The questions which ask you to describe and outline treatments/progammes/theories and techniques, really want you to explain HOW it works. Provide examples of how it works to show your understanding.
See the model answers below, both got full marks! Outline behavioural treatment for dysfunctional behaviour (10)
Theory: Behavioural treatment of dysfunctional behaviour is based on the theory that dysfunctional behaviour is learned. Describe the stages of the model/treatment/programme: Examples of learning include operant conditioning, classical conditioning and social learning theory. Treatment therefore uses the theory that dysfunctional behaviour is learnt to assume that it can be reversed using the same techniques. Example: For example, depressive behaviours are the result of operant and classical conditioning; an example of this could be, when someone is new in a job, they receive lots of attention and praise for doing well, however after a while, this attention and praise decreases, and so the rewards for doing well are less, this may lead to poorer performance which, in turn, leads to punishment, such as no bonus, or people getting angry with them. After a while this negative feedback leads to lower moods and an association between work and feeling sad forms. So to treat this, patients are rewarded for positive thoughts, and punished for negative thoughts (operant conditioning) in order to push them to have more positive thoughts. As well as this, the practitioner also tries to link negative situations to positive stimuli, in order for the patient to link that situation with something positive, and avoid depressive behaviours as a result.
Describe the health belief model (10) Theory: what does it believe: The health belief model is a cognitive theory which explains why people do or do not follow health belief regimes. Describe the stages of the model/treatment/programme: There are two main aspects of this in terms of threat to health, the perceived seriousness, and the perceived susceptibility. On top of this you finally have demographic variables which may influence people’s decisions about health behaviours. These variables include things like age, income, gender, occupation, education and family size. Finally you have the likelihood of action which is weighed up by the barriers and benefits. Example (how can this apply to an individual or situation): For example if you are making a decision about binge drinking you may perceive a hang over as not very serious and your threat to your health may not imply anything particularly dangerous. Demographic variables such as young age may make you think less responsibly about your decisions as you have little to lose. Whereas if you had a family, you may make decisions more cautiously as you know it could have a knock on effect on important people in your life. In addition, to these factors there is also the cost-reward analysis. If the benefits outweigh the costs, you are likely to change your behaviour. In this case if missing out on a fun night drinking is more important than avoiding a hangover, an individual will decide to binge drink.
If it asks you to outline/describe a piece of research/evidence/study then you need to puke up the study. If it has HOW or WHY in the question this is when you must use the PEEL structure X 1
TURNING TO CRIME: Outline one piece of research into criminal thinking patterns 
Using the structure of PUKING UP THE STUDY e.g. AIM-SAMPLE-PROCEDURE-RESULTS-CONCLUSIONS
AIM: Yochelson and Samenow wanted to investigate whether the type of offence committed affected cognition in criminals and whether criminals had ‘faulty’ thought processes. SAMPLE: The sample used was 255 males from a wide range of backgrounds and classes, in a secure mental hospital. PROCEDURE: The criminal thinking patterns were investigated by the investigators by using the self-report technique of interview. A Freudian based technique was used. This study was a longitudinal prospective study and followed the criminals over a period of 14 years – regularly interviewing them. RESULTS: Yochelson and Samenow analysed the data and found criminals to have similar characteristics to each other – by characteristics I mean ‘faulty, irrational thinking’. They felt separate from mainstream society, constantly setting themselves apart from others. They lacked empathy, were habitually angry and pre-judged situations. They also believed acts by parents/teachers towards them were purely impositions and they wanted to have a life of high risk-excitement at any cost. CONCLUSIONS: Yochelson and Samenow concluded they found 52 ‘errors’ of thinking in the criminals and even though these qualities exist in non-criminals they were much more ‘prominent’ in criminals. 10/10
REACHING A VERDICT: Describe how the attractiveness of a defendant can influence courtroom behaviour 
This question requires you to engage with the question. Use the structure PEEL – POINT-EXPLAIN-EVIDENCE-LINK
POINT & EXPLAIN: When appearing in court, defendants are generally advised by their solicitors to make the best of their appearance, in the hope that it will give them more credit with the jury. EVIDENCE: This idea was investigated by Castellow, with his work on attractiveness. In this study, a case of sexual harassment was given to participants, with attached photos. The participants were asked the question ‘Do you think Mr Radford was guilty of sexual harassment?’, and were also asked to rate the people in the photographs on scales of personality, e.g. kind-cruel, warm-cold. The results of this study found that an attractive defendant was less likely to receive a guilty verdict, and an unattractive defendant with an attractive victim was more likely to be found guilty. LINK: These results show that the more attractive a defendant, the less likely a guilty verdict. Therefore, defendants are well-advised to make the best of their appearance when appearing in court. 8/10
This question has not related to the theory e.g. the halo effect – the theories always help you to explain HOW!
AFTER A GUILTY VERDICT: How can probation serve as an alternative to imprisonment 
POINT: Probation can serve as an alternative to imprisonment by providing a supportive sentence that are agreed, and an offender must obey. EXPLAIN: It is an alternative as it can help offenders sort out problems that may be leading them to turn to crime. EVIDENCE: Fore example in the Mair and May study, offenders were interviewed about their experience on probation. 60% of the sample felt that probation was useful. They found that having an independent person to talk to was the most useful function of probation. It was also found that topics that were mostly discussed were problems with accommodation, money, families and drug use. LINK: The topics outlined above could potentially be key reasons why people turn to crime. Therefore, if probation can work to support and solve some of these issues, probation can work to deter crime by providing individualist help rather than prison which works as a one fits all punishment. 10/10
HEALTHY LIVING: Explain why people may not adhere to medical regimes 
POINT: Individuals may not adhere to medical regimes due to rationalising non-adherence. EXPLAIN: This means that an individual will way up the costs of adhering to a medical regime with the overall effects on their health. EVIDENCE: For example in the Bulpitt study they investigated the adherence to anti-hypertension drugs for high blood pressure. They found that anti-hypertension drugs have many side effects such as sleepiness, dizziness and lack of sexual functioning and this lead to people not taking them. LINK: This explains why people may not adhere to medical regimes as people will not take the medication if the costs of the medication, such as side effects, outweigh the benefits of treating an asymptomatic problem i.e. an illness which does not show indication/symptoms. 9/10
STRESS: Describe one piece of research which considers work as a source of stress 
AIM: Work is a source of stress. This evidence is from Johansson’s study of measurement of stress. SAMPLE: Johansson conducted a quasi-experiment of 24 workers in Swedish sawmill. 14 of the workers were in a high-risk group and 10 of the workers is in the control group. PROCEDURE: Both group were asked to give a urine sample arrived work and 4 other times per day and were also given a questionnaire about emotion, use of nicotine, caffeine. RESULTS: The results show that the high-risk group has an adrenaline levels 3 times higher at the beginning of day than the borderline and continued through the day. The control group has an adrenaline levels 2.5 times higher of the beginning day than the borderline but decrease through the day. The self-report of high risk group shows the usage of nicotine and caffeine much higher than the control group. CONCLUSIONS: These results suggest the more pressure at work, the more usage of nicotine and caffeine. And this result considers work as a source of stress. 8/10
Outline a cognitive technique for managing stress 
A cognitive technique for managing stress is ‘stress inoculation therapy. Meichenbaum used this in a group as a way of managing stress. Stress Inoculation Therapy has three levels to it. In the First level, the stressed person meets with the cognitive therapist and talks about why they are stressed and is made ware about how they are feeling and functioning with everyday task. The second level is changing these negative thinking patterns into positive patterns and ways of thinking. The third level is applying those new positive thinking patterns to a real-life stressful situation. Meichenbaum realised that people ‘faulty thinking’ can be changed to positive thinking by seeing a cognitive therapist and talking things through. 8/10
Outline how the biological approach would explain one of the following disorders (affective, anxiety, psychotic) 
POINT: The biological approach could be explained through genetics. EXPLAIN: This is the idea that we can inherit schizophrenic genes from our parents and therefore have a tendency to develop schizophrenia as a result of stress later on in life. EVIDENCE: For example in Gottesman and Shields they found that in all 3 adoption studies there was an increased incidence in schizophrenia where children who had schizophrenic parents but were brought up by foster carers without schizophrenia, compared to normal children brought up by adoptive parents with schizophrenia. LINK: This therefore shows are strong argument for a genetic link, as children who have schizophrenic parents, but are nurtured by non-schizophrenic parents, schizophrenia is still apparent, therefore nature over nurture. 8/10
JAN 2012: To
what extent are biological
explanations of why people turn to crime reductionist? 
biological explanations can be seen as reductionist, EXPLAIN: this means they explain criminal behaviour by reducing it
down to 1 factor. Taking a reductionist approach means that other important
factors may be ignored, for example situational factors such as peer pressure
may also be an important influence on criminal behaviour. EVIDENCE: For example Dabbs investigated how testosterone played a
role in violent crimes and or brain dysfunction as researched by Raine. CHALLENGE: However, taking a
reductionist approach has some benefits; it is a scientific approach and allows
study of that 1 factor in depth. For example Raine could look at activity in
specific parts of the brain such as the pre-frontal cortex using extremely
scientific methods and this allowed him to suggest preventative measures during
only biology to explain criminal behaviour does cause some problems also. This
focuses on the nature part of the debate which again is quite. EXPLAIN: This is difficult to suggest
seeing as nature and nurture can never be separated or studied individually. EVIDENCE: its explanations point out
innate factors causing criminality, for example genetic abnormalities as
investigated by Brunner. He found that in 1 family a genetic abnormality
affected production of mono-amine oxidase A (MAOA) an enzyme involved in the
regulation of serotonin (a neurotransmitter).
It was concluded this led to mental retardation and thence to criminal
behaviours e.g. Rape/arson. CHALLENGE:
However this explanation ignores the importance of Nurture on our behaviour. We
also learn behaviours from our environment; this might explain why not all of
the 5 males studied actually showed aggressive behaviour.
EVIDENCE: Farrington and West’s study identified a combination of factors from nature
(e.g. low IQ, impulsivity due to attention deficit hyperactivity disorder) and
nurture (e.g. convicted parent, delinquent siblings). EXPLAIN: This is arguably as better explanation as it is more
holistic and less reductionist. CHALLENGE:
However, having a holistic approach can often mean that the factors studied are
not studied in depth. This means that it can lack validity when the approaches
are explaining why people turn to crime.
To what extent does the
cognitive approach provide an explanation of criminal behaviour? 
Cognitive Approach focuses solely on the mental processes that go on in a person’s
mind or in terms of explanation for behaviour; EXPLAIN: it infers that if we have ‘faulty’ logic and ‘faulty’
processes this will cause us to behave in a criminal way. EVIDENCE: The studies by Yochelson and Samenow, Gudjohnsson and
Bowles and the stages of moral development by Kohlberg all support how the
cognitive approach could help to explain why criminals behave in the way they
do. CHALLENGE: However, Yochelson
and Samenow study has a high participant attrition rate and this could
potentially undermine its usefulness because we cannot rely on the conclusion
it draws when explaining criminal behaviour. CHALLENGE: Once more, the sample was androcentric and therefore
cannot be applied when assessing the explanation of women turning to crime.
& EVIDENCE: We meet a similar problem with Gudjohnsson study
as it is based in Northern Ireland and could be said to be ethnocentric EXPLAIN: and therefore the results
cannot be generalised far beyond these men in Ireland, this therefore provides
a rather limited cognitive explanation of criminal behaviour. CHALLENGE: On the other hand, this
study was repeated in England and was found to have similar results- implying
that this study could help us to understand criminal behaviour.
POINT: A major
weakness with using the cognitive approach is that how do we possibly know what
a criminal is thinking before they carry out their crime. EXPLAIN: This lends the approach to be very subjective and
therefore cognitive explanations may lack validity. EVIDENCE: Various self-report methods can be used – Interviews in
Yochelson study and the use of scales – the ‘blame attribution’ scale in Gudjohnsson
study. CHALLENGE: The major floor in
using these is that, how do we know the criminals are not giving socially
desirable answers? Or can we be completely sure they are telling the truth? The
answer is we cannot, and this is supported by Yochelson admitting that
participants lied occasionally – severely undermining the validity of the
study. CHALLENGE: Another problem
with using the cognitive approach is that it is extremely reductionist. It just
looks at mental process and does not look at past experiences of the criminal. Raine
looks at biological reasons, instead of cognitive, but this is just as
Evaluate the methodology used in research into witness appeal 
POINT: The first
methodological issue to be considered is that of data collection. Most studies
into witness appeal use a self-report method. EXPLAIN: The problem with this is it gives the possibility of
participants responding to demand characteristics and social desirability bias.
EVIDENCE: For example in the study
by Penrod and Cutler into the effect of witness confidence, the participants
were asked to fill in a questionnaire asking about their reasons for believing
one witness and the effect of the witness’ confidence on their verdict., for
example a participant may report that they are more influenced by a participant
who is 100% confidence simply because it appears to be the obvious answer but
is not necessarily the truth. CHALLENGE:
However, it could be argued that self-report in research is the most accurate
way to understand the decisions a jury might make.
factor of the methodology used in research that can be explored is the
sampling. It appears that the majority of research into witness appeal is based
on a student sample. EXPLAIN: This
is most likely the result of an opportunity sample, as students are the easiest
and most available individuals to act as participants. EVIDENCE: Studies such as Castellow uses student samples and this may
be particularly significant in his research on the attractiveness of a
defendant. Firstly, because a student sample is not representative of a typical
jury, and a group of students, particularly if they are all from one area, are
likely to have similar opinions and similar life experience rather than variety
found in universities. Therefore results from research using this sample is not
representative or generalisble. CHALLENGE:
Another issue with the sampling used in witness appeal research, is that students
from one areas of the world such as USA may have artificial/materialistic views
about appearance so again, may not be as valid as a varied jury.
the task used in research into witness appeal is artificial due to ethical
guidelines of confidentiality, EXPLAIN
& EVIDENCE: and studies such as Castellow’s whereby the trial is read
as a photo is unrealistic as in a real trial the full body would be on view,
mannerisms and gestures would have one effect on an individual’s attractiveness
and details for the case would not be on paper, allowing for scrutiny and
repeats of the case. This suggests that research into witness appeal provides
low ecological validity due to the task given to assess the effects on verdicts.
CHALLENGE: However, this can be
increased by using videotapes, actors and creating a shadow jury as done in
Ross et al’s study into the effect of shields on children.
Assess the effectiveness of offender treatment programmes 
POINT: Assessing the effectiveness of
offender treatment programmes can be difficult, EXPLAIN: as there is a debate as to what effective actually means,
does it mean reducing recidivism rates, reducing certain types of behaviour, or
does it link to the effectiveness of the treatment on a long-term perspective? EVIDENCE: For example the Wheatley ear
acupuncture investigation assessed the effectiveness of ear acupuncture for
drug addicts. Wheatley found that the offenders reported increased relaxation
and better sleep. CHALLENGE: Some
would argue that increased ‘relaxation’ does not show the effectiveness of the
offender treatment programme as this does not necessarily mean that they won’t
reoffend. CHALLENGE: On the other
hand, Wheatley did also find a 70% reduction in drug related incidents,
suggesting that ear acupuncture is effective in prevention of drug related
incidents which you can argue is effective.
POINT: This brings me on to my next point.
‘Proxy measures’ for the effectiveness of therapies can be untrustworthy, EXPLAIN: as they are often susceptible
to demand characteristics and therefore can reduce the validity of findings and
thus making the treatment less effective. EVIDENCE:
For example, Ireland demonstrated the effectiveness of the CALM treatment programme
through the use of behavioural checks and self-reported aggression (proxy
measures). These measures are useful, as they show how the offender regards the
treatment. CHALLENGE: However, the
offenders may have been behaving more ‘reformed’ when behaviour was checked
within the prison, in order to seek early parole. CHALLENGE: On the other hand, offender treatment programmes can be
suggested to be effective, as they can help change beliefs (e.g. ‘CALM’) as
well as behaviour (Wheatley). However, there are difficulties in measuring
their effectiveness, due to demand characteristics.
Discuss theoretical approaches to beliefs about health 
Theoretical approaches to beliefs about health can often take a reductionist approach
when explaining why people chose certain health behaviours. EXPLAIN AND EVIDENCE: To suggest that
just one personality trait such as locus of control, could greatly influence
something like giving up smoking is far too simplistic. The locus of control
simplistically assumes that if we have an internal belief (I’m in control of my
health) about our health behaviours we are more likely to change it compared to
an external belief (Others are responsible for my health). CHALLENGE: Biological factors such as addiction, social factors
such as social pressure, denial and illogical cognitions all can play a part
which the locus of control does not take into account. CHALLENGE: On the other hand, taking a simplistic and reductionist
approach can be useful to begin to understand why people make certain health
choices and can help researchers begin to understand some of the factors and
build an understanding on how to help people make the right decisions on their
POINT: The health
belief model is a theoretical approach that tends to be more holistic compared
to other approaches such as locus of control. EXPLAIN AND EVIDENCE: This is because it considers cognitive
factors such as perceived seriousness and perceived susceptibility. In addition,
it considers demographic variables such as age, gender, occupation and
education. This approach gives and explanation which assumes that a person
makes a decision on their health behaviour by considering the benefits of a
decision and deciding whether the costs outweigh the benefits or not. This
holistic approach is more complex and may be more representative of how people
make decisions on their health. CHALLENGE:
However, this approach, although more holistic, still does not take into
account individual differences such as personality traits and morals which
could be a key contributor to the reasons why people have certain health
behaviours. Therefore it is reasonable to suggest that taking only one
theoretical approach is not as beneficial as taking numerous approaches.
POINT: The final
theoretical approach is self-efficacy which again takes a cognitive approach in
understanding why people take upon certain health behaviours. EXPLAIN: It could be argued that health
belief approaches are therefore highly subjective as they all tend to take a
cognitive stance and therefore are susceptible to researcher bias and therefore
reduce the validity and usefulness when applying these theoretical approaches
to health behaviours. EVIDENCE: The
Bandura study found that if someone had a higher self-efficacy (i.e. they
believe in themselves that they will be successful in changing) they are more
likely to be able to overcome a phobia of snakes. CHALLENGE: Although highly subjective, taking a cognitive approach
can create a better understanding of the reasons why people make certain health
choices and lead to the development of cognitive models which are useful in
predicting behaviours and promoting healthy lifestyles.
Compare techniques of managing stress 
compare question your point needs to outline a similarity or difference
straight away, see below: COMPARE/EXPLAIN/EVIDENCE/CHALLENGE/CHALLENGE
& EXPLAIN: Stress Inoculation Therapy is a cognitive approach and
therefore is very subjective and therefore open to problems with validity
because it focuses on changing thought processes which you cannot physically
see, whereas behavioural approaches to managing stress are slightly more
objective, this is because they make assumptions about stress from behaviour
that can be visually observed EVIDENCE:
(Budzynski – measuring muscle tension in headaches) whereas the cognitive
approach assumes that cognitive processes occur that cannot be objectively
measured (Meichenbaum – perceptions of stress). CHALLENGE: However, even though behavioural measures are more objective,
it does not always mean that the interpretation of the behaviour is valid;
other confounding factors may play a role in managing stress. CHALLENGE: In addition, subjective
measures can be very useful to help understand concepts that we don’t fully
understand and can therefore by extremely useful when understanding how to
EXPLAIN: Social support is situational which may be harder to change and
may cause additional stress; this is because not all friends and family can
have a positive effect on health, on the other hand, cognitive therapy is expensive
and requires dedication and time. EVIDENCE:
The Waxler study, did find a positive effect on survival rate and social
support, but social support maybe harder to implement on a larger scale as only
133 women were used. Meichenbaum used SIT as a way to manage stress which
requires trained staff and 8 therapy sessions, arguably very time consuming. CHALLENGE: On the other, hand, the social
support offered may help to reduce stress more quickly and thus may be more
efficient. CHALLENGE: However, although time consuming SIT focuses on treating
the causes of stress rather than the symptoms which could arguably be more
effective in the long-term.
& EXPLAIN: Finally, there are too many factors involved in human
assume that the reductionist approach of one technique will be
sufficient to encompass the complexities of our activities and behaviour. This
is a similarity that all the methods of managing stress have. EVIDENCE: Waxler believes increasing
positive social support will increase survival rates, Meichenbaum assumes that
altering cognitive errors in thinking can reduce anxiety and Budzynski uses
Biofeedback and relaxation training to help teach behaviours that result in
more relaxed muscle tension. CHALLENGE:
However, it is useful to take a reductionist view on managing stress as it
enables researchers to develop focussed directions on managing different types
Evaluate the difficulties when identifying characteristics of psychological
POINT: One of the
difficulties in identifying disorders is that it can be highly subjective. EXPLAIN: This can lead to individuals
being diagnosed incorrectly. Therefore disorders may be interpreted. EVIDENCE: For example in Rosenhan –
sane in insane places. It was found that fake participants were diagnosed with
schizophrenia in a reliable manner. However, they were diagnosed with
schizophrenia, when they did not have any mental health issues. CHALLENGE: However, the DSM has now
adapted the criteria to make it clearer and therefore less likely to
addition, when identifying disorders it requires self-report from individuals
who may not perceive their behaviour as abnormal or dysfunctional, or who may
be prone to lying/disordered thoughts and social desirability. EXPLAIN: This may mean that again
individuals are diagnosed incorrectly. EVIDENCE:
In the DSM the symptoms include delusions, hallucinations, social
occupational and must be apparent for 6 months. If individuals do not put
forward all their symptoms it may be difficult for a doctor to diagnose
disorders accurately. CHALLENGE:
However, information from family and friends could potentially be collected to
collect a more holistic view of the patient and therefore more accurately
identify the characteristics of a disorder. CHALLENGE: But again this may not always be an option.
EXPLAIN & EVIDENCE: There is significant overlap between disorders e.g.
loss of pleasure is a factor in depression and schizophrenia, whilst bipolar
disorders and schizophrenia can feature delusions and disordered actions.
Anxiety is also somewhat common amongst people who are depressed, due to feelings
of worthlessness and pessimistic depressive thought patterns. CHALLENGE: However it is useful to
categorise symptoms for different disorders as it can help to direct the most
effective treatment and support. CHALLENGE:
On the other hand, if participants are diagnosed with a disorder they do not
have, it could create issues of self-fulfilling prophecy, or the effectiveness
of the support and treatments provided.
In this section you can use the studies that you have learned for disorders on questions for dysfunctional behaviour. There are a couple of questions that you would not be able to answer. I have highlighted these in bold. Basically if it is anything to do with biases or definitions of dysfunctional behaviour DO NOT ANSWER IT!
5 (a) Describe one way to measure non-adherence to medical advice. 
(b) Assess the reliability of research into non-adherence to medical advice. 
6 (a) Describe one piece of research which considers work as a source of stress. 
(b) Discuss problems of conducting research into the causes of stress. 
7 (a) Outline a cognitive technique for managing stress. 
(b) Compare techniques for managing stress. 
8 (a) Describe the characteristics of a psychotic disorder. 
(b) Evaluate difficulties when identifying characteristics of psychological disorders. 
5 (a) Describe self-efficacy as a theory of health belief 
(b) Discuss the theoretical approaches to beliefs about health 
6 (a) Describe one physiological measure of stress 
(b) Assess the validity of different methods for measuring stress 
7 (a) Outline one way in which a dysfunctional behaviour can be categorised 
(b) Discuss the limitations of diagnosing dysfunctional behaviour 
8 (a) Outline how the biological approach would explain your chosen disorder 
(b) Evaluate the different explanations of the disorder you referred to in part a.
5(a) How can fear arousal be used as a method of health promotion 
(b) Assess the effectiveness of the methods of health promotion 
6(a) Describe one cognitive technique for managing stress 
(b) Discuss whether stress should be managed through treating the individual or their situation 
7(a) Outline a biological explanation of dysfunctional behaviour 
(b) To what extent are biological explanations to dysfunctional behaviour reductionist 
8(a) Outline a behavioural explanation of one disorder 
(b) Compare explanations of the disorder you referred to in part a 
5 (a) Describe one piece of research into media campaigning as a method of health
(b) Discuss the ecological validity of research into methods of health promotion. 
6 (a) Outline one piece of evidence which suggests that stress can be caused by hassles
and/or life events. 
(b) Evaluate the reliability of methods of measuring stress. 
7 (a) How might cognitive psychologists explain dysfunctional behaviour? 
(b) Assess the appropriateness of different explanations of dysfunctional behaviour. 
8 (a) How could a psychological disorder (either affective or anxiety or psychotic) be
treated biologically? 
(b) Compare approaches to treating the disorder you referred to in part (a). 
5 (a) Explain why people may not adhere to medical regimes. 
(b) Discuss the difficulties of researching adherence to medical regimes. 
6 (a) Outline the social approach to managing stress. 
(b) Compare techniques for managing stress.  7 (a) Describe research into biases in diagnosis.  (b) Evaluate the reliability of diagnosis of dysfunctional behaviour. 
8 (a) Describe a behavioural treatment for dysfunctional behaviour. 
(b) Discuss ethical considerations regarding the treatment of dysfunctional behaviour. 
5 (a) Describe the Health Belief Model. 
(b) To what extent is there free will in relation to health belief? 
6 (a) Describe self-report as a method of measuring stress. 
(b) Compare different measures of stress.  7 (a) How has dysfunctional behaviour been defined?  (b) To what extent may diagnoses of dysfunctional behaviour be considered ethnocentric? 
8 (a) Outline a cognitive behavioural therapy as a treatment for one disorder (either affective or
anxiety or psychotic). 
(b) Assess the effectiveness of treatments for one disorder (either affective or anxiety or
5 (a) How has legislation been used as a method of health promotion? 
(b) To what extent is research into methods of health promotion limited? 
6 (a) How has dysfunctional behaviour been categorised (eg a classification system)? 
(b) Evaluate the validity of diagnoses of dysfunctional behaviour. 
7 (a) Outline a cognitive explanation of dysfunctional behaviour. 
(b) Compare explanations of dysfunctional behaviour. 
8 (a) Outline a behavioural treatment of one disorder (either affective or anxiety or psychotic).
(b) Assess strengths and weaknesses of treatments for the disorder you referred to in part (a).
5 (a) Describe locus of control with reference to health behaviours. 
(b) To what extent are theories of health belief reductionist? 
6 (a) How could adherence to medical regimes be improved? 
(b) Discuss the usefulness of research into adherence to medical regimes. 
7 (a) Outline behavioural treatment for dysfunctional behaviour. 
(b) Compare approaches to treating dysfunctional behaviour. 
8 (a) Describe the characteristics of one anxiety disorder. 
(b) To what extent is it valid to identify a disorder from a list of characteristics? 
5 (a) How can media campaigns be used to promote healthy behaviour. 
(b) Evaluate the strengths and weaknesses of research into the methods of health promotion 
6 (a) Outline how work can be a cause of stress 
(b) Evaluate the use of quantitative data when researching the causes of stress 
7 (a) Outline the characteristics of an affective disorder 
(b) Assess the reliability of identifying a disorder from a list of characteristics 
8 (a) Describe how dysfunctional behaviour could be treated biologically. 
(b) Discuss ethical issues in the treatment of dysfunctional behaviour 
Any questions that are highlighted in bold are for the topic MAKING A CASE, which we have not done.
1(a)Outline a biological explanation of why males commit more crimes than females. 
(b) To what extent does the biological approach provide an explanation of criminal
behaviour?  2 (a) Describe the cognitive interview.  (b) Discuss qualitative and quantitative approaches to collecting information when interviewing witnesses. 
3 (a) Describe the bottom up approach to creating a profile. 
(b) Assess the reliability of offender profiling. 
4 (a) Identify the link between imprisonment and suicide. 
(b) Evaluate the usefulness of research into the psychological effects of imprisonment. 
1(a) Outline one piece of research into criminal thinking patterns 
(b) To what extent does the cognitive approach provide an explanation of criminal behaviour  2(a) Describe one piece of research into how lies can be detected when suspects are interviewed  (b) Discuss the reliability of information gathered by suspects in interviews 
3(a) Describe how the attractiveness of the defendant can influence courtroom behaviour 
(b) Evaluate the methodology used in witness appeal 
4(a) Describe anger management as a treatment programme for offenders 
(b) Assess the effectiveness of offender treatment programmes 
1(a) Outline how brain dysfunction can explain criminal behaviour 
(b) Evaluate individual (biological) explanations of criminal behaviour 
2(a) How can upbringing in a disrupted family influence criminal behaviour 
(b) Evaluate the use of longitudinal research when considering upbringing as an explanation of crime  3(a) Describe one case study as an approach to offender profiling  (b) Compare different approaches to creating a profile 
4(a) What is the effect on a jury when evidence is ruled inadmissible in court 
(b) Evaluate the usefulness of research into persuading a jury 
1 (a) How might the view of the majority influence a jury when reaching a verdict? 
(b) Evaluate the application of research into what influences reaching a verdict in court.  2 (a) Outline one piece of research into factors which influence the accurate identification of a suspect.  (b) Assess the reliability of research into interviewing witnesses. 
3 (a) What effect does the order in which testimony is presented have on persuading
a jury? 
(b) Discuss limitations of research into persuading a jury. 
4 (a) Describe one piece of research into ‘looking death worthy’. 
(b) To what extent can research into alternatives to imprisonment be considered
1 (a) Outline evidence which shows that genes may influence criminal behaviour. 
(b) To what extent are biological explanations of why people turn to crime reductionist?  2 (a) Outline techniques for interrogation of crime suspects.  (b) How useful is research into interviewing suspects? 
3 (a) Describe research into the effect of shields and videotape on children giving evidence. 
(b) Discuss difficulties which may be encountered when researching witness appeal. 
4 (a) How has ear acupuncture been used as a treatment programme? 
(b) Compare the strengths of different offender treatment programmes. 
1 (a) Describe how social cognition can explain criminal behaviour. 
(b) Evaluate the validity of research into cognitive explanations of criminal behaviour.  2 (a) Describe how top down typology is used to create a profile.  (b) Assess the usefulness of qualitative and quantitative data when creating a profile. 
3 (a) Describe the stages of jury decision-making when reaching a verdict. 
(b) Discuss ethical issues when researching influences on reaching a verdict in court. 
4 (a) How can probation serve as an alternative to imprisonment? 
(b) Evaluate limitations of research into alternatives to imprisonment. 
1 (a) How can criminal behaviour be learnt from others? 
(b) Discuss the view that some people turn to crime because of their upbringing.  2 (a) Describe how researchers have used E-fit to investigate face recognition.  (b) Assess the strengths and limitations of research into interviewing witnesses to a crime. 
3 (a) Describe how persuasion may be used in a courtroom. 
(b) To what extent is research into persuading a jury useful? 
4 (a) Describe research into planned behaviours once freed from jail. 
(b) Evaluate the use of qualitative and quantitative data when researching imprisonment. 
1 (a) What does research into moral development tell us about criminal behaviour? 
(b) Discuss whether individuals have free will when turning to crime. 
2 (a) Describe research into the effect of witness confidence in the courtroom. 
(b) Assess the usefulness of research into witness appeal in the courtroom. 
3 (a) Describe research into the prison situation and roles. 
(b) Evaluate the methodology used in research into imprisonment. 
4 (a) How is restorative justice used after a guilty verdict? 
(b) To what extent are alternatives to imprisonment effective? 
1 (a) How can an upbringing in a poverty and disadvantaged neighbourhoods explain criminal behaviour 
(b) Evaluate the methods used to investigate upbringing as an explanation of crime  2 (a) Describe the use of the cognitive interview technique when interviewing witnesses  (b) Discuss the ecological validity of research into interviewing witnesses 
3 (a) Describe a cognitive skills programme used with offenders 
(b) Assess the usefulness of offender treatment programmes 
4 (a) Outline research into 'looking death-worthy' 
(b) Assess the validity of research into alternatives to imprisonment 
Evaluation of Explanations and Treatments for schizophrenia:
The biological treatments and explanations provide strong support for the nature debate. The behavioural approach supports the nurture side of the debate. Use this to draw comparisons. You can also question how each approach doesn't consider how they both work together to influence schizophrenia.
Cognitive therapies take more of an individual approach as it addresses the individual’s cognitive errors and irrational thinking. Whereas the behavioural approach takes a situational perspective. You can use this to evaluate the usefulness of the explanations and treatments.
All approaches are reductionist in the sense that they only consider one theory. In addition, they don’t consider how many approaches can work together and influence behaviour together. Cognitive approach is more holistic as it does consider behavioural and cognitive approaches e.g. CBT.
Biological treatments address the symptoms rather than the causes; therefore you can question the effectiveness. However, even though CBT tries to address the root cause, it is biological treatments that have the best effects in the long term.
Behavioural treatments are far too simplistic for a complex disorder such as schizophrenia. The long-term effects are questionable i.e. realistically, would they have long lasting effects if positive reinforcement has stopped after leaving the institution.
CBT and positive reinforcement requires trained professionals = more expensive. Biological medicine is works fast and is cost effective. However, many drugs for schizophrenia have nasty side effects. Many people on medication relapse e.g. come of the medication because they feel better, and then have to go back on it when psychosis reappears.
Behavioural explanation kind of assumes that schizophrenia is a choice and can be unlearned. This could be a very unproductive approach if it is has a greater biological cause.
High use of independent measures design in treatments and control groups to help establish cause and effect.
High use of review articles in explanations of schizophrenia, good because it increases the breadth of research, bad because it takes away the depth of research.
High use of longitudinal research in treatments of schizophrenia, good because it can highlight the effectiveness of treatment in the long-term, bad because it may not be effective outside the time frame that they are assessed.
Firstly, it is important to understand that schizophrenia cannot be treated, it will never go away. Schizophrenia can only help someone reduce and manage their symptoms.
BEHAVIOURAL TREATMENTS OF SCHIZOPHRENIA:
This is the idea that schizophrenic symptoms can be unlearned through the use of positive reinforcement (operant conditioning).
Paul and Lentz: Using social learning to facilitate institutionalised patients with schizophrenia.
Aim: Investigated the effectiveness of operant conditioning by reinforcing appropriate behaviour with schizophrenic patients.
Method: A longitudinal study over 4 years which used three different treatments:
Token economy (social learning therapy)
Usual therapies provided by hospital
Patients were assessed using observations, interviews, rating scales prior to the project and prior to release from the institution. They were also assessed numerous times after being released from the institution. An independent measures design was used.
The social learning therapy was based on the behaviourist assumptions of operant conditioning. This is also known as positive reinforcement. This works by rewarding a desired behaviour repeatedly in order to enforce that behaviour in a consistent manner. In this study a token economy system was used in the hospital ward. Patients were given tokens as reward when behaved appropriately i.e. didn't display symptoms of schizophrenia. These tokens could be exchanged for luxury items and activities.
The milieu therapy was designed to increase patients social skills and confidence by getting patients involved in a group therapy session. It includes social opportunities such as group problem solving and group interactions. This based on the assumption from Liberman's study. People with schizophrenia are not given the opportunity to learn 'normal' social skills, which can lead to negative schizophrenic symptoms (lack of emotion and withdrawn from society). Thus by putting them in social situations, they are given an opportunity to be positively reinforced by things like; creating a friendship, support network etc)
The hospital condition varied for different patients. Generally patients spent little time in focused activities ans more time eating, taking medication and using free time.
Positive and negative symptoms were significantly reduced in the social learning therapy (SLT- positive reinforcement).
92.5% of the patients who were part of the social learning programme were released. This was significantly higher than the other 2 therapies.
10.7% of the patients in SLT were released into independent living e.g. they did not need professional support in their care.
Conclusion: Operant conditioning is an affective means of treating people with chronic schizophrenia. However, once patients leave the institution is it very questionable whether the treatment would have long lasting effects.
BIOLOGICAL TREATMENTS OF SCHIZOPHRENIA
The biological treatments try to reduce the symptoms of schizophrenia by shutting off certain chemicals in the brain. This type of treatment greatly supports the idea that schizophrenia has a biological cause. However, it can be questioned how effective this treatment only addresses the symptoms and not the root cause.
Kane: Fluphenazine (medication) vs placebo with patients with schizophrenia which is more effective in reducing symptoms.
Method: A longitudinal study where patients were allocated into one of three groups (independent measures design):
Fluphenazine deaconate: Both of these drugs work by blocking the effect of a chemical in the brain which is thought to affect thinking, feelings and behaviour. Fluphenazine can help to treat the symptoms of schizophrenia or other psychoses. It has a long-lasting effect so it is usually only given once every two to five weeks. It is usually given when people need regular treatment for their symptoms over a long period of time.
Placebo (given a fake drug that would have no effect on their health or symptoms)
The effectiveness of the treatments were assessed on whether each patient had a psychotic episode.
Procedure: Patients were randomly assigned into the conditions. A psychotic episode was classed as a substantial clinical deterioration. Patients would be removed if there were toxic effects from the drugs or an extreme psychotic episode.
Results: The placebo groups experienced the most psychotic episodes and the most drop outs.
Among the drug groups there were no psychotic episodes. Only 2 patients dropped out due to toxic effects. This highlights the effectiveness of drugs as it works in reducing symptoms and is effective over a long period of time.
COGNITIVE TREATMENTS OF SCHIZOPHRENIA
This treatment is the idea that we can correct the irrational cognitive processes that people with schizophrenia have.
Sensky - Using Cognitive Behavioural Therapy (CBT) to reduce schizophrenic symptoms.
Aim: To compare CBT with the technique 'befriending' in reducing positive symptoms experienced in schizophrenic patients (e.g. delusions and hallucinations).
Method: Independent measures design
Sample: 90 patients from a mixture of Newcastle and London. These patients schizophrenia had not responded to medication.
Both treatments were delivered by 2 experienced nurses who received regular supervision. The 2 treatments involved the following:
CBT: The nurses engaged with the patient and asked the patient to tell stories about their schizophrenic episodes. The nurse would then try to develop a normalising reason for their behaviour. The nurse would also aid the treatment of others disorders which the patient may also have such as depression. Specific techniques were used to focus on the positive symptoms (auditory and visual hallucinations) experienced by the schizophrenic patients. This included using cognitive strategies to teach them coping strategies to help them deal with the voices in their head. It helps them to develop an understanding that the voices in their head are not rational.
The nurses in this therapy were empathetic and gave no medical/professional advice. The sessions mainly focused on hobbies, sports and current affairs. They simply acted as a supportive friend.
Patients symptoms and depression were assessed by blind raters to decrease bias. The patients received treatment for over 9 months.
Results: Both CBT and befriending resulted in reductions of positive and negative symptoms and depression.
At the 9 month follow up assessment, patients who had received CBT showed greater improvements on the reduction of schizophrenic symptoms and depression. Whereas the befriending group had lost some of the benefits gained during the treatment.
Conclusions: CBT is effective for people who have not responded to medication. However, it can be questioned whether a 9 month follow up is significant enough to suggest long-term effects of CBT.
HURRAY! YOU'RE ALL FINISHED! REMEMBER TO LEARN ALL THE THEORIES WITH THE STUDIES TO HELP YOU ANSWER THOSE HOW AND WHY QUESTIONS!
The behaviourist perspective might be considered one of the least effective explanations for schizophrenia. The idea that people learn hallucinations and delusions is pretty outrageous!
However, there has been research to suggest that schizophrenic symptoms can be unlearned, therefore it is reasonable to suggest they they could also be learned. The behaviourist perspective explains that schizophrenia is learned and is the result of the environment; particularly, schizophrenia is the result of poor learning experiences. Liberman argued that positive reinforcements were important; lacking positive reinforcement for social skills and activities means that these social skills are not learned. It is therefore argued that the psychotic symptoms of schizophrenia can be learned.
Liberman - Assessment of social skills in schizophrenia:
Method: Review of methods to assessing the problems that schizophrenic patients have with social skills, which results in a lack of social reinforcers.
Participants: Patients with schizophrenia
Procedure: The review article identified key features of social skills that were related to patients with schizophrenia.
Findings: Schizophrenic patients lack appropriate social learning from their past experiences. Therefore 'normal' social skills such as chatting about the weekend are not positively reinforced. Being institutionalised in a mental health hospital can often lead to a loss of social skills. This is because patients become so reliant of the routines and lifestyle of the institution, that it becomes normalised to them. They know nothing else. In addition, the excessive anxiety that they feel leads to schizophrenics avoiding social contact.
Conclusions: It is concluded that schizophrenic patients lack social skills that prevent them from functioning normally. Schizophrenics lack the opportunity to experience social skills ans this then leads to a lack of positive reinforcement (e.g. rewards such as friendship, laughter, closeness). This ultimately creates abnormal behaviour, as 'normal' behaviour has not been reinforced enough to have a positive effect.
BIOLOGICAL EXPLANATION OF SCHIZOPHRENIA
This is the theory that schizophrenia is passed on genetically. But surely this theory id far too simplistic?
Gottesman and Shields: A review of genetic causes of schizophrenia
Method: A review of twin studies and adoption studies into schizophrenia.
Sample: In total there was 711 in the adoption studies (these participants were not twins!), 210 pairs of identical twins, and 319 pairs of non-identical twins.
The incidence of schizophrenia in adopted children was calculated by working out the likelihood of schizophrenia developing when the child was brought up by non-schizophrenic parents, but had biological parents with schizophrenia. They also looked at the likelihood of schizophrenia developing in normal children who were brought up by non-biological schizophrenic parents. (I know what you're thinking. How can earth did they get away with this?)
The twin studies were calculated by working out how often both twins were diagnosed with schizophrenia in both identical and non-identical twins.
In all of the adoption studies, the children who had biological schizophrenic parents and were brought up by normal adopted parents had an increased chance of schizophrenia.
Whereas normal children who were brought up by schizophrenic parents showed little evidence of schizophrenia.
The twin studies showed that if one identical twin had schizophrenia, then there was a 58% chance the other twin would have schizophrenia.
When one non-identical twin had schizophrenia, there was a 12% chance that the other twin would have schizophrenia.
This study provides strong support to the nature side of the nature/nurture debate. However, with percentages of less than 100% it is clear that the environment does play some role in explaining schizophrenia. There is also confusion as to whether one or many genes are responsible for schizophrenia. Further research is needed.
COGNITIVE EXPLANATION OF SCHIZOPHRENIA
This theory is the idea that people with schizophrenia have a broken perception of how information is processed. Therefore, although some of their thoughts maybe bizarre to us, but to the schizophrenic patient, it seems completely logical. Maher – delusional thinking and perceptual disorder
This theory believes that errors in cognitive processes can explain delusions in people with schizophrenia. Every day we develop logical explanations for things that happen. We call these schemas.
A schema is a cognitive framework or concept that helps organize and interpret information. For example a schema to recognise a bird is that all birds have wings. However, what happens with people who have schizophrenia is that they believe their schemas are logical but in fact they are not. The delusional person is actually experiencing distorted information and this demands an explanation. This explanation is then developed into a distorted schema. This schema is then applied wrongly and produces delusional behaviours.
•A person with schizophrenia is sitting on a bus and sees someone in a suit looking at them.
•They may think that the person in the suit is spying on them.
•If someone is staring at me it means that they know something about me.
•If someone wants to know something about me, it must be something I did in the past.
•Maybe they know that I’m really good at solving puzzles and want me to help save the world, maybe they know about that time when I didn't pay all my taxes.
•That must mean they are trying to kidnap me!
We all need to have a logical explanation for things that happen. But in the case of someone with schizophrenia, the sensory input is impaired in some way. This leads the person to hold beliefs that a based on distorted information available to that person. Therefore, someone with schizophrenia, genuinely believe that the schemas that they have developed are completely logical and rational.
Highly subjective – can change from one health professional to the next.
Requires self-report from individuals who may not perceive their behaviour as abnormal or dysfunctional, or who may be prone to lying/disordered thoughts and social desirability
There is significant overlap between disorders e.g. loss of pleasure is a factor in depression and schizophrenia, whilst bipolar disorders and schizophrenia can feature delusions and disordered actions. Anxiety is also somewhat common amongst people who are depressed, due to feelings of worthlessness and pessimistic depressive thought patterns.
Ethnocentrism – it depends on the culture to how behaviour is perceived, some cultures may see behaviours as the norm where others would not.
Hard to diagnose reliably due to individual differences and bias
Ignores biological symptoms as it only focuses on behavioural symptoms.
Positive aspects of identifying disorders:
Helps to establish as reliable way to categorise and diagnose behaviours.
Helps to direct the most appropriate treatment for the individual.
Helps the individual come to terms with and understand why they are different. It is almost a relief to take the weight off their mind. The fear of the unknown is now reduced. Now they can get help.
There are two main manuals which give details about the categories of dysfunctional behaviour and disorders, and thus are manuals on how to diagnose dysfunctional behaviour. The International Classification of Diseases (ICD) is probably more widely used, whilst many studies conducted in the UK and US refer to the Diagnostic and Statistical Manual (DSM), which is a specific manual for psychological disorders, whilst the ICD contains one chapter on psychological disorders and is as a whole a manual on health disorders generally.
The DSM is a practical guide based on field trials and empirical research, as well as referring to past editions of both the DSM and ICD. It was produced by the APA and instructs psychiatrists to evaluate the patient in terms of five axes, although the latter two are optional. The axes are as follows: clinical disorders (such as depression), personality disorders (such as mental retardation), physical health (due to recognising that long-term illness, for example, can influence mental health), environmental factors (such as family problems), and global assessment of functioning. These axes reflect an understanding that disorders result from an interaction of biological, psychological and social factors, and thus it is necessary to look at these axes to give a thorough analysis and diagnosis.
The ICD is an international standard diagnostic classification manual, published by the World Health Organisation – it is now in its tenth revision. Chapter 5 is the only chapter relevant for mental and behavioural disorders, as it is a manual for all health disorders. It is more symptom-based than the DSM, and lists clinical and personality disorders on the same axis. There are also 5 more groups of disorders than in the DSM, with ten therefore in total. These axes include: organic mental disorders, delusional disorders, mood disorders, mental retardation, and stress-related and neurotic disorders.
It is important to know that other cultures have diagnostic manuals, for example the Chinese Classification of Mental Disorders. Interestingly it includes 40 culturally-related diagnoses.
Anxiety disorders -
An anxiety disorder is broadly described as a disorder which gives a continuous feeling of fear or anxiety, which is disabling and reduces daily functioning. Anxiety may be triggered by something that appears trivial to others, or may even be “non-existent” – but it feels very real and can have disastrous effects on the person with the disorder. Anxiety disorders encompass many different types of disorders, such as OCD and phobias. Phobia:
The DSM IV will classify a phobia on the basis that the phobic reaction is marked, persistent and excessive or unreasonable and recognised as so.
SPADE: (Rhymes with afraid = phobia)
S – six months under the age of 18
P – persistent fear
A – avoid phobic situation
D – disrupts normal life
E – excessive fear is recognised
These are the symptoms that most with phobias will exhibit; however one or two not shown in the patient is unlikely to hinder their diagnosis as individual differences means people react differently to phobias.
Affective (mood) disorders -
An affective disorder is one which is affects someone’s mood and emotions. Whilst it is completely normal to have varied and sometimes irrational moods, sometimes such severe or debilitating moods are the result of an affective disorder. The most common affective disorder is depression, which is likely to affect most people directly either through an individual themselves having it or someone they are close to having it.
The DSM IV would require a patient or client to be exhibiting five or more of the listed symptoms in the manual in order to diagnose somebody with depression. Symptoms are frequently split with episodes of perceived normality, and periods of mania and depression can last anywhere between days and years.
Because when you FLIRT with someone and get rejected, you get depressed :(
F – Fidgeting
L – Less ability to concentrate
I – Insomnia
R – Recurrent thoughts of death
T – Tiredness
F – Feelings of worthlessness, guilt
Psychotic disorders -
Psychosis is the general term for disorders which involve loss of contact with “reality”, and those diagnosed with psychotic disorders frequently exhibit symptoms such as disordered thought and speech, delusions and withdrawal from the outside world. One psychotic disorder in which these symptoms are typical is schizophrenia.
The DSM would require two or more of these symptoms in order for a diagnosis to be made, as well as social occupational dysfunction which is unexplained by medication or developmental disorders.
Because I couldn't think of a word that made sense, and its hilarious! :)
D – Delusions
D- Disorganised speech
D- Disorganised behaviour
S – Social Occupational
N- Negative symptoms
S- Six months duration
Research favour situational causes of stress, but the treatments tend to be dispositional, so this could be a good issue to look into.
Usefulness and application of causes of stress.
Measures of Stress:
Low construct validity in that it's hard to define stress and thus hard to know when you're measuring it, as well as face validity because the measures of stress can be affected by lying, memory, and demand characteristics. Also, different people experience stress differently so using only one measure on participants may not be a valid approach.
Reliability issues, different people experience stress differently; measures are unlikely to give consistent results if used again in similar situations.
Reductionism, measures which are only self-report (e.g. SRRS) or only physiological (e.g. heart rate monitor) are reductionist and don't look at many features of stress response or the dynamic between them, whilst combined measures are holistic and thus more useful.
Consider which types of management of stress focus on symptoms or causes of stress, and the usefulness of this.
Consider the cost and time effectiveness, long-term/short-term effects.
Ethics, Geer and Maisel, put participants on waiting lists rather than giving them therapy.
SOCIAL APPROACH - Managing stress
Many forms of dysfunctional behaviour are treated in group therapy and support sessions, such as alcoholism, drug addiction and anger management. Some stress management also emphasises the need for social support in coping with stressful situations.
Cohen and Willis argue that there are four types of social support (all of which we need):
1. Instrumental support; practical support such as help with taking care of loved ones or help with getting to where you need to be.
2. Informational support; advice on what to do and how to cope with different situations.
3. Esteem support; emotional support from friends, colleagues, loved ones and others which makes you feel valued, loved and respected.
4. Social companionship; general interaction with others for its own sake rather than functional relationships such as at work. Waxler-Morrison: How social relationships influence women's survival rates with breast cancer.
Sample: 133 Canadian women under the age of 55 who had been diagnosed with breast cancer.
Method and procedure: Quasi-experiment: women with breast cancer and used the social network support and those who didn't. Data was taken from medical records as well as self-report methods (largely questionnaires but also some interviews).
Results:The findings suggested six aspects of social support were most closely associated with cancer survival:
1. Marital status (married women who survived tended to report supportive husbands)
2. Support from friends
3. Contact with friends
4. Employment (employed women found this important in coping with cancer as it was a source of information and social support).
5. Social network
6. Total support
Conclusions: A strong social support system was concluded to reduce the stress associated with life-threatening but not necessarily terminal illnesses such as breast cancer, and thus make survival more likely. Though, obviously the most important factor in survival is the diagnosis of the cancer (i.e. how developed the cancer is).
COGNITIVE APPROACH - Managing stress
According to the cognitive approach, stress is the result of faulty thinking and poor perceptions. However, you will be glad to hear that behaviour these errors in thinking can be improved or cured via cognitive restructuring. This is known as cognitive behavioural therapy (CBT).
One form of CBT specifically targeted at coping with stress is Stress Inoculation Therapy (or SIT). It was developed by Meichenbaum, and has three stages which aim to help clients to replace "self-defeating thoughts" which cause stress with more positive ones, which can help to reduce the effect of potential stressors, and thus reduce the overall stress response.
Meichenbaum - baum sounds like bum, you SIT on your bum. Miss Smiths top tip for remembering this study ;)
The three stages of SIT are:
1. Education - the client and therapist work together to identify the nature of stress, and the therapist educates the client on the general effects of stress to help them understand what stress is and how it can be overcome.
2. Skills acquisition - the therapist helps to train the client in relevant skills which will aid them to cope with and reduce their stress. This often includes monitoring their own internal dialogue and reassuring themselves that things are okay if not everything goes to plan.
3. Application - the patient has to apply their skills to real-life situations, and the therapist helps them with this.
Meichenbaum: comparing SIT to systematic desensitisation and a control group in reducing test anxiety (a major cause of stress)
Sample: The study consisted of 21 students aged 17 to 25, who had responded to an advert asking for participants in a study on anxiety that is experienced when taking tests/exams.
Method: It was a field experiment, where the IV was the type of therapy the participant received (none, SIT or systematic desensitisation), and the DV was levels of anxiety, which was measured through self-reports, and their performance on a test measured by the score they achieved in an IQ test. These measures were carried out before and after the therapy.
Procedure: It was a matched pairs design where they were matched on anxiety levels. There were three conditions:
Group 1 received eight therapy sessions of SIT where they were taught to identify stress, learn how to reduce thoughts which increased their stress, monitoring their internal dialogue, etc.
Group 2 received the same number of sessions but were given the behavioural therapy of systematic desensitisation
Group 3 were put on a waiting list.
Both therapy groups had improved results on their anxiety levels, but Group 1 (SIT group) performed better in test conditions and had reduced anxiety levels than both other groups.
Conclusion: SIT helped to reduce the stress people felt during test situations and enabled them to perform better.
BEHAVIOURAL APPROACH - Managing stress
The behaviourist approach to psychology assumes that we are all born as a blank slate, and we learn all of our behaviour. It's a very reductionist approach as it is purely on the nurture side of the nature-nurture debate, the situational side of the situational-dispositional debate, and deterministic on the freewill-determinism debate.
It essentially works on the basis of three concepts: classical conditioning (learning via association), operant-conditioning (learning via punishment and reinforcement) and social learning theory (learning via imitation and interaction with others).In terms of stress management, the behaviourist approach takes the view that as behaviour is learned, you can be taught to manage stress through the same processes.
Biofeedback is not a treatment. Rather, biofeedback training is an educational process for learning specialised body skills. Learning to recognize physiological responses and alter them is not unlike learning how to play the piano or tennis - it requires practice. Through practice, we become familiar with our own unique physiological patterns and responses to stress, and learn to control them rather than having them control us.
By giving audible feedback on the state of the body it is assumed that we would be more likely to repeat the method of reducing stress. This is the method used by Budzynski's research on patients with tension headaches. These headaches are thought to be caused by sustained contraction of the scalp and neck muscles. Which is associated with stress, therefore by relaxing the muscles (reducing the stress response), the headaches should be reduced.
Budzynski - Conducted a study on the role of biofeedback in reducing stress management.
Method: It was a field experiment. Data was collected using muscle tension measurements (EMG). Patients were also given a psychometric test for depression (MMPI) and asked to complete questionnaires on their headaches.
Sample: 18 volunteers who had responded to an advert asking for people with tension headaches.
Procedure: Participants were split into 3 conditions:
Group 1 were taught relaxation techniques during two weekly sessions for eight weeks, during which they had their muscle tension measured by an EMG machine (genuine measure). They were informed about the biofeedback in terms of clicks, (more clicks = more tension) and encouraged to relax.
Group 2 had the same relaxation training received biofeedback clicks that did not represent their true muscle tension. This was to see if this technique could be successful when used as a placebo treatment. This means that the patients believe they are receiving the treatment, but they actually aren't.
Group 3 were not trained in the relaxation techniques nor taught about the biofeedback and so acted as a control group.
The study showed that Group 1 had the lowest muscle tension, lowest levels of hysteria and depression and the fewest tension headaches by the end of the study.
In addition, a follow up study 18 months (not all original participants took part) showed that 3 participants reported VERY low head ache activity, and one participant reported SOME reduction in headaches.
Conclusion: Biofeedback combined with relaxation techniques help to significantly reduce stress-related illness.
In this topic of stress you can use the same studies for both causes and measures of stress. This can make a big difference to your revision as you have less studies to learn :) WIN, WIN!
Johansson (cause = work, measure = combined approach) Kanner et al (cause = hassles/life events, measure = self-report measures) Geer and Maisel (cause = lack of control, measure = physiological measures)
Johansson (cause = work, measure = combined approach)
Work-related stress is generally caused by when the pressures or demands of a job are not suited to the employee. The daily pressures of work can consist of a lot of stressors, including responsibility, meeting deadlines, long hours, repetitiveness and lack of control. High stress can lead to both poor mental and physical health. Stress at work also costs businesses billions of pounds per year and is a common reason for sick leave from work. Thus, it's important that work as a cause of stress is considered.
Aim: To look at work as a cause of stress with Swedish Sawmill workers.
Method: It was a quasi-experiment in a field setting which compared the stress experienced by maintenance workers and piece workers.
Sample : The first part of the sample was 14 "finishers", who completed piece work. The work was repetitive, mechanised, socially isolated, complex and pressured, and so this group was given the category of "high risk". Also in the sample were 10 maintenance workers, who were deemed as "low risk" workers; they worked as technicians or cleaners.
Procedure: (combined approach measure) Psychological measures included self-reported mood and well-being, as well as nicotine consumption, whilst physiological measures consisted of urine sample to assess adrenaline levels. These measures were taken before work started (baseline measure) and at various intervals throughout the working day.
Findings: The results showed that the adrenaline levels of the high risk workers was 2x their baseline reading, and that this increased throughout the day
The low risk workers had adrenaline 1.5x their baseline reading, and this dropped throughout the day.
Thus, physiological measures suggested stress was more pronounced in the high risk group.
Self-report measures showed similar findings; the finishers (high risk group) reported being more irritable, and having lower well-being.
Conclusions: Thus, it was concluded that work which is repetitive, mechanised and paid per piece (wood work) may be more stressful than work which is paid per hour and is less pressured.
Kanner et al (cause = hassles/life events, measure = self-report measures)
The effects of daily hassles on stress are often ignored. Hassles are minor irritating inconveniences that occur on a daily basis, such as losing keys, getting stuck in traffic, or the water running cold halfway through your shower. Hassles are individual to each person, because we're not all bothered by the same things.
Psychologists believe that if you are subject to an overwhelming number of hassles, and these are not balanced by uplifts (little things that cheer you up, like listening to your favourite song or finding money in your jeans' pocket), then you're more likely to feel stressed. And, the more hassles, the more stress you'll feel.
Aim: Investigating whether hassles and uplifts or life events were better indicators of stress was.
Method: It was a longitudinal study where questionnaires were sent via post
Sample: 100 Californians
Participants were asked to record (self-report measures) their daily hassles and uplifts for nine months, and they had to complete it every month. At the end of ten months, they were asked to complete the Holmes and Rahe Social Readjustment Rating Scale to measure their life events. Psychological stress response was measured by the Bradburn Morale Scale and the Hopkins' Symptom Checklist which were also given every month for 9 months.
The findings suggested that hassles were more significantly correlated with stress response and thus were a better predictor of stress. Therefore, if someone experienced more hassles they were more stressed.
For women the more life events that a woman experienced, the more hassles and uplifts they had (positive correlation)
For men, the more life events men had experienced, the more hassles they had (positive correlation).
Interestingly, for men, the more uplifts men had the fewer the life events (negative correlation).
Typical, the more responsibility and commitment men have lead to less uplifting happiness :/
The questionnaires that were used in the study are displayed below: Bradburn Morale Scale:
The scale is made up of two components: the positive affect and the negative affect component. Each component has 5 items. The scale asks participants if, in the past few weeks, they have felt certain emotions. The participant answers “Yes” or “No” to each question. The “No” score is subtracted from the “Yes” score to create a positive/negative affect difference score.
Positive affect questions: During the past few weeks (did you feel)…
1.Particularly excited or interested in something?
2.Proud because someone complimented you on something you had done?
3.Pleased about having accomplished something?
4.On top of the world?
5.That things were going your way?
Negative affect questions:
During the past few weeks (did you feel)…
1.So restless that you couldn't sit long in a chair?
2.Very lonely or remote from other people?
4.Depressed or very unhappy?
5.Upset because someone criticized you?
Hopkins Symptom Checklist:
Below is a List of problems and complaints that people sometimes have. Please read each one carefully. After you have done so, please put a check ( ) in one of the four boxes to the right that best describes how much that problem has bothered you during the last week (7 days), including today. Check only one box for each problem and do not skip any items. Make your checks carefully. If you change your mind, erase your first mark completely. Read the example below before beginning.
If the symptom is "backaches" and backaches have bothered you not at all, put a 1 = Not At All. If backaches have bothered you a little bit, put a 2 = A Little Bit. If backaches have been bothering you quite a bit, put a 3 = Quite A Bit. If backaches have been bothering you extremely, put a 4 = Extremely.
Now put a 1, 2, 3, 4 for each of the following based on how much it bothers you.
2. Nervousness or shakiness inside
3. Being unable to get rid of bad thoughts or ideas
4. Faintness or dizziness
5. Loss of sexual interest or pleasure
6. Feeling critical of others
7. Bad dreams
8. Difficulty in speaking when you are excited
9. Trouble remembering things
10. Worried about sloppiness or carelessness
11. Feeling easily annoyed or irritated
12. Pains in the heart or chest
14. Feeling low in energy or slowed down
15. Thoughts of ending your life
18. Feeling confused
l9. Poor appetite
20. Crying easily
21. Feeling shy or uneasy with the apposite sex
22. A feeling of being trapped or caught
23. Suddenly scared for no reason
24. Temper outbursts you could not control
26. Blaming yourself for things
27. Pains in the lower part of your back
28. Feeling blocked in getting things done
29. Feeling lonely
30. Feeling blue
31. Worrying too much about things
32. Feeling no interest in things
33. Feeling fearful
34. Your feelings being easily hurt
35. Having to ask others what you should do
36. Feeling others do not understand you or are unsympathetic
37. Feeling that people are unfriendly or dislike you
38. Having to do things very slowly to insure correctness
39. Heart pounding or racing
40. Nausea or upset stomach
41. Feeling inferior to others
42. Soreness of your muscles
43. Loose bowel movements
44. Trouble falling asleep
45. Having to check and double check what you do
46. Difficulty making decisions
47. Wanting to be alone
48. Trouble getting your breath
49. Hot or cold spells
50. Having to avoid certain things, places or activities because they frighten you
51. Your mind going blank
52. Numbness or tingling in parts of your body
53. A lump in your throat
54. Feeling hopeless about the future
55. Trouble concentrating
56. Feeling weak in parts of your body
57. Feeling tense or keyed up
58. Heavy feelings in your arms or legs
Social Readjustment Rating Scale:
To use the scale, simply add up the values for all of the listed life events that have occurred to you within
the past year. If a particular event has happened to you more than once within the last 12 months,
multiply the value by the number of occurrences. Enter your value total at the end of the list.
Each life event is assigned a value in arbitrary “life changing units” chosen to reflect the relative amount
of stress the event causes in the population studied. Stress is cumulative, so to estimate the total stress
you are experiencing, add up the values corresponding to the events that have occurred in your life over
the past year.
Life Event Value
Death of Spouse - 100
Divorce - 73
Marital separation - 65
Jail term - 63
Death of close family member - 63
Personal injury or illness - 53
Marriage - 50
Fired at work - 47
Marital reconciliation - 45
Retirement - 45
Change in health of family member - 44
Pregnancy - 40
Sex difficulties - 39
Gain of new family member - 39
Business readjustment - 39
Change in financial state - 38
Death of close friend - 37
Change to a different line of work - 36
Change in number of arguments with spouse - 35
Home Mortgage over $100,000* - 31
Foreclosure or mortgage or loan - 30
Change in responsibilities at work - 29
Son or daughter leaving home - 29
Trouble with in-laws - 29
Outstanding personal achievement - 28
Spouse begins or stops work - 26
Begin or end school - 26
Change in living conditions - 25
Revision of personal habits - 24
Trouble with boss - 23
Change in work hours or conditions - 20
Change in residence - 20
Change in schools - 20
Change in recreation - 19
Change in church activities - 19
Change in social activities - 18
Mortgage or loan of less than $100,000* - 17
Change in sleeping habits - 16
Change in number of family reunions - 15
Change in eating habits - 15
Vacation - 13
Christmas - 12
Minor violation of the law - 11
The Hassles and Uplifts Scale:
PLEASE FILL OUT THIS QUESTIONNAIRE JUST BEFORE YOU GO TO BED.
0 = None or not applicable
1 = Somewhat
2 = Quite a bit
3 = A great deal
DIRECTIONS: Please circle one number on the left-hand side to present how much of a hassle the item was for you today? and one number on the right-hand side to present how much of an uplift the
this item was for you today?
0 1 2 3 Your child(ren) 0 1 2 3
0 1 2 3 Your parents or parents-in-law 0 1 2 3
0 1 2 3 Other relative(s) 0 1 2 3
0 1 2 3 Your spouse 0 1 2 3
0 1 2 3 Time spent with family 0 1 2 3
0 1 2 3 Health or well-being of a family member 0 1 2 3
0 1 2 3 Sex 0 1 2 3
0 1 2 3 Intimacy 0 1 2 3
0 1 2 3 Family-related obligations 0 1 2 3
0 1 2 3 Your friend(s) 0 1 2 3
0 1 2 3 Fellow workers 0 1 2 3
0 1 2 3 Clients, customers, patients, etc. 0 1 2 3
0 1 2 3 Your supervisor or employer 0 1 2 3
0 1 2 3 The nature of your work 0 1 2 3
0 1 2 3 Your work load 0 1 2 3
Geer and Maisel (cause = lack of control, measure = physiological measures)
The NHS has reported that one of the major causes of stress is feeling overwhelmed by a situation and thus feeling out of control. It's important to recognise the applications of this explanation, because control is a part of so many activities relating to stress, including work, life events, and hassles. It also suggests why people with physical illnesses such as cancer feel more stressed, and why we get stressed when we're not sure what's going on.
Method: The study was a laboratory experiment.
Sample: 60 students,
Procedure: The participants were made to look at photographs of dead car crash victims. The sample was split into three conditions, each with a varying amount of control.
Group 1 were told the timings of the photographs so they knew when they'd appear and disappear, and they were also told how to get rid of the photographs from the screen.
Group 2 knew the timings of the photos and tones, but had no control over the photos
Group 3 were unaware of timings and how to get rid of the photographs.
Stress response was measured physiologically by two measures: an ECG machine measuring heart rate (though this measurement was discarded) and through galvanic skin response, which is essentially the change in your skin's ability to conduct electricity due to an emotional response, such as fear or stress.
Results: Group 1 had the lowest stress according to the GSR, and Group 2 had the highest, suggesting that lack of control can increase stress, and that control over your environment could help to reduce stress.