Question 1

What is the difference between the DSM-5 and ICD-10 in diagnosing mental disorders?

Accepted Answer

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) is published by the American Psychiatric Association and is primarily used in the USA, while the ICD-10 (International Classification of Diseases, 10th edition) is from the World Health Organization and used globally, including the UK. Both classify disorders but have some differences: for example, the DSM-5 includes more specific criteria for PTSD and has a dimensional approach for autism, whereas the ICD-10 uses a broader categorical system. In exams, you may need to compare their reliability and validity, noting that the ICD-10 is often seen as more culturally flexible.

Question 2

How effective is CBT for treating depression?

Accepted Answer

CBT (Cognitive Behavioural Therapy) is highly effective for depression, with research showing it reduces symptoms in about 50-60% of patients, comparable to antidepressant medication. It works by identifying and challenging negative automatic thoughts and maladaptive behaviours (e.g., rumination, avoidance). A key study by March et al. (2007) found that CBT combined with SSRIs was more effective than either alone. However, CBT requires active participation and may not suit everyone, especially those with severe depression who struggle to engage. Long-term, CBT can reduce relapse rates more than drugs alone.

Question 3

What are the main characteristics of OCD?

Accepted Answer

OCD (Obsessive-Compulsive Disorder) has two main components: obsessions (recurrent, intrusive thoughts, images, or urges that cause anxiety) and compulsions (repetitive behaviours or mental acts performed to reduce the anxiety). Behavioural characteristics include compulsions like hand washing or checking, and avoidance of triggers. Emotional characteristics include intense anxiety, distress, and sometimes shame. Cognitive characteristics include obsessive thoughts (e.g., fear of contamination) and irrational beliefs (e.g., inflated responsibility). The DSM-5 specifies that these symptoms must be time-consuming (over 1 hour per day) and cause significant impairment.

Question 4

Is depression caused by low serotonin?

Accepted Answer

The serotonin hypothesis suggests that low levels of serotonin (a neurotransmitter) contribute to depression, but the evidence is mixed. While SSRIs (which increase serotonin) are effective for many, this doesn't prove causation—correlation isn't causation. Some studies show that artificially lowering serotonin doesn't always trigger depression in healthy people. Modern research points to a more complex picture involving other neurotransmitters (e.g., norepinephrine, dopamine), neural circuits (e.g., prefrontal cortex), and genetic factors (e.g., the 5-HTT gene). So, while serotonin plays a role, it's not the sole cause.

Question 5

What is systematic desensitisation and how does it treat phobias?

Accepted Answer

Systematic desensitisation is a behavioural therapy for phobias based on classical conditioning. It involves three steps: 1) the patient learns relaxation techniques (e.g., deep breathing), 2) they create a fear hierarchy (a list of feared situations from least to most anxiety-provoking), and 3) they gradually expose themselves to each item while staying relaxed. This process is called counterconditioning—replacing fear with relaxation. Wolpe (1958) successfully treated a phobia of cats using this method. It is highly effective for specific phobias, with success rates over 75%, but less so for complex phobias like agoraphobia.

Question 6

What are the ethical issues with using drug therapies for mental disorders?

Accepted Answer

Drug therapies (e.g., SSRIs for depression, benzodiazepines for anxiety) raise several ethical issues. Side effects can be significant: SSRIs may cause nausea, insomnia, and sexual dysfunction; benzodiazepines can lead to dependence and withdrawal symptoms. There are concerns about informed consent, especially if patients are not fully told about side effects. Additionally, drug companies may bias research to show positive results (publication bias). Some argue that drugs offer a 'quick fix' rather than addressing underlying causes, and they may be overprescribed. However, for many, drugs are life-saving and cost-effective.

Clinical Psychology and Mental Health

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