Practise clinical psychology through diagnosis, explanations, assessment and treatment of mental disorders, applying evidence and debates to patient scenarios.
The key study by Freeman et al. (2003), using virtual reality to investigate persecutory ideation, included a number of self-reports such as the VR-Paranoia questionnaire.
Give two examples of items (questions) included in the VR-Paranoia questionnaire.
Give two examples of items (questions) included in the VR-Paranoia questionnaire.
Syllabus 1.1.1 Key study using virtual reality to investigate persecutory ideation: Freeman et al. (2003).
1 mark for each correct answer
NOTE: Any item from the items listed in the study list, e.g. 'they were hostile towards me', 'they were watching me' (does not need to be word for word for credit).
Explain two strengths of using virtual reality to treat schizophrenia.
Explain two strengths of using virtual reality to treat schizophrenia.
Up to 2 marks for each strength × 2 .
Award 2 marks for an appropriate strength stated and applied as required by the question with detail / elaboration / example.
Award 1 mark for an appropriate strength/ stated but not applied.
Answers may include:
- VR controls the environment (1) allowing a range of situations and settings to be investigated with schizophrenic patients (2).
- It ensures valid data (1) that patients with psychosis are not making up situations and symptoms (2).
- Treatment can be conducted in a safe environment (1 mark) for both the patient (and public) (2 marks)
Other appropriate responses to be credited.
Dr Begum is a clinician who sees a patient, Joan. Joan describes how she spends her day feeling miserable and not knowing what to do with her time. She thinks it is her own fault because she cannot decide if she wants to go out, so she stays in. Joan wants to sleep but this is also difficult.
Suggest how Dr Begum could use the Beck depression inventory (BDI) with Joan.
Suggest how Dr Begum could use the Beck depression inventory (BDI) with Joan.
Award 3-4 marks for a detailed answer with clear understanding of using BDI with Joan.
Award 1-2 marks for a basic answer with some understanding of using BDI with Joan.
Beck Depression Inventory
21-item multiple choice questionnaire. It is a psychometric self report that measures the severity of depression. The patient reads various statements and answers with how much the statement applies to them on a 0-3 / 4 point scale over the past two weeks. The statements cover issues such as self-dislike, tiredness, etc. The higher the score, the more depressed the person is deemed to be.
e.g.
- (0) I do not feel sad.
- (1) I feel sad.
- (2) I am sad all the time and I can't snap out of it.
- (3) I am so sad or unhappy that I can't stand it.
1-10: These ups and downs are considered normal
11-16: Mild mood disturbance
17-20: Borderline clinical depression
21-30: Moderate depression
31-40: Severe depression over-40: Extreme depression
4
Cap at 2 marks outlining the features of the BDI with no link to Joan or how it can be used with her.
Cap at 3 marks if no reference is made to Joan specifically (e.g. one of her symptoms) but the response refers to how Dr Begum can use the BDI with Joan (e.g. diagnosis).
Used to diagnose Joan with depression = 1 mark
3(a)
Version 2-got rid of the statements that had the same scoring.
Version 3 - changed questions on body image, hypochondria and difficulty working and added in questions on sleep loss and appetite.
For example:
Dr Begum could use the Beck Depression Inventory with Joan where she would read 21 statements ( 1 ) and answers on a 0-3 scale over the past week. (1) Joan will likely give high scores to the statements about sadness, sleep, losing interest in other people (1). She might also score highly on feeling she is worse than other people and feeling like a failure as she thinks it is her fault. (1) A score over 21 would indicate a diagnosis of depression as this is moderate depression. (1) OR a score over 17 might be considered for a diagnosis of depression as this is borderline clinical depression. (1)
Other appropriate responses should also be credited.
Explain one reason why the Beck depression inventory (BDI) is valid.
Explain one reason why the Beck depression inventory (BDI) is valid.
Award 2 marks for an explanation of why BDI is valid.
Award 1 mark for a basic explanation of why BDI is valid.
Likely answers from:
- There are 21 items, so the measure is valid as measuring a wide variety of symptoms of mood (affective) disorder. Includes both cognitive and physical symptoms (e.g. sadness, sleep).
- There is a choice of 4 items per statement rather than yes/no responses. Gives respondent opportunity to express how they feel in more depth.
- Good validity as covers the symptoms for depression that are in the ICD-11 such as depressed mood and loss of interest in activities.
- Good concurrent validity with Hamilton Psychiatric Scale (another measure of depression). The BDI has a positive correlation with the HAMD.
Example:
The Beck Depression Inventory is a valid way to measure depression as it includes 21 items so measures a wide variety of symptoms. (1) These symptoms include both cognitive and physical symptoms so patients with different types of symptoms (e.g. mainly cognitive) could receive a diagnosis of depression. (1)
Other appropriate responses should also be credited.
2
Allow reference to either ICD-11 or DSM V.
Objective data can be credited where the response explains that the clinician isn't interpreting the response of the patient.
No credit to identifying that the data is objective or quantitative on its own.
No credit to reliability.
Kleptomania can be assessed using the Kleptomania Symptom Assessment Scale (K-SAS).
State one question used on the K-SAS.
State one question used on the K-SAS.
Syllabus 1.3.1 measure of impulse control disorders: Kleptomania Symptom Assessment Scale (K-SAS).
Award 1 mark for partial answer.
Award 2 marks for full answer.
Definitive answer:
1 If you had urges to steal during the past WEEK, on average, how strong were your urges?
During the past WEEK,
2 how many times did you experience urges to steal?
3 how many hours (add up hours) were you preoccupied with your urges to steal?
4 how much were you able to control your urges?
5 how often did thoughts about stealing come up?
6 approximately how many hours (add up hours) did you spend thinking about stealing?
7 how much were you able to control your thoughts of stealing?
8 on average, how much tension or excitement did you have shortly before you committed a theft? If you did not actually steal anything, please estimate how much anticipatory tension or excitement you believe you would have experienced, if you had committed a theft.
9 on average, how much excitement and pleasure did you feel when you successfully committed a theft? If you did not actually steal, please estimate how much excitement and pleasure you believe you would have experienced if you had committed a theft.
10 how much emotional distress (mental pain or anguish, shame, guilt, embarrassment) has your stealing caused you?
11 how much personal trouble (relationship, financial, legal, job, medical or health) has your stealing caused you?
12 how many times did you steal?
NOTE: marks awarded for 'closed question responses' i.e. scale to answer question. See attached.
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).