18. Research methods in Clinical Psycholog

What is primary data?

• A01

• First-hand data gathered by the researcher.

• Primary data is information that the researchers gather themselves directly from a group of participants.

• Rosenhan gathered first-hand primary data - he used a field/natural experiment and used observations.

• Scott Van Zealand.

• You can do interviews, observations, experiments, questionnaires.

What are strengths of primary data?

• A03

• Potentially more reliable and valid as researcher is investigating exactly what they aim to find out in a standardised way.

• More valid because the researchers can do it in the way they want to, and more reliable as they are following their own standardised procedures - they aren’t following someone else’s.

• Variables can be manipulated and controlled according to their aim.

• They can create their own conclusions from data they know for sure isn’t flawed.

What are weaknesses of primary data?

• A03

• Gathering primary data is more time-consuming because the researcher is conducting the entire investigation from start to finish.

• And the researchers may face many ethical considerations in working directly with patient groups.

• Data from a single study can be limited.

What is secondary data?

• A01

• Data gathered by other researchers and used by others.

• Secondary data relies on evidence that has been gathered by other researchers by accessing other peer-reviewed articles or public access statistics.

• Carlsson - did a literature review.

• Gottesman & Shields - used data that was already out there/meta-analysis.

• Twin studies, adoption studies, meta analysis, literature reviews.

What are strengths of secondary data?

• A03

• Gathering secondary data is less time consuming as they do not have to gather the data themselves directly from a group of participants.

• They will also not have to face ethical considerations when working directly with patient groups.

• Data from multiple studies can be obtained, so multiple comparisons can be made from large samples - increasing validity + generalisability.

• Multiple studies show consistent findings - increased reliability

What are weaknesses of secondary data?

• A03

• However, relying purely on secondary data means that it is difficult for researchers to know how reliable or valid the original research actually was.

• This could mean that conclusions are drawn from data that was originally flawed, especially if multiple types of secondary data are being used.

• Difficult to make valid conclusions if original data was flawed.

• Research could be unpublished data but hopefully studies that have been peer reviewed would be used.

• Typically research using secondary data eliminates research studies that are considered to be unreliable or flawed in some way, or at least comment on this in their analysis.

What are longitudinal studies?

• A01

• Longitudinal research takes place over a long period of time, and often involves comparing a single sample group with their own performance over time, which means that developmental or time based changes can be seen through the patterns of measurements.

• In mental health research, clinicians may be interested in monitoring changes in symptoms in a patient group undergoing a certain treatment.

• In this case measurements may be taken of the symptom expression and severity over a specific time period at certain intervals.

• This should allow psychologists to see if there is any reduction in the symptoms to assess how effective the treatment is.

What are strengths of longitudinal studies?

• A03

• The advantage of using longitudinal research in clinical psychology is that, as patients often have very different symptoms and experiences even when suffering with the same illness, there is no difficulty in making comparisons between different people that could be affected by individual differences.

• It is also the only way of being able to reliably measure the effect of time on behaviour in question, which is very important when considering whether treatments actually have the ability to significantly improve a patient’s quality of life in the long term.

What is the weakness of longitudinal studies?

• A03

• However, one of the major problems is that the research clearly has to go on for a long period of time.

• This can lead to several issues.

• One is that patients may drop out, die, or not be able to be contacted, reducing the sample size and making the final outcome less valid.

• Another problem is that by the time meaningful data can be used to draw a conclusion in the study, the data may be irrelevant.

• Clinical psychology is a fast-paced area of research with new ideas and treatments being developed all the time, especially in relation to biological factors and drug treatments, so research that published findings years after it was started could be outdated.

What are cross-sectional studies?

• A01

• When researchers want to take a quick ‘snapshot’ of behaviour in a given population they will usually use a cross-sectional design rather than waiting for longitudinal data to be gathered.

• In cross sectional research the investigators will usually use a large group of people in the sample, so as to get a good ‘cross-section’ of the whole target population, and then draw conclusions from the data gathered from them.

• E.g. researchers may want to know about the experience of people at different ages suffering from schizophrenia, but rather than conducing time-consuming and expensive research using longitudinal design they could take a sample of Pp of different ages at the same time and investigate them.

What are the strengths of cross-sectional studies?

• A03

• The advantage of this is that the data is drawn together much more quickly, meaning that the conclusions drawn can then be used and acted on more rapidly.

• It is also much more likely that the results will be more valid as they will be reported at the same time when they have the most application rather than several years later.

What are the weaknesses of cross-sectional studies?

• A03

• The major drawback of this research is that the comparisons being made will be between different groups of people, therefore individual differences are likely to have a significant effect on the conclusions drawn.

• With cross-sectional studies there may be issues with the cohort effects whereby the results of the research could be attributed to the effects of being raised in a particular time and/or place.

• This may have an impact on some research into abnormal behaviours.

• For example, in studies into different age groups suffering from anorexia, not all of the groups would have been exposed to the same cultural ideals and images.

• This may make each group unique, and therefore affect any study into the development of anorexia, as the groups are not comparable because they weren’t subject to the different social and cultural ideals of their time.

What are cross-cultural studies?

• Cross cultural research involves taking samples from different cultural groups to draw comparisons about the similarities and differences between them to consider how culture may impact on the behaviour in question.

 

• There are many reasons why this may be relevant in clinical psychology.

• For example, there may be questions over whether the experience of patients suffering from schizophrenia is the same in different cultural groups, whether the same symptoms are shown in all cultural groups, or whether treatments are equally effective across cultural groups.

What are the strengths of cross-cultural studies?

• By taking measurements in one cultural group and comparing the same measurements taken in a different cultural group, it allows the researchers to gain an understanding of how culture plays a role in the validity and reliability of diagnosis in clinical psychology.

 

• Cross cultural research can also identify elements of abnormal behaviour that can be attributed to purely biological factors.

• This is done by identifying universal trends in behaviour that seem to remain unaffected by cultural variation.

 

• Cross-cultural research can also reduce the level of ethnocentrism in psychological studies and conclusions and improve generalisability of research.

 

• An advantage of cross-cultural methods is that they aid clinicians understanding of the cultural factors they should take into account when diagnosing and treating patients from different cultural groups, especially when the culture of the patient is different from their own.

• Doctors who diagnose and treat patients who are not from their own cultural groups must be encouraged to refer to this cross-cultural evidence in order to understand the subjective experience of the patient.

What are the weaknesses of cross-cultural studies?

• A03

• The disadvantage is that in conducting research across cultures there is likely to be a conflict between the cultural values of some or all of the participants and those of the researcher.

• Because of this, the conclusions drawn may lack validity if the interpretation of the patients’ behaviour does not take into account their own cultural backgrounds.

What is a meta-analysis?

• A01

• Meta-analyses involve looking at secondary data from multiple studies conducted by other researchers and drawing the findings together to make overall conclusions.

• A meta-analysis is typically conducted when there is a huge body of psychological research where firm conclusions cannot be drawn without comparing this research, or where the research findings may be inconsistent.

• The researchers will seek out studies from a variety of places, cultures and times, which have all tested the same area, with the aim of bringing the findings together.

• Doing this means they can more easily consider a large amount of information gathered from a huge overall sample size rather than having to go out and gather primary data.

 

• In clinical psychology, researchers have conducted meta-analyses in many different areas such as effectiveness of therapies and treatments across different patient groups.

• As such, meta-analyses focuses on effect sizes.

• This means that a meta-analyses of research looking at the effectiveness of CBT will focus its analysis on the size of the effect of CBT found by all of the research gathered.

What are the strengths of Meta-analysis?

• A03

• The benefit of meta-analyses is that conclusions can be drawn from a vast array of different areas and huge overall sample, very quickly and at much less cost than would be involved in conducting all the studies themselves.

 

• They also do not have any of the ethical concerns associated with conducting research on participants first hand.

What are the weaknesses of meta-analysis?

• A03

• However, a major disadvantage is that the researchers do not have involvement in gathering the data directly, so there may be undisclosed issues of reliability and/or validity in the methods of data gathering which they are unaware of.

 

• There is also the possibility of publication bias impacting on the validity of meta-analyses.

• Research that produces null effects may not be published and therefore would be ignored by meta-analytic research, which generally focuses on peer-reviewed publications.

• This would mean that the evidence produced by meta-analyses is often biased against research where no effect has been found.

• Some researchers may choose to include unpublished work in the analysis to make their data more valid, but then there is an increased risk of using that data as it has not been scrutinised by peer review in the same way.

What are case studies?

• A01

• Case studies involve studying individuals or small groups with some kind of unique characteristic or experience.

• Researchers involved in conducting case studies will use a variety of different research methods to gather information on the group, and then triangulate the data to draw conclusions.

 

• In clinical psychology, these case studies may be of people with rare symptoms or individuals taking part in a specific therapy.

• Often the evidence gathered from case studies will be qualitative, allowing an in-depth analysis of the group being studied.

• This allows the conclusions gathered to be highly valid for the sample being studied.

• In clinical psychology this will mean that a full understanding of the patient's problems can be assessed and all the factors that may have an effect on them can be taken into account.

• Lavarenne et al (2023)

What are the strengths of case studies?

• Research like this provides brilliant insight into the behaviour of the patients involved, but this is very reliant on the interpretation of the researcher.

• Rich data to draw conclusions - qualitative.

• Qualitative and quantitative data.

• Rare situations and individuals.

• Triangulation.

What are weaknesses of case studies?

• A03

• In the Lavarenne et al (2013) study there is also a concern that the memory of the group leaders may be inaccurate as they do not record the sessions.

• If they recall something incompletely or inaccurately, or interpret information in a subjective way, there is a risk that the conclusions drawn could be unreliable or invalid.

 

• Another concern with research like this is that a small group of participants is unlikely to represent the whole target population and therefore the population validity of the research could be extremely limited.

• Idiographic - lack generalisability.

 

• Researcher bias caused by the relationship between the Pp and researcher.

What are interviews?

• A01

• Interviews involve verbal questioning of patients to gather information from them.

• Interviews can be structured, involving a specific list of questions.

• Semi structured, involving a range of themes to explore.

• Unstructured, where the direction of the conversation can be decided along the way.

• Vallentine et al (2010)

What are strengths of interviews?

• A03

• Gaining information from interviews allows patients to fully explain their own point of view, which should help the researchers understand their perspective clearer.

• Using semi structured or unstructured interviews allows more detail to be gained from patients.

• The researchers in Vallentine et al (2010) recorded their interviews to allow them to play back and check the accuracy of the data they report on.

• This means that they can check the reliability of the interpretation using the themes by having another researcher to also code the data.

What are the weaknesses of interviews?

• Unstructured/semi - However it also means that there is a lack of reliability in the way data is fathered because the questions are not standardised.

What was the aim Lavarenne et al’s (2023) study? - case study

• To investigate the experiences of people with schizophrenia or schizophrenic type mental illness.

What was the sample for Lavarenne et al’s (2023) study?

• 10 long term between 3 weeks and 22 years group members with schizophrenia or schizophrenia type disorder (6 present in the observed session).

What was Lavarenne et al’s (2023) procedure?

• Participants discussed their feelings and thoughts as they have something in common so they can talk about their experiences and feelings with other people who have schizophrenia so they are not isolated from society.

• The purpose of the group is to support the patients by giving them some structure to help them cope with their illness, and encourage a sense of connection with others for the group who are generally quite isolated in everyday life.

• The therapists observed a pre-Christmas session and wrote notes immediately after the meeting.

• The sessions are not recorded.

• He focuses on the one session before Christmas, there was 6 of the group present and they would be having a break of more than 7 days before their next session.

What was Laverenne et al’s (2023) findings?

• Patients showed ‘‘fragile ego boundaries’’ (they can easily get triggered and anxious) becoming anxious and confused due to the upcoming longer break.

• Triggered by being out of routine.

• The group provided them with support, taking that away for even a week fills them with anxiety.

• The group helped them maintain their sense of self and reality so not seeing them will break it down.

What are Lavarenne et al’s (2023) conclusions?

• The group may be reacting to the potential change in routine by having a break for more than 1 week over Christmas.

• The fragile ego boundary is because they know they will not have that support system over the week.

What is a strength of Lavarenne’s (2023) study in terms of insights into real patients?

• Gives a brilliant insight into the behaviour of the patients involved.

What is a weakness of Lavarenne’s (2023) research in terms of sample size?

• Ideographic.

• Very small group - unlikely to represent the whole target population of people with schizophrenia.

What is a strength of Lavarenne’s (2023) research in terms of qualitative data?

• Increased validity - Data is highly valid for the sample being studied.

• Triangulation - Uses multiple observations and therapist notes to support conclusions.

What is a weakness of Lavarenne’s (2023) research in terms of reliability of data (after session) and subjectivity?

• Reliability of data (after session) - sessions were not recorded, so memory of the group leaders may be inaccurate.

• Subjectivity - interpretation may be biased, leading to unreliable or invalid conclusions.

• What was Vallentine et al’s (2010) aim?

• To investigate the usefulness of psycho-education within group work for offender patients in a high security forensic hospital setting.

What was Vallentine’s (2010) procedure?

• Research used semi-structured interviews to gather information from a patient group on their experiences as a part of a psycho-educational group treatment programme.

• The patients were 42 males detained in Broadmoor high security hospital, most of whom had received a diagnosis of schizophrenia or a similar disorder.

• They were part of a programme aimed at helping them understand and cope with their illness, and several measures were taken to assess the impact of this on their symptoms.

• The aim of the interviews was to understand their experiences better, but also get information about how the group could be improved in the future.

• Following the interviews, a content analysis was conducted on the data gathered to pick out key themes in the responses.

• 4 key themes were identified in the data ‘what participants valued and why’ ‘what was helpful about the group’ ‘clinical implications’ and ‘what was difficult/unhelpful’.

What was Vallentine’s (2010) findings?

• Some of the key findings were that patients valued knowing and understanding their illness, and the group sessions allowed them not only to understand their own symptoms, but also how other people’s experiences were similar.

• Many also reported increased confidence in dealing with their illness, which made them more positive about the future.

What were Vallentine’s (2010) conclusions?

• The violence reduction programme was perceived as helpful and gave offenders insight into aggression, supporting its use in forensic setting.

What are the strengths of Vallentine’s (2010) research in terms of triangulated methods?

• Gaining information from interviews allows patients to fully explain their own point of view, which should help the researchers to understand their perspective more clearly.

• Using semi-structured or unstructured interviews allows more detail to be gained from the patients.

• However, it also means that there is a lack of reliability in the way the data is gathered because the questions are not standardised.

• Interviews are not standardised therefore unreliable as we cannot replicate it.

• However, the interviews were recorded so it makes it easier to be able to try and replicate it.

What are weaknesses of Vallentine’s research in terms of length of programme?

• Long treatment may reduce completion rates.

• Attribution rates - takes so long people drop out.

• Because they have mental health issues they don’t have to be part of it and can drop out if they want to.

• They may even commit suicide.

What is a strength of Vallentine’s (2010) research in terms of first research into these types of offenders?

• Provided new knowledge in an under-studied population.

• Group of Pp’s that haven’t been focused on before all in one place at the same time.

• Gaining valuable insight in an under researched group.

What is thematic analysis?

• A way of analysing qualitative data without losing its meaningfulness by using themes, patterns or trends.

What is the inductive approach of thematic analysis?

• Review the data first, then generate themes and codes that emerge from it.

What is the deductive approach of thematic analysis?

• Researcher generates themes and codes they want to look for, then analyse the data.

What is grounded theory?

• A method of generating theory by analysing research data first (inductive method).

What is the process of grounded theory?

1. Aim of research.

2. Gather data.

3. Analyse the data - generate themes, codes, patterns, trends.

4. Gather more data, analyse and code more specifically.

5. What theory explains the data based on codes/themes - further research can be done.

What are the strengths of grounded theory?

• Evidence for the theory is integrated as the data comes first and throughout the process - increasing validity.

• Able to make policy decisions, procedural improvements, treatment improvements based on a large body of data - application value.

• Samples can include all relevant sources of data - patients, staff, families, education professionals etc - increasing validity of opinions and generalisability to similar areas.

What are the weaknesses of grounded theory?

• However, validity and application value only applies if there is no element of researcher bias in the data gathering or interpretation - reduced validity due to subjectivity and not actually ‘grounded’.

• Also, selecting the data to collect based on the themes that are emerging could lead to the researcher missing information or important themes that contradict the direction they choose.

• Process may not be standardised - reduces replicability and reliability of data analysis, difficult to check.

• Very time consuming - gathering and analysing data - forming patterns when the researcher is unsure of exactly what they are looking for, then narrowing down to codes and themes.