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Summary Chapter 4, 9-15 Clinical Psychology
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Uitgebreide samenvatting van de hoofdstukken 4, 9-15 van het boek Abnormal Psychology by Kring and Johnson.
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Chapter 4Research methods in psychopathology
Science and scientific methods
Science: Systematic pursuit of knowledge through observation.
● Theory: Set of propositions meant to explain a class of observations.
○ Science proceeds by disproving theories, never by “proving theories.”
○ Each facet must be carefully defined so that findings can be replicated.
● Hypotheses: Expectations about what should occur if a theory is true.
Approaches to research on psychopathology
The case study: Recording detailed information about one person at a time. May be biased
by the observer’s theories, and the patterns observed in one case may not apply to others
● The case study as rich description: Include much more detail than other research
methods typically do.
● The case study can disprove but not prove a hypothesis: Case studies can
disprove a hypothesis, they do not provide good evidence in support of a particular
theory because they do not provide a way to rule out alternative hypotheses.
● Using the case study to generate hypotheses: Clinicians may notice patterns and
then formulate important hypotheses that they could not have formed otherwise.
The correlational method: Variables measured as existing in nature. High external validity.
● Measuring correlation:
○ The first step in determining a correlation is to obtain pairs of observations of
the two variables in question.
○ The strength of the relationship between the paired observations can be
computed to determine the correlation coefficient →between +1.00 and 1.00.
● Statistical and clinical significance:
○ Statistical: Statistical finding is usually considered significant if the probability
that it is a chance finding is p < .05.
■ Influenced by size relationship and number of participants.
○ Clinical: Whether a relationship between variables is large enough to matter.
● Problems of causality: Directionality problem: Correlation between two variables
tells us only that they are related to each other, but we do not know if either variable
is the cause of the other.
○ Longitudinal: Researcher tests whether causes are present before a
disorder has developed.
○ Cross-sectional: Causes and effects measured at the same point in time.
○ High-risk method: People with elevated risk of developing a psychological
disorder are recruited and followed over time.
○ Third-variable: Third factor may have produced the correlation →
confound.
● Epidemiological research: Study of the distribution of disorders in a
population → designed to be representative of the population being
studied.
, ○ Prevalence: The proportion of people with the disorder either currently or
during their lifetime
○ Incidence: The proportion of people who develop new cases of the disorder
in some period, usually a year.
○ Risk factors: Variables that are related to the likelihood of developing the
disorder.
● Behavior and molecular genetics:
○ Family method: Study a genetic predisposition among members of a
family because the average number of genes shared by two blood
relatives is known → to see how the presence of a disorder varies by
the proportion of genes shared by family members.
○ Twin method: Looking at monozygotic and dizygotic twins → to see
whether monozygotic twins with more shared genes are at greater
risk for developing a disorder than are dizygotic twins.
○ Adoptees method: Studies children who were adopted and reared
completely apart from their biological parents → to help separate
genetic and environmental effects.
○ Molecular genetics: Designed to identify specific genes or combinations of
genes that may be associated with the presence of a particular disorder in a
large population of people.
■ Association study: Researchers examine the relationship between a
specific allele and a trait or behavior in the population.
■ Genome-wide association studies (GWAS): Examines the entire
genome of a large group to identify variation between people.
The experiment
High internal validity.
○ Basic features of experimental design: Most powerful tool for
determining causal relationships → involves random assignment of
participants, manipulation of independent variable, measurement of
a dependent variable.
○ Internal validity: Extent to which the experimental effect can be attributed to
the independent variable. Need for a control group and random assignment.
○ External validity: Extent to which results can be generalized beyond the
study.
● Treatment outcome research: Designed to address a simple question: does
treatment work?
○ Randomized controlled trials: Studies in which clients are randomly
assigned to receive active treatment or a comparison.
● The use of treatment manuals: Detailed books on how to conduct a
particular psychological treatment → to help therapists be more similar in
what they do.
○ Might constrain therapists → not sensitive to unique concerns →
developing manuals that give therapists lots of freedom.
● Defining control groups:
○ No treatment control group → allows to test whether the mere
passage of time helps as much as the treatment does.
, ○ Placebo control group → therapy that consists of support but not the
active ingredient of therapy under study → controls for expectations
of relief.
■ Double-blind procedure: Psychiatrist and patient not told
whether patient receives medication or a placebo → reduction
of bias.
■ Placebo effect: Physical or psychological improvement due to
expectations of help rather than any active ingredient in a treatment.
● Defining a sample: Most studies, though, also exclude many potential participants, a
process that can limit the external validity of findings.
○ One of the major gaps in treatment outcome studies has been the exclusion
of people from diverse cultural and ethnic backgrounds.
● Assessing how well treatments work in the real world: Might include clients with
a broader range of problems and provide less intensive supervision of therapists.
● The need for dissemination of treatment outcome findings: Facilitating adoption
of efficacious treatments in the community by offering guidelines about the best
available treatments along with training on how to conduct those treatments.
● Analogue experiments: Investigators attempt to create or observe a related
phenomenon (an analogue) in the laboratory to allow more intensive study. These
experiments are very helpful but findings must be considered conjointly with studies
not depending on analogues.
○ Testing temporary symptoms produced through experimental manipulations.
○ Testing participants because they’re considered similar to people with certain
diagnoses.
○ Testing animals as a way to understand human behavior.
● Single case experiments: Experimenter studies how one person responds to
manipulations of the independent variable. Potential lack of external validity.
○ ABAB design:
■ A: An initial time period, the baseline
■ B: A period when a treatment is introduced
■ A: A reinstatement of the conditions of the baseline period
■ B: A reintroduction of the treatment (B)
Integrating the findings of multiple studies
Meta-analysis:
● The researcher defines which studies will be included.
● The effect size within each study is calculated.
● The average effect size across studies is calculated
, Chapter 9
Schizophrenia
Clinical descriptions of schizophrenia
Positive symptoms:
● Delusions: Beliefs contrary to reality and firmly held in spite of disconfirming
evidence.
○ Thought insertion: Person may believe that thoughts that are not his or her
own have been placed in his or her mind by an external source.
○ Thought broadcasting: Person may believe that his or her thoughts are
broadcast or transmitted, so that others know what he or she is thinking.
○ Grandiose delusions: Exaggerated sense of his or her own importance,
power, knowledge, or identity.
○ Ideas of reference: Incorporating unimportant events within a delusional
framework and reading personal significance into trivial activities of others.
● Hallucinations: Sensory experiences in the absence of any relevant
stimulation from the environment → can occur in all modalities but most
common in auditory.
Negative symptoms: Consist of behavioral deficits.
● Avolition: Lack of motivation and a seeming absence of interest in or
inability to persist in what are routine activities → work or school, hobbies,
or social activities.
● Asociality: Severe impairments in social relationships → few friends, poor
social skills, and very little interest in being with other people.
● Anhedonia: Loss of interest in or a reported lessening of the experience of pleasure.
○ Consummatory pleasure: Amount of pleasure experienced in-the-moment
or in the presence of something pleasurable.
○ Anticipatory pleasure: Amount of expected or anticipated pleasure from
future events or activities.
● Blunted affect: Lack of outward expression of emotion → may stare
vacantly, the muscles of the face motionless, the eyes lifeless and when
spoken to, may answer in a flat and toneless voice and doesn’t look at
conversation partner.
● Alogia: Significant reduction in the amount of speech production → don’t
talk much.
Disorganized symptoms:
● Disorganized speech: Problems in organizing ideas and in speaking so that
a listener can understand → problems in executive functioning.
○ Loose associations/derailment: Person may be more successful in
communicating with a listener but has difficulty sticking to one topic.
● Disorganized behavior: They seem to lose the ability to organize their
behavior and make it conform to community standards → dress in unusual
clothes, act in a childlike or silly manner, hoard food, or collect garbage.
○ Catatonia: May gesture repeatedly, using peculiar and complex sequences of
finger, hand, and arm movements, which often seem to be purposeful.
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