Methods (Clinical Psychology)

Question 1

What is Primary Data?

Answer 1

Information on mental health that researchers gather themselves. This can take the form of experiments, interviews, questionnaires etc This might be concordance rates of twins when assessing the extent to which mental disorders are genetic. Interviews and questionnaires that ask patients about their symptoms comparisons can be drawn regarding differences/similarities between particular groups Primary data can be collected for a case study on a patient suffering from a particular mental disorder

Question 2

What is an Example of using Primary Data to research mental health?

Answer 2

Rosenhan (1973) field study into mental health a in institutions.

Question 3

What are the Strengths of Primary Data?

Answer 3

More valid conclusions surrounding the reason for a particular mental disorder can be gathered if the experimenter collects their own data relevant to their aim. The experimenter can ensure trustworthy d has been collected (in secondary data, some researchers have manipulated data by rounding statistics u or down), leading to valid conclusions. relevant to the aim of the study as variables will have been operationalised with the aims Primary data will in mind e g. to measure how effective therapy or medication is. However secondary data might ha been gathered for a different reason (e.g. government statistics on prescription rates in GP practices) s might not be focussed on the aim of the study

Question 4

What are the Weaknesses of Primary Data?

Answer 4

Primary data is more expensive because money will be required for paying for brain scans on mental health patients, genes to be analysed, neurochemicals to be tested etc Mental health patients may be unwilling to let researchers investigate about their mental illness or may not be in touch with reality to consent to be investigated. It will take a long time to analyse primary data this may be through statistical analyses or subjective interpretation of interview/questionnaire scripts when describing their mental illness.

Question 5

What is Secondary Data?

Answer 5

Information on mental health that is collected by someone other than the researcher for a different purpose. This can include previous studies research /medical records government statistics. Peer-assessed/reviewed articles or public statistics. Meta-analysis meta-analysis uses a statistical approach (inferential statistics) to combine the results from multiple studies related to mental disorders to gain more valid and generalizable conclusions. (see below) Government statistics on how many people have been diagnosed with a mental disorder or institutionalised.

Question 6

What is an Example of Secondary Data used to research mental health?

Answer 6

Gottesman and Shields (1966) Schizophrenia concordance in MZ and DZ twins from medical records showing there is a genetic cause

Question 7

What are the Strengths of Secondary Data?

Answer 7

It is cheaper to use secondary data as there are already statistics on mental disorder rates and concordance rates of mental illnesses. Researchers can simply do a meta analysis with the data, which requires less funding. “ Using a meta analysis means comparisons regarding the conclusions on mental health research can be made, making conclusions more valid. “

Question 8

What are the Weaknesses of Secondary Data?

Answer 8

Data may have been gathered for another aim (looking at a range of mental disorders), so may not fit the needs of the secondary investigation (if you are just looking at one disorder) “ The data could be outdated-with DSM changing, the population might be diagnosed differently today, meaning comparisons with studies regarding concordance rates may be outdated. “ Researchers aim to get a significant result-researchers often round statistics up or down to make results significant. Therefore if a researcher investigating mental illness uses secondary data, their conclusions regarding mental illness may be invalid Lack of knowledge on the reliability or validity of original research means this can reduce the validity of the findings on mental disorders. Potential of cherry-picking which is when researchers only publish studies that show positive results leading to a bias in the literature, for example only publishing studies that show antidepressants to be effective Findings are produced after the research has taken place, decreasin validity.

Question 9

What are Cross Cultural Studies?

Answer 9

Samples are taken from different cultural groups to draw comparisons about the similarities and differences between them in terms of how they experience mental disorders. It looks at whether the experience of patients suffering from schizophrenia or other mental illnesses is the same in different cultural groups.

Question 10

What are some Examples of using Cross Cultural Studies to research mental health?

Answer 10

Tsuang et al. (2013) explored the relationship between schizotypy and handedness and looked at how this relationship stands up between different cultures by comparing western cultures to eastern cultures. Mandy et al. (2014) chose to test the DSM-5 diagnosis of autism spectrum disorder to see ifthe diagnosis in the USA and UK would generalise to other cultures.

Question 11

What are the Strengths of using Cross Cultural Studies?

Answer 11

Allows clinicians to understand how culture plays a role in the validity and reliability of diagnoses: Can identify elements of abnormal behaviour that can be attributed to purely biological factors by identifying trends in mental disorders that are unaffected by cultural variation. Aids in the understanding of cultural factors that should be taken into account when diagnosing and treating patients. This can reduce ethnocentrism (bias towards one culture, which in mental health, is usually the Western European or American culture)

Question 12

What are the Weaknesses of using Cross Cultural Studies?

Answer 12

Conducting research across cultures is likely to create conflict between the cultural values of some of the participants and those of the researcher

Question 13

What is a Meta Analysis?

Answer 13

Involves looking at secondary data from multiple studies and drawing the findings together to make overall conclusions. Conducted when there is a large amount of psychological research where firm conclusion on mental disorders or treatments cannot be drawn without comparing the research or where findings may be inconsistent. A large amount of information gathered from a large overall sample can be easily considered. Meta-analysis of research looking at the effectiveness of CBT will focus its analysis on the size of the effect of CBT found by ALL of the research gathered.

Question 14

What is an Example of using a Meta Analysis to research mental health?

Answer 14

Stafford et al. (2015) used it to look at treatments of psychosis and schizophrenia in children, adolescents and young adults by using studies that compared any drug, psychological or combined treatment for psychosis or schizophrenia that looked at children, adolescents or young adults. In total, 27 trials were used which had 3,067 participants.

Question 15

What are the Strengths of using a Meta Analysis?

Answer 15

Conclusions regarding treatment and mental disorders can be drawn from a vast array of different areas and a huge overall sample Time and cost-effective due to the fact that data already exists and must only be combined and analysed using statistical analyses No ethical concerns as the researchers do not have direct contact with the patients /participants.

Question 16

What are the Weaknesses of using Meta Analysis?

Answer 16

Much like secondary data, the research has not had direct involvement so issues in reliability andlor validity are unknown and may cause inaccurate conclusions on mental health to be drawn. Publication bias cherry picking may impact validity researchers only publish studies that show positive results leading to a bias in the literature, for example only publishing studies that show antidepressants to be effective. A way of finding out trends about a mental health issue and any relationships that might exist. Research method, procedure, sampling and decision-making are likely to differ between studies. This makes analysis difficult and perhaps in accurate.

Question 17

What are Longitudinal Studies?

Answer 17

Takes place over a long period of time for example a group of people with a mental disorder might be tracked over many years. Often compares a single sample group of people with a mental illness with their own performance over time, allowing for time- based changes to be seen. Clinicians may be interested in monitoring changes in symptoms in a patient group undergoing treatment Allows the psychologist to see how effective the treatment is over time. Includes questionnaires and observations to patients taken at intervals over many years.

Question 18

What is an Example of using Longitudinal Studies to research mental health?

Answer 18

Hankn et al. (1998) carried out a ten-year longitudinal study looking at gender differences in how depression emerges in young people from pre-adolescence to young adulthood, using structured interviews which they administered five times over ten years.

Question 19

What are the Strengths of using Longitudinal Studies?

Answer 19

Allows clinician to see if treatments have the ability to significantly improve a patient’s quality of life in the long term. Only way to reliably measure the effect of time on the behaviour or mental illness. A good way of finding out how development of mental illnesses can occur.

Question 20

What are the Weaknesses of Longitudinal Studies?

Answer 20

Expensive and time consuming due to needing to gather data repeatedly, track patients over many years and keep in communication in between interviews etc Even as have very different symptoms and experiences even if suffering from the same illness, there is no difficulty i making comparisons between different people that could be affected by individual differences. Patients may drop out, die, lose contact, making the final outcome less valid. Ethical considerations: following people for a long period of time may be intrusive especially those suffering from mental disorders

Question 21

What are Cross Sectional Studies?

Answer 21

This is a quick snap-shot of a group of people suffering from a mental disorder where a sample is taken and tested and conclusions are drawn for the target population. Patients might be tested using methods such as interviews, questionnaires, tests of cognitive functioning, brain scans, blood tests and other methods For example, researchers might be interested to know about the experience of people with schizophrenia at different ages, and so take a large sample of participants suffering from schizophrenia of various ages (rather than conducting a longitudinal study over many years)

Question 22

What is an Example of using Cross Sectional Studies to research mental health?

Answer 22

Wijesundera et al. (2014) looked at tobacco use and antipsychotic medication in out-patients with schizophrenia in one hospital in Sri Lanka, using systematic sampling (every third patient diagnosed with schizophrenia was chosen).

Question 23

What are the Advantages of Cross Sectional Studies?

Answer 23

Data can be collect much more quickly and therefore acted upon allowing for more immediate benefits for those suffering from mental disorders Results on symptoms and the efficacy of treatments are more valid as they are reported at the time rather than years later

Question 24

What are the Disadvantages of Cross Sectional Studies?

Answer 24

Individual differences are likely to have an effect on the results due to the fact that comparisons are made between different people Cohort effects can be an issue whereby the results of results might be due to being raised in a certain time and place, for example those affected by war, famine, recession or other socio-economic factors. When researching mental health, not all groups would have been exposed to the same cultures and such which means they cannot be comparable because they were exposed to different environments. For example when studying anorexia, groups are not comparable as they have been influenced by different cultures and social environments

Question 25

What are Case Studies?

Answer 25

Case studies investigate detail about a mental health rather than cause and effect relationships Individuals / small groups are studied, they will have a particular mental disorder, or a unique trait or experience connected to the disorder. Researchers use a range of methods in case studies, for example interviews, questionnaires, observations. These might be given to those suffering from a mental disorder and their families. Researchers triangulate data from different methods they draw them together and form overall conclusions about mental health. Researchers use mainly qualitative data on mental health in case studies, but there can be some quantitative data too.

Question 26

What is an Example of using Case Studies to research mental health?

Answer 26

One case study by Lavarenne et al. (2013) referred to a session known as the Thursday group a group of patients, most of whom suffer from schizophrenia or schizoaffective disorder, who meet every week. The purpose of the group is to support the patients by giving them some structure to help them cope with their illness, and encourage a sense of connection with others for a group who are generally quite isolated in everyday life. There are ten members of the group who are referred from various local out-patient and in-patient services in the local area. The group is currently made up of members who have been attending for between 3 weeks and 22 years. The sessions themselves are never recorded but, immediately afterwards, the group leaders note down key points about the patients’ behaviour, expressions and comments. The case study reports on one specific session with six patients present, which was just before Christmas, where the group members were facing a break of more than seven days before their next meeting because of the holidays. The key theme the leaders noted in this session was that of ‘fragile ego boundaries a breakdown in the line that people draw between the real and the unreal, or their own thoughts and those of other people. They suggested that the group may be reacting to the potential change in routine by having a break from the group for more than the usual one week.

Question 27

What are the Strengths of Case Studies?

Answer 27

Valid as in depth and detailed information about the individuals and groups i gathered so a detailed understanding of mental health is obtained. Case studies can be used to find out information about rate situations and individuals for example those with rare kinds of brain damage leading to mental health issues. These individuals often cannot be researched using experimental methods due to the fact that a large sample is not obtainable Triangulation of data can be used to test for reliability through consistency between different methods, and this therefore helps establish whether findings about mental health are valid/accurate and credible trustworthy.

Question 28

What are the Weaknesses of Case Studies?

Answer 28

Samples are not representative as they are small or atypical, therefore findings about mental health may not generalise to society Researchers involved in case studies often get to know the individual (s) very well which might causes bias in the recorded data, and subjectivity in the interpretations and conclusions about mental health

Question 29

What are Interviews?

Answer 29

Interviews involved verbal questioning of patients to gather information about mental health. They can be structured with specific questions about the mental disorder, unstructured with no questions but a general theme that is explored with spontaneous questions, or semi structured which has a range of possible themes and questions that can be followed and adapted. All interviews will have some standardisation in terms of the instructions, the aims of the interview and ethical issues. The interviewer will also find out about personal data needed for the study such as gender, age, employment, marital status. The responses can be recorded as an audio recording, video, or in written note form.

Question 30

What is an Example of using Interviews to research mental health?

Answer 30

Research reported by Vallentine et al. (2010) used semi structured interviews to gather nformation from a patient group on their experiences as part of a psycho-educational group treatment programme. The patients were 42 males detained in Broadmoor high-security hospital, most of whom had received a diagnosis of schizophrenia or a similar disorder. They were part of a programme aimed at helping them understand and cope with their illness, and several measures were taken to assess the impact of this on their symptoms. The aim of the interviews was to understand their experience better, but also get information about how the group could be improved in the future Following the interviews, a content analysis was conducted on the data gathered to pick out key hemes in the responses. Four core themes were identified in the data: “what participants valued and why, wiat was heipful about the group, clinical implications’ and ‘what was difficult/unhelpful ome of the key findings were that patients valued knowing and understanding their illness, and he group sessions allowed them not only to understand their own symptoms, but also how other eople’s experiences were similar Many aiso reported increased confidence in dealing with their iness, which made thern more positive about the future

Question 31

What are the Strengths of Interviews?

Answer 31

Interviews allow patients to fully explain their point of view which helps researchers to understand the experiences of those suffering from mental disorders more clearly. Unstructured interviews are useful for obtaining rich detailed qualitative data that therefore is considered to provide valid information about mental health. Structured interviews are considered reliable due to the fact that they are highly standardised and therefore questions about mental health are exactly the same for all patients

Question 32

What are the Weaknesses of Interviews?

Answer 32

Interviewer bias might occur where the researchers affect the findings on mental disorders due to the way they ask questions or other aspects of their appearance tone and personal beliefs. This reduces the validity of findings regarding mental health Subjectivity can affect the analysis of answers to any open questions about mental disorders from interviews, as the researchers’ personal judgements and experiences might shape the way they identify categories and themes within the qualitative data

Question 33

What is Grounded Theory?

Answer 33

This is a method of developing theory from research evidence (inductive method), rather than testing existing theory using research evidence (deductive method) developed in Glaser and Strauss in the 1960s This method is very useful in Clinical psychology to research the beliefs, opinions and experience of service users of the NHS or mental health professionals, since the themes in people’s experience are only known once data is analysed Grounded theory involves thematic analysis, in which first, “codes” and “categories” are identified in qualitative data. These codes are general at first, and become more specific as patterns emerge. Concepts are then grouped according to their similarities and differences, and the researcher takes notes on this process, allowing their thought processes to be followed (this is called “memo-ing”) Once clear concepts become obvious, the researchers start to selectively code only the relevant data, and they will move to sampling that gathers more evidence to support what they have started to see (e.g. by to particular of people) After the researcher has conducted the thematic analysis, they will attempt to create a theory or model that can explain the data. This might also involve looking at other literature and research. This is the part that makes the process “grounded theo (rather than just thematicanalysis)

Question 34

What are the Advantages of using Grounded Theory?

Answer 34

Grounded theory means that evidence is integrated into the theory, therefore the theory should be an accurate explanation of the experiences of patients with mental health issues.

Question 35

What are the Disadvantages of using Grounded Theory?

Answer 35

Grounded theory has issues with subjectivity and bias, since the researchers might selectively sample and use data that supports a theory about mental he lth that is emerging and unintentionally miss any vital evidence that challenges their emerging theory Since the researchers opinions are used to identify the themes in the qualitative data, this process is also highly subjective and open to interpretation. There might be issues with reliability since it is possible that another person conducting the same research might come to different conclusions about mental health. Grounded theory does not promote falsification as a means of testing the accuracy of theories regarding mental health (and falsification is considered to be an important feature of science). This is because the theory evolves from the data so by definition the research supports the theory.