Psychopathology

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What are the four definitions of abnormality?
Statistical deviation, Deviation from social norms, Failure to function adequately and Deviation from ideal mental health.
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What is meant by statistical deviation as a way to define abnormality?
Numerically unusual behaviour or characteristic compared to most of the population.
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What is meant by deviation from ideal mental health as a way to define abnormality?
This is when someone does not meet a set of criteria for good mental health.
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What is meant by deviation from social norms as a way to define abnormality?
This is when an individual behaves in a way that is different to how we expect people to behave or different to the social norms.
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What is meant by failure to function adequately as a way to define abnormality?
This is when an individual is unable to cope with ordinary demands of day-to-day living.
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A limitation of statistical deviation
Unusual POSITIVE characteristics are just as uncommon as unusual negative characteristics. E.g IQ scores over 130 are just as unusual as those below 70 but we wouldn't think of super-intelligence as a bad thing.
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Another limitation of statistical deviation
People with low IQ function fine and don't benefit from being labelled "abnormal " as it may have a negative effect on the way people view them and they way they view themselves.
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Strength of statistical deviation?
It has real-life application in the diagnosis of intellectual disability disorder.
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Strength of deviation from social norms?
Has real-life application in the diagnosis of antisocial personality disorder.
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Limitation of deviation from social norms?
Social norms vary a lot for each generations and every culture, so its unfair to judge someone from another culture as their behaviour may be normal in their culture, there are very few behaviours that would be considered universally abnormal.
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According to Rosenhan and Seligman what are the signs of failing to function adequately?
Signs include no longer conforming to interpersonal rules E.g respecting personal space or maintainin eye contact, when a person experiences severe personal distress and when a person's behaviour becomes irrational or dangerous to themselves/others.
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What are the criterias for the diagnosis of intellectual disability disorder?
Having a low IQ (a statistical deviation) and failure to function adequately.
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What are Jahoda's criteria for ideal mental health looked like?
Have no symptoms/distress, rational and perceive ourselves accurately,self-actualise (reach our potential), cope with stress, realistic view of world, good esteem, lack guilt, independent, successfully love & enjoy our leisure.
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Strength of failure to function adequately?
It captures the experience of people with mental distress problems, it acknowledges that the experience of the patient (an/or others) is important.
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A limitation of failure to function adequately?
May be hard to say whether its a deviation from social norms or failure to function E.g not having a job may be seen as a sign of failure to function adequately but it may be because the individual decides they're happier not to have a job.
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Another limitation of failure to function adequately?
When deciding whether someone is failing to function adequately, it requires subjective judgements, so one psychiatrist may think a patient is not functioning properly, whereas another psychiatrist may say the patient is distressing temporarily.
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Strength of deviation from ideal mental health?
It is a comprehensive definition so includes all the reasons anyone might seek help.
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Limitations of deviation from ideal mental health? (2)
(1) The ideas are specific to western cultures (so its culture-bound) so may not apply to other cultures. E.g some cultures may see independence from other people are a bad thing. (2) Few people achieve all/most of the ideals.
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What is a phobia?
An irrational fear of an object or situation.
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Definition of behavioural
Ways in which people act.
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Definition of emotional
Ways in which people feel
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Definition of cognitive
Refers to the process of thinking - knowing, perceiving, believing.
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What are the DSM's three categories of phobias?
Specific - an object (e.g. animal) or a situation (e.g. flying/having injection), social phobia - social situation (e.g. public speaking or public toilets), agoraphobia - being outside or in a public place.
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What are the three behavioural characteristics of phobias?
Panic, Avoidance & Endurance
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What happens when the phobic person panics in response to the presence of phobic stimulus?
They may have a range of behaviours such as crying, screaming, freezing or running away.
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How does the phobia sufferer use avoidance?
They tend to go to a lot of effort to avoid coming into contact with the phobia stimulus. This can make it hard to go about daily life as it could interfere wth work, education and a social life.
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What is endurance in terms of phobias?
When a sufferer remains in the presence of the phobic stimulus but continues to experience high levels of anxiety. This may be unavoidable in some situations E.g for a person who has a phobia of flying.
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What are the emotional characteristics of phobias?
Irrational and unreasonable fear and anxiety.
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What are the cognitive characteristics of phobias?
Selective attention to phobic stimulus - If a sufferer sees it is hard to look away, Irrational beliefs, Cognitive distortions - the phobic's perception of the phobic stimulus may be distorted E.g an arachnophobic may see spiders as disgusting
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What is depression?
A mental disorder characterised by low mood and low energy levels.
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What are the three behavioural characteristics of depression?
Reduced levels of energy, Disruption to sleep and eating behaviour & Aggression and self-harm.
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How does reduced levels of energy affect sufferers of depression?
It can make them lethargic which may lead to sufferers withdrawing from work, education and social life. In severe cases, the sufferer may not be able to get out of bed.
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How does eating behaviour affect sufferers of depression?
It may increase or decrease leading to weight gain or loss.
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What are the three emotional characteristics of depression?
Lowered mood (feelings of worthlessness and emptiness), anger (this can be directed at self by self-harming or others) and lowered self-esteem leading to them hating themselves.
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What are the three cognitive characteristics of depression?
Poor concentration (may find themselves unable to stick with a task, this can interfere with daily life), Attending to and dwelling on the negative (and ignoring positives) and Absolutist thinking.
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What is absolutist thinking?
Most situations are not all-good or all-bad but a sufferer of depression would tend to think on these terms. This is sometimes known as "black and white thinking". This means that when a situation goes slightly badtheytendtoseeitasanabsolutedisaster.
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What is OCD (Obsessive-compulsive disorder)?
A condition characterised by obsessions and/or compulsive behaviour.
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What are the two behavioural characteristics of OCD?
Compulsions and Avoidance (e.g. sufferers who wash compulsively may avoid coming into contact with germs, this can interfere with daily life)
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What are the two elements of compulsive behaviour in OCD?
(1) The compulsive behaviours are repetitive - sufferer of OCD feel compelled to repeat a behaviour E.g hand washing or counting. (2) Compulsions reduce anxiety - compulsive behaviours are performed inanattempttomanagetheanxietyproducedbyobsessions.
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What is the cycle of OCD?
Obsessive thought -> Anxiety -> Compulsive behaviour -> Temporary relief -> BACK TO OBSESSIVE THOUGHT ETC
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What are the three emotional characteristics of OCD?
Anxiety and distress (due to the urge to repeat a behaviour), accompanying depression and irrational guilt and disgust (either directed against something external or at the self).
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What are the three cognitive characteristics of OCD?
Obsessive, unpleasant thoughts, cognitive strategies to deal with obsessions (e.g religious person may pray or mediate to manage anxiety of OCD) and insight into excessive anxiety (They are aware their obsessions and compulsions are not rational)
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What is the two process model of phobias involve?
Acquisition (development of phobia) by classical conditioning and maintenance by operant conditioning,
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What was Watson and Rayner's Little Albert study?
They created a phobia in 9 month old baby "Little albert", they conditioned Albert to be scared of white rats by using an unconditioned stimulus that produces a fear response (loud noise) to be associated with a neutral stimulus (the white rat).
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How are phobias maintained by operant conditioning?
Avoidance of phobic stimulus reinforced by anxiety reduction so the phobia is maintained.
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Strength of the two process model of phobias?
Good explanatory power as it explains how phobias can both be acquired and maintained.
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A limitation of the two process model of phobias?
Theres an alternative explanation for avoidance, it may be motivated more by seeking safety rather than anxiety reduction for example in phobias such as agoraphobia this may be true.
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Another limitation of the two process model of phobias?
Its been criticised to be an incomplete explanation of phobias as it doesn't mention evolutionary factors such as biological preparedness (where we have acquired phobias that has been a source of danger in our evolutionary past (e.g dark/snakes)
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What is systematic desensitisation (SD)?
A behavioural therapy designed to gradually reduce phobic anxiety through the principle of classical conditioning. If the sufferer can learn to relax in the presence of the phobic stimulus they will be cured.
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What are the three steps of SD?
Drawing up an anxiety hierarchy together with therapist, teaching of relaxation techniques and exposure to the phobic stimulus.
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What is an anxiety hierarchy?
A list of situations related to the phobic stimulus that provoke anxiety arranged in order from least to most frightening, which the patient and therapist would slowly go through starting from least to most frightening.
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Examples of relaxation techniques?
Breathing exercises, learning mental imagery techniques, imagining themselves in relaxing situations or perhaps meditation.
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What is flooding?
This involves exposing phobic patients to their phobic stimulus without a gradual build-up in an anxiety hierarchy. Instead it involves immediate exposure to a very frightening situation.
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How does flooding work?
It makes the patient learn quickly that the phobic stimulus is harmless (this is known as extinction of conditioned fear response), the result is that the conditioned stimulus no longer produces the conditioned response (fear).
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Why is it important that patients of flooding give informed consent?
It is not unethical per se but it is an unpleasant experience so the procedure may be traumatic and they need to be fully prepared for that.
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A strength of SD?
Effective & Long-lasting - Gilroy followed up 42 patients who had been treated for spider phobia in three 45 mins of SD, findings were at both 3 months & 33 months after treatment SD group were less fearful than control group.
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2 other strengths of SD?
SD is suitable for a range of patients e.g. some sufferers of anxiety disorders like phobias also have learning difficulties this makes it hard for some patients to understand what is happening during flooding & Patients prefer it as not traumatic.
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Limitations of SD? (2)
(1) Takes alot more time = more expensive (2) Symptom substitution could occur (when one phobia disappears another may appear in its place) however, evidence for this is very mixed and behavioural therapists tend to believe it doesn't happen at all.
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Strength of flooding?
Cost-effective as patients are free of their symptoms as soon as possible and that makes the treatment cheaper.
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Limitations of flooding? (2)
(1) Less effective for complex phobias such as social ones. This may be because social phobias have cognitive aspects. (2) Treatment is highly traumatic so some patients are often unwilling to see it through the end so time and money are wasted.
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What is Beck's cognitive theory of depression?
That some people are more vulnerable to depression due to their cognitions.
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What are the three parts of Beck's cognitive theory of depression?
Faulty information processing, negative self-schemas and the negative traid.
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What is faulty information processing?
When depressed we attend to the negative aspects of the situation and ignore positives. E.g. if I was depressed and won £1 million on the lottery, I might focus on the fact that the previous week someone had won £10 million.
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What are negative self-schemas?
A schema is a package of ideas and information developed through experience. A self-schema is the package of information we have about ourselves. We use schemas 2 interpret the world, so ifwehaveanegativeself-schemaweinterpretallinfoinanegativeway.
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What is the negative traid?
Three elements of negative thinking that occur automatically, regardless of the reality of what is happening. This is negative view of world, future and the self.
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What is Ellis's ABC model?
He proposed that depression occurs when an activating event normally negative (A) triggers an irrational belief (B) which in turn produces a consequence (C) i.e an emotional response like depression. The key to this process is the irrational belief.
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A strength of Beck's cognitive theory of depression
Supporting evidence - Grazoli & Terry assessed 65 preg women for cognitive vulnerability and depression before and after birth findings were women judged to have been high in cognitive vulnerability were more likely to suffer post-natal depression.
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Another strength of Beck's cognitive theory of depression?
Has practical application in cognitive behaviour therapy (CBT) as negative thoughts can be identified and challenged by a therapist.
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Limitation of Beck's cognitive theory of depression?
Doesn't explain all aspects of depression such as cotard syndrome where some depressed patients have the delusion that they are zombies, also can't explain hallucinations and bizarre beliefs that some sufferers of depression suffer.
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Strength of Ellis's ABC model?
Has a practical application in cognitive behaviour therapy (CBT) as irrational thoughts can be identified and challenged by a therapist.
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Limitations of Ellis's ABC model?
(1) Partial explanation only applies to some kinds of depression as theres some kind of depression that arises without an obvious cause. (2) Doesn't explain all aspects of depression such as hallucinations and delusions that some patients suffer.
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What is cognitive behaviour therapy (CBT)?
A method for treating mental disorders based on both cognitive and behavioural techniques. From the cognitive viewpoint the therapy aims to deal with thinking, such as challenging negative thoughts. The therapy also includes behavioural activation.
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What happens at the beginning of CBT?
An assessment in which the patient and the CB therapist work together to clarify the patient's problems. One of the central tasks is to identify where they might be negative/irrational thoughts that will be challenged.It then works on changing these
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What is behavioural activation?
This is when the therapist encourages a depressed patient to be more active and engage in enjoyable activities.
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What is the technique used in the CT part of the CBT? Where did this come from?
Came from Beck: Therapist will identify negative thoughts and challenge them, including testing the reality of their negative beliefs. They might therefore be set homework such as to record when they enjoyed an event or when people were nice to them.
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What is the technique used in the REBT part of the CBT? Where did this come from?
Came from Ellis: Therapist will identify and challenge identify beliefs by argument to change the irrational belief and so break the link between negative life events and depression.
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Strength of CBT?
Significantly more effective than no treatment - March et al compared effects of CBT with antidepressants drugs and a combination of two in 325 adolescents. Findings were CBT emerged as just as effective as medication and helpful alongside medication
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A limitation of CBT?
May not work for severe cases - Not effective when patients are too depressed to engage with therapy
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What is the biological approach to explaining OCD?
A perspective that emphasises the importance of physical processes in the body such as genetic inheritance and neural function.
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What does the diathesis-stress model say about OCD?
That certain genes leave some people more likely to suffer a mental disorder but it is not certain - some environmental stress is necessary to trigger the condition.
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What are the three genetic explanations explaining OCD?
Candidate genes (genes that create vulnerability for OCD), OCD is polygenic (not caused by one gene but many aprox 230 variations), different combinations of gene variations may cause different kinds of OCD. (aetiologically heterogeneous)
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What does the gene 5HT1-D beta do? How could it explain OCD?
Its the gene that implicates the efficiency of transport of serotonin across synapses.
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What are neural explanations?
The view that physical and psychological characteristics are determined by the behaviour of the nervous system. In particular the brain as well as individual neurons.
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What are the two neural explanations explaining OCD?
Levels of serotonin and systems in the brain - frontal lobes (decision making prt of the brain) and evidence in the area in left of brain (parahippocampal gyrus) suggests that it is associatedwithprocessingunpleasantemotions,functionsabnormallyinOCD.
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How can the role of serotonin cause OCD?
Serotonin is a neurotransmitter that is believed to help regulate mood, if a person has low levels then normal transmission of mood-relivant information does not take place and mood and sometimes other mental processes are affected.
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A strength of genetic explanations of OCD?
Good supporting evidence that people's genes make them vulnerable - twin studies reviewed by Nestadt found 68% of identical twins shared OCD as opposed to 31% of non identical.
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Limitations of genetic explanations of OCD? (2)
(1) Too many candidate genes involved therefore has little predictive value. (2) OCD associated with environmental factors e.g. trauma, not entirely genetic in origin.
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A strength of neural explanations of OCD?
Supporting evidence - antidepressant work on the serotonin system by increasing this neurotransmitter and this reduces OCD symptoms, suggesting that serotonin system is involved in OCD.
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Limitations of neural explanations of OCD? (2)
(1) All the neural systems associated with OCD are only involved in some cases, therefore we cant claim to understand all the neural mechanisms involved in OCD (2) Neural abnormalities may be the result of OCD not the cause.
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What is drug therapy?
Treatment involving drugs i.e chemicals that have a particular effect on the functioning of the brain or some other body system. In the case of psychological disorders such drugs usually affect neurotransmitter levels.
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What are SSRIs? (Selective serotonin reuptake inhibitor)
They work on the serotonin system in the brain, they increase the levels of serotonin at the synapse.
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What other treatments are normally used alongside SSRIs? and why?
CBT treatment usually as SSRIs enable patients engage more effectively with the CBT. Research has found they improve quicker and more when using CBT as well. Sometimes other drugs are prescribed alongside SSRIs.
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Alternatives to SSRIs if ineffective? (2)
(1) Tricyclics such as Clomipramine which affect serotonin system and other systems (2) SNRIs (serotonin-noradrenaline reuptake inhibitors) these increase levels of serotonin and another neurotransmitter - noradrenaline.
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Advantages to drug therapy? (2)
(1) Drugs are cheaper than psychological therapy and non-disruptive to people's lives as it doesn't take much effort (2) Evidence support for SSRIs - Soomro reviewed studies and found SSRIs are more effective than placebos in treating OCD.
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A limitation to drug therapy?
Drugs have side effects such as indigestion, blurred vision and loss of sex drive, for those taking tricyclics the side-effects may be more common and more serious. This reduces effectiveness because people stop taking the medication.
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