Psychopathology

Question 1

Define abnormality

Answer 1

• a psychological or behavioural state leading to impairment of interpersonal functioning and/or distress to others

Question 2

Give the 4 ways Rosenham & Seligman defined abnormality

Answer 2

1. Deviation from social norms
2. Failure to function
   adequately
3. Statistical infrequency
4. Deviation from ideal mental health.

Question 3

Outline the key concepts of ‘ deviation from social norms’

Answer 3

• refers to behaviour violating accepted social rules
• society has norms , unwritten rules for accepted behaviour
• individuals with undesirable behaviours as socially deviant

Question 4

Outline the strengths of defining abnormality as a ‘deviation from social norms’

Answer 4

1. helps people:
   - allows society to get involved in individuals abnormal behaviour and help them.
2. gives a social dimension to the idea of abnormality.
3. situational norms:
   - considers the social dimensions of behaviour; seen as abnormal in one setting and normal in another.
4. Developmental norms
   - definition establishes what behaviours are normal for different ages.
5. Protects society.
   - from the effects an individual’s abnormal behaviour.
6. clear indication , distinguishing between normal and abnormal.

Question 5

Outline the limitations of defining abnormality as a ‘deviation from social norms’

Answer 5

1. subjective:
   - social norms are not real but based on the opinions of ruling elites within society rather than majority opinion. True definition should be objective and free from subjective factors.
   - Szasz (1960) sees the term’ mental illness’ as a form of social control. Those labelled as abnormal are discriminated against.
2. Change over time:
   - relate to moral standards that vary as social attitudes change e.g. Homosexuality was not removed from the ICD until the 1990s
3. Individualism:
   - does not account for those who do not conform to social norms but are not abnormal, such as those that are individualistic or eccentric in their behaviour
4. Ethnocentric bias in diagnosis:
   - based on western social norms and reflects the majority, which is a white population.
   - deviation from these norms by ethnic groups means that ethnic minorities are over-represented in the mental illness statistics.
5. Cultural differences:
   - social norms vary within and across cultures.

Question 6

Give research which supports the idea that ‘deviation from social norms’ as a definition is ethnocentric.

Answer 6

Cochrane (1977) found that in Britain, black people were more likely to be diagnosed with schizophrenia than white people, however, this was not in countries with a majority black population, such as Jamaica, which suggests there is a diagnostic bias.

Question 7

Outline the key concepts of ‘ the failure to function adequately’ as a definition for abnormality

Answer 7

• sees individuals are abnormal when their behaviour suggests that they are unable to cope with everyday life.
• Abnormal behaviours include; distress leading to not being able to function, behaviour that interrupts the individual’s ability to work or go to school

Question 8

Outline Rosenhan and Seligman (1989) features of personal dysfunction.

Answer 8

• the more an individual has , the more they are classed as abnormal:
• personal distress
• maladaptive behaviour
• unpredictability
• irrationality
• observer discomfort ( causes discomfort to others)
• violation of moral standards
• unconventionality

Question 9

Outline the strengths of defining abnormality as ‘ failure to function adequately’

Answer 9

• Observable behaviour : focuses on behaviours which can be observed in the individual, allowing others to judge if the individual appears to have abnormal behaviours.
• provides a practical checklist which individuals can use to assess their level of abnormality.
• Personal Perspective: recognises personal experience of sufferers thus allows mental disorders to be regarded from the perception of the individual’s suffering them.
• Assesses degree of abnormality; as the GAF is scored on a continuous scale, it allows clinicians to see the degree to which individuals need psychiatric help.

Question 10

Outline the limitations of defining abnormality as ‘ failure to function adequately’

Answer 10

• Abnormality is not always accompanied by dysfunction: does not explain people with dangerous personality disorders, such as psychopaths, who can appear normal, E.g. Harold Shipman a respected doctor who murdered over 200 patients but was seen as a respectable doctor
• Subjective nature of the features of dysfunction: Although GAF, measures level of functioning , it doesn’t consider behaviour from an individual’s perspective. What is normal behaviour for an eccentric is abnormal for an introvert.
• normal abnormality : times in people’s lives when it is normal to suffer distress i.e. grief
• cultural differences : what is considered normal functioning’ varies.

Question 11

Outline the key concepts of ‘deviation from the ideal mental health ‘ as a definition for abnormality

Answer 11

• failure to meet criteria for perfect psychological well-being
• abnormality = absence of mental wellbeing.
• any deviation away from what is seen as normal is classed as abnormal.
• Marie Jahoda (1958) described 6 characteristics that individuals should exhibit in order to be normal. An absence of any of these characteristics indicates individuals as being abnormal,

Question 12

Outline Marie Jahoda’s (1958) proposed characteristics for ideal mental health.

Answer 12

• positive attitude towards oneself
• self actualisation (experiencing personal growth and development)
• autonomy
• resisting stress ( effective coping strategies)
• accurate perception of reality
• Environmental mastery ( competent in all aspects of life + flexible to changing situations
• the more characteristics failed to be met , the more abnormal one is

Question 13

Outline the strengths of defining abnormality as ‘ deviation from the ideal mental health’

Answer 13

• Emphasises positive achievements rather than failures + stresses a positive approach to mental problems by focusing on what is desirable, not undesirable.
• allows targeting of areas of dysfunction and focus upon specific problem areas of a certain disorders i.e lack of self esteem & depression
• Holistic - the definition considers an individual as a whole person rather than individual areas of their behaviour

Question 14

Outline the limitations of defining abnormality as ‘ deviation from the ideal mental health’

Answer 14

• overdemanding criteria: most people do not meet all the ideals. Thus, according to the definitions , most people are abnormal and so the criteria may be seen as ideas rather than actualities
• subjective criteria: criteria are vague and difficult to measure. Unlike the objective measure of physical health. Diagnosing mental health is based on self reports of patients thus not reliable.
• criteria are affected by context
• perceptions of reality change over time; once seeing visions = religious commitment , now a sign of schizophrenia.
• Cultural variation: some criteria differ dependent on culture: Jahoda = White American woman → western individualistic bias so can’t apply outside America
• non-desirability of autonomy: collectivist cultures stress communal goals and see autonomy as undesirable. Western bias as they are more concerned with individual attainment and goals.

Question 15

Outline the key concepts of ‘ statistical infrequency’

Answer 15

• occurs when an individual has a less common characteristics relative to the population.
• The behaviours that are considered rare are dependent on normal distribution.

Question 16

Outline the strengths of defining abnormality as ‘statistical infrequency’

Answer 16

• objective way of collecting data about a behaviour/ characteristic thus able to measure abnormality.
• definition gives an overview of what behaviours and characteristics are infrequent within a given population.
• based on real data: gives a real, unbiased data thus objective
• evidence of assistance: statistical evidence that a person has a mental disorder can be sued to justify requests for psychiatric assistance.

Question 17

Outline the limitations of defining abnormality as ‘statistical infrequency’

Answer 17

• not all infrequent behaviours are abnormal such as high intelligence which is statistically rare but desirable
• cultural factors are not considered which may lead to judging people of one culture by the statistical norms of another culture
• not all abnormal behaviours are infrequent

Question 18

Define phobias

Answer 18

• anxiety disorders characterised by extreme irrational, uncontrollable fears which involve anxiety levels that are out of proportion to any actual risk.

Question 19

Outline the behavioural symptoms of phobias

Answer 19

Avoidant/Anxiety response: as confrontation with feared objects and situations produces high anxiety, efforts are made to avoid the feared objects in order to reduce the chances of such anxiety responses occurring.
Disruption of functioning: when anxiety responses are so extreme that they severely interfere with the ability to conduct everyday working and social functioning.

Question 20

Outline the emotional symptoms of phobias

Answer 20

• persistent , excessive fear : produce high levels of anxiety due to the presence of phobic stimulus
• fear from exposure to phobic stimulus: produce an immediate fear response , even panic attacks due to the presentation of the phobic stimulus.

Question 21

Outline the cognitive symptoms of phobias

Answer 21

• Irrational so believe they are in danger when they aren’t
• Self-aware =recognise that anxiety is excessive.

Question 22

Outline the three subtypes of phobias

Answer 22

• simple phobias
• social phobias
• agoraphobia

Question 23

What are simple phobias? Give examples.

Answer 23

• occur where sufferers have fears of specific things and environments.
• animal phobias - e.g. arachnophobia (fear of spiders)
• injury phobias - e.g. haematophobia (fear of blood)
• situational phobias - e.g. aerophobia (fear of flying)
• natural environment phobias - e.g. hydrophobia (fear of water)

Question 24

What are social phobias? Give examples.

Answer 24

• fear of being in social situations out of possibility of feeling judged / inadequate.
• performance phobias - being anxious about performing in public
• interaction phobias - being anxious about mixing with others.
• generalised phobias - being anxious about situations where other people are present.

Question 25

What is Agoraphobia?

Answer 25

• the fear of being outside in a public space
• the natural avoidance response to make in such situations is to find and stay in a safe place , generally at home.

Question 26

What is a behavioural approach to explaining and treating phobias?

Answer 26

• Sees phobias as being learned through experience via the process of association.
• In classical conditioning a stimulus becomes associated with a response.
• Operant conditioning involves learning behaviour due to the consequences of that behaviour.

Question 27

What is the two process model?

Answer 27

• the perception of phobias as acquired through classical conditioning and social learning , with their maintenance upheld through operant conditioning.

Question 28

Outline the components of the Two process model

Answer 28

1. The acquisition onset of phobias is seen as occurring through classical conditioning ( learning through association).
2. The maintenance of phobias is seen as occurring through operant conditioning, where avoidant responses acts as a negative reinforcer.

Question 29

Outline the aim and procedure to Little Albert

Answer 29

Aim: To provide empirical evidence that human emotional responses could be learned through classical conditioning
- Lab experiment was conducted with 1 participant, an 11-month-old boy.
- Albert was presented with various stimuli, including a white rat, a rabbit + some cotton wool, + his responses were filmed. He showed no fear reaction to any stimuli.
- Fear reaction was then induced into Albert by striking a steel bar with a hammer behind his head. This startled Albert, making him cry.
- He was then given a white rat to play with, of which he was not scared. As he reached to touch the rat, the bar + hammer were struck to frighten him.
- This procedure was repeated 3 times.
- Variations of these conditioning techniques continued for 3 months.

Question 30

Outline the Findings and Evaluations of Little Albert - Watson & Rayner (1920)

Answer 30

Findings
- Albert would cry, roll over + crawl away. He had developed a fear towards the white rat, which he also displayed to similar animals with less intensity + to other white furry objects, like a white fur coat and Santa Claus beard.
Eval:
- Extent of Albert’s fear response is disputed. Mentions in the original paper that Albert’s fear reactions were only ‘slight’.
- Unethical: it was performed without his mother’s knowledge or consent + the participant was subjected to unnecessary distress. It would not be possible to replicate the study to verify the findings.

Question 31

Outline research on phobias

Answer 31

Bagby (1922): reported on a case study of a woman who had a phobia of running water that originated from her feet getting stuck in some rocks near a waterfall. As time went by she became increasingly panic-stricken.
Although she was eventually de-conditioned, the neutral stimulus of the sound of the running water became associated with the fear she had felt and thus her phobia of running water was acquired.

Question 32

Evaluate the Two Process Model

Answer 32

• Behaviourist explanation supported by effectiveness of behavioural therapies EG systematic desensitisation in addressing phobic symptoms.
• not everyone experiencing traumatic events develops a phobia, where the initial association between phobic STIMULUS + fear is formed, which suggests that alternative explanations are needed.
• Bounton (2007) argues that the two-process model neglects the influence of evolution history, whereby avoidance responses are learned more rapidly if the required response resembles an animal’s natural defensive behavior

Question 33

Define systematic desensitisation

Answer 33

• a behavioural therapy for treating anxiety disorders in which the sufferer learns relaxation techniques + then faces a progressive hierarchy of exposure to the objects + situations that cause anxiety
• Developed by Wolpe (1958)

Question 34

Outline the general process of systematic desensitisation.

Answer 34

• a hierarchy is constructed from least to most feared contact
• patients are taught relaxation strategies for each stage of contact.
• Contact is normally achieved by imagining scenarios (covert desensitisation), but sometimes involves actual contact (in vivo desensitisation).
• this is a progressive step-by-step approach which can take months ( depending on the individual)

Question 35

What is flooding?

Answer 35

• a behavioural therapy used to remove phobias through direct confrontation of a feared object or situation.
• patients cannot make theirusual avoidance responses and axniety peaks at such high levels that it cannot be maintained and eventually subsides.

Question 36

Outline research on flooding

Answer 36

• Wolpe (1960) used flooding to remove a girl’s phobia of being in cars. The girl was forced into a car and driven around for four hours until her hysteria was eradicated , demonstrating the effectiveness of the treatment.
• Barlow (2002) reports that flooding has been shown to be equally as effective in treating phobias as SD , but SD is preferred as it is better tolerated by most patients.

Question 37

Outline research on systematic desensitisation

Answer 37

• Jones 1924 used SD to eradicate Little Peter’s phobia of white dluffy animas and objects. The rabbit was presented to the patient at closer distances each time his anxiety levels subsided to permit movements onto the next stage and Peter was rewarded with food to create a positive association, eventually he developed affection for the rabbit.

Question 38

Evaluate the ways of treating phobias

Answer 38

• SD is mainly suitable for patients who are able to learn and use relaxation strategies and who have imaginations vivid enough to imagine images of feared objects/situtations.
• Behaviourist treatments work best in treating simple phobais but ate less effective with agoraphobia and social phobias , which suggests these types of phobias may not be best explained through behaviourist means.
• there are ethical considerations with both SD and flooding , as they can be both psychologically harmful, though cost-benefit analyses may regard long-term benefits of eradicating the phobia as outweighing the short term costs of distress.
• flooding is not suitable for patients who are not in good physical health as the extreme anxiety levels caused by confontation with fearedpbjects/ situations, although short-lived, can be very stressful on the body, incurring risks of heart attacls etc.

Question 39

Describe Beck’s explanation of depression

Answer 39

• Beck argued people became depressed because the world is perceived through negative schemas, which dominate thinking and are triggered whenever individuals are in situations that are similar to those in which negative schemas are learned leading to automatic negative bias.
• Beck perceived negative schemas as developing in childhood and adolescence, when authority figures, such as parents, place unreal demands on individuals, and were highly critical of them
• these negative schemas then continue into adulthood, providing a negative framework to view life in a pessimistic fashion.

Question 40

Describe Beck’s negative triad

Answer 40

negative views about:
- the world
- the future
- oneself

Question 41

Give Beck’s negative scheams characterised with depression.

Answer 41

• ineptness: make despressives expect to fail
• self-blame: make depressives feel responsible for all misfortunes
• negative self-evaluation : constantly remind depressives of their worthlessness

Question 42

outline the cognitive biases which characterise depression

Beck’s negative triad

Answer 42

• arbitrary inference: conclusions drawn in the absence of sufficient evidence.
• selective abstraction: conclusiosns drawn from just one part of a situation.
• overgeneralisation: sweeping conlusions drawn on the basis of a single event.
• magnification + minimisation: exaggerations in evaluation of performance

Question 43

Outline Ellis ABC model of depression

Answer 43

• Ellis proposed his ABC three stage model that sees depression occurring through an activating agent(A), a belief (B) and a consequence (C).
• Ellis believed that depressives mistakenly blame external events for their own unhappiness BUT thought that it is their interpretation of these events that is to blame for their distress.
• it is negative perception that differentiates non-depressives and depressives

Question 44

Outline research on Beck’s negative triad

Answer 44

• Boury et al (2001) monitored students’ negative thoughts with the Beck depression inventory (BDI), finding that depressives minsinterpret facts and experiences in a anegative fashion and feel hopeless about the future, giving support.
• McIntosh & Fischer tested the cognitive triad to see if it contains the three proposed distinct types of negative thought and found no clear separation but instead a single 1 dimensional negative perceptionn of the self , suggesting retention of all 3 areas of the triad as separate dimensions is unesscessary.

Question 45

Evaluate Beck’s explanation of depression.

Answer 45

• Cognitive theories that explain depression have led to highly effective cognitive therapies; March showed CBT had an
  effectiveness rate of 81% after 36 weeks of treatment, the same as drug therapy. The fact these treatments are successful
  suggests the underlying cognitive explanations are valid.
• Family studies and genetic research suggests a predisposition to depression is inherited, likely genes that influence the activity of neurochemicals like serotonin in the brain; also, the effectiveness of drug treatments like SSRIs suggests the cognitive
  explanation is not complete, and there is a biological aspect to depression.
• it considers other aspects such as genes, development and early expeirences can lead to certain thinking patterns which then lead to depression.
• Grazioli and Terry (2000) assessed the thinking styles of 65 women before giving birth and six weeks after. Women with negative thinking styles were most likely to develop postpartum depression, especially in women with infants who were identified as having a difficult temperament.
• supports the idea that faulty thinking leads to depression, but also that there is a diathesis-stress mechanism to Beck’s theory, negative thinking is a vulnerability which can be triggered by aversive life experiences like motherhood.

Question 46

outline the genetic explanation to dperession

include research

Answer 46

• centres on the idea that vulnerability to depression is inherited
• Wender et al found that adopted children who develop depression were more likely to have a depressive bioological prent, even though adopted children are raised in different environments. - supports biological factors > cognitive.
• Plomin et al (2013) used gene-mapping techniques with a sample of 3,154 pairs of 12 year old twins to find that genetics accounted for about 66% of the heritability of cognitive abilities.
• This suggests that the congitive features of depression, such as negative schemas may have a large genetic component to them combined with cognitive.

Question 47

Evaluate the genetic explanation to depression

Answer 47

• if the genetic explanation was soley true, then concorandace rates between MZ ( identical) twins would be 100% and all depressives would share genetic material, which they don’t. So although research does indicate a genetic influence , other influences such as cognitive factors must also play a role.
• the similarity of symptoms across gender, age and cultural groups, plus the similarity in physcial symtpms suggests a genetic rather than a cognitive influence , though of course the cognitive features of depression may be genetically mediated, which suggests a combination of cognitive and biological.

Question 48

outline the behavioural explanation of depression

Answer 48

• sees depression as a learned condition.
• Lewinsohn (1974) proposed that negative life events may incur a decline in positive reinforcements and even lead to learned helplessnes, where one leants rhough experience that they can’t bring about positive outcomes.
• Coleman (1986) found that indidviuals recieving low rates of positive reinforcement for social behaviours become increasingly passive and non-responsive leading to depressive moods , which provided support for Lewinnsohn’s learning theory .

Question 49

Evaluate the behavioural approach to depression.

Answer 49

• there is little research evidene whihc backs up behaviourist explanations , while the cognitive apporach is supported by a body of research baeed evidence.
• Kanter et al (2008) state that behaviorism cannot offer an account of depression that addresses its complexity satisfactorily. Cognitive explanations are more able to do this as they can account for the irrational thought processes that are seen as underpinning the condition.

Question 50

outline the process of cogntiive behavioural therapy (CBT).

Answer 50

• CBT allows patients to identify irrational and maladaptive thoughts and change them.
• The patient acts as a scientist and tests hypotheses about the validity of their irrational thoughts; when they realise their thoughts don’t match reality, this will change their schemas and their irrational thoughts can be discarded.
• To do this they are assigned a homework task of keeping a diary, this is used to record negative thoughts and identify situations that cause negative thinking.
• To help raise the client’s mood the therapist will also encourage behavioural activation, this is taking part in activities that the sufferer used to enjoy so this may be team sports, travelling or socialising with friends.

Question 51

outline research investigating the effectiveness of CBT

Answer 51

• Lincoln et al (1997) used a questionnare to identify stroke victims who had developed clinical depression . 19 patients were then given CBT sessions for 4 months , resulting in reduced symptoms.
• Hollon et al (2006) found that 40% of moderately to severely depressed patients treated with CBT for 16 weeks relapased within 12 months compared to a relapse rate of 45% for patients treated for the same period with drug therapy and 80% for patients treated with a placebo. - CBT is favoured.
• The department of health reviewed research papers of treatments for depression , including behavioural, cognitive , humanistic and psychotherapeutic ones, finding CBT the most effective , but didn’t endorse the use of CBT alone.

Question 52

Evaluate the effectiveness of CBT in tre

Answer 52

• Family studies and genetic research suggests a predisposition to depression is inherited, likely genes that influence the activity of neurochemicals like serotonin in the brain; also, the effectiveness of drug treatments like SSRIs suggests there is a biological aspect to depression. This therefore casts doubt on the cognitive explanations as a sole cause of the disorder thus cannot be treated solely through CBT.
• March found that CBT also had a more significant reduction in suicidal events than drug treatment BUT the best results came from the combination treatment, with an effectiveness rate of 86% and fewer suicidal events than either treatment alone.
• ethical concerns with CBT as it can bee too therapist centred. Therapists may abuse their power of control over patients, forcing them into certain ways of thinking and patients can become too dependent on therapists.

Question 53

Outline the process of REBT

Answer 53

• therapists aim is to challenge patients’ thinking and sho how irrational their thoughts are.
• patients are told to practice positive and optimistic thinking. A central part of the therapy involves usiing the ABC model as a technique to record irrational beliefs.
• involves reframing where one challenges negative thoughts by reinterpreting the ABC in a more positive logical way.

Question 54

Outline the genetic explanation for OCD

Answer 54

• originally centres on idea of OCD being inherited through gene transmission.
• e.g. gene 8 , COMT , SERT genes inherited - COMT gene regulated dopamine and is more common in patients with OCD, compared to people without OCD.
• OCD is polygenic condition, which means that several genes are implicated. Taylor suggests that as many as 230 genes may be involved and different genetic variations contribute to the different types of OCD.

Question 55

What is OCD?

Answer 55

• OCD includes obsessive thoughts and compulsive behaviours.
• Obsessive thoughts are repetitive, distressing mental images or
  concerns that provoke anxiety.
• Compulsions are actions that
  individuals feel they need to perform to reduce the discomfort
  caused by these thoughts.

Question 56

outline research on the biological explanation of OCD

Answer 56

• Stewart et al. (2007) performed gene mapping on OCD patients and family members , dinding that a variant of the OLIG-2 gene commonly occured, which suggests a genetic link to the condition.
• Nestadt (2010) shows for OCD; there is a high concordance rate between close family members. Non-identical twins have 31% concordance, and identical twins have 68%. MZ and DZ twins grow up sharing similar environments like food, upbringing and education, and life events like bereavement or parental divorce. This suggests that the additional shared DNA is responsible for the increased concordance.

Question 57

Evaluate the genetic explanation of OCD

Answer 57

• there must be some enviromental influences to OCD , or else the concordance rate between MZ twins would be 100%.
• The Diathesis stress response may be a more valid explanation for OCD than biological processes alone.
• Cromer showed 54% of 265 participants with OCD reported at least one traumatic life event, and those with traumatic life events reported increased severity of OCD symptoms; this demonstrates an environmental aspect of OCD.
• A meta-analysis by Soomro demonstrated SSRls are more effective than placebos, suggesting there is a biological aspect to OCD,
  however despite altering levels of serotonin in the synapse within hours, these drugs take weeks to reduce symptoms, and 40% to
  60% of patients show no or just partial symptom improvement. These findings suggest low levels of serotonin have a role to play in
  but are not the sole cause or OCD.
• Nestadt (2010) shows for OCD; there is a high concordance rate between close family members. Non-identical twins have 31%
  concordance, and identical twins have 68%. MZ and DZ twins grow up sharing similar environments like food, upbringing and
  education, and life events like bereavement or parental divorce. This suggests that the additional shared DNA is responsible for the
  increased concordance.

Question 58

outline the neural explanation for OCD.

Answer 58

• Includes biochemical causes, an imbalance of neurotransmitters and the large neural structures in the brain that are made of many neurons and the large neural structures in the brain that are made of many neurons
• Low serotonin levels are thought to cause obsessive thoughts, and the low level of serotonin is likely due to it being removed too quickly from the synapse before it has been able to transmit its signal to the postsynaptic cell.
• PET scans also show relatively low levels of serotonin activity in the brains of OCD patients and as drugs that increase serotonin activity have been found to reduce the symptoms of OCD, it suggests that the neurotransmitter may be involved with the disorder.

Question 59

Outline research on neural explanations of OCD

Answer 59

• Hu (2006) compared serotonin activity in 169 OCD sufferers and 253 non-sufferers, finding serotonon levels to be lower in OCD patients, supporting such a claim.
• Saxena & Rauch (2000) reviewed studies of OCD that used PET, fMRI, and MRI neuro minaging techniques to find consistent evidence of an association between the orbital frontal cortex brain area and OCD symptoms, suggests neural mechanisms are involved with OCD.

Question 60

Evaluate the neural explanation of OCD.

Answer 60

• to what extent abnormal levels of serotonin and activity within the frontal orbital cortex are actual causes of OCD or merely effects of the disorder has not been established.
• not all sufferers to OCD respond positvely to serotonin enhancing drugs , which lessens support for abnormal levels of the neurotransmitter being the sole cause of the disorder.
• An NIMH study examined DNA samples from sufferers and found OCD to be associated with two mutations of the human serotonon transporter gene which led to diminished levels of serotonin.

Question 61

Outline the biological treatment of OCD.

Answer 61

• antidepressants are used to treat OCD, such as SSRIs which elevate levels of serotonin and cause the orbital frontal cortex to function at more normal levels.
• SSRIS inhibit the reuptake process in the synapse meaning that serotonin is still present in the synaptic cleft and continues to stimulate the postsynaptic neuron , decreasing anxiety.

Question 62

outline research on the biological treatment of OCD.

Answer 62

• Soomro et al reviewed 17 studies of SSRIs vs placebo treatments involving 3097 patients and founs SSRIs to be moderately effective in the short term in treating OCD of varying duration in adults. - support.
• julien reproted that studies of SSRIs show that although symptoms do not fully disappear between 50%-80% of OCD patients improve , allowing them to live a fairly normal lifestyle , which they wouldn’t be able to do without the treatments.

Question 63

Evaluate the biological treatment to OCD

Answer 63

• drug treatments are widely used to treat the symptoms of OCD as they are relatively cheap, don’t require a therapist to administer them and are user-friendly form of treatment.
• Goldacre points out that most research studies on drug therapies are conducted by the pharmaceutical companies that created them. This means the companies have a financial interest in showing the drugs are effective; this, and the file drawer
  problem (the fact that many negative results stay unpublished), means any metanalysis may be skewed, and drug therapies may not be as effective as claimed.
• Drug therapy is a relatively inexpensive and potentially more convenient treatment for the patient; this is in comparison to
  psychological therapies like CBT, which require the patient to find time for multiple sessions with a trained therapist. As CBT is much more expensive than drug therapy, from an economic perspective, health services like the NHS are more likely to
  provide drug therapy.
• Many patients prefer CBT; one reason is drug therapy can have a range of potential side effects; in the Soomro meta-analysis,
  it was found nausea, headache and insomnia were the most common side effects.

Question 64

outline and evaluate CBT as a treatment for OCD.

Answer 64

• O’Kearney et al assessed the ability to treat children and adolescents with OCD , finding it effective, but more so when combined with drug treatment.
• Jonsoon and Houggard found that CBT was better than drug treatments in reducing OCD symptoms , which suggests its a more effective treatment than drug therapy.
• although CBT was acknowledged to be more effective as it does not have the side effects of other treatments it isn’t suitable for those who have diifficulties in talking about their inner feelings