British College of Osteopathic Medicine (BCOM)
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Psychopathology
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Psychopathology exam questions 2022
• Bina has been diagnosed with depression. Her doctor says that depression is a
common problem but Bina is miserable. She cannot be bothered to get washed
in the morning and her manager is unhappy that she is taking a lot of time off
work. When she does go to work she is irritable, has temper tantrums and is rude
to customers.
• Using your knowledge of three definitions of abnormality, explain whether or not
Bina's behaviour might be considered to be abnormal. [6 marks] - Statistical
infrequency - the doctor says depression is quite common therefore Bina's
behaviour should not be considered abnormal.
• Failure to function adequately - Bina is neglecting personal hygiene she also
takes lots of time off work therefore her behaviour could be considered abnormal.
• Deviation from ideal mental health - Bina is miserable therefore her behaviour
could be considered abnormal.
• Deviation from social norms - Bina has temper tantrums/is rude to customers
which is not the norm for adults in a work environment therefore her behaviour
could be considered to be abnormal.
• Outline one behavioural and one cognitive characteristic of obsessive-
compulsive disorder (OCD). [4 marks] - Behavioural characteristic - this is the
compulsion element of the disorder, where a behaviour is performed repeatedly
in order to alleviate anxiety
• Cognitive characteristic - this is the obsessive element of the disorder, where the
sufferer experiences unwanted/intrusive thoughts or images that cause distress
• Credit other relevant characteristics e.g. avoidance (behavioural)
• Describe one drug therapy that has been used to treat obsessive-compulsive
disorder (OCD). Identify one limitation of drug therapy. [4 marks] - Use of SSRIs
e.g. fluoxetine
• Acts to inhibit the re-uptake or re-absorption of serotonin in the brain
• Enables the serotonin to remain active at the synapse
• Serotonin continues to stimulate the post-synaptic neuron
,• Outline and evaluate the cognitive approach to treating depression. [8 marks] -
*AO1*
• Features of Beck's CBT
• Focus on present experience
• Identifying automatic negative or irrational thoughts
• Thought catching
• Challenging negative thoughts
• Hypothesis testing via homework - patient as scientist
• Behavioural activation - engaging in previously enjoyed activities to raise mood
• Credit other relevant information e.g. Ellis's argumentation and disputation
• *AO3*
• Use of evidence to support effectiveness in alleviating symptoms, relapse rates
etc.
• Comparisons with medication e.g. March 2007
• Role of the patient as engaged and active rather than passive
• General enhancement of personal experience and efficacy
• Severely depressed cannot engage in the process and need medication
• Time and commitment where part of reasoned justification
• Distinguish between obsessions and compulsions. [2 marks] - Obsessions are
internal components because they are thoughts, and compulsions are external
components because they are behaviours.
• Researchers analysed the behaviour of over 4000 pairs of twins. The results
showed that the degree to which obsessive-compulsive disorder (OCD) is
inherited is between 45% and 65%.
, • With reference to the study described above, what do the results seem to show
about possible influences on the development of OCD? [4 marks] - Results
indicate development of OCD is at least partly genetic
• The findings suggest that heritability is high (between 45% and 65%)
• This means that there must also be other explanations (inherited influence is not
100%)
• So other factors (e.g. environment or other bio factors) may also partly account
for OCD.
• Steven describes how he feels when he is in a public place.
• 'I always have to look out for people who might be ill. If I come into contact with
people who look ill, I think I might catch it and die. If someone starts to cough or
sneeze then I have to get away and clean myself quickly.'
• Outline one cognitive characteristic of OCD and one behavioural characteristic of
OCD that can be identified from the description provided by Steven. [2 marks] -
Cognitive characteristics of OCD:
• Hypervigilance - 'looking out for people who are ill'
• Catastrophic thinking - 'I might catch it and die'.
• Behavioural characteristic of OCD:
• Repetitive cleaning - 'I have to clean myself'.
• Fill in A and B, to show Beck's negative triad as it is used to explain depression.
• Negative views about
• *A* for example: 'I am worthless'
• Negative views about
• *B*for example: 'I will never be any good at anything'
• Negative views about
• C *the world* for example: 'Nobody values me'
• [2 marks] - A: Self.
• B: The future.
• Briefly outline one strength of the cognitive explanation of depression. [2 marks] -
Based on sound experimental research
• Have provided effective treatments for depression
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