Option 2: Abnormal psychology studies Flashcards
(88 cards)
1
Q
A study to question normality and abnormality
A
Luhrman 2015
2
Q
Luhrman aim
A
investigate the impact culture has on the experience of hearing voices
3
Q
Luhrman sample
A
- 60 people diagnosed with schizophrenia
- From Ghana (Accra), US (California) and India (Chennai)
- All heard voices
- 31 women 29 men
4
Q
Luhrman method
A
- Structured interviews in english or native language
- Number, frequency and familiarity with voices
Whether they engaged and what the voices said - Whether they were a positive influence in their life
- What they thought the causes were
5
Q
Luhrman results
A
- All cultures had good and bad voices
- Non US = familiar eg. family or spirit, 75% in Ghana God, 50% positive
- US = 10% recognised voices, 25% God even though 75% religious, 70% told to hurt themselves or someone else
- Seen as intrusion or deeply distressing which was rare in non american and they usually described as enjoyable, interesting or playful
- US 85% said schizophrenia and disrupted thoughts
- 20% of non US used labels not an illness but a relationship
6
Q
Luhrman conclusion
A
- violent voices common in Western experience of schizophrenia not inevitable
- people connect with voices = may be able to modify = less frightening experience
7
Q
Luhrman strengths
A
- Structured interview = easy to compare
- Had native speaker
- Triangulation
- Controlled for religiosity and urban-dwelling
- Recorded and transcribed
8
Q
Luhrman limitations
A
- Social desirability
- Demand characteristics
- Might not want to talk badly about family members or spirits
- Did not identify race of american participants
9
Q
Two studies to question the validity of diagnosis
A
Rosenhan 1973
Li-repac 1980
10
Q
Rosenhan aim
A
investigate how doctors diagnose people as “sane” or “insane” - not used in modern psychology
11
Q
Rosenhan sample
A
- 8 pseudo-patients - 5 m 3 f, various ages
- Rosenhan was one himself
- staff of 12 hospitals in 5 states in USA - actual participants
- no consent
12
Q
Rosenhan method 1
A
- told doctor hearing voices - often unclear, but said words like “empty” and “thud”
- 1973, DSM II = clear sign of schizophrenia
described lives as they were - After admitted acted completely normal
- Talk to patients and staff, taking notes on experiences
only way to get out if convinced staff they were “sane”
13
Q
Rosenhan results 1
A
- All admitted
- Ranged from 7 to 52 days with average 19 days
- All released with “schizophrenia in remission,” and one “manic depressive psychosis.”
- nurse’s notes showed no signs of abnormality during stay
14
Q
Rosenhan conclusion 1
A
- once initial diagnosis, label of schizophrenia remained - even though no signs of abnormality
- challenged the validity of diagnosis and how may influence staff
15
Q
Rosenhan method 2
A
- hospitals told 1 or more pseudo-patients try to be admitted over three months
- staff rated all patients 1 - 10 scale for “likelihood of being a pseudo-patient.”
16
Q
Rosenhan results 2
A
- 193 patients - none were pseudo-patients
- 41 judged to be pseudo-patients
- one psychiatrist suspected 23
17
Q
Rosenhan conclusion 2
A
- validity affected when doctor’s credibility at risk
- less likely to make diagnosis and feared making mistake
- Sick role bias - when someone comes to dr, they assume there is a problem so look for symptoms
18
Q
Rosenhan limitations
A
- Limited sample
- Only tested for one disorder
- Ethical considerations - deception, consent, spent time working with fake patients which could have been - spent on real patients
- Stressful for pseudo-patients
- No can verify how they were treated in hospital and all notes self reported
- Researcher bias
19
Q
Li-repac aim
A
How clinician’s bias and stereotyping affects diagnosis
20
Q
Li-repac sample
A
- 10 patients used - 5 white and 5 Chinese
- all diagnosed with mental illness
- controlled for age, socioeconomic status and pathology
- 5 white clinicians and 5 Chinese-American male - actual participants
- recruited through personal contact
- white had no previous contact with Asian patients
21
Q
Li-repac method
A
- semi-structured interviews with patients + videotaped
- questions like “How have you been feeling lately?” and “How do you spend a typical day?”
- Participants describe ideal, functioning individual using 112-item test - no significant difference = similar definition of normality
- randomly assigned videos to rate for normality - 2 white and 2 Chinese patients
- describe personal traits and signs of pathology
22
Q
Li-repac results
A
- White rating white = easy going, adventurous, capable, reasonable etc
- White rating chinese = anxious, awkward, dependable, intelligent, mild etc
- Chinese rating chinese = adaptable, friendly, dependable, ambitious, self controlled etc
- Chinese rating white = aggressive, rebellious, talkative, rational, complicated etc
23
Q
Li-repac conclusion
A
- White saw Chinese patients more depressed Chinese raters
- White saw Chinese patients less socially competent and less capacity for relationships than Chinese raters
- Chinese rated more severe pathology when judging quiet patients
24
Q
Li-repac limitations
A
- Participant variables
- Social desirability
25
biological explanation of ptsd
- In animals exposure to severe stress can damage hippocampus
- Hippocampus - memory consolidation so decreased volume = memory loss symptoms
- some human studies show smaller hippocampal volume in individuals with PTSD
- Does this represent the neurotoxic effect of trauma, or is smaller hippocampal volume a pre-existing condition that renders the brain more vulnerable to the development of PTSD?
- Amygdala - stress response and release of hormones like adrenaline so decreased volume but hyperactivity = anxiety symptoms
- PFC - processing dangerous situations so decreased volume = decrease in positive appraisals and guilt or depressive symptoms
- All three associated with fear conditioning and extinction so if not functioning normally could = higher fear response for a long time
26
2 studies for the biological explanation of ptsd
Gilbertson 2002
Karl 2006
27
Gilbertson aim
To investigate whether low hippocampal volume is a symptom or etiology of PTSD
28
Gilbertson sample
- 34 sets of monozygotic twins
- with on trauma-exposed twin in each pair
- raised in the same household
29
Gilbertson method
- Two conditions
- trauma-exposed twin did not develop PTSD
- trauma-exposed twin developed PTSD
- MRI scans were used in order to gauge hippocampal volume
30
Gilbertson results
- Trauma-exposed with PTSD + trauma unexposed twins = both had smaller hippocampi
- As symptoms of severity increase = lower hippocampal volume
31
Gilbertson conclusions
Smaller hippocampal volume is an etiology of PTSD and increases vulnerability to PTSD
32
Gilbertson strengths
- Twins = Assumed they had similar experiences and so similar hippocampi in terms of structure and function
- fMRI = accurate and can’t show demand characteristics
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Gilbertson limitations
- Might have had very different experiences
- Only correlational = no cause and effect
- Different types of trauma
34
cognitive explanation of ptsd
- appraisals (way you mentally process an event) of traumatic event, PTSD symptoms, how you will cope
- negative appraisals = avoidance and maintaining a negative sense of self
- Adaptive appraisals = you are strong enough to cope, symptoms are normal after trauma, acceptance
- reappraisal = the ability to readjust an initial appraisal of an emotional stimuli
- vmPFC = ventromedial prefrontal cortex = linked to appraisals
- Has a top-down effect on amygdala = positive appraisals and reappraisals = reduce amygdala activity = reduce stress response
35
2 studies for the cognitive explanation of ptsd
Hitchcock 2015
Urry 2006
36
Hitchcock aim
investigated correlations between negative appraisals after experiencing a traumatic event and the development of PTSD symptoms
37
Hitchcock sample
- 97 children aged 7-17 years (mean age 12.8)
- admitted to hospital because they had experienced a one-off traumatic event (e.g. car accident, house fire, etc.)
- On average in hospital for a week
38
Hitchcock method
- Trauma interview
- - With parents
- - History of child trauma
- - Previous psychological treatment
- - Rating 0-3 injury severity
- Symptom measure
- - using the "Clinically Administered PTSD Scale (CAPS) (modified for children)
- negative appraisals measured
- - using a 25-item self-report questionnaire called the "Child Posttraumatic Cognitions Inventory (CPTCI)
- Done 1 month after events and 6 months after
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Hitchcock results
there was a moderate but statistically significant correlation between negative appraisals and PTSD symptom severity after 6 months
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Hitchcock conclusion
Negative appraisals can increase the chances of developing PTSD
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Hitchcock limitations
- Children not same for adults
- Ethical considerations
- Correlational = no cause and effect relationship
42
Sociocultural explanation of PTSD
- women, ethnic minorities and poor people = more likely to have PTSD
- all linked to socioeconomic status
- links to cognitive appraisals
- Appraisals better if rich eg. if house destroyed in hurricane you know you can cope and rebuild, protect family, access therapy etc = positive appraisals = top down control = less symptoms
- poverty also linked to smaller hippocampal volume
43
3 studies for the sociocultural explanation of ptsd
Garrison 1995
Luby 2014
Irish 2011
44
Garrison aim
To examine rates and correlates of posttraumatic stress disorder (PTSD) in adolescents after Hurricane Andrew
45
Garrison sample
- random-digit dialing
- 158 Hispanic, 116 black, and 104 white
- High and low impact areas within Dade County, Florida
- 6 months after Hurricane Andrew
46
Garrison method
- structured telephone interview
- emotional reaction
- disaster-related losses
- lifetime exposure to violent or traumatic events
- psychiatric symptomatology
47
Garrison results
- 3% of males and 9% of females met the criteria for PTSD
- highest rates among black people (8.3%) and Hispanics (6.1%)
- Also increased with age
48
Garrison conclusion
- Socio-economic disparity between racial groups and genders = whites have more net worth than minority groups
- Less money means more negative cognitive reappraisal.
49
Garrison limitations
- Only correlational
- Self reported data
- Only one type of traumatic event
50
two studies for the ethics of research of causes of ptsd
Luby and Hitchcock
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two studies for research methods into the etiology of ptsd
Garison and Urry
52
two studies for the ethics of research into diagnosis
Li-repac and Rosenhan
53
two studies for research methods into diagnosis
Li-repac and Rosenhan
54
3 studies for prevelance rates
Garrison 1995
Irish 2011
Luby 2014
55
Irish aim
To understand gender differences in the development of PTSD
56
Irish sample
- 365 participants who had been in a car crash
- from Ohio USA
57
Irish method
- Used questionnaires to gather data, the Clinician-Administered PTSD scale, (CAPS)
- The data was gathered on income levels, PTSD symptoms, showing the severity of their injuries and how close they were to death.
58
Irish results
- Women were more at risk of developing PTSD and a higher perceived life threat.
- Income was negatively correlated with PTSD symptoms (higher income, fewer symptoms).
- Differences in income between men and women explained why women were more at risk of developing symptoms of PTSD.
59
Irish conclusion
Women and people from low SES backgrounds are more at risk for PTSD.
60
Irish limitations
- Only correlational
- Self reported data
- Only one type of traumatic event
- Assumes that women are poorer than men
61
Karl aim
to see if brain structure is correlated with PTSD symptoms through meta-analysis of studies on PTSD patients
62
Karl method
- compared 50 studies involved MRIs on different areas of the brain (mainly amygdala and hippocampus)
- All studies used DSm iv
63
Karl results
- strongest correlation found between a decreased hippocampal volume and PTSD, also found between decreased amygdala and PFC volume
64
Karl conclusion
- brain abnormalities specifically decreased volume of hippocampus and amygdala can impact susceptibility to PTSD
65
Karl strengths
large sample size increases generalisability
66
Karl limitations
- Only correlational = no cause and effect
- reductionist
- Didn’t measure symptoms of PTSD so don’t know how severe it was
67
Urry aim
To investigate the effect of cognitive reappraisal on amygdala activation
68
Urry sample
19 participants
69
Urry method
- fMRI
- Exposed to a range of emotionally unpleasant stimuli
- Reappraisal was manipulated - command given as they saw each image
- Increase severity = imagine more intense scene with loved ones
- Decrease = think about it being unreal
- attend = focus on details of image
- Brain activity was measured
70
Urry results
- Higher activation of vmPFC during cognitive reappraisal to decrease the effect of the emotional stimulus = reduction in the activation of the amygdala
71
Urry conclusion
- If a patient has abnormalities in their vmPFC, they may not be able to perform reappraisal of affective stimuli
72
Urry strengths
- fMRI = reduce demand characteristics
- Cause and effect
73
Urry limitations
- None actually have PTSD
- Small sample
- Construct validity - does activity of brain area = appraisals
- Low ecological validity
74
Luby aim
To investigate whether poverty experienced in early childhood impacts brain development at school age
75
Luby sample
1415 children
76
Luby method
- cognitively and socially assessed annually for 3-6 years
- MRI scans measured brain volumes of white and grey matter, hippocampus and amygdala
77
Luby results
- Poverty = less white and grey matter and smaller hippocampus + amygdala volumes
- if caregiver supportive or hostile mediated effects of poverty
- stressful life events affected the volume of hippocampus only
78
Luby conclusion
- poverty in early childhood impacts development of hippocampus
- These effects on the hippocampus are reduced by supportive caregiver and increased by stressful life events
79
Luby strengths
- Large sample = generalisable
- MRI = reduce demand characteristics
- longitudinal
80
Luby limitations
- Low ecological validity
- Correlational
81
2 studies for classification systems
Parker et al 2001
Rosenhan 1973
82
Parker et al theory
- used to be thought disorders not universal as not all cultures experience same disorders
- now thought that disorders universal but symptoms are not
- Chinese somaticise symptoms of depression eg. headaches, insomnia, back pain rather than affective symptoms eg. sadness or pessimism
- may be due to cultural dimensions in collectivistic societies - less appropriate to reveal emotions = somatization is how you communicate mental distress
- may be because of the stigma associated with mental illness in Chinese society that leads people to express "appropriate symptoms."
83
Parker et al aim
to determine the extent to which symptoms of Major Depressive Disorder differed between Chinese and Australian patients
84
Parker et al sample
- 50 Malaysian participants of Chinese heritage
- 50 Australian participants of Western heritage
- Chinese first lang for 80% malaysians
- English 1st lang for all Australians
- Out-patients (patients but not staying in hospital overnight) = had been diagnosed with only Major Depressive Disorder
85
Parker et al method
- questionnaire
- mood and cognitive items common in Western diagnostic tools for depression
- somatic symptoms commonly observed by Singaporean psychiatrists
- translated into Malay and Mandarin Chinese and back-translated
- judge the extent to which they had experienced each of the 39 symptoms in the last week
- all the time, most of the time, some of the time, and not at all
86
Parker et al results
- Symptom that lead them to seek help = 60% Chinese somatic, 13% Australian sample
- More somatic symptoms in chinese
- More cognitive or emotional symptoms in australian
87
Parker et al strengths
Less of a culture bias as used not just western questionnaire
88
Parker et al limitations
- used DSM-IV = imposed etic approach as could have eliminated people who don’t meet Western criteria for diagnosis
- Self reported data = memory distortion and demand characteristics
- If west believe depression is emotional disorder, patients expect this is correct response
- Malaysia is modern and Westernized society = effects of globalization may impact results so more research on more cultures needed
