Topic Tuesday Psychopathology

2017 Cog characteristics of OCD (2) Behaviourist treat phobias (6) Outline and evaluate failure to function adequately and deviation from ideal mental health as definitions of abnormality. Refer to the experiences of Rob in your answer (16)

2018 Is negative schema score best described as measuring a cognitive, emotional or behavioural characteristic of depression? (1) Draw a suitable graphical display to represent the data in Table 1. Label your graph appropriately. (4) With reference to level of measurement, explain why Spearman’s rho is an appropriate statistical test for this data. (2) Discuss the cognitive approach to treating depression. (16)

Explanations

OCD: Explanation Two students were discussing their friend David who has recently been diagnosed with obsessive-compulsive disorder (OCD). Melanie says, “It wasn’t a surprise to me that David has OCD because his mum is always tidying things, putting them in order and checking switches”. Emma says, “Really, I didn’t know that. I always thought that people with OCD have something in their brains that makes them behave in that way”. Outline and evaluate neural and genetic explanations for obsessive-compulsive disorder. Refer to the conversation above in your answer. (12 marks)

Genetic explanations include •        Specific gene markers eg, COMT gene, SERT gene. •        Looking for gene markers that might have been inherited – such as gene The COMT gene is associated with the production and regulation of the neurotransmitter dopamine. One variation of the COMT gene results in higher levels of dopamine and this variation is more common in patients with OCD, in comparison to people without OCD. A second gene which has been implicated in OCD is the SERT gene (also known as the 5-HTT gene). The SERT gene is linked to the neurotransmitter serotonin and affects the transport of the serotonin (hence SERotonin Transporter), causing lower levels of serotonin which is also associated with OCD (and depression)

Thalamus  cleaning, checking and other safety behaviour The OFC is part of a brain circuit which includes the caudate nuclei and converts sensory information in to thoughts. It also Initiates activity after receiving an impulse and stops activity once impulse lessens. OCD patients have high levels of activity in their orbital frontal cortex resulting in difficulty in switching off or ignoring impulses. (Seretonin plays a part in preventing repetition of task - a lack of serotonin as a result of being removed too quickly before it has transmitted its signal) would therefore prevent the ability to inhibit the repetition of tasks…. So repetition would occur) Caudate nuclei are areas in the basal ganglia that filter messages coming from the OFC before passing important ones to other parts of the brain (thalamus). (dopamine is the main neurotransmitter in basal ganglia and high levels can lead to over activity) The hypersensitivity of the basal ganglia gives a rise to the repetitive motor behaviours seen in OCD, for example, repetitive washing/cleaning/checking. Thalamus  cleaning, checking and other safety behaviour – low levels of serotonin associated with anxiety; high levels of dopamine linked to compulsive behaviour / stereotypical movements.
Physiological explanation - basal ganglia in the brain responsible for psychomotor functions, hypersensitivity of the basal ganglia may result in repetitive movements; linked to abnormality / excessive activity in the orbital frontal cortex

Possible application Melanie suggests that David might have inherited OCD because his mother displays similar behaviours and may have passed on a genetic marker to him as a first degree relative – a genetic cause. Emma suggests that David could have OCD due to a biological factor which would be in his brain – a neural cause.

Possible evaluation points The findings from neural explanations are problematic as drugs used to affect serotonin such as SSRIs may decrease the symptom but that does not mean that an imbalance of serotonin was he cause in the first place. Improvement rates from use of drugs are only at 50% so there must be other causes. There is a time delay in which drugs affect levels of serotonin within hours / immediately but the effect on OCD may take up to weeks. Some research into brain structure has suggested the involvement of structural abnormalities such as dysfunction in the neuronal loop/lower grey matter density in people with OCD. Neurophysiological factors are not consistent with specific areas/circuits in the brain being implicated. Sometimes evidence relates only to one aspect of the disorder – the compulsions rather than the obsessions. Findings from family studies could be explained by shared environments as well as shared genes by SLT.

Outline and evaluate at least one cognitive approach to explaining depression. (Total 12 marks)

Underlying assumption of the cognitive explanation – depression is the result of disturbance in ‘thinking’. Abnormality stems from faulty cognitions about others, our world and us. These cognitions cause distortions in the way we see things; Ellis suggested it is through irrational thinking, while Beck proposed the cognitive triad Beck’s negative triad – childhood negative schemas develop providing a negative framework for viewing events pessimistically. In adulthood these become biases such as overgeneralisation; magnification; selective perception and absolutist thinking. The negative triad is where people think consistently negatively about the self, the world and the future. Ellis’s ABC model – developed to explain response to negative events – how people react differently to stress and adversity. The model provides the sequence of the process: A – the adversity or event to which there is a reaction; B – the belief or explanation about why the situation occurred; C – the consequence – the feelings and behaviour the belief now causes. In essence the external event is ‘blamed’ for the unhappiness being experienced. Both models explain depression as a consequence of faulty and negative thinking about events and suggest it can be managed by challenging this faulty thinking.

Possible evaluation: •        The use of examples to illustrate the negative triad or the ABC model. •        The use of evidence to support cognitive explanation(s). •        The development of successful therapies based on cognitive explanations: CBT and / or REBT. •        Cognitive explanation(s) do not explain the links between anger and depression well. •        Cognitive explanations do not distinguish cause and effect factors. •        Cognitive explanations do not deal with the manic phases in bipolar I and II. •        Comparison with alternative explanations eg biological evidence suggests genetic, neurochemical and neuroanatomical influences are a biological predisposition.

Explain how findings of psychological research into the treatment of depression could have implications for the economy. (2)

psychological research findings into psychopathology may lead to improvements in psychological health/treatment programmes which may mean that people manage their health better and take less time off work. This would reduce costs to the economy •        psychological research findings may lead to better ways of managing people who are prone to mental health issues whilst they are at work which could improve their individual productivity, again boosting the economy overall •        ‘cutting-edge’ scientific research findings into treatments for mental health issues carried out in UK may encourage investment from overseas companies into this country which could boost the economy •        providing effective treatments might be a significant financial burden to an NHS service already under huge financial strain •        discovering that new treatments may be more effective than older therapies and that these may be more expensive so could increase the financial burden to the economy.

Outline at least two ways in which a cognitive psychologist might explain depression in a person who has recently become unemployed. (6)

cognitive triad - person will have negative thoughts about self, world, future eg I’m useless, the world is horrid, I’ll never get a job the person may overgeneralise ‘no-one wants me’ person may show selective perception of negatives eg focus on loss of job and ignore the many good things in life person may magnify significance / catastrophise eg loss of job will take on extraordinary significance and will be seen as major disaster person makes negative attributions – person will blame themselves for loss of job and negate the influence of external factors eg world economy person shows absolutist thinking ‘if I can’t have that job then it’s a disaster, no other job will do’.

  Hamish has a phobia of heights. This phobia has now become so bad that he has difficulty in going to his office on the third floor, and he cannot even sit on the top deck of a bus any more. He has decided to try systematic de–sensitisation to help him with his problem. Explain how the therapist might use systematic de-sensitisation to help Hamish to overcome his phobia. (8)

Main techniques are: firstly, teach deep muscle or progressive relaxation. Then the therapist and client construct an anxiety hierarchy, starting with situations that cause a small amount of fear – in Hamish’s case this might be standing on a small stepladder – then listing situations that cause more fear, with the most frightening situation being at the top of the hierarchy, such as standing on top of a mountain. Finally, they work through this list, with the client remaining relaxed at each stage. The two main features are relaxation and working through the anxiety hierarchy.