Psychopathology

Question 1

psychopathology

Answer 1

psychopathology is the study of mental health and diagnosis it deals with emotional and behavioural problems
involves research into the diagnosis and classification, causation, prevention, and treatment of psychological disorders

Question 2

abnormal

Answer 2

means deviating from the average, so any rare behaviour or ability would be abnormal

Question 3

statistical infrequency

Answer 3

statistically rare behaviour seen as abnormal depends on normal distribution curve
occurs when an individual has a less common characteristic

Question 4

statistical infrequency example

Answer 4

IQ and intellectual disability disorder
when we deal with characteristics that can be easily and reliably measured like intelligence, we know that in human characteristics that majority of peoples scores will be around the average and further below or above the fewer people
this is called normal distribution
average IQ is set at 100, 68% of people range from 85 to 115, 2% are below 70 those individuals below this are called abnormal and receive a diagnosis of intellectual disability disorder

Question 5

statistical infrequency - a03 - real life application

Answer 5

real life application in diagnosis of intellectual disability disorder, statistical infrequency has a place in thinking about what are normal and abnormal behaviours and characteristics
all assessments of patients with mental disorders include measurements of how severe their symptoms are compared to statistical norms, statistical infrequency is a useful part of clinical assessments

Question 6

statistical infrequency - a03 - unusual characteristics can be positive

Answer 6

IQ over 130 is as unusual as IQ under 70, but intelligence is not thought of as undesired characteristic
just because a characteristics is rare it is classed as statistically abnormal but doesnt mean it requires treatment to turn back to normal
limitation because statistical infrequency cannot alone diagnose

Question 7

statistical infrequency - a03 - not everyone unusual benefits from a label

Answer 7

someone living a happy fulfilled life might be labelled as abnormal no matter how unusual they are, them being labelled might have a negative effect on the way others view them and they way they view themselves

Question 8

deviation from social norms

Answer 8

concerns behaviour that is different from the accepted standards of behaviour in a community or society, making a collective judgement as a society about what is right
norms are specific to the culture we live in, social norms may be different from each generation and each culture, so few behaviours are considered universally abnormal on the basis that they breach social norms

Question 9

deviation from social norms example

Answer 9

antisocial personality disorder, a person with antisocial personality disorder is impulsive aggressive and irresponsible, one important symptom of antisocial personality disorder is an absence of prosocial internal standards associated with failure to conform to lawful or culturally normative ethical behaviour

Question 10

deviation from social norms - a03 - not a sole explanation

Answer 10

it has real life application in the diagnosis of antisocial personality disorder, there is a place for it in thinking what is normal and abnormal
however there are other factors to consider for example the distress to others resulting from antisocial personality disorder, so in practice deviation from social norms is never the sole reason for defining abnormality

Question 11

deviation from social norms - ao3 - cultural relativism

Answer 11

social norms very tremendously from one generation to the next and from one community to another
e.g. one person from on cultural group may label someone from another cultural group as behaving abnormally according to their standards an example of this is that hearing voices is okay in some cultures but not others like in the UK, this creates problems for people from one culture living within another cultural group

Question 12

deviation from social norms - a03 - can lead to human rights abuse

Answer 12

overreliance on deviation from social norms to understand abnormality can lead to systematic abuse of human rights in the past diagnoses were in place to maintain control over minority ethnic groups and women
the classifications now appear ridiculous - but only because our social norms have changed more radical psychologists suggest that our categories of mental disorder are really abuses of peoples right to be different

Question 13

failure to function adequately

Answer 13

occurs when someone is unable to cope with ordinary demands of day to day living
we can tell if someone if failing to function adequately by the signs proposed by Rosenhan and Seligman which are used to determine when someone is not coping
- when a person no longer conforms to standard interpersonal rules for example respecting personal space
- when a person experiences severe personal distress
- when a persons behaviour becomes irrational or dangerous to themselves or others

Question 14

failure to function adequately example

Answer 14

intellectual disability disorder - one criteria for this is having low IQ however a diagnosis would not be made on this basis only and individual must also be failing to function adequately before a diagnosis is given

Question 15

failure to function adequately - a03 - patients perspective

Answer 15

attempts to include the subjective experience of the individual, not entirely satisfactory approach because difficult to assess distress, but at least acknowledges that the experience of the patient is important
therefore this is a strength because it captures the experience of many people who need help, suggests that failure to function adequately is a useful criteria for assessing abnormality

Question 16

failure to function adequately - a03 - it is simply a deviation from social norms

Answer 16

in practice it is hard to say when someone is failing to function and when they are just deviating from social norms
not having a job or a permanent address could be seen as a sign of failure to function adequately, people with alternative lifestyles who choose not to have these things are labelled as abnormal for example having spiritual and religious beliefs could be seen as abnormal
if we treat these behaviours as failure to function adequately we limit personal freedom and discriminate against minority groups

Question 17

failure to function adequately - a03 - subjective judgements

Answer 17

when judging if someone is failing to act adequately, distress has to be judged, these judgements can be made as objective as possible by using checklists however the principle remains that someone has the right to make this judgement

Question 18

deviation from ideal mental health

Answer 18

occurs when someone does not meet a set of criteria for good mental health
Jahoda’s criteria
we have no symptoms or distress
we are rational and can perceive ourselves accurately
we self actualise
we can cope with stress
we have a realistic view of the world
we have good self esteem and lack guilt
we are independent of other people
we can successfully work, love and enjoy our leisure

Question 19

deviation from ideal mental health - a03 - comprehensive definition

Answer 19

covers a broad range of criteria for mental health, covers most of the reason someone would seek help from mental health services or be referred for help, the sheer range of factors discussed in relation to jahoda’s ideal mental health make it a good tool for thinking about mental health

Question 20

deviation from ideal mental health - a03 - cultural relativism

Answer 20

Jahoda’s classification is specific to western european and north american cultures, emphasis on self actualisation could be seen as self indulgence in much of the world because the emphasis is so much more on the individual than the family and community
similarly much of the world would see independence from other people as a bad thing (individualist cultures)

Question 21

deviation from ideal mental health - a03 - sets an unrealistically high standard for mental health

Answer 21

very few attain Jahoda’s criteria for mental health therefore this approach sees pretty much all of us as abnormal, we can see this as a positive and negative
positive because it is clear to people the ways in which they could benefit from recieving treatment to improve mental health
negative because deviation from ideal mental health is probably of no value in thinking about who might benefit from treatment against their will

Question 22

DSM-5 categories of phobias

Answer 22

all phobias are characterised by excessive fear and anxiety, triggered by an object place or situation, the extent of the fear is out of proportion to any real danger presented by the phobic stimulus
specific phobia: phobia of an object, such as an animal or body part, or a situation such as flying and having an injection
social anxiety: phobia of a social situation such as public speaking or using a public toilet
agoraphobia: phobia of being outside or in a public place

Question 23

what are behavioural characteristics of phobias

Answer 23

panic, avoidance, endurance

Question 24

behavioural characteristic of phobias: panic

Answer 24

a phobic person may panic in response to the presence of the phobic stimulus, panic may involve a range of behaviours including crying, screaming or running away
children may react slightly differently, for example by freezing clinging or having a tantrum

Question 25

behavioural characteristics of phobias: avoidance

Answer 25

unless the sufferer is making a conscious effort to face their fear they tend to go to a lot of effort to avoid coming into contact with the phobic stimulus

Question 26

behavioural characteristics of phobias: endurance

Answer 26

the alternative to avoidance is endurance, in which a sufferer remains in the presence of the phobic stimulus but continues to experience high levels of anxiety, this may be unavoidable in some situation, for example for a person who has an extreme fear of flying

Question 27

emotional characteristics of phobias: anxiety

Answer 27

phobias are classed as anxiety disorders, they involve an emotional response of anxiety and fear, anxiety is an unpleasant state of high arousal this prevents the sufferer relaxing and makes it very difficult to experience any positive emotion
anxiety can be long term, fear is the immediate and unpleasant response we experience when we encounter or think about the phobic stimulus
e.g. arachnophobia, seeing or entering places associated with spiders increase anxiety and fear levels

Question 28

emotional characteristics of phobias: emotional response are unreasonable

Answer 28

the emotional response we experience in relation
to phobic stimuli go beyond what is reasonable, for example a fear of spiders which are tiny and harmless is therefore our fear is disproportionate to the danger posed by any spider we are likely to meet

Question 29

cognitive characteristics of phobias: selective attention to the phobic stimulus

Answer 29

if a sufferer can see the phobic stimulus it is hard to look away from it. keeping our attention on something really dangerous is a good thing as it gives us the best chance of reacting quickly to a threat, but it is not so useful when the fear is irrational

Question 30

cognitive characteristics of phobias: irrational beliefs

Answer 30

a phobic may hold irrational beliefs in relation to phobic stimuli, for example social phobias can involve beliefs like ‘i must always sounds intelligent’
this kind of belief increases the pressure on the sufferer to perform well in social situations

Question 31

cognitive characteristics of phobias: cognitive distortions

Answer 31

the phobic’s perceptions of the phobic stimulus may be distorted, so for example an omphalophobic is likely to see belly buttons as ugly and disgusting

Question 32

what is the two-process model

Answer 32

Mowrer in 1960 proposed the two-process model based on the behavioural approach to phobias, this states that phobias are acquired by classical conditioning and then continue because of operant conditioning

Question 33

what part of phobias can the behavioural approach explain

Answer 33

avoidance, endurance, panic

Question 34

acquisition by classical conditioning

Answer 34

learning to associate something of which we initially have no fear with something that triggers a fear response
Little Albert was a nine month old baby that Rayner and Watson conditioned to have a phobia, Little Albert showed no unusual anxiety at the start of the study
unconditioned stimulus (noise) > unconditioned response (fear)
neutral stimulus (rat) + conditioned stimulus (noise) > unconditioned response (fear)
conditioned stimulus (rat) > conditioned response (fear)
Little Albert also expressed dislike to any fur white animal, this means the conditioning was generalised

Question 35

maintenance by operant conditioning

Answer 35

responses acquired by classical conditioning are temporary while phobias are permanent, Mowrer explained this as the result of operant conditioning, both negative and positive reinforcement
in the case of negative reinforcement, when we avoid the phobic stimulus we escape fear and anxiety that we would have suffered if we had remained there
reduction in fear reinforces avoidance behaviour and so phobia is maintained

Question 36

the behavioural approach to explaining phobias - a03 - good explanatory power

Answer 36

a step forward from the normal concept of classical conditioning, it explained how phobias could be maintained over time and this therefore had important implications for therapies because it explains why patients need to be exposed to feared stimulus
once a patient is prevented from practising their avoidance behaviour the behaviour ceases to be reinforced and so it declines
the application to therapy is a strength of the two-process model

Question 37

the behavioural approach to explaining phobias - a03 - alternative explanation for avoidance behaviour

Answer 37

not all avoidance behaviour associated with phobias seems to be the result of anxiety reduction, at least in more complex phobias like agoraphobia
there is evidence to suggest that at least some avoidance behaviour appears to be motivated more by positive feelings of safety
in other words the motivating factor in choosing an action is not so much to avoid the phobic stimulus but to stick with the safety factor, this is a problem for the two-process model which suggests that avoidance is motivated by anxiety reduction

Question 38

the behavioural approach to explaining phobias - a03 - an incomplete explanation of phobias

Answer 38

even if we accept that classical and operant conditioning have a part to play in development and maintenance of phobias however there are parts of phobic behaviour that need more explaining for example Bounton mentioned that evolutionary factors probably have an important role in phobias but the two-factor theory does not mention this we easily acquire phobias that have been a danger in our evolutionary past
seligman called this evolutionary preparedness - the innate predisposition to acquire certain fears however it is rare to develop a fear of cars and guns presumably this is because they have only existed very recently and so we are not biologically prepared to have fear response towards them
this phenomenon of preparedness is a serious problem for the two factor theory because its shows there is more to acquiring phobias rather than just conditioning

Question 39

what is systematic desensitisation

Answer 39

is a behavioural therapy designed to gradually reduce phobic anxiety through the principle of classical conditioning, if the sufferer can learn to relax in the presence of the phobic stimulus they will be cured, essentially a new response to the phobic stimulus is learnt this is called counterconditioning

Question 40

what is reciprocal inhibition

Answer 40

this is when one emotion prevents another emotion, you cant be afraid and relaxed at the same time

Question 41

what are the 3 processes involved in systematic desensitisation

Answer 41

the anxiety hierarchy, relaxation, exposure

Question 42

systematic desensitisation: the anxiety hierarchy

Answer 42

this is put together by the patient and the therapist, this is a list of situations related to the phobic stimulus that provides anxiety arranged in order from least to most frightening e.g. an arachnophobe seeing a picture of a small spider as low anxiety and holding a tarantula as high anxiety

Question 43

systematic desensitisation: relaxation

Answer 43

the therapist teaches the patient to relax as deeply as possible, this might involve breathing exercises or mental imagery techniques, patients can be taught to imagine themselves in relaxing situation or they might learn meditation an alternative option is relaxation drugs

Question 44

systematic desensitisation: exposure

Answer 44

finally the patient is exposed to the phobic stimulus while in a relaxed state
this takes several sessions starting at the bottom of the anxiety hierarchy, when the patient can stay relaxed in the presence of the lower levels of the phobic stimulus they move up the hierarchy, treatment is successful when the patient can stay relaxed in situations high on the anxiety hierarchy

Question 45

what is flooding

Answer 45

flooding also involves exposing phobic patients to their phobic stimulus but without a gradual build up, flooding involves immediate exposure to a very frightening situation, flooding sessions are typically longer that systematic desensitisation sessions, one session often lasting two to three hours
sometimes only one session is needed to find a cure

Question 46

how does flooding work

Answer 46

flooding stops phobic responses very quickly, without the option of avoidance behaviour the patient quickly learns that the phobic stimulus is harmless
in classical conditioning this is called extinction, a learned response is extinguished when the conditioned stimulus is encountered without the unconditioned stimulus this results in the conditioned stimulus no longer producing the conditioned response

Question 47

ethical safeguards of flooding

Answer 47

flooding is not unethical per say but it is unpleasant experience so it is important that patients give fully informed consent to this traumatic procedure and that they are fully prepared before the flooding session, a patient would normally be given the choice of flooding or systematic desensitisation

Question 48

the behavioural approach to treating phobias - systematic desensitisation - a03 - it is effective

Answer 48

research shows that systematic desensitisation is effective in the treatment of specific phobias, for example Gilroy et al followed 42 patients who had been treated for spider phobia in three 45 minute sessions of systematic desensitisation
spider phobia was assessed on several measures including the spider questionnaire and by assessing response to a spider
a control group was treated by relaxation without exposure, at both three months and 33 months after the treatment the systematic desensitisation group were less fearful than the relaxation group
this is a strength because it shows that systematic desensitisation is helpful in reducing the anxiety in spider phobia and that the effects are long lasting

Question 49

the behavioural approach to treating phobias - systematic desensitisation - a03 - suitable for diverse range of patients

Answer 49

other alternatives are flooding and cognitive therapies these are not well suited to some patients, for example some sufferers of anxiety disorders like phobias also have learning difficulties, learning difficulties can make it very hard for some patients to understand what is happening during flooding or to engage with cognitive therapies that require the ability to reflect on what you are thinking for these patients systematic desensitisation is probably the most appropriate treatment

Question 50

the behavioural approach to treating phobias - systematic desensitisation - a03 - acceptable to patients

Answer 50

a strength of systematic desensitisation is that the patients prefer it, those given the choice of systematic desensitisation or flooding tend to prefer the former this is largely because it does not cause the same degree of trauma as flooding it also may be because it includes some elements like learning relaxation procedures which are pleasant
this is reflected in the low refusal rates and low attrition rates of systematic desensitisation

Question 51

the behavioural approach to treating phobias - flooding - a03 - it is cost-effective

Answer 51

flooding is at least as effective as other treatments for specific phobias, studies comparing flooding to cognitive therapies have found that flooding is highly effective and quicker than alternatives
this quick effect is a strength because it means that patients are free of their symptoms as soon as possible and that makes treatment cheaper

Question 52

the behavioural approach to treating phobias - flooding - a03 - less effective for some types of phobia

Answer 52

although flooding is highly effective for treating simple phobias it appears to be less so for more complex phobias like social phobias this may be because they have cognitive aspects for example a sufferer of a social phobia does not simply experience an anxiety response but thinks unpleasant thoughts about the social situation
this type of phobia may benefit more from cognitive therapies because such therapies tackle irrational thinking

Question 53

the behavioural approach to treating phobias - flooding - a03 - treatment is traumatic for patients

Answer 53

perhaps the most serious issue with the use of flooding is the fact that it is a highly traumatic experience, the problem is not that flooding is unethical but that patients are often unwilling to see it through to the end
this is a limitation of flooding because time and money are sometimes wasted preparing patients only to have them refuse to start or complete treatment

Question 54

behavioural characteristics of depression

Answer 54

self medication alcohol and substances
disruption to sleep (insomnia and hypersomnia) and eating behaviour
exercise and activity levels drop they lose interest in activities they normally found enjoyable, they withdraw from the social element
aggression and self harm

Question 55

emotional characteristics of depression

Answer 55

prolonged feelings of sadness
low self esteem, sufferers like themselves less than usual
anger this can be directed at themselves or others this emotion can lead to aggressive or self harming behaviour

Question 56

cognitive characteristics of depression

Answer 56

poor memory, lack of concentration, unable to do things they would normally be able to do
said and thought negative things, they dwell on the more negative aspects of a situation
absolutist thinking (black and white thinking) no grey areas

Question 57

Becks cognitive theory of depression

Answer 57

american psychiatrist Beck suggested a cognitive approach to explaining why some people are vulnerable to depression , Beck suggested three parts to this cognitive vulnerability
faulty information processing
negative self schemas
the negative triad

Question 58

faulty information processing

Answer 58

when depressed we attend to the negative aspects of a situation and ignore the positive
we also tend to blow small problems out of proportion and think in black and white terms

Question 59

negative self schemas

Answer 59

a schema is a package of ideas and information developed through experience they acts as a mental framework for the interpretation of sensory information
we use schemas to interpret the world, so if we have negative schemas we interpret all information about ourselves in a negative way

Question 60

the negative triad

Answer 60

three types of negative thinking that happen automatically
negative view of the world
negative view of the future
negative view of the self

Question 61

Ellis’s ABC model

Answer 61

in 1962 Ellis suggested a different cognitive explanation of depression, he explained that depression is a result of irrational thoughts, not as illogical or unrealistic thoughts, but as any thoughts that interfere with us being happy and free of pain, Ellis used the ABC model to explain how irrational thoughts affect our behaviours and emotional state

Question 62

A - activating event

Answer 62

whereas Becks emphasis emphasis was on automatic thoughts, Ellis focused on situations in which irrational thoughts are triggered by external events, we get depressed when we experience negative events and these trigger irrational beliefs

Question 63

B - beliefs

Answer 63

Ellis identified a range of irrational beliefs, he called the belief that we must always succeed ‘musturbation’

Question 64

C - consequences

Answer 64

when an activating event triggers irrational beliefs there are emotional and behavioural consequences

Question 65

Beck - a03 - good supporting evidence

Answer 65

a range of evidence supports that depression is associated with becks theories
Grazioli and Terry assessed 65 pregnant women for cognitive vulnerability and depression before and after birth, they found that those women judged to have been high in cognitive vulnerability were more likely to suffer post natal depression

Question 66

Beck - ao3 - practical application in CBT

Answer 66

becks theory forms the basis of CBT, all cognitive aspects of depression can be identified and challenged in CBT. this means a therapist can challenge them and encourage the patient to test whether they are true, this is a strength of the explanation because it translates well into a successful therapy

Question 67

Beck - ao3 - doesnt explain all aspects of depression

Answer 67

Becks theory neatly explains the basic symptoms of depression, however depression is complex
some depressed patients are deeply angry and becks explanation cannot explain this emotion
some sufferers of depression suffer hallucinations and bizarre beliefs
becks theory cannot explain these cases

Question 68

Ellis - a03 - partial explanation

Answer 68

in some cases depression follows activating events this is called reactive depression and see it as different from depression that arises without a cause
this means that Ellis’s explanation only applies to some kinds of depression and therefore is only a partial explanation for depression

Question 69

Ellis - a03 - has practical application in CBT

Answer 69

it has led to successful therapy, by challenging irrational negative beliefs, a person can reduce their depression this is also supported by research evidence
this in turn supports the basic theory because it suggests that irrational beliefs had some role in depression

Question 70

Ellis - ao3 - it doesnt explain all aspects of depression

Answer 70

although Ellis explains why some people appear to be more vulnerable to depression than others as result of their cognitions, his approach has vey much the same limitation as Beck’s
it doesnt easily explain the anger associated with depression or the fact that some patients suffer hallucinations and delusions

Question 71

CBT - cognitive behaviour therapy

Answer 71

most commonly used psychological treatment for depression and a range of other mental health problems
CBT begins with an assessment in which the patient and the cognitive behaviour therapist work together to clarify the patients problems
they jointly identify goals and a plan
one of the central tasks is to identify where there might be negative or irrational thoughts that will benefit from challenge
they challenge the thoughts and put more effective behaviours in place
most therapists draw on both Ellis’s and Beck’s theories

Question 72

CBT: Beck’s cognitive therapy

Answer 72

cognitive therapy is the application of Beck’s cognitive theory of depression
once the negative triad has been identified these thoughts must be challenged this is the central component of the therapy
as well as challenging these thoughts directly, cognitive therapy aims to help the patients these the reality of their negative beliefs they might be asked to record anytime they enjoy an event or when people are nice to them
this is sometimes referred to as the ‘patient as scientist’ investigating the reality of their negative beliefs

Question 72

CBT: Ellis’s rational emotive behaviour therapy (REBT)

Answer 72

REBT extends the ABC model to an ABCDE model - D stands for dispute and E for effect
the central technique of REBT is to identify and dispute irrational thoughts
for example a patient might talk and the therapist would identify the irrational thoughts and challenge them, this would involve a vigorous argument, the intended effect is to change the irrational belief and so break the link between negative life events and depression
the vigorous argument is the hallmark of REBT, Ellis identified different methods of disputing e.g. empirical argument involves disputing whether there is actual evidence to support the negative belief

Question 73

Behavioural activation

Answer 73

alongside the purely cognitive aspects of CBT the therapist may also work to encourage a depressed patient to be more active and engage in enjoyable activities, this behavioural activation will provide more evidence for the irrational nature of beliefs

Question 74

CBT - a03 - is it effective

Answer 74

there is a large body of evidence to support the effectiveness of CBT for depression
March et al compared the effects of CBT with antidepressant drugs and a combination of the two in 327 adolescents with a main diagnosis of depression, after 36 weeks 81% of the antidepressants group and 81% of the CBT group and 86% of the CBT and antidepressants group were significantly improved
thus CBT emerged as just as effective as medication and helpful alongside medication
this suggests there is a good case for making CBT the first choice of treatment in public health care systems

Question 75

CBT - ao3 - CBT may not work for the most severe cases

Answer 75

in some cases depression may be so severe the patients cannot motivate themselves to engage with the hard cognitive work of CBT
they may not even be able to pay attention to what is happening in a session
where this is the case it is possible to treat patients with antidepressants and commence CBT when they are more motivated
this is a limitation of CBT because it means CBT cannot be used as the sole treatment for all cases of depression

Question 76

CBT - ao3 - success may be due to the therapist - patient relationship

Answer 76

Rosenzweig suggested that the difference between different methods of psychotherapy, such as between CBT and systematic desensitisation, might actually be quite small
all psychotherapies share one essential ingredient - the therapist-patient relationship, it may be the quality of this relationship that determines the success rather than any particular technique that is used
having an opportunity to talk to someone who listens could be what matters the most

Question 77

behavioural characteristics of OCD

Answer 77

compulsions
-compulsion are repetitive, sufferers feel compelled to repeat a behaviour e.g. hand washing
-compulsions reduce anxiety, patient have no obsessions just a general sense of irrational anxiety, vast majority of compulsive behaviours are performed in an attempt to manage the anxiety produced by obsessions
avoidance, reduce anxiety by keeping away from situations that might trigger it, this avoidance can lead to people acoiding very ordinary situations and this can interfere with leading a normal life

Question 78

emotional characteristics of OCD

Answer 78

anxiety and distress accompany both obsessions and compulsions, obsessive thoughts are unpleasant and frightening and the anxiety that goes with these can be overwhelming
accompanying depression
guilt and disgust, irrational may be directed to something external or the self

Question 79

cognitive characteristics of OCD

Answer 79

obsessive thoughts these are thoughts that occur over and over these are unpleasant
cognitive strategies to deal with obsessions some strategies can make the person appear abnormal to others and distract them from everyday tasks
insight into excessive anxiety, they are aware that their obsessions and compulsions are not rational they also tend to be hypervigilant

Question 80

Genetic explanation of OCD

Answer 80

some mental disorders have a stronger biological base than others, OCD is a good example of this
genes are involved in individual vulnerability to OCD
Lewis observed that of his OCD patients 37% had parents with OCD and 21% had siblings with OCD
this suggests that OCD runs in families, although what is probably passed on is genetic vulnerability not the certainty of OCD

Question 81

candidate genes

Answer 81

researchers have identified genes, which create vulnerability for OCD, called candidate genes
some of these genes are involved in regulating the development of the serotonin system
for example the gene 5HT1-D beta is implicated in the efficiency of the transport of serotonin across synapses

Question 82

OCD is polygenic

Answer 82

this means that OCD is not caused by one single gene but that several genes are involved
Taylor analysed previous studies and found that up to 230 different genes may be involved with OCD
genes that have been studied in relation with OCD include those associated with the action of dopamine as well as serotonin, both neurotransmitters believed to have a role in regulating mood

Question 83

different types of OCD

Answer 83

one group of genes may cause OCD in one person but a different group of genes may cause the disorder in another person the term used to describe this is aetiologically heterogenous

Question 84

neural explanations

Answer 84

the genes associated with OCD are likely to affect the levels of key neurotransmitters as well as structure of the brain, these are neural explanations

Question 85

neurotransmitters

Answer 85

these are chemical messengers they carry boost and regulate signals between neurons and others cells in the body, they are linked to mood
serotonin is a neurotransmitters linked to OCD, it sends mood relevant information, if this doesnt not take place then mood and mental processes can be affected

Question 86

role of serotonin

Answer 86

if a person has low levels of serotonin then normal transmission of mood relevant information
at least some cases of OCD may be explained by a reduction in the functioning of the serotonin system in the brain

Question 87

decision making systems

Answer 87

some cases of OCD seem to be associated with impaired decision making this in turn may be associated with abnormal functioning of the lateral of the frontal lobes of the brain they are responsible for logical thinking and making decisions
there is also evidence to suggest that an area called the parahippocampal gyrus associated with processing unpleasant emotions functions abnormally in OCD

Question 88

structural explanation of OCD

Answer 88

some biopsychologists believe that OCD is caused by abnormality in the brain
three parts of the barin have been linked to OCD
orbito-frontal cortex - part of the brain which notices when something is wrong
thalamus - directs signals from many parts of the brain to places that can interpret them
caudate nucleus - regulates signals sent between OFC and thalamus

Question 89

genetic explanations - ao3 - good supporting evidence

Answer 89

evidence from variety of sources that some people are vulnerable to OCD due to their genetic make up
twin studies is one of the best sources of evidence
Nestadt reviewed previous twin studies and found that 68% of identical twins shared OCD as opposed to 31% of non identical twins, this strongly suggests a genetic influence on OCD

Question 90

genetic explanation - a03 - too many candidate genes

Answer 90

although twin studies strongly suggest that OCD is largely under genetic control, psychologists have been much less successful at pinning down all the genes involved, one reason for this is because it seems that several genes are involved
the consequence is that a genetic explanation is unlikely to ever be very useful because it provides little predictive value

Question 91

genetic explanation - ao3 - environmental risk factors

Answer 91

these can also trigger or increase the risk of developing OCD
Cromer et al found that over half the OCD patients in their sample had a traumatic event in their past, and that OCD was more severe in those with more than one trauma
this suggests that OCD cannot be entirely genetic in origin at least not in all cases

Question 92

neural explanations - ao3 - there is some supporting evidence

Answer 92

some antidepressants work purely on the serotonin system, increasing levels of this neurotransmitter
such drugs are effective in reducing OCD symptoms and this suggests that the serotonin system is involved in OCD
also OCD symptoms form part of a number of other conditions that are biological in origin like parkinsons, this suggests that the biological processes that cause the symptoms in those conditions may also be responsible for OCD

Question 93

neural explanations - ao3 - it is not clear exactly what neural mechanisms are involved

Answer 93

studies of decision making have shown that these neural systems are the same systems that function abnormally in OCD
however research has also identified other brain systems that may be involved sometimes but no system has been found that always plays a role in OCD
we cannot therefore really claim to understand the neural mechanisms involved in OCD

Question 94

neural explanations - ao3 - we should not assume the neural mechanisms cause OCD/ direction of causality

Answer 94

there is evidence to suggest that various neurotransmitters and structures of the brain do not function normally in patients with OCD
however this is not the same as saying that this abnormal functioning causes the OCD
these biological abnormalities could be a result of OCD rather than its cause

Question 95

drug therapy

Answer 95

drug therapy for mental disorders aims to increase or decrease levels of neurotransmitters in the brain or to increase/decrease their activity

Question 96

SSRI’s

Answer 96

standard medical treatment used to tackle symptoms of OCD involves a particular type of antidepressant called a selective serotonin reuptake inhibitor
SSRI’s work on the serotonin system in the brain, serotonin is released by certain neurons in the brain, it is released by the presynaptic neurons travels across the synapse, the neurotransmitter chemically conveys the signal from the presynaptic neuron to the postsynaptic neuron and then it is reabsorbed by the presynaptic neurone where it is broken down and reused
by preventing the reabsorption and breakdown of serotonin the SSRI’s effectively increases its levels in the synapse and thus continues to stimulate the post synaptic neuron, compensating for whatever is wrong in the serotonin system
20mg is the normal does however can be increased or decreased

Question 96

combining SSRIs

Answer 96

drugs are often used alongside CBT to treat OCD, the drugs reduce a patients emotional symptoms, such as feeling anxious or depressed, meaning that patients can engage more effectively with CBT
in practice some people respond better to CBT alone whilst other benefit more from drugs like Fluoxetine

Question 97

alternatives to SSRI’s

Answer 97

where an SSRI is not effective after three to four months the dose can be increased or it can be combined with other drugs
tricyclics are sometimes used, such as Clomipramine these have the same effect on the serotonin system as SSRI’s
Clomipramine has more side effects
SNRI’s these are like clomipramine they are a second line of defence for patients who do not response to SNRI’s

Question 98

drug therapy - ao3 - drug therapy is effective at tackling OCD symptoms

Answer 98

clear evidence of SSRI’S effectiveness and their ability to improve quality of life for OCD patients
Soomro et al reviewed studies comparing SSRI’s to placebos in the treatment of OCD and concluded that all 17 studies reviewed showed significantly better results for the SSRI’s than for placebo conditions , effectiveness is greatest when SSRI’s are combined with a psychological treatment usually CBT
typically symptoms decline significantly for around 70% of patients taking SSRI’s
so drugs can help most patients with OCD

Question 99

drug therapy - ao3 - drugs are cost effective and no disruptive

Answer 99

an advantage of drug treatments in general is that they are cheap compared to psychological treatments, using drugs to treat OCD is therefore good value for a public health system like the NHS
compared to psychological therapies SSRI’s are not disruptive to peoples lives, if you wish you can simply take drugs until your symptoms decline and not engage with the hard work of psychological therapy

Question 100

drug therapy - ao3 - drugs can have side effects

Answer 100

although drugs like SSRI’s are often helpful to sufferers of OCD, a significant minority will get no benefit, some patients also suffer side effects like indigestion, blurred vision, loss of sex drive, these side effects are usually temporary
for those taking clomipramine side effects are more common and cane be more serious, more than one in ten patients suffer erection problems, tremors and weight gain
more than one in a hundred become aggressive and suffer disruption to blood pressure and heart rhythm
such factors reduce effectiveness because people stop taking the medication