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PSYCHOPATHOLOGY - Coggle Diagram
PSYCHOPATHOLOGY
Cognitive Approach to Explaining Depression
What is the cognitive approach?
how thinking shapes our behaviour
--> concerned with how irrational thinking leads to mental disorders
Elli's ABC model
Activating event (A)
Irrational belief (B)
Unhealthy emotion (C)
--> source of these irrational thoughts is
musturbatory
thinking
--> the idea that certain ideas/assumptions MUST be true
Elli's focused on 3 key irrational beliefs:
I must be approved/accepted by people I find important
I must do well or I am worthless
The world must give me happiness or I will die
EXAMPLE
A: failed an exam
B: stupidity
C: depression
Beck's negative triad
--> proposed that depressed individuals feel as they do because their thinking is biased
--> they have created a negative schema during childhood
--> this leads to cognitive bias
the self
the world
the future
Linked research:
Krantz - found that depressed patients made more errors in logic when asked to interpret written material then non depressed patients
March - found that CBT was as effective as antidepressants
Treatment for depression:
CBT = cognitive behaviour therapy
the treatment involves identifying irrational thinking
aim is to challenge irrational and dysfunctional thought processes
extras = homework, behavioural activation + positive regard
Ellis: extended his ABC model to DEF
D - disputing irrational thoughts + beliefs
E - effects of disputing and attitudes on life
F - new feelings produced
EVALUATION
+ves
CBT has been found to be very effective
--> MARCH found 81% improvements
--> shows that CBT is valid
offers a more long term solution that drugs
e.g., CBT teaches patients coping strategies to use
people who use CBT rather than drug treatment are less likely to relapse as coping mechanisms are developed
-ves
not the most cost effective treatment
--> 8 - 20 sessions
--> £100 each
--> commitment
treatment may not be useful for people who have past trauma
--> someone with severe depression
THEREFORE... CBT works for some people but not others
requires a lot of motivation from the clients
e.g., diary entries, the will to change etc
--> shows that drugs may be more useful for certain individuals as it requires less motivation + is easy to do (SSRI'S)
MIDDLE GROUND:
the most effective method could be combining the 2 ( drugs + CBT )
--> 86% improvement
--> this suggests that one size doesn't fit all + that a combination may be more effective
Logical disputing = beliefs which do not follow logically from information available
Empirical disputing = beliefs which are not consistent with reality
Pragmatic disputing = the lack of usefulness of self defeating beliefs
EVALUATION
+ves
evidence to support the link between irrational thinking + depression
e.g., KRANTZ
--> found that depressed people make more errors in logic
--> negative thinking can occur because of pre existing depression
This shows that negative thinking pattens are associated with depression
the explanation has led to develop successful treatments for depression
--> CBT is now used for irrational thought processes
--> 81% improvement in people w/ depression
This suggests that treatment can give long lasting improvements to depression
THEREFORE... people who receive various treatments should be considered as this isn't the case for everybody
gives responsibility to the patient as they suggest it is their own thoughts and feelings which cause the depression
--> gives control over their diagnosis + have a responsibility to find the cause
-ves
cannot establish cause + effect
--> negative thinking and depression are associated with each other, but these thoughts can occur BECAUSE of depression
handing over the responsibility to the patient can be viewed as socially sensitive as it suggests their own thoughts and feelings are to blame for their depression
--> increases the stigma
--> contrasts to the biological explanation because they are not in control + not as socially sensitive as their is no blame
4 Main components of abnormality
Statistical Infrequency
What is it?
the extremes on a graph which is not define as morel i.e. 'abnormal'
it's a behaviour which is found in very few people in regards to the population
EXAMPLE
levels of IQ.. the top and bottom percentage are 'abnormal' (2.5%)
EVALUATION
+ves makes levels of people with the abnormalities more objective (a fact) and measurable than some of the other definitions
e.g., seeing someone with a low IQ would allow them to qualify for extra support in school
-ves the cut of point can be seen as arbitrary + subjective
e.g., if someone was 1 point above the boundary, they would need be qualified for the extra support
-ves fails to distinguish between harmful and adaptive behaviours
e.g., high IQ = rare (desired) depression = common (undesired)
-ves the definition can be hard to use in other cultures as one culture may have behaviours more common that others
Deviation From Social Norms
What is it?
norms are defined by society e.g., brush your teeth in the morning. These people aren't able/choose not to follow by these social norms
e.g., homosexuality was classified as abnormal and regarded as a mental disorder before it became normalised
EVALUATION
-ves an issue with this definition is that social norms vary from time to time within each culture
e.g., homosexuality is allowed in most countries, but in the past it was classified as a disorder
-ves the definition may also stigmatize certain individuals who's behaviour is eccentric but norm harmful
e.g., some people may decide to dress differently to others within society
Failure To Function Adequately
What is it?
being unable to manage everyday life e.g., eating regularly
e.g., P2 the DSM considered 6 areas including: understanding, communicating, getting around, self-care etc
answered on a scale 1-5 and given a score out of 180
EVALUATION
-ves the definition can be criticised for being too subjective, as the judgement may vary across different individuals
e.g., hearing voices may be harmful for one individual, but manageable for another
this is an issue because people may be diagnosed differently even though they have the same symptoms
-ves not all people with mental health issues/ 'abnormal' behaviour will show impaired functions
e.g., functioning alcoholics can still have friends and hold down a job etc
this is a problem because abnormal behaviours may not be treated because they are able to function
Deviation From Ideal Mental Health
What is it?
Marie Jahoda - identified characteristics commonly used to describe competent people:
high self - esteem
self - actualisation (reaching our full potential)
integration
autonomy
an accurate perception of reality
mastery of the environment
e.g., absence of these criteria would indicate abnormality
EVALUATION
-ves argued that this definition could be culturally biased on western ideals
e.g., goals of self actualisation may be more important in individualised societies rather than collective ones (Germany vs rural Japan)
this is a problem because there is limits how useful the definition is in all cultures
there is also an issue with how to define the criteria
e.g., self actualisation --> lacks validity
-ves the definition is also over idealistic
e.g., Jahoda says that all criteria must be met, which is unrealistic
this is a problem because if this was true, the majority of the population would be considered 'abnormal'
Biological approach to explaining OCD
The biological approach looks at both genetic and neural explanations
--> genetic explanations show that ODC is passed down through an individuals recessive gene ( parents )
--> neural explanations suggests that OCD is through the abnormal levels of serotonin + dopamine
What is a neuron?
nerve cells that transmit nerve signals to and from the brain
dendrite = branches from the cell body and bring information from the cell body e.g., receive signal from other neurones
axon = takes information away from the cell body
myelin = coats + insulates the axon
synapse = gap between the neuron + axon
What are neurotransmitters?
found in the synapse
made up of presynaptic endings ( contain receptor sites )
synaptic cleft = space between the presynaptic endings + postsynaptic endings
neurotransmitters = chemical messengers that allow neurons to communicate
DOPAMINE
higher levels of serotonin of dopamine are associated with OCD, in particular, the compulsive behaviours
COMT
SEROTONIN
lower levels of serotonin are associated with mood disorders, e.g., depression
SERT
Genetics in psychological research
HEREDITY = studies which show whether the OCD trait runs in families
focused on twin studies/family studies
IDENTICAL (MZ)
share 100% of their DNA
68% concordance rate
NON-IDENTICAL (DZ)
share 50% of their DNA
31% concordance rate
CANDIDATE GENE = studies looking for a particular gene that are involved in the traits
COMPT = involves the break down of dopamine
SERT = involved in serotonin transport
Genetic Explanations
focused on DNA and identifying specific candidate genes which implicate OCD e.g., COMP + SERT
Diathesis stress model - idea of a simple link between one gene and a complex disorder like OCD is unlikely
there must be other factors ( 'stressors' ) which affect the condition developing
Neural explanations:
orbital frontal cortex
basal ganglia
thalamus
The 'Worry' Circuit
basal ganglia + thalamus are the most effected for OCD to occur
Biological approach to treating OCD
anti-depressants !!! ( main focus )
anti-anxiety drugs
Anti-depressants
SSRI'S are used to increase the levels of serotonin in the synapse
usually serotonin is released from the pre-synaptic neuron, and is either absorbed or taken back into the sending cell
SSRI'S prevent the serotonin from being sent back, increasing the levels of serotonin in the synapse, resulting in higher levels
The drugs are seen to have improved moods, and reduce anxiety
+ves
easily accessible
requires little motivation
effective
cheaper
-ves
side effects
will not treat the CAUSE, but just manage the symptoms
Anti-anxiety
quietening influence on the brain
reduce anxiety ( experienced due to the obsessive thoughts )
Characteristics of Mental Disorders
PHOBIAS
What are phobias?
irrational fears which produce a conscious avoidance and fear e.g., spiders
2-6%
EMOTIONAL characteristics:
excessive, unreasonable, persistent
--> cued by the presence/anticipation of the object/situation
BEHAVIOURAL characteristics:
avoidance
--> body creates immediate response to avoid it
--> e.g., freezing/fainting
COGNITIVE characteristics:
irrational nature of a persons thinking
--> excessive/unreasonable responses
DEPRESSION
What is depression?
classified as a 'mood disorder'
--> must be over a long period of time/recurring
5%
EMOTIONAL characteristics
sadness, loss of interest, anger, lack of control
BEHAVIOURAL characteristics
activity levels decrease and/or increase
--> most likely decrease
sleep becomes affected
--> insomnia or oversleeping
COGNITIVE characteristics
negative thoughts = negative emotions
--> negative view of the world, relationships etc
OCD
What is OCD?
obsessive-compulsive disorder
--> classed as an anxiety disorder
2%
EMOTIONAL characteristics
considerable anxiety/stress
embarrassment + shame
consistent feeling of disgust
BEHAVIOURAL characteristics
repetitive, unconcealed e.g., consistent handwashing
feel 'compelled' to do these actions
--> all creates anxiety
COGNITIVE characteristics
recurrent + intrusive thoughts
--> perceived as inappropriate
uncontrollable which creates anxiety
--> disorder usually isn't recognised
Behavioural Approach to Explaining Phobias
Suggests that all behaviours are LEARNED, all through learning theory, developed by behaviourists.
How do phobias develop?
WATSON + RAYNER CASE STUDY:
Little Albert
subject was an 11 year old boy called Albert
he showed no fear responses to white furry object
e.g., white rabbit, white rat, cotton wool
W + R created a condition response to these objects, using a steel bar and hitting it, creating a loud bang
2 process model
used to explain how phobias are learnt , with the first stage being
classical
conditioning, the second being
operant
conditioning
Classical ( initiation )
NS - neutral stimulus
UCS - unconditioned stimulus
CS - conditioned stimulus
NR - neutral response
UCR - unconditioned response
CR - conditioned response
Operant ( maintenance )
explains why the individual continuous to maintain the fear
EXAMPLE: fear of dogs
... avoids houses with dogs
crossing the road if the person sees a dog
lock dogs away
EVALUATION
A01:
define both classical + operant conditioning and the components to go with them both ( use dog example )
+ves W + R support the two process model
Little Albert
--> demonstrates how phobias are introduced to children
e.g., steal bar + white mouse
--> generalise the fear
THEREFORE... supports behaviourists explanation for phobias as the theory is scientifically in a lab setting
--> increasing the validity of the theory
+ves led to develop more successful treatments
e.g., flooding + systematic desensitisation
--> provides extra supporting evidence
learnt vs unlearnt
-ves behaviourists explanation cannot explain why some phobias are more common than others
e.g., common = spiders/doctors
rare = mirrors/outside
THEREFORE... there must be a better explanation that shows that humans have adapted phobias because they were useful in our evolutionary past
-ves explanation also struggles to show why people sometimes never develop phobias
e.g., not all scary/traumatic experiences lead to phobias
THEREFORE... suggests that people have been predisposed to developing phobias
--> explanation cannot show how all phobias develop
--> could simply be because of vulnerability
The Behavioural Approach to Treating Phobia
The two therapies involve 'counterconditioning'
flooding
systematic desensitisation
attempts to spark a relaxation response
systematic desensitisation:
involves counterconditioning --> taught a new association that runs counter to the original association
relaxation --> focused breathing + slow breathing
desensitisation hierarchy --> Sd works by gradually introducing the person to the fear each step at a time so it is less overwhelming and their anxiety diminishes
( requires many sessions )
McGRATH : found 75% of patients phobias were treated through SD
flooding:
immersed into the experience in one long session, experiencing the phobia at its worst
--> session continues until the anxiety disperses
--> procedure can be conducted by real or virtual exposure to the fear
( one session 3 hours long )
--> the rational of flooding is that the person will release adrenaline until it reaches its limit
--> as adrenaline levels ultimately decrease, a new stimulus response link can be learned
EVALUATION
+ves
both treatments are effective
--> McGRATH found that they were 75% effective
--> CHOY found that both were effective, but flooding was the better option
both work to decrease phobias (long lasting
processes are much quicker than alternatives e.g., CBT
--> CBT 6 - 20 sessions ( 30 mins - 1hr )
--> SD 3 - 8 sessions ( 1hr - 15hrs )
--> F 1 session ( 2 - 3hrs )
behavioural therapies are much more cost effective... travel less + pay less
-ves
flooding isn't suitable for all patients
e.g., younger patients
--> can increase their anxiety even more
--> SD can be more suitable as it is more useful for a wider range of people
these therapies may only be effective for treating specific types of phobias
--> wouldn't be able to help people with more complex phobias e.g., social phobias
--> limits the usefulness of the therapies
--> therefore, CBT may be more effective ( using cognitive aspects )