Abnormal Psychology Studies

Kinzie et al. (1987)

Aim

To determine if individuals of different cultures have differences in compliance rates for treatment.

Method

True laboratory experiment with a repeated measures design

Procedure

• 41 South-East Asian patients with MDD, undergoing treatment with TCA had their TCA levels in blood measured

• Patients discussed with doctors about the benefits and problems with TCA

  • After the conversation, TCA blood levels were measured again

Results

• Before the discussion, 61% of patients had no detectable levels of TCA in blood

• After discussion, compliance rates in patients had increased

Conclusion

• Patients may have cultural attitudes towards authorities that cause them to avoid offending the doctor

  • May be a result of the high PDI in South-East Asian countries

  • Patients accept the medication even though they do not want to use it, leading to an ineffective treatment

Strengths

• Use of participants from multiple countries (eg. Vietnam and Cambodia) increase generalizability for the target population

• The results are congruent with Hofstede’s cultural dimensions which improve the study’s credibility

Limitations

• The research may no longer be relevant to modern healthcare conditions

  • TCA has the unique detriment of its significant side effects, therefore making discussion with doctors more important

  • Current medication such as SSRIs have less severe side effects and therefore these discussion may be of less value

  • Issues with compliance may be due to other factors instead

• Participants may be uniquely pressured by the presence of researchers and may thus be more likely to comply

  • Results may be less generalizable to real-world situations with no third-party involved

Fournier et al. (2013)

Aim

To examine how different treatments for MDD can affect specific symptoms differently

Method

True laboratory experiment

Procedure

• 231 patients with depression were assigned to cognitive behavioral therapy, SSRIs, or a placebo

• Patients had their symptoms measured over the span of several weeks at specific intervals

  • These included suicidal ideation, anxiety, and vegetation

Results

• After 4 weeks, medication was more effective in reducing suicidal ideation

• After 8 weeks, CBT was more effective than medication in reducing suicidal ideation

• CBT is overall superior in reducing vegetative symptoms

Conclusion

• The different results between the two treatments allow for them to be applied to different situations

  • SSRIs may be better for more severe MDD because of its fast acting effects reducing harmful symptoms to a more manageable state

  • CBT is better overall since it is more effective in the long run

• Patients with different symptoms may benefit from different treatment options

Strengths

• Studying a broad range of symptoms allows for a more holistic understanding of the treatments’ impacts

Limitations

• Self-reported data can be subject to social desirability effect and sensitivity bias

  • Mental illness can be stigmatized in many cultures and participants may thus not want to accurately share about it

• The shorter duration of the study may not account for more long-term impacts of each therapy

  • The study may not have been able to test for tolerance, a more delayed, negative aspect of treatment

Hollon et al. (2005)

Aim

To find whether CBT or the continued use of SSRIs has a greater long-term effect on MDD symptoms.

Method

True laboratory experiment and a subsequent naturalistic follow-up

Procedure

• Patients from University of Pennsylvania and Vanderbilt University who responded to CBT were removed from treatment

  • These patients were compared to a different set of patients who were either assigned to continuation medication or a placebo withdrawal

• All patients were observed for a 12-month period and those without relapse were further observed for another 12 months

  • The extra phase had complete treatment withdrawal

Results

• Patients withdrawn from CBT were significantly less likely to relapse during the continuation period

• They were also no more likely to relapse during the initial period as those using continued medication

Conclusion

• CBT seems to have a more enduring effect with its benefits still existing after the treatment period ends

Strengths

• The longitudinal nature allows for the direct exploration of long-term impacts

  • Creates a more robust understanding of treatment effectiveness

• There is high ecological validity since participants received previous treatment under standard conditions

Limitations

• There are potential ethical harms on participants since their potential relapses could lead to psychological or physical harm

  • Could also mean that participants do not receive equitable treatment as compared to other patients

Griner and Smith (2006)

Aim

To examine the effectiveness of culturally specific treatments.

Method

Meta-analysis

Procedure

• 76 studies totaling 25,000 participants were analyzed using quantitative data to measure success

Results

• Cultural adaptations had a moderately strong benefit to effectiveness

  • This was further increased when the therapist and patient were from the same country and when patients’ native language is spoken

Conclusion

• Culturally sensitive treatment has greater effectiveness compared to regular treatment since it connects better with participants

  • Use of native language allows for ideas unique to certain cultures to be expressed and discussed

  • Culturally sensitive treatments can focus on values and beliefs specific to a culture and therefore provide coping strategies that align better with patients

Strengths

• Use of a meta-analysis compiles data from multiple culturally sensitive treatments, improving generalizability

  • Also looks at data from many sets of therapists whose aid may vary depending on personal preference and extent of knowledge

Limitations

• Solely quantitative data negates any more nuanced explanations of the type of culturally specific treatment (eg. folk stories, language used during therapy)

  • Cannot differentiate between dissimilar techniques that may all be considered culturally specific overall