Goldstein and use of clinical interviews Flashcards
Goldstein (1988)
looked at differences in how males and females experience SZ using secondary data
- aimed to see if there were any gender differences with regard to re-hospitalization of people with SZ
- other factors affecting the course of SZ including subtypes of the illness, premorbid history etc.
what was the aim for testing the reliability of diagnosis using the DSM?
- to see if diagnosis using DSM-III was different from a previous diagnosis using DSM-II
procedure
- sample consisted of 199 women and men who were in the early stages of the disorder from a NY psychiatric hospital who were followed for 10 years
- patients chosen were those who between 1972-3 had a hospital diagnosis of SZ using DSM-II, had a stay of less than 6 months, aged between 18 and 45 and no drug/alcohol misuse
- the course and severity of the illness was measured by looking at secondary data, the number of times the patients had been in hospital and how long the hospital stats had been over a 10 year period
results
- schizophrenic women were found to have a significantly lower number of re-admissions and shorter stays in the hospital over the 10 years
- difference in gender was even stronger when looking at a 5 year period
conclusion
reinforced the findings of other studies and suggested that SZ males have poorer outcomes than females
strengths of Goldstein
- interviews were used to explore issues, and it is important as symptoms in a mental health disorder may not be easy to describe or record
- Angermeyer carried out a similar study in Germany and produced same findings
- longitudinal, and no patients dropped out
- the men and women were well-matched in terms of marital status, age, education, religion and socio-economic status
- tow experts who did not know the name of the study tested the reliability of the re-diagnosis and so the inter-reliability rate was 80%
weaknesses of Goldstein
- interviewers may have affected the data by the way they asked questions e.g., about the symptoms
- study used a relatively small sample size from a limited area, and a similar cultural background (non-Hispanic white)
- problems generalising the results as all the participants returned to their families after hospitalisation, the results may not be true for those who do not return to their families
- the sample age limit was 45, as 9% of women and very few men have their first SZ episode after this age, but this may have made the sample biased in favour of finding the gender differences
use of clinical interviews in psychology
mainly qulaititavie data, involve a face-to-fcae situation and a series of questions. interviews can be structured, unstructured and semi-structured. most clinical interviews are unstructured so the clinician can base questions on patients’ answers
strengths of the clinical interview
- questions can be explained and enlarged and so produce in depth and detailed qulaitaitve data, and when a researcher needs to explain an issue to a pp or investigate a topic further they are more useful than questionnaires, as some disorders can prevent communication
- interviews gain in-depth data that are likely to be valid, interviewees talk in their own words and are not as constrained by questions as they are with a questionnaire and therefore the data is more valid
- provide in-depth detailed knowledge of symptoms and can be used with the 4Ds to diagnose disorders
weaknesses of clinical interviews
- interviewer may unintentionally influence data e.g., tone/gender could lead to researcher bias
- analysis may be subjective and influenced by the researcher’s views e.g., when generating themes which involves selection and the appropriate grouping of data
- pps may give socially desirable answers
- open ended questions and qualitative data from unstructured interviews are difficult and time consuming to interpret
- cultural issues of over-diagnosis and under-diagnosis, suggested by Sue and Sue and Cassas
