Question 112 marks
Question
(a) Identify two characteristics of bipolar disorder. [2] (b) Describe rational emotive behaviour therapy (REBT) as a treatment for depression (Ellis, 1962). [4] (c) Explain one similarity and one difference between REBT and one biological treatment for depression. [6]
Mark scheme
1(a) Identify two characteristics of bipolar disorder. 2 Award 1 mark for each characteristic of bipolar disorder. Must include both reference to a symptom of low mood and a symptom of high mood for full marks. Two strongly contrasting phases – high mood (manic phase) followed by very low mood. (2) High mood phase symptoms – euphoria, increased activity/energy, racing thoughts, impulsiveness. (1 max) Low mood phase symptoms – depressed mood, low energy/oversleeping, lack of interest in normal activities. (1 max) Other appropriate responses should also be credited. 1(b) Describe rational emotive behaviour therapy (REBT) as a treatment for depression (Ellis, 1962). 4 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 – This follows the ABC model. (1) Activating agent – what is the behaviour and/or attitude of the patient towards events in their lives. (1) Beliefs – what is the belief of the patient toward the event. (1) Consequence – behavioural response in relation to the belief about the event. (1) Ellis believes if a person has constant negative beliefs about events in their lives, they are likely to suffer from depression. (1) The goal of therapy is to identify the unhelpful thoughts and replace them with more rational and constructive thoughts. The patient will go away between sessions and practice developing more helpful thoughts about life experiences and the depression symptoms should improve. (2) Other appropriate responses should also be credited. 1(c) Explain one similarity and one difference between REBT and one biological treatment for depression. 6 Comparison will be for the rational emotive behavioural therapy by Ellis (1962) and biological treatments including chemical/drugs (MAOIs, SSRIs) Similarities Provides an effective treatment for depression – those receiving the treatment be it biological or REBT showed significant improvements compared to their baseline at the start of treatment and the control group. Studies that have investigated the effectiveness of these treatments include a control group of patients who do not receive the treatment as a comparison. Allows valid conclusions to be drawn about the effectiveness of the treatment. Deterministic – it is the biological treatment/REBT that is causing the depression to lift and no other events/ experiences in the person’s life. It could be that the person changed jobs, and this is what caused their depression symptoms to improve rather than the biological treatment/REBT. Not as effective when there are co-morbidities such as anxiety, schizophrenia. Differences Biological treatments have side effects such as weight changes, appetite changes, sexual dysfunction, headaches, changes to sleep patterns and REBT does not have any side effects. The biological treatments might be more appropriate for patients who do not want to see a therapist/not comfortable with talking about their issues compared to REBT. REBT helps the patient to develop skills to challenge their irrational thoughts and replace them with more helpful thoughts. These skills can be used after therapy is over to continue to treat the depression. In contrast, biological treatments alter neurochemistry and treat the symptom of the disorder (low serotonin) so if the patient stops having the treatment the depression is likely to return. Biological treatments are from the biological approach which assumes that it is low serotonin levels that are causing the depression, and this is what is treated. In contrast, REBT is from the cognitive approach which assumes that it is due to faulty thinking patterns that the patient has depression, and this is what is addressed by this therapy. 1(c) 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 include one similarity and one difference. Candidates will provide a good explanation with clear detail. Level 2 (3–4 marks) Candidates will show an understanding of the question and will include one appropriate similarity in detail or one appropriate difference in detail. OR one similarity and one difference 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 similarity and/or difference. This could include both but just as an attempt. Candidates will provide a limited explanation. Level 0 (0 marks) No response worthy of credit. Other appropriate responses should also be credited.