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Psychopathology - Coggle Diagram

- - - - SSRIs are Selective Serotonin Reuptake Inhibitors (eg. fluoxetine) and work by preventing the reabsorption of serotonin by receptors in the pre-synaptic neuron. This means more serotonin is transmitted across the synapse, increasing the levels of the neurotransmitter.
      - Tricyclics (eg. clomipramine) also block the reabsorption of serotonin and act on noradrenaline as well but are not selective and can cause side effects.
      - MAOIs are another type of antidepressant which increase serotonin by preventing enzymes in the synapse from breaking down levels of serotonin.
      - SNRIs are a newer groups of drugs and may also be given to OCD sufferers which work by increasing both serotonin and noradrenalin.
  - - - OCD is inherited and polygenic.230 candidate genes have been identified for vulnerability of OCD
        
        SERT
        
        Reduces SERoTonin levels lower than they should be.
        
        COMT
        
        When mutated does not regulate dopamine as well as it should which means the levels rise and cause OCD
      - EVALUATION
        
        MZ twins shared 68% rate in comparison to DZ twins who share 31%.Findings suggest that the closer the genetic relationship you are with someone who has OCD, the greater your chances are of being diagnosed with the condition.
        
        Limitation=patients have mutated SERT and COMT genes but do not have OCD this supports genetic vulnerability (diathesis stress model)
    - - Suggests that there are abnormalities in the brain
        
        OFC (orbitofrontal cortex) responsible for sending worry signals such as worrying about germs if you have touched something dirty.
        
        If there is not enough serotonin another bit of the brain called the caudate nucleus, it doesn't work properly and does not 'switch off' the worries. This creates a 'worry circuit' which causes the obsessive symptoms of OCD.
  - - - Cognitive characteristics
        
        Obsessive thoughts such as worries of germs. Aware that there obsessions and compulsions are irrational. Sufferers are hyper vigilant as they try to maintain constant alertness on potential hazards.
      - Emotional characteristics
        
        Anxiety for the sufferer, can also be coupled with low mood and lack of enjoyment of activities (depression). OCD also involves other negative emotions such as guilt and disgust.
      - Behavioural characteristics
        
        COMPULSIONS. In order to reduce anxiety created by the obsessions. i.e. compulsive handwashing is due to an obsessive fear of germs.
- - - - Testing and challenging patients irrational thought processes. A patient may be set homework to record when people are nice to them so they act as a 'patient as scientist' collecting evidence.
  - - - Negative view of the future.
      - Negative view of the self.
      - Negative view of the world.
      - Together these 3 elements will cause a person to have a depression as it reduces self-esteem and confidence leading to feelings of sadness.
    - - Irrational (B)elief
        
        "I am stupid because I failed"
      - (C)onsequences
        
        Undesirable emotions (worthlessness) OR undesirable behaviours (Not bothering to revise for a test dues to the belief that you will fail because you are stupid)
      - (A)ctivating event
        
        Failing test
- - - - Phobia acquired through classical conditioning.
        
        Neutral stimulus (eg. white rat) which is paired with an unconditional stimulus (eg. loud noise), producing a negative response (UCR) such as fear or anxiety.
        
        The neutral stimulus becomes the conditioned stimulus (the phobic stimulus) that results in a conditioned response of the same fear or anxiety. For example the presence of the white rat alone would produce anxiety in the experiment of 'Little Albert' carried out by John Watson on Douglas Merritte in 1920.
        
        Classical conditioning
        
        Before conditioning: UCS 🡪 UCR
        
        During conditioning: UCS + NS 🡪 UCR
        
        After conditioning: CS 🡪 CR
      - Phobia is maintained through operant conditioning.
        
        The phobia is maintained through negative reinforcement is when an individual escapes/avoids their feared/unpleasant situation which reduces their anxiety but reinforces their fear.
        
        Individual can also be rewarded with attention for showing fear or anxiety.
  - - - Patients first taught relaxation techniques
        
        Breathing exercises to cope with anxiety
      - Patients then create anxiety hierarchy of situations involving the phobic stimulus ranging from most threatening at the top of the 'pyramid' and least threatening at the bottom of the 'pyramid'.
      - Patient will then be exposed to one level of the 'pyramid' and once they learn to remain relaxed at one stage they are able to proceed to the next stage.
    - - The patient has to endure the high levels of anxiety through sudden exposure, the body will eventually return to a relaxed state even though the phobic stimulus is still present.
      - Higher attrition rates and is less favourable by the patient as it may be too intense for them and can be dangerous if patient has medical conditions triggered by high anxiety for this traumatic procedure.
      - Therapist takes control of the session and may have to go against patients wishes so informed consent must be given. Not appropriate for children.
  - - - Irrational beliefs towards phobic stimuli. Cognitive distortion eg. spiders look bigger or are more aggressive looking. Selective attention
    - - Fear (immediate response of terror) and the anxiety which is the unpleasant state of high arousal, which prevents a sufferer from relaxing, whenever they think about the phobic stimulus.
    - - panicking when in presence of stimuli