Example Essay: Causality and Biological Treatments for Mental HealthPaper 1

I wrote this essay to test my theory that you don’t need specific studies in the Paper 1 essays. However, you’ll probably need to know basic research processes to connect to the concept. In this essay, I discuss SSRIs in depression and relate this to causality by explaining the basic procedures used in true experiments. 

The following essay would score top marks. At first glance it might appear beyond the reach of most students. However, if you look closely it’s built from some pretty basic knowledge:

• What are SSRIs? Why are they used for depression?
• What is a randomised, placebo-controlled, double-blind experiment?
• What are CBT and high tryptophan diets?

Along with this are a bunch of commonly used key terms in the IB Psych course, like researcher bias and extraneous variables. Connect this to causality and you’ve got a top essay. ChatGPT also estimates the writing age of this essay to be 16-18 years old. I’ve read so many student essays I like to think I’m pretty good at imitating their style. In short, I think this is a realistic exemplar for students aiming for 7s.

The Question: In the context of health and well-being, discuss causality in relation to one or more biological treatments for one mental health disorder.

The Essay

Depression is one mental health disorder that people treat using a range of treatments. One common biological treatment is selective serotonin reuptake inhibitors (SSRIs). But are these more effective than natural biological treatments, like improving diet? Or are they better than psychological therapies like cognitive behavioural therapy (CBT)? We can use studies designed around causality to test which of these therapies are better.

SSRIs are a medication commonly prescribed for depression. They work by blocking the serotonin transporters on the pre-synaptic neuron – this means that the serotonin can’t be re-absorbed by the pre-synaptic neuron, resulting in serotonin staying in the synaptic cleft for longer. This will increase serotonin binding and hopefully counteract the low levels of serotonin which are thought to be the cause of depression.

But do they work? Clinical trials on SSRIs have produced mixed results, but nonetheless these studies are based on the concept of causality. To establish causality, researchers need to isolate the independent variable as the only factor causing a change in the dependent variable. In experiments on SSRIs, the SSRI is the IV and the level of depression is the DV. To manipulate SSRIs and control for the placebo-effect, researchers randomly allocate participants to either receive the SSRI or the placebo. If both groups are similar and participant variability is reduced researchers can confidently make causal conclusions about SSRIs effect on depression.

Another important factor to control in these studies to establish causality is researcher bias. This is why double-blind procedures are used in SSRI trials – single blind is when the researcher doesn’t know which condition they’re in. This is easy with SSRIs because pills that look identical to the SSRI but have no active ingredients can be made and used. The second blind element to make it double-blind is the researcher measuring depression doesn’t know which condition the participant is in. This reduces the chances of researcher bias skewing the measurement of depression and can makes causal effects more likely.

However, SSRIs have lots of downsides including side-effects, costs and the need to continually use them. Other alternative biological treatments that naturally boost serotonin could be just as effective. For example, researchers can study the effects of high tryptophan diets on depression and see if they’re helpful. High tryptophan diets might help because serotonin is built from tryptophan, so having more of it might mean more serotonin is produced. This could also address the possible root cause of depression – low serotonin.

Once again, researchers can run randomised controlled trials (RCT) to see if improving diet causes decreased depression symptoms. The same procedures described above can be used, including random allocation and blind designs. However, a major problem with something like diet is that it’s much harder to control and keep consistent compared to SSRIs. With a pill people just take it daily, whereas with diet they have to prepare it, cook it, etc. Also controlling quantities is much harder. All of these factors introduce extraneous variables (factors that aren’t the IV which might affect the DV), which jeopardise any causal conclusions that could be made.

Even though they are the only way of establishing causality, the findings from RCTs on SSRIs have provided mixed findings. One reason might be because they’re based on the serotonin hypothesis of depression – low levels of serotonin cause depression. Recent studies have suggested there’s little evidence to support this hypothesis. So maybe psychological treatments like CBT could be better. Once again experiments can be conducted to see which is better SSRIs or CBT. Participant variables can be controlled and psychologists can compare both and see which causes a bigger improvement, or is a combination better. Experiments using these designs tend to show a combination is best.

But there’s a big problem with RCTs using SSRIs – some people who may benefit from treatment are getting a placebo. The placebo group is really important to control for participant expectancy effects and to help establish causality, but it does mean some people might spend weeks not getting better. To counter this, researchers can get informed consent and tell people there’s a chance they might be in the placebo group. This makes the study more ethical.

In conclusion, randomised, placebo-controlled, double-blind experiments are the only way psychologists can establish causality when it comes to testing the effectives of SSRIs in treating depression. These same methods can also be used to compare the effectiveness of SSRIs with other treatments, like CBT or improving diet. However, these designs have basic ethical and practical considerations which researchers must bear in mind. (750 words)

The Plan

The following plan is copied and pasted from the document I created making this video – How to Study for Paper 1 Essays

Teacher Tips

My confirmation bias at work here suggests the best way to prepare for the essays is to first teach the content, then focus on research methodologies and third focus on the concepts. The whole point of the concepts is to show students truly understand the content. If they do they can apply that knowledge to any concept. Remember as well, you don’t need to teach to every essay question throughout the course. I wouldn’t expect my students to be able to write the above essay immediately after learning about SSRIs and depression. That’s because this would be covered before the class practicals and my research methods unit. The above essay focuses just as much on experimental key terms as it does depression. However, by the end of the course (exactly when they take the exams) they’re far more likely to be able to be able to write this essay. And that’s the whole point – we’re not teaching to the essays – we’re teaching psychology. The essays merely assess how well we did that. This makes perfect sense in my little brain and I hope it does for you, too.