1. Clinical Research, Assessment, and Diagnosis in Abnormal Psychology
Chapter Three
Clinical Research, Assessment, and Diagnosis in Abnormal Psychology

2. Clinical Research, Assessment, and Diagnosis in Abnormal Psychology
Psychopathology:
Study of mental or behavioral disorders
Etiology:
Cause or origin of a disorder

3. The Scientific Method in Clinical Research
Replication:
Results repeated in multiple studies to reduce the chance of findings due to experimenter bias, methodological flaws, or sampling errors
Scientific method:
Provides systematic collection of data, controlled observation, and the testing of hypotheses
Hypothesis:
Conjectural statement that usually describes a relationship between two variables

4. The Case Study Case study:
Intensive study of one individual that relies on clinical data, such as observations, psychological tests, and historical and biographical information
Provides detailed information about development and psychopathology in a specific individual
Helps to develop a strong therapeutic relationship

5. The Case Study (cont’d.)
Limitations:
Findings cannot be generalized to others
Data reflects theoretical perspective or bias of investigator
Cannot be used to demonstrate cause and effect relationships

6. Correlational Studies
Statistical analysis preformed to determine the relationship between variables
Positive correlation:
Increase in one variable accompanied by increase in the other
Negative correlation:
Increase in one variable accompanied by decrease in the other

7. Correlational Studies (cont’d.)
Figure 3-1 Possible Correlation Between Two Variables The more closely the data points approximate a straight line, the greater the magnitude of the correlation coefficient r. The slope of the regression line rising from left to right in example (a) indicates a perfect positive correlation between two variables, whereas example (b) reveals a perfect negative correlation. Example (c) shows a lower positive correlation. Example (d shows no correlation whatsoever.

8. Correlational Studies (cont’d.)
Allow for the study of variable that cannot be controlled
Correlations indicate the degree to which two variables are related, not the reason for the relationship
Cannot determine cause and effect
Factors may be influenced by an additional variable

9. Experiments Experiment: In its simplest form, an experiment involves:
Perhaps best tool for testing cause and effect relationships because variables can be manipulated
In its simplest form, an experiment involves:
Experimental hypothesis
Independent variable
Dependent variable

10. Experiments (cont’d.) Experimental hypothesis: Independent variable:
Prediction concerning how an independent variable will affect dependent variable
Independent variable:
(Possible cause) experimenter manipulates to determine effect on dependent variable
Dependent variable:
Expected to change when an independent variable is manipulated

11. Experiments (cont’d.) Experimental group: Control group:
Subjected to independent variable
Subjective: taking place in person’s own mind
Control group:
Similar in every way to experimental group except for exposure to independent variable
Placebo control group:
Induces expectancy without actual treatment (no manipulation at all)

12. Experiments (cont’d.) Additional controls in clinical research:
Blind design:
Those helping with the study are not aware of research
Reduces impact of experimenter expectations
Double-blind design:
Neither participants nor experimenters are aware of experimental conditions
Reduces impact of experimenter and participant expectations
Researchers attempt to increase degree of blindness and decrease expectancy effects

13. Experiments (cont’d.) Shortcomings:
Effectiveness of blind designs depends on participants being truly “blind”
Some variables cannot be manipulated
Questions regarding generalizability of results

14. Analogue Studies
Replicate or simulate real-life situations under controlled conditions
Used when not possible to control all variables in real-life situations
Advantage: allows study of phenomenon using experimental designs that are not possible with correlation studies

15. Field Studies
Behaviors and events are observed and recorded in their natural environment
Sometimes used to examine catastrophic events or personal crises
Offer a more realistic investigative environment

16. Field Studies (cont’d.)
Limitations:
Cannot be used to determine cause and effect relationships
Many factors affecting real-life situations makes it impossible to control and distinguish all possible variables (difficult to interpret)
Observer can never be sure their presence did not influence interactions they observed

17. Biological Research Strategies
Genetics and epigenetics:
Focus on influence of specific genes in development of psychopathology
Epigenetics:
Shedding light on how the environment influences or programs gene expression
Genetic linkage studies:
Attempts to determine whether a disorder follows a genetic pattern

18. Biological Research Strategies (cont’d.)
Endophenotypes:
Measurable characteristics (neurochemical, cognitive, etc.) that can give clues regarding specific genes involved in a disorder
Characteristics must be heritable
Seen in family members who do not have the disorder
Occur more frequently in affected families than in the general population

19. Biological Research Strategies (cont’d.)
Epidemiological survey research:
Study of the rate and distribution of mental disorders in the population
Prevalence:
Percentage of individuals in targeted population with a particular disorder during a specific period of time
Incidence:
Number of new cases of a disorder that appear in an identified population within a specific period of time
Important in analyzing possible causal factors

20. Assessment of Abnormal Behavior
Therapists collect and organize information about a person’s current condition and past history to better understand symptoms and mental state
Psychodiagnosis:
Description of an individual's psychological state and inferences about possible causes of distress

21. Reliability and Validity
Degree to which a procedure yields the same results repeatedly under the same circumstances
Test-retest reliability:
Same results when given at two different points in time
Internal consistency:
Various parts of measure yield similar or consistent results
Inter-rater reliability:
Consistency of responses when different raters administer measure

22. Reliability and Validity (cont’d.)
Degree to which an instrument measures what it was developed to measure
Predictive validity:
Is measure able to predict how a person will behave, respond, or perform
Construct validity:
Is measure related to phenomena related to measure

23. Reliability and Validity (cont’d.)
Standardization:
Crucial to reliability and validity of tests
Administration of all testing requires that common rules and procedures are followed
Requires a comparison group to which an individual’s test performance can be compared

24. Assessing Abnormal Behavior
Assessment:
Process of gathering information and drawing conclusions about an individual’s traits, skills, abilities, emotional functioning, and psychological problems of an individual
Principal means of assessment:
Observations
Interviews
Psychological tests and inventories
Neurological tests

25. Assessing Abnormal Behavior (cont’d.)
Observations:
Controlled (analogue) observations:
Made in laboratory, clinic, or other contrived setting
Naturalistic observations:
Made in natural setting (schoolroom, office, hospital ward, home)
Can be highly structured and specific or less formal
Observe appearance and behavior

26. Assessing Abnormal Behavior (cont’d.)
Interviews:
Observe client and collect data about the person’s life history, current situation, and personality
Analyze:
Verbal behavior
Nonverbal behavior
Content
Process of communication

27. Assessing Abnormal Behavior (cont’d.)
Interviews:
Vary in degree of structure and formality with which they are conducted
Mental status examination:
Evaluate individual’s cognitive, psychological, and behavioral functioning
Useful diagnostic tool
Fallible and subjective

28. Assessing Abnormal Behavior (cont’d.)
Psychological tests and inventories:
Standardized instruments used to assess:
Personality
Maladaptive behavior
Social skills
Intellectual abilities
Vocational interests
Cognitive impairment

29. Assessing Abnormal Behavior (cont’d.)
Projective personality tests:
Test taker is presented with ambiguous stimuli and is asked to respond to them in some way
Rorschach Technique
Thematic Apperception Test (TAT)
Sentence-completion test
Draw-a-person test
Limited support for interpretations of TAT, Rorschach, and draw-a-person test
Questionable cultural relevance

30. Assessing Abnormal Behavior (cont’d.)
Self-report inventories:
Test taker answers specific written questions or selects specific responses from a list of alternatives
Minnesota Multiphasic Personality Inventory (MMPI and MMPI-2)
Most widely used
Beck Depression Inventory (BDI)

31. Assessing Abnormal Behavior (cont’d.)
Figure 3-2 The 10 MMPI-2 Clinical Scales and Some MMPI-2 Items Shown here are the MMPI-2 clinical scales and a few of the items that appear on them. As an example, answering “no” or “false” (rather than “yes” or “true”) to the item “I have a good appetite” would result in a higher scale score for hypochondriasis, depression, and hysteria.
Source: Adapted from Dahlstrom & Welsch, (1965). These items from the original MMPI remain unchanged in the MMPI-2.

32. Assessing Abnormal Behavior (cont’d.)
Limitations of self-report inventories:
Fixed number of choices hinder accurate presentation
Unique response sets may distort results
Interpretations of responses may be inaccurate if culture context is not addressed
Cultural factors may shape way a trait or characteristic is viewed

33. Assessing Abnormal Behavior (cont’d.)
Intelligence tests:
Obtain intelligence quotient (IQ), or estimate of current level of cognitive functioning
Wechsler scales
Stanford-Binet scales

34. Assessing Abnormal Behavior (cont’d.)
Table 3-2 Items Similar to Those for the Wechsler Adult Intelligence Scale-IV

35. Assessing Abnormal Behavior (cont’d.)
Criticisms of intelligence tests:
Popularized as measuring innate intelligence, but actually reflect cultural and social factors
Predictive validity
Inadequacies of current conceptions of IQ tests
Misses multidimensional attributes of intelligence

36. Assessing Abnormal Behavior (cont’d.)
ABC Video: Measure of IQ Can IQ tests accurately measure how smart you are or determine your future success? The theory of multiple intelligence may explain why traditional IQ tests may not always be an accurate measure of intelligence.

37. Assessing Abnormal Behavior (cont’d.)
Tests for cognitive impairment:
Detect and assess cognitive impairment
Bender-Gestalt Test
Halstead-Reitan Neuropsychological Test Battery
Are widely used and have been found to be effective and valid in evaluating cognitive impairment due to brain damage

38. Assessing Abnormal Behavior (cont’d.)
Figure 3-4 The Nine Bender Designs The figures presented to participants are shown on the left. The distorted figures drawn by an individual with suspected brain damage are shown on the right.
Source: L. Bender, (1938)

39. Assessing Abnormal Behavior (cont’d.)
Neurological tests:
Electroencephalograph (EEG)
Computerized axial tomography (CT) scan
Magnetic resonance imaging (MRI)
Positron emission tomography (PET) scan
Increase diagnostic accuracy and understanding when coupled with psychological tests

40. Assessing Abnormal Behavior (cont’d.)
ABC Video: MRI as a Lie Detector Learn about the experimental use of Functional Magnetic Resonance Imaging to map activity in the region of the brain used for deception.

41. Diagnosis and Classification of Abnormal Behavior
Classification system:
Provides distinct categories, indicators, and diagnostic names for particular patterns of behavior, thought processes, and emotional disturbances
Means of diagnosing disorders
Facilitates communication between mental health professionals
Forms foundation for research

42. Diagnostic and Statistical Manual of Mental Disorders (DSM)
Widely used classification system
Lists all officially designated mental disorders and the characteristics or symptoms needed to confirm diagnosis
Traditionally a categorical system but most recently proposed as a dimensional model

43. Diagnostic and Statistical Manual of Mental Disorders (cont’d.)
DSM-5:
Dimensional system:
Disorders lie on a continuum with “normality” at one end
Includes culturally focused interview
Comorbidity:
The co-occurrence of different disorders

44. Evaluation of the DSM Classification System
Positive aspects of DSM-5:
Moves away from a categorical system and towards a dimensional system
Developed to increase reliability and validity
Criticisms of DSM-5:
Lowers diagnostic thresholds
Inclusion of questionable “new disorders”
Cultural concerns
Focus on resilience:
Should strengths be assessed?