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Describe goldstein schizophrenia study 1998?

• The original sample consisted of 199 schizophrenics, both male & female

• All were rediagnosed 10 years later with the newer version of DSM

• Everyday functioning was assessed using a variety of measures included marital status, occupational status, peer relationships, 

isolation and interests (at least 2 from list)/eq; 

• The number and duration of hospitalisations over the ten year period was measured

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Evaluate Goldstiens study ?

The study used a large sample and was able to retain them 

through the use of interviews and such measures at the start of 

the study and hospital records later/eq; 

• The re-diagnosis was conducted by two independent experts 

who were unaware of the purpose of the study

 • Data such as number and duration of hospital stays is objective and reliable 

• Although men and women were matched for employment status types of jobs varied between the sexes

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Describe Systematic desensitization

  • Uses the principles of classical conditioning to treat phobias 

• The individual creates a hierarchy of fear ranging from the least 

to the most frightening aspect of their phobia/eq; 

• They are taught to be able to relax and become calm

• The therapist will start with the least frightening level and guide 

the person through, getting them to relax at each stage/eq; 

• Progression onto the next level only occurs when the patient is 

comfortable and in control of the situation

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Evaluate Systematic desensitisation

Only helps if have a similar phobia or anxiety disorder 

It is unlikely to be very effective if the disorder is agoraphobia, as SD only tends to be effective for specific

Ethical theraphy as patient in control of their theraphy 

doesn't address the underlying course 

Systematic desensitisation is more acceptable than flooding to treat a phobia so is more ethica

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outline one explanation for uni-polar depression

  • Depression is caused by a shortage of one or more monoamine 
  • neurotransmitters
  • • The low level of serotonin is thought to induce anxiety
  • • Dopamine and noradrenalin are also believed to be low
  • • The individual may produce too much monoamine oxidase so the neurotransmitters are broken down too fast
  • • People may have a genetic predisposition that means they produce less serotonin when 
  • under stress
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Evaluate Unipolar depression

If neurotransmitter imbalance caused depression, drugs designed to treat this would always work, but they don’t/eq; 

• The level of neurotransmitters rises very quickly once on medication but any improvement associated with the drugs takes some time to manifest itself 

• In some instances the drugs do work almost instantaneously suggesting that depression is not a unitary disorder

  • Rausch et al (2002) showed the success of SSRI treatment is dependent on the sufferer’s genes, suggesting another aspect to the biological substrate/eq;
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Evaluate social abnormality

Deviation from social norms means behaviour is abnormal if perceived as different to that seen as acceptable within society 

• If the patients come from a different culture than the doctor’s s/he may not recognise normal behaviour as normal 

• What is seen as abnormal will vary between cultures as well as over time 

• Socially normal behaviour is likely to be context and role specific

A social norm definition of abnormality could be used to control those seen as not conforming to the social norm according to Szasz 

• Behaviour deemed as normal in one society may be seen as abnormal in another gaining someone a label unjustifiably 

• It allows the global nature of behaviour to be assessed rather than relying on a specific symptom 

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evaluate statistical abnormality

Deviation from the statistical norm means behaviour seen as rare in the population will be deemed abnormal. 

• It uses the normal distribution curve with both extremes deemed equally abnormal and the middle regions as normal. 

• The cut off point is generally put at +/- 2 SDs from the mean 

• Deviation from social norms means behaviour is abnormal if perceived as 

different to that seen as acceptable within society 

  • Depression is not statistically infrequent and yet is seen as abnormal 
  • • If all extremes of behaviour are seen as abnormal this will include behaviour seen as socially desirable as well as undesirable 
  • • The arbitrary nature of a statistical cut off point means there is no scope to account for how well the individual is coping 

• The arbitrary nature of a cut off point means that personal judgement cannot  bias diagnosis

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Explain one factor that would make a study scienti

The data collected will be empirical  This means that it is objective/can be tested

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Explain why the Psychodynamic Approach is often se

Psychodynamic approach fails to provide objective evidence so cannot support or refute theories like other approaches

• Evidence heavily biased by interpretation such as analysis of symbols meaning it is subjective

• A lack of empirical evidence because the concepts are not easily tested

• The heavy reliance on case studies makes it difficult to generalise conclusions to the wider population/eq;

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why is the biological approach scientific

Uses the scientific method to create and test hypotheses

• Uses objective means of collecting quantifiable data/

• Subjects the data collected to rigorous statistical analysis

• Is able to falsify a theory based on the likely probability that results occurred by chance

• Uses studies on animals where all conditions can be carefully and closely controlled leaving little opportunity for confounding variables to affect results

• Produces studies that have been repeated many times demonstrating replicability

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Describe how harm my be done in society?

• Milgram showed that even when very distressed a substantial number of 

people are willing to obey an order seen as cruel/wrong 

• The universality of this has been well established by replications world-wide 

• Even quite limited pressure will lead to compliance if the authority of the 

person giving the instruction is accepted 

• Hofling showed that nurses were willing to endanger a patient’s life 

• It is now recognised that eyewitness memory of an event may not always be accurate particularly if violence/weapon was used 

• Intervening material can distort the memory e.g. media stories/questioning 

• Loftus & Palmer showed leading questions can cause faulty memory 

• The presence of a weapon can cause witnesses to switch focus away from the criminal during an incident as shown by Pickel 

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Evaluate how harm can be done to society?

• There is evidence obedience to authority is no less now (e.g. Slater et al 2006), however it is no longer seen as excusable so soldiers in a court martial can no longer use obedience as a defence 

• It has led to major changes in military training in countries such as USA/UK, as recruits are now taught to be more willing to take the initiative and make decisions for themselves rather than only accepting orders from superiors 

• Society needs people to be obedient to authority but discriminating between malign and benign authority may be difficult 

 • Loftus’ work on the problems associated with distortion of memories through leading questions has led to changes of practice in police interviewing and the cognitive interview is now much more widespread 

• However the practice has not been barred from the courtroom so witnesses and jurors can still be misled and even if the question is ‘withdrawn’ it has still been heard 

• Work by Yuille & Cutshall suggests that if an incident carries the weight of reality it may be more resistant to distortion than in a lab exercise 

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Describe the care in community program?

Care/Treatment is provided while the patient lives in the community, either at home or in sheltered accommodation/eq; 

• They can call on Community Psychiatric Nurses for support/eq; 

• Care in the community uses drop-in centres, half way houses, and home medication/eq;

 • There will be drop-in centres that provide a 24/7 service/eq; 

• Medication will be self administered for many, though those needing extra support can receive it/eq; 

• Hospitalisation will only be used as a last resort if the person feels they cannot cope/eq; 

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Evaluate the care in the community program?

Poor levels of supervision may mean medication is not taken, leading to dangers for the patient and/or the community/eq; 

• Coping with a mentally ill person may put strain on families leading to further problems/eq;

Potentially improves the quality of life for recipients as they are able to maintain a normal lifestyle(e.g. Trauer et al 2001)/eq; 

• Symptoms /problems of institutionalisation tend to be reduced as a result of living in the community (e.g. Leff 1997)/eq;

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Using an example, outline what is meant by validit

Validity in diagnosis means that the symptoms of the patient match those considered to be present for that disorder/eq; 

• A client diagnosed with schizophrenia using DSM should have at least two symptoms continuously for at least two months or the diagnosis does not fit the necessary criteria so lacks validity/eq; 

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evaluate issues in the diagnosis of mental disord

Successful diagnosis relies on patients being honest and divulging all information to clinicians, something which does not always happen/eq; 

• The symptom clusters for disorders have some overlap, so not always possible to successfully distinguish between e.g. bipolar disorder and schizophrenia (e.g. Comer, Rosenhan)/eq; 

• Stereotypes/Expectations held by clinicians/ supported by the phrasing in DSM could create bias meaning some groups are over diagnosed with a particular disorder e.g. Blake 1973/eq

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Describe the findings (results and/or conclusions)

Of 8 pseudopatients, 7 were given a diagnosis of schizophrenia and one person was given a diagnosis of manic depression/eq; 

• 8 pseudopatients were admitted to 12 different hospitals of varying types in five different states in the USA/eq; 

• The average stay was 19 days though the range was from 7 up to 52/eq; 

• At discharge the pseudo-patients were given a diagnosis of schizophrenia in remission/eq; 

• Staff tended to ignore patient requests, invaded privacy and acted in a way that dehumanised patients/eq; 

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Evaluate the study by Rosenhan (1973) ‘On being sa

Clinicians wouldn’t expect those presenting as apparently mentally ill not to be so, so wouldn’t doubt the report of symptoms/eq; 

• The pseudopatients did say they heard a voice so there was deception albeit briefly/eq; 

• Cannot blame staff on wards for interpreting ‘normal’ behaviour as abnormal as context would suggest that patients are ill and therefore would be behaving in abnormal ways/eq; 

• The study has high ecological validity as it was conducted within real psychiatric hospitals/eq; 

• Several different hospitals were used in several different states so there is evidence of some generalisability/eq; 

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