Clinical Psychology 

HideShow resource information
View mindmap
  • Clinical Psychology
    • What  is it?
      • Clinical Psychology includes  many areas, focusing on describing, explaining and treating mental disorders.
    • Definitions
      • Statistical definition of abnormality
      • Social Norms definition of abnormality
      • Schizophrenia
      • Reliability
      • Validity
      • Primary data
      • Secondary data
    • Methodology
      • Primary data: Collecting information first hand
      • Secondary data: Getting data already collected by another researcher to back up own data
      • Evaluation of research methods
      • Two research methods in schizophrenia studies
        • Twin Studies. Comparing MZ and DZ twins to study nature vs. nurture. Gottesman and    Shields (1966). They aimed to see to what extent schizophrenia had a biological basis.
        • Interviews. (structured, semistructured, unstructured) . Goldstein (1988) used interviews to find out how males and females experience schizophrenia
    • Content
      • The DSM
        • Most commonly used classification and diagnostic system
        • There are 5 revisions
        • It is a multi axial system. The individual is rated on 5 axes to help with diagnosis.
        • Evaluation of the DSM
        • Reliability, diagnosis and the DSM. Studies looking at reliability of the DSM: Goldstein (1988), Brown et al (2001)
        • Validity, diagnosis and the DSM. Studies  looking at the validity of the DSM: Hoffman (2002), Stinchfield (2003), Kirk and Kutchins (1992)
          • Construct validity. If the DSM is to define mental disorders, then mental disorders need to be operationalised. It needs to measure what it claims to measure.
          • Etiological validity. If a diagnosis has etiological validity, a group of people who have been diagnosed with the same disorder will have the same symptoms or factors causing it.
          • Concurrent validity. When the result of a test or study matches a result from another set of data or study done at the same time. For results to have concurrent validity the 2nd diagnosis has to match a 1st diagnosis or result that has been shown to be valid,
          • Predictive validity. Same as concurrent validity, except that the result being compared was obtained at a different time. Eg, the DSM could diagnose a mental disorder. Then another measure would be done later for that mental disorder such as family comments, a doctor's view or observations by a mental health personnel could be taken to see if the diagnosis and the other measure agreed.
          • Convergent validity. When a test result converges another test result that measures the same thing. A correlational test would be carried out.
          • Evaluation of validity, diagnosis and the DSM
      • Social Norms definition of abnormality. Takes into account culture, situation, age , gender and historical context. It is not scientific.
      • Statistical definition of abnormality. It uses a normal distribution bell curve to see who is abnormal, based on that person's score and whether it is between the "normal range" calculated using standard deviation.
      • Cultural issues, diagnosis and the DSM. Can it be used in all cultures?
        • Culture does not affect diagnosis. Mental disorders are scientific. No matter where you are, the symptoms, features and explanations should be the same. Lee (2006) in Korea found that the DSM IV TR was valid for ADHD.
        • Culture affects diagnosis (a spiritual model). Eg, symptoms seen in schizophrenia such as hearing voices that are seen in Western countries are interpreted in other countries as showing possession by  spirits, deemed as a positive thing. depending on culture, the DSM may not always be correct.
        • Cultural differences in symptoms of schizophrenia eg more grandiosity in white Americans and more auditory hallucinations in Mexican born people than white Americans.
        • Ideas for overcoming cultural bias in diagnosis
          • Take emphasis off features that  might be affected by culture.
          • Move away from emphasis on first rank symptoms (+ve symptoms) as they are more open to interpretations.
          • Focus more on -ve symptoms as they are more objectively  measured.
        • Culture bound syndromes eg Penis panics in Africa and Asia and Kuru, an incurable brain disease in Papua New Guinea. Includes headaches, shaking, aching limbs and death. May be due to the funeral practice of eating the brain.
      • Schizophrenia
        • Positive and Negative symptoms.
          • +ve: hallucinations, delusions, thought disorders.
          • -ve symptoms: Social withdrawal, no emotion, lethargy, not looking after appearance.
        • Features (facts)
          • 5 different types. Paranoid, disorganised, undifferentiated, catatonic and residual.
          • Found universally. Jablensky (2000) found 1.4-4.6 per 1000 people in every country.
          • Patients do not know they are ill usually at first.
          • 1/4 people who have sch episode dont get another. 1/4 have it continually and 1/2 have periods of recovery and periods of symptoms.
        • Mental disorder described as split between thinking and emotion.
        • Described as disintegration of the personality  Speaking, thinking and feeling changes dramatically they lose focus on reality.
        • Explanations
          • Biological: DOPAMINE HYPOTHESIS
            • Evidence for (strengths) and evidence against (weaknesses)
            • Evaluation of the methodology used to study the dopamine hypothesis.
            • Supporting study: Lindstroem et al (1999)
            • Study against: Depatie & Lal (2001)
          • Social:  THE ENVIRONMENTAL BREEDER HYPOTHESIS. THE IDEA OF SOCIAL DRIFT AND SOCIAL ADVERSITY
            • Evaluation of the environmental breeder hypothesis
            • Supporting studies for social adversity: Castle et al (1993), Eaton et al (2000) and Freeman (1994). For social drift, study found that schizophrenic men were in lower classes than their fathers.
        • Treatments for Schizophrenia
          • Biological: Drug treatment.
            • Evaluation of drug treatment. Supporting study: Meltzer et al (2004)
          • Social: ACT (Assertive Community Therapy). Where patients live independently in their own homes but still have the support of fully committed staff in their area.
            • Evaluation of ACT. Study supporting: Bond et al (2001). Study against: Gomory (2001)
      • Unipolar Depression
        • A mental and mood disorder that features sadness, disappointment, self-doubt, loneliness and hopelessness. Feelings can be intense and last a long time. Coping with activities may be difficult.
        • Symptoms: Extreme lethargy, disturbed sleep, irritability  feelings of despair and hopelessness, lack of concentration, loss of interest, lack of sex drive and irrational fears and suicidal thoughts.
        • Features
          • Twice as common in women than men, but men more likely to commit suicide
          • Develops around 30-40, reaches a peak between 50-60.
          • In some cases, depression only occurs once while for others much longer and more severe.
          • Depressed people tend to live shorter lives, probably because linked to heart disease and other illnesses.
          • Affects functioning such as eating and sleeping and also family life
          • Over 20 mill people suffer in USA, and over 3.5 million in the UK
        • Explanations
          • Biological: Monoamine hypothesis
            • Evaluation of monoamine hypothesis.
          • Cognitive: The cognitive model of depression. 3 aspects of Beck's model: Cognitive triad, cognitive errors and schemata.
            • Evaluation of cognitive explanation. Supporting studies: Alloy and Abramson (1999), Hollon et al (2002) and Watkins and Baracaia (2002) and Teichman et al (2002)
        • Treatments
          • CBT (where the therapist explores what the patient says in their own words to discover why they are depressed. If the patient says they are  a bad person for exampl,e the therapist may keep asking questions like "what is a bad person to you?" until they realise they actually are not a bad person
            • Evaluation of CBT.Supporting studies: Kuyken et al (2008) Studies against: Stiles et al (2006)
          • Psychodynamic: Word association
            • Evaluation
          • Learning: Token Economy programmes
            • Evaluation of TEPs
      • Studies in detail
        • Goldstein (1988).
          • Aim: T o see if there were gender differences with regard to length of their hospital stays and re-hospitalisation of people with schizophrenia. Aimed also to look at social factors, mainly factors present before diagnosis to see if it had impact on the course of the disorder with regard to gender
          • Procedure: Sample, Rediagnosis (testing for reliability of the re-diagnosis), features of the sample, gathering information about the disorder
          • Results: Men stayed longer in hospitals and had more re-hospitalisations than women. Look at brain book
          • Conclusion: Females with schizophrenia experienced fewer re-hopitalisations and shorter lengths of stays over a 5 and 10 year period. Gender differences seemed to start early in the disorder and premorbid functioning accounted for 50% of the effect of outcome if a 1 year observation was done, though only 1.9% on a 10 year outcome. This means other factors become more prominent than premorbid functioning as the illness progresses.
        • Rosenhan  (1973)
          • Aim: to see if 8 sane people could gain admission into 12 different hospitals and could be detected or found out to be sane. A further aim was to see what being insane was like.
          • Study 1.  All 8 gained admission. They pretended to hear voices and acted normal once in the institution. 35/118 patients voiced their suspicions
            • Study 2: Told each staff member to rate a group of patients on a scale of 1-10 on the likelihood of them being a pseudo patient. there were 193 patients that were judged. 41 judged with high confidence to be pseudo, 23 suspect, 19 thought to be by at least 1 psychiatrist and 1 other staff member. There were NO pseudo patients.
          • Evaluation
          • Conclusion: Doctors more likely to call a  healthy person sick than a sick person healthy. It is also difficult to diagnose and tell. Insanity label is so strong
        • Brown et al (2001)
          • Hypothesis: Lack of support and low self esteem increase the risk of depression given a later provoking agent. Support from husband or close person will reduce chances of developing. Support during crisis protects against depression even if people have low self esteem.
          • Procedure: Took place in Islington, north london.Had two phases to test measures of self esteem and collected data about the onset of any psychiatric disorder and experienced interviewers were used.
          • Findings:29/32 women who experienced major life event such as loss developed depression. Out of these, 33% had low self esteem. Women who had support during crisis saw it as helpful (85/92). Women who had support at first but not during crisis felt let down so developed depression (42%)
          • Conclusions: Women with close relationships have lower chance of suffering. Women more likely to suffer if husband or close relationship let them down during crisis. Something needs to provoke depression in order for it to develop.
          • Evaluation
    • Practical: Making a leaflet for a specific audience and why. What were the outcomes? What did I choose to include? Evaluate my leaflet
  • Content
    • The DSM
      • Most commonly used classification and diagnostic system
      • There are 5 revisions
      • It is a multi axial system. The individual is rated on 5 axes to help with diagnosis.
      • Evaluation of the DSM
      • Reliability, diagnosis and the DSM. Studies looking at reliability of the DSM: Goldstein (1988), Brown et al (2001)
      • Validity, diagnosis and the DSM. Studies  looking at the validity of the DSM: Hoffman (2002), Stinchfield (2003), Kirk and Kutchins (1992)
        • Construct validity. If the DSM is to define mental disorders, then mental disorders need to be operationalised. It needs to measure what it claims to measure.
        • Etiological validity. If a diagnosis has etiological validity, a group of people who have been diagnosed with the same disorder will have the same symptoms or factors causing it.
        • Concurrent validity. When the result of a test or study matches a result from another set of data or study done at the same time. For results to have concurrent validity the 2nd diagnosis has to match a 1st diagnosis or result that has been shown to be valid,
        • Predictive validity. Same as concurrent validity, except that the result being compared was obtained at a different time. Eg, the DSM could diagnose a mental disorder. Then another measure would be done later for that mental disorder such as family comments, a doctor's view or observations by a mental health personnel could be taken to see if the diagnosis and the other measure agreed.
        • Convergent validity. When a test result converges another test result that measures the same thing. A correlational test would be carried out.
        • Evaluation of validity, diagnosis and the DSM
    • Social Norms definition of abnormality. Takes into account culture, situation, age , gender and historical context. It is not scientific.
    • Statistical definition of abnormality. It uses a normal distribution bell curve to see who is abnormal, based on that person's score and whether it is between the "normal range" calculated using standard deviation.
    • Cultural issues, diagnosis and the DSM. Can it be used in all cultures?
      • Culture does not affect diagnosis. Mental disorders are scientific. No matter where you are, the symptoms, features and explanations should be the same. Lee (2006) in Korea found that the DSM IV TR was valid for ADHD.
      • Culture affects diagnosis (a spiritual model). Eg, symptoms seen in schizophrenia such as hearing voices that are seen in Western countries are interpreted in other countries as showing possession by  spirits, deemed as a positive thing. depending on culture, the DSM may not always be correct.
      • Cultural differences in symptoms of schizophrenia eg more grandiosity in white Americans and more auditory hallucinations in Mexican born people than white Americans.
      • Ideas for overcoming cultural bias in diagnosis
        • Take emphasis off features that  might be affected by culture.
        • Move away from emphasis on first rank symptoms (+ve symptoms) as they are more open to interpretations.
        • Focus more on -ve symptoms as they are more objectively  measured.
      • Culture bound syndromes eg Penis panics in Africa and Asia and Kuru, an incurable brain disease in Papua New Guinea. Includes headaches, shaking, aching limbs and death. May be due to the funeral practice of eating the brain.
    • Schizophrenia
      • Positive and Negative symptoms.
        • +ve: hallucinations, delusions, thought disorders.
        • -ve symptoms: Social withdrawal, no emotion, lethargy, not looking after appearance.
      • Features (facts)
        • 5 different types. Paranoid, disorganised, undifferentiated, catatonic and residual.
        • Found universally. Jablensky (2000) found 1.4-4.6 per 1000 people in every country.
        • Patients do not know they are ill usually at first.
        • 1/4 people who have sch episode dont get another. 1/4 have it continually and 1/2 have periods of recovery and periods of symptoms.
      • Mental disorder described as split between thinking and emotion.
      • Described as disintegration of the personality  Speaking, thinking and feeling changes dramatically they lose focus on reality.
      • Explanations
        • Biological: DOPAMINE HYPOTHESIS
          • Evidence for (strengths) and evidence against (weaknesses)
          • Evaluation of the methodology used to study the dopamine hypothesis.
          • Supporting study: Lindstroem et al (1999)
          • Study against: Depatie & Lal (2001)
        • Social:  THE ENVIRONMENTAL BREEDER HYPOTHESIS. THE IDEA OF SOCIAL DRIFT AND SOCIAL ADVERSITY
          • Evaluation of the environmental breeder hypothesis
          • Supporting studies for social adversity: Castle et al (1993), Eaton et al (2000) and Freeman (1994). For social drift, study found that schizophrenic men were in lower classes than their fathers.
      • Treatments for Schizophrenia
        • Biological: Drug treatment.
          • Evaluation of drug treatment. Supporting study: Meltzer et al (2004)
        • Social: ACT (Assertive Community Therapy). Where patients live independently in their own homes but still have the support of fully committed staff in their area.
          • Evaluation of ACT. Study supporting: Bond et al (2001). Study against: Gomory (2001)
    • Unipolar Depression
      • A mental and mood disorder that features sadness, disappointment, self-doubt, loneliness and hopelessness. Feelings can be intense and last a long time. Coping with activities may be difficult.
      • Symptoms: Extreme lethargy, disturbed sleep, irritability  feelings of despair and hopelessness, lack of concentration, loss of interest, lack of sex drive and irrational fears and suicidal thoughts.
      • Features
        • Twice as common in women than men, but men more likely to commit suicide
        • Develops around 30-40, reaches a peak between 50-60.
        • In some cases, depression only occurs once while for others much longer and more severe.
        • Depressed people tend to live shorter lives, probably because linked to heart disease and other illnesses.
        • Affects functioning such as eating and sleeping and also family life
        • Over 20 mill people suffer in USA, and over 3.5 million in the UK
      • Explanations
        • Biological: Monoamine hypothesis
          • Evaluation of monoamine hypothesis.
        • Cognitive: The cognitive model of depression. 3 aspects of Beck's model: Cognitive triad, cognitive errors and schemata.
          • Evaluation of cognitive explanation. Supporting studies: Alloy and Abramson (1999), Hollon et al (2002) and Watkins and Baracaia (2002) and Teichman et al (2002)
      • Treatments
        • CBT (where the therapist explores what the patient says in their own words to discover why they are depressed. If the patient says they are  a bad person for exampl,e the therapist may keep asking questions like "what is a bad person to you?" until they realise they actually are not a bad person
          • Evaluation of CBT.Supporting studies: Kuyken et al (2008) Studies against: Stiles et al (2006)
        • Psychodynamic: Word association
          • Evaluation
        • Learning: Token Economy programmes
          • Evaluation of TEPs
    • Studies in detail
      • Goldstein (1988).
        • Aim: T o see if there were gender differences with regard to length of their hospital stays and re-hospitalisation of people with schizophrenia. Aimed also to look at social factors, mainly factors present before diagnosis to see if it had impact on the course of the disorder with regard to gender
        • Procedure: Sample, Rediagnosis (testing for reliability of the re-diagnosis), features of the sample, gathering information about the disorder
        • Results: Men stayed longer in hospitals and had more re-hospitalisations than women. Look at brain book
        • Conclusion: Females with schizophrenia experienced fewer re-hopitalisations and shorter lengths of stays over a 5 and 10 year period. Gender differences seemed to start early in the disorder and premorbid functioning accounted for 50% of the effect of outcome if a 1 year observation was done, though only 1.9% on a 10 year outcome. This means other factors become more prominent than premorbid functioning as the illness progresses.
      • Rosenhan  (1973)
        • Aim: to see if 8 sane people could gain admission into 12 different hospitals and could be detected or found out to be sane. A further aim was to see what being insane was like.
        • Study 1.  All 8 gained admission. They pretended to hear voices and acted normal once in the institution. 35/118 patients voiced their suspicions
          • Study 2: Told each staff member to rate a group of patients on a scale of 1-10 on the likelihood of them being a pseudo patient. there were 193 patients that were judged. 41 judged with high confidence to be pseudo, 23 suspect, 19 thought to be by at least 1 psychiatrist and 1 other staff member. There were NO pseudo patients.
        • Evaluation
        • Conclusion: Doctors more likely to call a  healthy person sick than a sick person healthy. It is also difficult to diagnose and tell. Insanity label is so strong
      • Brown et al (2001)
        • Hypothesis: Lack of support and low self esteem increase the risk of depression given a later provoking agent. Support from husband or close person will reduce chances of developing. Support during crisis protects against depression even if people have low self esteem.
        • Procedure: Took place in Islington, north london.Had two phases to test measures of self esteem and collected data about the onset of any psychiatric disorder and experienced interviewers were used.
        • Findings:29/32 women who experienced major life event such as loss developed depression. Out of these, 33% had low self esteem. Women who had support during crisis saw it as helpful (85/92). Women who had support at first but not during crisis felt let down so developed depression (42%)
        • Conclusions: Women with close relationships have lower chance of suffering. Women more likely to suffer if husband or close relationship let them down during crisis. Something needs to provoke depression in order for it to develop.
        • Evaluation

Comments

MrsMacLean

A large and very pretty mind map, thank you!

Similar Psychology resources:

See all Psychology resources »See all Health and clinical psychology resources »