EVALUATIONS

• What are the 3 evaluation points for statistical deviation?

  ✔️Real life application- diagnosis of intellectual disability disorder.

  • Used for measurement of severity - useful part of clinical assessment.

  ❌Unusual characteristics can be positive.

  • E.g, an IQ over 130 is just as unusual as those below 70, but high IQ is not something in need of treatment.

  • Therefore, statistical deviation alone can't be used to make a diagnosis

  ❌Labelling is not beneficial.

  • If someone is leading a healthy life, there is no benefit in labelling them as abnormal - more likely to have a negative effect.
• What are the evaluation points for deviation from social norms?

  ✔️Real-life application- diagnosis of antisocial personality disorder. Place for it when thinking about abnormal behaviour

  BUT - not a sole explanation. Other factors to consider, and in practice deviation from social norms is never the sole reason for defining abnormality

  ❌Cultural relativism.

  • Social norms vary from one generation to another, and from one culture to another.

  • Means that a person from one cultural group may label someone from another group as abnormal according to their standards.

  • Creates problems for people from one culture living within another cultural group.

  ❌Can lead to human rights abuses.

  • Many diagnoses were used to maintain control over minority groups - e.g, drapetomania was a diagnosis for slaves running away.

  • When our social norms change, classifications may also change. E.g, homosexuality in the UK - used to be illegal.
• What are the evaluation points for failure to function adequately?

  ❌Subjective judgements.

  • Someone has to judge whether a patient is distressed. Methods of making this objective - but psychiatrist still have to judge & this is subjective.

  ❌Could be deviation from social norms.

  • Hard to differentiate between someone failing to function or just not conforming to social norms.

  • E.g, not having a job is a sign of failing to function, but they may just be choosing to live that lifestyle.

  • Significant - limits personal freedom.

  ✔️Patient's perspective.

  • Attempts to include the subjective experience of the individual.

  • Acknowledges experience of patient - useful when assessing abnormality.
• What are the evaluation points for deviation from ideal mental health?

  ✔️Comprehensive definition. Covers a broad range of criteria for mental health - useful.

  ❌Unrealistically high standard for mental health. Very few people achieve all the criteria - therefore most people seen as abnormal. Of no value in thinking about who might benefit from treatment against their will

  ❌Cultural relativism. Some of the ideas are specific to Western culture - culture bound. E.g, emphasis on personal achievement in concept of self-actualisation would be considered self-indulgent in much of the world (individualist vs collectivist).
• What are the 4 evaluation points for the behavioural explanation of phobias?

  ✔️Good explanatory power

  • The two-process model goes beyond just classical conditioning

  • Explains how phobias can be maintained over time - idea of operant conditioning

  • Significant as it has had important implications for therapy - know how phobia is maintained, understand better how to break this.

  ❌Alternate explanation for avoidance behaviour

  • Not all avoidance behaviour is a result of anxiety reduction - especially the case in complex phobias, e.g agrophobia

  • Avoidance appears to be motivated by maintaining positive feelings of safety

  • Buck (2010) found that agrophobics are able to leave their house with a trusted person (feel safe), but cannot do so alone without high levels of anxiety - shows this explanation.

  • Significant - implications for treatment if anxiety is not always the motivating factor

  ❌Incomplete explanation

  • Behavioural explanation ignores the role of evolution

  • We easily acquire phobias of things that would've been a threat to us in the past - such as spiders and snakes. - phobias are adaptive

  • Called biological preparedness - innate disposition to acquire certain fears

  ❌Don't always follow trauma

  • Many people develop phobias of things that they have not had a traumatic experience, or possibly any direct contact with.

  • E.g, phobia of snakes is common in the UK - majority of people won't have come into direct contact with a poisonous snake in a threatening situation

  • Could be that social learning theory is a better explanation - we see that others are afraid of certain things, and so replicate their behaviour.
• What are the 3 evaluation points for systematic desensitisation?

  ✔️Effective in treating phobias - research support. Gilroy et al. (2003) - followed up 42 patients who had been treated for arachnophobia in three 45min sessions of SD. Assessed level of phobia. Control group treated by relaxation w/o exposure. At both 3 and 33 months after treatment the SD group were less fearful than the control group.

  ✔️Suitable for a diverse range of patients. Alternatives (flooding) are not well suited to some patients. E.g, sufferers of phobias w learning difficulties may not understand flooding.

  ✔️Acceptable to patients. Those given choice of SD or flooding choose SD - doesn't cause same degree of trauma. Reflected in low refusal rates of SD.
• What are the 3 evaluation points for flooding?

  ✔️Cost-effective. At least as effective as other treatments for phobias. Studies comparing flooding to cognitive therapies (Ougrin 2001) found that it is highly effective and quicker than alternatives. Patients free of symptoms faster - makes treatment cheaper

  ❌Less effective for some types of phobias- more complex phobias, such as social phobias. Possibly because they have more cognitive aspects. Would benefit from cognitive therapy, not flooding.

  ❌The treatment is traumatic for patients. Patients are often unwilling to see it through to the end. Time and money sometimes wasted preparing patients and them be unable to complete treatment.
• What are the 3 evaluation points for Beck's cognitive theory of depression?

  ✔️Practical application in CBT.

  • Forms basis of CBT.

  • All cognitive aspects of depression can be identified and challenged.

  • Includes negative triad - easily identified.

  ✔️Research support

  Grazioli and Terry (2000).

  • Assessed 65 pregnant women for depression before and after birth.

  • They found that those women judged to have been high in cognitive vulnerability were more likely to suffer post natal depression.

  ❌Doesn't explain all aspects of depression.

  • Explains basic symptoms - but depression is more complex than this.

  • Can't explain extreme anger, hallucinations, or bizarre beliefs - e.g, Cotard Syndrome (Jarrett 2013) - person beliefs that they, or parts of their body, are dead.
• What are the 3 evaluation points for Ellis's ABC model of depression?

  ❌Partial explanation.

  • Ellis's explanation only applies to reactive depression - more kinds than this.

  ❌Doesn't explain all aspects of depression.

  • Explains basic symptoms - but depression is more complex than this.

  • Can't explain extreme anger, hallucinations, or bizarre beliefs - e.g, Cotard Syndrome (Jarrett 2013) - person believes that they, or parts of their body, are dead.

  ✔️Has practical application in CBT.

  • Has led to successful therapy.

  • Lipsky et al (1980) found that by challenging irrational negative beliefs, a person can reduce depression.

  • Supports basic theory as suggests that irrational thoughts have a role in depression.
• What are the 4 evaluation points for the cognitive approach to treating depression?

  ✔️Effective

  • Large body of evidence to show that CBT can be highly effective in treating depression

  • March et al. (2007) - compared effects of CBT with antidepressants, and a combination of the two.

  • Sample of 327 adolescents diagnosed w. depression

  Findings (after 36 weeks):

  • Antidepressants: 81% improved

  • CBT: 81% improved

  • Both: 86% improved

  - therefore, CBT is just as effective as antidepressants - should be used alongside.

  ❌Doesn't work for severe cases

  • For people with severe depression, CBT can require too much hard work and concentration - depression results in lack of motivation and difficulty concentrating.

  • Patients in this situation would have to take antidepressants first, before starting CBT

  • Limitation of treatment - often drug therapy is necessary

  ❌Type of therapy isn't important

  • Rozenweig suggests that the success of therapy all comes down to the therapist-patient relationship, regardless of the method of therapy used.

  • Technique of CBT may not be as important as building a good relationship is - put most emphasis on this aspect.

  ❌Role of past

  • Argued that CBT does not treat the root cause of someone's depression

  • Focus of CBT is on present and future, not the past - but talking through a patients past experiences may help them to understand the underlying causes of their depression

  • Means that short-term symptoms/cognitions of depression can be improved, but not necessarily in the long term.

  • Significant as CBT may not be most effective way to treat depression.
• What are the 3 evaluation points for the genetic explanation of OCD?

  ❌Too many candidate genes.

  • Psychologists haven't been able to identify all the genes involved.

  • Appears that there are several genes, and each genetic variation increases risk of OCD by a fraction.

  • ∴, genetic explanations are unlikely to be very useful, because it provides v little predictive value.

  ❌Ignores environmental factors.

  • They can trigger/increase risk of developing OCD (diathesis-stress model).

  • Croner et al (2007) found that over half of OCD patients had a traumatic event in their past - OCD is more severe in those w. more than 1 trauma.

  • ∴, OCD can't be entirely genetic - more productive to focus on environmental causes as these can be altered.

  ✔️Good supporting evidence.

  • Nestadt et al (2010) reviewed twin studies and found that 68% of monozygotic twins shared OCD as opposed to 31% of dyzogotic twins.

  • Strongly suggests a genetic influence on OCD.

  BUT - twin studies are flawed. Ignore the fact that monozygotic twins are not only more similar in terms of genes, but also in terms of environment.
• What are the 3 evaluation points for the neural explanation of OCD?

  ❌Causality.

  • Various neurotransmitters & structures of the brain do not function normally in patients with OCD.

  • Cannot say that this brain abnormality caused OCD, or is a result of the persons OCD.

  ❌Not clear exactly what neural mechanisms are involved.

  • Incomplete explanation - research has identified neural systems that are sometimes involved in OCD, but not always.

  • Cannot really claim to understand the neural mechanisms involved in OCD

  ✔️Strong supporting evidence.

  • Drug treatments - some antidepressants work on the serotonin system (increase levels).

  • Drugs are effective - suggests that serotonin levels play a role in OCD.

  BUT - doesn't suggest cause - absence of drug is not cause of illness.
• What are the 4 evaluation points for the drug treatment of OCD?

  ✔️Effective.

  • Reduces symptoms of OCD.

  • Soomro et al. (2009) - Meta-analysis of 17 studies comparing SSRIs to placebos in the treatment of OCD.

  • All 17 studies showed sig. better results for SSRIs than placebos.

  • Symptoms decline for around 70% of patients taking SSRIs

  BUT - found that it was most effective when combined with CBT. Drug therapy alone not as effective.

  ✔️Cost-effective and non-disruptive.

  • Cheap compared to psychological treatment - good value for NHS.

  • Not disruptive to patient's lives - don't have to make time to have therapy

  ❌Side effects.

  • Indigestion, blurred vision, loss of sex drive, increases blood pressure.

  • Sig. as reduces effectiveness as people stop taking medication.

  ❌Treats symptoms, not cause.

  • CBT tackles obsessive thoughts, but drugs are unable to do so.

  • People often need therapy, especially when OCD follows trauma.