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Psychopathology - Coggle Diagram

- - - - Maladaptive behaviour - individuals behave in ways that goes against their long term interests
        
        Personal anguish - The individual suffers from anxiety or distress
        
        Observer discomfort - The individual's behaviour causes distress to those around them
        
        Irrationality - Unexpected/unpredicted behaviour
        
        Unconventionality - behaviour doesn't match what is typically expected in society
  - - - Environmental Mastery - The ability to adapt and thrive in new situations
        Autonomy - The ability to act independently and trust in ones own abilities
        Resistance to stress - The internal strength tope with the stresses of daily life
        Self-actualisation - The ability to reach ones potential through personal growth
        Positive attitude towards one-self - Characterised by high self esteem and self-respect
        Accurate perception of reality - The ability to see the world as it is without being distorted by personal biases
        
        Evaluation: :no_entry: According to the features of ideal mental health most people would be seen as abnormal as it is very hard on a day to day basis to achieve all criteria
        :no_entry: Imposed epic - problematic when a perspective from one culture is generalised globally
        :check: More holistic approach to mental health - considers multiple factors in diagnosis
- - - - Emotional: Anxiety - An uncomfortable and persistent state of arousal making it difficult to relax - heightened when encounter the phobia
        Fear - An intense emotional state linked to the fight or flight response a sensation of extreme and unpleasant alertness in the presence of the phobia
        
        Cognitive: Irrational thoughts - Negative and irrational mental processes that include an irrational belief in the harm the phobic object could cause them
        Reduced cognitive capacity - People with a phobia can not concentrate on day to day activities like work due to excessive attentional focus on the phobic objects
  - - - Acquisition: Classical conditioning - A phobic object (a bee) starts as a neutral stimulus as there is a neutral response to it (no response).
        An unconditioned stimulus (pain - being stung) creates an unconditioned response of fear.
        An association is formed when the neutral stimulus (bee) is paired with the unconditioned stimulus (pain - being stung) to create the phobic object to become the conditioned stimulus and the conditioned response being fear.
        
        Maintenance: Operant conditioning - learning through consequence
        A person with a phobia is aware of their phobia and will try to avoid their phobia and the situations that put them in contact with it.
        The avoidance of behaviour leads to a reduction in anxiety which is a pleasant sensation - this reinforcement strengthens the phobia making the person more likely to avoid the phobic object in the future
      - Phobias can be generalised so that a conditioned fear response can also be experienced in the presence of stimuli similar to the conditioned stimulus (other flying insects)
        
        Evaluation: :check: Supporting research by Watson and Rayner - Little Albert - generalisation also shown as fear of white rat also lead to fear of other white fluffy objects
        :no_entry: Behaviourist approach does not fully explain all behaviours - DiNardo found people who had experienced a conditioning event such as dog bite only 56% had phobia of dog - Mendes and Clark found that only 2% of children with phobia of water could recall a negative experience of water
        :no_entry: Evolutionary phobias - snakes and spiders - phobias of ancestors therefore suggesting phobias are hereditary
        :check: Practically applied in counter-conditioning therapies such as systematic desensitisation and flooding
  - - - Systematic desensitisation:
        
        Therapist teaches the client relaxation techniques like breathing exercises.
        
        The client creates an anxiety hierarchy
        
        the client is exposed to each level of the hierarchy starting at the lowest and when exposed the client must learn to relax - the therapist only moves the client to the next level when the client fully relaxes on the level they are at
        
        When the client can hold the phobic object without fear the association is extinct and new association with relaxation is formed
        
        Evaluation: :check: Client controls SD making it a more pleasurable experience as they limit their anxiety
        :no_entry: SD is time consuming and some pptc's may drop out of completing it - also as it is a talking therapy it is expensive
        :no_entry: Due to its stressful nature, flooding isn't appropriate for older people, people with heart conditions or young people - phobia is reinforced if flooding fails :check: temporary nature of drugs and possibly side effects - people prefer behavioural treatments
      - Flooding: Attempts to counter-condition a phobia by immediate and full exposure to the maximum level of phobic stimulus . Immediate exposure is expected to cause extreme panic response in the client - the therapists job is to stop the client escaping the situation. A fear response takes energy - eventually client will exhausted and calm down in the presence of the phobic object
- - - - Emotional: Sadness - a persistant low mood.
        Guilt - linked to helplessness and a feeling that they have no value in comparison to other people
        
        Cognitive: Poor concentration - People with depression cannot give their full attention to tasks
        Negative Schemas - Automatic negative biases when thinking about themselves, the world and the future
  - - - Beck's Negative Triad: Three schemas with a persistent automatic negative bias -
        The Self - Aka self schema's, feeling inadequate or unworthy
        The World - Thinking people are hostile or threatening
        The future - Thinking things will always turn out badly
        This can lead to avoidance, social withdrawal or inaction
        Develops in childhood but provides the framework for persistent adult biases - cognitive distortions.
        Cognitive Distortions - Overgeneralisation = One negative experience occurs - same thing will always happen
        Selective abstraction - Mentally filtering out positive experiences and focusing in negative ones
      - Schema - mental frameworks/ expectations based on experience
      - Ellis's ABC Model -
        Activating Event = Anything that happens to someone
        Belief = Irrational beliefs about the activating event
        Consequence= irrational beliefs lead to negative consequences
        
        Mustabatory thinking: The consequence of not accepting that we don't live in a perfect world
        
        Evaluation: :check: Cognitive explanation of depression has led to highly affective therapies e.g. CBT - 81% effect after 36 weeks
        :no_entry: Family studies suggests a predisposition to depression is inherited - biological aspect to depression
  - - - Ellis' REBT: Rational emotive behavioural therapy - development of ABC model adding D for dispute (therapist confronts irrational beliefs) and E for effect (reduction of irrational thoughts - restructured beliefs leading to better consequences in the future)
        Shame attacking exercises - the client performs a behaviour they fear doing in front of others showing the client they can act against their emotions in an unpleasant setting and survive other peoples dissaproval
        
        Evaluation: :check: March (2007) randomly assigned 327 patients to one of three groups CBT, drug therapy and a mixture of both - after 36 weeks 81% success rates for CBT and drugs and less suicide rates for CBT (more personal therapy)
        :no_entry: Expensive and time consuming therapy - less completion - requires motivation
        :no_entry: Some critics argue that CBT may be victim blaming arguing that if they just changed their way of thinking then their depression would go away
- - - - Emotional: Anxiety - An uncomfortable and persistent state of arousal making it difficult to relax - Anxiety results from the obsession, the constant worse case scenario thinking that defines OCD
        Depression - A consistent and long-lasting sense of sadness - unable to control the anxiety that the obsession causes - leads to social withdrawal
        
        Cognitive: Obsessions - intrusive, irrational and recurrent thoughts that tend to be unpleasant catastrophic thoughts about potential dangers
        Hypervigilance - A permanent state of alertness where the sufferer is looking for the source of their obsessions
        Selective attention - the individual with OCD is so focused on the objects connected to the obsession they cannot focus on things in their environment or a conversation
  - - - Genetic explanation: There is no ONE OCD gene although it is through that a vulnerability or predisposition to OCD is inherited - OCD is polygenic as many candidate genes have been found more frequently in people with OCD such as the SERT gene which affects the reuptake of serotonin in the system, gene 9 and COMT gene. - family and twin studies - concordances rate with general pop is 2%, first - degree relatives 10%, DZ twins 31% and MZ twins 68% suggesting predisposition to OCD is inherited
        
        Neural explanation: Biochemical causes - an imbalance of neurotransmitters. Low serotonin levels are thought to cause obsessive thoughts - due to it being removed too quickly from the synapse before it has been able to transmit its signal.
        Sratonin and other euro transmitters are chemical messengers - Presynaptic neurons release neurotransmitters, receptors on the post-synaptic neutron detect these - if the signal is strong enough then the message is passed on - the neurotransmitters detach from the receptors and are taken back to the presynaptic neutron (reuptake) - this process happens too quickly in people with OCD - SERT gene is responsible for transportation of Serotonin
        
        Neural Structures: The 'worry circuit' - Set of brain structures - orbital frontal cortex(OFC) (rational decision making) the basal ganglia system specifically the caudate nucleus and the thalamus - communication between these (the worry circuit) high in people with OCD - in normal functions basal ganglia filters out minor worries from the OFC - if this area is hyperactive then worries reach the thalamus which is then passed back to the OFC forming a loop (reoccurring obsessive thought) - repetitive motor functions (compulsions) attempt to break this loop (temporary relief)
        
        Parahippocampal gyrus - also linked to OCD as responsible for regulating and processing unpleasant emotions and functions abnormally in people with OCD
        
        Evaluation: :check: Nestadt (2010) - concordance rate between close family = 10% between DZ twins 31% and between MZ twins 68%
        :no_entry: Correlation between family and twins studies and genetics does not mean causation - MZ twins 68% not 100% suggest other factors may be involved (environmental)
        :check: Several neuroimaging using PET scanners have shown hyperactivity in the OFC and caudate nucleus in people with OCD when scanning the brain at rest and when Sam,ptoms are stimulated
  - - - SSRIS - Selective Seratonin reuptake inhibitors - They only influence serotonin in the brain; as reuptake inhibitors, they inhibit (slow down) the reuptake process in the synapse - serotonin will remain in the synaptic cleft and continue to stimulate the post-synaptic neuron - decreasing anxiety by normalising the activity of the worry circuit.
        
        SSRIs can take up to four months to reduce symptoms - for some patients are not affective - dosage can be increased for drug - resistant patients or other options such as benzodiazepines - these enhance the neurotransmitter called GABA slowing the CNS = general relaxation
        
        Tricyclics and SNRIs work by increasing serotonin and noradrenaline - because they work on multiple neurotransmitters (non-selective) may mean more intense side effects for patients
        
        Evaluation: :check: Soomro conducted a meta- analysis from 17 studies that compared SSRIs to placebo's - 3097 pptc's - results of the large-scale meta-analysis showed that SSRIs significantly reduced the symptoms of OCD compared to placebos between 6-17 weeks after treatment
        :check: Relatively in-expensive and potentially more convent for patient compared to psychological treatments like CBT
        :no_entry: potential of side effects
        :no_entry: Drug treatments only cover up the symptoms of OCD not treat the cause = temporary solution