Please enable JavaScript.

Coggle requires JavaScript to display documents.

PSYCHOPATHOLOGY - Coggle Diagram

- - - - Unpredictability: we rely on behaviour around us to be predictable, so if a person's behaviour seems unpredictable and uncontrolled suggests that there is something wrong
      - irrationality: we can usually interpret the behaviour of others as being rational, but if the behaviour does not seem to be rational and hard to understand it can suggest that there is a problem
      - maladaptiveness: maladaptive behaviour and behaviour which is not helpful, it limits the ability of a person to adjust to a particular situation
      - personal suffering and distress: this is when an inability to cope with every day life causes personal distress/suffering to the individual themselves
      - observer discomfort: this is when a persons behaviour causes distress and discomfort to an observer
    - - Strengths
        
        this definition has practical applications, it can be used to identify people who need psychiatric help for example if someone cannot get up for work or feed them selves they be diagnosed as depressive using this definition and would get treatment therefore it can improve peoples lives
      - Weaknesses
        
        One limitation is that this definition is culturally specific for example Escobar 2012 was pointed out that white psychiatrist may tend to over interpret the symptoms of black people during diagnosis such factors as cultural differences in language and mannerisms can cause issues, can lead to a definition which applies to all cultures
        
        this definition is not reliable, for example people with antisocial personality disorder do not feel guilt and therefore can harm or kill others this definition cannot be generalised to all cases of abnormality as it doesn't cover this
        
        another limitation is that many people partake in maladaptive behaviour but aren't necessarily abnormal for example adrenaline sports, smoking or drinking alcohol would class someone as abnormal therefore this cannot offer complete definition
  - - - Strengths
        
        another strength is that it is not affected by culture or context such as deviation from social norms, this is because judgements are made relying on statistical information about frequency, this reduces stigma associated with mental illness being wrong or unacceptable rather it just is less frequent than other traits
        
        One strength is that it gives a quantitative and objective measure as there is a clear cut-off point as to what is and isn't abnormal this means it's more reliable as someone else conducting the test would get the same result for the same person, this is important as defining abnormality can be subjective, and this ensures objectivity and scientific method
      - Weaknesses
        
        The main limitation is that not all statistically rare behaviours or traits are negative bring sample someone with a high IQ is infrequent but it isn't an undesirable trait that needs treatment this is therefore a serious limitation to the concepts and means that it couldn't be used alone to make a diagnosis
        
        another limitation is that not all abnormal behaviours are infrequent for example depression occurs in around 10% of the population according to this definition depression wouldn't be abnormal because their behaviour is so common is a weakness because it may not let people access the treatment they need
  - - - an implicit social norm is not a written role but one that we tend to follow such as eating dinner with cutlery
      - with reference to abnormality someone who is suffering from OCD may perform compulsive behaviour such as having to turn the light switch off and on a high number of times this goes against the social norm of just turning the light switch off once
    - - an explicit social norm is one that is a written rule/law for example that we do not use our mobile phones while driving
      - With reference to abnormality common, somebody who is depressed or agoraphobia and may not leave the house and therefore not attend school this goes against written rules in the UK that children should be attending full-time education
    - - Weaknesses
        
        social norms change between cultures and over time and so do peoples perceptions of abnormality for example homosexuality was regarded as mental illness until 1973 but not anymore also cross cultural misunderstanding is a common and may contribute to high diagnosis rates amongst non-white British people
        
        classification of abnormality may be based on the context in which behaviour occurs for example the same behaviour might be normal or abnormal in different contexts, undressing in the bathroom or in the classroom, therefore there is a level of subjective judgement required and it cannot be an objective measure of abnormality
        
        this definition raises ethical concerns, this is because people who do not fit into societies norms are then often labelled as abnormal and may even be institutionalised, for example young unmarried mothers in the past were locked up in mental institutions because their behaviour was seen as unacceptable, this suggests that the definition is linked to issues of social control
      - Strengths
        
        this definition has practical applications, it can be used to identify people who need psychiatric help example the behaviour of someone who hears voices is different from the norm is very likely to be diagnosed and receive treatment therefore this definition can improve peoples lives
  - - - autonomy: being independent, self-reliant and able to make personal decisions
      - resisting stress: having effective coping strategies and being able to cope with everyday anxiety provoking situations
      - self actualisation: experiencing personal growth and development
      - accurate perception of reality: perceiving the world in a non-distorted fashion with an objective and realistic view of the world
      - positive attitude towards oneself: having self-respect and a positive self-concept
      - environmental mastery: being competent in all aspects of life unable to meet the demands of any situation. Having the flexibility to adapt to changing life circumstances
    - - Weaknesses
        
        The definition is culturally specific for example in individualistic cultures it is positive if someone puts their own interests first but in collectivist cultures the ideal person puts others before themselves and works for the common good this suggests the definition is limited and it cant lead to a universal definition of abnormality across all cultures
        
        The definition is overinclusive, it cannot be a true measure of abnormality because nobody achieves "ideal mental health ". Most people struggle with at least one of the criteria for mental health, a lot of people have negative views about themselves sometimes, this suggests that hardly anyone would be normal
      - Strengths
        
        it's a more positive approach, because it focuses on the positives rather than negatives of behaviour in terms of looking at what behaviour is ideal rather than what behaviour is abnormal. its a strength as it could lead to mental health being seen with less of a stigma in society and more people become willing to seek help
        
        it has practical applications, if someone is deviating from one of the characteristics we know exactly what that individual needs support with in order to feel better, this allows professionals to create personal goals and work towards things such as self growth or resisting stress
- - - - Endurance- alternative to avoidance where the sufferer remains in the prescence of the phobic stimulus because they have to (having to go on a plane for business) causes high levels of anxiety
      - Panic- in response to the phobic stimulus a person may cry scream or run away
      - Avoidance- avoiding the phobic stimulus
    - - Fear
      - Unreasonable emotional responses (irrational exaggerated fear)
      - Anxiety- an unpleasant state of high arousal
    - - Selective attention- hard to look away from phobic stimulus, this is good for protecting yourself but not good if you have an irrational fear
      - Irrational beliefs, about the phobic stimulus (that a small spider will kill you)
      - Cognitive distortions- the sufferer may percieve in an exaggeratedly negative way, snakes looking alien and aggressive when it is calm
  - - - Relief provided by doing complusions
      - Co- morbidity can occur, commonly causing depression or eating disorders
      - Obsessions create anxiety
    - - High anxiety
      - Compulsions as a result of obsessive thoughts
      - Avoidance of situations which may highten obsessive thoughts, causing disrupton to daily life
    - - Awareness of irrationality (but cant stop themselves)
      - Attentional bias- focus on anxiety generating stimuli
      - Obsessive and intrusive thoughts
- - - - 3 stages
        
        Relaxation techniques- the patient is taught by the therapist how to relax at each stage of exposure to the stimuli
        
        Exposure
        
        Either done in vivo- in real life
        
        Or in vitro- via imagination
        
        Prevents avoidance
        
        Anxiety hierarchy- a range of scenarios devised by the therapist with the patient ranging from most to least fear inducing (talking about spiders vs holding one)
      - The aim is to turn the conditioned phobic response into a new learnt relaxation response
      - Based on the idea that phobias are learnt, implying that they can be unlearnt
      - This is called counter conditioning
      - Reciprocal inhibition- the idea that you cannot feel things such as relaxation and fear at the same time so hopefully the relaxation prevents the fear
      - Evaluation
        
        +
        
        Gilroy
        
        Used SD on patients for fear of spiders
        
        Followed up 45 patients who had done three 45 minute sessions and a control group who only did relaxation tehniques
        
        Long term the SD group were less fearful of the stimulus than the control group
        
        Shows that the results of SD are strong and long lasting
        
        Appropriate
        
        More ethical than drugs which are associated with side effects or risk of addiction
        
        More accessible to all patients such as children or people with learning difficlties as it does not require high communication skills or understanding of the phobia
        
        _
        
        Symptom substitution
        
        Occurs when the phobia goes but anxiety remains, so it manifests in a new phobic stimulus
        
        Means that SD doesn't treat the root cause of the phobia only the symptoms and the stimulus
        
        Unsuitable for all phobias
        
        This is because they have an underlying survival component so weren't learnt and can't be unlearnt
        
        Includes things such as fear of dark or heights
        
        Ohman suggests that SD is not useful for evolutionary phobias
        
        Means alternative treatments may be required and SD is not always useful
    - - Principles
        
        Reciprocal inhibition means that you cannot be in high anxiety and fear at the same time, they are opposing and cancel eachother out, the aim of the therapy is for relaxation to dominate
        
        Phobias are learnt and so can be unlearnt
        
        You can't maintain a state of high anxiety forever as your body has to eventually calm down
      - Flooding is when the patient is exposed to the phobic stimulus in a controlled environment, with the therapist present encouraging the use of relaxation techniques
      - One long session of exposure until the relaxation overtakes the fear
      - Replaces relaxation as the conditioned response by exposing patient to phobic conditioned stimulus alongside relaxation, replacing fear
      - Evaluation
        
        +
        
        Rothbaum
        
        Treated flying phobia by either flooding, VR or getting put on a waiting list
        
        Waiting list did not treat the phobia, flooding and VR were equally successful
        
        93% of participants had flown within the next 6 months- success
        
        More efficient
        
        Means it is more accessible as it is cheaper and quicker- suits more lifestyles and makes treatment easier
        
        Flooding is done in one long session
        
        _
        
        Doesnt help social phobias
        
        Isn't as useful for things like social phobias which are more complex and don't have a clear cause which can be targeted
        
        Therefore it is not a treatment for all phobias and other ways need to be considered
        
        Only useful for phobias with a particular focus or stimulus (arachnophobia)
        
        Dropout rate
        
        Due to this, a lot of people find it overwhelming and drop out before they reach relaxation
        
        This is a weakness as it means time and resources are wasted on something people might give up on
        
        Though it is voluntary it is quite traumatic for the patient as they experience high anxiety before relaxing
  - - - +
        
        More research
        
        DiNardo found that 60% of people with phobia of dogs could relate thier fear to a specific frightening experience
        
        Munjack found that half of people scared of cars could relate the fear to a frightening experience
        
        Practical applications
        
        Learning about how phobias form can inform us on how to treat them
        
        Systematic desensitisation is based on the idea that phobias are learnt and then can be unlearnt
        
        This therapy improves lives of people with phobias so this is good
        
        Watson and Rayner
        
        After the incident he is scared of white rats and similar looking fluffy animals even without the unconditioned stimulus
        
        Weakness
        
        As the neutral and unconditioned stimulus were presented simultaneously multiple times, it is not accurate to real life where they may only appear together once, this means it lacks ecological validity
        
        Unethical as they caused him distress therefore not reliable as it shouldn't be replicated and then can't be checked
        
        Unethical as they gave him a phobia which may have lasting effects
        
        When they showed him a white rat, they created a loud noise behind him by banging a metal pole, causing a fear response
        
        Presented Little Albert with different animals, he showed no fear
        
        Shows that phobias can be learnt via classical conditioning
      - _
        
        Ignores evolution
        
        Biological approach would argue that we have evolved to have an innate fear of things that risk our survival such as being at great heights or aggressive animals
        
        Shows there may be more factors affecting phobias than conditioning
        
        Doesn't consider biological factors which may be crucial
        
        Simplistic approach
        
        Ignores cognitive factors such as focus of attention and thought processes
        
        The irrational nature of phobias suggests that there are complex throught proesses involved
        
        Suggests that phobias are not as simple as learning and unlearning
        
        In DiNardo's study, there were many people in the control group who had had traumatic experiences with dogs but did not develop phobias suggesting there is some individual differences that contribute towards developing a phobia
    - - Classical conditioning
        
        First the dentist creates no fear, but after associating it with the pain of a drill or procedure, you fear the dentist as well
        
        Associating something we have no fear of with something which already creates a fear response
        
        Doesn't explain how phobias are maintained as you are unlikely to have the unconditoned stimulus always paired with the neutral stimulus
      - Operant conditioning
        
        Suggests that the consequences of our actions can determine whether we do a behaviour again
        
        Phobias are maintained through negative reinforcement, avoiding the phobic stimulus takes away the fear of it, so you are more likely to avoid it again
        
        Avoidance gets rid of the fearful unpleasant feelings
        
        When you avoid going to the dentist, you take away the associated fear and therefore keep avoiding it
      - Assumes that phobias are learnt via classical conditioning and maintained through operant conditioning
- - - - Specific genes
        
        SERT
        
        Also called the 5-HTT gene
        
        Affects transmission of serotonin
        
        Bengel compared 75 OCD patients to 397 who did not have OCD
        
        He found that Ocd patients were more likely to carry the long form of the 5-HTT gene than controls
        
        Genetic material of those with OCD is compared to those without it
        
        COMT
        
        This gene variation caused lower gene functioning and higher dopamine levels
        
        Gene involved in the production of dopamine
        
        Tukel et al found that one variation of the COMT gene was common in OCD patients
        
        It is unlikely that one specific gene alone causes OCD but there are a few genes which are linked to vulnerability to OCD
      - Twin and family studies
        
        Lewis observed
        
        37% of patients had parents with OCD
        
        21% had siblings with OCD
        
        Miguel
        
        Comapred MZ and DZ twins
        
        If OCD was fully caused by genetics we would assume that if one MZ twin has it the other definitely will as they share 100% of DNA
        
        Findings
        
        If one MZ twin had it the chance of the other geting it was 53-87%
        
        If one DZ twin had it then the chance of the other getting it was 22-47%
        
        Looking at concordance rates we can infer that OCD has some genetic causes as the MZ rate is higher, but because it isn't 100% we can conclude that environmental factors also have an influence
        
        Twin and family studies are used to see if OCD has a genetic link
      - Suggests that the onset of OCD is a result of our genetic makeup, we receive 50% of our genes from each biological parent
    - - NTs
        
        Serotonin
        
        OCD patients typically have low levels of serotonin
        
        Regulates a number of the bodys functions such as mood anxiety memory and sleep
        
        Dopamine
        
        Linked to experiencing motivation rewards and compulsions
        
        Over time with OCD, the anxiety of an obsession is only relieved by completing the compulsion
        
        Two NTs play a role in OCD
      - Neural correlates
        
        An area of the brain linked to OCD is the orbitofrontal cortex, an area associated with reward guided learning and decision making
        
        The 'worry circuit'
        
        Thalamus of people with OCD tends to be more active
        
        The OFC sends signals to the Thalamus when things are worrying, but if the caudate nucleus is damaged then it allows minor worries to reach the Thalamus, leading to over excitation and strong signals being sent back to the OFC which causes an increase in obsessive compulsive behaviour
        
        If damaged the caudate nucleus fails to suppress minor signals from the OCF
        
        Brain activity that corresponds with and is necessary to produce a particular experience
        
        OCD put simply can be related to communication problems in the brain
    - - +
        
        Prac apps
        
        Neural explanation can help inform treatment
        
        If we can explain OCD with low serotonin, we can prescribe SSRIs, increase serotonin and treat OCD (in theory)
        
        Saxena and Rach
        
        Reviewed studies that used PET, MRI and fMRI scanners
        
        Found consistent evidence of an association between the OFC and obsessive compulsive symptoms
      - _
        
        Inconsistency
        
        Not all sufferers of OFC have basal ganglia (caudate nucleus) impairments, some people who do have impairments do not have OCD
        
        Inconsistencies across research mean that researchers cannot establish cause and effect between biological factors and the cause of OCD, if it was biologically determine we would see consistent results, there must be other factors contributing which means the biological approach isn't a full explanation
        
        No study into genetics finds a 100% concordance rate meaning there are non biological factors contributing to OCD development
        
        Reductionist
        
        To reduce the entire cause to genetic makeup or neural factors does not reflect the complex nature of unique human lifes and the disorder
        
        Not looking at the disorder holistically ignores factors such as the 2 process model, SLT ect.
        
        OCD is a very complex disorder which includes emotional behavioural and cognitive symptoms
        
        Means we could be missing vital contributors to the development and therefore missing new ways to treat it
        
        Correlational research
        
        Looking at the relationship betweeen genes and OCD doesnt establish the root cause as genes of parents may contribute to how they treat the child leading to an environmental cause of OCD, not genetic
        
        Levels of NTs in OCD patients may be different to control BECAUSE they have OCD, the disorder may have caused them not been caused by them
        
        Correlational research means we cannot establish cause and effect
  - - - SSRIs
        
        How they work
        
        Blocks the reuptake of serotonin in the synapse by blocking the presynaptic nerve terminal so that serotonin must stay in the synaptic cleft
        
        Keeping serotonin in the synapse longer than usual leads to repeated stimulaton of the receptors in the post synaptic neuron
        
        This means the levels of serotonin are increased
        
        They dont cause more serotonin to be produced, but make more use of what is already produced
        
        Don't work for everyone
        
        Most common is Prozac
        
        Originally designed to increase serotonin as a treatment for depression, but have been found to work for OCD as well
      - SNRIs
        
        Increase levels of serotonin (NT) and noradrenaline (NT and hormone)
        
        Work by blocking reuptake in the synapse
        
        Used when SSRIs don't have an effect
        
        Serotonin helps regulate mood, anxiety, and other functions and norepinephrine helps mobilize the brain for action and can improve energy and attentiveness
    - - +
        
        Quick and easy
        
        In this way drugs are better than therapy because it can be hard for someone who is suffering to commit to going to therapy for a long time, and exert lots of cognitive effort during the sessions
        
        No waiting list, quick to prescribe and starts working quickly
        
        Requires little time and cognitive effort for someone to do, just take some pills everday
        
        Soomro
        
        Reviewed 17 studies that compared SSRIs to placebos
        
        SSRIs were found to always be more effective than placebos
        
        Found SSRIs work best with CBT and 70% of these patients can see a decline in symptoms
      - _
        
        Don't work for everyone
        
        Ignores the fact that OCD can have some non biological causes and so doesn't work for everyone
        
        If someones OCD is mainly caused by maldaptive parenting or life issues, altering NTs won't treat the causes effectively
        
        Drug therapy does not work for all people so enduring side effects may not be worth it this can negatively impact peoples lives
        
        Side effects
        
        Both SSRIs and SNRIs come with unpleasant side effects
        
        Including indigestion blurred vision weight gain
        
        Can negatively impact sufferers lives, where psychological therapy does not have side effects
        
        Only treats symptoms
        
        Drugs do not treat the root cause of OCD
        
        If you stop taking the drugs, the symptoms reappear and the disorder is not cured, this means you must stay on them
        
        Simpson found that within 12 weeks, 45% of patients treated with meds had relapsed and 12% of people treated with psychological therapy had relapsed
        
        Questions whether drug therapy is a sustainable way to help patients or if it only a short term solution