Outline one cause of impulse control disorders or non-substance addictive disorder.

Mark scheme

Marking points from the official mark scheme (Feb/Mar 2020). The mark or mark type is shown in brackets.

1. [1-2] (a) Award 1 mark for a basic outline of the term/concept. Award 2 marks for a detailed outline of the term/concept. Answer could come from the following bullet points in the syllabus: biochemical: dopamine; behavioural: positive reinforcement; cognitive: feeling-state theory (Miller, 2010).
2. [2] (a) Biochemical – dopamine: Dopamine’s release is triggered by rewarding stimuli, such as engaging in pleasurable behaviours. Deficiency in dopamine can lead to compulsions and addictions. So a pyromaniac will feel the reward of this ‘happy chemical’ when they start a fire.
3. [2] (a) Behavioural – positive reinforcement: Engaging in the behaviour provides a reward (e.g. gambler wins money). This acts as positive reinforcement so the behaviour continues. Also credit examples e.g. Operant conditioning states that the frequency of a behaviour is increased by the use of a reward. For the gambler this can be money (for the kleptomaniac and pyromaniac the thrill associated with their behaviours). Positive reinforcement explains gambling well by the use of schedules of reinforcement. Gambler is compelled to continue because they ‘might’ win the next time.
4. [2] (a) Cognitive - feeling-state theory (Miller, 2010): Intense positive feelings link with specific behaviours such as gambling. Impulse control disorders are caused because these links form a ‘state- dependent memory’ (feeling state). The intense feeling-state experienced is all the emotions, thoughts and physiological arousal, and this leads to impulse-control problems and cause obsessions. The individual with negative thoughts about themselves can experience an intense feeling of euphoria and power when they indulge in their impulsive behaviour, overcoming that negative thought to a great extent. Example 2 mark response: The person with impulse control disorder forms a feeling state with the behaviour which is positive (1). If the person has existing negative thoughts about themselves the intense feelings of pleasure when engaging in the impulsive behaviour causes them to do this behaviour more frequently (1).
5. [4] (b) Award 1-2 marks for a basic answer with some understanding of the topic area. Award 3-4 marks for a detailed answer with clear understanding of the topic area. Study - 16/18 week trial (1) where 284 patients assigned randomly to the two (1). 16 weeks of nalmefene or 18 weeks of naltrexone or placebo (1). Patients were given Y-BOC scale modified for gambling to assess symptoms (1). Gambling severity did decrease with nalmefene/naltrexone compared to control (1). Individual differences were noted with specific factors contributing to reduction in Y-BOCS scores e.g. family history of gambling and those who received the highest doses of the opiate antagonists. (1) Other appropriate responses should also be credited.
6. [6] (c) Likely weaknesses include: Generalisability (284 patients with pathological gambling); Validity and reliability of Y-BOCS; Reductionist management of the individual’s disorder; Does not deal with the underlying reason for disorder; Medication can take time to take effect.
7. [5-6] (c) Level 3 (5–6 marks): Candidates will show a clear understanding of the question and will explain two weaknesses. Candidates will provide a good explanation with clear detail.
8. [3-4] (c) Level 2 (3-4 marks): Candidates will show an understanding of the question and will explain one appropriate weakness in detail. OR two weaknesses in less detail.
9. [1-2] (c) Level 1 (1-2 marks): Candidates will show a basic understanding of the question and will attempt an explanation of a weakness. They could include both but just as an attempt. Candidates will provide a limited explanation.
10. [0] (c) Level 0 (0 marks): No response worthy of credit. Other appropriate responses should also be credited.