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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