AO3

• statistical infrequencyis a good starting point for diagnosis


  those who are more than 2 SD from the average are diagnosed with intellectual disability disorder
• practical application of statistical infrequency


  in some situations, it is appropriate to use statistical criteria on to define abnormality

  - intellectual disability is defined in terms of the normal distribution using the concept of standard deviation to establish a cut-off point for abnormality

  - any individual whose IQ is more than two standard deviations below the mean is judged as having a mental disorder

  - suggests SI has practical application as a definition of abnormality
• deviation from social norms has real life application


  real life application in the diagnosis of antisocial personality disorder however, other factors need to be considered such as the failure to function adequately therefore deviation from social norms isn’t a sole explanation for defining abnormality
• failure to function adequatelyprovides a threshold for professional help


  25% of the population experience symptoms of mental disorders to some degree, most of the time we function through it but when we do cease to function adequately people tend to seek or are referred to professional help. This means that the failure to function criteria provides a way to target treatment and provide services to those who need them
• deviation from ideal mental healthis a comprehensive definition

  includes a range of criteria specific to traits that cover most of the reasons why a person may need help with their mental health. This means that mental health can be discussed meaningfully with a range of professionals such as psychiatrists or CBT therapists. Therefore, this definition provides a checklist against which we can assess ourselves and others
• little albert


  aim was to establish whether emotional responses such as fear could be conditioned. whenever little albert played with a white rat, a loud noise was made in his ear. the rat didn't cause fear until it was paired with the noise, through classical conditioning he started associating the rat with fear
• the two-process model has real-world application


  the idea that phobias are maintained by avoidance is important in explaining why people with phobias benefit from exposure therapies such as SD and flooding therapy

  - once avoidance behaviour is prevented it ceases to be reinforced by the reduction of anxiety and therefore avoidance behaviour declines

  - shows the value of the two-process model because it identifies a means of treating phobias
• link between phobias and bad experience


  - 73% of dental phobics had experienced a trauma involving dentistry

  - control group of people with low dental anxiety where only 21% had experienced a related traumatic event

  - highlights association between a stimulus and an unconditioned response leading to a phobia However, not all phobias appear following a bad experience

  - snake phobias occur in populations where very few people have any experiences of snakes

  - not all frightening experiences result in phobias

  - behavioural theories don't provide an explanation for all phobias
• two-process model is environmentally reductionist


  the two process model explains phobic behaviour in the case of avoiding the phobic stimulus - incomplete explanation for phobias

  - we know that phobias have a significant cognitive component such as people having irrational beliefs about the phobic stimulus that requires further explanation

  - evolutionary factors may have an important role in phobias

  - we easily acquire phobias of things that have been a source of danger in our evolutionary past

  - phobia of the dark or snakes

  - it's adaptive to acquire such fears

  - biological preparedness is the innate disposition to acquire certain fears
• diathesis-stress model - phobias


  proposes that we inherit a genetic vulnerability for developing mental disorders however they will only manifest if triggered by a stressor such as a life event

  - not everyone who has been bitten by a dog develops a phobia of dogs which can be explained because they aren't biologically predisposed to develop phobias
• SD is not appropriate for all phobias


  - SD may not be effective in treating phobias that have an underlying survival component

  - fear of the dark

  - these fears have an evolutionary benefit rather than a phobia which has been acquired through personal experience
• comparison of SD to CBT

  SD is a relatively fast process that requires less effort from the patient than other treatments such as CBT which requires a lot of resilience from the patient in trying to understand their behaviour and apply insights

  - lack of thinking in SD means the technique is also useful for people who may lack insight into their motivation or emotions, such as children
• SD useful for people w learning disabilities


  the main alternatives of SD are unsuitable for people with learning disabilities

  - cognitive therapies require a high level of ration thought and flooding therapy is distressing

  - SD doesn't require understanding or engagement on a cognitive level and it's main aim is to teach relaxation which isn't distressing

  - SD often most appropriate treatment for some people
• research support for effectiveness of SD


  researcher followed up on 42 patients who had SD for spider phobia and found that they were less fearful than a control group

  - second researcher concluded that SD is effective for the three types of phobias, and further research suggests that SD is likely to be helpful in treating phobias
• SD is overly reductionist


  - overlooks other factors therefore more likely to make errors

  - Wolpe developed systematic desensitisation and treated woman for fear of insects

  - no improvement in symptoms

  - he later discovered that her husband, who she had not being getting along with, was given insect as a nickname

  - lower level explanations can be dangerous for individuals
• flooding is cost-effective


  not an expensive form of therapy yet is clinically effective. Flooding can be successful in just one session meaning more people can be treated at the same cost by flooding than SD or other therapies which may take longer
• individual differences - flooding


  it can be a highly traumatic procedure therefore it may not be suitable for every patient and some may quit during the treatment which reduces the effectiveness of the outcome- both patients and therapists rate flooding as more stressful than SD, thus there are ethical concerns about knowingly causing stress to clients, and the traumatic nature of flooding also leads to higher attrition rates compared to SD therefore patients must give informed consent to go ahead with treatmentHowever,for those patients who complete the full course of flooding therapy, the process appears to be an effective treatment and is relatively quick
• symptom substitution - flooding


  behavioural therapies don’t treat the cause meaning that symptoms are treated not removed and they can reappear in different forms

  However, symptom substitution is largely theoretical and there’s only relatively poor empirical evidence to support it
• flooding is not effective for all phobias


  - less effective for phobias such as social phobias because there's a cognitive aspect to it such as low self-esteem

  - CBT may be a more effective treatment for social phobias as it challenges irrational thoughts meaning it will challenge where the patient's irrational thoughts have stemmed from and help them to develop more rational ones
• research support for irrational thinking in depression

  - depressed ppts made more errors in logic when asked to interpret written material than non-depressed ppts

  - depressed ppts who were given negative automatic-thought statements became more depressed which supports the idea that negative thinking leads to depression

  However,the fact that there’s a link between negative thoughts and depression doesn't mean that they cause depression

  - may be that a depressed individual develops a negative way of thinking because of their depression rather than the other way around
• cognitive is a partial explanation


  - depressed people show particular patterns of cognition even before the onset of their depression therefore Beck’s idea of vulnerability is at least a partial explanation

  However, some aspects of depression cannot be explained by cognitive factors eg experiences of extreme anger, and sometimes hallucinations and delusions

  - cognitive approach isn’t a particularly good explanation for all repressive phenomena involved in depression
• alternative explanation for depression

  - biological approach may be a better explanation of depression

  - suggests genes and neurotransmitters may cause depression

  - research supports the role of low levels of serotonin in depressed people which is further supported by the success of drug therapies that involve increasing serotonin levels, in treating depression,

  - neurotransmitters play an important role in depression
• Ellis' model has limited application


  - only explains reactive depression- reactive depression is a form of depression triggered by negative activating eventsHowever,in many cases it's not obvious what triggers depression - this is known as endogenous depression- Ellis’ ABC model can only explain some cases of depression
• research support for CBT


  - 327 depressed adolescents comparing the effectiveness of CBT with antidepressants and a combination of the two

  - after 36 weeks 81% of the CBT group

  - 81% of the antidepressant group

  - 86% of the combination group were significantly improved

  - valid evidence for making CBT the first choice of treatment in public health care systems such as the NHS
• confounding variables effecting CBT


  - Ellis claimed a 90% success rate for CBT, taking an average of 27 sessions to complete the treatmentButEllis recognised the therapy was not always effective- suggested this could be because some clients did not put their revived beliefs into practice- Kuyken and Tsivirkos suggested therapist competence could also play an important factor- CBT is effective but other factors may be limiting its effectiveness
• CBT has high relapse rates


  - early studies into the long-term effectiveness of CBT and recent studies suggest that relapse is common after undergoing CBT treatment

  - researcher assessed people with depression for 12 months following a course of CBT

  - 42% released within six months of ending treatment

  - 53% within a year relapsed

  - CBT may need to be periodically repeated to be effective in treating depression
• CBT is not appropriate for all clients


  - in severe cases of depression clients may not be motivated to engage with the cognitive work of CBT- any form of psychotherapy isn’t suitable for people with learning disabilities- CBT may only be suitable for a specific range of clients and drug therapy may be a more suitable optionHowever,there’s now evidence to challenge this- Lewis and Lewis- concluded that CBT was as effective as other treatments for severe depression- another researcher concluded that it can also be effective for people with learning difficulties- CBT may have a wider application than originally thought
• practical application of bio explanation of OCD


  - led to effective treatments such as SSRIs which provide support for the role of serotonin in OCD

  - patients with OCD who were given SSRIs had a reduction in symptoms compared to those who were given a placebo

  - low levels of serotonin are implicated with OCD as through increasing the levels of serotonin it's been found to alleviate symptoms in OCD patients
• research support for bio explanation from family studies

  - Nestadt et al. identified 80 patients with OCD and their first-degree relatives and compared to control patients without mental illness

  - people w first-degree relative w OCD were at a five times greater risk of having the illness themselves

  - meta-analysis of twin studies of OCD

  - on average, MZ twins more likely to OCD if their co-twin had the disorder

  - points to a clear genetic basis for OCD but the fact that the concordance rates are never 100% means that environmental factors but play a role too
• real-world application of genetic explanation

  - the mapping of the human genome has led to the hope that specific genes could be linked to particular mental and physical disorders

  - it might be where one or the other parent to be has the COMT gene, the mother's fertilised eggs could be screened, thus giving the parents the choice of whether to abort those eggs with the gene

  - alternatively, gene therapy may produce a means of turning certain genes 'off' so that the disorder is not expressed

  - both raise important ethical issues
• there is not one distinct gene associated w OCD


  - the gene for OCD has been found to be the expression of a gene that's implicated with other disorders such as autism and tourettes

  - there isn't a specific gene associated with OCD and different expressions of the same gene can cause different disorders

  - the presence of the gene doesn't necessarily mean we can predict that person will develop OCD

  
  

  - Paul and Leckman studied patients with Tourette's syndrome and their families

  - concluded OCD is one form of expression of the same gene that determines tourettes

  - the obsessional behaviour associated with OCD is also found in children with autism and is typical of people with anorexia

  - multiple disorders could be different expressions of the same gene
• alternative explanation for OCD


  - reductionist explanation as it reduces behaviour to genes and neurochemistry, ignoring other factors

  - psychological explanations such as the two process model which suggests that OCD is acquired and maintained through classical and operant conditioning

  - an anxiety provoking stimulus, such as germs, is associated with anxiety therefore the person avoids the stimulus to reduce anxiety and this creates an association between avoidance and reduction in anxiety

  - a compulsion is learned to reduce anxiety and this is then maintained through operant conditioning as the person is negatively reinforced as through avoidance they escape the discomfort of anxiety
• research support for effectiveness of drugs


  - 17 studies of SSRIs for treating OCD were reviewed and all showed better outcomes following SSRIs than those who were given placebos

  - symptoms typically reduced for 70% of ppts when given SSRIs

  - drugs can be effective in treating the majority with OCD However, cognitive and behavioural therapies may be more effective SSRIs for treating OCD
• drugs are palliative


  - treat the symptoms not the cause

  - drugs are effective at treating symptoms in the short term however, there's little evidence for long term effectiveness

  - combination of drug treatment and CBT has been found to be the most effective treatment for disorders such as OCD

  - CBT may provide better long lasting support
• drugs are cost-effective and non-disruptive


  - cheap compared to psychological treatment which is good value for patients and the NHS

  - SSRIs non-disruptive to peoples lives as people can simply take the drug until their symptoms decline whilst still being able to go to work or attending an institute of education rather than spending time out of their day and money on going to therapy sessions

  - many doctors and people with OCD prefer drug treatments
• drugs can have serious side effects


  - a minority of people taking SSRIs get no benefit and some also experience side effects such as blurred vision and loss of sex drive

  - people's quality of life is poor when taking drugs

  - side effects may cause people to stop taking their medication altogether which can be dangerous and lead to them relapsing

  - reducing the effectiveness of the treatment
• research support for ISI


  Lucas et al. asked students to give answers to maths problems that were either easy or difficult and found that when the task was more difficult there was greater levels of conformity to the wrong answer. This was most true for students who rated their maths abilities as 'poor'. This is strength as it shows that people conform in situations where they're unsure of the answer or when there is ambiguity, which are the outcomes explained by ISI
• research support for NSI


  Asch's study found that conformity levels to the wrong answer increased alongside task difficulty and group size. In a post-investigation interview some participants reported they conformed because they were afraid of disapproval and felt self-conscious giving the wrong answer. When Asch repeated his study but had ppts write down their answers instead of verbally giving them, conformity rates fell to 12.5%. This is a strength as it shows that people conform because they don't want to be rejected by a group, and when their answers didn't have to be shared with the group this fear disappeared, providing support for NSI as an explanation for some conforming behaviour
• individual differences in ISI

  research from Asch's study showed that students showed a lower level of conformity compared to non-student participants, this finding is supported by research that found science and engineering students showed very little conformity. This is a limitation as it shows that studies into ISI doesn't affect everyone's behaviour in the same way, suggesting individual differences influence the level of conformity
• individual differences in NSI


  people less concerned with being liked are less affected by NSI than those who care more about being liked and social approval, these people are known as nAffiliators who are more likely to conform due to having a greater need to have affiliation

  Research found that students high in need of affiliation were more likely to conform. This shows that the desire to be liked raises the likelihood to conform however this is a weakness as it shows there are differences in the way individuals respond