In this chapter we explore some of the most important issues in psychology. We learn what we know about psychology from our research and it is critical that students of psychology understand the components of a research study as well as the ethical issues involved in conducting research.

Review this section in the textbook. More information on

research methods

can be found in this chapter. 

Recognize that all elements of a research study and design are important. However, for this discussion, tell us what you think are the three most critical issues for a researcher to consider. Also include what you see as particular problems in researching psychological disorders.

 This site is part of the American Psychological Society. It includes

psychology research on the Internet.

The American Psychological Association’s guidelines for the

ethical use and care of animals in research

. 

 This Learning Module item should open in a new window. If not, then click the link below.

Click to Launch

This program will help you review

basic research issues

REFERENCE TO ALL SITES AND POWERPOINT

Abnormal Psychology:
Past and Present

chapter one

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Abnormal Psychology:
Past and Present
What is ABNORMAL PSYCHOLOGY?
Scientific study of abnormal behavior in an effort to describe, predict, explain, and change abnormal patterns of functioning
Workers in the field may be:
Clinical scientists
Clinical practitioners

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

When did these and similar words (including slang terms) make their debut in print as expressions of psychological dysfunction?
The Oxford English Dictionary offers the above terms and dates.
VERBAL DEBUTS
There was a time not that long ago when terms used today did not exist.

PSYCH WATCH

What Is Psychological Abnormality?
Many definitions have been proposed, yet none has won total acceptance
Most definitions, however, have four features in common: “The Four Ds”
DEVIANCE
DISTRESS
DYSFUNCTION
DANGER
While this definition is a useful starting point, it has key limitations

DEVIANCE – Different, extreme, unusual, perhaps even bizarre
DISTRESS – Unpleasant and upsetting to the person
DYSFUNCTION – Interfering with the person’s ability to conduct daily activities in a constructive way
DANGER – Posing risk of harm
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Common Features of
Psychological Abnormality

From what?
From behaviors, thoughts, and emotions that differ markedly from a society’s ideas about proper functioning
From SOCIAL NORMS
Stated and unstated rules for proper conduct
Abnormal behavior tends to be dysfunctional – it interferes with daily functioning
Here again culture plays a role in the definition of abnormality
Abnormal behavior may become dangerous to oneself or others
Behavior may be consistently careless, hostile, or confused
Although often cited as a feature of psychological abnormality, research suggests that dangerousness is the exception rather than the rule
Examples?
Judgments of abnormality vary from society to society as norms grow from a particular culture
They also depend on specific circumstances
Examples?
According to many clinical theorists, behavior, ideas, or emotions usually have to cause distress before they can be labeled abnormal
Not always the case
Examples?
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Deviance

From what?

Distress

Behavior, ideas, or emotions

Dysfunction

Abnormal behavior tends to interfere with daily functioning

SOCIAL NORMS and societal values

Specific circumstances or context

Usually have to cause distress before being labeled abnormal

Culture plays a role

Danger

Dangerous to oneself or others

May be exception rather than the rule

MARCHING TO A DIFFERENT DRUMMER: ECCENTRICS
Eccentrics
Deviate from common behavior patterns or display odd or whimsical behavior (Dictionary)
Possess many common characteristics: Nonconformity, creativity, strong curiosity, idealism, extreme interests and hobbies, lifelong awareness of being different, high intelligence, outspokenness, disinterests in others, noncompetitiveness, unusual eating and living habits, eldest or only child, poor spelling skills (Weeks and others)
Do not typically suffer from mental disorders or severely disrupted thought processes (Weeks)
Lady Gaga
Musical Eccentric?

PSYCH WATCH

The Elusive Nature of Abnormality
A society selects general criteria for defining abnormality and then uses those criteria to judge particular cases
Szasz finds the concept of mental illness to be invalid, a myth of sorts
Do you know why?

Szasz finds the concept of mental illness to be invalid, a myth of sorts.
Deviations called “abnormal” are only “problems of living.”
Societies invent the concept of mental illness to better control or change people who threaten social order.
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The Elusive Nature of Abnormality
Even if we assume that psychological abnormality is a valid concept
Our definition may not be applied consistently
Criteria often are vague and subjective
Few categories of abnormality are clear-cut; most continue to be debated by clinicians

Although abnormality generally is defined as behavior that is deviant, distressful, dysfunctional, and sometimes dangerous, these criteria often are vague and subjective.
Examples:
Diagnosis of alcohol problems in colleges
Issue of abnormality versus eccentricity
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What Is Treatment?
TREATMENT, OR THERAPY
Procedure designed to change abnormal behavior into more normal behavior
Clinical treatment requires a careful definition
Carl Rogers
Jerome Frank
Others

Once clinicians decide that a person is suffering from abnormality, they seek to treat it.
Treatment requires careful definition.
Carl Rogers
“Therapists are not in agreement as to their goals or aims. . . . They are not in agreement as to what constitutes a successful outcome of their work. They cannot agree as to what constitutes a failure. It seems as though the field is completely chaotic and divided.”
According to Jerome Frank, all forms of therapy have three essential features:
A sufferer who seeks relief from the healer
A trained, socially accepted healer, whose expertise is accepted by the sufferer and his or her social group
A series of contacts between the healer and the sufferer, through which the healer tries to produce certain changes in the sufferer’s emotional state, attitudes, and behavior
Others
Abnormality as illness: therapy cures
Abnormality as problem in living: therapy teaches
Clinical treatment is surrounded by conflict and confusion:
Lack of agreement about goals or aims
Lack of agreement about successful outcome
Lack of agreement about failure
Are clinicians seeking to cure? To teach?
Are sufferers patients (ill) or clients (having difficulty)?

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What Is Treatment?
But…despite their differences, most clinicians agree that large numbers of people need therapy of one kind or another
Evidence also indicates that therapy is indeed often helpful

How Was Abnormality Viewed
and Treated in the Past?
In any given year as many as 30 percent of adults and 19 percent of children and adolescents in the United States display serious psychological disturbances and are in need of clinical treatment
In addition, most people have difficulty coping at various times
Is this the fault of modern society?

Although modern pressures may contribute, they are hardly the primary cause; every society, past and present, has witnessed psychological abnormality.
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

How Was Abnormality Viewed
and Treated in the Past?
Many present-day ideas and treatments have roots in the past
Let’s take a look on the next slides

Ancient Views and Treatments
Ancient societies probably regarded abnormal behavior as the work of evil spirits
Treatment for severe abnormality was to force the demons from the body through trephination and exorcism
The two holes in this skull recovered from ancient times indicate that the person underwent trephination

Ancient societies probably regarded abnormal behavior as the work of evil spirits.
This view may have begun as far back as the Stone Age.
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Greek and Roman
Views and Treatments
500 B.C. to 500 A.D.
Philosophers and physicians offered different explanations and treatments for abnormal behaviors
Hippocrates believed and taught that illnesses had natural causes
Looked to an imbalance of the four fluids, or humors
Sought to correct the underlying physical pathology

To treat psychological dysfunction, Hippocrates sought to correct the underlying physical pathology.
Four fluids, or humors, that flowed through the body: yellow bile, black bile, blood, and phlegm
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Europe in the Middle Ages: Demonology Returns
500 – 1350 A.D.
The church rejected scientific forms of investigation and religious beliefs dominated all aspects of life
Abnormality greatly increased, was seen as a conflict between good and evil, and often subject to demonological treatment
At the end of the Middle Ages
Demonology and its methods began to lose favor again

500 – 1350 A.D.
The church rejected scientific forms of investigation and controlled all education.
Religious beliefs dominated all aspects of life.
Once again, abnormality was seen as a conflict between good and evil.
Abnormal behavior apparently increased greatly during this period.
Some of the earlier demonological treatments reemerged.
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The Renaissance
and the Rise of Asylums
1400 – 1700 A.D.
Demonological views of abnormality continued to decline
German physician Johann Weyer believed that the mind was as susceptible to sickness as the body
The care of people with mental disorders continued to improve in this atmosphere

The Renaissance
and the Rise of Asylums
Shrines
Across Europe, religious shrines were devoted to the humane and loving treatment of people with mental disorders
Asylums
There was a rise of asylums where the mentally ill became virtual prisoners due to overcrowding
The “crib”
Outrageous devices and techniques, such as the “crib,” were used in asylums, and some continued to be used even during the reforms of the nineteenth
century.

Across Europe, religious shrines were devoted to the humane and loving treatment of people with mental disorders.
One, at Gheel, became a community mental health program of sorts.
Unfortunately, this time also saw a rise of asylums – institutions whose primary purpose was care of the mentally ill.
The intention was good care, but because of overcrowding they became virtual prisons.

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The Nineteenth Century:
Reform and Moral Treatment
As 1800 approached
Treatment of people with mental disorders began to improve once again
Advocacy for more moral treatment emerged
Pinel (France) and Tuke (England)
Benjamin Rush and Dorothea Dix (U.S.)
By the end of the nineteenth century, reversal of the moral treatment movement began

Pinel (France) and Tuke (England) advocated moral treatment – care that emphasized moral guidance and humane and respectful techniques.
In the United States, Benjamin Rush (father of American psychiatry) and Dorothea Dix (Boston schoolteacher) were the primary proponents of moral treatment.
Dix’s work led to the creation of state hospitals.
By the end of the nineteenth century, several factors led to a reversal of the moral treatment movement:
Money and staff shortages
Declining recovery rates
Overcrowding
Emergence of prejudice

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The Early Twentieth Century:
Dual Perspectives
As the moral movement was declining in the late 1800s, two opposing perspectives emerged

By the early years of the twentieth century
The moral treatment movement had ground to a halt; long-term hospitalization became the rule once again
As the moral movement was declining in the late 1800s, two opposing perspectives emerged
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The Somatogenic Perspective

Abnormal functioning has physical causes

The Psychogenic Perspective

Abnormal functioning has psychological causes

The Early Twentieth Century:
The Somatogenic Perspective
Two factors were responsible for the rebirth of this perspective
Argument that physical factors (such as fatigue) are responsible for mental dysfunction
New biological discoveries
Biological approaches yielded mostly disappointing and sometimes immoral solutions
Eugenics
A number of effective medications were finally discovered

The somatogenic perspective has at least a 2,400-year history.
Two factors were responsible for the rebirth of this perspective:
Emil Kraepelin’s textbook argued that physical factors (such as fatigue) are responsible for mental dysfunction
New biological discoveries were made, such as the link between untreated syphilis and general paresis
Biological approaches yielded mostly disappointing results throughout the first half of the twentieth century.
A number of effective medications were finally discovered.
See Table 1.1 for additional information about eugenics and mental disorders.

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The Early Twentieth Century:
The Psychogenic Perspective

Perspective was based on work of
Friedrich Mesmer and hysterical disorders
Recent research has clarified, however, that hypnotic procedures are as capable of creating false memories as they are of uncovering real memories.
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Hypnotism

Perspective based on work of

Breuer

Psychoanalysis

Perspective holds that many forms of abnormal and normal psychological function are psychogenic

Mesmer and hysterical disorders

Recent research

Hypnotic procedures are as capable of creating false memories as they are of uncovering real memories

Freud

Unconscious psychological processes

Techniques of psychoanalysis developed

Current Trends
This not yet a period of great enlightenment about or dependable treatment of mental disorders
43 percent of people surveyed believe that people bring mental health disorders upon themselves
35 percent consider mental health disorders to be caused by sinful behavior
Past half century has brought major changes in the ways clinicians understand and treat abnormal functioning—and more disagreements

How Are People with Severe Disturbances Cared For?
In the 1950s, researchers discovered a number of new psychotropic medications
Antipsychotic drugs
Antidepressant drugs
Antianxiety drugs
These discoveries led to deinstitutionalization and a rise in outpatient care
This change in care was not without problems
Can you identify any of these problems?
The impact of deinstitutionalization in the United States

As a result, hundreds of thousands of persons with severe disturbances fail to make lasting recoveries, and they shuttle back and forth between the mental hospital and the community. After release from the hospital, they at best receive minimal care and often wind up living in decrepit rooming houses or on the streets.
At least 100,000 people with such disturbances are homeless on any given day; another 135,000 or more are inmates of jails and prisons. Their abandonment is truly a national disgrace.
The approach has been helpful for many patients, but too few community programs are available in the United States; only 40 to 60% of those with severe disturbances receive treatment of any kind
Figure 1-1
The impact of deinstitutionalization
The number of patients (fewer than 40,000) now hospitalized in public mental hospitals in the United States is a small fraction of the number hospitalized in 1955. (Information from: Althouse, 2010; Torrey, 2001; Lang, 1999.)
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

How Are People with Less Severe Disturbances Treated?
Since the 1950s
Outpatient care has continued to be the preferred mode of treatment for those with moderate disturbances
Once exclusive to private psychotherapy
Now covered by most health insurance plans
Includes various settings and specialty care

How Are People with Less Severe Disturbances Treated?
Surveys suggest
Nearly 1 in 6 adults in the United States receives treatment for psychological disorders in the course of a year
Majority receive fewer than 5 sessions
Outpatient treatments are becoming available for more kinds of problems
Some outpatient care is devoted exclusively to one kind of psychological problem

A Growing Emphasis on Preventing Disorders and Promoting Mental Health
The community mental health approach has given rise to the prevention movement
Correct the social conditions that underlie psychological problems
Help individuals at risk for developing disorders
Prevention programs have been further energized by the growing interest in POSITIVE PSYCHOLOGY

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

A Growing Emphasis on Preventing Disorders and Promoting Mental Health
POSITIVE PSYCHOLOGY
Clinical practitioners teach people coping skills that may
Help protect them from stress
Encourage them to pursue psychological wellness, meaningful activities, and enriching relationships
Prevent mental disorders
Positive psychology in action

POSITIVE PSYCHOLOGY is the study and promotion of positive feelings such as optimism and happiness, positive traits like hard work and wisdom, positive abilities, and group-directed virtues, including altruism and tolerance.
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Multicultural Psychology
In response to growing diversity in the United States, MULTICULTURAL PSYCHOLOGY has emerged
MULTICULTURAL PSYCHOLOGISTS seek to understand how culture, race, ethnicity, gender, and similar factors affect behavior and thought and how people of different cultures, races, and genders may differ psychologically

The Increasing Influence
of Insurance Coverage
Today the dominant form of insurance coverage is the MANAGED CARE PROGRAM
At least 75 percent of all privately insured persons in the United States are enrolled in managed care programs
Reimbursements for mental disorders tend to be lower than those for medical disorders
Legislation
U.S. Congress federal parity law (2008)
Affordable Care Act (ACA/2014)

MANAGED CARE PROGRAM – A program in which the insurance company determines key care issues
Reimbursements for mental disorders tend to be lower than those for medical disorders; this places persons with psychological difficulties at a distinct disadvantage.
It is not yet clear whether such provisions in the legislation mentioned above will in fact result in better treatment for people with psychological problems.
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What Are Today’s Leading Theories
One of the most important developments in the field of abnormal psychology is growth of numerous THEORETICAL PERSPECTIVES
Psychoanalytic
Biological
Behavioral
Cognitive
Humanistic-existential
Sociocultural
At present, no single perspective dominates the clinical field

What Are Today’s Leading Professions?
In addition to multiple perspectives, a variety of professionals now offer help to people with psychological problems
How many can you identify?

Psychiatrists
Clinical psychologists
Counseling psychologists
Educational and school psychological psychologists
Psychiatric nurses
Marriage therapists
Family therapists
Psychiatric social workers
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Profiles of Mental Health Professionals in the United States
Degree Began to Practice Current Number Average Annual Salary Percent Female
Psychiatrists MD, DO 1840s 50,000 $144,020 25
Psychologists PhD, PsyD, EdD Late 1940s 174,000 $63,000 52
Social workers MSW, DSW Early 1950s 607,000 $43,040 77
Counselors Various Early 1950s 475,000 $47,530 90

Table 1-2
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Technology and Mental Health
Effects of technological change on mental health and psychological dysfunction
Provision of new triggers and tools for abnormal behaviors
Negative consequences of violent media
Contributions to cognitive difficulties
Development and growth of CYBERTHERAPY (offered by professionals and non-professionals)

MIND TECH

How can consumers optimize the chance of good outcomes when using a mental health app today?
New tools for stalking or bullying others, sexual exhibitionism, and pedophilic desires
CYBERTHERAPY The use of computer technology, such as Skype or avatars, to provide therapy. In the absence of regulation and proper research, consumers and therapists alike would be wise to investigate the reputation, manufacturer, content, and therapeutic principles of apps that they are considering.
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What Do Clinical Researchers Do?
Clinical researchers face certain challenges that make their work very difficult
They work to discover universal laws, or principles, of abnormal psychological functioning
Search for NOMOTHETIC UNDERSTANDING
Typically do not assess, diagnose, or treat individual clients
Rely on the scientific method to pinpoint relationships between variables

Search for NOMOTHETIC UNDERSTANDING
General or universal laws or truths
Clinical researchers face certain challenges that make their work very difficult:
Measuring unconscious motives
Assessing private thoughts
Monitoring mood changes
Calculating human potential
Clinical researchers must consider different cultural backgrounds, races, and genders of the people they study.
They must always ensure that the rights of their research participants, both human and animal, are not violated.

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What Do Clinical Researchers Do?
Three methods of investigation are used to form and test hypotheses and to draw broad conclusions
Case study
Correlational method
Experimental method

The Case Study

Freud’s theories based mainly on case studies
Limitations addressed by the two other methods of investigation
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Definition: Case study

Provides a detailed, interpretative description of a person’s life and psychological problems

Advantages

Can be a source of new ideas about behavior

May offer tentative support for a theory

May challenge a theory’s assumptions

May inspire new therapeutic techniques

May offer opportunities to study unusual problems

Limitations

May include reports by biased observers

Relies on subjective evidence

Provides little basis for generalization

The Correlational Method

Freud’s theories are based mainly on case studies.
Limitations are addressed by the two other methods of investigation.
Preferred method of clinical investigation
Typically involve observing many individuals
Researchers apply procedures uniformly
Studies can be replicated
Researchers use statistical tests to analyze results.
Correlations can be trusted based on a STATISTICAL ANALYSIS OF PROBABILITY.
They ask how likely it is that the study’s particular findings have occurred by chance.

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Definitions

CORRELATION is the degree to which events or characteristics vary with each other

Advantages

Can be trusted based on STATISTICAL ANALYSIS OF PROBABILITY

Measures variables, observes participants, and applies statistical analyses

Limitations

Does not explain the relationship

CORRELATIONAL METHOD is a research procedure used to determine the “co-relationship” between variables

Can repeat studies with new samples to check earlier study results and generalize findings

Does not explain causation

Can determine co-relationships between variables

Correlations

Relationships
When variables change the same way, their correlation is said to have a POSITIVE direction.
In a NEGATIVE correlation, the value of one variable increases as the value of the other variable decreases.
Variables also may be UNRELATED, meaning there is no consistent relationship between them.
The magnitude (strength) of a correlation is also important.
HIGH MAGNITUDE = variables that vary closely together
LOW MAGNITUDE = variables that do not vary as closely together
Direction and magnitude of a correlation are often calculated numerically.
This statistic is the “CORRELATION COEFFICIENT.”
The correlation coefficient can vary from +1.00 (perfect positive correlation) to -1.00 (perfect negative correlation).
SIGN (+ or -) indicates direction.
NUMBER indicates magnitude.
0.00 = no consistent relationship
Most correlations found in psychological research fall far short of “perfect.”

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Correlational relationships

POSITIVE correlation

NEGATIVE correlation

UNRELATED correlation

Correlational strength or magnitude

HIGH MAGNITUDE

LOW MAGNITUDE

Correlational numerical calculation

CORRELATION COEFFICIENT

Perfect positive correlation to perfect negative correlation

SIGN

NUMBER

Special Forms of Correlational Research
EPIDEMIOLOGICAL STUDIES
Reveal the incidence and prevalence of a disorder in a particular population
INCIDENCE
PREVALENCE
Epidemiologic Catchment Area Study
LONGITUDINAL STUDIES
Involve observation of same individuals on many occasions over a long period

Incidence = Number of new cases that emerge in a given period
Prevalence = Total number of cases in a given period
Over the past 40 years, clinical researchers throughout the United States have worked on one of the largest epidemiological studies of mental disorders ever conducted, called the Epidemiologic Catchment Area Study.
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Most Investigated Correlational Questions in Clinical Research
Most Common Correlational Questions
Are stress and onset of mental disorders related?
Is culture (or gender or race) generally linked to mental disorders?
Are income and mental disorders related?
Are social skills tied to mental disorders?
Is social support tied to mental disorders?
Are family conflict and mental disorders related?
Is treatment responsiveness tied to culture?
Which symptoms of a disorder appear together?
How common is a disorder in a particular population?

Twins, Correlation, and Inheritance
Correlational studies of many pairs of twins have suggested a link between genetic factors and certain psychological disorders. Identical twins (who have identical genes) display a higher correlation for some disorders than do fraternal twins (whose genetic makeup is not identical).

These healthy twin sisters are participating in a twin cultural festival at Honglingjin Park in Beijing, China.
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The Experimental Method
EXPERIMENT is a research procedure in which a variable is manipulated and the manipulation’s effect on another variable is observed
INDEPENDENT variable
DEPENDENT variable
Questions about causal relationships can only be answered by an experiment

Manipulated variable = INDEPENDENT variable
Variable being observed = DEPENDENT variable
Experimental method allows researchers to ask questions such as: Does a particular therapy relieve the symptoms of a particular disorder?”

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The Experimental Method
Statistics and research design are very important
Researchers must try to eliminate all CONFOUNDS
Three features are included in experiments to guard against confounds:
Control group
Random assignment
Bias, blind, and double-blind design

Researchers must try to eliminate all CONFOUNDS – variables other than the independent variable that may also be affecting the dependent variable.
A CONTROL GROUP is a group of research participants who are not exposed to the independent variable, but whose experience is similar to that of the experimental group.
By comparing the two groups, researchers can better determine the effect of the independent variable.
Researchers must also watch out for differences in the makeup of the experimental and control groups.
To do so, researchers use RANDOM ASSIGNMENT – any selection procedure that ensures that every participant in the experiment is as likely to be placed in one group as in another.
A final confound problem is bias.
To avoid bias by the participant, experimenters employ a “BLIND DESIGN,” in which participants are kept from knowing which assigned group (experimental or control) they are in.
One strategy for this is providing a PLACEBO – something that simulates real therapy but has none of its key ingredients.
To avoid bias by the experimenter, experimenters employ a “DOUBLE-BLIND DESIGN,” in which the experimenters and the participants are kept from knowing which condition of the study participants are in.
Often used in medication trials

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Alternative Experimental Designs
It is not easy to devise an experiment that is both well controlled and enlightening
Clinical researchers often must settle for designs that are less than ideal
QUASI-EXPERIMENTAL, or MIXED, DESIGNS
NATURAL EXPERIMENTS
ANALOGUE EXPERIMENTS
SINGLE-SUBJECT EXPERIMENTS
REVERSAL DESIGN
Can you give an example for each of these?

In QUASI-EXPERIMENTAL, or MIXED, DESIGNS, investigators do not randomly assign participants to groups, but make use of groups that already exist.
Example: Children with a history of child abuse
To address the problem of confounds, researchers use MATCHED CONTROL GROUPS.
These groups are “matched” to the experimental group based on demographic and other variables.
In NATURAL EXPERIMENTS, nature manipulates the independent variable and the experimenter observes the effects.
Example: Psychological impact of flooding
ANALOGUE EXPERIMENTS allow investigators to freely manipulate independent variables while avoiding ethical and practical limitations.
They induce laboratory subjects to behave in ways that seem to resemble real life.
Example: Animal subjects
In a SINGLE-SUBJECT EXPERIMENT, a single participant is observed both before and after manipulation of an independent variable.
An example is the ABAB, or reversal, design.
In an ABAB (REVERSAL) DESIGN
Participant’s reactions are measured during a baseline period (A), after the introduction of the independent variable (B), after the removal of the independent variable (A), and after reintroduction of the independent variable (B).

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Most Investigated Causal Questions in Clinical Research
Most Common Causal Questions
Does factor X cause a disorder?
Is cause A more influential than cause B?
How does family communication and structure affect family members?
How does a disorder affect the quality of a person’s life?
Does treatment X alleviate a disorder?
Is treatment X more helpful than no treatment at all?
Is treatment A more helpful than treatment B?
Why does treatment X work?
Can an intervention prevent abnormal functioning?

Table 1-4
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

The study: Spitzer’s (2001) research on “reparative” therapy
The findings: By undergoing reparative therapy, the paper claimed, gay men and women could change their sexual orientation
The recantation: Spitzer (2012) revealed two serious flaws in his study: Unreliable self-reports and lack of control group
The consequences: Then… and now?
Flawed Study, Gigantic Impact
Protesting reparative therapy

MEDIA SPEAK

Protesting reparative therapy Protestors from a gay rights group in Hong Kong hold up a banner outside a social welfare department in 2011 to protest the department’s endorsement of reparative therapy.
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What Are the Limits of Clinical Investigations?
The field has yet to agree on one definition of abnormality
Currently made up of conflicting schools of thought and treatment
Members are often unimpressed by the claims and accomplishments of the others
Clinical practice is carried out by a variety of professionals trained in different ways
Current research methods each have flaws that limit our knowledge and use of clinical information

Protecting Human Participants
Human research participants have needs and rights that must be respected
Researchers’ primary obligation is to avoid physically or psychologically harming the human participants in their studies
INSTITUTIONAL REVIEW BOARD (IRB)
An ethics committee in a research facility that is empowered to protect the rights and safety of human research participants

Institutional Review Board

Government doctors and researchers conducted the Tuskegee Syphilis Study, a research undertaking conducted from 1932 to 1972, prior to the emergence of Institutional Review Boards. In this infamous study, 399 participants were not informed that they had the disease, and they continued to go untreated even after it was discovered that penicillin is an effective intervention for syphilis.
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

IRB Participant Rights

IRB Limitations

Unclear informed consent forms

Voluntary participation

Informed consent

Right to end participation at any time

Study benefits outweigh costs/risks

Protection from physical and psychological harm

Access to study information

Protection of privacy (confidentiality or anonymity)

Subtle and elusive notions not easily translated into regulations

Ethical decisions influenced by differences in perspective, interpretation, and decision-making style