Psychopathology (PSYC 4240) Day 4
Psychopathology (PSYC 4240) Day 4 PSYC 4240
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This 6 page Class Notes was uploaded by Selin Odman on Thursday May 19, 2016. The Class Notes belongs to PSYC 4240 at University of Georgia taught by Miller in Summer 2016. Since its upload, it has received 17 views. For similar materials see Psychopathology in Psychology (PSYC) at University of Georgia.
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Date Created: 05/19/16
PSYC 4240 - Psychopathology 5/19/16 Domains of Assessment: Psychological Testing and Projective Testing Psychological Testing -Must be reliable and valid -Intelligence; neuropsychology; psychopathology Used to assess specific forms of psychopathology or uses broad tests to diagnose long-standing personality traits/disorders Projective Tests -This type of testing was developed by modern-day psychologists (not done by Freud) -Projects aspects of personality onto ambiguous stimuli with roots in psychoanalytic tradition -High degree of inference in scoring and interpretation (low inter-rater reliability, so not reliable in general) -Rorschach Inkblot Test, Thematic Apperception Test Objective Tests -Test stimuli are minimally ambiguous -Roots in empirical tradition -Require minimal inference in scoring and interpretation Objective Personality Tests -Minnesota Multiphasic Personality Inventory (MMPI, MMPI-2, MMPI-A); Over 549 true or false items Extensive reliability, validity, and normative database Items picked not for face validity but because of predictive utility Validity scales: Lie scale (measures if you’re trying to make yourself look good), Infrequency scale (measures if you’re trying to make yourself look bad), Defensiveness (a little like Lie scale), Cannot-say (skipped too many items) Objective Intelligence Tests -IQ tests (intelligence quotient) was originally designed to predict school performance 1916 Stanford-Binet is prominent American version Old way: mental age/chronological age x 100 (doesn’t really work because types of intelligence change when you get older; children develop faster at a certain age) Current way: deviation score – how much does an individual’s score deviate from the average performance of other similarly aged individuals (SD=15; IQ – 130; 2 SDs above the mean) Wechsler Adult Intelligence Scale (WAIS-III) Includes verbal and performance domains (verbal: vocab, arithmetic, comprehension; performance: picture completion, block design, picture arrangement) Psychological Testing and Neuropsychology Neuropsychological Tests -Assess broad range of skills and abilities (i.e. receptive and expressive language, memory, attention, concentration, learning, abstraction) -Goal is to understand brain-behavior relations -Used to evaluate a person’s assets and deficits -Overlap with intelligence tests, but are linked to organic brain damage (stroke, concussions, etc.) Problems with Neuropsychological (and all) Tests -False Positives: diagnosing a problem that isn’t there -False Negatives: saying there isn’t a problem when there is Neuroimaging and Brain Structure 2 types of examinations of the brain -Structure: signs of damage, size of parts, presence of tumors -Function: look at blood flow during certain tasks Imaging Brain Structure: -CAT or CT scan; detailed x-rays of brains -MRI; better resolution than CAT scan and less radiation, but takes longer and is more expensive Imaging Brain Function -PET scan, SPECT -Inject radioactive isotopes which react with oxygen, blood and glucose in the brain to show which parts of the brain “light up” when performing certain tasks -fMRI (preferred method) can show changes in brain activity Advantages and Limitations -Provides detailed info, but they are expensive and lack a “norm” baseline, so they have limited clinical utility in psychology Psychophysiological Assessments Methods used to assess brain structure, function and activity of the nervous system Psychophysiological Assessment Domains -EEG: brain wave activity -Heart rate and respiration: cardiorespiratory activity -Electrodermal response and levels: sweat gland activity -Electromyography (EMG): muscle tension -Penile/Vaginal plethysmograph: sexual arousal Uses of Routine Psychophysiological Assessment -Disorders involving a strong emotional component like PTSD, sexual dysfunctions, sleep disorders, headache and hypertension -Can provide insight into underlying causes of disorder Diagnosing Psychological Disorders: Foundations in Classification Clinical Assessment vs. Psychiatric Diagnosis Assessment: idiographic approach – what is unique to that person (personality, family background, culture, etc) Diagnosis: nomothetic approach – applying what we know about patient to what we know about people more broadly and seeing if specific problems fit with a general class of problems Both important for treatment planning and intervention Diagnostic Classification -Classification is needed for all science -Develop categories based on shared attributes Terminology of Classification Systems -Taxonomy: classification in scientific context -Nosology: taxonomy in psych/medical contexts -Nomenclatures: nosological labels (i.e. panic disorder) Two Widely Used Classification Systems International Classification of Diseases and Health Related Problems (ICD-10); published by WHO Diagnostic and Statistical Manual of Mental Disorders (DSM); published by the American Psychiatric Association; currently the DSM-5 (2013) The Nature and Forms of Classification Systems Classical (or pure) categorical approach -Yes/No decisions. Each disorder viewed as fundamentally different from others with a clear underlying cause. Individual is required to meet all requirements for classification -Considered more useful in medicine; if you know diagnosis, you know the treatment -Viewed as inappropriate to the actual complexity of psychological disorders Dimensional Approach – classification along dimensions -Symptoms or disorders existing on a continuum (i.e. 0 to 100) -Patient might be mildly depressed and moderately anxious while leads to a patient’s profile to represent their functioning -There’s no agreement on number of dimensions needed or which dimensions needed to represent psychopathology Prototypical approach – Both classical and dimensional -categorical (yes/no) but individual does not have to fit every symptom. Rather, patient must meet some minimal number of prototypical criteria (i.e. 5 out of 9 symptoms) Creates within-category heterogeneity Presumes homogeneity with the “yes” and “no” groups; so you’re treating them all the same. Patients with 0/9 vs. 4/9 should be treated differently Purposes and Evolution of the DSM Purposes of the DSM System -Aids communication -Evaluate prognosis and need for treatment -Treatment planning DSM-I (1952) and DSM-II (1968) Both relied on unproven theories and were unreliable -Based on psychoanalytical ideas DSM-III (1980) through IV (1994) Atheoretical, emphasizing clinical description not underlying etiology Detailed criterion sets for disorders Emphasis on reliability (inter-rater; test-retest) Questions about validity -Many decisions were not empirical; why depressed symptoms for 2 weeks? Why 4 panic attacks in 4 weeks? Why 5 out of 9 symptoms? DSM-5 (2013) Emphasis on understanding that many symptoms aren’t specific to a single disorder, but cut across many disorder (co-morbidity) like anxiety, depression and suicidal ideation Introduction of new dimensional measures that exist across disorders CHAPTER 4 Science and Abnormal Behavior Questions Driving a Science of Psychopathology -What problems cause distress or impair functioning? -Why do people behave in unusual ways? -How can we help people behave in more adaptive ways? Basic Components of Research Starts with Hypothesis or an Exploratory/Educated Guess -Not all hypotheses are testable -Scientific hypotheses must be testable (Freud’s theories were not testable) Can be rejected (you can’t really accept hypotheses…) Research Design -Method to test hypotheses -Independent variable/Dependent variable i.e. Exercise reduces depression Considerations in Research Design Balancing Internal vs. External Validity -Internal: Did you study rule out confounds? Did the independent variable really produce those outcomes? Confidence in our IV -External: Are the findings generalizable to other settings, locations, types of samples, other problems? Increase internal validity by minimizing confounds -Factors that might make the results uninterpretable -By: controlling for levels of depression, levels of exercise, random sample, making sure they’re exercising -Use a control group (individuals NOT exposed to IV but are similar to experimental groups in other ways) Group A: exercises 4 days a week Group B: exercises 0 days/exercises normally -Random assignment procedures to avoid systematic bias -Used of analog models: study related phenomenon in controlled conditions of laboratory settings (i.e. alcohol) Relation Between Internal and External Validity Can be opposite to each other Increasing IV can lower EV -i.e getting people drunk in a lab vs. watching drunk people downtown *In an experimental environment, internal validity is more valued at first since we’re trying to explain relationship between IV and DV Example: Exercise reduces depression Increase IV: Only include people with depression, but no other comorbid disorders like anxiety Hurts EV: It’s uncommon to see depression without anxiety Researchers work to balance these variables by designing multiple studies -Start with strict IV and then slowly move towards EV and see if your findings are generalized TEST 1 – 45 Multiple Choice questions, 5 fill in the blank 1 hour 15 min
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