Module 2 - Research Methods, Assessment, and Intersectional Approaches to Understanding Mental Disorder

Question 1

Beginning in the early twentieth century, what have been the 2 main streams of thought concerning mental disorders?

Answer 1

1) Biological aspects of disorders
2) Environmental influences

Question 2

Some behavioural theories attribute no effects at all to biology, assuming that humans are born tabula rasa. What does this term mean?

Answer 2

A blank slate upon which experience writes all that is meaningful in thought and behaviour.

Question 3

What is a single-factor explanation?

Answer 3

To state that a genetic defect or a single traumatic experience causes a mental disorder.

(Most single-factor models reflect the primary focus of the researcher, theorist, or clinician rather than the belief that there really is a single cause.)

Question 4

What are Interactionist explanations?

Answer 4

They view behaviour as the product of the interaction of a variety of factors and generally make more satisfactory theories in describing mental disorders.

Question 5

Scientific theories are judged to be valuable because they embody what three essential features?

Answer 5

1) They integrate most of what is currently known about the phenomena in the simplest way possible (parsimony)

2) They make testable predictions about aspects of the phenomena that were not previously thought of; and

3) They make it possible to specify what evidence would deny the theory.

Question 6

What is the null hypothesis?

Answer 6

Proposes that the prediction made from the theory is false.

Question 7

Experiments are not set up to prove the worth of a theory but rather to reject (or fail to reject) what is called ____________.

Answer 7

The null hypothesis.

Question 8

True or False?

Theories gain strength not just because the evidence supports their predictions, but primarily because alternative explanations are rejected.

Answer 8

True.

Despite popular belief to the contrary, scientists do not set out to prove their theories to be true and, in fact, no amount of evidence can ever prove the truth of a theory.

Question 9

True or False?

Theories are facts.

Answer 9

False.

Theories are not facts. They are simply the best approximation we have at any moment.

Question 10

The general aims of theories about mental disorders are to:

Answer 10

1) explain the etiology (that is, the causes or origins) of the problem behaviour

2) identify the factors that maintain the behaviour

3) predict the course of the disorder

4) design effective treatments

Question 11

True or false?

Factors involved in the etiology of a problem may not be relevant to its maintenance.

Answer 11

True.

Question 12

True or False?

The factors that determine the course of a disorder may have more to do with the lifestyle of the sufferer than with the factors that caused the disorder in the first place.

Answer 12

True.

Question 13

True or False?

Even in disorders where there is a clear biological cause, environmental manipulations may alleviate or even prevent the development of the most serious symptoms.

Answer 13

True.

(Example given in textbook about PKU in infants.)

Question 14

What are the 6 most popular theories regarding the etiology of mental disorders?

Answer 14

1) Biological

2) Psychodynamic (derived from the theories of Freud or his followers)

3) Behavioural or Cognitive-behavioural theories

4) Cognitive theories examining dysfunctional thoughts or beliefs

5) Humanistic or existential theories that examine interpersonal processes

6) socio-cultural influences

Question 15

Define Resilience

Answer 15

The process of positive adaptation to significant adversity through the interaction of risk and protective factors.

Question 16

Describe the difference between risk factors and protective factors.

Answer 16

Risk factors are the conditions or events that increase the likelihood of negative mental health outcomes,

Protective factors are assets or resources that help to offset, or buffer, risk factors.

Question 17

What is an internal locus of control?

Answer 17

The degree to which people believe they have control over events that influence their lives.

Question 18

What is the term for the summation of a person’s risk for a disorder or disease?

Answer 18

Cumulative risk.

(The more risk factors that are present, the more vulnerable a person is to a wide range of mental health problems.)

Question 19

What is the most influential explanation for the mechanisms of multiple risk factors?

Answer 19

The stress-response model.

(Which postulates that multiple risk factors lead to frequent activations of the body’s various stress-response systems, which contribute to physiological weathering over time.)

Question 20

What are the four central mechanisms that can help people cope with adversity and develop positive mental health?

Answer 20

1) Reducing risk impact

2) Interrupting unhealthy chain reactions stemming from stressful life events

3) Enhancing self-esteem and self-efficacy

4) Creating opportunities for personal growth.

Question 21

What is Internalized racism?

Answer 21

The psychological internalization of negative beliefs and stigma about a person’s own racial or ethnic group.

Question 22

What is Interpersonal racism?

Answer 22

Relational interactions that convey hostility, disgust, or other forms of denigration of others according to their racial identity, and includes both overt and covert forms.

Question 23

What are microaggressions?

Answer 23

Covert forms of interpersonal racism.

These unconscious, unintentional, subtle, and frequent acts (e.g., condescending statements, crossing the road when seeing a person of colour) have been shown to have significant negative effects on mental health.

Question 24

What is structural racism?

Answer 24

Collective beliefs, behaviours, practices, and policies of societies and institutions that function to disadvantage radicalized people and produce racial inequities between groups. (Related concepts include systemic and institutional racism).

Question 25

What is a psychological assessment?

Answer 25

A systematic gathering and evaluation of information pertaining to an individual with suspected abnormal behaviour.

Question 26

True or False?

A psychological assessment is a single score.

Answer 26

False.

It’s a series of scores placed within the context of the history, referral information, behavioural observations, and life of an individual to provide a comprehensive understanding of that individual.

Question 27

A ________ is only a sample of behaviour, a tool to be used in the process of assessment.

Answer 27

Test.

(A good medical analogy is a blood sample. The medical assessment takes the blood work information from the lab and integrates it with other information (e.g., symptoms, age, history) to arrive at a comprehensive understanding of the client’s presenting complaints and problems.)

Question 28

A good assessment tool depends on what two things?

Answer 28

1) an accurate ability to measure some aspect of the person being assessed.

2) Knowledge of how people in general fare on such a measure, for the purposes of comparison.

Question 29

What is test-retest reliability?

Answer 29

The degree to which a test yields the same results when it is given more than once to the same person.

Question 30

An obvious problem with test-retest reliability is that a person may improve on a test the second time around because of practice with the procedures or familiarity with the questions. To circumvent this problem, behavioural scientists often attempt to ascertain a test’s ________ reliability.

Answer 30

Alternate-form reliability.

(Where test designers create two forms of the same test that would test that construct, and then word those questions in a slightly different way to create a comparable second version of the test that correlates highly with the first test.)

Question 31

Define internal consistency.

Answer 31

The degree of reliability within a test. That is, to what extent do different parts of the same test yield the same results?

Question 32

What is split-half reliability?

Answer 32

It’s one measure of internal consistency, which is often evaluated by comparing responses on odd-numbered test items with responses on even-numbered test items. If the scores for these responses are highly correlated, then the test has high split-half reliability.

Question 33

What is coefficient alpha?

Answer 33

It is another method for evaluating internal consistency, calculated by averaging the intercorrelations of all items on a given test. The higher the coefficient alpha, the higher the internal consistency of the test.

Question 34

What is face validity?

Answer 34

That the user of a test believes that the items on that test resemble the characteristics associated with the concept being tested.

(Ie: Suppose that a test for assertiveness asks questions like “How do you react when you are overcharged in a store? When someone cuts in front of you in a line?” Because such behaviours seemingly relate to the general concept of assertiveness, the test would have face validity.)

Question 35

What is content validity?

Answer 35

Requires that a test’s content include a representative sample of all behaviours thought to be related to the construct that the test is designed to measure.

(For example, the construct of depression includes features such as lack of energy, sadness, and negative self-perception. A test that focused only on sadness without considering other features would not have good content validity.)

Question 36

What is criterion validity?

Answer 36

It is the test instrument that is being evaluated.

(Ie: Suppose you wanted to know whether a calculator was working properly; you could input a problem to which you already know the answer: say, “6 × 5.” If the calculator gives an answer of 368, you know it is not a valid instrument.)

Question 37

What is construct validity?

Answer 37

The importance of a test within a specific theoretical framework and can only be understood in the context of that framework.

(This type of validity is especially useful when the construct to be measured is abstract, such as self-esteem. To design a measure of self-esteem, you could draw from theories that predict self-esteem. Developmental psychologists suggest that children who come from emotionally supportive families have higher self-esteem than those from neglectful or abusive families. Therefore, the measure of self-esteem could be given to groups of children from either back- ground to see how much the construct validity of the self- esteem measure was related to the backgrounds of these children.)

Question 38

What is the difference between a clinical approach and an actuarial approach?

Answer 38

Clinical Approach: Argues that there is no substitute for the clinician’s experience and personal judgment. They prefer to draw on all available data in their own manner; they are guided by intuition honed with professional experience rather than by formal rules.

Actuarial approach: argues that a more objective standard is needed—something primarily based in empirical data. They rely exclusively on statistical procedures, empirical methods, and formal rules in evaluating data.

Question 39

Which method is superior: a clinical approach or an actuarial approach?

Answer 39

The actuarial approach tends to be much more efficient in making predictions in a variety of situations (e.g., relapse, dangerousness, improvement in therapy, success in university), especially when many predictions must be made and the base of data is large.

Question 40

True or False?

Statistical rules (e.g., regression equations) outperform clinical hunches.

Answer 40

True.

However, there are 2 problems with statistical rules. Many of the equations and algorithms found in the literature do not generalize to practice settings. There are no prediction rules for the bulk of our decisions.

Question 41

What are some examples of Biological Assessment methods?

Answer 41

1) EEG (electroencephalogram) - electrodes placed on various parts of the scalp to measure the brain’s electrical activity.

2) CAT (Computerized axial tomography) or CT scan - a narrow band of X-rays is projected through the head and onto scintillation crystals, producing a matrix of dark and light areas, combined into a detailed tomography, a two-dimensional image or cross-section of the brain. (Can be used to look at changes in structural abnormalities before and after the treatment of a disorder.)

3) MRI (magnetic resonance imaging) - A strong homogeneous magnetic field is produced around the patient’s head. Reveals both the structure and the functioning of the brain. & fMRI (Functional magnetic resonance imaging) - provides a dynamic view of metabolic changes occurring in the active brain.

4) PET (Positron emission tomography) - combination of computerized tomography and radioisotope imaging. Generated by injected or inhaled radioisotopes.

Question 42

What are some examples of neurobiological assessments (used to determine relations between behaviour and brain function)?

Answer 42

1) Bender Visual-Motor Gestalt Test (copy designs and draw from memory. Main drawback: produces many false negatives; some people with neurological impairment can complete the test with few errors.)

2) Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). - simple to administer, age-normed.

3) Montreal Cognitive Assessment (MoCA) - valid, brief and very rapid which makes it more practical thatn RBANS in hospital settings.

4) Halstead- Reitan Neuropsychological Test Battery. -similar to 2 above, but includes tests of sensory perceptions like touch.

Question 43

What are some examples of psychological assessments?

Answer 43

1) Unstructured Clinical Interview - open-ended, follow the patient’s lead, easy to avoid sensitive topics which puts patient at ease. Pro: facilitate rapport, mutual trust, and respect between clinician and patient. Con: clinicians may tend to uncover only the info that fits their theoretical orientation and confirms their hypotheses.

2) Structured Clinical Interview - The Diagnostic Interview Schedule, Version IV. Pro: Removes some subjectivity of interviewer and increases reliability Con: Jeopardize rapport.

3) Semi-Structured Clinical Interview - uses SCID-5 or mental status evaluation (psychiatric settings). Clinician has leeway about what questions to ask, in what order, and with what wording. But questions are guided by an outline listing certain dimensions of the patient’s functioning that need to be covered (appearance, affect, risk, behaviour, sensory, orientation, thought etc.

4) Rating scales - best ones indicate not only the presence or absence of a trait or behaviour but also its prominence or degree.

Question 44

What are some examples of personality assessments?

Answer 44

1) Projective Tests - (ie Rorschach Inkblot & Thematic Apperception) - rooted in psychoanalytic principles. Cons: relies on clinician’s interpretation, hard to standardize scoring of responses, people will give socially desirable responses. So not very valid or reliable.

2) Minnesota Multiphasic Personality Inventory (MMPI) - most widely used objective test of personality. True/False questions. Results don’t constitute a diagnosis, just a profile of traits.

3) Millon Clinical Multiaxial Inventory (MCMI) - to help clinicians make diagnostic judgments about personality disorders and other clinical syndromes. True/False questions that yield scores for 25 clinical scales based on DSM criteria. Con: might under-estimating the severity of depressive disorders and overestimating the presence of personality disorders.

4) The Personality Assessment Inventory (PAI) - items are each scored using a 4-point Likert scale to assess symptoms ranging from mild to severe + includes critical items to indicate crisis situations.

Question 45

The first scientific study of intellectual functioning was conducted by the biologist ___________ in 1883, to test the hypothesis that intelligence has a hereditary aspect.

Answer 45

Sir Francis Galton.

Question 46

The first widely accepted and successful test of intelligence was designed by Alfred Binet to _____________.

Answer 46

Predict academic performance.

(His approach was to take a child’s mental age, which was determined by the child’s successful performance on age-grouped tests that had been normed, divide it by the child’s chronological age, and multiply the quotient by 100. This would result in an intelligence quotient, or IQ.)

Question 47

Binet’s work developed into the Stanford-Binet Intelligence Scales. Virtually all contemporary, standardized tests of intelligence, as well as other types of psychological tests, share Binet’s basic principle of comparison.

Answer 47

(This is just a fact that might be good to know. I was too tired to make it into a question, haha).

Question 48

What is the average IQ score?

Answer 48

100.

Question 49

True or False?

Of all psychological traits, IQ shows the most stability.

Answer 49

True.

(IQ has consistently been considered the strongest predictor of academic performance, even after accounting for other social, economic, genetic, and personality-related factors.)

Question 50

Why has the use of IQ tests become quite controversial?

Answer 50

The issue of fairness. Critics have argued that the IQ differences that have been found in North America between Whites, Blacks, and people of Asian background are actually a function of poor test construction; others argue that these differences are a function of respondents’ socio-economic environments, and others still argue that IQ is highly genetic and differences in IQ scores may represent real differences in IQ among different populations. Certainly, IQ scores have to be evaluated within the context of ethnic, age, gender, and culturally appropriate norms.

Question 51

What is the person by situation interaction?

Answer 51

The idea that predicting a person’s behaviour requires knowledge of both the person’s typical behaviour patterns and the characteristics of the setting,

Question 52

What are some examples of behavioural assessment?

Answer 52

Observational - behaviour rating scales (ie Child Behaviour Checklist), observer notes presence, absence, and/or intensity of targeted behaviours.

In vivo observation = clinician goes into person’s environment.

Analogue observational setting = an artificial setting in an office or laboratory constructed to elicit specific classes of behaviour in individuals.

Cons: Impractical, validity undermined by reactivity (the change in behaviour often seen when people know they are being observed or recorded) and behaviour is often specific to particular situations, observations in one setting cannot always be applied to other settings.

Question 53

Many social learning theorists concluded that the underlying personality structures and traits assessed by more traditional psychological tests (such as hostility, rigidity, paranoia, or obsessiveness), while interesting, are of limited usefulness in predicting behaviour. Instead, they have suggested that the best predictor of future behaviour is ______________.

Answer 53

past behaviour.

(This thinking lead to techniques for behavioural assessments.)

Question 54

What are some examples of Cognitive-Behavioural Assessments?

Answer 54

1) The Dysfunctional Attitudes Scale & Automatic Thoughts Questionnaire - easily administered.

2) “Real-Time” Assessments - asking their patients to record their ongoing thoughts on smartphone apps in addition to completing questionnaires.

3) Leiden Index of Depression Sensitivity (LEIDS) - to see who is more vulnerable to developing disorders and more likely to relapse.

4) Self-Monitoring - converts a patient into an assessor. Asked to note the frequency with which they perform various acts, and sometimes the circumstances surrounding these occurrences and their response to them. Pro: Cheap Con: the individual must be competent and motivated.

Question 55

What is the difference between broad-band instruments and narrow-band instruments?

Answer 55

Broad-band instruments seek to measure a wide variety of behaviours.

Narrow-band instruments, which focus on behaviours related to single, specific constructs such as hyperactivity, shyness, or depression.