Clinical psychology: dysfunctional behaviour

diagnosis, explanationas and treatments of dysfunctional behaviour

HideShow resource information

ICD-10

1 of 32

  • manual published by World Health Organisation
  • used to diagnose physical/mental conditions
  • 1978 ICD-8 used in cross-cultural collaborations - refine defs for disorders in ICD-10
  • this removed inconsistencies and ambiguities
  • each disorder has description of main features + important associated features
  • diagnostic section - how many of each feature + balance between dif types needed
  • each disorder given code A00-Z99 - replaces numerical code in ICD-9 001-099
  • gives more possible categories
2 of 32

DSM-IV

3 of 32

  • mainly used in USA
  • compiled by 1000+ people
  • field trials used to compare DSM-III and ICD-10 to DSM-IV
  • simpler classifications using criteria sets
  • empirical research used to support criteria
  • some new diagnoses included
  • it now recognises limitations of calling itself a manual of mental disorders - implies mind/body split that might not exist
  • problems with individual differences - features of illness may be different for different people
  • attempt to highlight ethnic diversity of US
  • diagnosis may be more difficult if culture of patient different to clinician
  • is a multi-axial tool - have to consider if disorder from axis 1 (clinical disorders) or axis 2 (personality disorders
  • general physical condition considered + social/environmental problems
  • used to assess functioning on scale 1-100
  • more holistic than ICD-10
4 of 32

Rosenhan and Seligman

date

aim

4 types + pros and cons

5 of 32

  • 1995
  • looking at definitions of dysfunctional behaviour/abnormal psychology
  • 1) statistical infrequency
  • any behaviour not seen often in society
  • difficult to use on its own - might include behaviours like stamp-collecting/high IQ
  • other behaviours e.g. substance abuse are common but are abnormal
  • 2) Deviation from social norms
  • if society doesnt approve of a behaviour then its dysfunctional
  • makes some behaviours dysfunctional in some cultures and not in others
  • doesnt allow for societies to be changed by forward-thinking people
  • 3) failure to function adequately
  • if they arent functioning in way that enables them to live independently in society
  • context of behaviour might influence our view of it e.g. someone who had been in house fire will obsessively check appliances are off - subjective
  • 4) deviation from ideal mental health
  • if you lack one thing (health) you must have the opposite (illness)
  • Jahoda (1958) for ideal mental health you should: have positive view of yourself, be independent, have accurate view of reality, be resistant to stress
  • based on western individualist cultures + relies on subjective view of clinician
6 of 32

Ford and Widiger

date

aim

method

participants

procedure

findings

7 of 32

  • 1989
  • aim: see if clinicians stereotype genders when diagnosing disorders
  • method/desgin: self report / independent design
  • pps: 354 clinical psychologists from 1127 randomly selected from national register with mean of 15.6 years clinical experience
  • procedure: pps randomly provided with 1 of 9 case histories
  • case studies = antisocial personlity disorder/histronic personalty disorder/ equal balance of symptoms from both and were male/female/sex-unspecified
  • pps asked to diagnose illness by rating on 7 point scale extent patient appeared to have each of 9 disorders
  • findings: sex-unspecified case histories diagnosed more often with borderline personality disorder
  • ASPD correctly diagnosed 42% in males 15% in females
  • females with ASPD misdiagnosed with HPD 46% and males 15%
  • HPD correctly diagnosed in 76% of females and 44% of males
  • tendency to diagnose females with HPD not ASPD because characteristics of HPD might be concidered gender specific - a female typical disorder
  • (excessively emotional, attention-seeking, inappropriate seductiveness)
8 of 32

Ford and Widiger (1989) evaluation

9 of 32

  • self report - low ecological validity ( clinicians dont normally diagnose without seeting patient + are under more pressure to give correct diagnosis)
  • ethnocentric - based on western ideas of gender
10 of 32

Watson and Raynor

date

aim

method

participants

procedure

findings

11 of 32

  • 1920
  • aim: see if possible to induce fear through classical conditioning
  • if fear transferred to similar objects + if possible to remove in lab
  • effect time has on fear response
  • method: case study in laboratory conditions
  • pps: little albert - test at 8 months showed his fear of loud noises
  • procedure: baseline reactions to stimuli noted (no fear response)
  • 1 - presented with rat and steel bar was struck as he reached for the rat x2
  • 2 - next week rat alone was presented and the rat and noise
  • after 5 paired presentations he reacted to rat alone by crying
  • 3 - five days later presented with blocks to play with (neutral stimulus)
  • presented with rat then rabbit, dog, wool & santa claus mask
  • rabbit etc produced negative response
  • 4 - 5 days later rat presented on its own - response was weaker
  • freshened his response to rat dog and rabbit
  • taken to lecture theatre to see if response was the same
  • fear response to dog rat and rabbit were pronounced
  • in different room fear response was slight but was pronounced after freshened
  • 5 - one month later albert was tested with various stimuli
  • continued to show fear reactions to varying degree to all stimuli
12 of 32

Watson and Raynor (1920) evaluation

13 of 32

  • ethics - using a child - cant give informed consent
  • didnt remove fear response - psychological harm
  • only used 1 participant so cant generalise to others
  • albert wasnt typical of other children as he lived in a hospital environment
14 of 32

Gottesman and Shields

date

aim

method

participants

procedure

findings

15 of 32

  • 1976
  • Aim: review research on genetic transmission of schizophrenia
  • method: review of adoption (3) and twin (5) studies into schizophrenia 1967-76
  • procedure: incidence of schizophrenia in adopted children and monozygotic twins
  • comparing biological parents and siblings and adoptive parents and siblings
  • concordance rates for monozygotic and dizygotic twins compared
  • findings: adoption studies found increased incidence of schizophrenia in adopted children with schizophrenic biological parent
  • normal children fostered to schizophrenic parents and vice versa showed little evidence of schizophrenia
  • biological siblings of children with schizophrenia showed higher percentage (19.2%) than with adoptive siblings (6,3%)
  • higher concordance rate for schizophrenia in monozygotic twins (58%) than dizygotic (12%)
16 of 32

Gottesman and Shields (1976) Evaluation

17 of 32

  • concordance rates between monozygotic twins arent 100% so environment must play some part in the development of schizophrenia
  • biological approach = scientific
  • reductionist
18 of 32

Beck et al (explanations)

date

aim

method

participants

procedure

findings

19 of 32

  • 1974
  • aim: understand cognitive distortions in patients with depression
  • method:clinical interviews with patients undergoing therapy for depression
  • pps: 50 patients diagnosed with depression - 16m & 34f 18-48 middle class+ av IQ
  • procedure: interviews with retrospective reports of patients thoughts + spontaneous reports of thoughts during session
  • records kept of non-depressed patients verbalisations to compare with depressed
  • findings: themes appeared in depressed patients that didnt in non-depressed
  • low self-esteem, self-blame, desire to escape, paranoia, accusations against others
  • depressed had stereotypical responses to situations even when innapropriate e.g. if someone didnt smile at them they would think themselves inferior
  • depressed patients regarded themselves as inferior to others in their social groups
  • distortions tended to be automatic, involuntary, plausible and persistent
20 of 32

McGrath

date

aim

method

participants

procedure

findings

21 of 32

  • 1990
  • aim: treat girl with specific noise phobias using systematic desensitisation
  • method: case study
  • pps: Lucy 9yrs with fear of sudden loud noises. lower than av. IQ, wasnt depressed
  • procedure: constructed hierarchy of feared noises
  • taught breathing + imagery to relax - imagine herself at home on bed with her toys
  • had hypothetical fear thermometer for rating fear 1-10
  • given stimulus of loud noise she paired feared object with relaxation and imagery
  • this lead to feelings of calmness so she associated the noise with feeling calm
  • findings: after 4 sessions she learned to feel calm when noise was presented + didnt need to use imagery
  • 10th and final session fear thermometer scores gone from 7/10 to 3/10 for ballons
  • 9/10 to 3/10 for party poppers
  • 8/10 to 5/10 for cap guns
  • conclusions: important factors - giving lucy control to say when/where noises made
  • using inhibitors of fear response (relaxation and playful environment)
22 of 32

McGrath (1990) evaluation

23 of 32

  • single participant design: cant generalise to other people/phobias
  • useful - able to treat noise phobia using systematic desensitisation
  • ethics - children
24 of 32

Karp and Frank

date

aim

method

participants

procedure

findings

25 of 32

  • 1995
  • aim - compare drug treatment and non-drug treatment for depression in women
  • method - review article
  • pps - women diagnosed with depression
  • procedure - depression analysed useing depression inventories
  • general testing prior to treatment, after and in some cases some time after as a follow up
  • some health practioner assessment of symptoms were used by some research
  • findings: adding psychological treatment to drug therapy didnt increase drugs effectiveness
  • combination therapy had lower attrition rates
26 of 32

Karp and Frank (1995) Evaluation

27 of 32

  • androcentric - only used females
  • ethics - placebo group
  • independent measures - individual differences
  • holistic - considers psychological and biological treatment
28 of 32

Beck et al (treatments)

date

aim

method

participants

procedure

findings

29 of 32

  • 1978
  • aim: compare effectiveness of cognitive therapy and drug therapy
  • method: controlled experiment with pps allocated to 1 of 2 conditions
  • pps: 44 patients diagnosed with moderate-severe depression attending psychiatric outpatients clinics
  • procedure: pps assessed with 3 self-reports before treatment (Becks Depression Inventory, Hamilton Rating Scale and Rasking Scale)
  • for 12 weeks patients had 1-hour cognitive therapy session twice a week or 100 imipramine prescribed by visiting doctor for 20mins each week
  • cog therapy sessions prescribed and controlled and therapists were observed to ensure reliability
  • findings: both groups showed significant decrease in depression symptoms
  • cognitive treatment group showed significantly greater improvements on self-reports and observer-based ratings (78,9% compared to 20% of those with drug therapy)
  • drop-out rate 5% in cognitive therapy and 32% in drug treatment
30 of 32

Beck et al (1978) Evaluation

31 of 32

  • it may have been simply getting out of the house for 1 hour twice a week and having social interaction that improved the patients depression
  • didnt have a control group to account for this variable
  • independent design - participant variables
  • useful - shows cognitive therapy is a good way to treat depression
  • self-report - social desirability
32 of 32

Comments

A92

Excellent Revision Cards !

nesimipolat

thanks..

Similar Psychology resources:

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