Psychopathology

Question 1

4 Definitions Of Abnormality?

Answer 1

Deviation from social norms,
Failure to function adequately,
Statistical infrequency,
Deviation from ideal mental health.

Question 2

Deviation From Social Norms?

Answer 2

Social norm is an unwritten rule about what is acceptable in a society. A person is seen as abnormal if their thinking or behaviour violates these social norms, for example, walking around naked in London. Social norms differ between countries. For example, walking around naked in a remote African tribe would be normal.

Question 3

Deviation From Social Norms Evaluation?

Answer 3

Cultural Relativism- social norms differ between cultures,
No global standard for abnormal behaviour,

Hindsight Bias- social norms change over time, e.g. homosexuality is now acceptable,
Diagnosis from hindsight bias may have been given as a form of social control over minority groups,

Degree- deviations from social norms are mediated on a scale of severity, e.g. deviating from social norms once may be fine but persistent repetition could be evidence of abnormality,

Context- e.g. walking topless on a beach is considered normal but wearing the same attire for the office may be abnormal,
Fails to offer a complete explanation on its own as it is related to degree and context.

Question 4

Failure To Function Adequately?

Answer 4

A person is considered abnormal if they are unable to cope with the demands of everyday life and live independently in society. Furthermore, for a person to be classified as ‘abnormal’, their behaviour should cause distress or discomfort to themselves or others around them.

For example, someone suffering from depression may struggle to get out of bed and go to work. This behaviour would be considered abnormal because the individual is unable to cope with demands of daily life, which causes distress.

Question 5

Failure To Function Adequately Evaluation?

Answer 5

Individual Differences (Weakness) - two people suffering from mental illness will differ. One sufferer may be able to cope with everyday life, however, the other suffer may not. This would result in different diagnosis even though the sufferers both have the same mental illness.

Personal Experiences (Strength) - failure to function takes the sufferers thoughts and feelings into considerations,
This makes the definition useful as it involves the personal viewpoint of the sufferer, helping to diagnosis correctly.,

Distinguishing From Social Norms (Weakness) - e.g. someone not going to work may be considered as deviation from social norms if the sufferer is choosing to not go. We label this as “failing” ; this does not take personal freedom into consideration. This suggests that the failure to function adequately definition is too deterministic. It is considered that abnormality should be diagnosed by behaviour that is maldaptive.

Question 6

Statistical Infrequency?

Answer 6

A behaviour is seen as abnormal if it is statistically uncommon or not seen often in society. Abnormality can therefore be determined by looking at the distribution of a particular behaviour within a society.

For example, the average IQ is 100, 65% of population have an IQ between 85 -115. An IQ which deviates from this range is seen an uncommon, therefore can be used to determine abnormality.

(Not in essay - a normal distribution curve can be used to represent the this).

Question 7

Statistical Infrequency Evaluation?

Answer 7

Misdiagnosis (Weakness) - shouldn’t be used in isolation to define abnormality as high IQ’s are desirable but statistically uncommon. 10% of population will experience depression, making this behaviour “normal”, so depression cannot be defined abnormal?,

Labelling (Weakness) - labelling an individual as abnormal can be unhelpful, especially when someone has a low IQ, as it may lead to a poor self-image or distress the individual further. This can lead to more distress than the condition itself,

Desirable Traits (Weakness) - some traits (such as high IQ) is celebrated but may be unusual whilst some traits (such as depression) are unusual and not desirable. Therefore, abnormality can only be defined when the trait is both infrequency and undesirable. Statistical infrequency cannot be used solely to define abnormality.

Question 8

Deviation From Ideal Mental Health?

Answer 8

Jahoda suggested that abnormal behaviour should be defined by the absence of ideal characteristics used to define ideal mental health,

There are 6 principles of ideal mental health;- Having a positive view of yourself with strong sense of identity,

• Being capable of personal growth and self-actualisation,
• Being independent of others (autonomous) and self-regulating,
• Having am accurate view of reality,
• Being able time integrate and resist stress,
• Being able to master your environment (love, friendship, work and leisure time).

If an individual does not demonstrate one of the criteria, they can be classified as abnormal.

Question 9

Deviation From Ideal Mental Health Evaluation?

Answer 9

Weakness- unrealistic criteria. There are times when everyone will experience stress and negativity (grief), this would classify them as abnormal. How many of these criteria must be absent for abnormality?,

Strength- takes a positive and holistic stance. Definition focuses on only positive and desirable characteristics. Also, the definition considers the whole person. The definition covers a broad range of criteria, making it comprehensive,

Weakness- cultural relativism. Some of the criteria could be considered western in origin. E.g. emphasis on personal growth and development could be considered self-centred in other countries. Therefore, it is suggested that the ideal mental health criteria is culture bias because they are considered to be Westernised. It is suggested that different criteria should be used for different cultures.

ISSUES AND DEBATES:
- It takes a nomothetic Approach - everyone is individual so using a idiographic approach could be more useful.

• Ethnocentricity- is another issue with defining abnormality, especially regarding Jahoda’s criteria for ideal mental health. E.g. ‘being independent and self-regulating’ might not be seen as a valued quality.

Question 10

Phobias?

Answer 10

Phobias are catergorised as an anxiety disorder which cause an irrational fear of a particular object or situation,

There are three categories of phobia:

• Simple (specific) phobias,
• Social phobias,
• Agoraphobia.

Question 11

Simple Phobias?

Answer 11

Most common,

A person will fear a specific object in the environment, e.g. arachnophobia,

Common phobias:

• Ophidiophobia; fear of snakes,
• Haematophiobia; fear of blood,
• Aerophobia; fear of flying,
• Hydrophobia; fear of water.

Question 12

Social Phobias?

Answer 12

Imvolve feelings of anxiety in social situations, e.g. when giving a speech,

Sufferers feel like they’re being judged, which leads to inadequacy and apprehension,

Social phobias further split into three categories:
Performance phobias, interaction phobias and generalised phobias.

Question 13

Performance Phobias?

Answer 13

Anxiety when performing in public, e.g. eating in a restaurant.

Question 14

Interaction Phobias?

Answer 14

Anxiety when mixing with others, e.g. answering questions during an interview.

Question 15

Generalised Phobias?

Answer 15

Anxiety when other people are present, e.g. in a large crowd.

Question 16

Agoraphobia?

Answer 16

Fear of open or public spaces and sufferers may experience panic attacks and anxiety which make them feel vulnerable in open spaces,

Can be caused by simple phobias and/or social phobias, e.g. mysophobia (fear of contamination) could lead to fear of public spaces.

Question 17

Behavioural Characteristics Of Agoraphobia?

Answer 17

Can be divided into two characteristics: avoidance and panic,

Avoidance- when a person is presented there phobia, their immediate response is to avoid it,

Panic- When the sufferer cannot avoid their phobia, they will experience high levels of anxiety and fear, resulting in panic,

Sometimes, the fear is so intense, they ‘freeze’ which is part of the ‘fight or flight’ fear response (think they’re dead).

Question 18

Emotional Characteristics Of Agoraphobia?

Answer 18

The key emotional characteristics of phobias are: excessive and unreasonable fear, anxiety and panic,

This excessive emotional response is triggered by the presence or the anticipation of a phobia.

Question 19

Cognitive Characteristics Of Agoraphobia?

Answer 19

Also divided into two characteristics: selective attention and irrational beliefs,

Selective attention- causes a person to become fixated on the object they fear, because of the irrational beliefs they have,

Irrational beliefs- phobia is defined by irrational beliefs, e.g. someone might believe that spiders will kill them even though no spiders in the UK are deadly.

Question 20

Depression?

Answer 20

Mood disorders that are categorised into: unipolar and bipolar disorder,

To be given a diagnosis of depression, sufferers are required to display 5 symptoms every day for 2 weeks.

Question 21

Behavioural Characteristics Of Depression?

Answer 21

Loss of energy,
Sleep disturbance,
Changes in appetite.

Question 22

Emotional Characteristics Of Depression?

Answer 22

Depressed mood or feelings of sadness,
Feelings of worthlessness,
Lack of interest or pleasure in all activities,

Some also experience anger which can be directed at themselves or others,
This can lead to self-harming.

Question 23

Cognitive Characteristics Of Depression?

Answer 23

Diminished ability to concentrate,
Tendency to focus on the negative,
Difficult to pay or maintain attention and are often slower in responding to, or making decisions.

Question 24

OCD?

Answer 24

Anxiety disorder that has two main components: obsessions and compulsions,

Obsessions are reoccurring and persistent thoughts,

Compulsions are repetitive behaviours,

70% of OCD sufferers experience combined obsessions and compilations,

20% experience just obsessions,

10% experience just compulsions.

Question 25

Behavioural Characteristics Of OCD?

Answer 25

Centres on the compulsive behaviour and has two properties,

The compulsions are repetitive in nature and sufferers will often feel compelled to repeat a behaviour,

The compulsions are used to manage or reduce anxiety,

E.g. excessive hand washing is due to a fear of germs.

Question 26

Emotional Characteristics Of OCD?

Answer 26

Mainly characterised by anxiety which is caused by the obsession,

However, some sufferers of OCD will experience depression depression,

Obsessions are persistent and/or forbidden thoughts and ideas which cause high levels of anxiety in OCD sufferers,

OCD can often lead to depression and the anxiety can result in a low mood and loss of pleasure in every day life,

These every day life activities are being interrupted by obsessive thoughts and repeated compulsions.

Question 27

Cognitive Characteristics Characteristics Of OCD?

Answer 27

Obsessive thoughts are the main cognitive feature of OCD,

Examples of recurring thoughts include: fear of contamination (by germs or dirt), fear of safety (leaving doors open), religious fears of retribution for being immoral, perfectionism (fear of not being the best),

For sufferers, these thoughts occur over and over,

Some sufferers adopt cognitive strategies to deal with their obsessions, e.g. sufferers with religious obsessions may pray over and over, to reduce feelings of being immoral,

Sufferers know their obsessions and compulsions are irrational and experience selective attention directed towards the anxiety-generating stimuli (similar to the selective attention found in phobias).

Question 28

Evaluation of Phobias, Depression and OCD?

Answer 28

Ethnocentric Bias -
Because of lack of cross-cultural statistics on these disorders, most of the research and information comes from organisations in western cultures, which inevitable leads to an ethnocentric bias,

Environmental Determinism -
There is an aspect of environmental determinism in that phobias and OCD especially can be seen as learned responses to stress triggers. Phobias and OCD both allow for stress reduction, the first by avoidance and the second by obsessive rituals.

Question 29

Behavioural Approach - AO1?

Answer 29

Mowrer proposed the two-process model to explain how phobias are acquired.

Phobias are aquired through classical conditioning. In this process, a neutral stimulus (e.g. spider) is associated with something we have a natural feared response of (unconditioned stimulus). The unconditioned stimulus becomes a conditioned stimulus through repeated pairing. The conditioned response is now fear and consequently, we develop a phobia.

Watson and Ranyer investigated classical conditioning of a phobia in an 11-month-old child called ‘Little Albert’. Before the experiment, Albert showed no response to a white rat. A metal bar was struck with a hammer behind Alberts head to induce a feared response whenever Albert went to reach for the rat. After the experiment, Albert would cry when shown a white rat, showing a feared response.

Operant conditioning occurs through negative reinforcement (where a behaviour is strengthened because an unpleasant consequence is removed). For example, a person with a phobia of lifts will always take the stairs to avoid their phobia. This avoidance reduces the individual’s feelings of anxiety and so negatively reinforces their behaviour, making the person more likely to repeat this behaviour (avoidance) in the future. This explains maintenance of phobias.

Question 30

Behavioural Approach To Explaining Phobias Evaluation?

Answer 30

Strength - behaviourist approach has been used to develop treatments such as flooding and systematic desensitisation. Successful treatments further support the effectiveness of the behaviourist explanation.

Strength - Furthermore, Watson and Rayner’s reserach evidence of Little Hans supports the behavioural approach. (Weakness of study-) However, this was a case study and therefore, the results are difficult to generalise the finishing to other children or even adults due to the unique nature of the investigation,

Weakness - it ignores the roles of cognitive processes.
Phobias might develop as a result of irrational thinking, not just learning. For example, ‘I am going to be trapped in this lift and suffocate’ is an irrational thought that could lead to a phobia of lifts. The cognitive approach has also led to the development of cognitive behavioural therapy (CBT), a treatment which is said to be more successful that the behaviourist treatments. This suggests that alternative explanations may be stronger than the behavioural approach.

Weakness - Bounton highlighted the fact that evolutionary factors could play a role in phobias, For example, we could be scared of snakes because we are awake they can kill us and we have an innate tendancy to survive. Phobias could be a survival mechanism that have developed from our ancestors. This predisposition to certain phobias is called biological preparedness (Seligman) and casts doubt on the two-process model.

Question 31

Behavioural Treatments?

Answer 31

Two behavioural treatments for phobias:

• Systematic desensitisation,
• Flooding,

Both therapies use the principles of classical conditioning to replace a persons phobia with a new response.

Question 32

Systematic Desensitisation?

Answer 32

Systematic desenses counter-conditioning to unlearn the maladaptive response to a situation/object (the phobia) through electing a new response (relaxation).

There are three critical components to this treatment; fear hierarchy (ranking different phobic situations from least to most terrifying); relaxation training (the teaching of relaxation techniques such as breathing and imagery techniques); and reciprocal inhibition (exposing the patient to their phobia situation, while relaxed).

The patient will gradually move their way up the fear hierarchy until they are completely relaxed at the most feared situation.

Question 33

Systematic Desensitisation Evaluation?

Answer 33

Strength - research evidence that shows the effectiveness of the treatment. McGrath et al found that 75% patients were successfully treated using this treatment. Particularly good when the treatment is used with vivo (coming into contact with fear instead of vitro - just imagining).

Strength - Gilroy et al examined 42 patients with arachnophobia and they were each treated with 45 mins of systematic desensitisation sessions. 33 months later, the patients were more relaxed than a control group (who were only taught relaxation techniques). This shows how this treatment is long term.

Weakness - not effective with all phobias. Patients who have not developed a phobia through classical conditioning (personal experience) are not effectively treated this way. Evolutionary phobias have an innate basis.

Strength - ethical in nature and is often favoured in comparison to flooding. Does not cause the same levels of distress that can occur with flooding. High number of patients continue with systematic desensitisation and not with flooding. More appropriate treatment for patients with learning disabilities or suffer from extreme anxiety..

Question 34

Flooding?

Answer 34

Flooding involves exposing the individual to the phobic stimulus immediately. Intense exposure is done over an extended period of time in a safe and controlled manner. With flooding, a person is unable to avoid (negatively reinforce) their phobia which leads to anxiety levels eventually decreasing.

Avoidance is removed so extinction will soon occur since fear is a time-limited response to a situation which eventually subsides. Exhaustion sets in for the individual; they may begin to feel a sense of calm and relief which creates a new, positive association to the stimulus.

Question 35

Flooding Evaluation?

Answer 35

Strength - cost effective treatment. Ougrin suggests that flooding is equally effective as other treatments (such as cognition therapies and systematic desensitisation) but takes much less time in achieving.

Weakness - highly traumatic for the patients (compare to systematic desensitisation - which is less traumatic).
Elicits a high level of anxiety. Wolpe recalled a case with a patient becoming so anxious that she required hospitalisation. Patients provide consent so it is not unethical but they may not complete the treatment.

Weakness - less effective for other types of phobias such as social phobia and agoraphobia. Some psychologists suggest that social phobias are caused by irrational thinking and not by unpleasant experience (or classical conditioning). (Compare this with weakness of systematic desensitisation - which is also said to be less effective).

Weakness - symptom substitution. One phobia may be successfully removed through counter-conditioning and another phobia may take the place of the last. If symptoms are treated and removed, the underlying cause may remain and simple resurface under a new guise. Research in this area is mixed and heavily disputed by behaviourists.

Question 36

Behavioural Treatments For Phobias: Issues And Debates?

Answer 36

Behavioural explanation for the development of phobias has been criticised for being reductionist and overly simplistic in its reduction of human behaviour to a simple stimulus-response association. It ignores the role of cognition and irrational thinking making it subject to environmental determinism in ignoring the role of individuals free will in the formation of phobias. E.g. not everyone bit by a dog develops a phobia so other processes must be at play,

Nomothetic approach has created universal laws regarding the formation and maintenance of phobias. If we accept individual cognition plays a part, a more idiographic approach may be effective.

Question 37

Cogntive approaches to explaining depression?

Answer 37

Emotional problems are the result of cognitive distortions (irrational thinking),

There are two key cognitive theories which attempt to explain depression:

• Beck’s cognitive triad,
• Ellis’s irrational thinking (ABC model).

Question 38

Becks Cognitive Traid?

Answer 38

Beck suggested that depression is caused by negative self-schemas that maintain the cognitive triad (a negative and irrational view of ourselves, our future and the world around us).

For sufferers of depression, these thoughts occur automatically.
Schemas are ‘packages’ of knowledge, which store information and ideas about ourselves and the world around us. These schemas are developed during childhood and according to Beck, depressed people possess negative self-schemas which may have come from negative experiences, e.g. criticism from parents,

Examples of negative self-schemas are; ineptness schemas (sufferers expect to fail); self-blame schema (sufferers feel responsible for any misfortunes); and self-evaluation schemas (sufferers are constantly reminded of their worthlessness).

Beck found that depressed people are more likely to focus on negative aspects of a situation and ignore the positives, and in turn, this distorts information (cogntive bias). Examples of cognitive biases include; overgeneralizations (e.g. “I’ve failed one of my end-of-unit tests so I’m going to fail all of my AS exams!”); and catastrophizing (e.g. “I’ve failed one end-of-unit test, therefore, I am never going to study at university or get a job!”).

Beck suggested that negative self-schemas and cognitive biases maintain the negative triad (the self, the world and the future). For example, “I will always be a failure” is a negative triad of the future, which is caused by depression.

Question 39

Ellis’s ABC Model?

Answer 39

Ellis explained what is required for ‘good’ mental health in order to explain depression. Ellis described good mental health as the result of rational thinking which allows people to be happy and pain free. He described depression as the result of irrational thinking, which prevents good mental health.

The three stage model shows how irrational thoughts lead to depression.
A - The activating event, in which an event occurs (e.g. you greet a friend in the corridor and they don’t reply).
B - Beliefs, which is the interpretation of the event. This can be rational (e.g. “my friend is busy”) or irrational (e.g. “my friend hates me”).
C - Consequences, which is the outcome of the belief. Rational beliefs lead to healthy emotional outcomes, e.g. “I’ll talk to my friend later”. Irrational beliefs lead to unhealthy outcomes, e.g, “I’ll block my friend on everything and never talk again”.

The interpretation of an event, irrational or rational, influences the outcome. Beck suggested that irrational thinking leads to depression.

Question 40

Cognitive Approach To Explaining Depression Evaluation?

Answer 40

Strength - application to therapy. Cognitive explanations have been used to develop effective treatments for depression. Treatments: Cognitve Behaviroual Therapy (CBT) and Rational Emotive Behaviour Therapy (REBT). These therapies attempt to identify and challenge negative, irrational thoughts.

Strength - Boury et al found that patients with depression were more likely to misinterpret information negatively (cognitive bias) and feel hopeless about their future (cognitive triad). Bates et al gave depressed patients negative automatic through statements to read and found that their symptoms became worse. These findings support different components of Becks theory and the idea of negative thinking.

Weakness - does not explain the origin of irrational thoughts. Research in this area is correlational so psychologists are unable to determine if irrational thoughts cause depression or if depression causes irrational thoughts. Doesn’t take into consideration other factors such as genes and neurotransmitters,

Weakness - there are alternative explanations which suggest that depression is a biological condition. Could be caused by genes and neurotransmitters. Research focused on the role of serotonin has found lower levels in patients with depression. Drug therapies, including SSRIs (Selective Serotonin Reuptake Inhibitors) which increased the level of serotonin, have been effective. Casts doubt on the cognitive explanation as a sole cause of the disorder.

Question 41

Cognitive Treatments For Depression?

Answer 41

Cognitive Behavioural Therapy (CBT) is based on the assumption that faulty thinking causes vulnerability to depression. CBT involves; an initial assessment (where the patient and therapist identify problems); goal setting (the patient and therapist agree on goals and a plan to achieve these); challenging irrational thoughts using Becks Cognitive Therapy or Ellis’s REBT.

Beck’s cognitive therapy involves identifying negative thoughts in relation to themselves, their world and their future (Beck’s negative triad). The patient and therapist then work together to challenge these thoughts, by discussing evidence for and against them. The patient is then asked to test the validity of their negative thoughts.

Ellis developed his ABC model to include D (dispute) and E (effective). During this therapy, irrational thoughts are challenged through a ‘dispute’ argument; the therapist disputes the patient’s irrational beliefs, to replace them with effective (rational) ones. Logical disputes (the logic of the thoughts is questioned, e.g. “does the way you think about that make any sense?”) or empirical disputes (where evidence for the thoughts are asked for, e.g. “what has made you think that way?”) are used.

The patient is given homework to identify their own irrational beliefs and prove them wrong (e.g. someone with social anxiety goes for a drink in a public place).

Question 42

Cognitive Approach To Treating Depression Evaluation?

Answer 42

Strength - research evidence which demonstrates its effectiveness in treating depression. March et al found that CBT was as effective as antidepressants. He researched 327 adolescents with a diagnosis of depression and looked at the effectiveness of CBT, antidepressants and the combination of the two.
After 36 weeks, 81% of the antidepressants group and 81% of the CBT group has significantly improved. However, 86% of the combination of the CBT and antidepressants group improved which shows how this might be more effective.

I+D Strength - Cognitive approach considers both nature and nurture, since maladaptive thinking, according to Beck, is automatic (nature) but can be modified by experience such as undertaking CBT (nurture). Soft determinism is therefore advocated where behaviour is regulated by meditational processes and an individual can dispute their irrational thoughts, with practice,

Weakness - requires motivation. Severe depression may not engage with CBT or attend the sessions. Antidepressants do not require the same level of motivation and might be more effective. CBT might not work without motivation (see my depressed patients lack motivation).

Weakness - criticised for its overemphasis on the role of cognition as the primary cause of depression. Some psychologists have criticised CBT for not taking into account other factors such as social circumstances which might contribute to depression. E.g. person suffering abuse doesn’t need to change their irrational thoughts but needs to change their circumstances. In this situation, CBT would be unaffective,

Weakness - Rosenzweig argued that it is the relationship between the client and the therapist which is the most important in determining the success of a psychological therapy. Simply having someone to talk to may be the critical component in having a positive outcome. Luborsky et al conducted studies which show very little difference between different methods of psychotherapy.

Question 43

Biological Approach To Explaining OCD?

Answer 43

The biological approach attempts to explain OCD using genetic and neural explanations.

Genetic explanations suggest that OCD is inherited from genes which influence the onset of OCD. OCD is a polygenic condition (several genes are involved).

The COMT gene is associated with the production of COMT, which regulates dopamine. One variation of the COMT gene is common in OCD patients and results in higher levels of dopamine.

The SERT gene (5-HTT) affects transport of serotonin. Lower levels of serotonin are associated with OCD. Ozaki et al published results from a study of two unrelated families who both had mutations of the SERT gene and found six out of seven of the family members had OCD.

Neural explanations suggest that abnormal levels of neurotransmitters (serotonin and dopamine) cause OCD. Serotonin regulates mood and lower levels of it are associated with OCD. Piggott et al found that antidepressants (SSRI’s) which increase levels of serotonin are effective in treating patients with OCD. Higher levels of dopamine have also been associated with OCD (compulsive behaviour in particular).

Neural explanations brain structures influence OCD devlopement. The basal ganglia (a cluster of neutrons at the base of the forebrain) is involved in coordination of movement. Patients who suffer head injuries in this region often develop OCD-like symptoms.

The orbitofrontal cortex converts sensory information into thoughts and actions. PET scans found higher activity in the orbital frontal cortex in patients with OCD, resulting in compulsions.

Question 44

Biological Approach To Explaining OCD Evaluation?

Answer 44

Strength - research support seen in family studies. Lewis examined patients with OCD and found 37% of the patients with OCD had parents with OCD. He also found 21% had siblings who suffered from OCD as well. Furthermore, Nestadt et al found that individuals who have a first degree relative with OCD are up to five times more likely to develop the disorder.

Strength - twin studies. Billett et al concluded that monozygotic (MZ) twins has double the risk of developing OCD compared to dizygotic twins (DZ) if one of the twins had the disorder. This shows genetic vunrability for the development of the disorder.

(Weakness with top) - However, the explanation does not look at other factors, such as environmental factors. The biological explanation explains vulnerability to OCD development, but not why OCD actual develops. This could be an interaction of genetic and neural factors with the environment. Therefore, the diathesis-stress model may be a better explanation whereby genetic vulnerability is inherited and triggered by a stressors in the environment.

Weakness - issue with understand neural mechanisms involved in OCD. Evidence suggests certain neural systems do not function normally in patients suffering from OCD (such as bagal ganglia and orbital-frontal cortex). Other areas of the brain are also involved which means that there is not a consistently effected part of the brain which has a role in OCD. Evidence, therefore, cannot be concluded because there is no cause and effect relationship. It is also difficult to determine weather biological abnormalities are a cause of OCD or the result of OCD.

Weakness - credible alternative explanations. The two-process model proposed by behaviourists. This is where classical condition can associate a phobia of dirt which can lead to OCD. This is maintained through operant conditioning - negative reinforcement and avoidance.
Albucber et al said that the two-process model could create an obsession which is linked to the development of the compulsion. Evidence to support this is found in Albucber’s successful behavioural treatments for OCD where symptoms are improved for 60-90% of adults.

Question 45

Biological treatments for OCD - AO1?

Answer 45

Biological treatments restore chemical imbalances in the brain that the biological explanation suggests is causing OCD.

Low levels of serotonin are associated with OCD. Choy and Schneier suggest a type of antidepressent, called selective serotonin reuptake inhibtors (SSRI’s), improve mood in OCD patients.

When serotonin is released from the pre-synaptic cell into the synapse, it travels to the receptor sites on the post-synaptic neuron. If serotonin is not absorbed into the post-synaptic neuron, it is reabsorbed into the pre-synapse. SSRI’s work because they prevent serotonin from being reabsorbed into the sending cell. This increases levels of serotonin in the synapse, which increases the concentration of serotonin at the receptor sites and intensifyes the stimulation on the receiving nerve.

Benzodiazepines (BZ’s) are a range of anti-anxiety drugs that include names such as Valium and Diazepam. BZ’s work by enhancing the action of the neurotransmitter, GABA (which tells neurons in the brain to ‘slow down’ and ‘stop firing’). Therefore, BZ’s generally reduce anxiety, which is experienced as a result of the obsessive thoughts common in OCD.

GABA inhibits GABA receptor sites at the synapse, causing an influx of chloride into the neuron. The chloride ions make it more difficult for the receiving neuron to be stimulated by further neurotransmitters. This slows the nervous system, making the patient feel more relaxed.

Question 46

Biological treatments for OCD - AO3?

Answer 46

Strength - the treatment is more practical for the sufferer. They are cost effective in comparison to sessions, such as CBT, and the sufferer does not have to be motivated for the SSRI’s to work (which is good for severely depressed individuals).

Strength - research support for their effectiveness. Randomised drug trails compare the effectiveness of SSRI’s and a placebo. Soomro et al conducted research and found that SSRI’s were significantly more effective than placebos across 17 trails. However, the the study’s only examined short term effects.

Weakness - side effects. Evidence suggests that they are effective but some patients experience side effects such as indigestion, erection problems and raised blood pressure. BZ’s are highly addictive, might increase aggression and cause long term memory impairments. BZ’s are recommended for short term treatments.

Weakness - criticism. Drug therapies are criticised for treating symptoms of the disorder and not the cause. Work by increasing levels of serotonin in the brain, which reduces anxiety and alleviates the symptoms of OCD, it does not treat the underlying cause of the OCD. Koran et al suggest that psychological treatments such as CBT are more effective, long term treatments and will avoid relapse.

I+D weakness - too biologically deterministic. This explanation reduces a complex human behaviour to a single gene or brain chemical and so is considered biologically reductionist, e.g. the biological explanation does not consider the role cognitions (thinking) or learning in the development or maintenance of OCD.