ICD Paper 4

Question 1

explain techqniue of Imag D

Answer 1

• Technique involves teaching brief PMR procedure
• Cilents instructed to visulise hemselves being exposed to a situation that triggers the urge to carry out impulsive behaviour
• contemplating acting on urge but then leaving situation IN STATE of continued relaxation w/o acting on urges
• Sessions can be recorded on casette audiotape for practise

Question 2

2 advanatges of Imag D

Answer 2

• Blaszinski and knower
• reduces strength of drive to carry out habitual behaviour
• ehances self efficacy by demonstaring that the client is in control of actions
• can be used anywhere once indiviudal has learnt technqiue
• empowers client by providing necessary skils to resist urges

Question 3

suggets 2 problems of Relaxation monitoring tables

Answer 3

• patienst may forget to fill them in
• may fill in even if they didnt complete the session
• may lie about progress
• may misjudge ratings of feelings when planning the behaviour
• may not be able to complete sheets at appropriate time each day + forget what happened

Question 4

Discuss adv and disadv of psychological treatments to treat ICDs

Answer 4

ADV
- Once trained, techniques can be applied anywhere/anytime (at home, clinic etc) by client
- no drugs taken so no side effects and no risk of addiction to drugs
- technqiues can be applied to many diff disorders e.g gambling/kleptomoania/ compulsive buying etc

Disadv:
- time w therapist is mcuh more than that given by a pshyciatrist prescring drugs
- a person may decide to withdraw from treatment to engage in impulsive behaviour
- any pshycological theraphy takes more time than drug treatment taken at same tiem each day
- patienst must be motivated and respoibsle to practise techniques if not treatment ineffective
- can be constly for some/inconveneinet

Question 5

Pryomania Burton et al

Answer 5

Psycological:
- not all firesetters have commited arson; most do not meet diagnostic criteria for pyromania
- firesetting is a beahv…..

Question 6

Glover

Question 7

Grant

Answer 7

The biochemical treatment using nalmefene is believed by Grant et a to help reduce the urge to gamble.
- To test its effectiveness,
participants were assessed to ensure they were suitable to participate.
- They were then randomly allocated to either a group receiving nalmefene or to a group receiving a placebo.

Question 8

Blazinsyk and nower

Question 9

Miller feeling state methodlogy

Answer 9

• Miller 2010- ICDs as gambling,compulsive shopping, sex addiction causes suffering in ppls lives
• The FST of ICDs suggest these disorders caused when INTENSE POS feelings become linked w specific bheaviours
• The effect of the linkage is the need to generate the feeling so person compulsivley replicates the beavhiour realted to positive feeling event even if bad to their well being
• Impulse control disorder protoccol theraphy usuing EMDR to address fixations

Question 10

explain feeling state theory

Answer 10

• The feeling state is when positive feelings are linked w specific events and from a state dependent memory

Question 11

2 diff between ICDP and EMDR

Answer 11

EMDR= reduces negative beliefs caused by traumatic events
ICDP= involves trying to reduce pos beliefs associated w a feeling state

EMDR effectiveness is assede usuing Subjective units of disturbance SUDS
ICDP effectiveness assed by usuing Positive feeling scale PFS

Question 12

describe 2 psychological CB tharpies for treating ICDS

Answer 12

**Covert sensetisation (Glover) **
- where an imagined aversive stimulus is paired w an undersirable behaviour so behaviour is not repeated
- e.g asking a gambling addict to imagine gambling then shwoing pictures of bankrupcy

Imaginal desensitization (Blaszczynski and Nower)
- Teaching PMR w person visualizing themeselves beinge exposed to situation that triggers drive to carry out impulsive behaviour

Question 13

S+ W of usuing case studies to study ICDs

Answer 13

Strengths
- General principles of theraphy can apply to other ppl
- Case study give in depth qualative detail showing how therapy can work in specific cases
- If many case studies produce similiar results its possibel to generalise

Weakness:
- No standerdised method taken
- Theraphist was assesor
- Case study may not be generaisable to other ppl w gambling problems or other ICDs
- No objective behavioural assesements conducted
- A longer term follow up neccessary to determine if ICD problems return

Question 14

Explain characteristics of kleptomania

Answer 14

• Not being able to resist the urge to collect/hoard things
• involves experiecing tension before thft then feelinsg of pleasure/relief when comminting theft
• uncontrollable urge to steal

Question 15

suggest 2 limitations of the answer ppt may give to the question asking “how many hours a week do you think about stealing”

Answer 15

• Question is ambigious as 1-4 hrs appears twice so which to choose
• what catgeorises thinking abt stealing, vague thoughts or planning in detail
• ppt may give socially desirable answers to hide their symptoms to show theraphy is working
• only quant data

Question 16

suggest how reliability of KSAS can be assessed

Answer 16

• Relibaility use retest by giving same test to same person at a later date
• relibaility use split half

Question 17

suggest how validity of KSAS can be assessed

Answer 17

Concurrent validity- compared w alternative measure
- Face validity- looks like it measure kleptomania
* criterion validity: by comparing the KSAS to other measures of kelptomania + if 2 scores have a strong correlation the test is valid
**- construct validity **by seeing if seeing if the KSAS matches up 2 theoretical ideas about what it is supposed to be measuring + if it does the KSAS is valid
* ecological validity: does the scale apply to real life, do the questions reflect real life experiences of people
* temporal validity: test the KSAS over time to see if the person shows any improvement

Question 18

Discuss S+W of using self report questionnares to measure klepto

Answer 18

Strengths
- questionnares usuing quantative data provides therapist w useful info so they an asses extent of the problem
- The KSAS question may show that person may spend over 10hrs per week thinking abt stealing
- Asking ppl directly means that ppl given opportunity to express their feelings + explain their behaviour RATHER than the researcher trying to work out reasons for their behaviour from other methods
- large numbers of ppt can be done easily
- questionnares easy to replicate
- data can be qual or quant depending on questions

Weaknesses
- Socailly desirable response: not truthful respond to demand C
- closed/fixed questions may force ppl into choosing answers that dont reflect their true opnion + lowers validity
- researchers may ask leading questions so affects validity of data collected

Question 19

Describe term placebo

Answer 19

• a substance liek pill/injection of sugar or saline
• given to ppt that has NO therpautic effect BUT ppt responds as if they have recieved active ingredients

Question 20

outline 2 testing procedures used to asses ppt gambling severity in study by Grant

Answer 20

• gambling severity assesed w Yale Brown obsessive compulsive scale modified for pathological gambling PG-YBOCS
• first 5 items of PG- YBOCS consists of the gambling thought/urge subscale
• final 5 consists of conisist of the gambling behaviour upscale
• “Studies enrolled only individuals w DMS-IV PG combormbidity was assessed usuing the structural clinical interview for DSM-IV
• Semi ss interview: rater administered questionnare used to collect info

Question 21

outline 2 reasons why this assements (GRANT) excluded some ppt from study

Answer 21

• infrequent gambling that did not DMS-IV criteria for PG
• unstable medical illness
• pregnancy/lactation currently
• a need for meds other than nalmefene and naltrexone w possibel psychotropic effects/unforavle interctions
• lifetime history w bipolar disorder type 1/2, dementia, schizo
• previous nalmefene/naltrexone treatment
• clinially sig suicudilaity

Question 22

S+ W of using biochemicals to treat gambling

Answer 22

Strengths
- easy to take/swallow a pill
- means gambler is passive in their treatment so good for working ppl
- prevent production of endorphins/nueorchemical releated w pleasure

**Weakness:
- addictive + aim is to REDUCE addictive behaviour
- may not be taken as prescribed
- ignore role of alternative reasons a gambler may be addicted

Question 23

Explain whats meant by EMDR

Answer 23

• treatment involving identifying trauma + negative feelings/beliefs associated w the trauama
• Eye movements then used to process trauama + feelings + install pos beliefs/feelings

Question 24

Outline procedure of EMDR used by Miller

Answer 24

1. Obtain history, frequency and context of compulsive behaviour
2. Identify specific aspect of the compulsive behaviour that has MOST emotional intensity associated with it
3. Identify specific positive feelings linked w compulsive behaviour along w its rating on PFS
4. Locate/identify any physical sensations created by pos feelings
5. Client combines an image of perforiming compulsive bevahiour, pos feelings, physical s
6. eye movement sets perfromed while client focuses on material e.g memory, feeling, image that was identified in prior set
7. Homework
8. Second sesson for reeval sepeating steps 2-8 if needed

Question 25

Suggets 1 similairty and 1 diff between ICD theraphy and Imaginal desen

Answer 25

• Both ICT and ID treatments for ICDs
• Both ICT and ID involve a therapist conducting treatment
• Both ICT and ID require patient to imagine exposure to trauma
• ICT is eye movements vs ID is PMR