; However, some patients may benefit from the fact of just talking to a doctor during consultations as it could help.
    1. I; There is a problem with side effects of drug therapy. J; Common side effects of SSRIs are insomnia, headaches and nausea, tricyclics show hallucinations and Bzs may show aggression. E; This, therefore shows that there are side effects with drug therapy in treating OCD

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	Created by Charlotte Summerly almost 10 years ago