Psychopathology

Question 1

What are the four definitions of abnormality?

Answer 1

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

Question 2

Define statistical infrequency.

Answer 2

Abnormality is defined as those behaviours that are extremely rare or uncommon. Behaviour found in very few people found to be abnormal. We can distinguish what is and isn’t common through Using a normal distribution curve.

Question 3

Define deviation from social norms.

Answer 3

Abnormal behaviour is seen as a deviation from unstated rules about how one ‘ought’ to behave. Some rules about unacceptable behaviour are implicit whereas others are policed by laws.

Question 4

Define failure to function adequately.

Answer 4

Abnormality is seen as lacking the ability to go about daily life resulting in distress to themselves or others.

Question 5

Define deviation from ideal mental health.

Answer 5

Abnormality is defined in terms of an absence of criteria which indicates good mental health.

Question 6

What does Jahoda suggest about defining abnormality

Answer 6

Marie Jahoda says that we define physical illness in part by looking at the absence of signs of physical health. She says we should define mental illness in this way too, by looking at the signs of ideal mental health

Question 7

What are Jahoda’s six criteria for ideal mental health?

Answer 7

1. Self attitudes (high self-esteem)
2. Personal growth and self-actualisation (developing to full capabilities)
3. Integration (coping with stressful situations)
4. Autonomy (being independent and self regulating)
5. Accurate perception of reality
6. Environmental mastery (love, relationships, problem solving ect.)

Question 8

1 Strength, 2 limitations of Statistical infrequency

Answer 8

Real-life application:
Using statistics has proven to be a useful diagnostic and assessment tool.
For example, the diagnosis of intellectual disability disorder. A diagnosis of this requires an IQ of below 70 (bottom 2%). Additionally,
the Beck depression inventory (BDI) – a score of 30+ (top 5%) is widely interpreted as an indication of severe depression.

Some abnormal behaviours are desirable:
For example, very few people have an IQ over 150, yet this abnormality is one deemed as desirable. Some ‘normal’ behaviours are undesirable e.g. experiencing depression is relatively common.

Cut-off point is subjective:
If abnormality is defined in terms of statistical infrequency, we need to decide where to separate normality from abnormality. For example, one of the symptoms of depression is ‘difficulty sleeping’ – some people might think abnormal sleep is less than 6 hours a night, others might think the cut-off should be 5 hours

Question 9

1 Strength 1 limitation of Deviation from social norms

Answer 9

Distinguishes between desirable and undesirable behaviours:
It takes into account the effect that behaviour has on others. Deviance is defined in terms of transgression of social rules, and social rules are established in order to help people live together. According to this definition, abnormal behaviour is behaviour that damages others and so offers a practical way of identifying undesirable and potentially damaging behaviour.

Cultural relativism:
Social norms vary from one culture to another. A person from one cultural group may label someone from another culture as behaving abnormally according to their standards.
For example, hearing voices is socially acceptable in some cultures, but is seen as a sign of mental abnormality in the UK. The DSM’s classification systems are almost entirely based on social norms of the West

Question 10

1 limitation for failure to function adequately

Answer 10

Subjective judgements:
The individual may be quite content with the situation and are unaware that they are not coping – it is others who judge their behaviour as abnormal.

Question 11

1 Strength 2 Limitations of Deviation from ideal mental health

Answer 11

Positive approach:
Jahoda’s ideas are in accord with the ‘positive psychology’ movement as it offers an alternative perspective on mental disorder that
focuses on the ‘ideal’ rather than what is undesirable.

Unrealistic criteria:
Very few of us attain all Jahoda’s criterion for mental health and potentially no one is able to achieve all of them simultaneously. Therefore, according to this approach most of us are abnormal as we are likely to deviate from ‘good mental health’ at many points in life.

Cultural relativism:
Many of Jahoda’s mental health criteria are culture-bound.
For example, the goal of self-actualisation is relevant to members of individualist cultures but not collectivist cultures where people promote the needs of the group not themselves. If we apply Jahoda’s criteria to people from collectivist cultures, we will likely find a higher incidence of abnormality

Question 12

What is a phobia?

Answer 12

An irrational fear of a particular stimulus or situation which causes high levels of anxiety and interferes with normal living.

Question 13

Why are phobias categorised by irrational fear?

Answer 13

The extent of the fear is out of proportion to any real danger presented by the phobic stimulus.

Question 14

List and outline the three categories of phobia recognised by the DSM-5.

Answer 14

1. Specific phobia – fear of a specific object or situation
2. Social phobia – fear of social situations
3. Agoraphobia – fear of being trapped in a public place where escape is difficult.

Question 15

Outline the 3 types of characteristics we can use to identify the symptoms of a phobia?

Answer 15

Behavioural (how it makes you act)
Emotional (how it makes you feel)
Cognitive (how it makes you think)

Question 16

Outline three behavioural characteristics of phobias.

Answer 16

1. Panic (crying, screaming, running away)
2. Avoidance (conscious effort to prevent coming into contact with phobic stimulus)
3. Endurance (alternative response to avoidance is to remain in the presence of it)

Question 17

Outline three emotional characteristics of phobias.

Answer 17

1. Anxiety (unpleasant state of high arousal)
2. Persistent fear
3. Unreasonable emotional response (fear is disproportionate to any threat posed)

Question 18

Outline three cognitive characteristics of phobias.

Answer 18

1. Irrational beliefs (unfounded thoughts in relation to phobic stimulus that cannot be explained and do not have any basis in reality)
2. Cognitive distortions (perceptions inaccurate and unrealistic)
3. Selective attention to phobic stimuli

Question 19

What is the behavioural approach?

Answer 19

A way of explaining behaviour in terms of what is observable and in terms of learning.

Question 20

What is classical conditioning?

Answer 20

Learning through association – a neutral stimulus is consistently paired with an unconditioned stimulus so that it eventually produces a conditioned response.

Question 21

What is operant conditioning?

Answer 21

Learning through reinforcement or punishment – if a behaviour is followed by a desirable consequence, then that behaviour is more likely to occur again in the future.

Question 22

Name the researcher who proposed the two-process model.

Answer 22

Orval Hobart Mowrer (1947).

Question 23

What is the two-process model?

Answer 23

A theory that explains the two processes that lead to the development of phobias – they are acquired through classical conditioning and are maintained through operant conditioning.

Question 24

State the research study that demonstrates the acquisition of a phobia through classical conditioning.

Answer 24

Watson and Rayner (1920) – Little Albert.

Question 25

Describe the Little Albert research

Answer 25

At the beginning of the study, Albert showed no fear response to white furry animals (NS)
They created a conditioned response of fear by pairing it with a loud noise which produced fear (Unconditioned stimulus). Whenever Albert reached out to the rat they struck a steel bar with a hammer behind his head. The NS of the rat became associated with the US of the loud bang so that the white rat alone caused the fear response, becoming a CS.

Question 26

Explain how a phobia is maintained through operant conditioning.

Answer 26

Reinforcement applies to phobias as whenever we avoid a phobic stimulus we successfully escape the fear and anxiety we would have suffered if we had remained. This reduction in fear reinforces the avoidance behaviour (negative reinforcement) so we are more likely to repeat it and the phobia is maintained.

Question 27

2 Strengths (and counter) of the behaviourist approach to explaining phobias

Answer 27

Good explanatory power:
Ad De Jongh et al. (2006) - 73% of people with a fear of dental treatment had experienced a traumatic experience compared to a control group of people with low dental anxiety where only 21% had experienced a traumatic event. COUNTER- However, not everyone who has a phobia can recall a traumatic experience that caused it.
Also not all frightening experiences lead to phobias. This suggests that other processes, other than classical conditioning, may be involved in the development of phobias.

Practical applications:
The behavioural explanation has been used to develop effective treatments for phobias- systematic desensitisation and flooding. This has proved very practical in the real world to help
people deal and overcome their fears, using research based on the behavioural approach.

Question 28

2 Limitations of the behaviourist approach to treating phobias

Answer 28

Ignores biological factors:
Research has found that not everyone who has a traumatic experience develops a phobia. This could be explained by the diathesis-stress model. This suggests that we inherit a genetic vulnerability for developing mental disorders. However, a disorder will only manifest itself if triggered by a life event. Therefore, the behavioural explanation is incomplete on its own, as it does not take into account biological factors.

Ignores cognitive factors
There are cognitive aspects to phobias that cannot be explained in a traditionally behaviourist framework. An alternative explanation is the cognitive approach, which proposes that phobias may develop as the consequence of irrational thinking. For example, a person in a lift may think ‘I could become trapped in here and suffocate’ (an irrational though). Such thoughts create extreme anxiety and may trigger a phobia. The two-process model explains avoidance behaviour but does not offer an adequate explanation for phobic cognition

Question 29

What is extinction?

Answer 29

The gradual weakening of a conditioned response that results in the behaviour decreasing when a conditioned stimulus is no longer paired with an unconditioned stimulus.

Question 30

What is counterconditioning?

Answer 30

When a patient is taught, through classical conditioning, a new association that runs counter to the original association.

Question 31

What are the two ways behavioural psychologists use to treat phobias?

Answer 31

1. Systematic desensitisation
2. Flooding.

Question 32

What is systematic desensitisation (SD)?

Answer 32

A form of behavioural therapy based on classical conditioning whereby a client is gradually exposed to the phobic stimulus using a hierarchy, under relaxed conditions until the anxiety reaction is extinguished.

Question 33

Explain the three stages involved in systematic desensitisation.

Answer 33

1. Anxiety hierarchy - A list of situations related to phobic stimulus in order from least to most frightening
2. Relaxation techniques - Such as breathing mental imagery. Works through reciprocal inhibition (relaxation prevents the emotion of fear)
3. Gradual exposure - work through hierarchy using relaxation techniques until client is ready to confront real fear.

Question 34

What are four examples of relaxation techniques?

Answer 34

1. Breathing exercises
2. Mental imagery
3. Muscle relaxation
4. Anti-anxiety drugs.

Question 35

What is flooding?

Answer 35

A form of behavioural therapy whereby a client is exposed to an extreme form of the phobic stimulus under relaxed conditions until the anxiety reaction is extinguished.

Question 36

Briefly outline one difference between flooding and systematic desensitisation.

Answer 36

Exposure to the phobic stimulus is gradual with SD, whereas with flooding the exposure is immediate.

Question 37

1 Strength 1Limitation of Systematic desensitisation.

Answer 37

Research evidence for effectiveness:
Research has found that SD is successful for a range of phobias. Its been reported that about 75% of patients with phobias respond to SD.

Not appropriate for all phobias:
Researchers have suggested that SD may not be as effective in treating phobias that have an underlying evolutionary survival component (e.g. fear of the dark, fear of heights etc.), than in treating phobias which have been acquired as a result of personal experience. This suggests that SD can only be used effectively in tackling some phobias and not all.

Question 38

1 Strength 1 Limitation for Flooding

Answer 38

Cost-effective:
Studies comparing flooding with other cognitive therapies
(such as Cognitive-behavioural therapy) have found that flooding is highly effective and quicker. This quick effect
means that patients are free of their symptoms as soon as possible and that makes the treatment cheaper. Flooding can work in as little as one session as opposed to say ten sessions for SD to achieve the same result.

Traumatic for patients: Flooding produces high levels of fear and this can be very traumatic for the patient. Therefore, patients are often unwilling to see it through to the end which reduces the ultimate effectiveness of the therapy for some people. Individual differences in responding to flooding therefore limit the effectiveness of the therapy.

Question 39

1 Strength 1 Limitation of behavioural therapies

Answer 39

Suitable for diverse range of patients:
Effective for all types of patients as it requires little
effort on patient’s part.
CBT requires a willingness for people to think deeply about their mental problems, which is not true for behavioural therapies. This lack of ‘thinking’ means that the technique is useful for people who lack insight into their motivations or emotions, such as children and patients with learning difficulties.

Symptom substitution: Behavioural therapies may not work with certain phobias. If the symptoms are removed the cause still remains, and the symptoms will simply resurface, possibly in another form (known as symptom substitution).
In the case of Little Hans who developed a phobia of horses. The boy’s actual problem was an intense envy of his father, but could not express this directly and his anxiety was projected onto the horse. The phobia was cured when he accepted his feelings about his father. Behavioural therapies would struggle to treat this phobia. Need to treat the underlying causes of a phobia rather than just the symptoms.

Question 40

What is depression?

Answer 40

A mood disorder characterised by persistent feelings of sadness and a lack of interest in formerly enjoyed activities.

Question 41

What are the two major diagnostic criteria for depression?

Answer 41

1. Extreme feelings of persistent sadness
2. Loss of pleasure in normal activities.

Question 42

List and outline the four categories of depression recognised by the DSM-5.

Answer 42

1. Major depressive disorder – severe but often short-term depression
2. Persistent depressive disorder – long-term or recurring depression
3. Disrupted mood dysregulation disorder (DMDD) – childhood temper tantrums and chronic irritability
4. Premenstrual dysphoric disorder (PMDD) – disruption to mood prior to and/or during menstruation.

Question 43

Explain three behavioural characteristics of depression.

Answer 43

1. Shift in activity level (either reduced displayed as lethargy, or increased in the form of psychomotor agitation)
2. Disruption to sleep and eating patterns (reduced sleep - insomnia or increased sleep - hypersomnia, appetite and weight may increase or decrease)
3. Aggression and self-harm (verbal or physical aggression)

Question 44

Explain three emotional characteristics of depression.

Answer 44

1. Low mood (sadness, worthlessness and lack of pleasure in normal activities)
2. Anger (directed at self or others)
3. Lowered self-esteem (self-loathing or hatred)

Question 45

State three cognitive characteristics of depression.

Answer 45

1. Poor concentration
2. Negative schema (bias towards recalling unhappy memories and always expecting things to turn out badly)
3. ‘Black and white’ thinking (all good or all bad. When something unfortunate happens, it is seen as a disaster)

Question 46

What is the main assumption of the cognitive approach? Main cause of depression?

Answer 46

Our thought processes shape our behaviour and should be studied scientifically.
Faulty/negative thinking

Question 47

What is a schema

Answer 47

A mental framework, gained from experience, which helps organise and interpret new information in the world.

Question 48

Outline what is meant by musturbatory thinking.

Answer 48

Thinking that certain ideas must be true in order for an individual to be happy.

Question 49

What is Ellis’ ABC model (1962)?

Answer 49

A cognitive approach to understanding depression focusing on the effect of irrational beliefs on emotions.
A – activating event
B – irrational belief triggered by the event
C – consequence of the belief (unhealthy emotion à development of depression).

Question 50

What is Beck’s negative triad (1967)?

Answer 50

A cognitive approach to understanding depression focusing on how negative schemas about the self, world and future lead to depression.

Question 51

How does a person with depression acquire negative schemas according to Beck?

Answer 51

Through their childhood as a result of many factors including parental/peer/teacher rejection and criticism.

Question 52

What are systematic cognitive biases? And example.

Answer 52

Drawing sweeping conclusions regarding self-worth on the basis of one small piece of negative feedback. Performing poorly on a test and making the sweeping conclusion that you are rubbish at everything.

Question 53

2 Strengths (and 1 counter) for the cognitive approach to explaining depression

Answer 53

Emphasises client responsibility over situational factors:
The cognitive approach suggest that it is the client who is
responsible for their disorder à placing emphasis on the
client is a good thing because it gives the client the power
to change the way things are. COUNTER -Increase feelings of self-loathing and hatred.

Practical applications in therapy:
The cognitive explanations have both been applied to
cognitive-behavioural therapy (CBT). CBT is consistently
found to be the best treatment for depression for example March et al.(2007) showed it’s effectiveness.
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.

Question 54

2 Limitations of the cognitive explanation for depression

Answer 54

Alternative explanation:
The biological approach to understanding mental disorders suggests that genes and neurotransmitters may cause depression.
E.g., research supports the role of low levels of the neurotransmitter serotonin in depressed people. The success of drug therapies for treating depression suggests that neurotransmitters do play an important role.
The existence of alternative approaches and effective therapies suggest that depression can’t be explained by the cognitive approach alone.

Doesn’t explain all types of depression:
not all people develop depression as a result of an ‘activating event’- reactive depression. Some people have depression without an obvious cause, and this is considered a different type of depression to ‘reactive depression’. Endogenous depression is characterized by depression caused by internal factors rather than external triggers, such as environmental stressors.
Ellis’ ABC model would struggle to explain these different types of depression and is therefore only a partial explanation for depression

Question 55

What is cognitive-behavioural therapy (CBT)?

Answer 55

A combination of cognitive therapy ( a way of changing maladaptive thoughts ) and behavioural therapy (changing behaviour in response to these thoughts.

Question 56

Outline the two types of cognitive-behavioural therapy.

Answer 56

1. Beck’s cognitive therapy - challenge negative schemas about the world, themselves and the future.
2. Ellis’ rational emotive behaviour therapy (REBT) - Turn irrational thoughts into rational ones.

Question 57

What are irrational thoughts?

Answer 57

Rational thinking is flexible and realistic, based on logic whereas irrational thinking is rigid, unrealistic and lacks internal consistency.

Question 58

How does REBT extend Ellis’ ABC model?

Answer 58

Extends ABC model to ABCDE model:
D – disputing irrational thoughts
E – effects of disputing/revising beliefs.

Question 59

Outline the three ways to dispute irrational thoughts.

Answer 59

1. Logical disputing - make client aware of how self-defeating beliefs don’t follow logically from the information available.
2. Empirical disputing - Make client aware of how beliefs are not consistent with reality.
3. Pragmatic disputing - emphasis on the lack of usefulness of self-defeating beliefs.

Question 60

How can disputing make a person with depression feel better?

Answer 60

Helps them turn irrational thoughts into rational ones and stops them from catastrophising.

Question 61

State and outline two methods used in CBT.

Answer 61

1. Keeping a diary – monitoring events where negative thoughts occur and target them.
2. Homework assignments – carry out tasks to test their irrational beliefs/negative schemas against reality “patient as a scientist”. Engaging in previously enjoyed activities to raise mood (behavioural element)

Question 62

What is “patient as a scientist?

Answer 62

The patient is encouraged to investigate the reality of their negative schemas/irrational thoughts in a way a scientist would evaluate evidence.

Question 63

2 Strengths (1 counter) for cognitive approach to treating depression

Answer 63

Research support for behavioural activation:
There is research support for the idea that the behavioural aspect of CBT is effective in alleviating depression.
Babyak et al. (2000)- studied 156 adult volunteers diagnosed with major depressive disorder. They were randomly assigned to a course of aerobic exercise, drug treatment or a combination of the two. 6 months after the end of the study, those in the exercise group had significantly lower relapse rates than those in the medication group.

Research support for effectiveness:
March et al. (2007) investigated the effects of CBT in adolescents with depression. It was found after 36 weeks that 81% CBT group showed improvement (Same as those who used antidepressants) . COUNTER - CBT may not be effective for everyone. CBT appears to be less suitable for people who have high levels of irrational beliefs and cannot motivate themselves to engage with the hard cognitive work of CBT. Some people prefer to just share their worries with a therapist without getting involved in the cognitive effort associated with recovery. Sturmey et al. (2005) found any forms pf psychotherapy not effective for those with learning difficulties. May not be able to engage in the complex rational thinking required for CBT.

Question 64

2 Limitations of CBT

Answer 64

Relapse rates:
Although CBT is quite effective in tackling the symptoms of depression, there are concerns over how long the benefits last. Shehzad et al. (2017) assessed depression in clients every month for 12 months following a course of CBT. 42% of the clients relapsed into depression within 6 months of ending treatment and 53% relapsed within a year.

Success may be due to therapist parent relationship:
Rosenzweig (1936)- the differences between different methods of psychotherapy might actually be quite small. The aspect that could be resulting in effective treatment is not the cognitive and behavioural basis of the psychotherapies but the therapist-patient relationship.

Question 65

What is obsessive-compulsive disorder (OCD)?

Answer 65

An anxiety disorder where anxiety arises from repetitive behaviour (compulsions) accompanied by obsessive thinking (obsessions).

Question 66

What is an obsession?

Answer 66

Persistent thoughts which recur over and over again and create anxiety.

Question 67

What are compulsions?

Answer 67

Repetitive behaviours carried out to reduce the anxiety created by obsessions.

Question 68

List and outline the four categories of OCD recognised by the DSM-5.

Answer 68

1. OCD – characterised by either obsessions and/or compulsions
2. Trichotillomania – compulsive hair pulling
3. Hoarding disorder – the compulsive gathering of possessions and the inability to part with anything.
4. Excoriation disorder – compulsive skin picking.

Question 69

Outline two behavioural characteristics of OCD.

Answer 69

1. Repetitive compulsions - compelled to repeat specific behaviours to reduce the anxiety caused by obsessions
2. Avoidance - Attempt to reduce anxiety by staying away from situations which trigger it.

Question 70

Outline three emotional characteristics of OCD.

Answer 70

1. Anxiety and stress - obsessive thoughts are unpleasant and frightening and compulsions create anxiety.
2. Guilt and disgust - Irrational guilt over minor issues and disgust at a stimulus or themselves
3. Depression - Anxiety can lead to low mood and lack of enjoyment in activities

Question 71

Outline three cognitive characteristics of OCD.

Answer 71

1. Obsessive thoughts - Seemingly uncontrollable, repetitive and unpleasant thoughts.
2. Cognitive coping strategies - Strategies adopted to deal with obsessions which can distract from everyday tasks. Religious person tormented by excessive guilt may pray/madidate
3. Aware of excessive anxiety - Comprehend that thoughts and compulsions are irrational or excessive. Can also be hypervigilant.

Question 72

State the two biological explanations for OCD.

Answer 72

1. Genetic explanations 2. Neural (brain) explanations.

Question 73

What are candidate genes? What are the two candidate genes for OCD?

Answer 73

Genes which create vulnerability for a specific disorder.
1. Allele of the COMT gene
2. SERT gene.

Question 74

How does an allele of the COMT gene is implicated in OCD

Answer 74

The allele produces less COMT. COMT regulates dopamine. This results in increased levels of dopamine, which is associated with compulsions, as it is not regulated.

Question 75

Explain how the SERT gene is implicated in OCD.

Answer 75

SERT gene affects the transport of serotonin, causing a decrease in serotonin levels. Serotonin levels are too low in people with OCD.

Question 76

What are two neural explanations for OCD?

Answer 76

1. Influence of neurotransmitters 2. Abnormal brain circuits.

Question 77

Outline two neurotransmitters that have been implicated in OCD.

Answer 77

1. Dopamine – levels are too high in people with OCD
2. Serotonin – levels are too low in people with OCD.

Question 78

Outline how serotonin and dopamine are implicated in OCD.

Answer 78

Decreased levels of serotonin lead to obsessive thoughts and anxiety.
Increased/excessive levels of dopamine lead to compulsive behaviour.

Question 79

What is the ‘worry circuit’?

Answer 79

Orbitofrontal cortex (OFC) sends “worry signals” to the thalamus. These signals are usually supressed by the caudate nucleus. People with OCD tend to have a damaged caudate nucleus as they have abnormal levels of serotonin. This means the caudate nucleus does not supress the worry signals so the thalamus is alerted and confirms the worry to the OFC.

Question 80

2 Strengths(1 counter) for the biological approach to explaining OCD

Answer 80

Evidence for genetic basis- family and twin studies:
Family study: Marini and Stebnicki (2012) A person with a family member diagnosed with OCD is four times as likely
to develop it as someone without.
Twin study: Nestadt et al. (2010)à reviewed twin studies and found that 68% of monozygotic twins shared OCD as opposed to 31% of non-identical twins.
COUNTER - Twin studies make the incorrect assumption that MZ twins are only more similar than DZ twins in terms of their genes - overlook the fact that MZ twins may also be more similar in terms of shared environments. E.g. DZ twins might be a boy and a girl who have quite different experiences and it could be these experiences that make DZ twins less similar than MZ twins rather than their genes.

Evidence for neural basis:
There is evidence to support the role of neurotransmitters in OCD. Some antidepressants work to increase the levels of serotonin and these drugs have been found to reduce the symptoms of OCD.
Soomro et al. (2009) reviewed 17 studies comparing SSRIs to placebos in the treatment of OCD. Found that SSRIs to be more effective than placebos in reducing the symptoms of OCD up to 3 months after treatment.

Question 81

2 Limitations for the biological approach to explaining OCD

Answer 81

Alternative explanations:
The two-process model can be used to explain OCD.
Classical conditioning= learning occurs when a neutral stimulus (dirt) is associated with an unconditioned stimulus (germs) producing anxiety.
Operant conditioning= This association is maintained because the anxiety-provoking stimulus is avoided and they receive negative reinforcement. An obsession is formed and a link is learned with compulsive behaviours (hand-washing) that appear to reduce anxiety.
A treatment called exposure and response prevention (ERP) has been developed based on the behaviourist two-process model. Patients have to experience their feared stimulus and stop performing their compulsive behaviour. Studies have supported a high success rate for people with OCD.

Serotonin not relevant to OCD:
Many people with OCD also experience clinical depression- this is known as co-morbidity (having two disorders together). This depression probably involves disruption to action of serotonin. This suggests that it could simply be that serotonin activity is disrupted in many people with OCD because they are depressed as well and so serotonin may not be relevant to OCD symptoms.

Question 82

What are two types of drugs used to treat OCD?

Answer 82

1. Anti-depressants 2. Anti-anxiety drugs.

Question 83

State the three types of antidepressant drugs used to treat OCD.

Answer 83

1. Selective serotonin re-uptake inhibitors (SSRIs)
2. Tricyclics
3. Serotonin-noradrenaline reuptake inhibitors (SNRIs).

Question 84

Explain how SSRIs treat depression

Answer 84

They inhibit the re-absorption of serotonin in the pre-synaptic neuron, increasing the concentration of serotonin at the synapse. This increase in serotonin reduces anxiety and thus obsessive/irrational thoughts.

Question 85

Explain how SNRIs treat OCD.

Answer 85

They block the transporter mechanism that re-absorbs both serotonin and noradrenaline.

Question 86

How do anti-anxiety drugs work? (Benzodiazepine)

Answer 86

They reduce anxiety by slowing down the activity of the CNS by enhancing the activity of the neurotransmitter GABA. GABA has a quieting effect which redues anxiety

Question 87

2 Strengths (1 counter) of biological approach to treating OCD.

Answer 87

Research support for effectiveness:
Soomro et al. (2009): Reviewed 17 studies comparing SSRIs to placebos. Found that SSRIs are more effective than placebos in reducing symptoms of OCD up to 3 months after treatment. Symptoms reduced by about 70%
COUNTER - Not the most effective form of treatment. Skapinakis (2016) found CBT more effective than SSRIs in treating OCD.

Drug therapies are cost-effective and non-disruptive:
Drug therapies require little input from the user in terms of effort and time. In contrast, therapies such as CBT require the patient to attend regular meetings and put considerable thought into tackling their problems.
Also drug therapies are cheaper for the health service because they require little monitoring and cost much less than psychological treatments

Question 88

3 Limitations of the biological approach to treating OCD

Answer 88

1. Side effects – nausea, headaches, hallucinations, aggressiveness. These side effects limit effectiveness as people may stop taking the medication due to these extraneous effects.
2. Not a lasting cure – symptoms return when patient stops taking medication. Maina et al (2001) found that patients relapse within a few weeks if medication is stopped.
3. Publication bias: There is evidence of a publication bias towards studies that show a positive outcome of antidepressant treatment, –> exaggerating its benefits. Drug companies have a strong interest in the continuing success of psychotherapeutic drugs and much of the research is funded by these companies.