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
Two process model (Mowrer, 1960)
Acquisition by CC
NS is paired with UCS which creates a CS-CR link
Little Albert - generalisation
Maintenance by OC
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)
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Cognitive approach to treating depression
AO1
Identify and challenge irrational thoughts, involves homework e.g. thought diaries, client as scientist
Beck: Identify and challenge neg thoughts about self, world and future
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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