Abnormal Approach Studies Flashcards
Cooper et al (1972)
Classification Systems, Validity & Reliability
Aim: to investigate reliability of depression and schizophrenia
Procedure: sample of American and British psychiatrists and patients
1. psychiatrists watched a number of videotaped interviews
2. then asked to diagnose the patients
Results: not very reliable diagnosis due to differences in DSM and ICD
British psychiatrists diagnosed patients to be clinically depressed 2x as often
American psychiatrists diagnosed patients to be schizophrenic 2x as often
Evaluation:
- - low reliability
Lipton & Simon (1985)
Classification System, Validity & Reliability
Aim: To test the reliability of diagnosis
Procedure: random sample of 131 abnormal patients
1. 7 clinical experts reevaluated the patients
2. diagnoses were compared w/ the original one.
Results: differences in re-evaluation
- of original 89 diagnosis of schizophrenia, only 16 received the same diagnosis
- 50 were diagnosed w/ a mood disorder, however only 15 had been diagnosed w/ this disorder initially
Evaluation:
- + high ecological validity (natural setting)
- + highly generalizable
- - patients already undergoing treatment
- - could have led to changes in symptoms
- - studying reliability of diagnosis in naturalistic setting is problematic
Luhrmann (2015)
Normality & Abnormality, Clinical biases
Aim: explore how local culture affects experience of hearing voices
Procedure: sample of 60 schizophrenics from USA, India and Ghana
1. interviewed about nature of voice, familiarity, speaking with god and causes of the voices
Results: overall differences between cultures
- harsh/violent voices more common in Western experiences
- nature: Ind +, USA - ; familiarity: I&G +, USA -
Evaluation:
- + structured interviews (comparison possible)
- + high credibility (recorded & transcribed)
- + method triangulation
- - social desirability bias (face-to-face interviews)
Li-Repac (1980)
Normality & Abnormality, Validity & Reliability, Clinical biases
Aim: test the role of stereotyping in diagnosis
Procedure: sample of 10 patients with mental illnesses (5 chinese, 5 white) and 10 clinicans (5 chinese-american, 5 white)
1. researcher videotaped semi-structured interviews with patients
2. clinicians were asked to describe normal functioning individual based on test to assure that they have similar understandings
3. each randomly assigned 4 videos (2 white/2 chinese) and asked to describe the patients
Results: overall differences in describing the patients:
- White raters tended to see signs of lower self-esteem, higher depression and inhibition in Chinese patients
- Chinese raters tended to see Whites as more aggressive and quiet patients as more pathologic
Evaluation:
- - small sample (hard to generalize)
- - no pre test of stereotyping
- - patients had different disorders
- + controlled for cultural differences
Brown & Harris (1978)
Clinical biases, Prevalance of Disorder, Sociocultural Etiologies
Aim: to see to what extent social and cultural factors may play a role in the onset of depression in women
Procedure: sample of 460 London women
1. survey on daily life and depressive episodes
2. measured three factors affecting development of depression
Protective factors
Vulnerability factors
Provoking agents
Results: social factors in the form of life stress can be linked to depression
working-class mothers were more likely to develop depression than middle-class mothers
low social status leads to increased exposure to vulnerability factors and provoking agents
Evaluation:
- + high credibility (semi-structured interviews)
- + high reliability (big sample)
- - sampling bias (only women) -> not generalizable
- - based on self-reporting (impossible to determine level of depression)
- - no cause and effect (survey)
- - biological factors not considered
Caspi et al (2003)
Serotonin Hypothesis
Aim: to determine whether functional change in 5-HTT gene is linked to higher/lower risk of depression
Procedure: sample of 850 NZlanders, age 26
1. divided into 3 groups based on alleles: G1had 2 short alleles, G2 had 1 long 1 short alleles and G3 had 2 long alleles
2. asked to fill questionnaire on stressful life events & assessed for depression
Results: gene’s interaction with stressful life events increased likelihood of depression
- 1+ short allele demonstrates more symptoms of depression in response to stress
Evaluation:
- + holistic approach (acknowledges interaction of biological & environmental aspect)
- - low reliability (replication apparently not possible)
- - correlational (no cause effect relationship)
- - assumption that serotonin causes depression
- - gene alone cannot cause depression
Rausch et al (1985)
Serotonin Hypothesis
Aim: explain the origins of depression to see if the levels serotonin have influence on depression
Procedure: sample 18 subjects in a double-blind study split into two groups
1. either administered physostigmine (a serotonin antagonist)
2. or a placebo
3. measured depression through self- and observer rated depression scores
Results: compared to placebo, physostigmine caused a significant depression in mood
Evaluation:
- + double blinded test
- - correlation =/= causation
- - not much data = not as reliable
Videbech & Ravnkilde
Cortisol Hypothesis
Aim: to compare brains of depressed and healthy patients
Procedure: meta-analysis of 12 studies
1. used brain scans to see hippocampal volume in 351 depressed patients compared to 279 healthy controls
Results: patients with more depressive episodes could have excess of cortisol (due to hyperactive HPA-Axis) which lead to the hippocampal cell death
- up to ten percent reduction of the hippocampus in the brain of depressed patients
- shrinking was correlated to the number of depressive episodes
Evaluation:
- - cross-sectional and correlational
- - no knowledge on size of the hippocampus before diagnosis
- - assumes small hippocampus is result of a lack of neurogenesis and reason for depression.
- - not longitudinal
- - bidirectional ambiguity
Nolen Hoeksema (2000)
Rumination, Prevalance of Disorders
Aim: to carry out a prospective study of the role of rumination on symptoms related to depression
Procedure: random sample of 1132 participants in San Francisco area
1. interviewed two times over a period of one year
2. clinical interview lasted for 90 minutes
3. included tests like Beck Depression Inventory, the Hamilton Rating Scale for depression, the SCID, and the Beck Anxiety Inventory
4. given a rumination and coping questionnaire ( for example asked to rate how often they think, “Why do I react this way”, “I think about how sad I am”)
Results:
- participants who showing MDD signs at 1st interview had higher score of rumination responses
- participants who had never been depressed had lower rumination scores
- depressed but improved had lower rumination scores than those who remained chronically depressed
Evaluation:
- + supported by biological evidence
- - relied on self-report questionnaires and diagnosis through clinical interviews
- - original participants with the strongest symptoms dropped out –> possible bias
- - no information on participants treatment or other protective factors
- - uncontrolled confounding variables
supports Beck’s theory that patterns of cognition have negative effect on mental health
Elkin et al (1989)
Biological & Psychological Treatments, Effectiveness of Treatment
Aim: to see if there was any significant difference in the effectiveness of the three approaches to therapy
Procedure: sample of 250 patients with only MDD randomly assigned to 1 of 4 treatments for 4 months
1. IPT, CBT, the drug imipramine or a placebo pill
2. all treatments lasted 16 weeks with careful monitoring and many assessments
Results: three treatments successful and superior to placebo
- Imipramine was faster but the psychotherapies caught up by week 16
- 18-month follow-up: only 20 - 30% remained symptom-free regardless which treatment
- Patients in IPT or CBT reported greater effects of treatment on capacity to understand their depression.
Evaluation:
- + data triangulation
- - differences in hospital (low realiability)
- - high attrition rate for drug treatment
- - sample becomes less representative of the general population of depressed patients
- - problems with comparing these different treatments
- - possible demand characteristics or observer bias
Riggs et al (2007)
Biological & Psychological Treatments, Effectiveness of Treatment
Aim: to investigate the effectiveness of CBT in combination with an SSRI or placebo
Procedure: double-blind study with sample of 126 depressed teens randomly assigned CBT with either SSRI (selective serotonin reuptake inhibitor, antidepressant drug) or placebo
- improvements/responses to treatment assessed by a self-report scale and clinician (blind to the participants’ conditions)
Results: CBT & drugs is effective for adolescent depression, but treatment with placebo and CBT is nearly as effective
- 76 % of patients in drugs and CBT group improved
- 67% of patients in CBT and placebo group improved
Evaluation:
- + Generalizable to USA teens.
- + reduced researcher bias (double blind design)
- + low drop out rates
- + high ethics (right to withdraw, free treatment)
- - sampling bias (only teens) -> not generalizable
- - low validity (self-reported data)
- - deception
