Psychological Problems

Question 1

Psychological Problems

Name 5 charactearistics of good mental health.

AO1

Mental Health Introduction

Answer 1

Possible answers:
* Positive engagement with society
* Effectively copes with challenges
* Not being overcome by difficult feelings
* Good relationships with others
* Ability to deal with disappointments and problems
* Ability to cope with stresses and demands of every day life
* Ability to make decisions

Individuals with poor mental health have an absence of several factors.

PENGAAA

Question 2

Psychological Problems

How do beliefs in mental health vary culturally?

AO1

Mental Health Introduction

Answer 2

People around the world have different interpretations as to what poor mental health is. Behaviours considered abnormal in the Western world may be normal in other cultures (e.g. hearing voices is a sign of schizophrenia, but it may be interpreted as God in India and Africa)

Some mental health disorders may be culturally bound syndromes because they are only recognised in certain cultures (e.g. Koro in Asia, anorexia in the West)

Question 3

Psychological Problems

Why has the incidence of mental health problems increased over time?

AO1

Mental Health Introduction

Answer 3

1. Increased challenges in modern living: Economic deprivation in modern times, especially in low-income households compared to high-income households. Elderly people in cities who have lost relatives/have mobility issues also live in isolation and struggle to socialise.
2. Increased recognition of the nature of mental health problems: There has been a growth in the identification of mental and physical health problems. Historically, mental health problems were associated with supernatural/spiritual causes, but psychiatric science was developed in the 19th century and over time medication was used to treat mental health disorders. Biological and psychological explanations are becoming more recognised and diagnoses rates are expected to rise.
3. Lessening of social stigma: Historically, people with psychological problems were labelled as insane/lunatics. These labels can be harmful or discriminatory, reducing the likelihood of seeking treatment. The term ‘mental health problems’ aimed to reduce the stigma. Research has also found that as people become more aware and accepting of mental health problems, others are more likely to seek treatment and be diagnosed because there is a lessening in the social stigma.

Question 4

Psychological Problems

What are the 3 main individual effects of poor mental health?

AO1

Mental Health Introduction

Answer 4

1. Damage to relationships: People with mental health problems may struggle to communicate with family and friends. They also tend to isolate themselves in fear of being judged or because they feel bad about themselves. This may be misinterpreted by those around them, which damages the relationship.
2. Negative impact on physical wellbeing: When individuals are stressed or anxious, their body releases a hormone called cortisol. This weakens their immune system and makes them more susceptible to illnesses (e.g. colds). People with mental health problems may also undereat or overeat, causing weight loss or weight gain. There may also be changes in their sleep pattern. These can be treated with medication which may also have side effects (e.g. trouble concentrating)
3. Difficulties coping with day-to-day life: Individuals with poor mental health may not be able to keep up with the demands of every day life, including getting out of bed, getting dressed, preparing food, or keeping their home tidy. They may also struggle with activities outside of home such as socialising or engaging in hobbies. This may lead to poor attendance at work (which leads to unemployment) or school (which leads to poor qualifications).

DND - do not disturb me

Question 5

Psychological Problems

What are the 3 main social effects of poor mental health?

AO1

Mental Health Introduction

Answer 5

1. Need for more social care: In the UK, taxes pay for social care services which provides basic necessities such as food, warmth, and human company for those struggling with mental health problems. They may encourage people to learn new social and work skills to help them feel less isolated and more competent. As the number of people diagnosed with mental health problems increases, so does the need for social care services.
2. Increased crime rates: Although mental health problems do not directly cause violent behaviour, victims of substance abuse can result in a person becoming violent. People with mental health problems are often more isolated and have a lower standard of living, which can also cause violent behaviour.
3. Implications on the economy: In England, the direct costs of mental health is around 22 billion a year. This does not include indirect costs such as the impacts on the criminal justice system and unemployment benefits. Additionally, as life expectancy increases, so does the development of dementia. This means older people require more care which will cost the government more money.

Question 6

Psychological Problems

What symptoms does the ICD-10 classify depression as?

AO1

Depression

Answer 6

• Low mood
• Loss of interest in pleasurable activities
• Reduced energy levels (lethargy)
• Changes in sleep patterns
• Changes in appetite levels
• Decrease in self-confidence
• Reduced concentration and attention
• Ideas of self-harm or suicide
• Ideas of guilt or worthlessness
• Pessimistic view of the future

Question 7

Psychological Problems

Compare unipolar and bipolar depression.

AO1

Depression

Answer 7

People with unipolar depression only experience one emotional state (depression), whereas people with bipolar depression experience changes between two mood states (depression and mania). Individuals diagnosed with bipolar depression alternate between states of manic behaviour, running around, making big plans, and feeling very excited, and then periods of depression. There may be periods of ‘normal’ moods in between (episodic disorder).

Question 8

Psychological Problems

Describe the biological explanation behind depression.

AO1

Depression

Answer 8

The biological explanation behind depression focuses on neurochemistry, perticularly the neutransmitter serotonin. Serotonin is responsible for mood regulation. If enough serotonin is transmitted through the synaptic cleft, the post-synaptic neuron is stimulated, leading to improved mood. However, individuals with depression have a dysregulation of the reuptake mechanism in the synaptic cleft, which means serotonin diffusing through the synapse is taken back into the pre-synaptic neuron. The post-syneptic neuron will therefore not be stimulated due to a lack of serotonin. This results in low mood, however it can also affect other behavioural aspects such as sleep, memory, and appetite.

Question 9

Psychological Problems

Evaluate the biological explanation behind depression.

AO3

Depression

Answer 9

A weakness of the biological explanation is that the research is based on correlations. This is a problem because correlations only show a link between depression and serotonin levels, meanwhile there could be a third factor such as the loss of a loved one that could affect these results, making it difficult to establish a cause and effect. Therefore, this reduces the validity of the biological explanation.

Furthermore, the biological explanation of depression can be criticised for being reductionist. This is because it reduces the complex behaviour of depression down to serotonin levels. It ignores the holistic approach which considers social and psychological aspects as well. Therefore, the biological explanation may lack validity as an explanation for depression.

An alternative explanation of depression is the cognitive approach which suggests that depression is due to faulty thinking and negative schemas, rather than low levels of serotonin in the brain. Therefore, the biological explanation may not be the only explanation to consider when explaining depression, and specialists must consider psychological reasons.

Question 10

Psychological Problems

How do SSRIs work?
(selective serotonin reuptake inhibitors)

AO1

Depression

Answer 10

According to the biological approach, low levels of serotonin cause depression. Therefore, in order to treat depression, we increase an individual’s serotonin levels using SSRIs. This works by blocking the reuptake of serotonin from the synapse back into the pre-synaptic neuron. This leaves more serotonin in the synapse in addition to the new serotonin being released from the presynaptic neuron. This allows the serotonin to continue stimulating the post-synaptic neuron and transmitting messages, as a result this decreases the symptoms of depression and mood will be improved.

Question 11

Psychological Problems

Evaluate the use of SSRIs as a way to treat depression.
(selective serotonin reuptake inhibitors)

AO3

Depression

Answer 11

A weakness of SSRIs is that they have side effects including nausea, insomnia, and dizziness. Some people also reported having suicidal thoughts while on antidepressant medication. This is unlike CBT which does not cause side effects. Therefore, SSRIs may not be effective in treating depression as people may stop taking them to stop the side effects.

A further limitation of SSRIs as a treatment for depression is that there is some uncertainty as to how effective they are. Around 50-65% of people will experience some improvement by taking them but 25-30% will also improve after taking a placebo. Just the belief that they are taking medication leads to an improvement. This limits the use of SSRIs as a treatment for depression because it suggests there may not be a physical basis for depression at all

Another weakness of SSRIs is that the treatment is reductionist. It reduces the treatment of depression to increasing serotonin. It neglects the holistic approach which considers psychological and social factors that may be causing depression. This limits the use of SSRIs as a treatment for depression.

use SERM

Question 12

Psychological Problems

Explain what is meant by faulty thinking as a psychological explanation of depression.

AO1

Depression

Answer 12

When a person suffers from depression, they tend to focus more on the negative aspects of a situation rather than the positives. This is known as magnification and minimisation as the negative aspects are exaggerated and the positives are ignored. This leads to feelings of hopelessness and depression.

Question 13

Psychological Problems

Explain what is meant by negative schemas as a psychological explanation of depression.

AO1

Depression

Answer 13

Schemas are a mental representation an individual has of the world, themselves, and other situations. They are developed through past experiences.
Individuals with depression have a negative self-schema, which means they are likely to interpret all information about themselves in a negative way, making them more susceptible to developing depression.

Question 14

Psychological Problems

Explain what is meant by attributions as a psychological explanation of depression.

AO1

Depression

Answer 14

An attribution is the process of explaining causes of behaviour. When we observe a behaviour, we unconsciously attribute explanations for it. We also explain our own behaviour this way. Some people have a negative attribution style where they tend to attribute blame to themselves. The three main types are internal, stable, and global.
Someone who does not directly attribute blame to themselves and their abilities has an unstable and external attribution style.
Research has found that individuals who have internal and stable attribution styles are more likely to develop depression because they see problems as their fault and permanent.

Question 15

Psychological Problems

Evaluate the psychological explanation behind depression.

AO3

Depression

Answer 15

Research to support the psychological approach was conducted by Grazioli and Terry. They tested 65 pregnant women on their cognitive vulnerability, and they found that those with a high cognitive vulnerability (displayed negative thinking) were more likely to develop post-natal depression than those who didn’t. This supports the cognitive approach to explaining depression because it demonstrates the role of negative thoughts in the development iof depression.

However, a weakness of psychological explanation is that many of the research into it is based on correltaions. This is a problem because correlations only show a linl between depression and negative schemas/attributions, so a cause and effect cannot be established. It may be that depression is causing faulty thoughts rather than faulty thoughts causing depression. Therefore, this lowers the validity of the psychological explanation of depression.

An alternative explanation of depression is the biological approach, which suggests depression is due to low serotonin levels in the brain rather than faulty thinking, negaitve schemas or attribution styles. Therefore, the psychological exlplanation may not be the only explanation to consider when explaining and diagnosing depression.

Question 16

Psychological Problems

Outline the use of psychological therapies (CBT) to treat depression.

AO1

Depression

Answer 16

The aim of cognitive behavioural therapy is to challenge faulty, irrational thought processes and change them into rational, logical ones. The cognitive aspect focuses on challenging the client’s irrational and faulty thoughts via disputing. The therapist will ask the client questions like “where is the proof that everybody hates you” or “do you always do badly in schoolwork?”. This will make the client see through their irrational thoughts and change them into more rational, logical ones. The therapist also encourages the client to take part in pleasurable activities daily such as exercise or hobbies they once enjoyed. This will create positive emotions and improve mood. Additionally, clients are asked to complete a thiught diarty where they write down any negative irrational thoughts they have and write a rational response. This helps them practive disputing techniques in real life to reduce the negative thoughts causing their depression.

Question 17

Psychological Problems

Evaluate the use of psychological therapies (CBT) to treat depression.

AO3

Depression

Answer 17

One strength of CBT is that it has no side effects because it is a non-invasive treatment. This is unlike SRRIs which can cause nausea, insomnia, and dizziness. This means people are more likely to attend CBT sessions to avoid side effects, making it a more effective method to treat depression.

Research to support the effectiveness of CBT was conducted by Wiles et al. She randomly allocated depressed participants to either the antidepressants condition or the antidepressants paired with CBT condition. She found that those who had combined antidepressants with CBT showed more reduction in symptoms compared to those with antidepressants alone. This shows that CBT is effective in reducing depression and there is a greater chance of recovery comapred to antidepressants alone.

Furthermore, CBT as a treatment for depression is holistic. This is because it looks at the bigger picture by focusing on a person’s thoughts and feeling and how these are impacted by their depression, unlike SSRIs which is a reductionist treatment because it reduces treatment down to neurotransmitters. This suggests CBT may be a more appropriate treatment for depression compared to SSRIs as it focuses on a wide range of factors that may impact an individuals’s depression.

Question 18

Psychological Problems

What is addiction?

AO1

Addiction

Answer 18

An addiction is when an individual takes a substance or engages in a behaviour that is pleasurable which eventually becomes compulsive with harmful consequences. Addiction is characterised by physical or psychological dependence, tolerance, and withdrawel.

Question 19

Psychological Problems

What is meant by dependency?

AO1

Addiction

Answer 19

A strong need to continue a behaviour or substance use because the brain/body only works normally when the substance or behavious is present. Without it, withdrawel symptoms may occur.

Question 20

Psychological Problems

What is meant by withdrawel symptoms?

AO1

Addiction

Answer 20

When substance use or an activity is stopped, a person may experience physical problems such as headaches, difficulty sleeping, or psychological problems such as moodiness.

Question 21

Psychological Problems

List the characteristics of addiction. (based on the ICD-10)

AO1

Addiction

Answer 21

• A strong desire to use the substance (compulsion)
• Persisting with the substance or behaviour despite harm
• Difficulty in controlling use
• A higher priority being given to the substance or behaviour than other activities or obligations
• Withdrawel symptoms
• Evidence of tolerance

Question 22

Psychological Problems

What is meant by tolerance?

AO1

Addiction

Answer 22

When people with addictions require increased dosages to feel the same effects

Question 23

Psychological Problems

What is the difference between substance misuse and substance abuse?

AO1

Addiction

Answer 23

Substance misuse is when an individual uses a substance for the wrong purpose, whereas substance abuse is when an individual uses a substance for mood modification although that is not its intended purpose.

Question 24

Psychological Problems

What is meant by ‘genetic vulnerability’ to an addiction?

AO1

Addiction

Answer 24

Addiction is influenced by hereditary factors, meaning addiction are inherited and run in families. Genetic vulnerability refers to the increased likelihood of an individual developing an addiction if there is a family history of addiction. It is likely that environmental stresses will trigger the addiction.

Question 25

# Psychological Problems Outline Kaij's twin studdy on addiction. | AO1 ## Footnote Addiction

Answer 25

Kaij's aim was to see whether alcoholism could be explained in terms of hereditary factors. She had a sample of 384 male twins from Skane in Sweden, where by at least one twin had alcoholism. Kaij conducted interviews with the twins and sometimes close relatives to collect data about their drinking habits. She found that 61% of the identical twins (share 100% of their DNA) were both aloholics, whereas 39% of the non-identical twins (share 50% of their DNA) were both alcoholics. The percentage for the identical twins was higher than the non-identical twins, which suggests there is a genetic link in the development of alcohol addiction.

Question 26

# Psychological Problems Evaluate Kaij's twin studdy on addiction. | AO3 ## Footnote Addiction

Answer 26

One strength is that there is further research to support the genetic explanation of addiction, which was conducted by Kendler et al. He repeated kaij's research with a larger sample and still found that if one twin was an alcoholic, the other twin is also likely to be alcoholic. The percentages were also higher for the identical twins than they were for the non-identical twins. This suggests Kaij's research into genetic vulnerability and addiction has high reliability One weakness of Kaij's study is that she used self-report methods which are open to social desireability. The twins may have lied about their drinking habits to present themselves in the best possible light or as to not present as an alcoholic. This reduces the validity of Kaij's study into genetic vulnerability and the development of addiction. However, an alternative explanation for addiction is the psychological explanation (social learning theory), which suggests addictions are influenced by nurture not nature. This can be through observing others and imitating their behaviours. Therefore, genetic vulnerability may not be the only explanation of addiction.

Question 27

# Psychological Problems Outline the psychological explanation behind addiction. | AO1 ## Footnote Addiction

Answer 27

The psychological explanation behind addictions suggests peers can influence an individual's development during adolescence as they spend more time with them and less time with their family (influence of nurture). According to the social learning theory, individuals may observe a role model who they identify with due to similarities and imitate their behaviour, especially if they are being rewarded for doing so (vicarious reinforcement). In addiction, an individual may observe their role models engaging in addictive behaviour and imitate them because they want the reward (a fun time). Additionally, an individual may also believe that the social norm of their peer group is to drink and take drugs and therefore conform to that behaviour because they want to avoid being left out or rejected by the group. Peers can also act as gateways to addictive behaviours because they can provide opportunities to take substances.

Question 28

# Psychological Problems Evaluate the psychological explanation behind addiction. | AO3 ## Footnote Addiction

Answer 28

Research to support peer influence as an explanation for addiction was conducted by Simons-Morton and Farhat who reviewed 40 studies into the relationship between peers and smoking. They found that there was a strong correlation between peer influence and the development of smoking in most studies. This supports peer influence as an explanation of addiction because it shows that addiction is initially influenced by peers. One problem with the research into peer influence as an explanation of addiction is that it is based on correlations which only show a link between two-co variables, so a cause and effect cannot be established. There could be a third factor such as culture or genetics that could lead individuals to develop an addiction. This lowers the validity of the research into peers as a factor affecting addiction. However, an alternative explanation for addiction is the biological explanation, which suggests individuals inherit a genetic predisposition that makes them more vulnerable to developing an addiction and life experiences and stresses trigger this addictive behaviour rather than friends providing opportunities to take addictive substances. Therefore, the psychological explanation may not be the only explanation behind addiction.

Question 29

# Psychological Problems Outline what is meant by aversion therapy with an example. | AO1 ## Footnote Addiction

Answer 29

The aim of aversion therapy is to unlearn an addictive behaviour by replacing the pleasant association with something unpleasant. Examples include: **Alcohol addiction: Anatabuse** * A patient takes a drug which eventually causes them to vomit * Just before the individual vomits, they take an alcoholic drink * This is repeated to strengthen the association between drinking alcohol and vomitting * Eventually, the patient will associate drinking alcohol with vomitting, replacing the pleasant association with an unpleasant one. **Nicotine addiction: Rapid smoking** * Individuals will have a puff of a cigarette every six seconds * This will cause the individual to become nauseous and sick * Eventually, the patient will associate smoking with nausea, replacing the pleasant association with an unpleasant association **Gambling addiction: Electric shocks** * Gamblers think fo phrases related to their gambling behaviour and write them down on cards. Some non-gambling behaviours are also included * The participants read out loud each card. When there is a gamblign related phrase they are given a two second electric shock * This is repeated to strengthen the association between gambling and pain * Eventually, the patient will associate gambling with pain, replacing the pleasant association with an unpleasant one.

Question 30

# Psychological Problems Evaluate the use of aversion therapy as a treatment for addiction. | AO3 ## Footnote Addiction

Answer 30

Research to contradict aversion therapy was conducted by McConaghy. They looked at the effectiveness of electric shock therapy when treating gambling addictions. In a one year follow-up, only 30% of patients had reduced their gambling behaviours. This does not support aversion therapy as a treatment for gambling addiction because it shows that over time, individuals relapse into their gambling addiction afterwards. Furthermore, aversion therapy as a treatment for addiction is reductionist. This is because it reduces the treatment for addiction down to replacing pleasant associations with unpleasant associations. This neglects the holistic approach which considers psychological and social factors that could be contributing to the addiction such as peer influence. This limtis the use of aversion therapy as a treatment for addiction. Another weakness for aversion therapy is that it requires motivation and commitment from the patient. This is because the patient has to commit to attending sessions and working with the therapist to unlearn their addictive behaviour placing themselves in unpleasant situations such as feeling sick or receiving electric shocks in order to reduce their addiction. This means that aversion therapy may not be an effective therapy for addiction because individuals may drop out.

Question 31

# Psychological Problems Evaluate the use of aversion therapy as a treatment for addiction. | AO3 ## Footnote Addiction

Answer 31

Research to contradict aversion therapy was conducted by McConaghy. They looked at the effectiveness of electric shock therapy when treating gambling addictions. In a one year follow-up, only 30% of patients had reduced their gambling behaviours. This does not support aversion therapy as a treatment for gambling addiction because it shows that over time, individuals relapse into their gambling addiction afterwards. Furthermore, aversion therapy as a treatment for addiction is reductionist. This is because it reduces the treatment for addiction down to replacing pleasant associations with unpleasant associations. This neglects the holistic approach which considers psychological and social factors that could be contributing to the addiction such as peer influence. This limtis the use of aversion therapy as a treatment for addiction. Another weakness for aversion therapy is that it requires motivation and commitment from the patient. This is because the patient has to commit to attending sessions and working with the therapist to unlearn their addictive behaviour placing themselves in unpleasant situations such as feeling sick or receiving electric shocks in order to reduce their addiction. This means that aversion therapy may not be an effective therapy for addiction because individuals may drop out.

Question 32

# Psychological Problems Outline what is meant Self-Help Groups. | AO1 ## Footnote Addiction

Answer 32

Self-help groups are a type of self-management programme designed to treat addictions. They are composed of people who all same the same problem, for example narcotic addictions, and regard themselves as equals. Self-help groups involve individuals sharing their experiences so they can gain support from others and see they are not alone in their problem. Members of the group who are expeirenced can also provide a positive example to new members.

Question 33

# Psychological Problems Outline what is meant by 12 Step Recovery Programmes. | AO1 ## Footnote Addiction

Answer 33

The 12 Step Recovery Programme is a well-known self-help group which was developed by Alcoholic Anonymous, which is based on 12 spiritual principles. It does have a spiritual concept as the addicts surrender themselves to a higher power, but many non-religious people have found it helpful too. Some steps involve a person coming to terms with what they have done wrong by sharing confessions. They recognise recovery as a lifelong process where individuals support each other both in group and outside, by having names and numbers to call when they feel they need support. The combination of emotional healing, accountability, and ongoing support reduces the likelihood of relapse. *Addition: the 12-step-programme can be divided into 3 key stages:* * Acceptance and surrender * Accountability and transformation * Continued growth and service

Question 34

# Psychological Problems Evaluate the use of self-management techniques for addiction. | AO3 ## Footnote Addiction

Answer 34

Research to contradict the effectiveness of the 12-step programme was confucted by Ferri et al. They found there was no significant difference in terms of effectiveness between the 12-step programme and other forms of treatment. It is difficult to find data into how many people ae still in the programme, how many dropped out, and how many still have addictios. This means there is no clear data into how effective self-help groups such as the 12-step programme are in helping people to overcome their addictions. However, a strength of self-help groups such as the 12-step programme in helping people overcome their addictions is that it takes a holistic approach to treatment. This therapy focuses on the whole person, particularly theior emotions, feelings of guilt, and relationships with others. This is better than reductionist treatments like aversion therapy that reduce treating addictions to associations. This suggests self-management programmes may be more appropriate as they focus on a wide range of factors that impact a person's addiction. Whereas another weakness of self-management programmes is that they require a lot of motivation and commitment. This is because participants have to attend sessions at least once a week and complete the 12-step programme. Often, they are expected to restart if they relapse. This may take a long time and be difficult for people as they may feel like they cannot control their addiction. Therefore, this may not be an effective theraoy for addiction as people might drop out.