1. Modal Answers
Psychopathology

2. Q1 and 2
Flooding is when the client is immediately exposed to their phobia stimulus. During the procedure the client has no way of avoiding the stimuli and therefore must stay until they have calmed down. Eventually their anxiety will reduce and this leads to the fear being extinguished.
Systematic desensitisation is a gradual exposure to the phobia stimulus. This exposure takes place after the client has been taught relaxation exercises and they have constructed fear hierarchy. They are slowly exposed to the items on the fear hierarchy starting with the item they are least fearful of. They move on to the next level only when their anxiety levels have dropped.

3. Q3
Obsessions are internal intrusive, repetitive and unwanted thoughts and the compulsions are the external repetitive behaviours that a patient performs. Bob is overwhelmed with fear that his family could be in danger (obsessive thoughts) and the only way of reducing this fear is by completing his checking of plug sockets and doors (compulsions).

4. Q3
Part b
The biological approach would explain Bob’s OCD as problems with circuits in the brain. Areas such as the basal ganglia and the orbital frontal cortex (OFC) are thought to be implicated in the disorder. He may have overactivity in the OFC and problems with the basal ganglia mean that minor worries are not being blocked causing obsessional thoughts and repetitive behaviours. He could also suffer from problems with the neurotransmitter serotonin. It could be that the reuptake of serotonin from the synapse is too strong and it is unable to pass to the post synaptic neuron.
The biological explanation could look at genetics as a cause. Bob is having his family history examined and this might be because the clinicians expect to say other family members suffering from the disorder. This is because OCD may have a genetic component as the incidence is higher in people with a family history of the disorder. Also studies have revealed two genes that could be involved as they are more common in people with OCD. These are the COMT gene and the SERT genes. These genes are involved in neurotransmitter regulation such as dopamine and serotonin.

5. Q4
Psychological research in the treatment of depression could lead to abetter understanding of how to treat the disorder. This means that patients can get more effective treatments which would result in less days of work and would be good for the economy. The more effective treatment, however, could put a further financial burden on the NHS especially if the treatment was expensive such as one to one therapy.

6. Q5 – Please note this is for the old spec and now they will ask for cognitive, emotional or behavioural characteristics.
The characteristics can be separated into cognitive characteristics, such as; suicidal thoughts and feeling of guilt and worthlessness, emotional characteristics such as low mood and behavioural characteristics such as; social withdrawal and difficulties sleeping and lack of or increased appetite.

7. Q6
One strategy in CBT is that the therapist will help the patient to identify the patients negative thoughts about the world, future and themselves using Beck’s cognitive triad. The patient and therapist work collaboratively to challenge these irrational beliefs by discussing evidence for and against them. The patient is encouraged to test the validity of their negative thoughts (reality testing) and can be set homework to test out their negative beliefs. This evidence collected through homework sessions can then be evaluated in the therapy sessions. This strategy aims to get the client to think in a more realistic and positive manner about events.

8. Q7 Neural explanations include:
Low levels of serotonin (this can be related to genes as in the SERT gene)
Possible that the reuptake of serotonin is too strong and therefore it is reabsorbed into the presynaptic neuron before it reaches the receptors in the post synaptic neuron.
Neural explanations can also include the basal ganglia, caudate nucleus and the OFC
Genetic explanations include:
Comt and SERT gene
Family studies and comparing the prevalence in the normal population with close family members.
MZ and DZ twin studies.
For this question there are 2 marks for application. Make direct quotes from the scenario and ensure you link Melanie to genes and Emma to neural.

9. Q9
See mark scheme

10. Q10 Beck’s cognitive triad Ellis ABC Cognitive distortions
Describe each of these and give examples
Evaluation
Practical applications and effectiveness of this.
Problems with cause and effect
Comparison with other explanations such as biological explanations of depression.

11. Q11
Obsessions are the internal component of OCD as they are the thoughts which are intrusive. The compulsions are the external component as they are the repetitive behaviours.
B. The results in the scenario show that the risk of OCD is greatly increased if you have a twin with the disorder. This shows inhertiance is an important factor. This suggests that it is at least partly genetic as the risk in the general population is around 2%. However, the results show that the disorder is not completely genetic and that other factors such as the environment and external stressors must also be involved. This is because the inherited influence is not 100%

12. Q12
See mark scheme.