Drug therapy | AQA A-Level Psychology Revision

For 7182 specification, first teach in September 2025

AQA A-Level Psychology | Free Revision Notes

Estimated study time: 65 minutes

These drug therapy for stress A-Level Psychology revision notes explain how benzodiazepines and beta blockers can be used to reduce psychological or physiological symptoms of stress. You will connect benzodiazepines with inhibitory activity in the central nervous system and beta blockers with the effects of adrenaline and noradrenaline during rapid physiological arousal [The sympathomedullary pathway]. You will then evaluate whether medication is effective, appropriate for long-term use and preferable to psychological methods such as Stress inoculation therapy and Biofeedback.

Learning Objectives 🎯

By the end of this revision page, you should be able to:

• Define drug therapy as a method of managing stress.

• Explain how benzodiazepines reduce nervous-system activity.

• Explain how beta blockers reduce the physiological effects of stress.

• Link drug treatment to the central and peripheral nervous systems.

• Apply drug therapy to unfamiliar stress scenarios.

• Distinguish effectiveness from appropriateness.

• Evaluate drug therapy using evidence, side effects, dependency, duration and alternative treatments.

Revision Notes 📚

What does the AQA specification require?

Within the Stress option, AQA requires students to study three methods of managing and coping with stress:

• Drug therapy

• Stress inoculation therapy

• Biofeedback

The specification does not name particular drugs, but AQA mark schemes identify benzodiazepines and beta blockers as the main examples and expect students to understand their effects on the brain or peripheral nervous system.

For this lesson, you should understand:

1. What drug therapy aims to achieve.

2. How benzodiazepines affect neural activity.

3. How beta blockers reduce bodily arousal.

4. How each treatment connects with the physiology of stress.

5. Whether symptom reduction means that the source of stress has been addressed.

6. Whether the benefits of medication outweigh its possible costs.

What Is Drug Therapy?

Definition

Drug therapy is a biological method of managing stress in which medication is used to reduce psychological or physiological symptoms.

The treatment may target symptoms such as:

• Anxiety.

• Tension.

• Difficulty relaxing.

• Sleep disturbance.

• Increased heart rate.

• Raised blood pressure.

• Trembling.

• A pounding heart.

Drug therapy changes biological activity within the body. It does not necessarily change:

• The stressful workplace.

• The life event.

• The recurring daily hassle.

• The person’s interpretation of the stressor.

• Their long-term coping skills.

The main drug treatments

The two main categories recognised in AQA assessment materials are:

Drug type	Main area of action	Main aim
Benzodiazepines	Central nervous system	Reduce neural activity, anxiety and tension
Beta blockers	Peripheral nervous and cardiovascular systems	Reduce the bodily effects of adrenaline and noradrenaline

A useful memory distinction is:

Benzodiazepines calm activity in the brain, while beta blockers reduce bodily arousal.

Drug therapy manages the response

Drug therapy usually targets the person’s response to a stressor.

For example:

An employee has a pounding heart because an excessive workload repeatedly activates sympathetic arousal. A beta blocker may reduce the pounding heart, but it does not reduce the amount of work assigned.

This distinction is central to evaluating drug treatment.

Benzodiazepines

What are benzodiazepines?

Benzodiazepines, often abbreviated to BZs, are drugs that reduce nervous-system activity.

They may be used to reduce symptoms such as:

• Anxiety.

• Tension.

• Agitation.

• Difficulty sleeping.

• Excessive psychological arousal.

Their main action occurs within the central nervous system, which consists of the brain and spinal cord.

GABA

Benzodiazepines enhance the action of gamma-aminobutyric acid, abbreviated to GABA.

GABA is an inhibitory neurotransmitter.

An inhibitory neurotransmitter reduces the likelihood that the receiving neuron will become activated.

The basic process is:

1. GABA is released at a synapse.

2. GABA produces an inhibitory effect on the receiving neuron.

3. Benzodiazepines enhance this inhibitory action.

4. Neural activity is reduced.

5. The person may experience reduced anxiety or arousal.

What does inhibition mean?

Inhibition means reducing neural activity.

It does not mean that every neuron stops functioning.

A benzodiazepine strengthens the calming effect associated with GABA, reducing excessive nervous-system activation.

A useful examination chain is:

Benzodiazepine → enhanced GABA inhibition → reduced neural activity → reduced anxiety and tension

Benzodiazepines and synaptic transmission

Neurons communicate across synapses using neurotransmitters.

When GABA produces an inhibitory effect:

• Activity in the postsynaptic neuron becomes less likely.

• Communication through relevant neural pathways is reduced.

• General nervous-system activity may decrease.

Benzodiazepines do not create GABA. They enhance its existing inhibitory effect.

📌 Exam tip: Do not write that benzodiazepines are themselves neurotransmitters. They are drugs that affect neurotransmission.

Psychological and physiological effects

Reducing central nervous-system activity may help a stressed person feel:

• Calmer.

• Less anxious.

• Less tense.

• Better able to rest.

• Less overwhelmed by physiological arousal.

However, the same general reduction in neural activity can also contribute to unwanted effects such as:

• Drowsiness.

• Cognitive impairment.

• Unsteadiness.

These effects are important when judging whether treatment is appropriate.

Benzodiazepines and the physiology of stress

Stress can involve continuing psychological and physiological activation.

Benzodiazepines do not prevent the original stressor from occurring. Instead, they reduce neural activity associated with the stress response.

For example:

A person facing a prolonged family difficulty may continue experiencing the external problem, but enhanced GABA activity may reduce anxiety and help them feel calmer.

This can provide short-term relief while leaving the external demand unchanged.

Applying benzodiazepines

Consider this example:

Helena has experienced several weeks of stress. She feels constantly anxious, struggles to relax and lies awake at night thinking about her problems.

A developed application would explain:

• Helena’s anxiety and sleeplessness indicate continuing nervous-system activation.

• A benzodiazepine could enhance the inhibitory action of GABA.

• Increased inhibition would reduce neural activity.

• This may reduce Helena’s anxiety and help her feel calmer.

• The medication would not automatically resolve the problems causing her stress.

What benzodiazepines do not do

Benzodiazepines do not necessarily:

• Remove an excessive workload.

• Increase workplace control.

• Teach the person to reinterpret a threat.

• Develop coping skills.

• Prevent future stressors.

• Permanently alter the source of stress.

Their usefulness must therefore be judged partly according to whether immediate symptom relief or long-term coping is the treatment goal.

Beta Blockers

What are beta blockers?

Beta blockers are drugs that reduce the effects of physiological arousal.

They act mainly on the peripheral effects of stress hormones rather than reducing anxious thoughts directly.

They may reduce symptoms such as:

• Increased heart rate.

• A pounding heart.

• Raised blood pressure.

• Trembling.

• Other signs of sympathetic activation.

AQA’s specimen mark scheme specifically identifies the ability of drugs to act quickly on physiological responses such as heart rate and blood pressure.

Beta receptors

During stress, adrenaline and noradrenaline affect receptors in organs such as the heart.

Beta blockers occupy or block beta-adrenergic receptors.

This reduces the ability of adrenaline and noradrenaline to produce their usual effects.

The process is:

1. A stressor activates the sympathomedullary pathway.

2. The adrenal medulla releases adrenaline and noradrenaline.

3. These hormones would normally increase cardiovascular arousal.

4. Beta blockers reduce their effects at beta receptors.

5. Heart rate and blood pressure may be reduced.

Link with the sympathomedullary pathway

The sympathomedullary pathway involves:

1. Activation of the hypothalamus.

2. Activation of the sympathetic nervous system.

3. Stimulation of the adrenal medulla.

4. Release of adrenaline and noradrenaline.

5. Increased fight-or-flight arousal.

Beta blockers do not necessarily stop adrenaline and noradrenaline from being released.

Instead, they reduce the effects of these hormones on parts of the body.

This connects directly with adrenaline, noradrenaline and fight or flight [The sympathomedullary pathway].

Cardiovascular symptoms

Adrenaline and noradrenaline normally help prepare the body for action by:

• Increasing heart rate.

• Increasing blood pressure.

• Supporting the rapid circulation of blood.

• Preparing muscles for activity.

These effects are adaptive during an immediate physical threat.

They may be uncomfortable or disruptive when the stressor is psychological, such as:

• Giving a presentation.

• Attending an interview.

• Sitting an examination.

• Performing in front of an audience.

A beta blocker may reduce the visible or uncomfortable cardiovascular symptoms.

Beta blockers and the experience of stress

Reducing bodily arousal may help interrupt a cycle in which physical symptoms increase psychological anxiety.

For example:

1. A person notices their heart pounding.

2. They interpret this as evidence that they cannot cope.

3. Anxiety increases.

4. Physiological arousal increases further.

If a beta blocker reduces the pounding heart, the person may become less focused on the physical symptoms.

However, a beta blocker does not directly teach the person to challenge the thought that they cannot cope.

Applying beta blockers

Consider this example:

Before giving presentations, Jacob experiences a rapid heartbeat, trembling and a feeling that his heart is pounding.

A developed application would explain:

• Jacob’s symptoms indicate sympathetic or cardiovascular arousal.

• Adrenaline and noradrenaline normally contribute to these effects.

• A beta blocker could block their action at beta receptors.

• This may reduce Jacob’s heart rate and other physical symptoms.

• It would not necessarily change his beliefs about public speaking.

Beta blockers and raised blood pressure

AQA has previously used a scenario in which a person experiencing stress was prescribed medication for raised blood pressure.

This type of scenario provides a clue that a treatment targeting physiological or cardiovascular activity may be relevant.

Do not assume that every stress-related prescription must be a beta blocker unless the information supports that conclusion.

Benzodiazepines and Beta Blockers Compared

Feature	Benzodiazepines	Beta blockers
Main area of action	Central nervous system	Peripheral and cardiovascular systems
Main biological target	GABA-related neural inhibition	Effects of adrenaline and noradrenaline at beta receptors
Main outcome	Reduced neural activity and anxiety	Reduced physical arousal
Possible symptoms targeted	Anxiety, tension and difficulty relaxing	Increased heart rate, blood pressure and trembling
Connection with stress physiology	Reduces central nervous-system activation	Reduces effects associated with the sympathomedullary pathway
Important limitation	Dependency and withdrawal	Side effects and failure to address psychological causes
Long-term coping skills	Not developed automatically	Not developed automatically

Similarities

Both treatments:

• Are biological interventions.

• Aim to reduce symptoms of stress.

• Can act more quickly than some psychological therapies.

• May cause side effects.

• Do not automatically remove external stressors.

• May be unsuitable for some people.

• Require a balance between benefits and costs.

Key difference

The clearest distinction is:

Benzodiazepines reduce central nervous-system activity, whereas beta blockers reduce the peripheral physical effects of adrenaline and noradrenaline.

Drug Therapy and the Physiology of Stress

Biological intervention

Drug therapy is based on the assumption that changing biological activity can reduce the stress response.

It therefore fits with the biological approach because it focuses on:

• Neurotransmission.

• Nervous-system activity.

• Hormones and receptors.

• Cardiovascular functioning.

• Measurable physiological symptoms.

Connection with acute stress

Beta blockers may be particularly relevant when the person experiences short-term physical symptoms associated with an identifiable situation.

For example:

• Heart pounding before a speech.

• Trembling before a performance.

• Increased blood pressure during an immediate demand.

AQA’s June 2022 mark scheme identifies Kelly’s research in relation to beta blockers for short-term stress.

Connection with prolonged stress

A person experiencing prolonged stress may show:

• Continuing anxiety.

• Sleep disturbance.

• Repeated physiological arousal.

• Raised blood pressure.

Medication may reduce some of these symptoms.

However, prolonged reliance on drugs creates particular concerns because:

• Side effects may continue.

• Benzodiazepine dependency may develop.

• The external source of stress may remain.

• The person may not develop independent coping skills.

Drug therapy and the HPA system

The HPA system maintains the response to prolonged stress through cortisol.

The drug treatments covered here are not usually described as directly stopping the complete HPA sequence.

Instead:

• Benzodiazepines reduce central neural activity and anxiety.

• Beta blockers reduce peripheral effects associated particularly with adrenaline and noradrenaline.

Do not claim that beta blockers block cortisol. Cortisol belongs to the prolonged hormonal stress pathway [The HPA system].

Symptoms versus causes

Stress may originate from:

• Life changes.

• Daily hassles.

• High workload.

• Low control.

• Personality-related behaviour.

• Limited coping resources.

Medication acts on the biological response.

For example:

Source of stress	Possible symptom	Drug effect
Excessive workload	Pounding heart	A beta blocker may reduce cardiovascular arousal
Relationship difficulty	Anxiety and sleeplessness	A benzodiazepine may reduce neural activity
Recurring hassles	Tension	Medication may reduce symptoms
Low workplace control	Raised blood pressure	Medication may affect the bodily response

In each example, the original source remains unless it is addressed separately.

Applying Drug Therapy to a Complete Scenario

Consider this example:

Nina has been under pressure at work for several months. Her manager repeatedly increases her workload, and she has little control over her deadlines. Nina feels anxious, sleeps poorly and experiences a pounding heart before meetings.

Benzodiazepine application

A benzodiazepine may be relevant to Nina’s:

• Anxiety.

• Tension.

• Difficulty sleeping.

It could enhance GABA’s inhibitory effect, reducing neural activity and helping her feel calmer.

Beta-blocker application

A beta blocker may be relevant to Nina’s:

• Pounding heart.

• Cardiovascular arousal before meetings.

It could reduce the effects of adrenaline and noradrenaline on beta receptors.

Evaluation within the scenario

Medication would not:

• Reduce Nina’s workload.

• Increase her control over deadlines.

• Change the manager’s behaviour.

• Teach her long-term coping skills.

A fuller intervention might therefore combine symptom management with changes to the workplace or a psychological treatment.

Application structure

Use the following structure:

Scenario symptom → relevant drug → biological mechanism → likely effect → remaining limitation

For example:

Nina’s pounding heart suggests sympathetic arousal. A beta blocker could reduce the effects of adrenaline and noradrenaline at beta receptors, lowering cardiovascular activity. However, it would not alter her excessive workload or lack of control.

Evaluating the Effectiveness of Drug Therapy

What does effectiveness mean?

Effectiveness concerns whether a treatment produces its intended outcome.

Possible outcomes include:

• Reduced anxiety.

• Lower heart rate.

• Reduced blood pressure.

• Improved mood.

• Better sleep.

• Fewer stress-related symptoms.

A treatment could be effective at reducing symptoms without being appropriate for long-term use.

Rapid symptom reduction

A major strength is that drugs may act quickly.

This may be valuable when:

• Symptoms are severe.

• Physiological arousal interferes with everyday functioning.

• The person needs short-term relief.

• Psychological treatment has not yet begun.

• The person is temporarily unable to engage fully with therapy.

AQA’s specimen mark scheme recognises that drugs can act quickly and effectively on physiological outcomes such as heart rate and blood pressure.

Objective outcomes

Some effects can be measured objectively.

For example, researchers can record:

• Heart rate.

• Blood pressure.

• Physiological arousal.

This may provide stronger evidence than relying only on the participant saying that they feel better.

However, reduced heart rate does not necessarily mean:

• The source of stress has disappeared.

• The person has developed better coping skills.

• Psychological distress has ended.

Evidence recognised by AQA

AQA’s June 2022 mark scheme identifies several examples students may use when evaluating drug therapy:

• Kelly in relation to beta blockers and short-term stress.

• Baldwin’s comparison of benzodiazepines and placebo.

• Lindholm’s meta-analysis of beta blockers for hypertension.

• Zandstra in relation to individual differences among long-term benzodiazepine users.

These examples illustrate several useful evaluation themes:

• Short-term effectiveness.

• Comparison with placebo.

• Evidence synthesised across studies.

• Variation between individuals.

• The difference between immediate and long-term outcomes.

Do not invent precise findings or statistics unless they have been learned accurately from an appropriate source.

Placebo-controlled research

A placebo is an inactive treatment designed to resemble the real drug.

Researchers can compare:

• A group receiving the active drug.

• A group receiving the placebo.

If the active-drug group improves more, this provides evidence that the drug’s biological action contributed to the outcome.

AQA has assessed how demand characteristics and investigator effects could be reduced in research comparing a new stress drug with a placebo.

Double-blind procedure

A double-blind procedure can be used when:

• Participants do not know whether they received the drug or placebo.

• The investigators interacting with them also do not know.

This reduces:

• Demand characteristics.

• Participant expectations.

• Investigator effects.

• Biased treatment or interpretation.

After data collection, the treatment codes can be revealed.

Meta-analysis

A meta-analysis combines the results of several studies statistically.

AQA’s 2024 examination explicitly identified meta-analysis as the appropriate technique for combining findings from studies of drug therapy for stress.

A meta-analysis may provide a broader estimate of effectiveness than one small study.

However, its conclusion depends on the quality and comparability of the included research.

Combined treatments

Drug treatment may be combined with psychological therapy.

AQA’s June 2022 paper compared:

• Drug therapy alone.

• Drug therapy combined with stress inoculation therapy.

A combined treatment may offer:

• Faster symptom reduction from medication.

• Development of longer-term coping skills through psychological therapy.

However, a higher post-treatment mean for one group cannot be interpreted properly without information such as:

• The groups’ scores before treatment.

• A measure of dispersion.

• Whether extreme scores affected the mean.

Individual differences in effectiveness

Not everyone responds to medication in the same way.

People may differ in:

• The reduction in symptoms.

• Side effects.

• Tolerance of the treatment.

• Long-term use.

• Willingness to continue.

• Existing health circumstances.

This means that a finding based on the mean response may conceal substantial variation.

A treatment can be effective overall while being ineffective or inappropriate for a particular individual.

Evaluating the Appropriateness of Drug Therapy

What does appropriateness mean?

Appropriateness concerns whether a treatment is suitable for:

• The particular person.

• Their symptoms.

• The duration of treatment.

• Their circumstances.

• The balance between benefits and risks.

• The intended outcome.

A drug may reduce symptoms but still be inappropriate because of side effects, dependency or the need for long-term change.

Side effects of benzodiazepines

AQA mark schemes identify possible benzodiazepine side effects including:

• Drowsiness.

• Weight gain.

• Unsteadiness.

• Cognitive impairment.

• Paradoxical effects.

A paradoxical effect is a response opposite to the intended calming effect, such as increased agitation.

Side effects matter because they may:

• Interfere with work.

• Affect concentration.

• Increase accident risk.

• Reduce willingness to continue treatment.

• Create new difficulties for the person or family.

Side effects of beta blockers

AQA’s 2024 mark scheme identifies possible beta-blocker side effects including:

• Tiredness.

• Psychotic symptoms such as hallucinations.

The significance of any side effect depends on:

• Its severity.

• How frequently it occurs.

• The benefits produced.

• The individual’s circumstances.

Listing a side effect is only the beginning of an evaluation. You should explain why it affects appropriateness.

Dependency

A major limitation of benzodiazepines is the risk of dependency.

A person may come to rely on the drug and experience difficulty stopping it.

AQA’s 2024 mark scheme states that benzodiazepines can be addictive even at low doses and that withdrawal symptoms may occur when treatment stops.

Dependency may mean:

• Continued use despite problems.

• Difficulty managing without the drug.

• Withdrawal symptoms.

• Increased concern about long-term treatment.

• The costs of treatment outweighing its initial benefits.

Withdrawal symptoms

Withdrawal symptoms are unpleasant effects that occur when a person who has become dependent reduces or stops the drug.

The existence of withdrawal symptoms makes benzodiazepines less suitable as a long-term solution.

It also means that apparent continued effectiveness may partly reflect avoidance of withdrawal rather than continuing treatment of the original stress.

Short-term versus long-term use

Drug therapy may be more appropriate for short-term symptom relief than for managing chronic stress indefinitely.

Short-term use	Long-term use
Can provide rapid relief	Side effects may continue
May help during a temporary crisis	Dependency risk may increase
May allow engagement with another therapy	The source of stress may remain
Useful for immediate physiological symptoms	Independent coping skills may not develop

AQA mark schemes specifically recognise that some stress drugs may not be suitable for long-term use.

Drugs may mask symptoms

Medication may reduce:

• Anxiety.

• Heart rate.

• Blood pressure.

• Sleeplessness.

However, it may mask the symptoms without addressing the external cause.

For example:

A beta blocker reduces an employee’s pounding heart, but the employee continues facing an impossible workload and no control over deadlines.

The person may feel temporarily better while remaining exposed to the same harmful conditions.

This limitation was frequently recognised by students in the 2024 examination.

Source-focused treatments

A treatment that addresses the source may involve:

• Reducing workload.

• Increasing workplace control.

• Resolving practical problems.

• Developing coping skills.

• Changing stressful thought patterns.

• Seeking appropriate social support.

Drug therapy may still be useful alongside these changes.

The evaluation point is not that symptom relief has no value. It is that symptom relief may be incomplete when the stressor continues.

Practical advantages

Drug therapy can be convenient because:

• Medication can be taken without regular lengthy therapy sessions.

• It does not require the same level of insight or verbal participation as psychological treatment.

• It may provide rapid relief.

• It may initially require less time from the person.

These advantages may make it appropriate for someone who:

• Cannot immediately access therapy.

• Is too distressed to participate fully.

• Needs short-term physiological symptom management.

However, practical advantages should be explained rather than reduced to vague statements such as “drugs are quicker”.

Cost and economic implications

Drug therapy may initially require less therapist time than psychological treatment.

This may reduce immediate costs.

However, the overall economic judgement should consider:

• Repeated prescriptions.

• Medical monitoring.

• Treatment of side effects.

• Dependency.

• Continued workplace absence.

• The cost of leaving the external stressor unchanged.

AQA’s examiner report warns that vague references to time or cost are not creditworthy without a developed argument.

Ethical issues

Ethical concerns may arise if medication is used mainly to control a distressed or agitated person rather than promote their wellbeing.

Questions include:

• Has the person given informed consent?

• Are the benefits greater than the risks?

• Is the medication being used for the person’s welfare?

• Are less restrictive alternatives available?

• Is long-term use being monitored appropriately?

AQA’s 2024 mark scheme recognises ethical concerns about using drugs to control distressed patients in care settings.

Comparison with Psychological Methods

Drug therapy and stress inoculation therapy

Drug therapy	Stress inoculation therapy
Biological intervention	Cognitive-behavioural intervention
Can reduce symptoms quickly	Requires learning and practice
Does not automatically change thoughts	Develops psychological coping skills
May cause side effects or dependency	Requires commitment and participation
May be useful for immediate relief	May provide longer-lasting independent coping
Often symptom-focused	Addresses how stressors are interpreted and managed

The next lesson examines developing coping skills in stages [Stress inoculation therapy].

Drug therapy and biofeedback

Drug therapy	Biofeedback
Changes biological activity through medication	Uses feedback to help the person control physiological activity
May work without learning a skill	Requires learning and practice
May produce side effects	Requires equipment, at least initially
Relief may depend on continuing medication	Skills may be used independently once learned
Passive treatment	More active treatment

Biofeedback is developed in learning to control physiological arousal [Biofeedback].

Passive and active treatments

Drug therapy is often described as relatively passive because the person takes medication rather than learning a new coping response.

Advantages of a passive treatment include:

• Limited psychological effort.

• Suitability when distress is severe.

• Rapid symptom relief.

Limitations include:

• Dependence on the treatment.

• Limited development of self-management.

• Symptoms potentially returning when medication stops.

Psychological treatments may require more effort but may help the person develop skills that continue after formal treatment ends.

A combined approach

A combined approach may use:

• Medication to reduce severe symptoms.

• Psychological treatment to change coping or interpretation.

• Environmental changes to address the stressor.

For example:

A person experiencing severe workplace anxiety might receive short-term symptom relief while also learning coping skills and negotiating changes to workload.

This is more holistic than relying on one intervention alone.

Broader Evaluation Issues

Biological reductionism

Drug therapy is biologically reductionist because it treats stress by focusing on biological processes such as:

• Neurotransmission.

• Receptors.

• Neural activity.

• Heart rate.

• Blood pressure.

This can be useful because biological processes are measurable and can be altered directly.

However, stress also involves:

• Thoughts.

• Appraisal.

• Social relationships.

• Workplace conditions.

• Life events.

• Coping resources.

Reducing stress to physiology may therefore overlook important causes.

This links with levels of explanation [Holism and reductionism].

Treating the person rather than the environment

A biological treatment can place the focus on changing the individual.

This may be inappropriate when the stress arises from:

• Unsafe working conditions.

• Excessive workload.

• Low control.

• Serious financial demands.

• Inadequate practical support.

Medication should not become a substitute for addressing preventable environmental stressors.

Effectiveness is outcome-specific

A drug might be:

• Effective at reducing heart rate.

• Less effective at reducing negative thoughts.

• Effective during treatment.

• Less effective after treatment ends.

• Effective for one person.

• Ineffective or unsuitable for another.

An evaluation should always specify:

Effective for what outcome, for whom and for how long?

Reliance on symptom scores

Studies may measure effectiveness using:

• Mood scores.

• Anxiety scores.

• Heart rate.

• Blood pressure.

• Participant reports.

Each outcome measures a different part of stress.

A treatment might improve one measure but not another.

For example:

• Heart rate may fall.

• The person may still report severe worry.

• Mood may improve.

• The external stressor may remain.

Placebo effects

Improvement may partly result from the expectation of receiving treatment.

A placebo-controlled design helps separate:

• Improvement caused by the drug’s biological action.

• Improvement caused by expectations or attention.

However, placebo research must be designed carefully to avoid demand characteristics and investigator effects.

Methodological quality of effectiveness research

When evaluating a study, consider whether it included:

• A placebo group.

• Random allocation.

• A double-blind procedure.

• Baseline measures.

• An appropriate control condition.

• Measures of dispersion.

• Follow-up after treatment.

• Clear operationalisation of stress.

A high post-treatment mean is not enough to prove that one therapy was better if the groups differed before treatment.

Overall Evaluation

Drug therapy can be effective and appropriate when rapid relief from severe psychological or physiological symptoms is needed. Benzodiazepines reduce neural activity by enhancing GABA inhibition, while beta blockers reduce peripheral arousal by limiting the effects of adrenaline and noradrenaline. These mechanisms connect treatment directly with the biology of stress.

However, side effects, benzodiazepine dependency and withdrawal reduce suitability for long-term use. Medication may also mask symptoms while leaving workload, life changes or other stressors untouched. Drug therapy is therefore often most defensible as a short-term or combined intervention rather than a complete solution to every source of stress.

Planning an Extended Response

For a question asking you to discuss drug therapy as a way of managing stress, organise your answer carefully.

Knowledge and understanding

Explain:

• Drug therapy as a biological treatment.

• Benzodiazepines and beta blockers.

• GABA as an inhibitory neurotransmitter.

• Enhancement of GABA inhibition.

• Reduced central nervous-system activity.

• Adrenaline and noradrenaline.

• Beta receptors.

• Reduced heart rate and blood pressure.

• Links with the physiology of stress.

Application

For each scenario detail:

1. Identify the symptom.

2. Select the relevant drug type.

3. Explain the biological mechanism.

4. State the likely effect.

5. Consider whether the source of stress remains.

Evaluation

Develop points such as:

• Rapid action.

• Effectiveness for physiological symptoms.

• Evidence using placebo comparisons or meta-analysis.

• Side effects.

• Benzodiazepine dependency and withdrawal.

• Short-term versus long-term use.

• Individual differences.

• Symptom masking.

• Cost and convenience.

• Ethical concerns.

• Comparison with stress inoculation therapy and biofeedback.

• Biological reductionism.

• Combined treatment.

📌 Exam tip: If the question is entirely AO3, do not spend most of the answer describing drug mechanisms. Use the mechanisms only where they support an evaluative argument.

Key Words 🔑

Key word	Student-friendly definition	How it may be used in an exam
Drug therapy	A biological treatment using medication to reduce stress symptoms	Identify the overall method of stress management
Benzodiazepine	A drug that enhances inhibitory activity in the central nervous system	Explain how anxiety and neural arousal may be reduced
BZ	An abbreviation for benzodiazepine	Use after writing the full term once
Beta blocker	A drug that reduces the peripheral effects of adrenaline and noradrenaline	Explain reductions in heart rate and blood pressure
Central nervous system	The brain and spinal cord	Identify the main area affected by benzodiazepines
Peripheral nervous system	Nerves outside the brain and spinal cord	Link beta blockers with bodily effects
GABA	An inhibitory neurotransmitter whose effects are enhanced by benzodiazepines	Explain reduced neural activity
Inhibitory neurotransmitter	A chemical messenger that reduces the likelihood of neural activation	Explain how GABA calms nervous-system activity
Synapse	The junction across which neurons communicate chemically	Describe where neurotransmitters act
Beta receptor	A receptor affected by adrenaline and noradrenaline	Explain the action of beta blockers
Adrenaline	A hormone involved in immediate fight-or-flight arousal	Link beta blockers to stress physiology
Noradrenaline	A hormone released alongside adrenaline during the sympathomedullary response	Explain the physical stress response
Physiological arousal	Increased bodily activity associated with stress or alertness	Apply drug treatment to pounding heart or raised blood pressure
Effectiveness	The extent to which a treatment produces its intended outcome	Evaluate symptom reduction
Appropriateness	Whether a treatment is suitable for a particular person and situation	Evaluate side effects, duration and individual differences
Side effect	An unintended effect of treatment	Evaluate costs of benzodiazepines or beta blockers
Dependency	Reliance on a drug that makes stopping difficult	Explain a limitation of benzodiazepines
Withdrawal symptom	An unpleasant effect occurring when a dependent user stops or reduces a drug	Evaluate long-term appropriateness
Placebo	An inactive treatment resembling the real drug	Evaluate evidence for biological effectiveness
Double-blind procedure	A procedure in which participants and relevant researchers do not know treatment allocation	Explain how bias may be reduced
Meta-analysis	A statistical technique combining findings from several studies	Explain how wider evidence of effectiveness may be produced
Biological reductionism	Explaining or treating a complex experience through biological processes	Evaluate the narrow focus of drug therapy
Symptom masking	Reducing signs of a problem without removing its underlying cause	Explain why medication may be incomplete

Hints from the Examiner Reports 💡

Examiner hint: Follow the assessment objective. In the 2022 examination, Question 30 required evaluation only. Some students wasted time describing the drugs and their modes of action instead of assessing them.

Examiner hint: Do not write only that “drugs work”. The examiner report states that vague, unsupported claims about effectiveness were not creditworthy.

Examiner hint: Develop points about time and cost. Explain why rapid action is beneficial or why long-term prescriptions, side effects and dependency may create additional costs.

Examiner hint: For a short limitation question, one fully explained limitation can gain full marks. For example, identify benzodiazepine dependency and explain that withdrawal makes long-term use unsuitable.

Examiner hint: Link the drug to the correct physiological process. Benzodiazepines enhance GABA inhibition, whereas beta blockers reduce the peripheral effects of adrenaline and noradrenaline.

Examiner hint: Do not say beta blockers stop the release of adrenaline. Explain that they reduce its effect at beta receptors.

Examiner hint: Separate effectiveness from appropriateness. A drug may reduce a pounding heart effectively but be inappropriate for long-term use because it leaves the stressor unchanged.

Examiner hint: Use evidence accurately. AQA accepts studies concerning short-term beta-blocker use, benzodiazepines versus placebo, hypertension and long-term individual differences, but muddled or invented findings weaken evaluation.

Common Mistakes ⚠️

Mistake: Saying benzodiazepines are neurotransmitters.

Why this is incorrect:Benzodiazepines are drugs that enhance the effect of the neurotransmitter GABA.

How to improve:Write the sequence: benzodiazepine, enhanced GABA inhibition, reduced neural activity.

Mistake: Saying GABA excites neurons.

Why this is incorrect:GABA is an inhibitory neurotransmitter.

How to improve:Explain that GABA reduces the likelihood of neural activation.

Mistake: Saying benzodiazepines increase nervous-system activity.

Why this is incorrect:Their intended effect is to increase inhibition and reduce neural activity.

How to improve:Connect reduced neural activity with reduced anxiety or tension.

Mistake: Saying beta blockers act mainly by increasing GABA.

Why this is incorrect:That mechanism belongs to benzodiazepines.

How to improve:Link beta blockers with adrenaline, noradrenaline and beta receptors.

Mistake: Saying beta blockers stop adrenaline being released.

Why this is incorrect:They reduce the hormone’s effects at beta receptors.

How to improve:Use the phrase “block or reduce the action of adrenaline and noradrenaline”.

Mistake: Saying beta blockers block cortisol.

Why this is incorrect:Cortisol belongs to the HPA response. Beta blockers are linked more directly with peripheral sympathomedullary effects.

How to improve:Separate cortisol from adrenaline and noradrenaline.

Mistake: Saying a reduction in heart rate proves all stress has ended.

Why this is incorrect:Psychological worry and the external stressor may remain.

How to improve:Distinguish physical symptom reduction from complete stress management.

Mistake: Treating effectiveness and appropriateness as identical.

Why this is incorrect:A drug may work while producing unacceptable side effects or dependency.

How to improve:Ask whether it works and whether it is suitable.

Mistake: Listing side effects without explaining them.

Why this is incorrect:The examiner needs to understand their effect on treatment suitability.

How to improve:For example, cognitive impairment may interfere with work, making treatment inappropriate for some users.

Mistake: Saying benzodiazepines are completely safe at low doses.

Why this is incorrect:AQA’s mark scheme recognises dependency and withdrawal even with low-dose use.

How to improve:Discuss the risk-benefit balance and long-term suitability.

Mistake: Saying medication removes the source of stress.

Why this is incorrect:It may reduce symptoms without altering workload, life events or recurring hassles.

How to improve:Identify the symptom treated and the external cause that remains.

Mistake: Writing detailed AO1 in an AO3-only question.

Why this is incorrect:Description does not receive marks when the question assesses evaluation only.

How to improve:Use each point to assess effectiveness, appropriateness or comparison with another treatment.

Exam-Style Questions ✍️

Question 1

Which statement correctly describes the action of beta blockers in managing stress?

A. They enhance the inhibitory effect of GABA.B. They increase the effects of adrenaline.C. They reduce the effects of adrenaline and noradrenaline at beta receptors.D. They prevent the adrenal cortex from releasing cortisol.

[1 mark]

Question 2

Define drug therapy as a method of managing stress.

[2 marks]

Question 3

Explain how benzodiazepines may reduce symptoms of stress.

[4 marks]

Question 4

Explain how beta blockers may reduce physiological symptoms of stress.

[4 marks]

Question 5

Explain two differences between benzodiazepines and beta blockers.

[4 marks]

Question 6

Samira has been given a demanding presentation at work. She feels anxious and has difficulty sleeping. Immediately before presentations, her heart pounds and her hands shake.

Use your knowledge of drug therapy to explain how two types of medication might manage Samira’s symptoms.

[6 marks]

Question 7

Outline one limitation of drug therapy as a treatment for stress.

[2 marks]

Question 8

Researchers compare a new stress drug with a placebo. Explain how they could reduce demand characteristics and investigator effects.

[4 marks]

Question 9

A study compares drug therapy with a combination of drug therapy and stress inoculation therapy.

Group	Mean mood score before treatment	Mean mood score after treatment
Drug therapy	37	51
Combined therapy	36	68

Higher scores indicate more positive mood.

Explain what the findings suggest. Identify one additional piece of information needed before drawing a firm conclusion.

[4 marks]

Question 10

Evaluate drug therapy as a way of managing stress.

[8 marks]

Question 11

Tomas has experienced severe workplace pressure for several months. Medication reduces his pounding heart and helps him sleep, but he feels tired during the day. His workload remains excessive, and he believes he cannot cope without the medication.

Discuss drug therapy as a method of managing stress. Refer to Tomas in your answer.

[16 marks]

Answers and Mark Scheme

Question 1

Answer: C

Beta blockers reduce the effects of adrenaline and noradrenaline at beta receptors.

[1 mark]

Question 2

Award up to two marks:

• Drug therapy is a biological method of managing stress using medication.

• Medication is used to reduce psychological or physiological symptoms of the stress response.

[2 marks]

Question 3

Award up to four marks:

• Benzodiazepines affect the central nervous system.

• They enhance the action of GABA.

• GABA is an inhibitory neurotransmitter.

• Increased inhibition reduces neural activity, which may reduce anxiety, tension or difficulty relaxing.

[4 marks]

Question 4

Award up to four marks:

• Stress activates the sympathomedullary pathway.

• Adrenaline and noradrenaline contribute to increased cardiovascular arousal.

• Beta blockers reduce the hormones’ effects at beta receptors.

• This may reduce heart rate, blood pressure, trembling or a pounding heart.

[4 marks]

Question 5

Award up to two marks for each developed difference:

• Benzodiazepines act mainly within the central nervous system, whereas beta blockers act on peripheral physiological responses.

• Benzodiazepines enhance GABA inhibition, whereas beta blockers reduce the effects of adrenaline and noradrenaline.

• Benzodiazepines primarily reduce anxiety and neural activity, whereas beta blockers primarily reduce cardiovascular symptoms.

• Dependency is a major concern with benzodiazepines, whereas beta blockers have a different pattern of possible side effects.

Maximum [4 marks].

Question 6

Award one mark for each clear application, up to six marks:

• Samira’s anxiety and difficulty sleeping may be targeted using a benzodiazepine.

• The benzodiazepine would enhance GABA’s inhibitory action.

• Reduced neural activity could help her feel calmer or sleep.

• Her pounding heart and shaking indicate physiological arousal.

• A beta blocker could reduce the effects of adrenaline and noradrenaline at beta receptors.

• This could reduce her heart rate, trembling or other physical symptoms.

Credit cautious recognition that neither drug necessarily changes the work-related demand.

[6 marks]

Question 7

Award up to two marks for one explained limitation:

• Benzodiazepines may cause dependency, meaning the person may find it difficult to stop taking them and experience withdrawal.

• Drugs may mask symptoms without removing the external source of stress.

• Side effects may make treatment unsuitable.

• Some drugs are not appropriate for long-term use.

[2 marks]

Question 8

Award up to four marks:

• Participants should not be told whether they receive the real drug or placebo.

• This reduces demand characteristics or expectancy effects.

• Researchers administering treatment or measuring outcomes should also be unaware of allocation.

• This double-blind procedure reduces investigator effects or biased treatment and assessment.

[4 marks]

Question 9

Award up to four marks:

• Both groups show improved mean mood after treatment.

• The combined group shows a larger increase than the drug-only group.

• This suggests that combining drug therapy with stress inoculation therapy may be more effective for mood.

• A measure of dispersion, information about statistical significance or evidence that groups were comparable would be needed before drawing a firm conclusion.

Credit other appropriately reasoned limitations of the data.

[4 marks]

Question 10

Indicative content may include:

• Drugs may act rapidly.

• They may reduce objective physiological symptoms such as heart rate and blood pressure.

• Placebo-controlled studies can provide evidence for biological effectiveness.

• A meta-analysis may combine results across several studies.

• Benzodiazepines may cause drowsiness, cognitive impairment, weight gain or paradoxical effects.

• Benzodiazepines may produce dependency and withdrawal.

• Beta blockers may cause tiredness or other side effects.

• Drugs may be more appropriate for short-term than long-term stress.

• Medication may mask symptoms without addressing the source.

• Individual differences affect response and side effects.

• Drug therapy may require less time and participation than psychological therapy.

• Long-term prescriptions and side effects may create costs.

• Stress inoculation therapy may produce longer-lasting coping skills.

• Biofeedback may provide greater personal control.

• A combined approach may offer immediate relief and long-term coping.

• Drug treatment is biologically reductionist.

For the highest marks, points should be developed and balanced rather than listed.

[8 marks]

Question 11

Indicative content may include:

Knowledge and understanding

• Drug therapy is a biological method of managing stress.

• Benzodiazepines enhance GABA inhibition.

• Increased inhibition reduces neural activity and anxiety.

• Beta blockers reduce the peripheral effects of adrenaline and noradrenaline.

• They may reduce heart rate and blood pressure.

• Drugs mainly target symptoms of the stress response.

Application to Tomas

• Tomas’s pounding heart suggests sympathomedullary or cardiovascular arousal.

• A beta blocker could reduce the effects of adrenaline and noradrenaline.

• Medication helping him sleep may reflect reduced nervous-system activation.

• Tiredness is a possible side effect and may interfere with daytime functioning.

• His excessive workload remains the source of stress.

• The treatment may therefore be masking symptoms.

• Believing he cannot cope without medication may indicate reliance or possible dependency.

• Several months of use raises concerns about long-term appropriateness.

Evaluation

• Rapid symptom reduction is valuable when stress is severe.

• Reduced physical arousal may allow Tomas to continue functioning.

• Objective outcomes such as heart rate could demonstrate effectiveness.

• Side effects may outweigh benefits for some people.

• Dependency and withdrawal make benzodiazepines less suitable for prolonged use.

• Medication does not develop coping skills.

• Workplace changes may be required to reduce Tomas’s workload.

• Stress inoculation therapy could help him develop cognitive coping skills.

• Biofeedback might help him learn greater control over physiological arousal.

• A combined intervention may be more appropriate than medication alone.

• Individual responses to drugs vary.

• Drug therapy is biologically reductionist because it focuses on physiology.

• Effectiveness should be judged separately from appropriateness.

• Short-term relief does not prove long-term recovery.

A high-level answer will explain the relevant biological mechanisms, apply several details from Tomas’s situation and develop a balanced judgement about both effectiveness and appropriateness.

[16 marks]