Abnormal Psychology 8 marks questions answered

Section B

1. Describe what psychologists have learned about abnormal affect. [8]

Firstly, psychologists have learned that there are two types of depression: unipolar and bipolar. The former affects a person’s overall performance for a prolonged period of time and involves symptoms like sadness, social withdrawal and disturbances in sleep. The latter shows alternating episodes between intense sadness and intense euphoria and involves symptoms like decreased need for sleep, frequent mood swings and setting unrealistic goals.

Secondly, it has been found that bipolar depression or manic depression is mainly caused by genetics and biochemical malfunctioning since 50% of patients have a family member with a similar disorder and monozygotic twins are 8 times more likely to both be diagnosed with the disorder than dizygotic twins, who have a 25% concordance rate. Also, Endgunlu, Duvarci and Cetin (2013) noted that the disorder could be caused by a defect in the X-chromosome because a man with muscular dystrophy, which is transmitted by that chromosome, also suffered with bipolar mania like his mother. Another study by Nery et al (2013) reported on isolated cases where people with the disorder had increased grey matter in the left thalamus and hippocampus regions of the brain and even though the results were inconsistent, the research was reliable.

Thirdly, there are many explanations on unipolar depression but one of the most consistent ones are Beck’s cognitive theory (1976) and learned helplessness. The first believes that depression is a result of faulty cognitive processes and a set of negative schemas that surround three things: themselves, the future and their experiences. This is called the cognitive triad. Thus, people with the disorder are dominated by these set of beliefs that leads to negative assumptions being made repeatedly until It becomes their ‘automatic way of thinking’. The second theory believes that individuals with depression have become accustomed to negative situations and eventually they have become passive to them that they do not try to escape. Seligman (1979) research this with dogs and found that the dogs who did not think they had a way to stop the shocks given to their feet did not try to escape the situation and just whined because they expected that nothing could stop the pain.

Lastly, psychologists have found different ways to treat both types of depression. Dierckx et al (2012) did a meta-analysis on whether the response to electroconvulsive therapy varies between bipolar and unipolar patients and found that the remission rates were very similar, about 50% each, which is encouraging. Furthermore, drug therapy has been found to be useful. Mahli et al (2013) found that the mood stabiliser lithium was well tolerated among bipolar patients and works well for controlling manic moods and suicidal thoughts. Similarly, Rucci et al (2011) found that suicidal thoughts took longer to re-emerge in patients taking selective serotonergic re-uptake inhibitors (SSRIs) compared to patients undergoing psychotherapy.

2. Describe what psychologists have discovered about phobias. (8)

Phobias are irrational fears of something, someone or some object. In many cases the fear may be illogical and unreasonable. They have been classified in three categories: agoraphobia, the fear of public/open spaces ; social phobia, the fear of social situations ; specific phobias, which have been classified further into 4 categories – animal, nature, medical and situational.

Firstly, Watson and Rayner conducted a study to see whether they could condition a boy, Albert, to fear a white rat through learning by association. The rat was placed in front of the boy and a hammer was hit against metal, so that Little Albert would associate the fear caused by the loud noise with the animal. This was found to be effective and researchers believe that classical conditioning can explain generalisations in phobias – Little Albert generalised his fear to any object that was white and fluffy – and the extinction when the stimulus no longer causes fear. For this reason, systematic desensitization was developed by Wolpe as a treatment, which aims to cure the phobia by creating an hierarchy of fear that patients work through using relaxation techniques The situations in the hierarchy can be in-vitro (imaginative) or in-vivo (real) and as they get closer to the top, they will become more challenging. Zettle found that the treatment was effective in reducing math phobias in students even though their abilities did not improve.

Secondly, the theory of preparedness believes that people are pre-programmed in the DNA to have certain phobias if they pose a threat to evolution – this mainly explains natural/animal phobias. Cook and Mineka researched the theory with monkeys and found that they were only scared of the crocodile and snake toy even if they had seen other monkeys acting scared in front of flowers and rabbits. This suggests that there is a genetic link between the fear we have and those of our ancestors. Furthermore, another study on genetics was carried out by Ost, who wanted to explore the family correlation of needle phobia. It was found that 64% of patients had a least 1 immediate family member with the same phobia. As a result of this, the researcher developed applied tension therapy as a treatment as the fear is more of a sense of nausea. Thus, patients are asked to tense their muscles when the fear is felt so that the feeling of disgust can be reduced and this has been found to be very effective in treating medical phobias.

Section C

1. Suggest how you would use cognitive behaviour therapy to treat a person with kleptomania (or any other impulse control disorder). [8]

CBT seems to be the most effective way of controlling kleptomania though the use of two techniques: covert sensitisation and imaginal desensitisation.

Cover sensitisation is based on the idea that patients need to associate the behaviours with a negative thought or image in order to make it decrease. Kohn and Antonuccio suggested that this therapy was more successful when the consequences were related to disorder – in the case of Kleptomaniacs, they would be going to jail for stealing. Also, describing the scenarios out loud would increase anxiety on the behaviour and reduce them; thus, for a person suffering with kleptomania, the consequence of being arrested could be described.

Furthermore, imaginal desensitisation teacher relaxation techniques to patients to reduce the kleptomaniac episodes since impulsion and relaxation cannot happen at the same time. Thus, a therapist would teach a kleptomaniac to put the relaxation method to work whenever the urge of stealing something comes to their body. This can work with other impulse control disorder like gambling, which has been studied by Jimenez-Murcia et al, who found out that it worked very well over a 16-week period.

2. Mrs Oliveira developed schizophrenia three years ago and is currently being treated. As a psychologist you want to find out about her symptoms, behaviour and treatment. Suggest how you would conduct a case study to investigate Mrs Oliveira’s schizophrenia. [8]

In order to investigate Mrs Oliveira’s schizophrenia using the case study research method, observations and interviews are likely to be the most appropriate since questionnaires may be found difficult to complete, mostly if the woman has disorganised schizophrenia.

Firstly, to carry out observations I would install CCTV cameras around Mrs Oliveira’s house/care home, if they are not installed already, and concentrate on her behaviour when she is alone and around other people for 6 weeks to see if certain symptoms only appear in certain occasions. The observation would help to see any improvements she is having while taking her treatment. Also, I would visit her house/care home three times a week to observe if her behaviour around me changes as she becomes to use to my presence.

Secondly, I would carry out unstructured interviews every time I visit the woman to know more about her internal symptoms that cannot be perceived from the outside like hallucinations, delusions and flattening of emotions. I would ask questions like “How do you feel when you are hallucinating?” “What makes symptoms worse or better? “Also, the interviews would serve to ask which treatments Mrs Oliveira has tried, which ones she feels were most useful and which symptoms decreased the most.