Question 112 marks
Question
(a) Outline the behavioural explanation of phobias. [2] (b) Describe the Generalised Anxiety Disorder assessment (GAD-7). [4] (c) Explain one strength and one weakness of the GAD-7. [6]
Mark scheme
1(a) Outline the behavioural explanation of phobias. 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: Classical conditioning can explain how a phobia can be learned. (1) A previously neutral stimulus can be repeatedly paired with an unconditioned stimulus that produces fear, so that the neutral stimulus becomes the conditioned stimulus. (2) This could occur as a result of trauma where one pairing may be sufficient.(1) Other appropriate responses should also be credited. 1(b) Describe the Generalised Anxiety Disorder assessment (GAD-7). 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: GAD-7 is a screening tool using a questionnaire for generalised anxiety. (1) It consists of 7 items each scored on a scale of 0 to 3. (1) Patients are asked to report how often in the last 2 weeks they have been bothered by the 7 items. (1) 0 represents not at all, 1 is several days, 2 is over half the days and 3 is nearly every day. (1) The 7 items are 1 Feeling nervous, anxious, or on edge 2 Not being able to stop or control worrying 3 Worrying too much about different things 4 Trouble relaxing 5 Being so restless that it’s hard to sit still 6 Becoming easily annoyed or irritable 7 Feeling afraid as if something awful might happen. (Maximum 2 marks for the items) Scored out of 21. (1) Scores of 0–5 (mild), 6–10 (moderate), and 15–21 (severe). (1) Other appropriate responses should also be credited. 1(c) Explain one strength and one weakness of the GAD-7. 6 Likely strengths • High reliability. 965 patients had a telephone interview with clinician and ‘good’ agreement found between self-report and interviewer- administered versions of the scale. • High validity – specifically criterion, construct, factorial, and procedural validity. Increasing scores on the scale were strongly associated with functional impairment. Despite depression symptoms and GAD symptoms frequently co-occurring, factor analysis (factorial validity) confirmed them as distinct. • Quick and easy to use as questions are clear and unambiguous. • Measures a number of characteristics of anxiety • Self-report – patient is giving their experience of anxiety rather than relying on the interpretation of someone else • Allows patient to self-monitor • Easy to analyse for comparisons e.g. before and after treatment Likely weaknesses • Only a screening tool. For diagnosis, a clinician would need to carry out further assessment • Self-report so prone to some subjective biases (patients may exaggerate or have poor memory of exactly how often they were anxious) • Psychometrics can fail to capture complexity of experience of anxiety • Patients may prefer to explain how anxiety has affected them in their own words (no open questions / qualitative data in GAD-7). • Some symptom overlap with other disorders can make it hard to distinguish the features due to GAD and those due to, say, depression. 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 explain one strength and one weakness. • Candidates will provide a good explanation with clear detail. Level 2 (3–4 marks) • Candidates will show an understanding of the question and will explain one appropriate weakness in detail or one appropriate strength in detail. • OR one weakness and one strength in less detail. Level 1 (1–2 marks) • Candidates will show a basic understanding of the question and will attempt an explanation of either a strength or a weakness. 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.