Depression and OCD Flashcards

Question

A03) Supports A01-

Answer 1

COMBINATION OF BIOLOGICAL AND COGNITIVE IS THE BEST!

Answer 2

P) Strength --> Research into its effectiveness in treating depression. E) March et al (2007) --> CBT was just as effective as antidepressants when treating depression. Researchers examined 327 diagnosed adolescents and focused on the effectiveness of CBT, antidepressants and the combination of both. E) 36 weeks --> 81% of the antidepressant group and 81% of the CBT group had largely improved- supports effectiveness. L) 86% of the combination group had significantly improved -> combination may be more effective.

Answer 3

P) Strength --> research into its effectiveness. Ellis (1957) claimed a 90% success rate for REBT, which took 27 sessions on average to complete the treatment. E) Review by Cuijpers et al (2013) of 75 studies found that CBT was superior to no treatment. E) However --> Ellis recognised that the therapy was not always effective. He believed an explanation for this was clients not putting their revised beliefs into action, as well as therapist competence, which explains a significant amount of the variation in CBT outcomes. L) Therefore --> REBT is effective, but other factors associated with both client and therapist may limit its success.

Answer 4

P) Requires motivation. E) Patients with severe depression may not engage or attend = ineffective treatment. E) Alternative treatments eg. antidepressants do not require a large level of motivation = more effective. L) CBT cannot be used as a sole treatment for severely depressed patients (who may lack motivation) to attend and discuss emotions.

Answer 5

P) Over emphasises the role of cognitions as the primary cause of depression. E) Some psychologists criticise CBT for not looking at other factors such as social circumstances, which may have contributed. E) Further demonstration = a patient suffering from domestic violence or abuse. In this case, they do not need to change their irrational beliefs, but need their circumstances to change. L) CBT would be ineffective in treating patients with social factors until their situation has changed.

Answer 6

P) Suggested that the success of CBT may actually be down to the relationship between client and therapist rather than the techniques. E) Rosenzweig (1936) argued that the relationship is the most important factor in determining the success of CBT. E) It is argued that simply having someone to talk to may be the crucial component rather than specific techniques adopted by Beck or Ellis. L) This viewpoint is backed up by Luborsky et al al (2002) who shows that there is very little distance between different methods of psychotherapy.

Answer 7

Issues and Debates: -Considers both nature and nurture, since maladaptive thinking, according to Beck is automatic (nature), but can be modified by experience such as undertaking CBT (nurture). Soft determinism is therefore advocated where behaviour is regulated by mediational processes and an individual can dispute their irrational thoughts, with practice. -Can be considered fairly scientific due to methods used to investigate. However, researchers are unable to directly observe the thinking processes involved for a depressed patient.

Answer 8

A disorder characterised by obsessions and compulsions. A person feels driven to perform in order to prevent or reduce anxiety. Often repetitive and rigid behaviours. Affects 2% of the population.

Answer 9

OCD- obsessions and/or compulsions. Trichotillomania- compulsive hair-pulling. Hoarding disorder- the compulsive gathering of possessions and the inability to part with anything, regardless of its value. Excoriation disorder- compulsive skin-picking.

Answer 10

Compulsions are repetitive- Repetitive, habitual eg. washing counting, ordering. Compulsions reduce anxiety- Only 10% of OCD show compulsions without obsessions. Most of the compulsions serve the sole purposed to reduce anxiety. Avoidance- Sufferers may attempt to avoid situations eg. germ avoiders may avoid bins.

Answer 11

Anxiety and distress- Unpleasant and frightening. Accompanying depression- Depression often accompanies OCD, compulsions may reduce anxiety, but they're only short term fixes. Guilt and Distress- These can be about the self or external factors (eg. dirt) and guilt is often irrational.

Answer 12

Obsessive thoughts- 90% of suffers have recurring thoughts which are unpleasant. Cognitive Coping Strategies (can seem abnormal)- They devise their own ways to cope with obsessive thoughts eg. family members dying - will choose to pray everyday. Can interfere with everyday life. Insight into excessive anxiety- They are aware their thoughts and behaviours aren't rational. They are hyper vigilant and alert of potential hazards.

Answer 13

Concordance rate- A measure of genetic similarity eg. the rate that one twin will have a disorder if the other one has it. Dopamine- A key neurotransmitter in the brain, which effects on motivation and drive. Serotonin- Another neurotransmitter which has an effect on mood regulation. Gene- Part of a chromosome of an organism that carries information in the form of DNA. Neurotransmitter- Chemical substances in the brain that play an important role in the nervous system by transmitting nerve impulses.

Answer 14

- An imbalance in the brain. - Genes are involved in individual vulnerability to OCD. - Lewis (1936) observed that: 37% of patients with OCD also had a parent with OCD. 21% had a sibling with OCD. This suggests that there is a genetically inherited vulnerability. - According to the diathesis-stress model, certain genes leave some people more likely to develop a mental disorder, but it is not certain. Some environmental stress is necessary to trigger the condition. Nestadt (2010)- Reviewed previous twin studies MZ (identical) - 68% rate. (100% genetic material) DZ (non identical) - 31% rate. (505 genetic material)

Answer 15

Candidate genes are specific genes which create vulnerability for OCD. It is believed that OCD is a polygenic condition - meaning several genes are involved. Taylor (2003) suggests that as many as 230 genes may be involved and perhaps different genetic variations contribute to the different types of OCD. Two examples of genes that have been linked to OCD are the COMT and SERT genes. COMT gene- Regulates dopamine production (an excitatory neurotransmitter --> responsible for compulsion and intrusive thoughts). One form of COMT gene more common in OCD patients. Lower levels of activity in the COMT gene leads to high levels of dopamine (Tukel et al, 2013) High level of activity in the COMT gene = low levels of dopamine. SERT gene- Involved in the transport of serotonin. If faulty, it can lead to a lower level. Low levels of serotonin implicated in OCD. Ozaki et al, 2003- A mutation of SERT gene in two unrelated families. (6/7 family members had OCD). High level of activity in the SERT gene = high levels of serotonin.

Answer 16

There is a link between genetic factors and abnormal levels of certain neurotransmitters. It is also evident that genetic factors affect certain abnormal brain circuits. Abnormal levels of neurotransmitters= Dopamine) High=High levels of compulsions and intrusive thoughts. Serotonin) Low=Depression - can involve mutations in the genes. - regulates mood - based on research into anti depressants which increases serotonin, so OCD symptoms have been reduced. (Pigott, et al- 1990) - anti depressants which have less effect on serotonin do not reduce OCD symptoms (Jenicke,1992) - PET scans --> whilst symptoms are active --> this shows heightened activity in the OFC. Strength: STRONG, VISUAL scientific evidence

Answer 17

1) Orbitofrontal cortex and the worry circuit- - OFC converts sensory info into thoughts and actions. - Caudate nucleus is located in the basal ganglia, supresses signals to the OFC. - OFC sends signals back to the thalamus about worrying things eg. germs. - When caudate nucleus is damaged --> Fails to suppress minor worry signals and the thalamus is alerted with many worries. - This sends signals back to the OFC. This increased activity prevents patients from stopping behaviour. Basal Ganglia- Involved in multiple processes such as coordination and movement. Patients who suffer head injuries in this region often develop OCD like symptoms after recovery. Max et al (1994) --> Basal ganglia is disconnected from the frontal cortex during surgery, OCD-like symptoms are reduced, providing support for the role of the basal ganglia in OCD levels. Serotonin and dopamine are linked to these regions. Comer (1998) - Serotonin plays a key role in the operation of the OFC and the caudate nuclei. Therefore, abnormal levels of serotonin = malfunctioning areas. Dopamine = Main neurotransmitter of the basal ganglia. High levels of activity = over activity of the region (Sukel, 2007).

Answer 18

P) Strength --> Seen in family studies. E) Lewis (1936) examined OCD patients. 37% had parents with the disorder and 21% had siblings with the disorder. E) As well --> Nestadt et al (2000) proposes that individuals who have a first degree relative with OCD are 5x more likely to develop the disorder, compared to the general population with no genetic link. L) Therefore, family studies support the bio genetic explanation, but it still doesn't rule out other environmental factors playing a role.

Answer 19

P) Twin studies --> Provided strong evidence for a genetic link. E) Billett et al (1998)'s meta analysis of 14 twin studies which looked at the genetic inheritance rate of OCD. E) MZ twins --> Double the risk of developing OCD compared to DZ (Billett), if one of the pair had the disorder. (68% - 31%)- Nestadt (2010). L) However, since the concordance rates are never 100% and are low in twin studies, the diathesis stress model is a better explanation, whereby a genetic vulnerability is inherited and can be triggered by an environmental stressor.

Answer 20

P) Support --> Menzies (2007) used MRI scans to produce images of brain activity in OCD patients and their immediate family members without OCD, as well as a group of unrelated healthy people. E) Discovered that OCD patients and their close relatives had reduced grey matters in their key brain regions, including the orbitofrontal cortex. E) Therefore, anatomic differences are inherited and this can cause OCD in certain individuals. L) This, STRONGLY IMPLICATES the ofc's role in the development of OCD.

Answer 21

P) An issue with understanding neural mechanisms in OCD is that other areas may be involved. E) While there is evidence to suggest that specific neural systems do not function normally in OCD patients, research has suggested otherwise, as other areas of the brain may be occasionally involved as well. E) This means that there is no brain system which plays a consistent role in OCD. L) Therefore, although there is evidence to support neurotransmitters and brain structures, it cannot be concluded that there is a cause and effect relationship between biological abnormalities and OCD or a result of the disorder.

Answer 22

P) An issue with understanding neural mechanisms in OCD is that other areas may be involved. E) While there is evidence to suggest that specific neural systems do not function normally in OCD patients, research has suggested otherwise, as other areas of the brain may be occasionally involved as well. E) This means that there is no brain system which plays a consistent role in OCD. L) Therefore, although there is evidence to support neurotransmitters and brain structures, it cannot be concluded that there is a cause and effect relationship between biological abnormalities and OCD or a result of the disorder.

Answer 23

P) Credible alternative explanations challenge the biological explanation. E) Two process model --> Proposed by behaviourists --> suggest that learning could play a crucial role in the disorder. Initial learning on the feared stimulus could occur through classical conditioning. For example, dirt is paired with anxiety. E) After this, the behaviour pattern would be maintained through operant conditioning and negative reinforcement, where patients avoid the stimulus, so anxiety is removed, which could result in obsession, which links to the compulsion, which reduces anxiety. L) Therefore, this alternative explanation is credible, due to the success of behavioural treatments for OCD, where symptoms of patients are improved for 60-90% of adults (Albucher et al, 1998).

Answer 24

Drug Therapy- Regulate to create balance in the brain. The most commonly used biological therapy for anxiety disorders. It assumes that there is a chemical imbalance in the brain. This can be corrected by drugs which regulate the neurotransmitters. GABA- Gamma amino butyric acid- Calms you down- Neurotransmitter - BZT regulate GABA. Nordadrenaline- A neurotransmitter --> SSNI's --> try to increase noradrenaline. It is expensive and new. Serotonin- Low levels in OCD lead to anxiety.

Answer 25

Selective serotonin reuptake inhibitors eg. fluoxentine - The standard medical treatment used to tackle the symptoms of OCD. - SSRI's work on increasing certain neurotransmitter in the brain by preventing the re absorption of serotonin. - By preventing the re-absorption of serotonin, SSRI's effectively increase its levels in the synapse and this continues to stimulate the post synaptic neuron.

Answer 26

- These work by adjusting the levels of serotonin and nor adrenaline, which are usually low in depressives. - Blocking post receptor sites.

Answer 27

- Drugs are often used alongside CBT. - The drugs reduce the sufferers emotional symptoms, such as anxiety and depression. - This means that the patient can engage more effectively with CBT. - Some suffers may respond best to CBT without medication.

Answer 28

BZs are a range of anti-anxiety drugs that include trade names like Valium and Diazepam. BZs work by enhancing the action of the neurotransmitter GABA. GABA tells neurons in the brain to "slow down" and "stop firing". Around 40% of the neurons in the brain respond to GABA. This means that BZs have a general quietening influence on the brain and consequently reduce anxiety, which is experienced as a result of the obsessive thoughts which are common in OCD.

Answer 29

MORE INFO REQUIRED (research).

Answer 30

P) Strength --> Supported by research with demonstrates their effectiveness. This was when randomised drug trials compare the effectiveness of SSRI's and a placebo (no pharmacological value). E) Soomro et al (2008) conducted a review of research which examined SSRI's effectiveness and they found that they were lots more effective than placebos, across 17 trials. E) Supports biological treatments for OCD. L) Criticised --> Only focuses on the short term effectiveness of drug treatments. Therefore, long term effects are still to be investigated empirically (objective experience).

Answer 31

P) Weakness --> May not be the most effective treatment available, even if they are helpful for most OCD patients. E) Skapinakis et al (2016) carried out a systematic review of outcome studies. E) He concluded that both cognitive and behavioural exposure therapies were more efficient and effective than SSRI's in treating OCD. L) Therefore, drug treatments may not be the optimum treatment for OCD.

Answer 32

P) Strength --> Cost effective biological treatments, as drug therapies such as BZ's and SSRI's are relatively cheaper in comparison to psychological treatments such as CBT. E) Therefore, many doctors tend to prescribe drugs, as they are a more cost-effective solution for treating OCD, which benefits health service providers. E) As well as this, psychological treatments like CBT require the patient to be motivated and willing to engage, whereas drugs are less time consuming and non - disruptive to everyday life and routines, as they are simply taken only until the symptoms subside. L) In conclusion --> Drug treatments are likely to be more successful for unmotivated patients who can't complete intense psychological treatments.

Answer 33

P) Weakness of drug treatments --> Potential side effects from drugs like SSRI's and BZs. E) Although evidence supports the effectiveness of SSRI's, some patients may experience mild side effects, such as indigestion. However, others may experience more serious side effects such as hallucinations, erection problems and high blood pressure. E) As well as this, BZs are renowned for being highly addictive and can cause increasing aggression and long term memory impairments. Therefore, Ashton (1997) says that Bzs are recommended for short term treatments of up to four weeks. L) Therefore, side effects diminish the effectiveness of drug treatments, as patients will stop taking medication, due to negative side effects.

Answer 34

P) Drug treatments are criticised and challenged for treating the symptoms of OCD and not the cause. E) Although SSRI's work by increasing the levels of serotonin in the brain (which decreases anxiety and alleviates symptoms), it still does not treat the underlying cause of OCD. E) In addition to this, once a patient stops taking the drug, they are prone to relapsing. L) Therefore, Koran et al (2007) proposes that psychological treatments (such as CBT) may be a more effective LONG TERM treatment and a potential cure.

Answer 35

This explanation for OCD reduces a complex human behaviour to a single gene or brain chemical and therefore is considered BIOLOGICALLY REDUCTIONIST. For example, the bio explanation does not consider the role of cognitions (thinking) or learning in the development or maintenance of OCD. The biological explanation follows a nomothetic approach, which suggests the same treatment for all people suffering from OCD, which fails to consider individual differences (everyone is different).

Depression and OCD Flashcards

(59 cards)