psychopathology

Question 1

psychopathology (A01)

Answer 1

scientific study of psychological disorders-when someone has physical disorder- doctor will examine patients symptoms + run various tests in order to make correct diagnose

Question 2

definitions of abnormality: deviation from social norms (A01)

Answer 2

Concerns behaviour that is different from accepted standards of behaviour in community or society

each society have unwritten rules for acceptable behaviour-‘norms’-classes any abnormal behaviour if goes against accepted, expected + approved ways of behaving in society-abnormality breaking ‘rules of society’

eg. eating w/your family on dining table compared to eating by yourself in front of TV

Question 3

deviation from social norms: changes vary (A03) (1)

Answer 3

P: main difficulty w/definition-social norms change vary as times change

E: what is socially acceptable now may not be socially acceptable 50yrs ago

E: eg. today homosexuality is acceptable but in past it was under ‘sexual + gender identity disorders’ in DSM

L: lacks consistency-reduces reliability of definition abnormality

Question 4

deviation from social norms: vary between cultures (A03) (2)

Answer 4

P: definition abnormality-social norms differ between different cultures

E: norms are culturally relative

E: eg-hearing voices is viewed as deviation from social norms in our culture but in others-more accepted + not necessarily views as deviant behaviour

L: problem-argued reliable definition should consistent between cultures

Question 5

deviation from social norms: punishing people who are trying to express their individuality (A03) (3)

Answer 5

P: abnormality can be seen as punishing people who are trying to express their individuality + repressing people who don’t conform to repressive norms of their cultures

E: eg. world health organisation (WHO) declassified homosexuality as mental illness in 1992 + transgender health issue in 2019

E: recent changes may have followed social norms/acceptance

L: limitation-definition of abnormality-damaging to certain people in society-so another definition could be seen as more appropriate

Question 6

definitions of abnormality: failure to function adequately (A01)

Answer 6

someone is unable to cope w/ordinary demands of day-to-day living

eg. unable hold down job OR may struggle w/everyday activities: always running late
not attending school
not eating + not sleeping

not functioning adequately causes distress + suffering for individual + maybe for others-bc in case of some mental disorders-individual may not be distressed at all-people w/schizophrenia lack awareness-but may be distressing to others

Question 7

deviation from social norms: its a more appropriate definition of abnormality (A03) (4)

Answer 7

P: strength-more appropriate definition of abnormality-compared to ‘statistically infrequency’ definition

E: distinguishes between desirable + undesirable behaviour + effect behaviour has on others

E: eg. spending lots of time washing your hands may not be statistically infrequent -but can damaging effect on person + loved ones

L: strength-more appropriate definition of abnormal behaviour

Question 8

failure to function adequately: includes persons perspective (A03) (1)

Answer 8

P: strength-includes persons perspective

E: allows us to view mental disorder-from point of view of person experiencing it

E: eg. level of distress experienced by patient is considered when defining their behaviour as abnormal

L: suggests failure to function adequately is useful criteria for assessing abnormality-provides checklist which patients-use to help them perceive their level of functioning

Question 8

failure to function adequately ROSENHAN+SELIGMAN: characteristics of abnormality (A01)

Answer 8

1. Suffering-abnormal person should be suffering in some way
2. Maladaptive behaviour-where person is stopping themselves from progressing
3. Unconventionality (odd)-to be abnormal-their behaviour needs odd in someways
4. Unpredictable + loss of control-most people tend to behave-in fairly predictable way on other hand an abnormal person-expected act-inappropriate manner
5. Irrational + incomprehensibility-instances someone may act certain way which people can’t understand

Question 9

failure to function adequately: cultural realism (A01)

Answer 9

Idea that persons beliefs, values + practices-should be understood based on persons own culture-rather than be judged against criteria of another

Question 10

failure to function adequately: limited in cultural realism (A03) (3)

Answer 10

P: limited in cultural realism

E: long periods of grief after bereavement is more acceptable in some cultures than others

E: so same behaviour could be defined as abnormal-viewed as failure to function in 1 culture yet functioning adequately in another culture

L: problem-definition-be classed as reliable-the same behaviour should be viewed consistently between cultures

Question 10

failure to function adequately: abnormality-not always accompanied by dysfunction (A03) (2)

Answer 10

P: abnormality-not always accompanied by dysfunction-psychopaths-people w/dangerous personality disorders can cause great harm yet still appear normal

E: Harold Shipman-GP murdered 215 of his patients over 23yr period-seemed to be respectable doctor

E: he was abnormal-didnt display features of dysfunction

L: definition to define abnormality may not be appropriate

Question 11

failure to function adequately: abnormality could be due to other factors (A03) (4)

Answer 11

P: abnormality could be due to other factors

E: eg. someone who is unable to hold down job-may be in situation due to economical reasons in their country-not their mental health

E: so using this definition-people would incorrectly be labelled as abnormal-when other definitions may not label them as abnormal

L: suggest that definition is not appropriate in all classes + another definition may be more valid on occasions

Question 12

definitions of abnormality: statistical infrequency (A01)

Answer 12

Occurs when an individual has less common characteristic-
eg. being more depressed or less intelligent than most of population

any behaviour-statically rare is abnormal-requires us to examine normal distribution curve in order

Things such as height, weight + intelligence fall w/in fairly broad areas -People outside these areas might be considered abnormally tall or short, fat or thin, clever or unintelligent

statistical terms they are abnormal because their behaviour is infrequent in population eg. 2 standard deviations from mean

Question 13

statistical infrequency: objective way to define abnormality as clear ‘cut off’ point has been agreed (A03) (1)

Answer 13

P: objective way to define abnormality as clear ‘cut off’ point has been agreed

E+ E: makes it easier to decide who meets criteria to be labelled as abnormal in comparison to other definitions

L: definition is seen as less subjective than other definitions

Question 14

statistical infrequency: normality + abnormality need to be separated (A03) (3)

Answer 14

P: separate normality from abnormality

E + E: depression vary greatly between individuals in terms of their severity-makes it difficult to decide where cut-off point lies eg. at what point does crying become abnormal?

L: problem as cut-off point is subjectively determined lacking validity needed to be an effective method of defining abnormality

Question 14

statistical infrequency: many abnormal behaviours that are actually quite desirable (A03) (2)

Answer 14

P: many abnormal behaviours that are actually quite desirable

E + E: eg. very few people have an IQ of over 150 yet it would not be suggested that having a high IQ is undesirable + there are some normal behaviours that are undesirable eg. experiencing depression after painful experience is quite common yet it is undesirable

L: problem when planning treatment as only undesirable behaviours need to be identified definition would never be used alone to make diagnosis

Question 15

statistical infrequency: culturally biased (A03) (4)

Answer 15

P: culturally biased

E: there are some behaviours that are statistically infrequent in some cultures but are more frequent in others eg. 1 of symptoms of schizophrenia is claiming to hear voices

E: an experience that is common in some cultures

L: problematic as statistical infrequency definition would class these individuals as abnormal even when they were displaying normal behaviour- definition can only be used to define abnormality in some cultures

Question 16

definitions of abnormality: deviation from mental health (A01)

Answer 16

attempts to define criteria required for normality- people who lack these criteria are defined as abnormal

Marie Jahoda defined ideal mental health through list of six characteristics which argue that psychologically healthy individual with ideal mental health should be able to show

Question 17

deviation from mental health MARIE JAHODA: six characteristics (A01)

Answer 17

Perception of reality –should be able to ‘see world as it is’

Resistance to stress – Being able to cope w/stressful situations

self-Attitude- High self-esteem + strong sense of self-identity

Autonomy- should function as independent individuals

Self-actualisation– Being focused on future + on fulfilling their potential

Environmental Mastery- ability to adjust to new situations functioning at work + in relationships w/others

fewer of these qualities you have more abnormal you are seen to be

Question 18

deviation from mental health: culturally biased (A03) (2)

Answer 18

P: culturally biased

E: bc ideals of mental health are not applicable to all cultures

E: eg. criterion of self-actualisation is relevant to members of individualistic cultures but not collectivists’ cultures, where individuals strive for greater good of community rather than for self-centred goals

L: problem bc for definition to be classed as reliable- same behaviour should be viewed consistently between cultures

Question 18

deviation from mental health: offers an alternative perspective on mental disorders (A03) (1)

Answer 18

P: offers an alternative perspective on mental disorders

E+ E: definition focuses on positives rather than negatives

L: Jahoda’s ideas therefore are in accord w/humanistic approach which also focuses on positive aspects of human nature

Question 19

deviation from mental health: unclear about criteria (A03) (3)

Answer 19

P: unclear how many criteria need to be lacking before we are seen to be ‘deviating from ideal mental health’

E: do all 6 criterion need to be present or could we lack 1 or 2 + still be viewed as normal?

E: order to make this decision subjective judgement must be make-left to individual psychiatrists to judge whether someone is deviating enough to be diagnosed + this could lead to inconsistency

L: lack of objectivity means that this definition of abnormality is rarely used in real world

Question 20

Behavioural, Emotional + Cognitive Characteristics of Phobias: DSM (A01)

Answer 20

no. of systems for classifying + diagnosing mental health problems

Perhaps the best known is DSM -Diagnostic + Statistical Manual of Mental Disorders which is published by American Psychiatric Association

DSM is updated every so often as ideas about abnormality change current version is DSM-5 published in 2013

Question 21

Behavioural, Emotional + Cognitive Characteristics of Phobias: DSM-5 Categories of Phobias (A01)

Answer 21

Specific phobia: Also known as simple phobia this is fear of an object, such as an animal, or situation such as flying or having an injection Social phobia: Phobia of social situation such as public speaking or using public toilet Agoraphobia: Fear of leaving home or safe place- Can be characterised by fear of being outside or in public place

Question 22

behavioural characteristics of phobias: panic (A01)

Answer 22

phobic people panic in response to presence of phobic stimuli Panic can be in form of behaviours such as crying, screaming, running away or freezing

Question 23

behavioural characteristics of phobias: avoidance (A01)

Answer 23

anxiety increases by being close to feared situation- natural to avoid certain situations where object will be eg. if someone has fear of ghosts they do not take short-cut home through graveyard at midnight

Question 24

behavioural characteristics of phobias: disruption of functioning (A01)

Answer 24

Anxiety + avoidance responses are so extreme that they severely interfere w/ability to conduct everyday working + social functioning eg. person w/social phobia will find it very hard to socialise w/others or indeed interact meaningfully w/ them at work

Question 25

emotional characteristics of phobias: anxiety (A01)

Answer 25

unpleasant state of high arousal which makes it very difficult to experience any positive emotions anxiety experienced can be long term- due to presence of or anticipation of feared objects + situations

Question 26

emotional characteristics of phobias: fear (A01)

Answer 26

emotional responses of fear which accompanies many phobic stimuli is often extremely unreasonable eg. an individual’s fear of spiders will involve very strong emotional response to tiny, harmless spider fear is disproportionate to actual danger posed by spider

Question 27

cognitive characteristics of phobias: irrational beliefs (A01)

Answer 27

Sufferers often hold irrational beliefs in relation to phobic stimuli- also very resistant to rational arguments eg. person w/fear of flying is not helped by arguments that flying is actually safest form of transport

Question 28

cognitive characteristics of phobias: selective attention (A01)

Answer 28

Sufferers will often look intently at phobic stimulus + find it very difficult to look away from them usually useful to keep our attention on something dangerous so we can react to threat quickly not useful when fear is irrational as this can interfere w/day to day life eg. pogonophobia will struggle to concentrate on what they’re doing if someone in room has a beard

Question 29

Behavioural Approach to Explaining Phobias: CC initiation (A01)

Answer 29

phobia is acquired through association of stimulus w/response eg. Watson + Rayner induced fear of white rats in Little Albert by pairing rat loud noise resulted in new stimulus being learnt eg. fear of dogs after being bitten: Being bitten (UCS) creates fear (UCR) Dog (NS) associated w/being bitten (UCS) Dog (now CS) produces fear response (now CR) same steps can explain how person might develop fear of social situations after having panic attack in such situation

Question 30

Behavioural Approach to Explaining Phobias: 2 process model (A01)

Answer 30

phobias are acquired- learned in first place by CC + maintained bc of OP

Question 31

Behavioural Approach to Explaining Phobias: OC maintaining (A01)

Answer 31

W/negative reinforcement individual avoids situation that is unpleasant eg. person w/fear of dogs will avoid visiting friends w/dogs person w/ fear of enclosed spaces will avoid going into lift avoiding phobic stimulus allows them to escape fear + anxiety that they would have suffered if they had remained reduction in fear reinforces avoidance behaviour + maintains phobia

Question 32

Behavioural Approach to Explaining Phobias: tested in objective + rigorous ways (A03) (1)

Answer 32

P: tested in an objective + rigorous way E + E: Mowrer tested his two-process model by pairing buzzer sound w/ an electric shock- use of negative reinforcement Mower trained rats to escape shock by jumping over barrier when buzzer sounded L: matters bc it increases scientific validity of behaviourist explanation of phobias

Question 33

Behavioural Approach to Explaining Phobias: practical applications (A03) (2)

Answer 33

P: practical applications E: several behavioural therapies which use principles of conditioning to successful treat phobias eg. ‘systematic desensitisation’ has been shown to be an extremely successful therapy for range of different phobias E: McGrath et al who found that 75% of phobic patients showed an improvement in their symptoms after treatment L: success of these treatments strengthens validity of behaviourist explanation of phobias

Question 34

Behavioural Approach to Explaining Phobias: fails to explain role evolution plays in many people’s fears (A03) (3)

Answer 34

P: fails to explain role evolution plays in many people’s fears E + E: Seligman found in his research that we are innately predisposed to fear such things as snakes + spider as these things have been source of danger in our evolutionary past- helps to explain why people may have fear of things they have never experienced or encountered L: 2 process model may be too simplistic as this suggests there is more to acquiring phobia than simply conditioning

Question 35

Behavioural Approach to Explaining Phobias: fails to explain cognitive aspects of a phobia (A03) (4)

Answer 35

P: fails to explain cognitive aspects of phobia E+ E: person in lift may think ‘I could become trapped in here + suffocate’ -irrational thought creates extreme anxiety + may trigger phobia L: weakness as behavioural explanation is failing to explain vital component of disorder- approach that incorporates both behavioural + cognitive components of phobia is therefore required in order to provide thorough explanation of disorder

Question 36

Behavioural Approach to Treating Phobias: systematic desensitisation (SD) (A01)

Answer 36

SD is behavioural therapy designed to gradually reduce phobic anxiety through principles of CC If sufferer can learn to relax in presence of phobic stimulus they will be cured new response to phobic stimulus is learned- learning of different response is called counterconditioning

Question 37

SD: anxiety hierarchy (A01)

Answer 37

phobic patient works w/therapist to develop an ‘anxiety hierarchy’ is list of situations related to phobic stimulus starting w/least fearful situation at bottom

Question 38

SD: relaxation (A01)

Answer 38

impossible to be afraid + relaxed at same time as 1 emotion prevents over- reciprocal inhibition teaching relaxation techniques is vital part of SD Typical relaxation techniques that are taught include deep breathing, mindfulness + visualisation relaxation is sometimes achieved using anti-anxiety drugs such as Valium

Question 39

SD: exposure (A01)

Answer 39

patient is exposed to phobic stimulus whilst in relaxed state patient starts at bottom of fear hierarchy + when they can remain relaxed at that level they progress onto next level Over several sessions patient gradually moves their way up the hierarchy SD is successful when patient can maintain relaxation in most highest level on hierarchy Exposure can be done in two ways: vitro – client imagines exposure to phobic stimulus vivo – client is actually exposed to phobic stimulus

Question 40

SD: effective at treating phobias (A03) (1)

Answer 40

P: effective at treating phobias E: McGrath et al reported that 75% of patients showed an improvement in their symptoms after systematic desensitisation E: Gilroy followed up 42 patients after they had been treated for spider phobia- 33 months later they showed less fear than control group L: strength bc it shows that SD can be used to treat majority of sufferers + that effects are long lasting

Question 41

SD: sufferers tend to prefer it to alternative behavioural therapy of ‘flooding’ (A03) (2)

Answer 41

P: sufferers tend to prefer it to alternative behavioural therapy of ‘flooding E+ E: largely bc it does not cause same degree of trauma as flooding supported by fact that SD has low attrition rates L: matters bc SD is able to help higher number of patients than flooding-empowers sufferers to choose therapy that is most acceptable to them

Question 42

SD: not an effective treatment for all phobias (A03) (3)

Answer 42

P: not an effective treatment for all phobias E: Ohman suggest that SD may not be as effective in treating phobias that have an underlying evolutionary component- reduces usefulness of this technique of treatment E: SD is only really suitable for patients who are able to effectively use relaxation techniques + who have imaginations that are vivid enough to think up images of fear objects L: therapy may not be appropriate to use for all sufferers of phobias

Question 43

SD: economic benefits (A03) (4)

Answer 43

P: economic benefits E: SD very cost effective for most phobias + is therefore cheap to deliver to sufferers compared to other therapies E: estimated that mental health issues cost English economy around £22.5 billion a year- figure does not include indirect costs such as loss of employment L: positive bc it means cost effective therapies for phobias not only have positive impact on sufferer’s lives but also have economic benefits too

Question 44

Behavioural Approach to Treating Phobias: flooding (A01)

Answer 44

involves exposing phobic patients to their phobic stimulus but w/x gradual progression seen in SD clients are immediately exposed to very frightening situation eg. person w/fear of flying may be taken up in an aircraft or person w/fear of spiders may be placed in room full of them Usually one long session is used in which the patient experiences their phobia at its worst, while at the same time practising relaxation. The session continues until the patient is fully relaxed. stops phobic responses very quickly bc patient cannot avoid stimulus- they quickly learn that phobic stimulus is harmless CC terms this processes- ‘extinction’ learned response (CR) is extinguished when CS is encountered without the UCS resulting in CS no longer producing CR

Question 45

flooding: cost effective treatment for phobias (A03) (1)

Answer 45

P: cost effective treatment for phobias E+ E: Research has shown that that flooding is just as effective at treating phobias as SD however it is significantly quicker L: strength as patients are free of their symptoms as soon as possible + this makes treatment cheaper than SD

Question 46

flooding: highly traumatic less effective for social phobia + agoraphobia (A03) (3)

Answer 46

P: highly traumatic less effective for social phobia + agoraphobia E+ E: behavioural treatments are unable to treat irrational thinking that is more common w/these complex phobias- suggests that other forms of treatment- CBT which treats irrational thinking may be a more effective method of treating social + agoraphobia L: problem bc it appears that flooding is restricted in its usefulness to just specific phobias

Question 47

flooding: highly traumatic experience for patients (A03) (2)

Answer 47

P: highly traumatic experience for patients E+ E: problem is not that flooding is unethical but that patients are often unwilling to see it through to end L: limitation of flooding bc time + money are sometimes wasted preparing patients only to have them refuse to start or complete treatment

Question 48

Behavioural, Emotional + Cognitive Characteristics of Depression (A01)

Answer 48

depression-mood disorder DSM-5 distinguishes between major depressive disorder which is severe but often short term + persistent depressive disorder which is longer term + recurring

Question 49

Behavioural characteristics of Depression: disruption of sleep + eating

Answer 49

associated w/ disruption in our normal eating + sleeping behaviours Insomnia + hypersomnia are common + appetite can also increase or decrease w/depression which can lead to weight loss or gain

Question 50

emotional characteristics of Depression: sadness (A01)

Answer 50

most common description people give of their depressed state along w/feeling empty w/this people may feel worthless hopeless + experience low self-esteem

Question 51

Behavioural characteristics of Depression: loss of energy (A01)

Answer 51

Some depressed people have reduced energy resulting in fatigue, lethargy + high levels of inactivity eg. they may struggle to get out of bed + do usual daily activities

Question 52

cognitive characteristics of depression: focusing + dwelling on negative (A01)

Answer 52

People w/depression often view themselves world + future in negative ways may have bias towards reporting unhappy events in their lives rather than happy events Such negative thoughts are irrational eg. they do not accurately reflect reality

Question 53

emotional characteristics of Depression: anger (A01)

Answer 53

Negative emotions can also be shown in form of anger anger can be directed as aggression towards oneself or towards others

Question 54

cognitive characteristics of depression: poor concentration (A01)

Answer 54

Sufferers often find themselves unable to stick to task or make decisions then likely to interfere w/sufferer’s work + ability to communicate

Question 55

Cognitive Approach to explaining depression: Ellis ABC model (A01)

Answer 55

A refers to an ‘activating event’- eg. getting sacked at work- like failing an important test or ending relationship might trigger irrational beliefs B is belief which may be rational or irrational-source of irrational beliefs lies in mustabatory thinking- belief that we must always succeed or achieve perfection eg. ‘I must be liked by everyone’ C is consequences – rational beliefs lead to healthy emotions whereas irrational beliefs lead to unhealthy emotions including depression

Question 56

Cognitive Approach to explaining depression: Becks negative triad (A01)

Answer 56

depressed people acquire negative schema about themselves during childhood- schemas are often caused by parental + peer rejection + criticism Negative self-schemas lead to cognitive biases in thinking self - Such thoughts enhance any existing depressive feelings because they confirm existing emotions of low self-esteem world- creates impression that there is no hope anywhere future- Such thoughts reduce any hopefulness + enhance depression

Question 57

Becks negative triad: supporting evidence (A03) (1)

Answer 57

P: evidence supports idea that depression is due to negative thinking E: Grazioli and Terry assessed 65 pregnant women before + after birth- found that those who had high no. of cognitive biases were more likely to suffer post-natal depression-these cognitive biases were present BEFORE depression developed E: Clark + Beck carried out meta- analysis of research into this area + found strong support for Beck’s cognitive theory L: evidence suggests that Beck’s theory is valid explanation of depression

Question 58

Ellis ABC model: can't explain all types of depression (A03) (1)

Answer 58

P: ABC model cannot explain all types of depression bc not all cases of depression are triggered by an activating event E + E: endogenous depression is caused by chemical + genetic factors rather than an activating life event L: means that ABC explanation only applies to some kinds of depression + is therefore an invalid explanation of depression

Question 59

Ellis ABC model + Becks negative triad: applied to cognitive behavioural therapy (CBT) (A03) (1)

Answer 59

P: applied to CBT E +E: CBT is consistently found to be best treatment for depression success of treatment lends support to cognitive explanation- depression is alleviated by challenging irrational thinking then this suggests such thoughts had role in depression in 1st place L: increases validity of cognitive explanations

Question 60

Ellis ABC model + Becks negative triad: cognitive approach appears to blame patient for their depression (A03) (2)

Answer 60

P: cognitive approach appears to blame patient for their depression E: suggests depression is result of way person thinks that recovery is only possible by changing person’s thought processes- places large burden of blame on person already prone to negative thinking E: stance may lead client or therapist to overlook how life events or family problems may be contributing to depression L: changing situation may be more important than focussing on cognitive factors

Question 61

Ellis ABC model + Becks negative triad: biological approach provides an alternative explanation for depression (A03) (3)

Answer 61

P: biological approach provides an alternative explanation for depression E +E: argues that depression is caused by low levels of neurotransmitter serotonin- success of anti-depressants- increase serotonin levels supports view that biological factors play part in disorder diathesis-stress approach is usually adopted by psychologists L: suggests that individuals w/ genetic vulnerability for depression are more prone to stressful life events which then leads to negative thinking

Question 62

Cognitive Approach to treating depression: CBT (A01)

Answer 62

aim of CBT is to replace irrational negative thoughts experienced by depressed patients w/more rational positive ones leading to more constructive emotional + behavioural responses CBT begins w/an initial assessment in which patient + therapist identify patient’s depressive symptoms + agree on set of goals help client achieve their goals + change their negative thinking most CBT therapists use techniques taken from both forms of CBT – Beck’s cognitive therapy + Ellis’s rational emotive behaviour therapy

Question 63

Cognitive Approach to treating depression: becks cognitive therapy (A01)

Answer 63

idea behind this therapy is to identify negative thoughts client has about world- self + future Patients are often set homework such as to record when they enjoyed an event or when someone was nice to them Homework can also be used to encourage depressed clients to become more active + to engage in pleasurable activities eg. patient who is anxious in social situations may be set homework assignment to meet friend for drink Cognitive therapy also aims to help patients test reality of their negative beliefs-referred to as ‘patient as scientist’, investigating reality of their negative beliefs in way scientist would

Question 64

Cognitive Approach to treating depression: Ellis’s Rational Emotive Behaviour Therapy (REBT) (A01)

Answer 64

REBT extends ABC model to an ABCDE model - D stand for disputing irrational beliefs + E for effects of disputing beliefs. REBT focuses on challenging or disputing (D) irrational beliefs + replacing them w/effective rational ones eg. Logical disputing – self defeating beliefs do not follow logically from information available Empirical disputing – self-defeating beliefs may not be consistent with reality Pragmatic disputing – emphasises the lack of usefulness of beliefs ‘Effect’ (E) of challenging these irrational thoughts is that patient will develop more rational beliefs turn helps client become less depressed leading to constructive behaviours

Question 65

CBT: effective in treating depression (A03) (1)

Answer 65

P: effective in treating depression E + E: March et al compared CBT w/ drug therapy after 36 weeks they found 81% of patients showed improvement in both groups L: strength bc it shows that CBT is just as effective as drug therapy at treating depression but w/x unpleasant side effects that most people experience whilst taking anti-depressants

Question 66

CBT: economic benefits (A03) (2)

Answer 66

P: economic benefits E+ E: estimated that mental health issues cost English economy around £22.5 billion per year- CBT has proven to be an effective treatment L: reduces unnecessary healthcare costs on treatments that are ineffective + also enables people to return to work helping economy

Question 67

CBT: not preferred method of treatment for most patients (A03) (3)

Answer 67

P: not preferred method of treatment for most patients E+ E: Unlike CBT drug therapy requires little effort + is just as effective at treating depression- drug therapy is less expensive as it does not require trained therapists L: drug therapy may prove to be more beneficial to economy than CBT

Question 68

CBT: may not work for all sufferers (A03) (4)

Answer 68

P: CBT may not work for all sufferers E+ E: requires patients to commit to attending regular sessions w/ therapist completing homework + putting into practice techniques learnt- more disruptive to patients’ lives than just taking medication many patients lack motivation to engage successfully in these programme L: especially true for those who are severely depressed suggesting that this method of treatment is not suitable for all sufferers

Question 69

Behavioural, Emotional + Cognitive Characteristics of obsessive compulsive disorder (OCD) (A01)

Answer 69

anxiety disorder- usually begins in young adult life + has 2 main components: obsessions-recurring thoughts compulsions-repetitive behaviours

Question 70

behavioural characteristics of OCD: compulsive behaviour (A01)

Answer 70

Sufferers feel compelled to repeat certain behaviour in order to reduce anxiety behaviours are externally visible + repetitive eg. include hand-washing, counting or tidying/ordering

Question 71

behavioural characteristics of OCD: avoidance (A01)

Answer 71

sufferers may avoid situations which usually trigger their anxiety aim being to reduce anxiety through avoidance eg. sufferers who compulsively wash their hands may avoid coming into contact w/germs but this behaviour may interfere w/normal day to day life

Question 72

emotional characteristics of OCD: anxiety + distress (A01)

Answer 72

obsessions + compulsions are source of considerable anxiety + stress feelings of anxiety are often reduced by carrying out compulsive behaviours eg. compulsive hand-washing might reduce anxiety caused by an excessive fear of germs, encouraging more hand-washing.

Question 73

cognitive characteristics of OCD: awareness of excessive anxiety (A01)

Answer 73

key element required for diagnosis of OCD is that person is aware that their obsessions + compulsions are irrational individual who believes their obsessive thoughts were grounded in reality would be suffering from very different form of mental disorder

Question 73

emotional characteristics of OCD: shame/disgust (A01)

Answer 73

Sufferers are aware that their behaviour is excessive + this causes feelings of embarrassment + shame irrational levels of disgust are felt over germs, dirt / mess

Question 74

cognitive characteristics of OCD: obsessions (A01)

Answer 74

major cognitive symptom for 90% of OCD sufferers Obsessions are persistent, recurring internal thoughts that often drive anxious feelings Obsessions could be ideas doubts, impulses or images- thoughts are seen as uncontrollable which creates anxiety

Question 75

Biological Approach to explaining OCD genetic explanations: COMT GENE (A01)

Answer 75

COMT is an enzyme that regulates dopamine however in people w/OCD this gene mutates preventing COMT enzyme from regulating dopamine levels-causes high levels of dopamine seen in many patients w/OCD

Question 75

Biological Approach to explaining OCD genetic explanations: SERT GENE (A01)

Answer 75

SERT gene is involved in transportation of serotonin an inhibitory neurotransmitter- levels of serotonin are low person is more likely to get OCD- SERT gene mutates causing lower levels of serotonin

Question 76

Biological Approach to explaining OCD genetic explanations: OCD IS POLYGENIC (A01)

Answer 76

appears that OCD is polygenic - OCD is not caused by 1 single gene but that several genes are involved eg. Taylor 2013 found that up to 230 different genes may be involved in OCD including SERT + COMT genes

Question 77

Biological Approach to explaining OCD neural explanations: ABNORMAL NEUROTRANSMITTER LEVELS (A01)

Answer 77

Serotonin helps to regulate mood Low levels of serotonin have been linked to depression + anxiety disorders such as OCD Support for this comes from fact that drugs which increase serotonin levels are effective in treating OCD neurotransmitter dopamine has also been implicated in OCD w/high levels of dopamine being associated w/compulsive behaviours

Question 78

Biological Approach to explaining OCD neural explanations: WORRY CIRCUIT (A01)

Answer 78

orbital prefrontal cortex (OFC) is region in brain which converts sensory information to thoughts + actions OFC sends signals about potential hazards to thalamus but if these ‘worry signals’ are not serious they will be suppressed by caudate nucleus preventing them from reaching thalamus caudate nucleus is damaged it fails to suppress minor or unimportant ‘worry’ signals unnecessary thoughts + impulses are allowed to alert thalamus signals are then sent back to OFC reinforcing belief that these unnecessary thoughts + impulses are major concern that need an immediate + powerful response

Question 79

Biological Approach to explaining OCD: supporting evidence (A03) (1)

Answer 79

P: supporting evidence E: Nestadt et al carried out meta-analysis of twin studies + found that MZ twins had an overall concordance rate of 68% compared to only 31% in DZ twins- link between genetics + OCD concordances rates are never 100% which means that environmental factors must also play part E: more supporting evidence comes from family studies eg. Nestadt et al found that people w/1st degree relative w/OCD were 5 times more likely to develop illness themselves compared to general population L: evidence further increases validity of biological explanation of OCD

Question 80

Biological Approach to explaining OCD: use of anti-depressants (A03) (2)

Answer 80

P: use of anti-depressants-supporting evidence E + E: Anti-depressants typically work by increasing levels of neurotransmitter serotonin effectiveness of these drugs at reducing symptoms of OCD provides support for neural explanation of OCD eg. Soomro et al found that SSRIs were significantly more effective than placebos in treating OCD L: supports the view that abnormal neurotransmitter levels must be contributing to cause of OCD

Question 81

Biological Approach to explaining OCD: supports role of OFD in OCD (A03) (3)

Answer 81

P: supports role of OFD in OCD E: Menzies conducted MRI scans on OCD patients + their immediate family members w/x OCD also healthy control group- that OCD patients + their immediate close family members had reduced grey matter in OFC supporting view that differences in this brain region are inherited + may be contributing to disorder E: but researchers have been unable to successfully identify which genes are causing this reduction in grey matter- consequence is that genetic explanation is unlikely to ever be very useful bc it provides little predictive value L: unable to predict which relatives w/reduction in grey matter will develop OCD

Question 81

Biological Approach to explaining OCD: other better models-diathesis-stress model (A03) (4)

Answer 81

P: diathesis-stress model may be better at explaining cause of OCD than biological explanation E+ E: acknowledges that both genes + environmental play role in OCD suggests that individual genes could cause vulnerability for OCD but whether illness develops depends on environmental factors eg. Cromer et al found that over half of their OCD patients had experienced traumatic life event + that OCD was more severe in patients who had experienced more than 1 traumatic event L: supports diathesis-stress model + view that genes alone cannot predictive who is likely to develop OCD

Question 81

Biological Approach to treating OCD ANTIDEPRESSANTS: how selective serotonin reuptake inhibitor work (SSRIs) (A01)

Answer 81

Serotonin is released into synapse by pre-synaptic neurone after serotonin has crossed synapse from presynaptic neurone it is reabsorbed by presynaptic neurone ready to be re-used SSRIs work by preventing this reabsorption- results in more serotonin staying in synapse for longer allows serotonin to stimulate postsynaptic neurone for longer compensating for deficiency in serotonin system SSRI’s help to reduce anxiety associated w/OCD + ‘normalise’ worry circuit

Question 82

Biological Approach to treating OCD ANTI-ANXIETY DRUGS: how GABA works (A01)

Answer 82

GABA is released into synapse by presynaptic neurone locks onto receptors on postsynaptic neurone opens channel that increases flow of chloride ions into neurone Chloride ions make it harder for neurone to be stimulated by other neurotransmitters slowing down its activity reduces anxiety experienced due to obsessions + makes person w/OCD feel more relaxed

Question 83

Biological Approach to treating OCD: supporting evidence (A03) (1)

Answer 83

P: evidence for effectiveness of drug therapy in reducing symptoms of OCD E + E: Soomro et al reviewed studies comparing SSRIs to placebos in treatment of OCD- found that SSRIs were significantly more effective than placebos in treating OCD Kahn et al compared placebos + Benzodiazepine in 250 patients found that BZs were significantly superior to placebos in treating anxiety L: strength bc drug therapy enables sufferers to cope w/their symptoms -anxiety thereby improving quality of their lives

Question 83

Biological Approach to treating OCD ANTI-ANXIETY DRUGS: SNRIs + tricyclics (A01)

Answer 83

SNRIs drugs work by preventing reuptake mechanism of both serotonin + noradrenaline increasing levels of both of these neurotransmitters + reducing anxiety Tricyclics older drug which work in same manner as SNRIs but have more severe side effects

Question 84

Biological Approach to treating OCD: cost effective (A03) (2)

Answer 84

P: cost-effective compared to psychological treatments E + E: don't require trained therapist + are less disruptive to patients’ lives- Drugs allow patients to reduce their symptoms w/x having to engage w/much of hard work needed by psychological therapies -CBT drug therapies are preferred method of treatment for many doctors + patients enable people to control their symptoms w/minimal effort saving time + money L: drug therapy combines well w/ CBT by reducing patient’s anxiety thereby enabling them to engage more successful w/techniques

Question 85

Biological Approach to treating OCD: CBT should be tried 1st (A03) (3)

Answer 85

P: drug therapies are more commonly used to treat OCD in comprehensive review of treatments for disorder E + E: Koran argued that psychotherapies such as CBT should be tried 1st bc drugs only treat symptoms of OCD rather than root cause- drug therapy is effective in the short-term by placing ‘chemical mask’ on symptoms they are not lasting cure eg. patients normally relapse w/in few weeks after medication is stopped L: issue as alternative therapies such as CBT or combined approach of drugs + CBT may be seen as more appropriate in long-term

Question 86

Biological Approach to treating OCD: side effects of drug therapy (A03) (4)

Answer 86

P: drug therapy are side effects that most patients experience E: Common side effects of SSRIs include blurred vision, indigestion + loss of sex drive-may not seem that terrible but often are enough to make patient prefer not to take drug- patients also experience more serious side effects like hallucinations, erection problems + raised blood pressure E: BZs are renowned for being highly addictive + can also cause increased aggression + long-term memory impairments- BZs are usually only prescribed for short-term treatment L: side effect diminish effectiveness of drug treatments as patients will often stop taking medication if they experience these side effects