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Psychopathology, Phobias, Involves identifying thoughts of the negative…

- - - - A primary Symptom is 'the absence of prosocial internal standards'. Essentially psychopaths are classified on whether they conform to societal standards.
    - - Strength:
        
        Useful for diagnosis, as many signs for disorders are compared against norms. For example what qualifies as 'strange' thoughts in schizophrenia is compared
      - Limitation:
        
        Culturally variety may lead to a person being classfied as abnormal just because they're from another culture. Meaning it cannot universally define abnormality.
  - - - they experience servere personal distress
      - their behaviours become irrational or dangerous to themselves or others
      - they no longer conform to standard interpersonal rules (e.g. maintaining eye contact + respecting personal space
    - - as well as requiring a low IQ for a diagnosis, an individual must also be failing to function adequately
    - - Strength:
        
        it represents a sensible threshold for when people need professional help, lots of people experience symptoms however now we can be target help at those who need it most
      - Limitation:
        
        non-standard lifestyles may be labelled as abnormal, for example living off-grid or choosing to engage in high-risk leisure activities, freedom of choice is restricted
  - - - Strength:
        
        It may be utilised in order to diagnose or establish the severity of an individuals symptoms. Being used in the Beck Depression inventory
      - Limitation:
        
        Stat Infrequency also qualifies positive attributes. For example someone who is diagnosed by IDD, is also just as abnormal with someone who has an IQ of 130.
  - - - Strengths:
        
        The range of criteria allows to cover most of the reasons why we might need help with mental health, means that mental health can be meaningfully discussed so therefore the theory provides a checklist in which we can use to assess ourselves
      - Limitations:
        
        The elements of the ideal mental health criterion aren't all equally applicable to different cultures. In particular the concept of self-actualisation would be dismissed as self-indulgent in collectivist cultures
- - - - Cognitive Coping Strategies: Mental techniques which alleviate stress but appear abnormal to others. E.g excessive praying
      - Insight into excessive anxiety: Those with OCD are aware their compulsions and obsessive thoughts are not based in reality
      - Obsessive Thoughts: Typically repetitive thoughts, which create unpleasant emotions
    - - Avoidance - staying away from situations that trigger anxiety
      - Compulsions reduce anxiety: So are maintained
      - Compulsions are repetitive: E.g Hand washing
    - - Accompanying depression: low mood and lack of enjoyment in activities
      - guilt and disgust: Even for minor issues (If even issues at all)
      - Anxiety/distress: obsessive thoughts are unpleasant and frightening
  - - - Candidate Genes - Several genes are impicated in the development of OCD, for example, 5Ht1-D beta, which is associated with the transportation of serotonin across synapses.
        
        Polygenetic - OCD is caused by multiple genes, all of which slightly increase the likelihood of developing it. Taylor (2013) suggested there are 230 genes involved in OCD.
        
        A03: (Strength)Research support from twin studies. Nestadt et al. found a concordance rate of 68% for MZ, and 31% for DZ
        
        (Limitation)However, if entirely genetic, should be 100% concordance. May be due to environmental factors. Cromer found that over half of those with OCD have experienced a traumatic event.
    - - Role of Serotonin - Serotonin is involved in regualting mood. If this does not occur a person will experience low moods
        
        A03:(Limitation) Many people with OCD have depression as well (Co-morbidity). It may be OCD is disrupted due to depression instead
      - Brain Structure - With some OCD, especially hoarding, is associated with improper decision making which is associated with abnormalities in the lateral frontal lobes.
  - - - SSRIs (selective serotonin reuptake inhibitor):
        
        Alternatives to SSRIs - dosage can be increased or combined with other drugs (if SSRIs are not effective)
        
        SNRIs - antidepressants which increase levels of serotonin and noradrenaline, more recent
        
        Tricyclics - antidepressants, works on various systems (including the serotonin system), has severe side effects, older
        
        A03!!!!
        
        Drugs can have severe side effects, e.g. blurred vision, indigestion and loss of sex drive. For most they are short-term however for some they are long-lasting, some people also get no benefits from the drugs. Tricyclics can cause more serious and common side effects
        
        They prevent the reabsorption and breakdown of neurotransmitters, increasing levels of serotonin in synapses
        
        Neurotransmitters are released by the pre-synaptic neurone, then chemically conveys the signal to the post-synaptic neurone before being absorbed, broken-down and reused by the pre-synaptic neurone
        
        When breakdown is prevented, the post-synaptic neurone continues to be stimulated, compensating for what is wrong with the serotonin system in OCD
        
        These can be used alongside CBT as drugs reduces emotional symptoms, allowing people to better engage with CBT
        
        AO3!!!
        
        Evidence for effectiveness of SSRIs: Soomro et al (2009) compared the drugs to placebos, participants with drug conditions all had significantly better outcomes than those with placebos. Typically symptoms reduce for 70% of people taking SSRIs
      - Aims to increase/decrease levels of neurotransmitters in the brain
      - AO3!!!
        
        Drugs are cost-effective and not disruptive to people's lives, thousands of drugs can be manufactured in the time it would take for one session of psychological therapy
- - - - Disruption to sleep and eating: Becomes irregualar, or too much / too little
      - Aggression and self-harm: Quick to anger, or anger for no reason, directed at others or the self
      - Activity Levels: Will likely experience reduced activity, and feelings of fatigue
    - - Poor Concentration: Unable to stay on one task, and make descions
      - Dwelling on the negative: Pessimistic view, remembering sad events not happy
      - Absolutist thinking: Considering events as black and white. Any minor negative is catastrophic
    - - Anger: Feelings of anger both at the self and others.
      - Lowered Mood: Feelings of worthlessness and emptiness
      - Lowered Self-esteem: Often going as far as to self hatred
  - - - Suggests those with depression have faulty information processing, only focusing on the negative
        
        A negative self-schema, which means all information is processed in a negative and depressive manner
        
        When a person is depressed they experience negative views on; the future, the world, and the self
        
        A03: (strength) Clark and Beck performed a review, looking at the concept of cognitive vulnerabilities to depression. They found these vulnerabilities even proceeded depression
        
        This was supported by Cohen et al. who tracked 471 adolescents, regularly measuring vulnerabilities. These predicted depression in later life
    - - A - Activating event: Ellis suggested a triggering event would lead to irrational thinking
        
        B - Beliefs: A range of irrational beliefs, e.g Utopianism, the view everything should always go smoothly
        
        C - Consequences: The emotional and behavioural consequences of irrational thoughts
        
        A03: (Strength) Real world application for the therapy REBT, which helps relieve symptoms and change beliefs (David et al. 2018)
        
        (Limitation) However, it only explains depression following event. Not endogenous depression (Depression which seemingly has no reason)
- - - - Johng et al. found that 73% of people who have a high level of dental anxiety, experienced some related degree of trauma, compared to 21% in the control.
        
        Counter; There are many who haven't experienced trauma. For example those with a snake phobia in countries which don't have snakes
- - - - There are three stages within SD...
        
        2.) Relaxation - The therapist teaches relaxation techniques. As it is impossible to be relaxed and anxious. One overpowers the other. (Reciprocal Inhibition).
        
        1.) Anxiety Hierarchy - Patient and Therapist create a list of events involving the phobic stimulus, from least to most fear inducing
        
        3.) Exposure - Bringing the hierarchy into practice over several sessions at a pace which they feel comfortable
      - A03: (Strength) Research for effectiveness, Wechsler et al. (2019) concluded that SD is effective for specific phobias, social phobias, and agoraphobia.
        
        Additionally this method of treatment is most applicable to people with learning disabilities
  - - - Flooding may work suddenly because it eliminates the act of avoidance so the client quickly learns the stimulus is harmless. However it can be a traumatic process so a participant must give informed consent
    - - Flooding is a highly unpleasant experience, it provokes extreme anxiety and attrition (drop-out rates) are higher than for SD and incomplete treatment can worsen phobias
      - Flooding is cost-effective, it is clinically effective + not expensive and can work in as little as one session