General Content

Question 1

What are the 4 definitions for abnormality?

Answer 1

• Statistical Infrequency
• Deviation from social norms
• Failure to function adequately
• Deviation from ideal mental health

Question 2

Outline statistical infrequency including an example

Answer 2

• According to the statistical infrequency definition, a behaviour is seen as abnormal if it is statistically uncommon or not seen very often in society
• Therefore abnormality is determined by looking at the distribution of a particular behaviour within society
• For example:
• the average IQ is approx 100 and 65% of the population have an IQ in the region of 85 to 115
• 95% of the population have an IQ in the region of 70 to 130
• However, a small % (approx 5%) have an IQ below 70 or above 130 and these people are statistically uncommon and would be classified as abnormal
• A normal distribution curve can be used to represent the proportions of the population who share a particular characteristic

Question 3

Evaluation of Statistical Infrequency

Limitation; Labelling

Answer 3

• Labelling an individual as abnormal can be unhelpful
• This is especially true of someone with a low IQ since they will be able to live happily without distress to themselves or others
• Such a label may contribute to poor self-image
• This means that being labelled as statistically infrequent could cause the person more distress than the condition itself

Question 4

Evaluation of Statistical Infrequency

Limitation: Some abnormal traits could be desirable

Answer 4

• Some statistically infrequent behaviours labelled as abnormal could be desirable traits
• For example:
• Having an high IQ is very unusual yet it is hugely celebrated
• Conversely, depression is experienced by many but not desirable
• Therefore it needs to identify those behaviours which are both infrequent and undesirable to avoid this pitfall

Question 5

Outline what is meant by deviation from social norms including an example

Answer 5

• A social norm is an unwritten rule about what is acceptable within a particular society
• Therefore, a person would be seen as abnormal if their thinking or behaviour violates these unwritten rules
• For example:
• Someone walking around the streets of London naked would be seen as abnormal
• But the same behaviour in remote african tribes would be considered perfectly normal as part of their culture

Question 6

Evaluation of deviation from social norms

Cultural Relativism

Answer 6

• One issue is the idea of cultural relativism
• Social norms differ between cultures and what is considered normal in one culture may be abnormal in another
• For example, in approx 75 countries homosexuality is still illegal and therefore considered abnormal. However in the rest of the world it’s considered normal
• The result of this is that there is no global standard and therefore abnormality isn’t standardised

Question 7

Evaluation of deviation from social norms

Incomplete explanation

Answer 7

• How far an individual deviates from a social norm is mediated by the degree of severity and the context
• For example, when someone breaks a social norm once this may not be deviant behaviour, but the persistent repetition of such behaviour could be evidence of psychological disturbance
• Likewise, someone walking topless on a beach would be normal but doing that in the office would be viewed as abnormal
• As a consequence this definition fails to offer a complete explanation in its own right since it is related to degree and context

Question 8

Outline what is meant by failure to function (ffa) adequately- use an example

Answer 8

• According to the FFA definition of abnormality, a person is considered abnormal if they are unable to cope with the demands of everyday life and live independently in society
• To be classified as abnormal, a person’s behaviour should cause personal suffering and distress because of their failure to cope
• However, they may also cause distress to others who observe them
• For example: someone with depression may struggle to get out of bed and go to work or they may find it difficult to communicate with others
• They would be considered abnormal as their depression is causing an inability to cope with everyday life while also causing distress to family + friends
• Rosenhan and Seligman=
• They proposed signs used to determine if someone isn’t coping:
  1) No longer conforms to standard interpersonal rules eg maintaining eye contact and respecting personal space
  2) Experiences of severe personal distress
  3) Behaviour becomes irrational or dangerous to either themselves or others

Question 9

Evaluate Failure to Function Adequately

Considers Personal Experiences

Answer 9

• 1 strength is that it considers the subjective personal experiences of the patient
• This definition considers the thoughts and feelings of the person experiencing the issue
• It doesn’t simply make a judgement without taking the personal viewpoint of the sufferer into consideration
• Suggesting that FFA definition is a useful model for assessing psychopathological behaviour

Question 10

Evaluate Failure to Function Adequately

Confusion with Deviation from Social Norms

Answer 10

• Often there’s confusion with distinguishing between failure to function adequately and deviation from social norms
• Sometimes a behaviour which appears to be a failure to function adequately, such as not being able to go to work, may in fact also be a deviation from the social norm
• That person may be choosing to live an alternative lifestyle out of the common system for that society
• It’s therefore difficult to ascertain if this behaviour should be considered maladaptive

Question 11

Outline what is meant by deviation from ideal mental health

Answer 11

• Jahoda suggested that abnormal behaviour should be defined by the absence of particular characteristics (eg behaviours which move away from ideal mental health)
• Similar to the approach taken by the medical profession for measures of physical health such as having high blood pressure within the normal range
• She proposed 6 principles for ideal mental health:
  1) Positive view of yourself (high self-esteem) with a strong sense of identity
  2) Being capable of personal growth and self-actualisation
  3) Being independent of others and self-regulating
  4) Having an accurate view of reality
  5) Being able to integrate and resist stress
  6) Being able to master your environment (love, friendships, work +leisure time)
• If an individual doesn’t show one of these criteria they would be classified as abnormal

Question 12

Evaluation of deviation from Ideal mental health

Unrealistic criteria

Answer 12

• 1 weakness is the unrealistic criteria Jahoda proposed
• There are times when everyone will experience stress and negativity, eg grieving
• However, according to this definition, these people would be classified as abnormal irrespective of the circumstances which are outside of their control
• With the high standards set by these criteria, how many need to be absent for diagnosis to occur must be questioned

Question 13

Evaluation of deviation from Ideal mental health

Cultural relativism

Answer 13

• An issue is cultural relativism
• Some of Jahoda’s criteria could be considered Western origin
• For example, her emphasis on personal growth and development may be considered overly self-centred in other countries who favour community over individualism
• Likewise, Independence within collectivist cultures isn’t fostered thus making the definition cultural bound

Question 14

What is a phobia?

Answer 14

An anxiety disorder which causes an irrational fear of a particular object or situation
And the extent of the fear is out of all proportion to any real danger presented by the phobic stimuli

Question 15

What are the 3 categories of a phobia?

Answer 15

• Simple phobias
• Social phobias
• Agoraphobia

Question 16

What is a simple phobia?

Answer 16

• The most common type

- This is where a person fears a specific object in the environment such as the fear of dogs

Question 17

What is a social phobia?

Answer 17

• Social phobias involve feelings of anxiety in social situations such as giving a speech in public
• Sufferers feel like they are being judged, which leads to feelings of inadequacy

Question 18

What is agoraphobia?

Answer 18

• It is a fear of open or public spaces

- Sufferers may experience panic attacks and anxiety, which make them feel vulnerable in open spaces

Question 19

What are the 3 types of characteristics of phobias?

Answer 19

Behavioural, emotional and cognitive

Question 20

Outline 2 behavioural characteristics of phobias

Answer 20

• Behavioural characteristics can be divided into 3:
  1) Key behaviour is avoidance= if a person with a phobia is presented with the object or situation they fear their immediate response is to avoid it
• However people aren’t always able to avoid their fears and sometimes they come face-to-face with an object/situation they fear
  2) This results in Panic=causing high levels of stress and anxiety
  3) Sometimes the fear is so intense the person ‘freezes’= which is part of the fight or flight response- and is an adaptive response to make a predator think that their prey is dead

Question 21

Outline emotional characteristics of phobias

Answer 21

• The key emotional characteristics are excessive and unreasonable fear, anxiety and panic
• An excessive emotional response is triggered by the presence or anticipation of a specific object/ situation
• Emotional responses are unreasonable and disproportionate to the danger posed by the stimulus

Question 22

Outline cognitive characteristics of phobias

Answer 22

• Cognitive characteristics are also divided into 2: selective attention and irrational beliefs
• Selective attention: If a person with a phobia is presented with an object they fear, they will find it difficult to direct their attention elsewhere causing them to become fixated on the object
• Irrational beliefs: a persons phobia is defined by their irrational thinking towards the object or situation such as people with arachnophobia may believe all spiders are deadly even though there are no deadly ones in the UK

Question 23

What is the two process model?

Answer 23

Mowrer proposed the model to explain how phobias are learned through classical conditioning and maintained through operant conditioning

Question 24

Describe the role of classical conditioning in the 2 process model

Answer 24

• It is a process of learning by associating 2 stimuli together to condition a response
• The process of classical conditioning can explain how we associate something we do not fear (neutral stimulus), for example a lift with something which triggers a fear response (unconditioned response), for example being trapped
• After association has formed the lift (now a conditioned stimulus) causes a response of fear (conditioned response)
• Consequently we develop a phobia of the lift following a single incident of being trapped

Question 25

Outline the key study by Watson and Raynor. Refer to aims, method, results and findings

(may not need for AO1, and could instead use it for AO3)

Answer 25

• aim= See whether a fear response could be learned through classical conditioning
• method= ppt was an 11 month old called ‘Little Albert’
• Before experiment Albert showed no response to various objects including a white rat
• To examine if they could induce a fear response they struck a metal bar with a hammer behind Albert’s head, causing a loud noise every time he went to reach for the white rat
• They did this x3
• Results= thereafter he began to cry every time he saw the white rat
• Conclusion= Showed that a fear response could be induced through the process of classical conditioning
• Albert also developed a fear towards similar objects including Santa’s beard
• Albert had generalised his fear to other white furry objects

Question 26

Describe the role of operant conditioning in the 2 process model

Answer 26

• According to Mowrer, our phobias are maintained through operant conditioning and they are negatively reinforced
• This is where a behaviour is strengthened because an unpleasant consequence is removed
• EG, if a person with a phobia of lifts always takes the stairs, then they are consequently avoiding their phobia= negative reinforcement
• Makes the person more likely to repeat this behaviour (avoidance) in the future and maintain their phobia

Question 27

Evaluation of the 2-process model

Research evidence

Answer 27

• Research evidence supports the behavioural explanation
• Watson and Rayner demonstrated the process of classical conditioning in the formation of a phobia in Little Albert, who was conditioned to fear white rats
• This supports the idea that classical conditioning is involved in acquiring phobias and that generalisation can occur
• However, since this is a case study, it is difficult to generalise the findings to other children or even adults due to the unique nature of the investigation

Question 28

Evaluation of the 2-process model

Application to Therapy

Answer 28

• A strength is its application to therapy
• Behaviourists ideas have been used to develop treatments, including systematic desensitisation and flooding
• Systematic desensitisation helps people unlearn their fears, using the principles of classical conditioning while flooding prevents people from avoiding their phobias and stop negative reinforcement from taking place
• Consequently these therapies have been successfully used to treat people with phobias providing further support for the effectiveness of the behaviourist explanation

Question 29

Evaluation of the 2-process model

Elements are ignored

Answer 29

• Behaviourist explanation for the development of phobias ignored the role of cognition
• Phobias may develop as a result of irrational thinking, not just learning
• For example, sufferers of claustrophobia may think; ‘L am going to be trapped in this lift and suffocate’, which is an irrational thought that is not taken into consideration in the behaviourist explanation
• Furthermore, the cognitive approach has also led to the development of CBT which is said to be more effective than the behaviourist treatments

Question 30

Evaluation of the 2-process model

Importance of evolutionary factors

Answer 30

• There’s a claim that the behaviourist approach may not provide a complete explanation of phobias
• For example, Bounton highlights that evolutionary factors could play a role in phobias, especially if the avoidance of a particular stimulus could have caused pain or death to our ancestors
• Evolutionary perspectives suggest phobias are not learned but are innate as such phobias acted as survival mechanisms for our ancestors
• This innate predisposition to certain phobias is called biological preparedness (Seligman) and casts doubts on the 2-process model since it suggests that there is more to phobias than learning

Question 31

Name 2 behavioural therapies for phobias

Answer 31

• systematic desensitisation

- flooding

Question 32

Outline what is meant by systematic desensitisation

Answer 32

• A behavioural therapy designed to gradually reduce phobic anxiety in response to a stimulus through classical conditioning
• There are 3 processes involved:
  1) anxiety hierarchy =a set of situations that provoke an increasing amount of anxiety
  2) relaxation= techniques like breathing, meditation or drugs etc
  3) exposure= the patient is exposed in a relaxed state to the first level in the hierarchy
• According to SD it is impossible to be afraid and relaxed at the same time= reciprocal inhibition
• When the patient can remain relaxed in the presence of this stimulus they move on to the next level
• This means a new response is learned to the stimulus= counter-conditioning

Question 33

Evaluation of Systematic desensitisation=

Research support

Answer 33

• Support comes from Gilroy et al who examined 42 patients with arachnophobia
• Each patient was treated using 3 45 minute SD sessions
• When examined 3 months and 33 months later, the SD group were less fearful than a control group
• This provides support for SD as an effective treatment for phobias long term

Question 34

Evaluation of Systematic desensitisation=

More ethical, less attrition

Answer 34

• SD is often favoured as a treatment for phobias in comparison to flooding, as it’s more ethical
• In comparison to flooding many patients report a preference for SD as it doesn’t cause the same level of distress that can occur when presented with the fear-inducing stimulus immediately
• This is reflected in the high number of patients who persist with SD providing low attrition rates
• It is therefore a more appropriate treatment for individuals who may have learning difficulties or suffer from severe anxiety disorders since learning relaxation techniques can be a positive and pleasant experience

Question 35

Outline what is meant by flooding

Answer 35

• Flooding is a behavioural therapy which, rather than exposing a person to their phobic stimulus gradually, exposes the individual to the anxiety-inducing stimulus immediately
• E.g. a person with a phobia of dogs would be placed in a room with a dog and asked to stroke the dog straight away
• This intense exposure is done over an extended period of time in a safe and controlled manner
• With flooding a person is unable to avoid their phobia and through continuous exposure, anxiety levels eventually decrease
• Since the option of employing avoidant behaviour is removed, extinction will soon occur since fear is a time-limited response to a situation which eventually subsides
• As exhaustion sets in for the individual they may begin to feel a sense of calm and relief which creates a new positive association to the stimulus

Question 36

What is extinction, in relation to flooding?

Answer 36

-It is where a learned response is extinguished when the conditioned stimulus is encountered without the unconditioned stimulus

Question 37

Evaluation of flooding=

Cost effective

Answer 37

• A strength is it provides cost effective treatment for phobias
• Research suggests that flooding is equally effective to other treatments including SD and cognition therapies (Ougrin)
• This a strength of the treatment because patients cure their phobias more quickly and it is therefore more cost-effective for health service providers who do not have to fund longer options

Question 38

Evaluation of flooding=

Highly traumatic

Answer 38

• Although flooding is considered cost effective, it can be highly traumatic for patients since it purposely elicits a high level of anxiety
• Wolpe recalled a case with a patient becoming so intensely anxious that she required hospitalisation
• Although it is not unethical as patients provide consent, many don’t complete their treatment because the experiment is too stressful
• Therefore, initiating flooding treatment is sometimes a waste of money and time if patients do not engage in or complete the full course of their treatment

Question 39

Evaluation for both phobia treatments=

Symptom substitution

Answer 39

• Behavioural therapies may not work with certain phobias because systems are normally just the tip of the iceberg
• If symptoms are removed the cause still remains and symptoms will resurface, possibly in another form
• E.g. a child struggling with a bereavement may displace their anxiety about death onto something like leaving the house, Here the real source of anxiety needs to be treated not the displaced fear
• Although behaviourists claim most phobias come through conditioning, this lack of focus on underlying causes could be problematic and is a limitation

Question 40

Outline what Beck means by the Cognitive Triad

Answer 40

• A negative and irrational view of ourselves, our future and the world around us
• For sufferers of depression, these thoughts occur automatically and are symptomatic of depressed people
• According to Beck, negative self-schemas and cognitive biases maintain the negative triad due to faulty info processing

Question 41

What are the stages of Beck’s cognitive triad?

Answer 41

-Negative Views about the World= ‘everyone is against me because I’m worthless’
-Negative Views about Oneself= ‘I’m worthless and inadequate’
-Negative Views about the Future= ‘I’ll never be good at anything’
(It’s a circular process)

Question 42

Describe what is meant by negative self-schemas

Answer 42

• A schema is a ‘package’ of knowledge, which stores information and ideas about our self and the world around us
• These schemas are developed during childhood and according to Beck, depressed people possess negative self-schemas, which may come from negative experiances eg critism from parents and peers
• Examples of negative self-schemas are=
• An ineptness schema- make sufferers except to fail
• A self-blame schema- them feel responsible for any misfortunes
• A negative self-evaluation schema- that constantly reminds them of their worthlessness

Question 43

Outline what is meant by cognitive biases in relation to Beck’s model of depression

Answer 43

• Beck found depressed people are more likely to focus on the negative aspects of a situation, while ignoring the positive
• These distort info, a process known as cognitive bias
• Beck detailed numerous cogntive biases, 2 of which; over-generalisation and catastrophising
• EG, depressed people may make over-generalisations,, where they make a sweeping conclusion based on a single incident
• Alternatively, a depressed person may experiance catastrophising, where they exaggerate a minor setback and believe that it’s a complete disaster

Question 44

Outline Ellis’s ABC model- use an example to illustrate your description

Answer 44

• He proposed a 3 stage model to explain how irrational thoughts could lead to depression:
• A= activating event= An event occurs, eg friend ignores you when you say hello
• B= Belief= Your belief is your interpretation of the event, which could either be rational or irrational (rational would be that the friend is busy and didn’t see them, but irrational would be that your friend doesn’t like you any more)
• C=Consequences= According to Ellis, rational beliefs lead to healthy emotional outcomes, whereas irrational beliefs lead to unhealthy emotional outcome, including depression

Question 45

Evaluating Cognitive Explanations of Depression:

Research Support

Answer 45

• There is research evidence which supports the cognitive explanation of depression
• Boury et al found that patients with depression were more likely to misinterpret information negatively (cognitive bias) and feel hopeless about their future (cognitive triad)
• Further to this, Bates et al gave depressed patients negative automatic through statements to read and found that their symptoms become worse
• These findings support different components of Beck’s theory and the idea that negative thinking is involved in depression

Question 46

Evaluating Cognitive Explanations of Depression:

Practical Application

Answer 46

• 1 strength of the cognitive explanation for depression is its application to therapy
• Cognitive explanations have been used to develop effective treatments for depression, including CBT and Rational Emotive Behaviour Therapy (REBT) which was developed from Ellis’s ABC model
• These therapies attempt to identify and challenge negative, irrational thoughts and have been successfully used to treat people with depression
• Thus providing further support to the cognitive explanation of depression

Question 47

Evaluating Cognitive Explanations of Depression:

Alternative Explanations

Answer 47

• There are alternative explanations which suggest that depression is a biological condition, caused by genes and neurotransmitters
• Zhang et al found that the gene related to lower levels of serotonin is x10 more common on depressed people
• In addition, drug therapies, including SSRI’s which increase the level of serotonin, are found to be effective in the treatment of depression, which provide further support for the role of neurotransmitters in the development of depression
• This therefore casts doubt on the cognitive explanation as a sole cause of the disorder

Question 48

Outline behavioural characteristics of depression

Answer 48

• There are numerous behavioural characteristics associated with depression, including; loss of energy, sleep disturbance and change of appetite
• Firstly, there is often a change in activity level; sufferers of depression often experience a reduction in energy and constantly feel tired
• Furthermore, sufferers often experience disturbances with their sleeping pattern; with sufferers sleeping significantly more, while others experiance insomnia
• Finally, sufferers often experiance chnages in appetite which cause significant weight changes

Question 49

Outline emotional characteristics of depression

Answer 49

• Emotional characteristics: The key emotional characteristics of depression is a depressed mood, or feelings of sadness
• Sufferers of depression will often experiance the following: Depressed mood, feelings of worthlessness and lack of interest of pleasure in activities
• Although a depressed mood is the most common emotional characteristic of depression, some experiance anger directed at themselves or others

Question 50

Outline cognitive characteristics of depression

Answer 50

• In addition to the emotional and behavioural characteristics, sufferers of depression often have a diminished ability to concentrate and a tendency to focus on the negative
• Sufferers of depression find it difficult to pay or maintain attention and are often slower in responding to or making decisions
• And inclinded to focus on the negative aspects of a situation, while ignoring the positives and in some cases, experiance recurrent thoughts of self-harm, death or suicide

Question 51

Describe the rationale behind cognitive therapies for depression and what the therapy involves

Answer 51

• Cognitive treatments are based on the assumption that faulty thinking makes a person vulnerable to depression
• CBT involves both cognitive and behavioural elements
• The cognitive element aims to identify irrational and negative thoughts, which lead to depression
• The aim is to replace these negative thoughts with positive ones
• The behavioural element encourages patients to test their beliefs through behavioural experiments and hw

Question 52

Outline some components to CBT (structure of session)

Answer 52

• Initial assessment
• Goal setting
• Identifying negative thoughts and challenging these by using either:
• Beck’s cognitive Therapy or Ellis’s REBT
• HW

Question 53

Describe Beck’s cognitive behavioural therapy

Answer 53

• If a therapist uses this therapy to treat depression, they will help the patient to identify negative thoughts in relation to themselves, their world and the future, using Becks triad
• The patient and therapist will then work together to challenge these irrational thoughts by discussing evidence for and against
• The patient will be encouraged to test the validity of their thoughts and may be set homework to test their thoughts

Question 54

Describe Ellis’s Rational Emotive Behavioural Therapy (REBT)

Answer 54

• Ellis developed his ABC model to include D (dispute) and E (effective)
• Like Beck the main idea is to challenge irrational thoughts, however with Ellis’s theory this is achieved through ‘dispute’ (argument)
• The therapist will dispute the patient’s irrational beliefs to replace them with effective beliefs
• There are different types of dispute, including:
• Logical dispute= therapist questions the logic of a person’s thoughts
• Empirical dispute= where the therapist seeks evidence for a person’s thoughts

Question 55

What are 2 different types of dispute used in Ellis’s REBT?

Answer 55

• Logical dispute= therapist questions the logic of a person’s thoughts
• Empirical dispute= where the therapist seeks evidence for a person’s thoughts

Question 56

What does a therapist encourage after a therapy session for depression?

Answer 56

-Homework
-The idea is that the patient identifies their own irrational beliefs and then proves them wrong
-As a result their behaviour begins to change
-For example someone who is anxious in social situations may be set a hw assignment to meet a friend for a drink
Sometimes Behavioural Activation, is also encouraged= active and engage in enjoyable activities

Question 57

Evaluation of Cognitive Treatments for depression:

Research Support

Answer 57

• 1 strength of CBT comes from research evidence which demonstrates its effectiveness in treating depression
• Research by March et al found CBT was as effective as antidepressants in treating depression
• Researchers examined 327 teens with diagnosed depression and looked at the effectiveness of CBT, antidepressants and a combination of both
• After 36 weeks, 81% of antidepressants and 81% of CBT hed significantly improved
• Shows CBT’s effectiveness in treating depression
• However 86% of CBT with antidepressants showed significant improvement
• This suggests that a combination of both treatments may be more effective

Question 58

Evaluation of Cognitive Treatments for depression:

Requires motivation

Answer 58

• 1 issue with CBT is that it requires motivation
• Patients with severe depression may not engage with CBT or even attend the sessions and therefore this treatment will be ineffective for them
• Alternative treatments such as antidepressants, do not require the same level of motivation and may be more effective in these cases
• This poses a problem for CBT, as CBT usually cannot be used as the sole treatment for severely depressed patients, who often lack motivation to attend therapy without the use of antidepressants.

Question 59

Evaluation of Cognitive Treatments for depression:

Overemphasis on the role of cognitions

Answer 59

• CBT has been criticised for its overemphasis on the role of cognitions as the primary cause of depression
• Some psychologists have criticised CBT for not taking into account other factors such as social situations
• For example, a patient who is suffering from domestic violence does not need to change their negative beliefs but in fact change their circumstances
• Therefore CBT would be ineffective in treating these patients until their circumstances have changed

Question 60

Outline behavioural characteristics of OCD

Answer 60

• The behavioural component of OCD centres on the compulsive behaviour, and for sufferers of OCD compulsions have 2 properties
• Firstly, compulsions are repetitive in nature and sufferers will often feel compelled to repeat a behaviour such as hand washing
• Secondly, compulsions are used to manage or reduce anxiety. For example, the excessive hand washing is caused by an excessive fear of germs and is a direct response to the obsession

Question 61

Outline the emotional characteristics of OCD

Answer 61

• The emotional characteristics of OCD are mainly characterised by anxiety which is caused by the obsessions, embarrassment and shame
• Obsessions are persistent and/or forbidden thoughts and ideas, which cause high levels of anxiety
• Some sufferers also experience depression
• The anxiety can cause a low mood and loss of pleasure in everyday activities as they are being interrupted by obsessive thoughts and repetitive compulsions

Question 62

Outline cognitive characteristics of OCD

Answer 62

• Obsessive thoughts are the main cognitive feature
• Examples of recurring thoughts include; fear of contamination, fear of safety and perfectionism
• For sufferers of OCD, these thoughts occur over and over again
• Some sufferers adopt cognitive strategies to deal with their obsessions
• For example, washing hands over and over again
• Also sufferers with OCD know that their obsessions and compulsions are irrational and experience selective attention directed towards the anxiety- generating stimuli

Question 63

What is the Diathesis-Stress model?

Answer 63

• This model proposes that people develop psychological disorders when they possess both an inherited gene and are exposed to a stressful event
• The genes produce vulnerability but the environmental stressors produce which/ any condition develops

Question 64

Outline the role of genes in OCD

Answer 64

• Genetic explanations have focused on identifying specific candidate genes which are implicated in OCD
• It is believed that OCD is a polygenic condition, which means that several genes are involved
• Taylor suggests that as many as 230 genes may be involved in OCD and perhaps different genetic variations contribute to the different types of OCD
• 2 examples of genes that have been linked to OCD are the COMT gene and SERT gene

Question 65

Describe the role of the COMT gene

Answer 65

• It is associated with the production of COMT which regulates dopamine
• Although all genes come in different forms, 1 variation of the COMT gene results in higher levels of dopamine and this variation is more common in patients with OCD

Question 66

Outline the role of the SERT gene in OCD

Answer 66

• The SERT gene is linked to serotonin and affects the transport of this neurotransmitter
• Transportation issues cause lower levels of serotonin to be active within the brain and are associated with both OCD and depression
• Ozaki et al published results from a study of 2 unrelated families who both had mutations of the SERT gene
• It coincided with the 6/7 of the family members having OCD

Question 67

Outline the role of Serotonin and dopamine in OCD

Answer 67

-Serotonin regulates mood and lowers levels of serotonin are associated with mood disorders, such as depression
-Some cases of OCD are also associated with lower levels of serotonin
-Evidence for the role of serotonin in OCD comes from research examining antidepressants (SSRIs) such as that conducted by Piggott et al
-They found that drugs (SSRIs) which increase the level of serotonin in the synaptic gap are effective in treating patients with OCD
Along with this higher levels of dopamine have been associated with some symptoms of OCD

Question 68

What is 1 of the brain regions that are specifically implicated with OCD?

Answer 68

The orbitofrontal cortex

Question 69

What is/ what does the orbitofrontal cortex do?

Answer 69

• It is a region of the brain which converts sensory information into actions and thoughts
• PET scans have found a higher activity level in the orbitofrontal cortex in patients with OCD, for example when a patient is asked to hold a dirty item with a potential germ hazard
• 1 suggestion is that the heightened activity increases the conversion of sensory information to actions which results in compulsions

Question 70

Evaluation of Biological Explanations for OCD:

Cause and effect relationships

Answer 70

• There’s an issue with understanding neural mechanisms in OCD
• Whilsts there’s evidence which suggests certain neural systems don’t function normally in patients with OCD, such as the orbitofrontal cortex, research has also identified other areas of the brain that are occasionally involved as well
• This means that there’s no brain system which has consistently been found to play a role in OCD
• So, although there is evidence that neurotransmitters and brain structures are implicated, it must not be concluded that there is a cause and effect relationship as it’s difficult to see if biological abnormalities are a cause or effect of OCD

Question 71

Evaluation of Biological Explanations for OCD:

Strength of genetics

Answer 71

• There’s evidence from many sources that people are vulnerable to OCD due to their genes
• 1 of the best sources of evidence for the importance of genes is twin studies
• Nestadt et al reviewed previous twin studies and found 68% of identical twins (MZ) shared OCD compared to 31% of non-identical twins (DZ)
• This strongly suggests a genetic influence on OCD

Question 72

Evaluation of Biological Explanations for OCD:

Support for Environmental Risk model (strength for Diathesis-Stress BUT weakness for genes)

Answer 72

• There is research support for the importance of environmental factors that can act as a trigger, or increase the risk of developing OCD
• Cromer et al found over 1/2 of OCD of his OCD patients had a traumatic past event with OCD being more severe in patients with more than 1 traumatic event
• This suggests OCD may not be entirely genetic in origin
• It may therefore be more productive to focus on the environmental causes because we are more able to do something useful about these

Question 73

What is the aim of drug therapies for mental illnesses like OCD?

Answer 73

-To increase or decrease the levels/ activity of the neurotransmitters in the brain

Question 74

Outline what SSRI’s are and how they relate to drug therapy (OCD)

Answer 74

• OCD is a result of low levels of serotonin
• SSRI’s are a type of antidepressant (which improve mood and reduce anxiety)
• Normally, when serotonin is released from the presynaptic cell into the synapse, it travels to the receptor sites of the postsynaptic neurons
• Serotonin which is not absorbed is reabsorbed by the presynaptic neuron
• SSRI’s increase the level of serotonin available in the synapse by preventing it from being reabsorbed
• This increases the level of serotonin in the synapse which improves the concentration of the brain chemical at receptor sites on the postsynaptic neuron

Question 75

Outline the use of Anti Anxiety Medication for OCD

Answer 75

• BZs are a range of anti-anxiety drugs that work by enhancing the action of GABA
• GABA tells neurons in the brain to ‘slow down’ and ‘stop firing’ and around 40% of the neurons in the brain respond to GABA
• This means BZs have a quirening influence on the brain and reduce anxiety
• Some neurons have GABA receptor sites at the synapse and when GABA locks onto one of these, the flow of chloride ions into the neuron is increased
• The chloride ions make it more difficult for the receiving neuron to be stimulated by further neurotransmitters= making the nervous system slower and the patient relaxed

Question 76

Evaluation of Biological Treatments for OCD:

Cost effective

Answer 76

• Advantage is their cost effectiveness
• Drug therapies are relatively cost-effective compared to psychological treatments such as CBT
• Consequently, many doctors prefer the use of drugs instead, as they are more cost-effective which is beneficial to health service providers. Treatments such as CBT require the patient to be motivated to engage whereas drugs are non-disruptive to everyday life and can be taken until the symptoms reduce
• As a result, this means that drug therapies are likely to be more successful for patients who lack the motivation to complete intense psychological treatments.

Question 77

Evaluation of Biological Treatments for OCD:

Symptoms not cause

Answer 77

• Drug treatments are criticised for treating the symptoms and not the cause
• Although SSRIs work by increasing the serotonin in the brain, which reduces anxiety and reduces OCD symptoms, it does not treat the underlying cause of OCD
• Also, once a patient stops taking the drug, they are prone to relapse
• Therefore, Koran et al suggests that psychological treatments such as CBT may be a more effective long-term solution to provide a lasting treatment and a potential cure

Question 78

Evaluation of Biological Treatments for OCD:

Research support

Answer 78

• A strength comes from research support for their effectiveness
• Randomised drug trials compare the effectiveness of SSRIs and a drug with no pharmacological value, called a placebo
• Soomro et al conducted a review of research examining the effectiveness of SSRIs and found that they were significantly more effective than placebos in the treatment of OCD, across 17 different trials
• This supports the use of biological treatments especially SSRIs
• However, studies such as this are criticised for only conducting short-term effectiveness of drug treatments with long-term effects still to be investigated