_______________________

Name:
_
2.4 Psychological
problems _______________________
Class:
_

_______________________
Date:
_

Time: 59 minutes

Marks: 59 marks

Comments:

Page 1 of 18
Q1.

Government announces increase in funding for mental health

prevention
The Government has announced they are increasing the funding for
programmes aimed at preventing mental health problems. When
asked why they were doing this, a spokesperson said ‘Research has
shown it is less expensive to fund prevention than it is to pay for all of
the costs caused to society by the effects of significant mental health
problems’.

Which of the following is a cost to society that the government spokesperson in the article
may have been referring to?

Shade one box.

A Increase in crime rates

B Lessening of social stigma

C Less need for social care

D Positive engagement for society

(Total 1 mark)

Q2.

Government announces increase in funding for mental health

prevention
The Government has announced they are increasing the funding for
programmes aimed at preventing mental health problems. When
asked why they were doing this, a spokesperson said ‘Research has
shown it is less expensive to fund prevention than it is to pay for all of
the costs caused to society by the effects of significant mental health
problems’.

Give two examples of the effects of mental health problems on an individual.

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________
(Total 2 marks)

Q3.
Explain one difference between unipolar depression and bipolar depression.

Page 2 of 18
 _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________
(Total 1 mark)

Q4.
Imagine you are a doctor with concerns about a patient.

Use your knowledge of unipolar depression to complete the following letter asking for a
place for Patient A on a cognitive behaviour therapy course (CBT).

To whom it may concern

I would like Patient A to have a place on your next CBT course. I have
diagnosed Patient A with unipolar depression because they have the
following three symptoms:

1 ____________________________________________________

2 ____________________________________________________

3 ____________________________________________________

Yours sincerely

Dr J Bloggs

(Total 3 marks)

Q5.
You have been asked to conduct a study to investigate the effects of cognitive behaviour
therapy (CBT) on people who have been diagnosed with depression.

You need to include:

• a description of the conditions in the study

• the sampling method you would use
• an example of one standardised procedure that you will use.

Explain your answer.

_______________________________________________________________________

_______________________________________________________________________

Page 3 of 18
 _______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________
(Total 6 marks)

Q6.
Alice is talking to her doctor about her relationship with alcohol.

Alice: I know it’s not good for me to drink so much, so I have been trying not to drink
anything, but the desire is just so strong. I can’t seem to focus on anything else until
I have a drink. I think it has become my main priority.

Doctor: Are you drinking the same amount each day?

Alice: No, I seem to need more and more to feel the same effect I used to get from
just a few glasses.

Doctor: Do you want to stop?

Alice: Yes, but I worry I don’t have the motivation or the time to address my drinking
problem.

(a) According to the International Classification of Diseases, which symptoms of

Dependence Syndrome is Alice experiencing?

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

Page 4 of 18
 ___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(3)

(b) Identify one intervention or therapy that the doctor might recommend for Alice if she
is diagnosed with Dependence Syndrome.

Justify your choice by referring to the conversation above.

Recommended intervention / therapy

___________________________________________________________________

___________________________________________________________________

Justification

___________________________________________________________________

___________________________________________________________________
(2)

(c) Outline one weakness of the intervention / therapy you have recommended in part
(b).

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(2)
(Total 7 marks)

Q7.
Evaluate Kaij’s twin study of alcohol abuse.

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Page 5 of 18
 _______________________________________________________________________

_______________________________________________________________________
(Total 5 marks)

Q8.
Suggest two changes in behaviour often seen in people who are diagnosed with unipolar
depression.

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________
(Total 2 marks)

Q9.
Catherine has been diagnosed with an addiction to alcohol. When Catherine is with her
friends they encourage her to drink more. Her mother and older brother have also been
diagnosed with an addiction to alcohol.

Read the following statements about mental health. Decide whether each statement is
True or False. Tick one box for each statement.

True False

An intervention that could be offered to treat

Catherine’s addiction is aversion therapy

Catherine may have a genetic vulnerability to addiction

One biological explanation for Catherine’s addiction is

that she is influenced by her peers
(Total 3 marks)

Q10.
Suggest one social effect of significant mental health problems in society.

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________
(Total 2 marks)

Q11.
Read the item and then answer the questions that follow.

Page 6 of 18
Researchers wanted to evaluate the effectiveness of using cognitive
behaviour therapy (CBT) to treat unipolar depression. They put up posters
in a Doctors’ surgery asking for volunteers who had been diagnosed with
depression to complete a questionnaire. The researchers chose 10
people who had only received medication for depression, and 10 people
who had received both CBT and medication.
The participants were asked to rate the effectiveness of their treatment on
a scale of 0-10 where 0 is not at all effective and 10 is very effective. The
results are shown in the table below.

Ratings of effectiveness for types of treatment for depression.

Medication and
Participant Medication Participant
CBT
1 3 11 10
2 6 12 5
3 5 13 7
4 4 14 8
5 6 15 8
6 8 16 9
7 9 17 6
8 4 18 8
9 7 18 8
10 8 20 9

(a) Calculate the median rating of effectiveness for the group that was treated with both
medication and CBT. Show your workings.

Workings:

Answer _________________________________________
(2)

(b) The median rating of effectiveness for the medication group was 6. Use your answer
from part (a) to sketch a suitable diagram of the median ratings for effectiveness of
treatment on the graph paper below.

Provide a suitable title and labels for your diagram.

Page 7 of 18
 (4)

(c) Give one strength of the sampling method used in this study.

___________________________________________________________________

___________________________________________________________________
(1)

(d) What do the results of this study suggest about the effectiveness of using both CBT
and medication to treat unipolar depression? Explain your answer.

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________
(2)
(Total 9 marks)

Q12.
Describe one study of hereditary factors in addiction and evaluate the research method
used in that study.
(Total 9 marks)

Page 8 of 18
Q13.
Using an example, outline what is meant by the term schema.

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________
(Total 3 marks)

Q14.
Using one example of each, explain the role of assimilation and accomodation in the
development of schema.

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________
(Total 6 marks)

Page 9 of 18
Mark schemes

Q1.
[AO2 = 1]

A
[1]

Q2.
[AO1 = 2]

1 mark for any of the following (MAX 2 marks).

• Negative impact on physical well-being

• Harm to body because of using things like drugs or food to try and feel better
• Difficulties coping with day to day life
• Not able to get to work or school on a regular basis
• Damage to relationships
• More arguments between partners and / or parents and children

Credit other relevant examples.

NOTE: Examples may be general or more specific (as in the list above)
NOTE: Do not accept examples that are just symptoms of depression or addiction
[2]

Q3.
[AO1 = 1]

People with bipolar have low moods and high moods (known as mania), with increased
energy and feelings of extreme excitement, whereas people with unipolar depression just
have low moods.
[1]

Q4.
[AO1 = 3]

1 mark for any of the following (MAX 3 marks)

• Low mood
• Reduced energy / activity levels
• Changes in sleep patterns
• Changes in appetite levels
• Decrease in self-confidence
• Lack of interest / enjoyment
• Reduced concentration / focus
• Feelings of worthlessness
• Negative thoughts about the future
• Suicidal thoughts
[3]

Page 10 of 18
Q5.
[AO2 = 6]

Up to 2 marks for a description of the two conditions.

2 marks: a clear description

1 mark: a limited / muddled description

PLUS

Up to 2 marks for naming and justifying an appropriate sampling method.

Examples:
• Opportunity sampling. Because I can choose people who I know and who are
available. This will make it quicker to find my participants (2 marks).
• Random sampling (1 mark).

PLUS

Up to 2 marks for identifying and explaining an appropriate standardised procedure.

Examples:
• Standardised instructions. Because then I can be sure that all the participants know
what they need to do and will do the same thing (2 marks).
• To prevent the instructions becoming an extraneous variable (1 mark).
[6]

Q6.
(a) [AO2 = 3]

1 mark for any of the following (MAX 3 marks).

• A strong desire to use substance / difficulty controlling use

• A higher priority given to the substance
• Difficulty controlling use of substance
3

(b) [AO1 = 1 AO2 = 1]

1 mark for correctly identifying the appropriate therapy for Alice

• Aversion therapy

PLUS

1 mark for justification of the therapy with reference to Alice’s situation

• Because Alice says that she does not ‘have the motivation or the time to
address my drinking problem’ so self-management programmes would not be
appropriate.

Do not credit self-management as this would not be appropriate in Alice’s situation.

2

(c) [AO3 = 2]

Examples

Page 11 of 18
 • the benefits of aversion therapy may only be effective in the short-term, so it
may not be a long-term solution and other support may be needed
• as it is an unpleasant treatment this means that there is often a high drop-out
rate, so the treatment is often not effective
• the unpleasant nature of the treatment raises ethical concerns, so it is
important that the process is fully explained to the client and gain informed
consent

NOTE: If answer to part (b) is incorrect then credit can be given to one weakness of
another intervention / therapy as long as it is an appropriate intervention or therapy
for addiction.
2
[7]

Q7.
[AO3 = 5]

Level Marks Description

Analysis and evaluation of Kaij’s twin study of alcohol

abuse is effective. Any conclusions drawn are sound
3 and fully expressed.
4-5
Detailed Relevant terminology is used consistently throughout.
The answer demonstrates a high level of substantiated
reasoning, is clear, coherent and focused.

There may be some effective analysis and evaluation

of Kaij’s twin study of alcohol abuse. There may be an
attempt to draw conclusions.
2
2–3 Relevant terminology is usually used. The answer
Clear
frequently demonstrates substantiated reasoning, and
is clear, generally coherent and focused although
structure may lack some logic.

Analysis and evaluation of Kaij’s twin study of alcohol

abuse is of limited effectiveness. Any attempts to draw
conclusions are not always successful or present.
1
1 Relevant terminology is occasionally used. The answer
Basic
occasionally demonstrates substantiated reasoning,
but may lack clarity, coherence, focus and logical
structure.

0 No relevant content

Indicative content:

• The information on alcohol use came from the participant and other family
members. This type of self-report method is subjective and there are many reasons
why the information provided may not be correct. These include lying about the
amount of alcohol consumed in order to give a sociably desirable answer.
• The sample is limited because all of the participants were twins, male, and Swedish.
This means that the findings are not representative of people who are female, or
who are not twins or Swedish.
• The sample is also limited because the participants were twins, where at least one

Page 12 of 18
 of them was publically known to abuse alcohol. Therefore, the results are not
representative of those who abused alcohol but did so in private.
• Identical twins are often brought up in the same ways and so it may be environment
(nurture) and not genetics (nature) that was the cause of the comparable rates of
alcohol use.
• Although Kaij found that 54% of the identical twins were in the same category as
their co-twin for alcohol use, that also means that 46% were not in the same
category and that suggests there are not just genetic factors involved in alcohol use.

Credit other relevant content

[5]

Q8.
[AO1 = 2]

Any two suggestions from the following:

Indicative content:

AO1

• lowering of mood
• decrease in activity
• change in sleep pattern
• reduced self-esteem or self-confidence
• ideas of guilt or worthlessness
• loss of pleasurable feelings
• agitation/anger
• loss or increase in appetite.

Accept other relevant symptoms.

[2]

Q9.
[AO2 = 3]

True False

An intervention that could be offered to treat

✓
Catherine’s addiction is aversion therapy

Catherine may have a genetic vulnerability to addiction ✓

One biological explanation for Catherine’s addiction is

✓
that she is influenced by her peers
[3]

Q10.
[AO1 = 2]

2 marks for a detailed suggestion of a possible social effect

1 mark for a brief or muddled suggestion of a possible social effect

Page 13 of 18
 Indicative content:

• as mental health problems become significant there will be increased demand on

mental health/NHS services as people have more need for social care
• increased crime rates are likely to occur as people whose mental health deteriorates
are likely to drop out of employment/lose social inhibitions and become more
involved in anti-social behaviours
• mental health problems tend to be expensive to treat and therefore have
implications for the economy.

Accept other valid social effects, e.g. social isolation of the mentally ill, public fear of
mental illness.
[2]

Q11.
(a) [AO2 = 2]

8 (2 marks)

5, 6, 7, 8, 8, 8, 9, 9, 10, 10 (1 mark)
2

(b) [AO2 = 4] Award one mark for each bullet point

• Use of a suitable diagram – i.e. a bar chart or frequency diagram

• Informative title
• Correct labelling of both axes
• Correct plotting of the results

A bar chart showing the median ratings of effectiveness for a medication group and
for a medication and CBT group

Page 14 of 18
 (c) [AO3 = 1]

It is a quick/efficient way of obtaining participants (1 mark).

1

(d) [AO3 = 2]

1 mark for appropriate reference to the results and direction of effectiveness and 1
mark for an appropriate explanation.

Possible answers:

The results suggest that using both medication and CBT is a more effective
treatment than using medication on its own (1 mark). This is because the people
who only received medication as a form of treatment had a lower median rating for
effectiveness than those who also had CBT (1 mark).

The people who only received medication as a form of treatment had a median
rating of 6 but those who also had CBT had a median rating of 8 (1 mark). This
result suggests that medication and CBT together is more effective than just
medication and holistic viewpoint (1 mark).

Note As the difference in the medians is only two rating points, answers that argue it
is not possible to draw a conclusion about effectiveness from these results are
acceptable.
2
[9]

Q12.
[AO1 = 4 AO3 = 5]

Level Marks Description

AO1: Relevant knowledge and understanding of a

study of hereditary factors in addiction is accurate with
detail.
3 AO3: Analysis and evaluation of a study of hereditary
7–9 factors in addiction is effective. Conclusions drawn are
Detailed sound and fully expressed.
Relevant terminology is used consistently throughout.
The answer demonstrates a high level of substantiated
reasoning, is clear, coherent and focused.
AO1: Relevant knowledge and understanding of a
study of hereditary factors in addiction is present.
Award up to a maximum of 4 marks if answer only
describes a relevant study at AO1 Level 3.
2 AO3: There may be some effective analysis and
4–6 evaluation/discussion of a study of hereditary factors in
Clear addiction. There may be an attempt to draw
conclusions.
Relevant terminology is usually used. The answer
frequently demonstrates substantiated reasoning, and
is clear, generally coherent and focused although
structure may lack some logic.

Page 15 of 18
 AO1: Knowledge and understanding of a study of
hereditary factors in addiction is present but limited.
Award up to a maximum of 3 marks if answer only
describes a relevant study which lacks the accuracy
and detail of AO1 Level 3.
1 AO3: Analysis and evaluation/discussion of a study of
1–3 hereditary factors in addiction is of limited effectiveness
Basic
or may be absent. Any attempts to draw conclusions
are not always successful.
Relevant terminology is occasionally used. The answer
occasionally demonstrates substantiated reasoning,
but may lack clarity, coherence, focus and logical
structure.
0 No relevant content

Examiners are reminded that AO1 and AO3 are regarded as interdependent. When
deciding on a mark in instances where there is an attempt at more than one assessment
objective all attempts should be considered together using the best fit approach. In doing
so, examiners should bear in mind the relative weightings of the assessment objectives.
More weight should therefore be given to AO3 than AO1.

When an answer only contains content related to one of the skills (AO1/AO3), then the
levels descriptors for the award of marks for the skill attempted should be applied to the
answer, up to the maximum mark available.

Indicative content:

AO1

• Twin study such Kaji (1960) on rates of alcohol abuse in identical and fraternal
twins.
• Kaji investigated the concordance rates for alcohol abuse between identical and
fraternal twins.
• He found that the concordance rate for identical twins was 54% but that it was only
28% for fraternal twins.
• He concluded that these findings suggest that there are genetic or hereditary factors
involved in alcohol addiction.

AO3

• Not representative, e.g. all the participant were twins so cannot generalise to other
siblings, or familial relations or general population.
• Findings cannot be generalised to other addictions, e.g. the study only looked at
rates of alcohol abuse and not addiction to other substances.
• Identical twins are often treated the same so it may be environment (nurture) and
not genetics (nature) that was the cause of the alcohol abuse.
• 46% of the identical twins were not concordant for alcohol abuse which suggests
factors other than genetic ones must also be involved.
• Difficulty of controlling family/social effects.

Accept other relevant studies.

[9]

Q13.

Page 16 of 18
 This mark scheme is from a question paper that assessed a previous specification and
has not been edited. Click [here] to access a document explaining the differences that
might apply to it.

[AO1 = 2 AO2 = 1]

AO1
A schema is a mental framework or cognitive structure. Schemas consist of knowledge
about objects, actions and events. Piaget believed that some of these are present at birth.
Allow ‘based on experience’.

AO2
One example of a schema is grasping. A baby wraps its hand around anything that
touches the palm of its hand.
[3]

Q14.
This mark scheme is from a question paper that assessed a previous specification and
has not been edited. Click [here] to access a document explaining the differences that
might apply to it.

[AO1 = 4 AO2 = 2]

When a child is using an existing schema to act on the environment, the child is
assimilating. For example, a baby is assimilating when it is using a grasping schema for
every object within reach. Accommodation happens when a schema has to be modified to
adapt to a new situation, hence a new schema is formed. For example, the grasping
schema has to be changed to deal with objects of different shapes.

The mark scheme for 3 marks is as follows because two explanations are required. Each
explanation should be treated separately and the marks then added together.

To 3 marks as follows

3 marks The role is clearly explained with an appropriate

example

2 – 1 marks The role is clearly explained without an example, or the

explanation is muddled.
[6]

Page 17 of 18
Examiner reports

Q14.
This was a badly answered question. Few candidates were able to distinguish between
the terms ‘assimilation’ and ‘accommodation’ successfully. Answers seemed to be full of
confusion although accommodation was understood marginally better than assimilation.

Page 18 of 18