All Class notes until Exam 2
All Class notes until Exam 2 PSY 35000 - 002
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Abnormal conditions exist on a continuum with normal behavior Decisions about formal diagnosis amp treatment are for professionals Humans are complex all alike in some ways all individual in other ways Social circumstances brain chemical amp structures contribute to complexities Prediction can be poor interventions don t always work as hoped Abnormal behavior canhas been studied scienti cally Clinical psychologist PhD or PsyDgrad school internship and postdoctoral supervised work Psychotherapy clinical assessment teaching neuropsych testing research Moderate to severe cases Counseling Psychologist PhD or PsyDlGrad school internship and postdoctoral work Psychotherapy vocational amp clinical assessment teaching research Mild cases ex relationship counseling Psychiatric social worker MSW Graduate school Depending on training psychotherapy case management etc Ex hospital work narrowly directed training Psychiatrist MDmedia school and residency Medications some psychotherapy some research Psychoanalyst Certificationusu MD in USApsychoanaytic institute Psychoanaysis amp psychoanalytic psychotherapy Psychotherapist EdD MFT religious leadership training etc Probem assessment amp intervention within specialized contexts Not regulated What is abnormal Deviant unusual nonnormative Ex sexual activity with children food binges followed by vomiting Irrational does not make sense in cultural context Ex loose associations bizarre gestures Maladaptiveharmful dangerous to self or others interferes with selfcare Ex neglect or selfcare selfmutilation suicide 8 9 2 7 41 Painfuldistressing subjective sense of discomfort or distress ashbacks to trauma in PTSD fear in paranoia Three key perspectives on Abnormal Behavior Spiritualsupernatural Cause of abnormality control by supernatural forces Necessary treatment drive out evi forces amp nurture good forces Professionas priests sensitive persons elders SomatogenicBiologicaMedica Cause of abnormality Somaticbodily processes gone wrong Necessary treatment Correct body andor physiological processes Professionas Physicians amp other experts in somatic processescare Psychogenic Cause of abnormality Disturbed feelings habits and attitudes Necessary treatment Change behavior by tak new experiences Professionas Training in social science amp human behavior quotSystematic waysquot are paradigms organize thinking Social and cultural issues are central to understanding abnormal behavior SpiritualSupernatural Model n Europequotthe westquot demonic possession as a cause of abnormal behavior Logical need for prayers amp spiritual interventions Treatment drive evil spirits out by making body inhospitable Rise and fall of moral therapy in late 1800searly 19005 In other traditional societies ex West Africa placate or nurture good spirits Healing and rest for less bene cent spirits Contemporary and related issues tensions between folk medicine and other approaches quotmoralquot issues and culpability ex addictions Limitations radica divergences in spiritualsupernatural systems meaning of problem behaviors vary with core beliefs how much faith does one need if issue is not enough faith how do you train appropriate professionals efficiency amp success rates in treating problems using other methods SomatogenicquotMedical Modelquot If viewing abnormal behavior like physical illness then underlying processes can be seen at levels of 1 Symptom discrete identi able abnormal process that may signal a larger problem 2 Syndrome pattern group of regularlycooccurring symptoms without reference to origin 3 Disorder syndrome with a clear coherent pattern re ecting a larger condition but with unknown etiology origin 4 Disease disorder with a known etiology Symptom ex sneezing hallucinations Syndrome ex sneezing watery eyes hallucinations with delusions Disorder ex a cold schizophrenia Disease ex a speci c cold virus schizophrenia if cause were known Etiology informs treatment but treating symptoms does not cure a disease Etiologies of Abnormal Behavior 1 Disease organisms virusesother pathogens ex syphilis as a cause of general paresis 2 Biochemistry imbalances in brain or other bodily chemicals ex dopamine hypothesis of schizophrenia 3 Neuroanatomy structural changes in brain or other parts of central nervous system ex brain injury cortical deterioration leads to dementia 4 Genetics inherited weakness or disposition ex concordance rates of schizophrenia autism identical twin amp fraternal twin concordances for behavioral disorders none are 100 concordant Key bene ts of a somatogenicmedical model Understand previously misunderstood patterns ex Alzheimer s disease as biologically distinct from normal agingother cognitive decline ex agreement that bipolar disorder likely genetic Potential for early amp reliable diagnosis amp treatment by identifying biological markers ex early identi cation of PKU gt avoid later mental retardation Foundations for effective new treatment ex discovery of major tranquilizers gt deinstitutionalization of SMI patients Impact of spiritual amp medical models on number of patients in US mental hospitals increasespeaks in 19505 then drops dramatically until 19805 Industrial revolution started increase changed family structures for caring World War increases PTSD brain injuries ILO Tranquilizersdrugs in uences decline in patients 19605 Kennedy administration meds gt possible to deinstitutionalize gt creation of CMHCs for outpatient care Criticisms of a somatogenicbiologicalquotmedical modelquot Reductionism not all abnormal behavior can be reduced to or treated as physical processes quotproblemsquot often extend well beyond just brain abnormalities ex anorexia PTSD affected by experiences skills Mental vs physical illness originscoursestreatment of many abnormal patterns differ from medical problems ex paranoia phobias or other nonpsychotic disorders Social responsibility if abnormal behavior is just faulty physical processes then quotmentally illquot should not be held responsible for their behavior ex alcoholism and drinking amp driving Current lack of understanding etiology few conclusive causal links between biological conditions and speci c abnormal behavior ex no blood test for schizophrenia Class exercise word association Ambiguous words abnormal condition Meanings amp feelings rather than biology Meanings salient audience s stage of life Abnormal condition l inappropriate context for focus on basic biological urges Abnormal feeling awkward l nervous behavior laughter I relieve tension diffuse energy generated by incongruity Evidence of Psychogenic model meaning social context as triggers shaping direction of any energybiological processes Psychogenic models abnormal behavior as result of disturbances in Thoughts inc meanings amp other cognitive activity Feelings inc positive amp negative emotions amp moods Behavior inc social amp privateinternal activity as well as habits Other quotpsychologicalquotbehaviora internal experiences and phenomena Freud s structural theory ID lnborn based in biological needs Repository of libidinal energy Pleasure principle satisfaction through direct grati cation primary process thinking wishful llment Unconscious Freud s structural theory EGO Develops out of id to meet the needs of the id in the quotreal worldquot 0 Reality principle satisfaction through grati cation by indirect means secondary process thinking logical planful thought Largely conscious Freud s structural theory SUPEREGO quotMoral Armquot of the psyche based on assuming the moral values of the samesex parent Develops out of fear of parents out of love of parents around ages 37 Partially conscious Freud s structural elements of the psyche amp consciousness of experience ID EGO l SUPEREGO unconscious l preconscious l conscious Freud s developmental theory Stage Age Erogenous Con ict Fixations zoneactivity Oral 01 Mouthsucking Weaning Dependency indulgence Anal 13 Anuselimination Toilet Stinginess training compulsiven ess Phallic 35 quotPenisquotmasturbat OedipalElect Morality ion ra homosexualit y Latency 512 None in None in particular particular consolidate same sex identity Genital 12 Genitalsintercour Societal Sexual se mores impulsivity Freudian approach to development of symptoms amp defenses Con ict lD impulses vs societal rules Neurotic anxiety l Mediation by EGO via some combination of 1 Symptoms sign of forbidden wish trying to be expressedsatis ed Anxiety conversion quotperversionsquot psychosis etc 2 Defense mechanisms effort to divert or minimize energy or object of a forbidden wish repression displacement projection sublimation Major criticisms Questionable evidence for unobservable constructs amp untestable processes ex test for quotOedipal con ictquot Alternatives to con ict as mechanism for normalabnormal development ex bicycle riding lrrational fear of animals Highly deterministic but not predictive ex who will be gaylesbian Cigarette smoker Stringent requirements for psychoanalysis ex age verbal ability reality contact time Major contributions Hard psychic determinism abnormal behavior as not random but the result of de nite psychological antecedents even if not well understood First internally consistent comprehensive theory of unconscious mental life societal conditions that shape it ex social needs for order curbs on particular id urges Abnormal and normal behavior are on continuum I everyone warped to some degree by common early experiences amp biology Con ict as basis for abnormal behavior sex amp aggression as most likely to cause con ict and anxiety as crucial symptom First major talking treatment with a clear guiding theoretical basis Psychoanalysis Theory Aspect Theoretical Implications for Tx Element Structural Drives are 0 Focus basic unconscious T Drives are 0 Assess amp r unconscious access e Overt behavior unconscious a lunconscious through t mental life quotunguardedquot m 0 Must gratify FOUteS amp 9 drives recurring n behavior t Developmental Con ict Identify society vs original trauma drives l l liberate development energy l 0 Early reduce sx experiences l 0 Focus fixations l childhood speci c sx Additional Drives don t Con icts will go awayquot l surface in anxiety amp new relationship areas of with neutral expression therapist process l Goals Recover information about quottrue underlying unconscious causes of problems free association projective tests dream analysis hypnosis Nurture insight repeated confrontation l observe patterns quotWork through the problems Transference Analyst presents neutral face to analysand person being analyzed Strong feelings develop toward analyst during tx transference Feelings therefore must represent unconscious life Psychoanalysis quotanalysis of transference Positive vs negative transference Positive allows acceptance of parentlike support Negative hostility resistance to interpretations Analyst s countertransference 910 0 Psychoanalysis procedural development Some key features Training analysis of psychoanalystsintraining Time for analysis Classical psychoanalysis Posture lying downnot facing analyst lregression Talking mostly by anaysand minimal by analyst Techniques tap into primitive unconscious life Focus uncovering unconscious con icts esp childhood sexualaggressive roots Modern Posture sitting up angled facing therapist Focus discussion of support of coping by ego than roots of id based con icts Humanistic approaches Contrary to quotPessimismquot of Freud humans gtgt con ict and biological urges Mechanistic views of behaviorists humans gtgtstimuus response history Focus unique aspects of human life Freedom choice amp personal growth Human health amp potential rather than pathology Subjective values amp experiences vs external events biology or other outer or impersonal in uences Hierarchy of needs Abraham Maslow 5 level of needs basic advanced 1 quotSelfactualizationquot 2 Esteem from self and others 3 Belongingness and love 4 Safety security order stability 5 Physiological ex food water More basic needs must be at least partly satis ed before moving up Failure to live up to potential due to Failure to get more basic needs met Lack of couragefear that growth will lead to situations the individual will be unable to handle Selfactualizing people are Open direct spontaneous playful creative Independent amp nonconforming ln touch with their spirituality amp in harmony with life peak experiences transcendent times when quoteverything falls into placequot feeling quotin the zonequot Able to establish deep intimate relationships 915 Concerned with the problems of others amp society based on highlydeveloped ethical sensibility Selfactualizing people are not Perfect just very comfortable with selves l sense of well being Finished growing Some selfactualized people Martin Luther King Gandhi Oprah Drew Brees Prototypical humanistic clinical approach Some basic Rogerian concepts Humans who are Free Do not need to distort information from the environment THEREFORE make goodoptimal choices behave effectively Actualizing tendency Basic tendency of all organisms to maintain its own phenomenological existence from the rest of the world it becomes a true SELF l the actualizing tendency focuses on that SELF quotl Rogers Phenomenologicalexperimental differentiation of the self In the presence of Unconditional positive regard l Congruence with experience amp reality l Accurate selfconcept l Fully functioning life amp self l Selfactualization Abnormal in the presence of Conditional positive regard l lncongruence with experience amp reality l Selective selfconcept l Protection of poorlyexplored self continuing search for positive regard l Distress Lecture exam I Lecture material through 917 Assigned parts of quotNRGquot chaps 12 NOT research methods sociocultural biopsychosocial MyPsychLab De ning abnormal behavior professions Historical perspectives Spiritual approaches Medicalbiologicalsomatogenic approaches therapies Psychologicalquotpsychogenicquot approaches therapies psychoanalytic behavioral humanistic De nitions comparisons examplesapplications HELP SESSION 921 700 PRCE 277 General contributions of humanistic approaches Emphasize importance of individuals subjective views Esp values of selfconcept amp choices Client as expert on own issues not therapist Views of healthy human personality Basis for current quotpositive psychology ideas Empirical validation of importance of therapist values amp competence to provide Unconditional positive regard Accurate empathy Genuineness Criticisms of humanistic approaches Many major constructs amp processes not empirically testable Truly selfactualized individuals probably rare quotNaivetequot about quotnatural goodness of human nature More like a philosophy than a psychology Humanistic approaches to treatment Rogers Clientcentered therapy aka person centered therapy Emphasizes unique individual qualities Therapist s rolequot create conditions for growth less emphasis on technique or speci c sx o Genuineness amp congruence transparent quotrealquot 0 Unconditional positive regard quotnonpossessive warmth o Accurate Empathy appreciation without getting lost Therapist s approach since client is expert on own needs amp unique potential therapist as facilitator 0 Non directive o Re ective 0 Not utility when focus on values not sxbehaviors Three major behavioral approaches 1 Classical conditioning neutral stimuli come to elicit conditioned responses by informational pairing with unconditional stimuli ex Pavlov s Dog 2 Operant conditioning reinforcement history in uences the probability of later behavior ex puzzle box superstition 3 Modeling observing the behavior of others may produce learning by imitation ex TV violence copycat crime Classical conditioning 917 Unconditioned stimulus food unconditioned response salivation Unconditioned stimulus plus conditioned stimulus Food sound l unconditioned response salivation Conditioned stimulus sound l conditioned response salivation Conditioned learned Factors that limit amp control classical conditioning processes Acquisition early pairings of the CS amp UCS must be quotTemporally contiguousquot close enough in time to each other to be related lnformational CS should quotsignalquot approach of UCS Extinction loss of ability of CS to elicit CR due to disruption of pairing or information associated with CS Stimulus generalization capacity of stimuli similar to the original CS to bring about the CR Discrimination process by which organism learns to emit the CR ln presence of speci c CS but Not to other similar stimuli John B Watson Behaviorism Apply Pavlov s ndings to make psychology a true natural science Term rst used Psychology as the Behaviorist Views it Watson thinking as nothing more than subvocal speech Watson amp Rayner Little Albert experiment demonstration of how basic emotions quotrage fear lovequot could be conditioned l model for phobia Compare name to quotLittle Hansquot Freud s example of the oedipal complex Mary CoverJones behavioral treatment of quotLittle Peter squot fear through exposure Psychological care of infant and child 1928 Main ideas of Watson39s Behaviorism and Classical Conditioning quotGive me a dozen healthy infants wellformed and my own speci ed world to bring them up in and I ll guarantee to take any one at random and train him to become any type of specialist I might selectdoctor lawyer artist merchantchief and yes even beggarman and thief regardless of his talents penchants tendencies abilities vocations and the race of his ancestorsquot The individual as tabula rasa Focus on observable behavior not unconscious or otherwise inaccessible internal processes Environmental determinism like Freud but unlike Rogers no free will Learning by conditioning as primary process of psychological development unlike Freud s biology is destiny closer to Rogers conditional regard ls classical conditioning quotenoughquot to account for all major learning Limitations Finding unconditioned responses Sometimes response l stimulus rather than the other way around ex learning to swim Thorndike s puzzle box Skinner s pigeons pecking a key Some application issues Classroom arrangements to facilitate learning Changing response probabilities quotShapingquot via operant conditioning Stimulus provided to organism Action Positive Negative Add Positive Punishment reinforcement goal increase desired decrease undesired behavior behavior Remove Extinction Negative Response Coast reinforcement goal decrease undesired increase desired behavior behavior Key factors in Operant Conditioning Reinforcement history Affects likelihood a behavior will be emitted Does not cause a behavior Most learned behavior is shaped by successive approximations Punishment can change behavior effectively but can backfire if excessive 922 Speed amp strength of learned behavior is a function of schedule of reinforcement Passage of time Frequency of correct behaviors emitted Some mediators of the effects of modeling Perceived similarity of model and learner Perceived consequences for model Translation of model s behavior into patterns that can be imitated Contributions of Behavioral Approaches Useful precision specifying quotabnormal behaviorquot Behavior IS the problem What conditions maintain it environmental determinism Minimal speculation re unobservable processes Ex conditioned fear in quotLittle Albertquot Basis for very successful treatment for speci c disorders amp strategies for managing maladaptive behavior Ex Mary CoverJones exposure treatment of quotLittle Peterquot Some dif culties with behavioral approaches Insufficient explanation for origins of some learned abnormal behavior Ex limits to classical conditioning theory of phobias Do not alone describe or prescribe treatments for abnormal behavior patterns that cannot be speci ed in terms of overt behavior or reinforcement contingencies Ex behavioral treatment can reduce dating anxiety but not resolve issues of whom to date relationship changes Behavioral treatments may be ineffective if applied quotMechanisticallyquot Without attention to emotional interpersonal andor cultural dimensions of therapy EXAM 1 Implications of behavioral approaches for intervention Abnormal behavior l learning amp reinforcement Maladaptive behaviors Radical behaviorism unconscious processes amp architecture do not exist Maladaptive thinking Thoughts true or distorted can mediate behavior beliefsexpectationsvalues selfrelevant beliefs thought patterns can be conditioned quotToolsquot classical operant social learning change stimulienvironment andor responses relationship with therapist is environmental N 39 CognitiveBehavioral approach Behavior connected to Cognitions Emotions Implications for tx Mutual in uence multiple intervention points Possible to change one ex thoughts to change another ex behavior Emotion domain less amenable to direct intervention ex ineffectiveness of just telling someone to quotfeel betterquot Work with distress not just l overt behavior Against strict environmental determinism Bandura39s reciprocal determinism Anxiety Thoughts feelings actions all implications Thoughts Worry quotdriving on the interstate is very dangerousquot Feelings Scared nervous Actions drive timidly which may reinforce worry Feelings Sweat heart pounds feel dizzy see spots Actions Completely stop what you are doing l focus on own body s response 3 Thoughts Everyone is looking at me I m having a panic attack Individuals will vary individually where sequence begins how much of each element they experience how prior experience in uences contexts they seek Cognitive behavioral example FEAR CBT explanation Fear an emotion is driven by our appraisal or thoughts of the situation Ex the physical and emotional responses to the situation are in uenced by thoughts CognitiveBehavioral therapy Objectives Identify maladaptive patterns of responses Often shortterm rewards gt longterm problems Frequent responses l habits over time Describe and understand maladaptive patterns Response triggers frequency timing etc Conditions that maintain response over time Change maladaptive patterns Behavior adaptive or maladaptive can be learned and unlearned Limit severityscope of maladaptive behavior Replace maladaptive with adaptive response CognitiveBehavioral Therapy Strategies Change thoughts amp behaviors change feelings Thoughtchanging techniques Identify problem thinking patterns Cognitive restructuring treat thoughts as hypotheses evaluate thoughts for distortions or errors Cognitive therapy treatment process About 1620 sessions Problem focused Behaviorchanging techniques Use classical operant and modeling Changing thoughts cognitive distortions amp thinking errors Black and white thinking quotIF I score lt98 100 its as good as an F Overgeneralization quotMarie dumped me I must be unlovablequot Should statements quotTo be a good son I must go home every weekendquot Magni cation quotMichelle mentioned another guy is funny she must be getting bored with mequot Minimization quotI get good grades mainly because I m lucky Changing thoughts Homework Phase 1 Need to identify patterns in daily life Clients describetrack relevant signi cant events using ABC s of irrational thinking A Activating events B Beliefsthoughts C Consequence I Targets for intervention Example Joe s case A I heard a loud noise at night B Someone is in my house I m being robbed C become nervous and scared Example A Joe s girlfriend of 3 years broke up with him B She doesn t want me I must be worthless C Joe is depressed Changing thoughts Homework phase 2 Once cognitive distortionsthinking errors identi ed Practice ways to question amp challenge maladaptive assumptions generate more adaptive healthy responses A asked a question in class today and stuttered when I spoke Automatic thoughts People thought I was stupid I sounded awful I should never talk again in class Disputations amp challenges Does stuttering stupid Will people even remember next week what I said Rational alternative response lots of people stutter doesn t mean stupidity many people likely didn t notice or care and will forget by next class Changing Behavior quotshapingquot via operant conditioning Decrease undesired behavior increase desired behavior Changing behavior some major techniques NB Use of conditioning and reinforcement Exposure to feared objectcontext lmaginal In vivo Virtual Token economies ex stickers for little kids Pleasant activity scheduling Cognitive behavioral therapy Speci c phobia example What are the behavioral elements Why does the therapist ENCOURAGE a fullblown panic attack Why does the therapist PREVENT her from escaping the elevator What are the cognitive elements What are this client s fears What preparation does she undergo before exposure What other elements must be in place for clients to be willing to go through with this What disorders might CBT be most useful 0CD conditions with clear thought and behavior patterns Must be willing to overcome fear and go through treatment Psychogenic approaches presented so far Psychoanalytic Classical Freudian Structural theory Psychosexual developmental theory Humanistic Rogedan Healthy amp unique human development Behavioral Classicalconditioning Operant conditioning Modelingobservational learning Other psychogenic approaches NeoFeudian amp other psychodynamic approaches Meaning outside of con icts with idbased biological drives Focus ego functions coping amp social relations Allow for shorterterm interventions Remaining problems Scienti c testability Continuing limitations in treatment applicability Cognitive approaches Focus on irrational amp maladaptive thought patterns as causes of behavior problems Often combined with behavioral techniques CBT but useful alone to monitor and change thought via learning Criticisms o Behaviorists mentalist concepts 0 Humanists mechanistic amp confrontative elements 0 Applicability requires capacity to re ect upon amp manipulate internal processes Some key commonalities among psychogenic approaches Psychological determinism Early experiences affect later behavior patterns And employ varying degrees of quotlearningquot Emotions are important contributors to abnormal behavior and its remediation Abnormal behavior treated by Engaging conscious effort amp Identifying thought patterns To rehearse or experience new behavior patterns In a supportive relationship Some key differences among psychogenic approaches Heritability of abnormal behavior patterns in individuals Focus on symptoms vs meanings Salience of biology in development of abnormal behavior patterns Testability of propositions Signi cance of unconscious and covert mental contributions Types of complaintsabnormal behavior patterns to which theory best applies Sociogenic approaches a special subtype of psychogenic approach Family system approaches Family dynamics central since individual behavior is shaped by family experiences structure roles amp processes Criticisms 0 Possible overemphasis on parental blame for dysfunctions o EuroAmerican de nitions of normal family structures and functions 0 Difficult to perform family treatment well 929 Sociogenic approaches continued Diathesis Stress Approaches Underpinning biopsychosocial model Psychopathology l interaction between 0 Individual risks or vulnerabilities diathesis 0 Environmental conditions amp demands stress Necessary community and preventative focus Criticisms 0 Individual vulnerabilities still must be assessed 0 Prevention is complex amp difficult Sociocultural approaches Consider disorder in context of cultural norms ethnic experiences amp social risks 0 Clear ethnic amp cultural differences in rates of some forms of abnormal behavior group differences exist 0 Vulnerabilities from unique culture values amp beliefs 0 Differential exposure to common risks ex poverty 0 Some consider psychological disorder entirely a cultural creation Criticisms 0 Very broad amp general hard to test unique constructs o Universality of many disorders 0 Which approaches for what problem Approaches covered 0 Consider different sources of distress which approaches likely to be helpful which approaches likely to be unhelpful Problem Approaches Rational Coulrophobia Adjusting to new culture Substance abuse Rebellious child Disturbed sleepnervousness following a violent attack Shyness around new people Cognitive behavioral Identify thought patterns Auditory hallucinations amp paranoia Somatogenic Chemical imbalance identify medication Key commonalities among psychogenic approaches Psychological determinism Early experiences affect later behavior patterns Emotions are important contributors to abnormal behavior and its remediation Abnormal behavior treated by Engaging conscious efforts and Identifying thought patterns To rehears or experience new behavior patterns In a supportive relationship Heritability 0 Symptoms vs meanings Salience of biology Testability of propositions Signi cance of unconscious and covert mental contributions 0 Types of complaintsabnormal behavior patterns Philosophical underpinnings of scienti c approach to abnormal behavior Perspectivesparadigms necessary because of breadth fuzziness of de nition of what is abnormal Scienti c inquiry allows systematic evaluation amp choice among paradigms Philosophical bases of scienti c approach Empiricism valid knowledge stems from quotobjectivequot sense knowledge Determinism behavior and other observable phenomena are the result of antecedent causes 0 Limits amp bene ts of scienti c approach to abnormal behavior 0 Empiricism amp determinism are not the only routes to valid knowledge 0 Using empiricism amp determinism does promoteprovide Precision Reduced likelihood of error Greater likelihood of agreement 0 Steps in scienti c method 1 Formulate hypothesis Hypothesis concrete but tentative statement about relationship among variables Variable a condition event behavior that can have different values varies betweenamong people vs a constant can be measured Ex Depressed students will show low selfesteem 2 Devise and execute test of hypothesized relationship between operationalized variables a quotOperationalizequot variables how to concretely measure Ex depressed score on a valid depression inventory being in treatment etc Ex selfesteem score on selfconcept questionnaire b Design amp carry out study 0 Epidemiological surveys case studies correlational studies experiments 3 Analyze data apply a decision rule Statistics ex correlation coef cients usually determine whether a signi cant relationship probably exists between variables Results almost never prove hypotheses absence of signi cant results does not disprove hypotheses only exception is to exhaust universe of cases 4 Report results and revise hypothesis Major research methods epidemiological Surveys Examine frequency amp distribution of phenomena in a population Investigations of Prevalence total number of cases as a proportion of entire population Incidence number of new cases Risk factors a condition that increases the likelihood of becoming a new case Value and limitations Useful for seeing who develops disorder amp tracking spread of disorder Retrospective Depends on comprehensiveness of sampling Case studies lntensive study of one individual or a very small number in order to Describe a newunusual phenomenon Discon rm allegedly universal propositions Generate hypotheses Limitations Multiple sources of uniqueness in any single case l Limited generalizability to other cases Correlational studies Investigate naturallyoccurring events especially under conditions that would be unethical to manipulate ex FAS epigenetics Includes outcomes by nonrandom groups cf case study amp epidemiological research Naturalistic observation Quasiexperiments Advantage external validity generalizability Limitations Correlation does not imply causation quotThird variablequot relationships Correlation coef cients r Coef cients from 100 to 100 indicating strength of relationship between 2 variables Two elements Magnitude o Closer r is to or 100 the stronger the relationship 0 Closer r 000 the weaker the relationship Sign o A positive coef cient r as variable x increases in value variable y increases in value 0 A negative coef cient r as variable x increases in value variable y decreases in value Example positive correlation As one variable increases so does other Size of teaching tip amp Psy 350 Test score Size of tip in uences grade or other way around Can t say one causes the other Example negative correlation As one variable increases the other decreases Negative relationship between watching TV amp GPA Experiments Control or manipulate one or more variables to observe changes in other variables Independent variable IV the variable controlledmanipulatedvaried by the experimenter Dependent variable DV the variable affected by quotdepends onquot the IV Protection of internal validity ability to infer cause Experimental vs control groupcondition o Experimentals get special treatment regarding IV 0 Controls similar subjectssame conditions as experimentals EXCEPT no manipulation of IV Provides baseline or comparison Random assignment to conditions Experimental quotblindnessquot quotnai39vet quot Common decision Mean Experimental Mean Control Common decision 39 395 Mean Experimental Mean Control ls effect greater than expected by chance alone plt 05 5 chance or less that the difference of means is due to chance Normal distribution of scores around a mean scores for this group tend to quotpile upquot around the mean Different possible distributions variability around two means in which cases are the means really different High variability where curves are broader Different means where curves overlap less Psychotherapy Research Which version of psychotherapy is being evaluated Even with a manual must address differences among 0 Therapists ex training amp skill personality 0 Client populations ex symptom levels comorbidities demographics 0 Settings Ef cacy experimentally controlled conditions vs Effectiveness in the messy confounded quotreal worldquot Can t have effectiveness without efficacy What are the quotactive ingredientsquot of treatment quotWhole therapiesquot vs isolating components 0 Placebo effects ex hope 0 quotNonspecific factorsquot cf humanistic treatment Doseresponse how much treatment is enough Are some approaches just easier to research than others Internal validity does not guarantee external validity Read critically look for features that might compromise internal validity or external validity Recruitment of nonrandom participants Methods that unduly advantage some participants Climate or context in which research is conducted Failure to account for interactions among variables No study is perfect Research should require some ethical consideration amp boundaries Key points in research ethics for psychologists Ethical principles of psychologists professional conduct for psychologists Key elements in research ethics include Informed consent for participants deception Humane treatment of animals especially pain Ethnic amp gender representation equity issues Training amp competence of research assistants Protection of con dential materials Value of results gt gt risks Institutional review board IRBs also check Embarrassment discomfort not just pain Withholdingdelaying treatment for control Approval l more than scienti c soundness Major bene ts of diagnostic classi cation Science observe patterns El predict l control Diagnostic classi cation informed by systematic evidence facilitates study of abnormal behavior syndromes by Recognizing reliable common patterns Identifying relevant differences among phenomena Valid reliable classi cation l better assignment to appropriate treatments American psychiatric association39s Diagnostic amp Statistical Manual of Mental Disorders PreDSM lack of consistent statistics on disorders DSM voting to try to unify de nitions using medical model Psychoanalyticin uence Disorders classi ed together based on theoretical origins Distinctions between affective amp cognitive symptoms DSMII revisions to re ect Research treatment advances conceptual changes ICD updates DSMII multiaxial classi cation system Diagnoses based on prototypical symptom pictures rather than usual psychoanalytic causal theories Field testing of explicit criteria for many disorders More comprehensive description of individuals and symptoms Axis I clinical syndromes Axis II Mental retardation and personality disorders Axis III physical disorders ailments Axis IV psychosocial stressors Axis V global assessment of functioning DSM revised DSMIV expanded research base Criterion of quotclinically signi cant distressimpairmentquot Cultural demographic epidemiological information included to aid differential diagnosis DSMlV TR researchbased updates Text references to people with disorders DSM5 Attempt to address shortcomings of DSMIV High rates of comorbidity and quotnot otherwise specified diagnoses Diagnosis markers not clear enough for treatment or research Continuing features changes re ect new theory research eld testing New processes coordination with WHO online open comments New features recognition of symptom patterns that quotcut acrossquot diagnoses multiaxial system removed combining some disorders based on common biology DSM5 de nition of mental disorder Mental disorder re ects a dysfunction in the psychological biological or developmental processes underlying mental functioning Harmful dysfunction deviant DSM5 diagnoses Diagnostic criteria amp codes including principle diagnoses Assessment of crosscutting symptoms Cultural formulation acknowledgement that systems of behavior amp meaning important to diagnosis and treatment Making a DSM5 diagnosis Assess crosscutting symptoms Assess impairmentdisability General clinical interview Determine if criteria met for Principal diagnosis Evaluate and create cultural formulation Assign diagnosis must have PhD or MD Develop treatment plan Monitor progress Criticisms of current diagnostic system Deviance vs quotmental illnessquot vs psychological disorder More dx categories more labeling More quotmedicalizationquot Consequences of labeling when is it helpful vs when is it not Reliability of diagnosis Some categories more reliable than others Reliability versus validity Problems of comorbidity continue in some areas Validity amp reliability of overall DSM5 Boundaries between normal amp abnormal Especially in a prototypical approach design to categorize symptoms diagnostician must judge how close individual is to diagnosis pro le Need dimensional approaches Universality vs sociohistorical amp cultural relativism WHODAS is an assessment schedule Criticisms of current American Diagnostic system Still relies on proper training to diagnose Assessment Goal to gather information relevant to Make diagnostic andor treatment decisions Objectively evaluate progress especially from a baseHne Speci c assessment tools amp techniques used depend on Nature of symptoms andor clinical question Theoretical orientation of assessor what questions need to be asked about problem Assessment standards amp some issues Example a new suicide risk scale for clinician use Reliability how consistent is measure 0 TestRetest similar results T1 and T2 ex r gt 90 o lnterrater different interviewers l same outcomes Validity actually measures construct 0 Content items tap common indicators ex ideation o Concurrent correlates well with existing measures 0 Predictive correlates well with later suicidal behavior Some issues 0 When should testretest be low When you expect therapy to change behavior 0 Reliability does not guarantee validity generalizability Three Major assessment Methods Clinical Interview Goal gather information on presenting problems in client s own words Often rst contact begins with an interview Put client at ease and get at expectations Typical coverage by unstructured interview Identifying data Description of presenting problems BackgroundDetailed psychosocial history including 0 Family history 0 Educationalacademicwork history 0 Social support peers 0 Trauma amp abuse physical emotional sexual o Medicalpsychiatric history inc substance abuse Clinical interview Formats Unstructured Largely openended free owing coverage of issues Advantages conversational enhance rapport Limitations reliability ex client OR clinician bias Semistructured Conversational but guided to targeted areas ex DSM Advantages comprehensive yet exible to follow up Limitations skill to balance quotfreequot vs targeted questions Structured Carefullyphrased set items linked to speci c criteria Advantages reliable useful for special diagnosis or research Limitations may seem stilted quotnitpicky repetitive Three major assessment methods Behavioral assessment Direct observation Naturalistic or Analogcontrolled setting Clinician observes records behavior in speci c contexts to see symptoms sequencesdynamics Useful when selfreport limitedunreliable ex client too young or unskilled Selfmonitoring Client tracks own behavior Useful when behavior too private ex thoughts or infrequentimpractical for outside observer Behavioral rating scales Checklist frequency intensity range of behavior symptoms Compare results to normative samples Three major assessment methods Psychological tests Test Sample of representative behavior Only to be used by licensed professionals Intelligence tests Cognitive functioning in key areas 0 Intelligence inferred from adaptive behavior l indirect measurement via levels amp speed of processing material 0 More than just accumulated knowledge schooling o Norms amp high reliability l diagnosis of developmental disabilities amp brain damage amp planning interventionsaccommodations Ex Wechsler Scales for adults WAIS kids WISC 0 Speci c tasks tapping Verbal Comprehension perceptual reasoning working memory and processing speed 0 l Full scale IQ Selfreport tests Personality tests 0 Minnesota Multiphasic Personality Inventory2 MMPI2 o Validity scales and clinical scales 0 Designed using purely empirical methods whatever distinguishes clinical groups regardless of content Sample psychological test items similar to Wechsler Scales Which of the following is least like the others Bear cow snake tiger dog If you rearrange the letters quotBARBITquot you would have the name of an Ocean animal country state plant Where is Versailles France Indiana etc Which of the following numbers does not t 978 67563 Psychological Tests continued Projective tests Client freely interprets ambiguous stimuli I projects own unconscious contents 0 Vs objective tests ie limited response targets Examples 0 HouseTreePerson HTP gure drawing 0 Rorschach lnkblots o Thematic apperception test TAT Issues of low reliability and questionable validity Thematic apperception Test quotTell me a story about what you see here a story with a beginning a middle and an end Include any relevant feelings or emotionsquot General criticisms and concerns with assessment Reductionism complex person amp circumstances l diagnostic category Potential forjudgment amp labeling Arti ciality of standard testing settings Underestimates impact of examinerexaminee relationship quality Overly intellectual complex concepts gt true understanding of the individual Biases in validating selecting amp interpreting results Who decides what is a representative stimulus response Again reliability does not guarantee validity generalizability Why ethnic amp cultural issues Am Psychological association says so APA Ethical principles APA multicultural guidelines Cultural diversi cation of US Need for more culturally competent research amp services Need for noncookbook dynamic perspective raised by 0 Withingroup diversity 0 In uences of intergroup contact 0 Growth amp change over time due to experience amp knowledge Each individual is a composite of multiple culturallyde ned groups Must understand who people are before attempting treatment change Race Categorization based on human genotypic or phenotypic characteristics Problems with construct include No pure races or even consistent categories ex people with multiple heritages Hispanics Substantial withingroup variations in behavior Confounding race with social conditions Cf American Anthropological Association 1998 Why keep term around Resource access associated with group memberships Race therefore acquires social signi cance Some limited biological group differences Racism amp ethnicity Racism differential treatment based on explicit or implicit ideology of superiorityinferiority based on race Can be individual or institutional Distinct from prejudice evaluative judgment attitude amp stereotypes expectations l littleno evidence Ethnicity shared heritage amp identi cation based on upbringing amp culture group differences in behavior Ex US Census Hispanics as ethnic group of any race Similar care with other human diversity constructs Gender vs Sex vs Sexual orientation Nationality immigrant status Socioeconomic status vs income vs wealth Culture Those aspects of the lived experience of a group of people that include Group habits of thought emotion History and experience Technology amp skills Culture is shaped by the experiences values choice and shared meaning systems of an identi ed group Cultural context of all human behavior Central determinant of our world and how we approach it Culture initially shapes behavior via socialization and upbringing Ex what we consider normal expected and acceptable Ethniccultural issues in abnormal psychology research Multiple sources of bias in objective science amp scienti c method Problems in epidemiological research sampling staf ng Problems in classifying symptoms group differences due to experience different symptom patterns amp reporting Withingroup diversity
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