Practise anxiety and phobia diagnosis, GAD-7 or BIPI measurement, competing explanations and systematic desensitisation, CBT or applied-tension treatment.
Generalised anxiety disorder can be assessed using the GAD-7.
Outline how answers are scored on the GAD-7 scale.
Outline how answers are scored on the GAD-7 scale.
Syllabus 1.4.1 Generalised Anxiety Disorder assessment (GAD-7).
Award 2 marks for a detailed outline. Award 1 mark for a partial outline.
Definitive answer:
- the 'GAD score' is calculated by assigning scores of 0 (not at all), 1 (several days), 2 (more than half the days), and 3 nearly every day, to all 7 questions (hence GAD-7).
- a GAD-7 total score for the seven items ranges from 0 to 21 . Scores represent: 0-5 mild anxiety, 6-10 moderate anxiety, 11-15 moderately severe anxiety and 15-21 severe anxiety.
Example: the GAD-7 has a four-point scale (1 mark) ranging from 0 not at all to 3 nearly every day (2 marks).
Describe the behavioural explanation and the psychodynamic explanation of fear-related disorders.
Use Table A: AO1 Knowledge and understanding to mark
candidate responses to this question.
Candidates must discuss both behavioural and psychodynamic
explanations of fear-related disorders, but they do not need to
use Watson's Little Albert and/or Freud's Little Hans examples
from the syllabus.
Behavioural (classical conditioning)
A phobia develops as the neutral stimulus is paired with something the person is afraid of (the unconditioned stimulus).
If enough pairings occur or the initial UCS is very frightening the person will end up with a fear of the NS. The NS then becomes
the CS .
e.g. Watson and Raynor (1920) Little Albert who was
conditioned to be afraid of a rat (NS) by Watson banging an iron bar (UCS) behind the baby which made him cry (UCR).
Eventually just the sight of the rat (CS) was enough to cause the
crying (CR).
Psychodynamic
A fear is repressed into the unconscious to protect the ego. The phobia can be a redirected fear during an intensely frightening experience (e.g. a physical attack) onto an object.
Denied/repressed impulses of the id which happen during
childhood - often during psychosexual stage of development -when there is conflict between the desires of the id and the
desires of the ego. Conflict is repressed into the unconscious and the phobic object/situation symbolises this conflict.
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Award up to 4 marks where the response has described only part of the question even if the response otherwise
meetsthe criteria for level 3.
4(a)
e.g. Freud, 1909 may also summarise the case of Little Hans with a focus on phobia (horse or bath). For example, Hans developed a fear of white horses as this was a redirected fear of his father. Hans was in the phallic stage of psychosexual development and was experiencing the Oedipus complex. He had sexual desires for his mother and feared his father would castrate him. Hans displaced these strong feelings of fear/hatred towards his father onto horses which reminded him of his father with long mane/black noseband (similar to his father's facial hair) and blinkers (similar to father's glasses).
Other appropriate responses should also be credited.
Evaluate the behavioural explanation and the psychodynamic explanation of fear-related disorders, including a discussion about longitudinal studies.
Evaluation in your answer can include strengths, weaknesses and a discussion of issues and debates.
Use Table B: AO3 Analysis and evaluation to mark candidate responses to this question.
A range of issues could be used for evaluation here.
These include:
Named issue - Longitudinal studies
Strengths
- Shows change in behaviour over time
- Watson's study lasted a few months ( 8 months 26 days until 12 months 21 days - 4 months) and conditioned Little Albert to become afraid of rats, white fluffy objects, etc. over the course of the study. Freud's study lasted from age 3-5 years and investigated the development and resolution of the Oedipus complex during the study.
- Often in-depth as time to collect a lot of data e.g. Freud collected in-depth data from letters from Little Hans' father describing events and conversations he had with Hans
- Holistic - develop a thorough understanding of the participant(s) in the study
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4(b)
- Freud had a holistic view of the causes of Hans' behaviour.
For example, he was sent letters with conversations
between Hans and his father describing little Hans'
thoughts/fantasies. Freud was able to report on how the
fantasies changed during and after the phallic stage to
explain how someone transitions from one psychosexual
stage to the next. Watson was somewhat holistic - tested
Little Albert on a number of different objects to explain the
development of the phobia of rats and also how phobias can
generalise to other objects similar to the phobic object.
- No recall bias as the participant doesn't have to remember
past events.
- Both Watson and Freud (through the father) were recording
events, behaviours, etc. as they occurred during the study.
For example, little Hans' father did not have to recall events
from Hans' childhood but could record them in his letters as
they happened. Makes the data more valid.
Weaknesses
- Time-consuming/attrition.
- In some longitudinal research participants drop out of the
study due to loss of contact, unwillingness to continue, etc.
This did not happen during Watson or Freud's studies, but
the Freud study was very time consuming. A researcher
can invest a lot of time in the study and as longitudinal
studies often have one or few participants if someone
leaves the study this could mean the research cannot
progress.
- Researcher can develop a close bond with the participant
and can be less objective in interpretation of data -particularly if qualitative data
- Freud's research has been accused of being biased as the
data was collected by the father who had a close
relationship with his son (as well as Freud).
4(b)
- Nature versus nurture - Behavioural is nurture as phobias are learned through association between a neutral stimulus and an unconditioned stimulus. In contrast, psychodynamic is both nature and nurture- we all go through the psychosexual stages but whether we pass through them successfully is due to life experiences/nurture.
- Determinism versus free will - The explanations of phobias are deterministic. The behavioural explanation suggests phobias are learned. This is deterministic because the person who develops the phobia has no choice but to develop it due to their learning experience. For example, Little Albert learned to be afraid of the white rat because of the noise he associated with the rat not because he chose to be afraid. However, some element of free-will as a phobic patient can unlearn their phobia (e.g. through systematic desensitisation). Psychodynamic is also deterministic. Freud theorised that a phobia is caused by the expression of anxiety in the unconscious over which we have no control. In addition, the repression of anxiety occurs due to early childhood experiences over which there is little to no control. However, a phobic patient does have free will to go to psychoanalysis and allow the psychotherapist to help them bring the fear into the conscious mind so that it can be resolved.
4(b)
- Case studies - Strengths - in depth research (Watson and Freud) and good ecological validity (e.g. Freud).
Weaknesses - lacks generalisability as just one young boy
(e.g. Watson and Freud) and researcher can become overly
involved leading to bias data (e.g. Freud).
- Validity - Freud's study is open to bias as data was
collected by the father of Little Hans and reported via letters
to Freud. All data was qualitative and open to interpretation.
Little Hans had a frightening experience with a horse which
could explain his phobia and yet this was dismissed by Freud. Watson's data was collected via observation -noting down the behaviour of little Albert (e.g. was he calm,
fussing, crying). As Albert was a 9-month-old baby there are
no demand characteristics or social desirability which
increases validity. It is unlikely that Watson misinterpreted
the behaviour of Albert as the difference between a baby
being calm and crying are clear. Also increasing validity.
However, poor ecological validity as no one is purposefully
conditioned to develop a phobia. Many phobias develop
with just one bad experience with the phobic object.
Repeated and systematic exposure to the banging of the
iron bar is very unrealistic.
Additional issues candidates may include:
- generalisations from findings (if not evaluated within case
studies)
- qualitative data
- subjective data
- ethics
Other appropriate responses should also be credited.
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Snyder and DeBono (1985) found that high self-monitors and low self-monitors have different preferences for advertising
strategies. This finding could be used for advertising winter coats.
Craig has a phobia of blood and injections. He watches someone having an injection on television, feels faint and now he is too frightened to turn on his television.
Suggest how applied tension could treat Craig's phobia so that he can watch television.
Award 3-4 marks for a detailed answer with clear understanding of applied tension linked to treating Craig's phobias so he can watch television.
Award 1-2 marks for a basic answer with some understanding of applied tension linked to treating Craig's phobia.
Example:
Craig should go to therapy to learn applied tension as he is likely to feel faint or actually faint when he tries to watch television. (1) During the therapy Craig can learn to tense his muscles (1) when he sees a television or tries to switch the television on. (1) Craig should practice this several times a day and he will find that he can watch television without fainting. (1)
Other appropriate responses should also be credited.
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For full marks
Must reference Craig needs to do the AT/tensing muscles while he is watching TV.
Must be in context to achieve 3-4 marks (e.g. referencing watching tv, blood/injections).
Can achieve 1 mark for tensing muscles and a 2nd mark for approximate timings of tensing/relax e.g. He should tense his muscles (1) for about 10 to 15 seconds and then relax for about 20 to 30 seconds. (1)
Relaxation on its own =0 marks.