Question 112 marks
Question
(a) Explain how SSRIs treat obsessive-compulsive disorder (OCD). [2] (b) Lehmkuhl et al. (2008) treated a boy called Jason who had OCD. Describe how exposure and response prevention treatment was used to reduce Jason’s symptoms. [4] (c) Discuss the validity of the study by Lehmkuhl et al. [6]
Mark scheme
1(a) Explain how SSRIs treat obsessive-compulsive disorder (OCD). 2 Award 1 mark for a basic explanation of the term/concept. Award 2 marks for a detailed explanation of the term/concept. For example: Selective serotonin reuptake inhibitors. These can help improve OCD symptoms by increasing the levels of a chemical called serotonin in the brain (1). This seems to then cause a lessening of anxiety experienced by the patient and therefore they do not need to engage in the OCD behaviours (such as hand washing) in order to relieve their anxiety (1). Other appropriate responses should also be credited. 1(b) Lehmkuhl et al. (2008) treated a boy called Jason who had OCD. 4 Describe how exposure and response prevention treatment was used to reduce Jason’s symptoms. Award 1–2 marks for a basic answer with some understanding of the topic area. Award 3–4 marks for a detailed answer with clear understanding of the topic area. For example: Exposure – getting Jason to touch objects he has difficulties with (1) such as elevator buttons, door handles, etc. (1) Response prevention – reducing the anxious response to the objects by using coping statements (1). Jason does have high anxiety responses, but he learns as therapy progresses that these reduce quickly within a few minutes (1). Other appropriate responses should also be credited. 1(c) Discuss the validity of the study by Lehmkuhl et al. 6 Discussion points could include: • + The study has good validity as it is a longitudinal/detailed study so provides a lot of information about the treatment and recovery of the patient. • + Shows that exposure and response prevention is a good therapy technique that can be adapted to suit the individual needs of a patient. Good validity • + Provides supporting evidence that the treatment is valid. • + Has both qualitative and quantitative data which increases validity. Qualitative gives detailed information and comparisons can be made before and after treatment to assess the effectiveness of therapy, which increases the validity of the study and shows that it was the treatment that improved Jason’s symptoms and not something else. • +/- There can be communication problems with children (lower validity) but as mentioned above this was taken into account with Jason and the therapy was adjusted (increases validity). • - But poor generalisability and therefore lower validity due to it being one participant so cannot be generalised to patients without autism/ASD or older/younger participants. Jason had not had OCD for very long compared to adults with the condition. This may mean we cannot generalise that a similar therapy could work with autistic adults but it does highlight if therapy is brought in early on in the condition, significant improvements can be made. • +/- Could have lower validity as Jason may have responded to demand characteristics/social desirability and said that he felt better than he really did. He could have done this due to the close relationship he built with the therapist. It is possible Jason didn’t think of himself as a ‘participant’ and more as a ‘patient’ and responded in a natural way to the therapy (good ecological validity) Mark according to the levels of response criteria below: Level 3 (5–6 marks) • Candidates will show a clear understanding of the question and will discuss at least two points regarding validity. • Candidates will provide a good explanation with clear detail. Level 2 (3–4 marks) • Candidates will show an understanding of the question and will discuss one point about validity in detail or two or more in less detail. • Candidates will provide a good explanation. Level 1 (1–2 marks) • Candidates will show a basic understanding of the question and will attempt a discussion. • Candidates will provide a limited explanation. Level 0 (0 marks) No response worthy of credit. Other appropriate responses should also be credited.