psycopathology

Question 1

statistical infrequency

Answer 1

a person’s trait, thinking or behaviour that is seen as abnormal if it statistically uncommon, or not seen very often in society. A normal distribution curve can be used to represent the proportions of population who share a particular characteristic.

Question 2

strengths of statistical infrequency

Answer 2

objective: the mathematical nature of this definition means that it is clear what is defined as abnormal and what is not. there is no opinion involved which means there is no bias

useful overview: this definition looks at the whole picture, taking all the population into account so it can give a useful insight into the whole picture of a particular characteristic

Question 3

weakness of statistical infreuquency

Answer 3

the issue of misdiagnosis: certain behaviours are statistically common; for example, approximately 10% of the population will experience depression at some point making this behaviour ‘normal’ technically. On the other hand, certain behaviours - for example, high IQ - are statistically uncommon and therefore considered abnormal despite their desirable nature. this is therefore a serious drawback of adopting the statistical infrequency definition in explaining abnormality and perhaps should not be used in isolating when making a diagnosis.

labelling an individual as abnormal could be unhelpful: this is especially true for someone with a low IQ since they will be able to live quite happily without distress to themselves or others. Such a label may contribute to a poor self-image or become an invitation for discrimination. This means that being labelled as statistically infrequent could cause the person more distress than the condition itself.

some statistically infrequent behaviours labelled as abnormal could, in fact, be desirable traits: for example, having a very high IQ would be considered unusual, yet this characteristic could be hugely celebrated. Conversely, depression is known to be experienced by many people at some point in their lives and as such is considered common, but not desirable. Statistical infrequency as a definition of abnormality therefore needs to identify those behaviours which are both infrequent and undesirable to avoid this pitiful.

Question 4

deviation from social norms

Answer 4

defines abnormality in terms of social norms and expected behaviours within society and certain situations.
within society there are standards of acceptable behaviour which are set by the social group and everyone within the social group is expected to follow these behaviour.
social norms can be explicit written rules or even laws. For example, the respect of human life and property which belong to others. These are norms enforced by a legal system within the UK, however other social norms are unwritten but still generally accepted as normal behaviour.

Question 5

strengths of deviation from social norms

Answer 5

flexibility: it is flexible dependent on situation and age. For example a social norm is to wear full clothing whilst out shopping, but a bikini is acceptable on a beach. It is also socially acceptable to drink milk out of a bottle with a teat if you are a baby, but not as an adult

Question 6

weakness of deviation from social norms

Answer 6

cultural differences: there is a lot of variation cross culturally. this can be a weakness as it is not always clear what is abnormal and what is not in cultures.

changes over time: social norms are subject to change over time and lacks temporal validity. behaviour that is socially acceptable now may be socially deviant later and visa versa. for example, today homosexuality is seen as socially acceptable however, based on this definition it was seen as socially deviant and classed as a mental disorder in the past.

Question 7

failure to function adequately

Answer 7

defining abnormality on the basis of failure to function adequately takes to account a persons ability to cope with daily demands for life. when someone’s behaviour suggests they are unable to meet these demands then they may diagnosed as abnormal.

Rosenhan et al suggested certain features which would help in the diagnosis of abnormality based on them failing to function adequately.
these include: observer discomfort, irrationality, maladaptive behaviours, unpredictability, personal distress.

Question 8

strengths of failure to function adequately

Answer 8

behaviour is observable: failure to function adequately can be seen by others around the individual because they may not get out of bed on a morning, or be able to hold a job down. this means that problems can be picked up by others and if the individual is incapable of making a decision or helping themselves others can intervene

consideration of how individual feels: the definition is focused on the individual and how they are managing in everyday life, so if someone feels as though they are struggling they will be deemed abnormal and get help

Question 9

weaknesses of failure to function adequately

Answer 9

abnormality does not always stop the person functioning: some abnormal behaviour may be missed. people may appear fine to others as they fit into society and have jobs and homes, but they may have distorted thinking which is causing them inner distress that they can hide.

everyday life varies: the ability to cope with everyday life depends on what is seen as normal everyday life. this varies within and across cultures. for example, some body clocks mean that individuals do not rise until midday. however, this may seen as abnormal to different individuals. this means that the definition is clear.

Question 10

deviation from ideal mental health

Answer 10

deviation from ideal mental health assesses abnormality by assessing mental health in the same way physical health would be assessed. this definition looks for signs that suggests deviation away from normal functioning which would be classed as abnormal.

Jahoda provides a set of characteristics which are defined as normal and deviation from these traits which would define a person as abnormal.

characteristics: positive attitudes towards one’s self, self actualisation, autonomy, integration, accurate perception on reality, understanding how the world works,

Question 11

strengths of deviation from ideal mental health

Answer 11

focuses on the positives of mental health - it covers a wide range of criteria and so can also be seen as comprehensive. most mental health problems can be identified using this definition and therefore it has good validity

Question 12

weakness of deviation from ideal mental health

Answer 12

unclear how many of these criteria we would need to deviate from, and to what degree, in order to be classified as abnormal - if we need to meet all of the criteria all of the time, then the definition is unrealistic and most of us would be considered abnormal. It can therefore be argued that Jahoda’s criteria are too strict, and represent and ideal, rather than an achievable reality.
culturally relative - this criteria stems from Western, individualistic cultural ideas. This makes it inappropriate to use in cultures which do not share these ideals. For example, autonomy and potential for personal growth would not be viewed as features of ideal mental health in collectivist cultures which place an emphasis on responsibility to the family and community.

Question 12

failure to function adequately

Answer 12

defining abnormality on the basis of failure to function adequately takes to account a persons ability to cope with the daily demands of life. When someone’s behaviour suggests they are unable to meet these demands then they may be diagnosed as abnormal.
Ronsenhan et al suggested certain features which would help in the diagnosis of abnormality based on them failing to function adequately. these include:

Question 13

strengths of failure to function adequately

Answer 13

behaviour is observable - failure to function adequately can be seen by others around the individual because they may not get out of bed on a morning, or be able to hold a job down. This means that problems can be picked up by others and if the individual is incapable of making a decision or helping themselves others can intervene.

consideration of how the individual feels - the definition is focused on the individual and how they are managing in everyday life from their perspective, so if someone feels as though they are struggling they will be deemed abnormal and get help

Question 14

weakness of failure to function adequately

Answer 14

abnormality does not always stop the person functioning: the focus on how someone is coping of this definition may mean that some abnormal behaviour is missed. People may appear fine to others as they fit into society and have jobs and homes, but they may have distorted thinking which is causing them inner distress that they can hide.

everyday life varies: the ability to cope with everyday life depends on what is seen as normal everyday life. This varies within and across cultures. For example, some body clocks mean that individuals do not rise until midday. However, this may be seen as abnormal to different individuals. This means that the definition is unclear.

Question 15

deviation from ideal mental health

Answer 15

deviation from ideal mental health assesses abnormality by assessing mental health in the same way physical health would be assessed. This definition looks for signs that suggest there is an absence of wellbeing and deviation away from normal functioning which would be classed as abnormal.

Jahoda (1958) provides a set of characteristics which are defined as normal and deviation from these traits which would define a person as abnormal eg. high levels of self esteem, self actualisation, autonomy

Question 16

strengths of deviation from ideal mental health

Answer 16

focuses on the positives of mental health - It covers a wide range of criteria and so can also be seen as comprehensive criteria of mental health as it is very specific and is therefore easy for people to pinpoint what is abnormal and what is not. Most mental health problems can be identified using this definition and therefore it has good validity

Question 17

weakness of deviation from ideal mental helath

Answer 17

unclear how many of these criteria we would need to deviate from, and to what degree, in order to be classified as abnormal - if we need to meet all of the criteria all of the time, then the definition is unrealistic and most of us would be considered abnormal. It can therefore be argued that Jahoda’s criteria are too strict, and represent and ideal, rather than an achievable reality.

culturally relative - this criteria stems from Western, individualistic cultural ideas. This makes it inappropriate to use in cultures which do not share these ideals. For example, autonomy and potential for personal growth would not be viewed as features of ideal mental health in collectivist cultures which place an emphasis on responsibility to the family and community.

Question 18

list of clinical characteristics

Answer 18

phobia, OCD and depression

Question 19

what are the types of phobias

Answer 19

specific phobia, social phobia, agoraphobia

Question 20

specific phobia definition

Answer 20

This is where a person fears a specific object in the environment, for example arachnophobia, the fear of spiders. Simple phobias are further divided into four categories: animal phobias, injury phobias, situational phobias and natural phobias.

Question 21

social phobia definition

Answer 21

social phobias involve feelings of anxiety in social situations, for example, when giving a speech in public. Sufferers feel like they are being judged, which leads to feelings of inadequacy and apprehension. Social phobias are further divided into three categories: performance phobias, interaction phobias and generalised phobias.

Question 22

agoraphobia definition

Answer 22

agoraphobia is a fear of open or public spaces and sufferers may experience panic attacks and anxiety, which make them feel vulnerable in open spaces. agoraphobia can be caused by simple and/ or social phobias. For example, the simple phobia of the fear of contamination could lead to fear of public spaces

Question 23

behavioural characteristics of phobias

Answer 23

the behavioural characteristics of phobias can be divided into two characteristics: avoidance and panic.

If a person with a phobia is presented with the object or situation they fear, their immediate response is to avoid it. For example, a person with arachnophobia will avoid being near spiders and people with a social phobia will avoid being in large crowds. The may also panic, causing high levels of stress and anxiety.

Question 24

emotional characteristic of phobia

Answer 24

the key emotional characteristics of a phobia, are excessive and unreasonable fear, anxiety and panic. An excessive emotional response is triggered by the presence, or the anticipation of a specific object or situation

Question 25

cognitive characteristic of phobia

Answer 25

the cognitive characteristics of phobias are also divided into two characteristics: selective attention and irrational beliefs

If a person with a phobia is presented with an object or situation they fear, they will find it difficult to direct their attention elsewhere. Therefore a persons selective attention will cause them to become fixated on the object they fear, because of their irrational beliefs about the danger posed.

Furthermore, a person’s phobia is defined by their irrational thinking towards the object or situation. For example, a person with arachnophobia may believe that all spiders are dangerous and deadly, despite the fact that no spiders in the UK are actually deadly

Question 26

behavioural characteristic of depression

Answer 26

• reduction in energy
• disturbances with their sleeping pattern
• insomnia
• changes in appetite,

Question 27

emotional characteristic of depression

Answer 27

• depressed mood
• feeling of worthlessness
• lack of interest or pleasures in all activities
• anger
• self harming

Question 28

cognitive characteristics of depression

Answer 28

• diminished ability to concentrate and a tendency to focus on the negative
• difficult to pay or maintain attention

Question 29

behavioural characteristic of OCD

Answer 29

• compulsions are repetitive
  compulsions are used to manage or reduce anxiety. For example, the excessive hand washing is caused by an excessive fear of germs and bacteria and is therefore a direct response to the obsession

Question 30

emotional characteristic of OCD

Answer 30

• anxiety
• depression
• obsessions are persistent and are forbidden ideas and thoughts
• result in low mood and loss of pleasure in everyday activities

Question 31

cognitive characteristic off OCD

Answer 31

• obsessive thoughts
• examples of recurring thoughts include: fear of contamination, by dirt or games; fear of safety, religious fears of retribution for being immoral

Question 32

what is the behavioural approach to OCD

Answer 32

classical conditioning and operant conditioning

Question 33

phobia (AO1) definition

Answer 33

phobias are a type of anxiety disorder. Phobias are characterized by a market and persistent fear that is excessive or unreasonable, cued by the presence or anticipation

Question 34

what is the two process model approach

Answer 34

classical conditioning and operant conditioning

Question 35

classical conditioning (AO1) defnition

Answer 35

It is learning through association and was discovered by Pavlov, a Russian psychologist. In simple terms, two stimuli are linked together to produce a new learned response in a person or animal. The process of classical conditioning can explain how we learn to associate something we do not fear - neutral stimulus (for example a life), with something which triggers a fear response - unconditioned stimulus (for example being trapped). After an association has formed, the now conditioned stimulus (lift) causes a response of fear which is the conditioned response and consequently, develop a phobia.

Question 36

operant conditioning (AO1) definition

Answer 36

It is learning through the consequences of behaviour. Reinforcement makes the behaviour more likely to occur, while punishment makes it less likely to occur. For example. behaviour can be strengthened by the addition of something such as praise or a direct reward. Or behaviour is strengthened by the consequence of the stopping or avoiding of a negative condition. A person with a phobia would therefore avoid the stimulus to reduce fear. This reduces the avoidance behaviour and thus maintains the phobia.

Question 37

positive reinforcement definition

Answer 37

the reward is desirable consequences, feeling relaxed, confident, gaining approval of friends

Question 38

negative reinforcement definition

Answer 38

the reward is the removal on an unpleasant consequence, relief from withdrawal symptoms

Question 39

strength of two process model explaining phobias (AO3)

Answer 39

the behavioural approach to psychopathology is scientific and its key principles can be measured in an objective way. For example, the phobia developed by Little Albert was clear for all to see and measure, variables could be manipulated and controlled to ensure that Little Albert’s phobia development was as a result of neutral stimulus being associated with an unconditioned response. This is positive because it allows concepts such as classical conditioning to be demonstrated scientifically and has resulted in a large amount of empirical support for behavioural therapies.

Question 40

weakness of two process model explaining phobias

Answer 40

reductionist - For example, the two process model suggests that complex mental disorders such as phobias are caused solely by our experience of association, rewards and punishments. This is a problem as it can therefore be seen as too simplistic as it ignores the role of other factors such as childhood experiences, everyday stress and the role of biology such as genes in the development of abnormality.

deterministic - For example, the two process model suggests that when an individual experiences a traumatic event and uses this event to draw an association between a neutral stimulus and an unconditioned response they will go on and develop a phobia. This is a weakness because this theory of phobias suggests that we are programmed by our environment experiences and ignores individual free will.

Question 41

outline and evaluate the two process model

Answer 41

AO1: definition of phobias. the two process model suggests that phobias are initiated through classical and operant conditioning.
AO3: strength - it is scientific and objective , little Albert

weakness - reductionist, it is too simplistic as it ignores other factors
determinist - ignores individual free will

Question 42

what are the two types of treatment of phobias

Answer 42

systematic desensitisation, flooding

Question 43

systematic desensitisation (AO1) definition

Answer 43

This uses reverse counter conditioning to unlearn the maladaptive response to a situation or object, by eliciting another response.

there are three critical components to systematic desensitisation:

• fear hierarchy
• relaxation training
• reciprocal inhibition

Firstly, the client and therapist work together to develop a fear hierarchy, where they rank the phobic situation from least to most terrifying.

Thereafter, an individual is taught relaxation techniques, for example, breathing techniques, muscle relaxation strategies, or mental imagery techniques. Thereafter, an individual is taught relaxation techniques, such as breathing techniques. The final component involves exposing the patient to their phobic situation while relaxed. According to systematic desensitisation, two emotional states cannot exist at the same time; a theory known as reciprocal inhibition. Therefore, a person is unable to be anxious and relaxed at the same time and the relaxation should overtake the fear. The patient starts at the bottom of the fear hierarchy and when the patient can remain relaxed in the presence of the least feared stimulus, they gradually progress to the next level until they are completely relaxed. At this point systematic desensitisation is successful and a new response to the stimulus has been learnt.

Question 44

strength (AO3) of systematic desensitisation

Answer 44

research evidence that demonstrates the effectiveness of this treatment for phobias - McGareth et al. (1990) found that 75% of patients with phobias were successfully treated using systematic desensitisation. This was particularly true when using in vivo techniques in which the patient came into direct contact with the feared stimulus rather than simply imagining. This shows that systematic desensitisation is effective when treating specific phobias, especially when using in vivo techniques .

Question 45

weakness (AO3) of systematic desensitisation

Answer 45

not effective in treating all phobias - Patients with phobias which have not developed through a personal experience (classical conditioning), such as fear of snakes, are not effectively treated using systematic desensitisation. Some psychologists believe that certain phobias have an evolutionary survival benefit and are not the result of learning. This highlights a limitation of systematic desensitisation, which is ineffective in treating evolutionary phobias which have an innate basis.

Question 46

flooding (AO1) definition

Answer 46

Flooding is a behavioural therapy which, rather than exposing a person to their phobia stimulus gradually, exposes the individual to the anxiety-inducing stimulus immediately. For example, a person with a phobia of dogs would be placed in a room with a dog and asked to stroke the dog straight away. This intense is done over an extended period of time in a safe and controlled manner.

With flooding, a person is unable to avoid their phobia and through continuous exposure, anxiety levels eventually decrease. Extinction will soon occur since fear is a time-limited response to a situation which eventually subsides. As 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 47

strength (AO3) of flooding

Answer 47

it is a cost-effective treatment for phobias - research has suggested that flooding is equally effective to other treatments, including systematic desensitisation and cognitive therapies, but takes much less time in achieving these positive results. This is a strength of the treatment because patients cure their phobias more quickly and it is therefore more cost-effective for health service providers who do not have to fund longer options

Question 48

weakness (AO3) of flooding

Answer 48

highly traumatic for patients - it purposefully elicits a high level of anxiety. Wolpe recalled a case with a patient becoming so intensely anxious that she required hospitalisation. Although it is not unethical as patients provide fully informed consent, many do not complete their treatment because the experience is too stressful. Therefore, initiating flooding treatment is sometimes a waste of time and money if patients do not engage the complete the full course of their treatment.

Question 49

outline and evaluate the treatment for phobia

Answer 49

for the treatment of phobias, systematic desensitisation and flooding is used.

AO1: systematic desensitisation - fear of hierarchy, relaxation technique, reciprocal inhibition
AO3: strength - research evidence
weakness - not effective in treating all phobias

AO1: flooding - immediately exposing a person to their phobia
AO3: strength - cost effective
weakness - highly traumatic

Question 50

what are the cognitive approach to explaining depression

Answer 50

the theories are:
- becks negative schema
- becks negative triad
- ellis’ ABC model
- Ellis’ masturbatory thinking

Question 51

Becks negative schema (AO1)

Answer 51

Beck’s negative schema is that depressed people have acquired negative schema during childhood and therefore have a tendency to be negative around the world. This is caused by a variety of factors: parental or peer rejection, criticism by teachers. Negative schemas lead to negative cognitive biases in thinking. Examples of cognitive biases that may be used by people with depression are minimisation, magnification, selective abstraction, all or nothing thinking.

Question 52

Beck’s negative triad (AO1)

Answer 52

Beck claimed that depression is caused by negative self-schemas maintaining the cognitive triad: a negative and irrational view of ourselves, our future and the world. These are the three key aspects of a persons life which leads to depression. Beck proposed that depressed people tend to selectively attend to the negative aspects of a situation and ignore the positive aspects.

Question 53

Elli’s ABC model (AO1)

Answer 53

Ellis suggests that good mental health is the result of rational thinking which allows people to be happy and pain free, whereas depression is the result of irrational thinking, which prevents us from being happy and pain free. Ellis proposed the ABC three stage model, to explain how irrational thoughts could lead to depression. A stands for activating event. an event that happens (eg. your friend ignores you in the corridor). B stands for beliefs. Your belief/ interpretation of the event (eg. rational belief your friend is busy, irrational belief your friend doesn’t like you anymore’. C stands for consequences. rational belief leads to healthy unemotional outcomes, whereas irrational beliefs lead to unhealthy emotional outcomes. (eg. rational, you try and talk it out with your friend, irrational you ignore you friend and remove their number).

Question 54

Ellis masturbatory thinking (AO1)

Answer 54

Ellis suggests that the source of irrational beliefs lies in masturbatory thinking that certain ideas or assumptions must be true in order for an individual to be happy. Ellis identified the three most important irrational beliefs: - i must be approved of or accepted by the people i find important, i must do well or i am worthless, the world must give me happiness or i will die. An individual who holds such expectations is bound to be disappointed and is at risk of becoming depression.

Question 55

strength of cognitive approaches to explaining depression

Answer 55

its application to therapy - cognitive explanations have been used to develop effective treatments for depression, including Cognitive Behavioural Therapy (CBT), and Rational Emotive Behaviour therapy (REBT) which was developed from Ellis’s ABC model. These therapies attempt to identify and challenge negative, irrational thoughts and have been successfully used to treat people with depression, providing further support to the cognitive explanation of depression.

Grazioli and Terry - Beck’s cognitive triad is backed by Grazioli and Terry, who looked at pregnant women, for cognitive vulnerability and depression, before and after birth. They found a positive correlation between an increased vulnerability and the likelihood of acquiring
depression. Thus, supporting the link between faulty cognition and depression, which is in line with
Beck’s predictions, increasing the validity of the study.

Question 56

weakness of cognitive approach to explaining depression

Answer 56

it does not explain the irrational thoughts - since most of the research in this area is correlational, psychologists are unable to determine if negative, irrational thoughts cause depression, or whether a person’s depression leads to a negative mindset. Consequently, it is possible that other factors, for example genes and neurotransmitters, are the cause of depression and the negative, irrational thoughts and the symptom of depression. Furthermore, some irrational thoughts may be realistic.

suggests that it is the patient who is responsible for having depression - this may mean that the therapist overlooks situational factors that were key contributors, leading to a lack of treatment of the cause of disorder, focusing on the symptoms only. This results in limited effects in the long term. Thus, the therapy may not be effective in all cases of depression, leaving the patients without an explanation or cure.

Question 57

outline and evaluate the cognitive approach to explaining depression

Answer 57

AO1: Becks cognitive triad, Becks negative triad. Ellis ABCD model, masturbatory thinking

AO3: strength - application to therapy, research support (Grazioli and Terry), weakness - does not explain the irrational thoughts, suggests that it is the patient who is responsible for having depression

Question 58

CBT (AO1) definition

Answer 58

CBT (cognitive behavioural therapy) is a form of talking therapy which can be used to treat people with a wide range of mental heath problems. It involves both cognitive and behavioural elements. The cognitive element aims to identify irrational and negative thoughts, which leads to depression. The aim is to replace these negative thoughts with more positive ones. The behavioural element of CBT encourages patients to test their beliefs through behavioural experiments and homework.

Question 59

Beck’s cognitive therapy for depression (AO1)

Answer 59

If a therapist is using Beck’s cognitive therapy, they will help a patient to identify negative thoughts in relation to themselves, their world and their future, using Beck’s negative triad. The patient and therapist will then work together to challenge these irrational thoughts, by discussing evidence for and against them. The patient will be the scientist and will be encouraged to test the validity of their negative thoughts and may be set homework, to challenge and test their negative thoughts.

Question 60

Rational emotive behaviour therapy - Ellis (AO1)

Answer 60

REBT is a type of therapy introduced by Albert Ellis in the 1950s. It is an approach that helps you identify beliefs and negative thought patterns that may lead to emotional or behavioural issues.

REBT focuses mostly on the present to help someone understand how their perceptions of situations can cause emotional distress, which in turn, leads to unhealthy actions and behaviours that interfere with their life goals. Once identified and understood and changed to more rational thoughts, this can help people to develop better relationships and approaches to situations and events.

Therapist and client work together to identify situations that cause negative reactions. Therapist then challenges these irrational thoughts in intense debates/vigorous argument giving them a more realistic perspective.

REBT extends the ABC model to an ABCDE model:

A - activating event

B - belief

C - consequence

D - dispute

E - effect

Question 61

strength of CBT (treating depression)

Answer 61

strength
research evidence - Research by March et al. (2007) found that CBT was as effective as antidepressants, in treating depression. The researchers examined 327 adolescents with a diagnosis of depression and looked at the effectiveness of CBT, antidepressants and a combination of CBT plus antidepressants. After 36 weeks, 81% of the antidepressant group and 81% of the CBT group had significantly improved, demonstrating the effectiveness of CBT in treating depression. However, 86% of the CBT plus antidepressant group had significantly improved, suggesting that a combination of both treatments may be mor effective.

effective - research suggests that REBT is effective at reducing irrational beliefs and changing behaviour. There is a wide range of applications for REBT. In practice, REBT has been applied to various domains such as clinical psychology, education, organisational settings, and counselling. Since it is focused on education and taking action, it can be effective for a variety of situations and mental health conditions. Many studies have shown the positive effects of this therapy, supporting REBT as a validated method to change negative responses and leading people to a happier life.

Question 62

weakness of CBT (treating depression)

Answer 62

requires motivation - patients with severe depression may not engage with CBT, or even attend the sessions and therefore this treatment will be ineffective in treating those patients. Alternate treatments, for example antidepressants, do not require the same level of motivation and maybe more effective in these cases. This poses a problem from CBT, as CBT cannot be used as the sole treatment for severely depressed patients.

criticised for its overemphasis on the role of cognitions - some psychologists have criticised CBT, as it suggests that a person’s irrational thinking is the primary cause of their depression and CBT does not take into account other factors. CBT therefore ignores other factors or circumstances that might contribute to a person’s depressions. For example, a patient who is suffering from domestic violence or abuse, does not need to change their negative/irrational beliefs, but in fact needs to change their circumstances. Therefore, CBT would be ineffective in treating these patients until their circumstances have changed.

Question 63

explanations to OCD

genetic explanations (AO1)

Answer 63

genetic explanations have focused on identifying specific candidate genes which are implicated in OCD. It is believed that OCD is polygenic conditions, which means that several genes are involved. Taylor (2003) suggests that as many as 230 genes may be involved in the condition and perhaps different genetic variations contribute to the different types of OCD. Two examples of genes that have been linked to OCD are the COMT gene and SERT gene.

COMT gene

The COMT gene is associated with the production of COMT, which regulates the neurotransmitter dopamine. Although all genes come in different forms, one variation of the COMT gene results in higher levels of dopamine and this variation is more common in patients with OCD, compared to people without OCD.

SERT gene

Secondly, the SERT gene is linked to serotonin and affects the transport of the neurotransmitter. Transportation issues cause lower levels of serotonin to be active within the brain and are associated with OCD. Ozaki et al (2003) published results from a study of two unrelated families who both had mutations of the SERT gene.

Question 64

what are the two main genes that could possible cause OCD

Answer 64

COMT gene and SERT gene

Question 65

strength of genetic explanations (AO3)

Answer 65

research support seen in family studies - Nestadt et al proposes that individuals who have a first-degree relative with OCD are up to five times more likely to develop the disorder over their lifetime compared to members of the general population without this genetic link. Research from family studies like this provides support for a genetic explanation for OCD, although it does not rule out other factors playing a role.

Question 66

weakness of genetic explanations (AO3)

Answer 66

There are too many candidate genes for OCD - potentially hundreds. This means that finding a definitive genetic cause is very unlikely, reducing the usefulness of this explanation.

Genes alone do not determine who will develop OCD - they only create vulnerability. Thus, they are not a direct cause as other factors must trigger the disorder. Evidence for this is that the concordance rates are not 100%, which shows that OCD is due to an interaction of genetic and other factors.

Question 67

explanations to OCD

neural explanations (AO1)

Answer 67

It is believed that several regions in the frontal lobes of the brain have abnormal brain circuits in patients with OCD. Two brain regions implicated specifically in OCD are: the basal ganglia and orbitofrontal cortex.

basal ganglia

a cluster of neurons at the base of the forebrain, which is involved in multiple processes, including the coordination of movement. Patients who suffer head injuries in the region often develop OCD-like symptoms.

orbitofrontal cortex

a region which converts sensory information into thoughts and actions. PET scans have found higher activity in the orbitofrontal cortex in patients with OCD when, for example, a patient is asked to hold a dirty item with a potential germ hazard. One suggestion is that the heightened activity in the orbitofrontal cortex increases the conversion of sensory information to actions which results in compulsions.

Question 68

strength of neural explanations (AO3)

Answer 68

supporting evidence from antidepressant studies - shows that increasing serotonin levels reduces OCD symptoms, suggesting serotonin has a role in the development of OCD.

Question 69

weakness of neural explanations (AO3)

Answer 69

lack of understanding - misunderstanding of what neural mechanisms are involved, making this an incomplete explanation

reductionist - it is too simplistic to suggest that the singular cause for OCD is due to nature (abnormal genetics or neurotransmitters), it ignores the role of nurture in the development of OCD.

Question 70

treating OCD (AO1)

Answer 70

biological treatments for OCD aim to restore biological imbalances. drug treatments are based on the assumption that chemical imbalances are the main cause of the problem. Two types of drugs are used for the treatment of OCD (1) anti-depressants (2) anti-anxiety drugs

SSRIs (selective serotonin reuptake inhibitors)

When serotonin is released from thepre-synapticcell into thesynapse, it travels to the receptor sites on thepost-synaptic neuron. Serotonin which is not absorbed into the post-synaptic neuron is reabsorbed into the sending cell (thepre-synaptic neuron). SSRIs increase the level of serotonin available in the synapse by preventing it from being reabsorbed into the sending cell. This increases level of serotonin in the synapse and results in more serotonin being received by the receiving cell (post-synaptic neuron).
Anti-depressants (like anti-anxiety drugs) improve mood and reduce anxiety which is experienced by patients with OCD.

Tricyclics

Tricyclics block the transporter mechanism that re-absorbs both serotonin and noradrenaline into the pre-synaptic cell after it has been fired. This means that the neurotransmitters are left in the synapse which makes them work for longer. Therefore, if there is more serotonin available in theory the OCD symptoms should be reduced.

Question 71

treating OCD

strengths of anti-depressant drugs (AO3)

Answer 71

drug use is quicker, cheaper and easier than psychological treatments, such as cognitive therapy. They are non-disruptive to a patients life - is not ‘hard work’

drugs are cost effective and non disruptive - cheap in comparison to psychological treatments and unlike psychotherapy, they are non-disruptive to patients lives

Question 72

treating OCD

weaknesses of anti-depressant drugs (AO3)

Answer 72

not always appropriate - although OCD is widely believed to be biological in origin, it is also accepted that OCD can have different causes e.g. cases of OCD where there is no family history and no trauma

drugs can have side effects - a significant minority receive no benefit and/or may suffer side effects: weight gain, dry mouth, sexual dysfunction, and loss of memory. Coming off a drug is a slow process in which the dosage has to be gradually reduced over a period of six months - risk of relapse.

Question 73

anti-anxiety drugs (AO1)

Answer 73

Benzodiazepines are a range of anti-anxiety drugs, which include trade names like Valium and Diazepam. BZs work by enhancing the action of the neurotransmitter (GABA)
GABA tells neurons in the brain to ‘slow down’ and ‘stop firing’ and around 40% of the neurons in the brain respond to GABA. This means that BZs have a general quietening influence on the brain and consequently reduce anxiety, which is experienced as a result of the obsessive thoughts.

Question 74

strengths of anti-anxiety drugs (AO3)

Answer 74

cost effective - biological treatments are relatively cost effective in comparison to psychological treatments, like cognitive behavioural therapy (CBT). consequently, many doctors prefer the use of drugs over psychological treatments, as they are a cost effective solution for treating OCD (and depression), which is beneficial for health service providers.

Question 75

outline and evaluate treatments of OCD

Answer 75

AO1: antidepressant drugs: SSRIs, Tricyclics
AO3: strength - drug use is quicker and cost effective. weakness - SSRIs can cause side

AO1: antianxiety drugs: BZs
AO3: strength - research support by Soomro et al and cost effective