Abnormal Psych Ch. 3

Validity

(= accuracy) is the degree to which a technique measures what it is designed to measure. i. Comparing the results of one assessment measure with the results of others helps determine concurrent/descriptive validity. ii. Predictive validity is how well the assessment predicts what will happen in the future. iii. One can have high reliability without validity, but not validity without reliability. For instance, two independent raters may agree perfectly in how they coded some behaviors (i.e., high reliability), but show low validity because they both coded the wrong behaviors systematically.

Reliability

(= consistency) is the most important requirement of assessment procedures and is the degree to which a measure is consistent. Consistency across two or more raters is called interrater reliability, whereas consistency across time is referred to as test-retest reliability.

research by experiment

1. Instead of simply measuring two things, an experiment involves the manipulation of an independent variable under carefully controlled conditions and the observation of its effects of the dependent variable(s) of interest. a. The independent variable is manipulated systematically to address the question of causality. Confounding variables are controlled for in laboratory settings. 2. Group experimental designs a. In group experimental designs, researchers introduce, change, and/or withdraw an independent variable to assess how that change influences the behavior of individual members of different groups (called manipulating a variable). 3. Typically use control groups a. Similar to the experimental group in every way except that they are not exposed to the independent variable. b. The placebo effect involves a behavioral change or outcome resulting from expectation alone and not from any experimental manipulation. Placebo control groups control for the possibility that changes observed in the study may have been due simply to the expectation of getting better (e.g., people getting the active treatment may believe it will help them, whereas those in the control group may be disappointed). A placebo in medicine is an inactive medication, but in psychology, having a true placebo control group is more difficult. Use of a placebo control group helps to distinguish effects due to positive expectations from effects resulting from the actual treatment. g. A double-blind control is a variant of the placebo control group procedure, where both the participants and researchers or therapists are blind (i.e., unaware) of what group they are in or what treatment they are given, including in some cases the diagnostic status of the patient. The double-blind procedure is used to control for subject expectations, but also researcher and therapist bias, particularly bias related to allegiance or belief in the superiority of a particular form of treatment (i.e., the allegiance effect). The double blind procedure is not perfect, however. 4. Comparative treatment research But, what if you want to know if a specific type of treatment is better than a different form of treatment? a. In this design, two or more comparable groups of people with a particular disorder are selected and provided with different forms of treatment. The goal is to determine which form of treatment is most effective. b. The process and outcome of treatment are two important issues that can be addressed with this particular design. i. With regard to treatment process, the question is "Why does the treatment work?" The answer may be found by addressing therapist, therapy (i.e., active ingredients), and client variables that may operate alone or in combination to produce beneficial outcome. ii. Outcome research focuses on the positive and/or negative consequences of treatment. The questions addressed here are "Does the treatment work?" and "Do the positive benefits of therapy outweigh the potential negative consequences and risks?"

studying individual cases

1. One way to intensively examine an individual with unique behavioral and physical patterns is the case study method. 2. This method involves extensive observation and clinical description of a person, and can provide important information about a particular disorder, its causes, and treatment. But low internal and external validity. 3. Case studies have been important in the history of psychology (e.g., Freud's development of psychoanalytic theory was based on intensive observations from single cases; Masters and Johnson debunked several myths about sexual behavior).

Research ethics

1. Research must follow ethical and legal guidelines (i.e., American Psychological Association's code of ethics) that are aimed at protecting participants and clients. For instance, all research in university and medical settings must be approved by institutional review boards that focus on protecting research participants. 2. All research participants are afforded the opportunity of informed consent- when research subjects are formally aggress to cooperate in a study only after they receive full disclosure about the nature of the study and their own role in it. They must be capable of consent (e.g., minors are not capable), they must not be coerced, they must have all the information they need to make a decision, and they must understand what participation will entail. 3. Ethics often extend beyond protection of research participants and clients, and include how researchers deal with their data, fraud in science, and giving publication credit to others.

Patient uniformity myth

1. This myth leads researchers to make broad and perhaps inaccurate generalizations about disorders and treatment from groups of treated patients to individuals who may later undergo the treatment. 2. The problem is that the average gains in the treatment group contain persons who got worse or did not improve at all. There is no way to know whether an individual client represents the part of the group that improved, remained the same, or got worse in response to treatment.

research by correlation

1. Unlike experimental designs, correlational designs do not involve the manipulation of an independent variable. Rather, data are sampled from phenomena just as they occur, and are then examined to see how the variables relate with one another. That is, correlation involves mathematical associations among variables. 2. For example: A researcher measured hours spent watching television and obesity in children. Time watching television was positively correlated with obesity. Positive means that when children watched more television, weight also tended to be greater. a. Does not give any information about what caused what--The results of a correlational study simply indicate that two or more dependent variables co-vary together or they do not. As such, correlation does not imply causation. Cannot say that one variable caused another b. The reason is the problem of directionality with regard to causes and effects (e.g., does A cause B, B cause A, or a third variable C [lack of activity, genetics, parenting practices] that causes A and B?). c. Correlation allows for prediction of the value of one variable based on a known value of another, but nothing more.

Genetics

1. We know that there is an interaction between our genetic makeup and our experiences. This interaction determines, in part, how we will develop. The goal of behavioral geneticists (i.e., people who study the genetics of behavior) is to identify the role of genetics in these interactions. i. Genetic researchers examine phenotypes (i.e., the observable characteristics or behaviors of an individual) and genotypes (i.e., the genetic composition of an individual). ii. The human genome project mapped out the approximately 25,000 human genes. iii. With the rapid advance of science, the focus has turned to endophenotypes (genetic mechanisms that ultimately contribute to the underlying problems causing symptoms and difficulties experienced by people with psychological disorders)

analog models

a third way to improve internal validity involve recreating aspects of real world phenomena in the laboratory so that they closely approximate the real world. Analog models could be thought of as creating a close replica of facets of the real world in the laboratory so that those facets can be studied more systematically

Types of Assessment

a. Clinicians often recommend a physical examination, particularly if the patient has not been seen by a medical doctor in the past year. it is important to conduct a physical examination with a physician. The reason for the physical exam is important to rule out organic and physical causes that may lead to psychological problems! b. clinical interview c. behavioral assessment d. Psychological tests e. intelligence tests f. neuropsychological tests g. neuroimaging h. Psychophysiological assessment

cross-sectional designs

a. Cross sectional designs represent a variation of correlational research involving comparisons of different people at different age groups, each called a cohort, on some characteristic. b. Confounding of age and experience is known as the cohort effect and represents a limitation of cross-sectional designs. c. Such designs do not address how problems develop in individuals. d. They could ask the individual subjects about what happened in the past (retrospective information) but this information is usually not accurate.

Epidemiological research

a. Epidemiology is the study of incidence, distribution, and consequences of a problem or set of problems in a population. b. The primary goal of epidemiologists is to determine the extent of a problem/disorder in a group of people and to find important clues as to why a disorder exists, the extent of the problem in the general population at a particular time point (i.e., prevalence), why a disorder/problem may be increasing or decreasing in the general population (i.e., incidence), and even the course of a disorder. c. Epidemiological research relies largely on correlational methods to address such issues. Examples include effects of stress following a natural disaster and issues with PTSD as a result of September 11, 2001.

Basic components of a research study

a. Hypothesis, or educated guess, about what is to be studied and what one expects to find. The research design is the method or plan of experimentation used to evaluate and test the hypothesis. 1. Not all hypotheses are testable, but those used in science must be formulated so that they are. Testability is the ability to subject the hypothesis to scientific scrutiny so as to be accepted or rejected. 2. When you want to test the hypothesis, you want to know what factors influence what the person does, thinks, feels, talks about, including biological factors, and you want to test for such relations in a more convincing and systematic way. b. You formulate a research design that includes specifying the independent variable(s)- the variable, sometimes manipulated by the experimenter, that is expected to influence outcomes- that you believe will influence aspects of the person's behavior you are interested in, the dependent variable(s)- the variable that is measured and expected to be influenced.

Randomization

another strategy that helps bolster the internal validity of a study, and is defined as a process of randomly assigning people to different experimental conditions in such a way that each person has an equal chance of being placed in any condition (e.g., random #s, coin toss). E.g., heads = treatment, tails = wait list control. Randomization helps to distribute differences evenly amongst participants and across conditions, and thus reduces systematic bias in study conditions that could confound interpretation of the results.

Adoption studies

begin to allow one to separate environmental from genetic contributions to psychopathology. b. scientists identify adoptees that have a particular behavioral pattern or psychological disorder and attempt to locate first-degree relatives who were raised in different family settings. c. If persons raised in different families display the disorder more frequently than expected by chance, then the inference may be made that genetic factors were influential in the development of the disorder.

Genetic linkage analysis

can locate the site of the defective gene principle: When a family disorder is studied, other inherited characteristics are also assessed. The other characteristics (called genetic markers) are selected because we know their exact location on the chromosome. If a match of link is discovered between the inheritance of the disorder and inheritance of a genetic marker, the genes for the disorder and the genetic marker are probably close together on the same chromosome. This analysis occurs in a large group of people with a particular disorder. c. Association studies also use genetic markers but compare markers in people with and without the disorder. If certain markers occur significantly more often in people with the disorder, it is assumed that the markers are close to the genes involved in the disorder. Association studies are better able to identify genes that may only be weakly associated with a disorder.

Program of research

comprises a series of inter-related questions, which often draw upon a series of research designs in order to find answers to them. They are conducted in stages over periods of years, and entail using multiple perspectives to derive a complete picture of a behavioral problem.

Confounds (aka confounding variable)

contaminating factors in a research study that make results uninterpretable, or uncontrolled alternative explanations for the changes observed in our dependent variable. These variables are not accounted for in the study. Confounds represent threats to internal validity. When they are present, we cannot be confident that the IV was responsible for producing changes in the DV. Three strategies are used by researchers to avoid confounds and to ensure that a study retains a high degree of internal validity.

Replication

credo of science (show me, show me again, and better yet, have someone else show me what you found). Programs of research replicate findings in different ways (e.g., designs, methods, populations), and hence build confidence that findings are not due to chance or coincidence. Findings of a single study on a phenomenon cannot be accepted without replication

Twin studies

give behavioral geneticists the closest possible look at the role of genes in development. b. Identical (monozygotic) twins look identical and have identical genes, whereas fraternal (dizygotic) twins come from different eggs and have about 50% of their genes in common (i.e., same as siblings). c. The main focus is on whether identical twins share a trait or disorder more often than fraternal twins do. d. Still, the problem of shared environment vs. genetic contribution is difficult to separate unless one combines the adoption study with a twin study.

control group

group of people who are similar to the experimental group in every way, but are NOT exposed to the independent variable. For example, one group may be given an active treatment (i.e., the independent variable) while the control group never gets the treatment and is simply placed on a waiting list. Control groups help rule out alternative explanations for changes in behavior that have nothing to do with the independent variable under study. They allow for comparison of the differential effects of the treatment

Psychological tests

must be reliable and valid, and include several specific tools designed to determine cognitive, emotional, or behavioral responses that may be associated with a specific disorder or personality features. i. Projective tests arose out of the psychoanalytic tradition and cover methods in which ambiguous stimuli are presented to a person who is asked to state what s/he sees. The theory is that people will project their own true personality, unconscious thoughts and fears onto ambiguous test stimuli and will reveal their hidden unconscious thoughts to the therapist. ii. Though such tests remain controversial due to their origins and weak psychometric properties (low reliability and validity), they are commonly used. Examples include: 1. The Rorschach Inkblot test that was developed by Hermann Rorschach to study perceptual processes and to diagnose psychological disorders. Currently, the Rorschach contains ten inkblot pictures that serve as ambiguous stimuli. Patients are instructed to inform what they see. John Exner developed a standardized version of the Rorschach Inkblot test called the Comprehensive System. It improved reliability through standardized rules and follow-up questions on content, but its use remains controversial. 2. The Thematic Apperception Test (TAT) is the best known projective test, developed in 1935 by Morgan and Murray. The TAT consists of 31 cards depicting less ambiguous pictures. The test taker is asked to tell a dramatic story about what they see in the picture. The TAT is based on the notion that people will reveal their unconscious mental processes in their stories about the pictures. TAT has limited reliability, validity, and standardization procedures. A Children's Apperception Test (CAT) and Senior Apperception Test (SAT) have also been developed for those age groups. iii. Personality inventories are self-report questionnaires that assess traits by asking respondents to identify descriptions that apply to themselves. They are more empirically-based than projective tests (higher reliability and validity) but often require a substantial amount of time for the patient to complete. Often scored by computer with interpretive graphics for result display 1. The most widely used personality inventory is the Minnesota Multiphasic Personality Inventory (MMPI and MMPI-2) and the Millon Clinical Multiaxial Inventory. Individual responses to items are not examined; instead, the pattern of responses is reviewed to see whether it resembles patterns from groups of people who have known psychological disorders (i.e., empirical criterion keying). The MMPI has extensive reliability, validity, standardization, and normative data to back it up. These measures also include scales that determine validity of participants' responses (e.g., lie, fake "good" or fake "bad").

Standardization

process by which a set of standards or norms is established for an assessment technique to ensure its consistency across different measurements. may refer to administrative procedures (rules for giving the assessment), evaluating the findings (scoring the test), and comparing individual findings to data for large numbers of people (via demographic factors).

statistical significance

psychological research means that the probability of obtaining an observed effect by chance is small. Whether that difference is important and meaningful is another matter. 3. Although results may be statistically significant, they may not be clinically significant. In other words, one may detect a statistically significant difference between experimental and control conditions, but the size of the effect (i.e., the difference or change) is clinically meaningless. This is particularly important in treatment research. For example, if I gave you an intensive studying program that shows statistically significant improvements in grades (say by 2 points on a 100 point scale), it is probably clinically insignificant in terms of producing clinically meaningful changes that would warrant recommending this program for routine student use. a. Such concerns led to the development of statistical methods that address effect size, which looks at how large the differences are. b. Assessing social validity, or the degree to which the person being treated (including significant others), feels that the changes that have occurred are important and meaningful is another way to address clinical significance.

Clinical assessment

the systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psychological disorder. exemplifies multidimensional, integrative approach to gathering information about a client to make informed, accurate decisions The process is analogous to a funnel in that it is initially broad in scope and then becomes more specific to focus on what is most relevant. For instance, to assess psychological disorders, the clinician first collects a broad range of information and then narrows the focus by ruling out problems in some areas and concentrating more specifically on other areas where problems seem to exist.

Neuropsychological tests

used to assess brain and nervous system functioning (person's abilities in areas such as receptive and expressive language, attention and concentration, memory, motor skills, perceptual abilities, and learning and abstraction). They do so by testing individual performance on various behavioral tasks i. The purpose of such tests is to help the clinicians to make educated guesses about the person's performance and the possible existence of brain impairment (injury, illness or disease, dysfunction) ii. Examples of neuropsychological tests include screening devices such as the Mini Mental State Examination, and more sophisticated batteries that can provide precise determinations of organic brain damage such as the Luria-Nebraska Neuropsychological Battery and the Halstead-Reitan Neuropsychological Battery. iii. Much overlap between intelligence and neuropsychological testing. iv. Problems of neuropsychological testing, however, include the presence of false positives (i.e., test shows a problem where none exists) and false negatives (i.e., test fails to detect a problem where one exists) as well as long administration time. Proper administration and scoring of these tests require a significant amount of training.

Diagnosis

the process of determining whether a person's presenting problem(s) meets the established criteria for a psychological disorder

Diagnosis

the process of determining whether a set of symptoms can be classified as a psychological disorder according to diagnostic criteria in the DSM-V. (or identifying a general class of problems that hang together). Diagnosis is useful for obtaining information about psychological profiles, etiology, and treatment. The clinician may be able to use psychiatric diagnosis to help establish a prognosis, or likely future course of a disorder under certain conditions. a. Classification is central to all sciences- Assignment to categories based on shared attributes or relations. i. Idiographic strategies involve close and detailed investigation of individuals emphasizing what makes them unique. Allows a clinician to tailor treatment to the person ii. Nomothetic strategies involve identification and examination of large groups of people with the same disorder to note similarities and develop general laws. This approach led to the development of the current DSM classification system b. Approaches to classification include three types... i. Classical (pure) categorical approach- based on assumption of clear-cut differences between disorders, each of which has a distinct cause and shared symptoms between all those expressing the disorder. This is the approach used in medicine quite successfully but does not apply well to the more heterogeneous symptoms in psychopathology ii. Dimensional approach- listing of specific symptoms (cognitions, moods, behaviors) displayed by patients along with a quantification of symptom intensity on a continuum. Likely the future of classification in psychopathology but the science is still young and researchers cannot agree on a list of necessary dimensions iii. Prototypical approach- uses essential, defining characteristics for each disorder, but allows for nonessential variations (different symptoms) for individuals that do not change the classification. So two individuals with the same diagnosis may only share 1-2 symptoms and then each present unique problems. Combines the categorical and dimensional approaches. Forms the current basis for the Diagnostic and Statistical Manual of Mental Disorders- 5th edition (DSM V) c. DSM system was first created in 1952 but early editions were theory driven. The DSM-III in 1980 adopted an atheorhetical approach and improved reliability with precise descriptions of disorders. More current editions have allowed for dimensional considerations to classification. However, validity of classification is still in question, and continuing research suggests that many forms of mental illness may not be "categorizable". Future editions are likely to focus much more on dimensions. d. Criticisms of DSM-V i. The boundaries between disorders are often fuzzy, and diagnostic comorbidity (presence of two or more psychological disorders in one individual) is quite often the rule, not the exception. ii. Emphasis on reliability at the expense of validity. iii. As with any diagnostic system, there is the danger of misuse, and particularly the tendency to reify diagnostic categories (i.e., treat them as "things" that exist). iv. A caution about labeling- applying a name to a phenomenon or pattern of behavior. 1. Has negative connotations and become pejorative (derogatory, critical). 2. Individuals may identify with their label and this will affect their self-esteem. 3. Stigma may contribute to avoidance of education and treatment for disorders. 4. We should label the behavior pattern not the person. A person is NOT a disorder. e. Current trends i. Process for changing criteria for existing diagnoses and creating new ones will continue especially considering the impact of new findings on brain circuits, cognitive processes and cultural factors. ii. Work on the DSM-VI has begun with a new approach that will incorporate a dimensional strategy or spectrum-based disorders to a much greater extent than DSM-V.

Single case experimental designs

This type of design, owing much to the methodological innovations of B. F. Skinner, involves the rigorous and systematic study of an individual under a variety of experimental conditions and over time. The independent variable is manipulated for a single individual under controlled conditions. 2. Single-case experimental designs differ from case studies in their use of several strategies to improve internal validity, while reducing the number of confounding variables. a. One of the more important strategies used in single-case experimental design is repeated measurement, in which the behavioral response (dependent variable) is measured several times instead of only once before and after you change the independent variable. Changes in behavior are evaluated for changes in variability, level, and trend as a function of time and changing conditions (i.e., independent variables) across time. This allows determination of whether observed changes are due to treatment effects. b. Withdrawal designs have three parts: (1) baseline; (2) a change in the independent variable is introduced and its effects on behavior assessed; (3) treatment is withdrawn (i.e., return to baseline). c. In multiple baseline designs, the effects of the intervention can be evaluated in a controlled systematic fashion across settings, behaviors, and persons. For example, three behaviors could be selected for treatment: (1) All behaviors undergo baseline; (2) first behavior would be targeted; (3) once first behavior shows stable response to intervention, the second behavior would be targeted; and so on.

Mental Illness in a social context- being sane insane places

a. In 1973, sociologist David Rosenhan sought to examine how difficult it would be for people to shed the "mentally ill" label. He was particularly interested in how psychiatric hospital staff process information about patients. b. Rosenhan and 7 associates had themselves committed to different mental hospitals by complaining that they were hearing voices (a symptom of schizophrenia). The staff did not know the "pseudopatients" were actually part of an experiment. Beyond the alleged symptoms and falsification of names and occupations, the important events of the pseudopatients' life histories were factually presented to hospital staff as they had occurred. c. The pseudopatients were instructed to act completely normal upon admission into the hospital. In fact, acting normal was the only way they could get out. d. Despite doing nothing out of the ordinary, the pseudopatients remained hospitalized for an average of 19 days (range 9 to 52 days). Ironically, their sanity was not detected by hospital staff, but it was detected by the actual patients in the hospitals. All of Rosenhan's associates retained the deviant label even after being discharged. Their schizophrenia was said to be "in remission," implying that it was dormant and could possibly resurface. At no time during their stay in the hospital was the legitimacy of their schizophrenic label questioned. It was simply assumed that they were schizophrenic, and everything the pseudopatients did and said while in the mental institutions was understood from this premise. i. Normal behaviors were overlooked entirely or were profoundly misinterpreted. Minor disagreements became deep-seated indicators of emotional instability. Boredom was interpreted as nervousness or anxiety. Even the act of writing on a notepad was seen by the staff as a sign of some deeper psychological disturbance. ii. Even though there was nothing "pathological" about the past histories, these records were reinterpreted to be consistent with the schizophrenic label. e. The moral = that psychiatric labels are so powerful that they can profoundly affect the way information is processed and perceived. Had the same behaviors been observed in a different context, they no doubt would have been interpreted in an entirely different fashion. Context influences our interpretations of abnormal behavior.

longitudinal designs

a. Longitudinal designs evaluate the same persons over time and assess changes directly. The cohort effect is not an issue. b. Limitations 1. Such research is costly and time-consuming, and 2. Danger that the original research question will become irrelevant by the time the study is complete. 3. There is also attrition of individuals due to death, family move, etc. 4. Suffer from the cross-generational effect (i.e., trying to generalize findings to groups whose experiences are very different from those of the study participants). 4. Sequential designs combine longitudinal and cross-sectional designs.

strategies to study interaction between environment and genetics

a. family studies b. adoption studies c. twin studies d. genetic linkage analysis

Types of research methods

a. studying individual cases b. research by correlation c. research by experiment d. single case experimental designs

Neuroimaging

name for a set of procedures that allow a window on brain and nervous system structure (i.e., parts of the brain) and function (i.e., what the brain does via blood flow and metabolic activity). They involve sophisticated computer-aided procedures that allow for non-intrusive examination. i. Images of brain structure 1. The computerized axial tomography (CAT scan) was developed in the early 1970s and uses multiple X-ray exposures of the brain at different angles. CAT scans are noninvasive and depict various slices of the brain. The image of structure is particularly useful for identifying and locating abnormalities in the structure or shape of the brain, including the location of brain tumors, injuries, and other structural abnormalities. 2. Magnetic resonance imaging (MRI) provides better resolution than the CAT scan and does not involve X-rays. The technique is called nuclear magnetic resonance imaging, whereby a person's head is placed in a high-strength magnetic field through which radio frequency signals are transmitted. These signals excite the brain tissue, altering protons and hydrogen atoms. A disadvantage is that a person is required to be totally enclosed inside a narrow tube with a magnetic coil around the head. ii. Images of brain function 1. The positron emission tomography (PET) procedure involves injection of a tracer substance containing radioactive isotopes (i.e., groups of atoms that react distinctively). This substance interacts with blood, oxygen, or glucose in the regions of the brain that are active. 2. The single photon emission computed tomography (SPECT) works much like PET, though a different tracer substance is used and SPECT is somewhat less accurate than PET. SPECT is less expensive than PET and for this reason is used more frequently. 3. Functional MRI (fMRI) takes only milliseconds and allows for examination of immediate responses of the brain to a brief event. Can examine the brain "at work" in real time. With new holographic projection platforms, it is one of the most advanced and exciting areas of brain research to date.

Psychophysiological assessment

refers to measurement of changes in the nervous system reflecting emotional or psychological events (anxiety, stress, sexual arousal) i. An Electroencephalogram (EEG) is a peripheral measure of electrical activity in the brain related to the firing of a specific group of neurons, which yields a measure of brain wave activity (i.e., low-voltage current usually associated with the cortex of the brain) taken through electrodes placed on the scalp. Used to assess brain activity associated with waking and sleep states (or other states of arousal such as hypnosis or drug intoxication). 1. Event-related or evoke potentials (ERPs) refer to EEG activity in response to specific events. 2. Alpha EEG waves are typically associated with waking and calmness and involve a regular pattern. During the deepest most relaxed stage of sleep, EEGs reveal a pattern known as delta waves (i.e., waves that are slower and more irregular than alpha waves). ii. Other typically assessed responses during a psychophysiological evaluation include: (a) heart rate, (b) respiration, and (c) electrodermal responding (formerly called galvanic skin response). iii. Psychophysiological assessment is used routinely in the assessment of disorders involving a strong emotional component such as posttraumatic stress disorder, sexual dysfunctions, sleep disorders, headache, and hypertension and form the basis for biofeedback. iv. These techniques require great skill and expertise by the clinician and may still yield inconsistent results due to procedural or technical difficulties or the nature of the response itself.

External validity (generalizability)

refers to the degree to which a study's results may be applied to other people or settings not involved in the study. That is, researchers want to be able to generalize their findings to real world phenomena. The rub, of course, is that if the experimental situation is so tightly controlled and artificial, the results may be compelling, but have very little meaning beyond the research setting. In general, as internal validity increases, external validity decreases.

Internal validity

refers to the extent to which we are confident that the independent variable caused the dependent variable to change

family studies

scientists examine a behavioral pattern or emotional trait shared among family members. a. Proband = family member with the trait singled out for study b. The role of genetics is supported, in part, if the trait occurs more often in first-degree relatives (i.e., parents, siblings, or offspring) than in second-degree or more distant relatives (e.g., cousins). Blood-injury-injection phobia is one example of many disorders that tend to run in families. c. The problem with family studies is that it is difficult to separate the contribution of shared environment from the contribution of genetics.

Behavioral assessment

takes the mental status exam a step further by using direct observation to formally and systematically assess an individual's thoughts, feelings, and overt behaviors in specific situations or contexts. i. Probably more appropriate than the interview in assessing young clients or clients who cannot report their problems and experiences. ii. Also used when patients are thought to withhold information from therapist, then the therapist can observe client's behavior directly. iii. Observations may occur in the therapy context, in the home, schools, the workplace, or in other real life situations. iv. The purpose of behavioral assessment is to identify target behaviors (problematic behaviors) and environmental events that may become targets of therapeutic intervention. 1. The ABCs of observations: This is accomplished via a functional analysis of Antecedents before the behavior, the target Behaviors themselves, and Consequences following the behavior. v. Behavioral observation may be either formal or informal. 1. In formal observation, the observation procedures are usually structured and systematic, and involve behavior rating scales or checklists and clear operational definitions (specific descriptions of how the behavior is observed measured- how is it quantified) of target behaviors. Informal observation is less standardized and systematic. 2. A more formal and structured way to observe behavior is through checklists and behavior rating scales, which may be used before, during or after treatment. These can be completed by the therapist or others closely involved with the patient (spouse, supervisor, parent, teacher). 3. People may also be asked to observe their own behavior using a technique called self-monitoring or self-observation (e.g., recording the number of cigarettes smoked per day). Self-monitoring may be formal (e.g., using scales, coding sheets, checklists) or informal (e.g., recording overall mood each day). Recording your own behaviors can make you more aware of their frequency and effects on functioning vi. Reactivity can distort observational data, and refers to changes in behavior resulting from knowing that one is being observed. Reactivity can occur while being observed by others or when self-monitoring. Behaviors tend to shift in the desired direction with reactivity.

Clinical Inteview

the core of most clinical work and is used primarily to gather information about past and present behavior, attitudes, emotions, and a history of the person's problem(s) and life circumstances (stress, trauma). i. Other important points to cover include precipitating events, family composition and history, interpersonal and social, history, sexual development, religious beliefs, cultural concerns, and educational achievement. ii. To organize information obtained during an interview, many clinicians will use a mental status exam- coarse preliminary test of judgment, orientation, and emotional/mental state. The exam involves the systematic observation of a client's behavior across five domains: 1) Appearance and behavior (e.g., well or poorly groomed; psychomotor agitation or retardation); 2) Thought processes (e.g., rate and flow of speech, clarity, and content of speech and ideas; loose associations, delusions, hallucinations); 3) Mood and affect (e.g., is affect and mood appropriate of inappropriate?); 4) Intellectual functioning (e.g., does the client have a reasonable vocabulary and memory?); 5) Sensorium (i.e., general awareness of surroundings such as date, place, time, knowledge of self- "oriented times three"). iii. It is important to conduct the clinical interview in a way that elicits the patient's trust and empathy in order to facilitate communication. In this way, a skilled interviewing can quickly build rapport and facilitate a good working relationship. iv. Information provided by patients to psychologists and psychiatrists is protected by laws of confidentiality. "Privileged communication" in treatment is protected by state law in almost all states. Authorities cannot have access to this information without patient consent. But there are limits to confidentiality- if the patient presents and significant and imminent risk of harm to themselves or another person (specific threats) or if the patient is aware of unreported child abuse, the therapist is bound by ethics and law to report the risk v. Structure of clinical interviews 1. Unstructured clinical interviews are not standardized, and follow no systematic format. 2. Semistructured clinical interviews contain questions that have been carefully phrased and tested to elicit useful information in a consistent manner, but also allow room for clinicians to depart from the format with additional questions of interest.

Intelligence tests

were initially developed to predict how well persons would do in school (e.g., Binet and Simon's work with French government in 1904). i. The Binet-Simon test was revised and translated by Lewis Terman of Stanford University in 1916 and became known as the Stanford-Binet in the US ii. The test provided an intelligence quotient (i.e., IQ)- score on an intelligence test estimating a person's deviation from average test performance. Originally was derived by taking the child's mental age based on the IQ test, dividing it by his/her chronological age, and multiplying by 100. Problems with this method concerned the lack of comparability in scores across age groups (e.g., a 4-year-old needed to score on 1 year above his or her chronological age to receive an IQ score of 125, whereas an 8-year-old had to score 2 years above his or her chronological age to receive the same IQ score). iii. These and other problems led to the current use of the deviation IQ, where a person's score is compared only to scores of others of the same age. iv. Other intelligence tests include the Wechsler tests; Wechsler Adult Intelligence Scale (WAIS) for adults, Wechsler Intelligence Scale for Children (WISC) children, and Wechsler Preschool and Primary Scale of Intelligence (WPPSI). v. IQ should not be confused with intelligence. IQ is a score a test that may predict academic success. IQ tests measure attention, perception, memory, reasoning, and verbal comprehension (all of which can influence academic performance). Many argue intelligence also involves adaptability to the environment, ability to generate new ideas (creativity), ability to process information efficiently, ability to read emotions in others, etc.