Clinical Psychology Flashcards
1
Q
What was Rosenham’s aim?
A
- to test the reliability of mental health diagnosis, to see if medical professionals could tell the sane from the insane in a clinical setting.
- also investigate the affects of labelling on medical diagnosis
2
Q
What was the IV and DV in Rosenhans study?
A
- was an observation not an experiment so no IV or DV
3
Q
What is the sample for Rosenhan?
A
- 8 psuedopatients
- 12 psychiatric hospitals in the US
- some had good staff to patient ratios others were quite understaffed
- only one was a private hospital
4
Q
Explain the procedure of Rosenhan?
A
- pseudo’s reported hearing voices to a clinician
- Rosenhan approached head of hospital and informed them of the deception. Staff did not know
- Rosenhan briefed lawyers to get pseudo patients out if anything went wrong
- when admitted they started acting normally and stopped reporting hearing voices.
- had notebook and pen to note down what they heard and saw
- secretly disposed of medication, otherwise polite and did every thing asked of them
5
Q
What were Rosenhan’s structured interviews?
A
- record was kept of how many patients voiced suspicions about pseudo’s in there hospitals and how much time the staff spent on ward interacting with patients
- in four hospitals patients approached staff with scripted questions, staff answer and body language was recorded.
6
Q
Rosenhan’s results?
A
- all 12 hospitals diagnosed the pseudo’s as mentally ill.
- 11 hospitals diagnosed schizophrenia, 1 (the private one) diagnosed manic- depression (bipolar)
- no staff recognised they were healthy
- between 7-52 days for pseudo patients to be discharged, mean was 19 days
- discharged with the diagnosis schizophrenia is remission in 7 cases, 1 was diagnosed with schizophrenia on their medical record.
7
Q
What did the psuedo’s observe in the hospitals?
A
- staff abusing patient, being physically and verbally abused. Awakened by shouting ‘ Come on you motherfuckers get out of bed’ and one was beaten for saying ‘I like you’ to an attendant.
- patients refusing medication
- depersonalisations and powerlessness. No doors on toilets and staff would inspect their medical record and personal belongings without asking for permission.
- staff would make eye contact with patients, would discuss them in earshot.
- would abuse them when other patients were watching but not when doctors were present.
8
Q
Conclusions of Rosenhan?
A
- cannot distinguish between sane and the insane
- private hospital diagnosed with manic depression the only different diagnosis. This is easier to treat. Wealthier people are more likely to be diagnosed with milder problems that have better therapeutic outcomes, background affects diagnosis.
- tendency toward false positives (type 1 errors) in normal diagnosis but false negative (type 2 errors) when stakes are high, ie the hospital knows its diagnosis is assessed.
- conditions in psychiatric hospitals can worsen patients
- conditions are psychologically mortifying and make healthy behaviour and healthy thoughts difficult
9
Q
What are the four D’s?
A
- dysfunction
- distress
- danger
- deviance
10
Q
What is dysfunction?
A
- when abnormal behaviour is significantly interfering with everyday tasks and living your life. Considered abnormal is they are unable to cope with demands of everyday life- looking after yourself- holding down a job, maintaining relationships with friends and family and making yourself understood etc.
11
Q
What is distress?
A
- abnormality involves being unhappy; experience negative feelings like anxiety, isolation, confusion and fear. Abnormality is when these feelings occur inappropriately or persist for longer than they should/
12
Q
What is danger?
A
- when behaviour harms or puts at risk the individual or others around them. Based on the harm principle which states that you have a right to behave in any way you like so long as you don’t cause harm. Abnormality puts yourself or others at excessive risk/
13
Q
What is deviance?
A
- these are behaviours and emotions that are views as unacceptable
14
Q
Why are the 4 D’s used?
A
- as an assessment tool to decide whether behaviour is abnormal. Abnormality may require investigation and diagnosis.
15
Q
Statistically what is considered normal?
A
-normal people are wishing 1SD of the mean.
16
Q
what is a social norm?
A
- an unwritten rule about acceptable behaviour. Behaviours and attitudes that people stick to in a society. Can differ from culture to culture and from time period to time period.
17
Q
What are diagnostic systems used for?
A
- to diagnose people with mental illnesses
18
Q
What is DSM-IVR?
A
- one of the main classification systems for mental health. Provides criteria from which a mental disorder can be diagnosed. Used around the world. 250 disorders included.
19
Q
How is the DSM-IVR organised?
A
- axial system
20
Q
What is meant by the term multi-axial?
A
- each diagnosis is split into five levels called axes that relate to different aspects of the disorder. Each level is part of the diagnosis.
21
Q
Name each axis 1 on the DSM-IVR?
A
- Axis 1: clinical disorders, major mental disorders, developmental disorders and learning disorders.
22
Q
Name each axis 2 on the DSM-IVR?
A
- underlying personality conditions, mental retardation
23
Q
Name each axis 3 on the DSM-IVR?
A
- physical conditions, general medical conditions
24
Q
Name each axis 4 on the DSM-IVR?
A
- psychosocial and environmental factors
25
Q
Name each axis 5 on the DSM-IVR?
A
- global functioning
26
Q
What is ICD-10?
A
- international classification or diseases
27
Q
How is ICD-10 organised?
A
- by codes, each disorder has a code starting with F, for example F20 is schizophrenia
- disorders are listed consecutively and there are 11 sections
- sub categories are further differentiated
- there are left over codes for new disorders to be added
28
Q
How are patients diagnosed using the ICD-10 system?
A
-0 clinicians select key words from the interview such as: hallucinations, delusions, incoherent speech, lack of emotion
- the clinical looks up these symptoms in alphabetic index or may go straight to the obvious sections
- clinician uses other symptoms to locate a subcategory
29
Q
Advantages of DSM and ICD?
A
- universal so allowed clinicians to communicate about their patients, report, record and monitor mental illness.
- eg schizo in England means the same as Schizo in France
- uniformity
30
Q
Disadvantage of DSM or ICD?
A
- Oversimplifies human behaviour
