Please enable JavaScript.
Coggle requires JavaScript to display documents.
PSYCHOPATHOLOGY AO1 - Coggle Diagram
PSYCHOPATHOLOGY AO1
Definitions of Abnormality
Statistical Infrequency
defining abnormality in terms of statistics
most obvious way to define anything as normal or abnormal is in terms of no. of times it's observed
rarely seen/different behaviour = abnormal
any relatively usual or often seen behaviour can be thought of as normal
e.g. intellectual disability disorder
IQ normally distributed
average IQ = 100
most people have IQ between 85-115
individuals scoring below 70 are statistically unusual/abnormal + are diagnosed with intellectual disability disorder
Deviation from Social Norms
abnormality based on social context
when person behaves in way different from how they're expected to behave they may be defined as abnormal
societies + social groups make collective judgements about correct behaviours in particular circumstances
relatively few behaviours would be considered universally abnormal
definitions related to cultural context
e.g. homosexuality viewed as abnormal in the past + in some cultures
e.g. antisocial personality disorder
failure to conform to lawful + culturally normative ethical behaviour
deviate from social norms or standards
absence of remorse, lack of empathy
Failure to Function Adequately
person may cross line between normal + abnormal at point where they can't deal with demands of everyday life
Rosenhan + Seligman
proposed signs of failing to cope
person no longer conforms to standard interpersonal rules
person experiences severe person distress
persons behaviour becomes irrational or dangerous to themselves or others
WHODAS can be used to measure functioning in areas such as self care, getting along with people, life activities + participation in society
Deviation from Ideal Mental Health
Jahoda
criteria for ideal mental health
positive self attitude
self actualisation
integration
autonomy + independence
having accurate perception of reality
mastery of environment
if one or more of these criteria absent, person may be experiencing a mental disorder
enable us to feel happy + behave competently
Phobias
Behavioural Characteristics
panic
avoidance
endurance
Cognitive Characteristics
irrational beliefs
cognitive distortions
selective attention
Emotional Characteristics
anxiety
fear
unreasonable emotional response
Explaining - Behavioural Approach
Acquisition of Phobias
classical conditioning
Watson & Rayner
created phobia in 9 month old Little Albert
when shown white rat Little Albert tried to play with it
whenever rat presented, researchers made loud, frightening noise noise
noise = UCS, fear = UCR
rat = NS
when UCS + NS presented together, they become associated + both produce response of fear
rat now CS >>> CR
conditioning generalised to similar objects
according to behaviourists, abnormal behaviour can be caused by classical + operant conditioning
Mowrer
two process model
phobias learned through classical conditioning + maintained through operant conditioning
Maintenance of Phobias
operant conditioning
negative reinforcement
individual avoids situation that's unpleasant
such behaviour results in desirable consequence which means behaviour reinforced + will be repeated
Mowrer suggested whenever we avoid phobic stimulus we successfully escape fear + anxiety
this reduction in fear reinforces avoidance behaviour so phobia maintained
Treating - Behavioural Approach
Systematic Desensitisation
based on classical conditioning, counter-conditioning, reciprocal inhibition
therapy gradually aims to reduce anxiety through counter-conditioning
CS paired with relaxation = new CR
phobic stimulus (CS) produces fear (CR)
reciprocal inhibition
not possible to be afraid + relaxed at the same time so one emotion prevents the other
anxiety hierarchy formed with fearful stimuli arranged in order from least to most frightening
e.g. for client with arachnophobia anxiety hierarchy may be small spider picture to holding tarantula
relaxation practised at each stage of hierarchy
person with phobia first taught relaxation techniques then work through anxiety hierarchy, being exposed to phobic stimulus in relaxed state
Flooding
exposing people with phobia to phobic stimulus without gradual build up in anxiety hierarchy
immediate exposure
e.g. client with arachnophobia may have large spider crawl over their hand until they can relax fully
learning through extinction
without option of avoidance behaviour, person quickly learns phobic object is harmless through exhaustion of fear response
not unethical but is an unpleasant experience so it's important person being treated gives fully informed consent so they're fully prepared + know what to expect
Depression
Behavioural Characteristics
reduced activity levels
verbal + physical aggression
disruption to sleep
Cognitive Characteristics
poor concentration
dwelling on the negative
'black or white' thinking
Emotional Characteristics
lowered mood
anger
lowered self esteem
Explaining - Cognitive Approach
Beck's negative triad
some people more prone to depression because of faulty information processing
when depressed, people attend to negative aspects of situation + ignore positives
tend to blow small things out of proportion + think in 'black + white'
attention + perception affected
negative schema acquired during childhood
tendency to adopt negative view view of the world
negative schemas activated whenever person encounters new situation that resembles original conditions in which schema learned
negative schema lead to systematic cognitive biases in thinking
negative schema + cognitive biases maintain negative triad
negative triad
pessimist irrational view of 3 key elements of persons belief system
the self
the future
the world
Ellis's ABC model
Activating trigger/event
event occurs
Beliefs
interpretation of event, rational or irrational
Consequences
Ellis says rational beliefs lead to healthy emotional outcomes whereas irrational beliefs lead to unhealthy emotional outcomes
musturbation
I must do well
You must treat me well
The world must be easy
sets person up for constant disappointment
Treating - Cognitive Approach
Beck's CBT
most common psychological treatment
challenge negative irrational thoughts + change behaviour so it's more effective
client + therapist work together
aims to identify negative thoughts about self, world + future
thoughts must be challenged by client taking active role in treatment
clients encouraged to test reality of irrational beliefs
might be set homework - client as scientist
in future sessions, therapist can produce evidence to prove clients belief incorrect
homework vital in testing irrational beliefs against reality + putting new rational beliefs into practice
Ellis's REBT
rational emotive behaviour therapy
extends ABC model to ABCDEF model
Dispute irrational beliefs
Effects of dispute/Effective attitude to life
Feelings produced
challenge irrational thoughts
therapist identifies utopianism + would challenge it as irrational
empirical argument = disputing whether there's evidence to support irrational belief
logical argument = disputing whether -ve thought actually follows from the facts
pragmatic disputing = emphasises lack of usefulness of self defeating beliefs
as individuals become depressed they tend to increasingly avoid difficult situations + become isolated which maintains + worsens symptoms
goal of behavioural activation is to gradually decrease avoidance + isolation + increase engagement in activities that have been shown to improve mood
effective disputing changes self defeating beliefs into rational thoughts
if therapist provides unconditional +ve regard, this will facilitate a change in beliefs + attitudes
OCD
Behavioural Characteristics
compulsions - repetitive
compulsions - to reduce anxiety
avoidance
Cognitive Characteristics
obsessive thoughts
cognitive coping strategies
catastrophic thoughts
Emotional Characteristics
anxiety + distress
accompanying depression
guilt + disgust
Explaining - Biological Approach
Genetic explanations
family studies have revealed conflicting results from 0-30% genetic inheritance of OCD
Hettema
meta analysis demonstrated overall risk of 8.2% in first degree relatives of patients with OCD vs 2% in control group of relatives without OCD
looked at twin studies which have demonstrated genetic influences on OCD
MZ twins have concordance rate for OCD as high as 70-80% compared with 22-47% for DZ twins
heritability = 26-33% for twin studies
COMT gene
involved in production of enzyme which regulates dopamine levels
one form of COMT gene leads to reduced enzyme production leading to elevated dopamine levels
high dopamine levels in certain brain areas has been linked to symptoms of OCD (Tukel et al)
SERT gene
affects transport of serotonin, causing lower activity/effectiveness of serotonin which is associated with OCD
polygenic
unlikely OCD has simplistic monogenic aetiology
genetic element creates only a vulnerability which will only trigger in some people in certain environmental conditions
diathesis stress
Neural explanations
seretonin
inhibitory
hyposerotonergic
depressed/can't calm anxiety
dopamine
excitatory
hyperdopaminergic
over anxious/worrying
worry circuit
caudate nucleus normally supresses signals from orbitofrontal cortex
OFC sends signals to thalamus about things that are worrying
when CN damaged, it fails to suppress minor signals + thalamus is alerted which sends signals to OFC
Treating - Biological Approach
SSRI's
selective serotonin reuptake inhibitors
by blocking reuptake site, neurotransmitters are prevented from being reabsorbed into pre-synaptic nerve
increases amount of neurotransmitters in synapse + subsequently increases likelihood of it binding + effecting post-synaptic nerve
typical daily dosage of fluoxetine = 20mg but may be increased if not benefitting person
takes 3-4 months of daily use for SSRIs to impact upon symptoms
dose can be increased if appropriate
Alternatives
Tricyclics
block transporter mechanism that reabsorbs serotonin + noradrenaline
clomipramine acts on various systems
more severe side effects
SNRIs
increase levels of serotonin + noradrenaline
2nd line of defence for those who don't respond to SSRIs
Benzodiazepines
enhance activity of GABA
GABA locks onto GABA receptors, opening channel that increases flow of chloride ions making it harder for neuron to be stimulated
reduces anxiety