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Psychopathology

Definitions of

abnormality

AO1

Statistical infrequency: top / bottom 2% is abnormal e.g. IQ

Deviation from social norms; culture and time bound

Failure to function adequately; cannot cope with demands of living, observer discomfort 

Deviation from Ideal Mental Health: Jahoda (1958) positive criteria, e.g. self actualisation

AO3

- Lack of cultural relativism 

+/- Real world application

+/- Distinguishes between helpful and unhelpful behaviour?

+/- Subjectivity v objectivity

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Behavioural approach to treating phobias

AO1

Systematic desensitisation

Gradual exposure

Based on reciprocal inhibition

Anxiety hierarchy with therapist

Relaxation until CS-CR link replaced - counter conditioning

Flooding

Immediate exposure

Cannot avoid - quick learning through extinction

AO3

+ SD is effective (Gilroy 2003) 42 ppt with spider phobia

+ SD suitable for diverse ppt

+ Flooding is cost effective - NHS

- High attrition rates flooding

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Biological approach to explaining OCD

AO1

Genetic

Inherit a genetic predisposition

Polygenic, 230 candidate genes (Taylor, 2013) aetiologically heterogenous

COMT gene - low COMT enzyme -high dopamine (obsessions)

SERT gene - high protein - low serotonin (anxiety)

Neural

Abnormal levels of neurotransmitters - high dopamine = compulsion / low serotonin = anxiety 

Worry circuit - OFC sends worry messages to thalamus. Damaged caudate nucleus does not suppress the messages

AO3

+ Nedstadt (2010) concordance rates of 68% MZ / 31% DZ

- Cromer (2007) 1/2 of OCD ppts experienced trauma

+ SSRIs are effective at reducing symptoms (link to serotonin)

+ Menzies (2007) brain scans of OCD and family members - both had reduced grey matter

+ Biologically deterministic

Phobias, depression & OCD

AO1 only

Phobias

Behavioural: Panic and avoidance

Emotional: Anxiety and fear

Cognitive: Irrational beliefs and cognitive distortions

Depression

Behavioural: Reduced activity, changes to eating/ sleeping

Emotional: Low mood, anger, low self esteem

Cognitive: Poor concentration, negative biases

OCD

Behavioural: External compulsions and avoidance

Emotional: Anxiety and distress

Cognitive: Internal obsessions, aware of irrationality

Cognitive approach to explaining depression

AO1

Dysfunctional thinking leads to depression

Beck - Faulty thinking e.g. black-white thinking, negative triad: negative schemas of self, world and future

Ellis - ABC Model: irrational beliefs around events - Activating event, Belief, Consequence

Mustabatory thinking - ''I must''

AO3

+ Grazzioli & Terry (2007) - 65 pregnant women

+ Real life application to CBT / REBT

- Reductionist - ignores biology

- Blames the client and ignores situation

- Ellis' model can only explain reactive depression

Biological approach to treating OCD

AO1

SSRIs: Prevents reuptake of serotonin as blocks the transporter & increases serotonin in synapse

e.g. Prozac - Fluoxetine - 20mg - 3 months to impact

Can be used with CBT

SNRIs: Works as above but on serotonin and noradrenaline and more side effects

Anti-anxiety drugs: Targets GABA (inhibitory) by increasing the activity

e.g. Benzodiazepines Valium

Can be addictive so given in small quantities

AO3

+ Soomro (2009) - 17 studies SSRIs - 70% effective

+ Cost effective and non disruptive

- Side effects e.g. vision, sex drive

- Publication bias due to funding from pharmaceuticals

Behavioural approach to explaining phobias

AO1

Phobias are learnt

Two process model (Mowrer, 1960)

Acquisition by CC (association)

NS (dog) is paired with UCS (bite) which creates a CS-CR link

Little Albert - generalisation

Maintenance by OC (consequences)

Negative reinforcement - avoidance is rewarded with no fear

AO3

+ Real world application - treatments of phobias

- Does not consider cognitions e.g. social phobias

- Ignores evolutionary factors (Bounton, 2007)​​

Cognitive approach to treating depression

AO1

Identify and challenge irrational thoughts, involves homework e.g. thought diaries.

Beck: Identify and challenge neg thoughts about self, world and future. Client as scientist.

Ellis: Rational Emotive Behavioural Therapy adds Dispute, Effective new belief to ABC Model

Logical, empirical, pragmatic disputing

AO3

+/- March (2007) 81% CBT, 86% CBT and drug therapy

- Relies on being motivation but symptom is avolition

- Too focused on thinking and not clients environment

- Not suitable if deep rooted childhood trauma

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