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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] 'A/S' LEVEL SPECIMEN PAPER 2 Gavin describes his daily life. I sometimes get gripped with the thought that my family is in danger. In particular, I worry about them being trapped in a house fire. I now find that I can only calm myself if I check that every plug socket is switched off so an electrical fire couldn't start. I used to switch each socket on and off, but now I have to press each switch six times. It takes me ages to leave the house." Outline two characteristics of obsessive-compulsive disorder. Refer to Gavin in your answer. [4 marks] 'A/S' LEVEL SPECIMEN PAPER 2 Outline one behavioural and one cognitive characteristic of obsessive-compulsive disorder (OCD). [4 marks] 1 Characteristic When responding to a phobic stimulus, individuals behave in Behavioural particular ways, e.g., high levels of anxiety Panic: Phobias the individual may 'panic' in the presence of the phobic stimulus as they cannot avoid it (avoidance), this may range: from crying, running to screaming, children may freeze, scream or cling (extra: panic, caused by the hypothalamus triggering increased levels of activity in the sympathetic branch of the autonomic nervous system) Avoidance: the individual will make a conscious effort to avoid the phobic stimulus or situation, this negatively reinforces the phobia, for example an individual scared of public restrooms may not stay outside for a long time, this may impact, academic life or work life Endurance: suffers may remain in the presence of the phobic stimulus Condition Depression O increased lethargy: O withdrawal from activities which were once enjoyed e.g., school, work, hobbies. O other individuals may have psychomotor agitation causing them to be agitated and struggle to relax e.g., may pace round the room; O suffers sleep may be disrupted by either reduced (insomnia) or increase of sleep (hypersomnia); O suffers eating may be affected e.g., increased, or decreased eating; O suffers may become aggressive to others or themselves e.g., self- harm; 2 Obessive-compulsive disorder Compulsions: Compulsions are repetitive behaviours/ acts, this is when sufferers feel compelled to repeat a behaviour e.g. hand washing Compulsions reduce anxiety, a large majority of compulsive behaviours are performed in attempt to manage the anxiety produced by obsessions e.g., compulsive hand washing is in response to the obsessive fear of germs Avoidance: To reduce anxiety sufferers of OCD may stay away from the situation/object in which trigger the compulsion/anxiety e.g. individuals who wash compulsively may avoid coming into contact with germs Emotional however continue to experience high levels of anxiety this may be unavoidable e.g. flying Anxiety: Fear: state of high arousal, this prevents the sufferers from relaxing and making it very difficult to experience any positive emotions, this may be long term. Being unreasonable can lead to the individual suffering from a strong emotional response which is disproportionate to the danger posed. the immediate and extremely unpleasant response we experience when we encounter or think about the phobic stimulus low self-esteem, patients often hating themselves; suffers may become angry at others or themselves this may lead to self-harm or aggression; o lowered mood as some patients may describe themselves as 'worthless' or 'empty'; O O 3 Anxiety and distress: The urge to repeat a behaviour can create anxiety, more over the obsessive thoughts are unpleasant and frightening Accompanying depression: ● Depression often accompanies OCD, anxiety is often accompanied by low moods and lack of enjoyment in activities, however compulsions provide a small relief from anxiety however this is only temporary Guilt and disgust: Could lead to negative emotions such as irrational guilt e.g. minor moral issues or disgust Cognitive Selective attention: patient remains focused on the phobic stimulus, even when it is causing them severe anxiety. This may be the result of irrational beliefs or cognitive distortions. Irrational beliefs: this may be the cause of unreasonable responses of anxiety towards the phobic stimulus, due to the patient's incorrect perception as to what the danger posed is. Cognitive distortions: phobic perception of the phobic stimulus may be distorted, individuals with ophiophobic is likely to see belly buttons as ugly O poor concentration, find it increasingly more difficult to concentrate on a task or to make straight forward decisions, unlike usual; o attending and dwelling on negative thoughts, for example individuals may suffer on the negative aspects of any situation causing them to ignore the positive aspects, moreover patients tend to recall negative events more often than positive ones; o suffers tend to have black and white' thinking e.g., if a bad situation occurs, they will view it as an disastrous situation; 4 Obsessive thoughts: Majority of OCD suffers have obsessive thoughts, thoughts which recur over and over again, these thoughts are usually unpleasant, e.g. being contaminated by germs AO1: obsessions - obsessions are intrusive/recurring/unwanted thoughts. Cognitive strategies to deal with obsessions: Individuals may adopt cognitive coping strategies e.g. an individual who is tormented by obsessive guilt may respond by praying or meditating however this could distract them from day to day tasks Insight into excessive anxiety: Suffers may experience Gavin describes his daily life. I sometimes get gripped with the thought that my family is in danger. In particular, I worry about them being trapped in a house fire. I now find that I can only calm myself if I check that every plug socket is switched off so an electrical fire couldn't start. I used to switch each socket on and off, but now I have to press each switch six times. It takes me ages to leave the house." 1. Outline two characteristics of obsessive-compulsive disorder. Refer to Gavin in your answer. [4 marks] 2. Using the example of Gavin (i.e. the stem) above to help you, write a stem suitable for the following question: Outline two characteristics of depression. Refer to (person X) in your answer. [4 marks] 3. Using the example of Gavin above to help you, write a stem suitable for the following question: Outline two characteristics of phobias. Refer to (person X) in your answer. [4 marks] catastrophic thoughts about worst case scenarios that may result if their anxieties were justified 5 ADDITIONAL PAST PAPER QUESTIONS: 'A' LEVEL JUNE 2022 OCTOBER 2021 ADDITIONAL PAST PAPER QUESTIONS: ‘A/S' LEVEL JUNE 2022 NOTES 6 7