Examples of courseworks (psychopahtology) from the last academic year 2017 18

Anglia Ruskin University Psychopathology Case Study 3 Word Count 1450 excluding references This essay is based on the case study of Kate Kate is a young female who is recently single following an unex.

Anglia Ruskin University Psychopathology Case Study 3

Word Count: 1450 excluding references

This essay is based on the case study of Kate Kate is a young female who is

recently single following an unexpected traumatic break-up with her partner Kate had a dysfunctional childhood, due to her parents being substance dependant and divorcing at an early age Kate’s Mother has bipolar and her Father died of a heart attack Based on the information provided, it can be hypothesised that her

psychopathological diagnosis is border line personality disorder, comorbid with

anxiety and depression

The case study will formulate an understanding of Kate’s underlying

psychopathological disorders following the theoretical models of psychodynamic and cognitive approaches The Psychodynamic approach was founded by Sigmund Freud Freud has been a huge influence in psychology and is his work is still used today (Glassman & Hadad, 2013) The Psychodynamic approach findings were largely based on Freud’s subjective case studies, and provide minimal empirical evidence and much of the work is queried today for its falsifiability The contrasting model is the Cognitive Approach Cognitive psychology was introduced in the 1960s

by Aaron T Beck The underlying principles are based on providing a cohesive narrative of the patient’s internal world Evidence and findings are obtained by

objective measures, including questionnaires and formulating models (Beck & Beck, 1995)

The Psychodynamic foundations centre on the notions that a dysfunctional

relationship with parents in early childhood are a determinant for the development of psychopathologies in adulthood This can be taken into consideration when reflecting

on the patient’s childhood It can be assumed that Kate’s parents were distant and displayed an inconsistent parenting style When a parent suffers with addictions, they unable to provide consist attention to children Kate states: “It was basically a case of who was most able to look after me at the time” Showing evidence of an insecure attachment style

Self-criticism and dependency are proposed personality dimensions the confer a vulnerability to developing depression Research from (Luyten, Sabbe, Blatt, &

Meganck, 2007) investigated diagnostic specificity of these traits, and their

relationship with severity of depression, gender differences and specific symptoms They found, self-criticism was strongly related with higher severity of depression, with medium effect sizes of dependency and larger for self-criticism “omen showed higher levels of dependency than men in the depressed group, and dependence and self-criticism may be effect of depression and not a cause

Object relations theory (Lubbe, 2010) identifies depression as a pattern of insecure attachment, set by the foundations established in childhood and progresses into adult life A study from (Herbert, McCormak, & Callahan, 2010) investigated the relationship between attachment of both friends and parents and made comparisons with symptoms of depression The results supported perceptions that childhood attachments and adult peer attachments, are predictive of current depressive

symptoms Object relation theories speculate depression can arise from fearing the

loss of an important and loved object, adopted in early life, and extends to being repeated in adult relationships (Kaslow & Magnavita, 2002)

In the understanding of personality disorders, defence mechanisms are a central aspect to understanding the pathology and development of the ego Patients

diagnosed with borderline personality disorder use a variety of defence mechanisms, such as repression In respect to this case, the patient may have repressed

memories of childhood trauma or of the death of her father

(Cooper, Perry, & Arnow , 1988) provide empirical evidence on studying defence mechanisms, evaluating the effect of Rorschach defence scales They concluded that the scales can predict aspects of psychological functioning, regarding

interpersonal relationships and tendencies towards self-destructive behaviour, but are not able to accurately detect specific defines mechanisms Further research from (Davidson & MacGregor, 1998) established that individuals with experienced early traumatic relationships and repressed memories are a factor of greater risk to mental health disorders

The psychodynamic theory focuses on internal conflict and explains that

experiencing thoughts of low self-worth and harbouring feelings of guilt, blame and anger, are a product of ongoing unconscious conflict in the mind This can manifest

in an individual as symptoms of anxiety A study from (Shevrin, 2012) focusing on patients with anxiety disorders aimed to measure unconscious conflicts contributed towards symptoms of anxiety Underlying conflicts were inferred by the researcher and their symptoms measured on a scale They concluded that those with

unconscious conflict scored greater, than those without, but further research should

be considered as a direct measurement of unconscious conflict is not possible

In contrast to the psychodynamic approach, the cognitive model considers personal beliefs and not behaviour, and argues that psychopathology results from patterns of negative thinking Behaviour, emotional and occasionally physical symptoms can occur from abnormal cognitions (Beck & Beck, 1995)

(Beck A T., 1967) argues that personality disorders assign individuals to behave in dysfunctional ways because of negative internal beliefs Core beliefs are

assumptions held about the world, other people are ourselves When the individual’s belief system is distorted are biased, this causes situations to be misinterpreted Dysfunctional behaviour can result in provoking reactions from the outside world which are consistent with the internal beliefs, and strengthening the initial incorrect belief

(Beck A T., 1967) theory of depression argues that people who negatively appraise events are prone to depression The underlying mechanisms contributing to

depression are: a cognitive triad of automatic negative thinking, including thoughts about the self, the world and the future In respect to the current case, Kate

experiences thoughts of “not being able to move forward” and feels “she has nothing

to offer” Examples of these negative thinking patterns arise naturally and

automatically

Negative schemas are personal expectations and can be beliefs that are negative and pessimistic in nature (Beck A T., 1967) argues these schemas are acquired in early life following from a traumatic event Traumatic events are defined as death or

a loved one, dysfunctional parenting or relationships and bullying or exclusion from friendship groups

Depressive schemas are dormant, but will be triggered following a stressful life

event, influencing how the experience is interpreted and the development of

dissatisfaction from the event Evidence from (Brown & Harris, 1986) conducted a longitudinal study on females, measuring personal support, levels of self-esteem, psychological disorders and personal life events They found that those who were diagnosed with depression had experienced traumatic life events in the last six

months They concluded that those who had personal support were less likely to experience depression, and those without pose a greater risk of relapse And

suggested poor intimacy and care from a parent in childhood is closely related to a poor self-image in adulthood External validation from others is a source of self-regard and those exposed to poor care in childhood are more likely to underestimate their own worth

(Seeds & Dozois, 2010) Studied the interaction of negative self-schemas and

negative life events of those diagnosed with depression There report found that those with cognitive vulnerabilities, such as negative schemas, contributes to the onset of depression (Ingram, Miranda, & Sagal, 1998) However, those without

cognitive vulnerabilities experience stressful events with appropriate levels of

negative mood and thoughts, and does not necessarily result in onset of depression

(Seligman & Maier, 1976) Provide a cognitive model of depression called learned helplessness Seligman’s theory argues depression can occur when someone learns their attempts to remove themselves from a negative situation makes no difference

to the negativity of the situation Consequently, they can become passive and remain stuck in the negative situation, and no longer are motivated to escape This theory relates to this case and explains a small number of symptoms to an extent, but it fails

to consider causal cognitions

(Golib & Colby, 1987) Studied people who have previously suffered with depression and those who have not, they found that those who had been depressed showed no differences when viewing their situation with attitudes of learned helplessness

Suggesting helplessness could be a symptom of depression and not a cause

In conclusion, it is important to consider the relationship between both approaches, and how they explain psychopathologies One theory does not fit everyone and comes down to the individual experiences The psychodynamic theory was argued

by Freud as a universal model of development for all, focusing on past events It has evolved and been modified over time, there is evidently observable evidence for his theories, but they remain unable to be falsified In comparison to the cognitive model,

it is passive and assuming Whereas, the cognitive model considers the interaction between maladaptive thinking and core belief systems and how they interact with depression and anxieties It is based on a construction of models and lays out

foundations, with an objective means of measurement, focusing on aspects of the present, taking a holistic approach

References

Beck, A T (1967) Depression: Causes and treatment Philadelphia: University of

Pennsylvania Press

Beck, J S., & Beck, A T (1995) Cognitive Therapy: Basics and Beyond

Brown, G W., & Harris, T (1986) Stressor, vulnerability and depression: a question

of replication Psychological Medicine, 16(4), 739-744

Cooper, S H., Perry, J C., & Arnow , D (1988) An emperical approach ti the study

of defense mechanisms: Reliability and preliminary validy of the Rorschach

defense scales Journal of Personality Assessment, 55(6), 187-203

Davidson, K., & MacGregor, M W (1998) A Critical Appraisal of Self-Report

Defense Mechanism Measures Journal of Personality, 66(6), 965-992

doi:10.1111/1467-6494.00039

Glassman, W E., & Hadad, M (2013) Approaches to Psychology: Theoretical

Foundations In Approaches to Psychology: Theoretical Foundations

Golib, I H., & Colby, C A (1987) Treatment of depression: An interpersonal

systems approach Pergamon Press

Herbert, G L., McCormak, V., & Callahan, J L (2010) AN INVESTIGATION OF

THE OBJECT Psychoanalytic Psychology, 219-234

Ingram, R E., Miranda, J., & Sagal, Z V (1998) In Cognitive vulnerability to

depression New York: Guildford Press

Kaslow, F., & Magnavita, J (2002) Comprehensive handbook of psychotherapy

New York: Wiley

Lubbe, T (2010) Object Relations in Depression A Return To Theory Hoboken:

Taylor & Francis

Luyten, P., Sabbe, B., Blatt, S., & Meganck, S (2007) Dependency and

self-criticism: Relationship with major depressive disorder, severity of depression,

and clinical presentation Depression and Anxiety, 24, 586-596

Seeds, P M., & Dozois, D J (2010) Prospective evaluation of a cognitive

vulnerability-stress model for depression: the interaction of schema

self-structures and negative life events Journal of Clinical Psychology, 66(12),

1307–1323 doi:10.1002/jclp.20723

Seligman, M., & Maier, S (1976) Learned Helplessness: Theory and Evidence

Journal ol Experimental Psychology, 105(1), 3-46

Shevrin, H (2012) University of Michigan Health Retrieved from

http://www.uofmhealth.org/news/unconscious-anxiety

Psychopathology

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PSYCHOPATHOLOGY 2

In psychology, there are key principles and concepts of different models that help a psychologist understand a patient’s issue In the case study, Sophie is a 66-year-old woman who has been referred by her GP to the community mental health team following a physical check-up

in which she described feeling “useless” and “lonely.” Her closest confidant, the husband, died some years earlier and she has been feeling the worst feelings possible In the following

discussion, the author analyzes the case study based on psychodynamic and social approaches in understanding the problem in the case study

Brandwein (2011) reports that the approach combines all the theories in psychology, especially the idea that human’s actions are affected by the unconscious from different aspects of the patient’s life The theory, developed from Sigmund Freud’s ideas postulate that a person’s feelings and behavior are influenced by a variety of factors The basic assumptions of the

approach are, first, that human behavior is affected by the unconscious (Greenson, 2016)

Secondly, the approach argues that a person’s behavior and feelings are rooted in childhood experiences, and that all actions are determined by the unconscious As the following discussion shows, psychodynamic approach can be used to understand the issues bedeviling the client

The first concept of the approach is that human behavior is determined by the

unconscious Wilson (2004) asserts that the unconscious part of the mind consists of mental processes which the conscious mind cannot access Freud (1916) had earlier theorized that the mind is the primary source of human behavior and that the most important part is the

unconscious part that a person cannot see Bornstein (2015) says that psychodynamic perspective emphasizes unconscious psychological processes The idea behind psychodynamic is that the issues individuals have and not resolved are usually pushed into the subconscious and

subsequently affects a person’s behavior

PSYCHOPATHOLOGY 3

Freud (1916) postulated that the conscious and the unconscious part of a human mind usually come into conflict producing a phenomenon called depression In majority of the cases, a person stores the undesired experiences they are not prepared to deal with in the unconscious mind, and they usually exploded bringing forth psychological issues In Sophie’s cases, she had a rough life that caused her current psychological situation Sophie is a caretaker; she used to take care of her parents, siblings, and later her husband In all these situations, it was not ideal

because the majority of the people she had to take care of were unwell and emotionally draining Hence, according to psychodynamic approach, she repressed these feelings, pushing them into the unconscious mind Her current problems are a manifestation of the issues in her life she has repressed into the unconscious mind

Bateman, Brown, and Pedder (2010) noted that early childhood experiences play role in future psychological underpinnings of the concerned person According to the approach,

traumatic childhood events have a significant influence on how adult live their lives and their psychological situations Traumatic events that occur in childhood are usually pushed into the subconscious (as discussed above), but later causes problems because they have never been resolved Sophie had a rough childhood She had to take care of her sick mother while at the same time ensuring the family was cared for because her father was a drunk who did not look after the family’s interests These early childhood experiences of taking care of sick people could

be the reason she is feeling “useless” and “lonely” because she has no one to take care of

Robinson and Gordon (2011) argues that psychodynamic approach is further based on the assumption that nothing in the mental sphere of a person happens by chance From Freudian thoughts, psychodynamic theory is strongly determinist because it assumes that a person’s

behavior is affected by unconscious issues which the individual has not control over (Freud,