Alternative transcript:

interpersonal rules o e.g. - IDD - may not be able to cook for themselves or make safe decisions if they have a low IQ Psychopathology ▪ useful for assessing abnormality because it considers the patients perspective ■ could be the same as deviation from social norms because society pick the criteria for not functioning adequately ▪ judgements are subjective as it requires judging distress • Deviation from ideal mental health - when someone does not meet the criteria for good mental health according to the criteria proposed by Jahoda 1. No symptoms of distress 2. rational and can perceive ourselves accurately 3. can self-actualise 4. can cope with stress 5. realistic view of the world 6. good self esteem and lack of guilt 7. independent of other people 8. can successfully work, love and enjoy our leisure O covers a range of criteria for mental health 2 o comprehensive o cultural relativism o sets unrealistically high expectations for mental health Phobias Characteristics of phobias • behavioural characteristics: ● o panic o avoidance o endurance cognitive characteristics: o selective attention - suppress irrelevant information o cognitive distortions - thoughts that cause catastrophic thinking o irrational beliefs emotional characteristics: o anxiety o emotional response is unreasonable Behaviourist approach to explaining phobias • Mowrer - two process model acquisition - we can learn the phobia through associating the object with something negative or scary • maintenance - a phobia is maintained through reinforcement o makes the phobia long lasting o avoidance to prevent the experience - negative reinforcement Psychopathology 3 ● ● o avoidance maintains the phobia as the thoughts are not tested and the fear increases ● Seligman - humans are biologically scared of things that threatened the life of our ancestors Behaviourist approach to treating phobias systematic desensitisation - slowly removes the fear response of a phobia and substitutes a relaxation response to the stimulus gradually using counter conditioning o limitation of two process model as it suggests there are more aspects to consider o start with the least scary version of the phobia and slowly work up o gradual process o effective when the phobias have been learned o Gilroy - assessed 42 patients with arachnophobia ▪ at 3 months and 33 months after SD treatment, the SD group were less fearful than the control group o easier to withdraw o patient controlled o lower refusal rates o lower drop out rates flooding - a therapy where the person is exposed to their phobia immediately o continuous exposure causes anxiety levels to decrease o person is unable to negatively reinforce their phobia o Ougrin - found that flooding was at least as effective as other phobia treatments Psychopathology 4 ● ■ highly effective and quicker ■ less sessions needed for the same effectiveness o only works for simple phobias and not social phobias o not good for vulnerable groups o cheaper Depression characteristics of depression • behavioural characteristics: o activity levels o disruption to sleep and appetite o aggression cognitive characteristics: o poor concentration o dwelling on the negative o absolutist thinking emotional characteristics: o anger o lowered mood o lowered self esteem Psychopathology 5 Cognitive approach to explaining depression Beck's cognitive theory of depression • there are 3 parts to cognitive vulnerability ● ● o faulty information processing - tendency to attend to negative aspects of a situation o negative self-schema o the negative triad Negative views about the world THE COGNITIVE TRIAD Negative views about one's self Psychopathology Negative views about the future mindmypeelings supporting evidence: o range of evidence to suggest that depression is the result of faulty information processing and negative self schema o Cohen - monitored 473 adolescents and found that those considered cognitively vulnerable were later diagnosed with depression • Ellis's ABC model • conditions like depression are the result of irrational thinking which interferes with being happy o A - activating event 6 o B- beliefs o C - consequences • reactive depression - depression as the result of external events o can be attributed to a cause • endogenous depression - depression that occurs without the presence of stress or trauma with no apparent cause o can't be explained by Ellis' ABC model Cognitive approach to treating depression cognitive behavioural therapy (CBT) o a psychological method for treating mental health problems using behavioural and cognitive techniques o looks at the patients thinking processes and aims to challenge negative, irrational and automatic thought o teaches the patient techniques to help them change their behaviour to make it more positive o the therapist develops a rapport with the patient o they educate the patient on their condition and identify triggers Psychopathology emotion Thoughts behaviour 7 • ANTS - automatic negative thoughts about the world, future and self o replace them with BATS - better alternative thoughts • evaluation: o March et al - compared the effects of CBT alone, antidepressants alone and combined treatment and found that after 36 weeks, 81% of the CBT group improved and 86% of the combined group improved o focuses on the present and future but ignores the past o high relapse rates we see after CBT may be a result of the relationship with the therapist ending o cannot explain endogenous depression so cannot treat all types of depression Ellis's rational emotive behavioural therapy (REBT) - o adds onto the ABC model ▪ D-dispute ■ E - effects o helps the patient to identify irrational thoughts and challenge them with empirical arguments OCD characteristics of OCD • behavioural : Psychopathology 8 o repetitive compulsions o anxiety o avoidance • cognitive: o obsessive thoughts o cognitive strategies o insight into excessive anxiety • emotional: o guilt and disgust o accompanying depression o anxiety and distress Biological approach to explaining OCD genes involved in vulnerability are passed through families o Lewis - 37% of patients had parents with OCD and 21% had siblings with OCD o Nestadt - monozygotic twins had a 68% change of having OCD and dizygotic twins had a 31% change of having OCD o candidate genes - a gene associated with or suspected of causing a particular disease o polygenic - not caused by 1 gene but several genes o aetiologically heterogeneous - the origins of OCD vary from person to person • role of serotonin as an explanation: o low levels mean that mood relevant information is not processed and mood is affected Psychopathology 9 • decision making systems as an explanation: o abnormal functioning of the lateral frontal lobes are responsible for faulty decision making o left parahippocampal gyrus is associated with processing unpleasant emotions and functions abnormally in someone with OCD • evaluation points: o Cromer - over 50% of the patients in the sample had experienced a traumatic event in the past suggesting that OCD may not be entirely biological o co-morbidity of OCD and depression - means that we cannot be sure if the serotonin system is disrupted in OCD or whether serotonin levels are different because of the depression they experience o most research on the brain of someone with OCD is conducted as a post mortem exam which could be a problem because we cannot determine the direction of cause and effect Biological approach as a treatment to OCD • selective serotonin reuptake inhibitors - SSRIS o blocks the serotonin reuptake valves • Noradrenaline reuptake inhibitors - (SNRIs) o work on serotonin as well as norepinephrine tricyclics - o act on serotonin and norepinephrine and generally have worse side effects so are used as a last resort • evaluation: • Soomro et al - compared SSRIs to placebos for treating OCD ▪ there were better outcomes for those with SSRI than placebo Psychopathology 10 ■ symptoms reduced for 70% of the people ▪ the remaining people were helped by alternative drugs o Skapinakis et al - systematic review showed that cognitive and behaviour therapies were more effective than SSRIs in treating OCD o side effects to drugs o benefits for the economy - people are more likely to return to work if they are given the medication Psychopathology 11