psychological problems

Question 1

define sadness, unipolar depression and bipolar depression

Answer 1

sadness - it is a normal human emotion and is a normal reaction to certain experiences, like a death of a pet

unipolar depression - an abnormal emotional state, when an individual experiences one emotional state, which is depression

bipolar depression - repeatedly change between two moods, mania and depression, mania is a state of euphoria/ frenzied activity

Question 2

define the ICD-10

Answer 2

a set of symptoms decided on by WHO used to diagnose an individual with unipolar depression

Question 3

give the three key symptoms and three other symptoms of diagnosing unipolar depression

Answer 3

1) low mood
2) loss of interest and pleasure in activities
3) reduced energy levels
4) changes in sleep patterns
5) changes in appetite levels
6) decrease in self-confidence

Question 4

define neurotransmitter and what an imbalance is caused by

Answer 4

the chemical transmitted between two neurons at a synaptic cleft

low levels of serotonin

Question 5

what is serotonin responsible for (functions)

Answer 5

helps to control mood, memory, sleep, appetite and aggression

Question 6

explain how low levels of serotonin are linked to depression

Answer 6

serotonin transmits a message from one neuron to another, if there is plenty of serotonin in the synaptic cleft the message is transmitted and the postsynaptic neuron is stimulated, which leads to improved mood

some people have low levels of serotonin in their brain, which means levels at the synapse are low and the message is not transmitted, resulting in low mood

Question 7

give the nature and nurture reasons for low serotonin

Answer 7

nature - they can inherit a poor ability to produce serotonin through genetics

nurture - may have low amounts of tryptophan, which is a key ingredient in making serotonin, and is found in high-protein and carb-rich foods

Question 8

evaluate biological explanations of depression

Answer 8

+ there is supporting research evidence, McNeal and Climbolic found lower levels of serotonin in the brains of depressed people, this suggests that there is a link between low levels of serotonin and depression

• low levels of serotonin could be an effect of being depressed instead of causing the depression, as thinking sad thoughts and having difficult experiences could cause low serotonin, so serotonin levels may be an effect of psychological experiences rather than the cause
• depression may not solely be caused by abnormal levels of neurotransmitters, as some people with low serotonin levels dont have depression and some people with depression dont have low serotonin levels, meaning neurotransmitter explanations are not enough on their own

Question 9

what are the negative schemas

Answer 9

negative views about the world -> negative views about oneself -> negative views about the future (starts again)

Question 10

define:
- internal and external attribution styles
- stable and unstable attribution styles

Answer 10

internal - dispositional factors e.g. personality
external - situational factors e.g. weather

stable - fixed/ no change e.g. gender
unstable - temporary e.g. tired

Question 11

define learned helplessness

Answer 11

a learned, negative attribution style where the person gives up trying

Question 12

evaluate psychological explanations for depression

Answer 12

+ there is research support for learned helplessness, Seligman found dogs stopped trying to escape electric shocks that they previously had no control over, claims this explains why some people become depressed, as person will have learned to ‘give up’ when given a challenge, therefore research supports his explanation as dogs’ previous negative attributes caused them to give up

• negative beliefs may simply be realistic than depressing, person with opposite attributional style may have other problems because they are unrealistic in understanding of the situation, Alloy and Abramson found depressed people gave more accurate estimate of likelihood of a disaster than non-depressed people, suggests that depressed people may be sadder yet wiser, therefore negative attributional style may be a more accurate way of looking at the world

Question 13

what does SSRI stand for

Answer 13

selective serotonin reuptake inhibitors

Question 14

outline how serotonin works in the brain under normal circumstances

Answer 14

• serotonin released by certain neurons in brain and stored at the end of a transmitting neuron in tiny sacs called vesicles
• electrical impulse travelling through neuron makes vesicles release neurotransmitter into synaptic cleft
• serotonin molecules convey signal form presynaptic to postsynaptic neuron by attaching to receptor sites
• remaining serotonin reabsorbed into presynaptic neuron

Question 15

how do SSRIs work in brain for depressed people with low serotonin

Answer 15

• people with depression have lower levels of serotonin
• so less serotonin is available to attach to postsynaptic neurons to convey message and improve mood
• SSRI antidepressants prevent serotonin from being reabsorbed into presynaptic neuron
• so more serotonin is available at synapse to bind to receptors on postsynaptic neuron

Question 16

evaluate the use of SSRIs as a treatment for depression

Answer 16

+ antidepressants are supported by a theory, the biological explanation of depression suggests that low serotonin could be the cause or effect of depression, SSRIs increase the amount of serotonin in the body and aims to rectify what the biological theory suggests, increases the validity of the use of antidepressants

• antidepressants have side effects, like nausea, insomnia, weight gain and a possible increase in suicidal thoughts, the side effects are a serious threat to the effectiveness of SSRIs as it may cause people to stop taking the drug as they feel numb

Question 17

what does CBT stand for

Answer 17

cognitive behaviour therapy

Question 18

explain thought, behaviour and emotion in Beck’s negative triad

Answer 18

thought - what we think affects how we feel and act

behaviour - what we do affects how we think and feel

emotion - what we feel affects how we think and act

Question 19

outline and explain the four steps of CBT

Answer 19

1) cognitive - CBT focuses on what the patient thinks and the therapist aims to change a client’s irrational thinking to rational
2) behaviour - CBT targets behaviour and encourages them to plan a pleasant activity a day to create more positive emotions and improve mood
3) therapist deals with irrational thoughts - therapist challenges clients’ thoughts to result in more rational thinking and build self liking/belief
4) client deals with irrational thoughts - clients record their negative thoughts and receive homework like writing in a diary, which leads to more rational thoughts

Question 20

evaluate CBT as a treatment for depression

Answer 20

+ there is lots of supporting evidence for CBT, March (2007) investigated the effectiveness of CBT in treating people who hadn’t improved after taking antidepressants, ppts who were randomly allocated to have both CBT and medication showed bigger life quality improvements than people on medication alone, it shows CBT is an effective way of treating depression along with medication

+ CBT is holistic, so it looks at the person’s complex mix of thoughts and feelings and deals with core symptoms of depression instead of individual parts e.g. feeling low, means it’s ultimately more effective than the reductionist biological approach

• not suitable for all patients as some cannot motivate themselves to engage in the hard cognitive work of CBT as it takes a lot of willpower and commitment, so may be more effective to use antidepressants, meaning a limitation of CBT is that it can’t always be used as the only treatment for all cases of depression

Question 21

define mental health and a mental health problem

Answer 21

mental health - someone’s emotional and psychological wellbeing which helps them cope with everyday life and function in society

mental health problem - a diagnosable condition where a person’s thoughts, feelings and behaviours change and they are less able to cope and function in a society

Question 22

name the four characteristics of good mental health

Answer 22

1) having good relationships with others
2) being able to deal with disappointments and problems
3) being able to cope with the stresses and demands of everyday life
4) positive engagement in society

Question 23

name the four reasons for changes in numbers of mental health problems

Answer 23

• increased challenge of modern living
• cultural variations
• increased recognition of mental health problems
• reducing social stigma

Question 25

explain and give an example of the effect on mental health due to:

• increased recognition of mental health problems
• reducing social stigma

Answer 25

increased recognition- signs and symptoms relating to mental illness focus on illness instead of health, signs of physical health are based on what we know physical health looks like, so now we can focus on characteristics and symptoms of mental illness to determine if someone has an illness, Jahoda suggested it may be more useful to list characteristics of positive mental health instead of illness and look for absence of the signs

reducing social stigma - social stigma can cause discrimination and may cause others to have an expectation of how someone with that disorder should act, and labels placed on people also may cause them to start acting that way or show symptoms they weren’t displaying before, as well as convince them the disorder is permanent

Question 26

describe the individual effects of mental health problems

Answer 26

damage to relationships - 50% of family members of someone with a mental illness can also develop some form of mental illness, they may also become caregivers, which could increase stress and conflict and affect household income levels, children may not know why their parents cannot care for them and blame themselves, people may become isolated and withdraw into themselves, usually making their situation worse

difficulties coping with daily life - trouble sleeping, low energy levels or trouble concentrating makes work and education more difficult, in the UK people with a mental illness are 4 times more likely to be unemployed, which causes low income and increases stresses and anxiety and makes illness worse

negative impacts on physical wellbeing - it could lead to the downfall of peoples physical wellbeing as they could gain or lose weight, there could be negative effects on their energy and mood levels which reduce the amount of exercise they do, people may abuse drugs or alcohol, stress may suppress their immune system and mean they can fall ill more frequently

Question 27

describe the societal effects of mental health problems

Answer 27

need for more social care - the NHS spends 15% of economic cost of all health issues on mental health, if there was better social care, people with mental health problems can receive medication that would help them go back to work and contribute back to the economy and society

increased crime rate - there is a 4 times increased risk between mental health problems and risk of violence, and many sufferers turn to substance abuse or become isolated, only 1 in 20 violent crimes were linked to mental health problems

economic implications - the NHS places focus on drugs and medicine treatments instead of psychological therapies e.g. counselling as it is more affordable, dementia is a major issue for future generations as people are required to live longer, so there will be a burden on the government as it will cost them an increasing amount of money

Question 28

outline wiles effectiveness of CBT study

Answer 28

aim: to investigate the effectiveness of CBT in treating depressed people who have not improved after taking medication

study type: a longitudinal field experiment, carried out in the real life environment of the ppts, the researcher still manipulates he IV but has limited control over extraneous variables, the ppts were living in the UK ages between 18-25 and had been taking antidepressants for at least 6 weeks with little to no improvement

method: ppts were randomly allocated into two groups, 234 ppts had both antidepressants and CBT as well as normal care for depression, control group of 235 ppts continued antidepressants and normal care, CBT group had 12 individual one hour sessions of CBT with a trained therapist
results: 90% of ppts could be followed up after. months, 46% of CBT ppts showed notable improvement in symptoms compared to 22% of control group, CBT ppts seemed to have greater improvement in quality of life after 12 months
conclusion: when used alongside antidepressants and other normal care, CBT effectively reduces the symptoms of depression in people who don’t respond to antidepressants on their own

Question 29

evaluate wiles’ effectiveness of CBT study

Answer 29

+ CBT is focused on creating a useful therapy and demonstrates that a more holistic approach to treating depression is more successful than medication alone, CBT was also relatively cheap per year and the equivalent to some antidepressants

• although almost half of the CBT group showed notable improvement in symptoms, 54% did not, so CBT does not work for everyone

Question 30

explain and give an example of the effect on mental health due to:

• the increased challenge of modern living
• cultural variations

Answer 30

increased challenge of modern living - people in lower income households are more likely to have a mental health problem, social media warps the views and thought processes of younger generations and social isolation affects older people as they cannot socialise as easily anymore

cultural variations - people around the world have different ideas about mental illnesses, ‘hearing voices’ would be abnormal in the western world, but may be a positive experience in Africa/India, while anorexia is rarely found outside of the western world and is culture bound