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Psychopathology, Depression, Definitions of Abnormality, Characteristics,…

- - - - Unipolar
        
        Bipolar
        
        Clinical symptoms of depression
        
        Cognitive Symptoms
        
        Reduced Concentration & Memory: Thinking may be slowed down due to indecisiveness. Depressives can have trouble with memory retrieval which can contribute to lack of decision making
        
        Thoughts of Death: Depressives can have constant thoughts of death and or suicide
        
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        Behavioural Symptoms
        
        Loss of Energy: Fatigue & lethargy lead to high levels of inactivity
        
        Social Impairment: Depressives reduce social interactions with friends, family and become socially withdrawn
        
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        Emotional Symptoms
        
        Loss of enthusiasm: Lost of interest & enthusiasm for daily activities. Depressant will stop engaging in activities they once found pleasurable
        
        Constant Depressed Mood: Depressant is overwhelmed by feelings of sadness and feel their situation is hopeless
        
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        2 opposite mood swings at various intervals. One can be intense sadness, the other can be intense happiness
        
        Person experiences 1 single mood swing shown by 1 emotion
      - People have normal mental health throughout most of the year but depressive symptoms return at the same time every year. e.g: every winter
- - - - Can take up to 4 months
        
        TNAT aims to directly challenge negative and distorted thinking patterns
        
        CBT strategies:
        
        Graded homework assignments
        
        Encourage new ways of thinking
        
        Problem solving
        
        Client is thought to think more constructively about problems and solutions
        
        Behavioural activation
        
        Client identifies pleasurable activities that they no longer enjoy.
        
        Thought catching
        
        Recording of automatic negative thoughts and looking for ways to challenge these
        
        Cognitive restructuring
        
        Overcoming negative thought processes e.g: distortions & biases
    - - Lasts 1 - 2 sessions/week for 15 sessions
        
        Based on ABC model of depression
        
        REBT aims to move the patient away from the unhealthy emotional consequence (C) by changing the negative belief (B) about the activation event (A)
        C --> B --> A
        
        Procedure
        
        Patient records activating event
        
        Record irrational beliefs that follow
        
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    - - Believed that people who think negatively will feel and act in a depressed way
        
        CBT aims to help the patient identify, rationalise (challenge) and change the cognitive mechanisms that sustain depression e.g: irrational thoughts, emotions or attribution style
  - - - In 2001, the Department of Health reviewed research papers on treatments for depression
        
        CBT was found to be the most effective treatment
        
        BUT, they warned that CBT should not be used alone
    - - Lincoln (1997) used a questionnaire to identify stroke victims who had developed clinical depression
        
        19 patients were given CBT sessions over 4 months.
        
        Results: Symptoms reduced
        
        Suggests that CBT is good for helping specific groups of depressants
    - - The quality of the therapist can significantly affect the quality of the treatment
        
        A good therapist is a more important factor than how complex the case is
    - - Cognitive therapies usually last minimum 16 weeks
        
        Patients need to attend all/most sessions for CBT to be effective
        
        Patients may give up if they do not feel like they're experiencing changes in mood, leading to high dropout rates.
- - - - Negative self-schemas
        
        Develops as a result of unhappy experiences (usually in childhood)
        
        Self schema: the way we think about ourselves
        
        Negative self-schemas cause us to automatically interpret events around us in a negative way
        
        Types of negative schemas:
        
        Sociotropic schemas: Failing relationships
        
        Inept schemas: Failure to achieve personal goals in life & work
        
        Self-critical/self-evaluation schemas: Negative view of one's own shortcomings
      - Faulty information processing
        
        Depressants were prone to faulty information processing
        
        They tended to cognitively distort reality in a way that makes life seem hopeless
        
        These 'errors in logic' are irrational thoughts that bare no resemblance to reality
        
        Cognitive disorders/biases: M MOPS
        
        Overgeneralisation
        
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        Magnification
        
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        Personalisation
        
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        Minimisation
        
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        Selective abstraction:
        
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      - Cognitive triad
        
        Individuals experience streams of automatic negative thoughts about...:
        
        Negative view of the world:
        
        "nothing good ever happens to me"
        
        Negative view of future:
        
        "nothing is going to change"
        
        Negative view of self:
        
        "I'm worthless"
      - Negative schemas & cognitive distortions (faulty information processing) help maintain the negative triad
- - - - The ABC Model:
        
        Activating event
        
        Belief
        
        Consequence
        
        Negative belief triggers an emotional response
        
        e.g: Feeling sad, worthless, lonely etc.
        
        Individual holds a particularly negative belief about the event
        
        e.g: "They always wanted me to fail"
        
        Something in the environment happens
        
        e.g: Break-up, death, job loss etc.
- - - - Model for depression can be improved and therefore, we can have a greater understanding of the disorder
  - - - Therapies like CBT have been shown to be very effective in treating depression
  - - - Beck's theory doesn't explain why some people are deeply angry or suffer from extreme emotions
        
        Theory also doesn't explain extreme symptoms such as hallucinations & bizarre beliefs e.g: Cotard syndrome - Patients suffer from the delusion that they are zombies!
  - - - Human is not taken into account as a whole person
        
        Other possible factors contributing to development of depression are ignored e.g: Genetics & neurochemistry
  - - - PET scans show that emotional information is processed before cognitive (thought) information
        
        Depressant will experience an emotion which stimulates a negative thought i.e: C --> B
        
        Possible that neurochemical imbalance causes emotional sadness
- - - - Features of personal dysfunction
        
        Unpredictability: We rely on the behaviour of people around us being predictable. When it is not, it leads us to think something is wrong
        
        Personal suffering & Distress: Failure to cope with everyday life causes personal suffering and distress to the individual
        
        Maladaptiveness: When behaviour hinders an individual from adjusting to a particular situation socially or occupationally
        
        Observer discomfort: Another's behaviour causes discomfort and distress to the observer
        
        Irrationality: Displaying behaviour that cannot be explained in a rational way or is hard to understand
- - - - Helps people: Allows society to take care of those who are abnormal
      - Situational norms: This takes into consideration that behaviour seen in one setting can be seen as deviant but may not be in another setting
      - Protects society: Society is protected from the effects that an individual's abnormal behaviour can have on others
    - - Cultural differences: If someone is from a different culture that has different norms, does it mean they're abnormal?
      - Social norms change overtime: Some norms become more/less acceptable with each new generation
      - Individualism: Hard to draw the line between abnormal and eccentric
- - - - The more characteristics an individual fails to meet, the more they are abnormal
        
        AO3
        
        Strengths:
        
        Goal setting: Definition clearly identifies what is needed to achieve normality. Easy to create personal goals to work towards
        
        Positivity: Definition emphasises positive attachments. Focuses on what is desirable not undesirable
        
        Holistic: Considers an individual as a whole person rather than focusing on specific areas of behaviour
        
        Weaknesses:
        
        Subjective criteria: Vauge, subjective and difficult to measure. E.g: Hard to tell where the cut-off point for self-esteem and personal growth is
        
        Cultural variation: Criteria is based on western ideals about what mental health looks like. Hard to generalise to other countries/cultures
        
        Over-demanding criteria: Criteria to be classed as normal is unrealistic
        
        Collectivist cultures: No focus on communal goals. People from poorer backgrounds may also struggle with achieving these goals than someone who has vast resources & support
- - - - About 5% of the population fall outside the 'normal distribution'
    - - The less frequently a behaviour occurs, the more likely it is to be abnormal
- - - - Sufferers reduce anxiety by staying away from triggers
        
        e.g: Compulsive hand-washers will avoid contact with germs.
        
        This avoidant behaviour could lead to interference with everyday life. e.g: putting rubbish in the bin
    - - Sufferers perform compulsive behaviours to try managed anxiety produced by their obsession
        
        e.g: Hand-washing is a response to obsessive fear of germs
    - - Compulsions make the suffer repeat the action
        
        e.g: Counting, ordering, washing etc.
  - - - Sufferers cope with their obsessions by trying to manage their anxiety e.g: a person who fears germs will wash their hands 3 times
        
        This helps them manage their anxiety, but will make them appear abnormal
    - - These thoughts can take over sufferers lives
        
        e.g: Constantly worrying about germs
    - - Sufferers know their obsessions & compulsions are irrational
        
        But they still have catastrophic thoughts about the worst outcomes of their anxieties
        
        Hyper-vigilant: Constant state of alertness
  - - - Experienced by sufferers with their obsessions & compulsions
        
        Obsessive thoughts are unpleasant, frightening & anxiety that goes with it can be overwhelming
        
        i.e: Intrusive thoughts
    - - Experienced by suffers over minor moral issues
        
        Guilt & disgust are directed against something external e.g: dirt
    - - Often accompanies OCD
        
        Anxiety can be paired with low mood & lack of enjoyment of activities
- - - - Irrational beliefs about the phobic stimulus e.g: 'If I try play the flute, people will think I'm terrible at it
        
        These beliefs will put extra pressure on the sufferer
    - - Person's perceptions of the phobic stimulus are distorted e.g: extreme danger of death
    - - People will find it hard to take eyes off the phobic stimulus if it's close by
        
        If the fear is irrational, sufferer may struggle to carry on with every day life due to avoiding behaviour
  - - - Response to phobic stimulus
        
        e.g: Crying, screaming or running away
    - - Opposite of avoidance
        
        Sufferer remains in the presence of the phobic stimulus
        
        Continues to feel anxiety
        
        e.g: Fear of flying. You can't avoid the plane whilst you're seated
    - - Opposite of endurance
        
        Sufferer avoids facing their fear
        
        Can make it difficult to go about everyday life
        
        e.g: Fear of public toilets
  - - - Relaxation is prevented & makes it difficult to feel positive emotions
        
        Fear: Immediate unpleasant response we feel when we see the phobic stimulus
    - - Emotional response we feel in relation to the phobic stimulus is out of context or beyond what is reasonable
        
        Emotional response is disproportionate to the danger posed by the phobic stimulus
- - - - Shows OCD runs in families, but is not guaranteed
        
        Genetic vulnerability is passed on instead
        
        Diathesis-stress model
        
        Genes turn off & on
        
        Diathesis-stress model suggests that certain genes leave people more likely to suffer OCD
        
        environmental trigger (stress/experience) is still required to elicit OCD
        
        Candidate genes
        
        Candidate genes: Genes that create vulnerability for OCD
        
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  - - - The role of serotonin
        
        Serotonin regulates mood
        
        If a person has depleted levels of serotonin, it will slow down the normal transmission of mood information
        
        This affects other mental processes, perhaps causing OCD
        
        Anti-depressant drugs e.g: SSRIs increase serotonin levels --> Reduces OCD symptoms
      - Brain Structure - Abnormal brain circuits
        
        Caudate nucleus: Suppresses signals from the orbitofrontal cortex. Located in Basal ganglia
        
        If caudate nucleus is damaged, the minor worry signals are not suppressed
        
        Worry signals flood the thalamus
        
        Thalamus is altered, causing great anxiety (obsession)
        
        Route:
        
        Orbitalfrontal cortex (OFC)
        
        Caudate nucleus (in Basal ganglia)
        
        Thalamus
        
        Some OCD (e.g: hoarding) may be due to abnormal brain functioning
        
        Occurs in the Lateral Frontal Lobe
        
        Area is associated with logical thinking & making decisions
  - - - Neural
        
        Brain structure & Neurotransmitters
      - Genes
        
        DNA
- - - - Maladaptive behaviour: undesirable behaviour
        
        Maladaptive behaviour can also be learnt = phobia
        
        Classical Conditioning
        
        Learning through stimulus --> response --> association
        
        Phobia acquired when 2 stimuli are repeatedly paired together
        
        Two-process model
        
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        Operant Conditioning
        
        Learning through rewards & reinforcement
        
        Behaviour is influenced by the consequences of our actions