Studies: One contemporary study on another disorder, from the following: Obsessive Compulsive Disorder (OCD) — Edexcel A-Level Psychology
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Studies: One contemporary study on another disorder, from the following: Obsessive Compulsive Disorder (OCD) explained
Symptom scales measure symptoms, not lives, so this study asked which part of the disorder actually damages quality of life.
Read the full explanation
Forty three outpatients completed a standardised severity interview that scores obsessions and compulsions on separate subscales, a depression inventory, and a measure of how far illness intrudes on valued activities and relationships. Depression severity emerged as the strongest predictor of poor quality of life, obsession severity also predicted it, and compulsion severity did not. Because the data are correlational and gathered at one point in time from one clinic, direction of causation stays open, but the clinical implication is direct: treating low mood and intrusive thought may do more for daily living than counting rituals does.
5.3.8 POTS team including March et al. (2004) Cognitive behaviour therapy, Sertraline and their combination for children and adolescents with OCD.
A four arm randomised trial in American clinics compared cognitive behavioural therapy built on exposure and response prevention, the antidepressant sertraline, the two combined, and a placebo, in children and adolescents of school age, over a twelve week course measured on the children version of the standard severity scale. All three active treatments beat placebo, the combination beat either treatment on its own, and the two single treatments did not reliably differ from each other; remission was reached by just over half in the combined arm, around four in ten with therapy alone, about one in five on medication alone and by almost nobody on placebo. Differences between sites in how well therapy performed matter too, because they show that delivery quality varies.
Your focus
- 5.3.7 Masellis et al. (2003) Quality of life in OCD: Differential impact of obsessions, compulsions, and depressions co morbidity.
- 5.3.8 POTS team including March et al. (2004) Cognitive behaviour therapy, Sertraline and their combination for children and adolescents with OCD.
Studies: One contemporary study on another disorder, from the following: Obsessive Compulsive Disorder (OCD) exam tips
Marking Points
- Describe the design as correlational and cross sectional, using three standardised measures on a modest outpatient sample, and make clear that the outcome variable is intrusiveness of the illness into life rather than a count of symptoms.
- Report the pattern with the subscales named, since separating obsessions from compulsions is the contribution of the study and a summary that lumps them together earns nothing.
- Offer the interpretation the paper invites: obsessions are constant, private and impossible to schedule, while rituals can be fitted around a day, and comorbid depression drains the motivation that ordinary activities need.
- Evaluate the method: standardised measures support reliability and replication, but the sample is small, self selected and drawn from one clinic, the measures are self report, and comorbid depression could be a cause of poor quality of life, a consequence of it, or both.
- Draw the applied conclusion that services should measure quality of life alongside symptom severity when judging whether treatment has worked, because the two can move independently.
- Describe the design as a randomised, placebo controlled trial with four conditions, participants of school age carrying the diagnosis, random allocation, and outcome measured on a standardised clinician rated severity scale after twelve weeks.
- Report the ordering of results rather than one figure: combined treatment best, each active treatment better than placebo, and no reliable difference between therapy alone and medication alone, with remission rates following the same order.
- Explain why the combination works, that exposure and response prevention teaches the child to tolerate the anxiety without performing the ritual while the medication lowers baseline anxiety enough for that exposure work to be bearable.
- Evaluate the controls: random allocation and a placebo arm are strong, but therapy cannot be delivered double blind, expectancy therefore favours the therapy arms, and the site differences show that the therapy condition was not a single fixed treatment.
- Give the limits and the ethics: twelve weeks says nothing about durability or about growth and side effects over years, severe comorbid cases were excluded, and giving a child with a distressing disorder a placebo needs justification, which is why the practical conclusion is that treatment should begin with therapy or with the combination rather than medication alone.
Examiner Tips
- 💡Correlational studies attract questions about causation and about statistics, so be ready to say why a correlation coefficient rather than a test of difference suits these data and what a five per cent significance level means.
- 💡Use it in an essay on the impact of the disorder or on why comorbidity complicates both diagnosis and the judgement of treatment success.
- 💡When the command word is assess, judge usefulness by naming a clinical decision the finding would change, which here is what gets treated first.
- 💡Short describe questions ask for aim, method, results and conclusion, so keep the numbers you are sure of and describe the rest qualitatively.
- 💡The standard treatment question asks you to assess effectiveness, so use the ordering of the four conditions as the evidence and then state clearly what the trial does not establish.
- 💡Review questions in the skills paper reward methodological vocabulary used correctly, so write about random allocation, blinding, placebo control and attrition rather than generic criticism.
- 💡Prepare one strength and one weakness each for drug treatment and for therapy, so that a compare question can be answered in either direction under time pressure.
- 💡If the question names a scenario about a young person, apply the findings to that person directly, because application marks are lost by writing a general essay.
Common Mistakes
- Writing that compulsions do not affect sufferers. The finding is that compulsion severity did not predict quality of life once obsessions and depression were taken into account, which is a claim about relative contribution.
- Reading the correlation as proof that depression causes poor quality of life, when demoralisation from a restricted life could equally produce the depression.
- Describing the sample as large, or as representative of everyone with the disorder, when it is a modest clinic group who agreed to take part.
- Leaving out the quality of life measure altogether and describing the study as though it were about symptom severity only.
- Assuming comorbidity is a flaw in the sample, when it is the variable the study set out to examine.
- Concluding that the drug did not work. It beat placebo clearly; what it did not do was beat therapy or match the combination.
- Treating the placebo group as a no treatment control. Placebo carries expectation and clinic contact, which is exactly why it is the right comparison.
- Describing the therapy in general terms without naming exposure and response prevention, which is the active ingredient for this disorder and the detail the marker looks for.
- Generalising the result to adults, or to long term outcomes, when the sample was children and adolescents followed for one course of treatment.
- Quoting remission rates as cure rates. Remission on a severity scale means symptoms fell below a threshold, not that the disorder has gone.