The behavioural, emotional and cognitive characteristics of phobias, depression and obsessive-compulsive disorder.

What this dot point is asking

AQA wants you to describe the behavioural, emotional and cognitive characteristics of phobias, depression and OCD. The exam skill is to sort each symptom into the correct one of the three categories (behavioural for actions, emotional for feelings, cognitive for thoughts), because mis-sorting is the single most penalised error in this topic.

Phobias

The crucial thing to master is the three-category framework, because every characteristic must be placed correctly: behavioural characteristics are what the person does, emotional characteristics are what they feel, and cognitive characteristics are what they think. For phobias, the behavioural characteristics are avoidance (going to great lengths to keep away from the phobic stimulus, which can disrupt everyday life) and, when avoidance fails, panic responses such as crying, screaming, freezing or fainting; some sufferers show endurance, staying with the stimulus while highly anxious. The emotional characteristics are an excessive, persistent and unreasonable fear that is disproportionate to the actual threat, plus high anxiety that is cued by the phobic object. The cognitive characteristics are irrational beliefs about the phobic stimulus (resistant to rational argument) and a selective attention to it, so the sufferer cannot easily look away when it is present.

Depression

Behavioural: reduced activity (or agitation), disrupted sleep and appetite, possible aggression. Emotional: persistent low mood, anger, lowered self-esteem. Cognitive: negative and absolutist ("black-and-white") thinking, poor concentration, dwelling on the negative.

Depression is diagnosed against ICD or DSM criteria, and again the characteristics divide three ways. Behaviourally, sufferers often show reduced activity levels (lethargy and withdrawal) or sometimes the opposite, psychomotor agitation; sleep is disrupted (insomnia or hypersomnia) and appetite changes (eating much more or much less), and some show increased aggression towards self or others. Emotionally, the defining feature is a persistent low mood (sadness and emptiness), often with anger and a markedly lowered self-esteem (feelings of worthlessness). Cognitively, sufferers show negative and absolutist (black-and-white) thinking, where situations are seen as all good or, more often, all bad, alongside poor concentration and a tendency to dwell on and attend to the negative aspects of a situation.

OCD

Behavioural: compulsions (repetitive actions) performed to reduce anxiety, and avoidance. Emotional: high anxiety, distress, guilt and disgust. Cognitive: recurring obsessive thoughts, with awareness (insight) that they are excessive or irrational.

OCD is defined by the interplay of obsessions and compulsions, and the obsession-compulsion distinction maps neatly onto the cognitive-behavioural divide. Behaviourally, the key feature is compulsions: repetitive actions (such as repeated hand-washing, counting or checking) that the person feels driven to perform to reduce the anxiety created by their obsessions, along with avoidance of triggering situations. Emotionally, OCD involves high anxiety and distress generated by the obsessions, frequently accompanied by guilt, disgust and low mood. Cognitively, the central feature is recurrent and intrusive obsessive thoughts (often about contamination, harm or order), combined with insight, the sufferer's awareness that these thoughts are excessive or irrational, and an attentional bias towards anxiety-related stimuli.