Question 1

What is the difference between the DSM-5 and ICD-11 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 US, while the ICD-11 (International Classification of Diseases, 11th revision) is published by the World Health Organization and used globally. Both classify mental disorders but have some differences in criteria. For example, the ICD-11 includes a broader category for schizophrenia spectrum disorders. In exams, you need to know that both systems aim to improve reliability and validity, but issues like co-morbidity and cultural bias still affect diagnosis.

Question 2

How effective is CBT compared to drug therapy for depression?

Accepted Answer

CBT (cognitive-behavioural therapy) and drug therapy (e.g., SSRIs) are both effective for depression, but they work differently. CBT addresses negative thought patterns and behaviours, while drugs alter neurotransmitter levels. Research shows that CBT has longer-lasting effects and lower relapse rates than drugs alone, but it requires time and motivation. Drug therapy works faster and is more accessible, but side effects (e.g., nausea, insomnia) can be problematic. NICE guidelines recommend CBT for mild to moderate depression and a combination of CBT and drugs for severe cases.

Question 3

What did Rosenhan's study (1973) show about the reliability of psychiatric diagnosis?

Accepted Answer

Rosenhan's study involved pseudo-patients (normal individuals) who reported hearing a single word ('empty') to gain admission to psychiatric hospitals. All were diagnosed with schizophrenia (except one with manic depression) and were kept for an average of 19 days. The study showed that psychiatric diagnosis lacked reliability and validity because the pseudo-patients' normal behaviour was misinterpreted as symptoms of illness. It also highlighted the power of labelling, as staff interpreted all behaviours as consistent with the diagnosis. This study is often used to criticise the medical model of mental illness.

Question 4

What are the main symptoms of schizophrenia?

Accepted Answer

Schizophrenia is characterised by positive symptoms (additional experiences) and negative symptoms (loss of normal functions). Positive symptoms include hallucinations (e.g., hearing voices), delusions (e.g., believing you are being controlled), and disorganised speech or behaviour. Negative symptoms include avolition (lack of motivation), alogia (poverty of speech), and anhedonia (inability to feel pleasure). For diagnosis, the DSM-5 requires at least two symptoms (including one positive) for a significant portion of time over one month.

Question 5

How do biological and psychological explanations for depression differ?

Accepted Answer

Biological explanations focus on genetic factors (e.g., heritability estimates from twin studies) and neurotransmitter imbalances (e.g., low serotonin). For example, the serotonin hypothesis suggests that reduced serotonin activity leads to depressive symptoms. Psychological explanations, like Beck's cognitive triad, emphasise negative thought patterns about the self, world, and future. Ellis's ABC model focuses on irrational beliefs (e.g., 'I must be perfect') that trigger depression. Both have evidence: drugs that increase serotonin improve mood, but CBT that changes thoughts is also effective, suggesting a biopsychosocial approach.

Question 6

What ethical issues arise in the treatment of mental disorders?

Accepted Answer

Ethical issues include informed consent (patients may not fully understand treatment risks), side effects of drugs (e.g., tardive dyskinesia from antipsychotics), and the use of coercion (e.g., involuntary hospitalisation). In therapy, issues include confidentiality (e.g., if a patient poses a risk to others) and therapist competence. The Rosenhan study also raised ethical concerns about deception and lack of consent. In exams, you should discuss how ethical guidelines (e.g., BPS Code of Ethics) aim to protect patients, but real-world practice can still be problematic.

Topic 5: Clinical psychology

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Related Topics in EDEXCEL A-Level Psychology

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Topic 1: Social psychology

Topic 2: Cognitive psychology

Topic 3: Biological psychology

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