Module 2: Research Methods, Assessment, and Intersectional Approaches to Understanding Mental Disorder Flashcards
The perspective taken when examining the cause of psychopathology determines many things (3):
-Directs research
-Guides diagnostic decisions
-Defines treatment responses
Biological and psycho-dynamic formulations view dysfunctional behaviour as…
product of forces beyond the individuals control
Biological model encourages researchers to seek…
-physical basis for disorders
-formulation of a diagnostic system that classifies people as disordered
-implies that physical interventions should be treatments of choice
Behavioural perspective leads researchers to seek…
environmental events that shape specific dysfunctional responses and emphasizes the classification of behaviours rather than people.
Treatment involves either manipulating the environment or modifying perceptions people have regarding their experiences and themselves
A theory that attributes the supposed causal chain of dysfunctional behavioural to a single factor. Attempts to trace origins of a particular disorder to one factor.
Ex: social anxiety runs in families
Single factor theory (reflects lack of current comprehensive knowledge of disorders).
What is the primary focus of most single factor models?
That they reflect the primary focus of the researchers, theorist, or clinician rather than the belief that there really is a single cause.
Human beh. is unlikely to be the product of a single defect or experience.
Interactionist Explanations
View behaviour as product of the interaction of a variety of factors
(make more satisfactory theories in describing mental disorders).
Scientific theories are judged to be valuable b/c they embody 3 essential features:
1) Parsimony.
Integrate most of what is currently known about the phenomena in simplest way possible
2) Make testable predictions.
about aspects of the phenomena that were not previously thought of.
3) Able to specify what evidence would deny the theory.
Null Hypothesis
Proposes that a prediction made from a given theory is false.
Experiments (and other research strategies) are set up not to prove the worth of a theory, but rather reject (or fail to reject) the null hypothesis.
Thus, theories gain strength b/c alternative explanations are rejected.
General aims of theories about mental disorders are to…
1) explain etiology of the problem behaviour
2) Identify the factors that maintain the behaviour
3) Predict the course of the disorder
4) Design effective treatments
Aaron T.Beck’s cognitive formulation of depression and anxiety
CT can not only altar an individual’s cognitive processes in order to reduce symptoms of depression or anxiety, but also affect their neurobiology
The most populat theories that have been advanced regarding etiology of mental disorders (6):
1) Biological theories
2) Psychodynamic theories (derived from Freud)
3) Behavioural or cognitive behavioural theories
4) Cognitive theories examining dysfunctional thoughts or beliefs
5) Humanistic/existential theories examining interpersonal processes
6) Socio-cultural influences
The fair and equitable allocation of burdens and privileges, rights and responsibilities, pains and gains in society. Bargaining powers.
Social Justice.
Evidence indicates that many psychological ills are rooted in social injustive, but mental health promotion and prevention programs rarely address these issues.
Cultural competence
The degree of compatibility between the cultural and linguistic characteristics of a community.
The manner in which the combined policies, structures, and processes underlying local mental health services seek to make these services available, accessible and utilized.
Promoting cultural competence through multiple levels of intervention includes:
1) Organization of health systems + institutions
2) Workforce training and composition
3) Provision of culturally focused service models. (e.g., developing and offering interventions that are tailored to cultural context of specific populations.)
Example of culturally adapted intervention
CBT
Example of culturally rooted intervention
cultural treatment centres
rites of passage programs
The process of identifying those perceived to be different in a way that reinforces relations of domination or subordination between those deemed to be mainstream or normal and those who are not.
Othering.
Some argue cultural competence serves to reinforce oppression by othering,
Mental Health Equity
State of fairness or impartiality, and applies to any systems that determine how individual or group rights and claims are fulfilled.
Inequities are often indicated by
disproportionalities and disparities
disproportionalities
differences between the propotion of a group within a service system compared to their proportion within general population
disparities
difference in outcomes or experiences between two or more groups who experience the same event.
An approach to social justice that centres issues of race and racism in understanding and addressing mental health and social problems
Anti-Racism
*There is a large body of evidence indicates that European colonization and intergenerational trauma are linked to the disproportionate rates of mental health distress among indigenous peoples.
Internalized racism
refers to psychological internalization of negative beliefs and stigma about a persons own racial or ethnic group.
Consists of beliefs, behavioural practices and policies of societies and institutions that function to disadvantage racialized people and produce racial inequities
Institutional racism
Frameworks to inform anti-racist practice in psychology and other health and social services proposes 5 main domains (rsssm):
1) Reflexive rational practice
2) Socio-political education
3) Structural power analysis
4) systems change
5) Monitoring and evaluation
Resilience, risk and protective factors
resilience - positive adaptation
risk - conditions that increase negative mental health outcomes
protective - resources that offset, buffer risk factors
Interactionist perspectives on resilience note that…
risk and protective factors do not affect everyone the same way and are influenced by individual differences and interactions with environmental differences.
Ex: divorce affects young boys more than girls in short term but girls suffer from “sleeper effects” and feel consequences later in adolescence.
Culmuative risk
The summation of a person’s risk for a disorder or disease up to a specified age.
4 central mechanisms can help ppl cope with adversity and develop positive mental health:
1) reducing risk impact
2) interrupting unhealthy chain reactions
3) self esteem + self efficacy
4) personal growth
Prevention activities may be biological or psychological
Ex: of biological primary prevention - encouraging pregnant women to avoid alcohol can prevent fetal alcohol disorder
Ex of biological secondary prevention is the administration of special diets to children born with phenylketonuria
An intervention or prevention program that targets individuals (usually children or adolescence) at high risk for disorder or disease.
High risk program
The most effective prevention programs are those that are (10):
- comprehensive
- varied teaching methods
- provide sufficient “dosage”
- theory driven
- promote positive relationships with adults and peers
- appropriately timed
- socio-culturally relevant
- use outcome evaluation
- have well-trained staff
Preventing substance abuse programs that work include active participation and role plays that focus on:
1) knowledge and attitudes
2) drug refusal interpersonal skills
3) intrapersonal skills (goal setting, problem solving, stress reduction)
Implementation is important for understanding outcomes
What is the role of theory in guiding our understanding of mental health disorders?
Hint: What a theory is, how we might use it in putting together a case, theory about what constitutes a mental health disorder
What are the criteria for judging assessment methods?
Hint: What does it tell us, what might it’s limitations be?
What are the pros and cons of various assessment methods?
Hint: What makes one method good or bad, or good for one purpose and not another.
prevention synthesis and translation
Acknowledges that scientific reports are insufficient tools for transmitting knowledge
Scaling up of a program to other settings for widespread adoption
Dissemination
Wandersman argue that dissemination is influenced by three inter-related systems:
1) prevention synthesis and translation
2) prevention delivery
3) prevention support
prevention delivery
Individual, organizational and community supports for prevention at local level.
prevention support
Stakeholders directly involved in implementing the program
A good assessment tool depends on two things:
1) Accurate ability to measure some aspect of the person being assessed
2) knowledge of how ppl in general fare on such a measure for the purpose of comparison
Alternate-form reliability
An attribute of a test demonstrated by a high correlation between scores on two versions of a test. To circumvent the problem that one may improve on a test the 2nd time around b/c of practice, text designers may prepare two forms of the same test —- That is, they decide what construct that want their test to measure, think up q’s (or items) that would test that construct, and then word those questions in a slightly different way in order to create a second test that measure the same construct as the first.
Refers to the degree of reliability within a test - the extet to which different parts of the same test yield the same results.
Internal consistency
Split-half reliability
A measure of internal consistency often ascertained by comparing responses on odd-numbered test items with responses on even-numbered test items and seeing if the scores for these responses are correlated.
A measure of internal consistency, calculated by averaging the intercorrelations of all items on a given test. T
Coefficient alpha
he higher the coefficient alpha, the higher the internal consistency of the test.
Face validity
Means that the user of a test believes that the items on the test resemble the characteristics assocaietd with the concept of being tested.
Content Validity
requires that a tests’ content include a representative sample of all behaviours thought to be related to the construct that the test is designed to measure.
An attribute of a test that gives higher scores to ppl already known to have greater ability in the area it tests. Used b/c some qualities are easier to recognize than to define completely, such as artistic ability.
Criterion validity
Neuropsychological screening tests:
Bender visual motor gestalt
Repeatable Battery Assessment of Neuropsych status update
Montreal cognitive assessment
Halstead-Reitan neuropsych test battery
Bender visual motor gestalt
produces many false negatives
Montreal cognitive assessment
Quicker, more practical
Halstead-Reitan neuropsych test battery
several hours, is not a screening test
Actuarial approach
An approach to evaluating the data on patients, making predictions, and coming to decisions that
relies exclusively on statistical procedures, empirical methods, and formal rules.
Clinical Approach
An approach to evaluating and interpretating the data on patients, making predictions, and coming to decisions that relies on judgement of clinician’s experience and personal judgement.
Guided by intuition honed with professional experience rather than formal rules.
Refers to the importance of a test within a specific theoretical framework and can only be understood in the context of that framework.
Construct Validity.
Useful when the construct to be measured is abstract, such as self esteem.
