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The document discusses the limitations of various psychological theories and models, including the two-process model of phobias, Beck's theory of depression, cognitive-behavioral therapy (CBT), genetic explanations of obsessive-compulsive disorder (OCD), research on the role of fathers in child development, and the continuity of attachment across the lifespan. It highlights areas where further research or alternative explanations are needed, and suggests directions for future research and clinical applications.
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Abnormality is defined as those behaviors that are ex- trimly rare, i.e. any behavior that is found in very few people is regarded as abnormal. E.g. IQ - statistically unusual if below
behavioural
c o g n i t i v e
negative reinforcement: phobic avoids phobic stimulus to escape anxiety response. this reduction in fear negatively reinforces avoidance behaviour and phobia is maintained.
important applications for therapy - if patient is prevented from practising avoidance behaviour phobic behaviour decreases. in conditions such as agoraphobia, avoidance is linked w/ feelings of safety. this explains why some agoraphobics are able to leave the house with others, just not alone. problem for two-process model ’ suggests avoidance is motivated by anxiety reduction some aspects of phobias require further explanation - easy to acquire phobias of things which were a danger in evolutionary past. this is biological preparedness (innate). shows there is more to acquiring a phobia than condition- ing. suggests conditioning alone cannot explain phobias. they may develop only where a vulnerability exists - two-process cannot explain this vulnerability. behav explanations are oriented twd explaining behav not cognition. however this is a limitation as there are cognitive elements of phobias such as selective attention and irrational be- liefs which cannot be explained thro' behaviourism.
DESENSITISA- patient and therapist form anxiety hierarchy - list of fearful TION (SD) stimuli from least to most frightening. relaxation is then practised at each stage of hierarchy. takes place over several sessions. 30 .
the exposure of the client to the actual anxiety stimulus until they can relax fully. w/o option of avoidance, patient learns quickly that phobic stimulus is harmless. this is known as extinction. patients must give informed consent & know fully what to expect. 31 .
Gilroy et al (2003): group of patients who had SD for spider phobia were less fearful than control group after three sessions after 3 and 33 months. shows positive effects are long-lasting. 32 .
flooding etc. are not suitable for some patients due to problems such as learning difficulties making it difficult for them to understand what is happening. for these patients, and most others, SD is an appropriate treatment as every step is discussed. 33 .
patients prefer it. it doesn't cause same degree of trauma as flooding. reflected in low refusal rates, and low drop-out rates.
social phobias cannot be treated this way due to their cognitive nature and so cognitive therapies may be more suitable to tackle irrational thinking. 35 .
Grazioli & Terry (2001) assessed pregnant women for cognitive vulnerability to depression before and after PORTING EVI- DENCE birth. women judged to be high-risk were more likely to suffer from PND. these congnitions can be seen before condition develops, suggesting Beck may be right about faulty cognition lead- ing to depression. 41 .
Beck's explanation forms basis for CBT which identifies and challenges elements of negative triad. strength of the explanation as it translates well into a therapy. 42 .
some depressed patients are deeply angry and Beck can- not explain this. some experience hallucinations, bizzare beliefs or the delusion that they are a zombie. Beck's theory cannot always explain all cases of de- pression - just focuses on one aspect of the disorder - reductionist 43 .
reactive depression follows activating event - but some forms arise for no apparent reason. Ellis' explanation only applies to some kinds of
depression 44 .
cognitive primacy: emotions are influenced thro' cogni- tions
disputing whether the negative thought actually follows from the facts 50 .
the goal of cognitive treatment is to get depressed individ- uals to gradually decrease avoidance and isolation and increase engagement in activities such as exercising. 51 .
compared w/ anti-depressant drugs after 36 weeks 81% of drug group and 86% of drug+ther- apy group were significantly improved. CBT just as helpful as medication and effective alongside medication good case for making CBT treatment of choice in NHS 52 .
in severe cases patients cannot motivate themselves to comply with the CBT in these cases it is better to treat w/ medication and have them take on CBT when they are more motivated limitation as it means CBT is not fully effective alone 53 .
all psychotherapies have the common basis of pa- tient-therapist relationship and the quality of this relation- ship may determine success rather than technique. comparitive reviews such as Luborsky et al (2002) find v small diffs btwn therapies - suggests they share a com- mon basis. 54 .
some patients want to explore their past, as their experi- ences may have led to the depression. however CBT has a focus on present and future
