Topic 5 Clinical - Classical & Contemporary studies Flashcards
What is the Contemporary Study: Carlsson et al (1999) aim?
Review studies into the relationship between levels of neurotransmitters, esp dopamine & glutamate, on symptoms of schizophrenia
What is the Contemporary Study: Carlsson et al (1999) procedure?
Is NOT an experiment
- Review methods & findings of studies they were looking at & use other studies & data gathering studies to build a body of knowledge about the area of dopamine & schiz
What are the Contemporary Study: Carlsson et al (1999) results?
- Dopamine hypothesis revisited
- PET scans support dopamine hypothesis
- Beyond Dopamine
- Drugs like PCP (angel dust) produce psychotic symptoms but instead of activating dopamine, they stimulate glutamate receptors called NMDA
- Glutamatergic control of dopamine release
- Glutamate regulates the behaviour of dopamine (increases dopamine or decreases it) acting as “accelerators” or “brakes”
- Decrease of glutamate → Increase of dopamine release
- Glutamate-Dopamine Interaction
- Hypoglutamatergia in the cerebral cortex → negative symptoms
- Hypoglutamatergia in the subcortical basal ganglia → positive symptoms
What is the Classical study for Topic 5 Clinical?
Rosenhan (1973)
What is the aim for Rosenhan (1973)?
To test reliability and validity of diagnosis by seeing whether people without a mental disorder would be admitted to a psychiatric hospital; and if so could this decision be reversed
What is the procedure for Rosenhan (1973)?
- 8 pseudo-patients (including Rosenhan) went into 12 hospitals across the USA.
- The pseudo-patients called the hospitals saying they were hearing voices ‘ thud, hollow, empty’.
- All other details, apart from their name and in some cases occupation, were kept the same.
- Once admitted, the pseudo-patients said the voices had stopped.
- They measured the length of time patients were admitted to hospital, and some pseudo-patients kept a diary of their experience.
What are the findings for Rosenhan (1973)?
- All pseudo-patients were admitted. Time spent in the institute was 7 – 52 days – 19 days as the average
- 7 were diagnosed with schizophrenia, one with bipolar
- 35/118 genuine patients were able to identify them as ‘sane’ e.g. ‘you’re a journalist’
- Over 2100 pills were given out – only 2 were taken
- Nurses in office 90% of the time, 7 mins per day per patient
- Behaviour interpreted based on the label of mental disorder Waiting outside the café for lunch = ORAL ACQUISITIVE SYNDROME; Writing in diaries = PATIENT ENGAGES IN PATHOLOGICAL WRITING BEHAVIOUR; Walking the corridor out of boredom = NERVOUSNESS
Conclusion: The diagnoses of mental illness is influenced by the context in which the behaviours are observed and the expectation of others. Once a patient has been labelled with a mental illness, it is hard to remove the label
What are the strengths for Rosenhan (1973)?
Generalisability: 12 hospitals used so can be generalised, not just one hospital labelling patients; However this was conducted in the 1970’s and only in the USA – may be cultural differences
Reliability: 8 people in 12 hospitals using the same procedure e.g. hearing ‘thud, hollow, empty’ – replicable and reliable. The number of days is also an objective measure.
Validity: Use of covert participation observation -> quan & qual data collected & staff were unaware psuedopatients were observers -> natural behaviour -> high ecological validity -> naturalistic observation
What are the weaknesses for Rosenhan (1973)?
Ethics:
- staff were left feeling embarrassed & incompetent that they were wrong in their diagnosis
- they would not have consented to the study
- staff lied to & deceived
- staff attention onto real patients may have been taken away as they focused on pseudo patients - real patients -> vulnerable -> couldn’t seek the help they needed
- real patients discriminated against due to clinicians believing they were fake (once a few ppl maybe slowly caught on)
