PSYC 372 Unit 4

In order to develop chicken pox, one must be exposed to the Varicella Zoster Virus (VZV), which causes chicken pox. Note, however, that not everyone who is exposed to VZV is affected (because they may have less sensitivity to it, or built prior immunity). In other words, VZV is a...

Necessary cause

Childhood abuse is commonly reported in those who develop dissociative disorders later in adult life. So, for adults with dissociative symptoms, childhood abuse could be described as a...

distal contributory cause

Recent research by Dr. Babson and colleagues indicates that there is a correlation between bodily arousal (e.g., physiological activation due to being startled or briefly deprived of oxygen) and symptoms of panic attacks. Specifically, they found that that relationship was much stronger
in those who’d recently experienced sleep deprivation, and weaker in those who’d slept well. What sort of variable is sleep in this three-part statistical model?

moderator

In another study on panic disorder, Dr. Berrocal and colleagues found that hypochondriacal concerns (i.e., persistent fears about one’s health) were correlated with symptoms of panic attacks. Specifically, they found that hypochondriacal fears were positively correlated with levels of “anxiety sensitivity” (i.e., being highly sensitive to what one feels in their own body), which then is positively correlated with frequency of panic attacks. When removing anxiety sensitivity from the calculations, the relationship of hypochondria to panic attacks was nearly non-existent. What sort of variable is anxiety sensitivity in this three-part statistical model?

mediator

Which of the following is the best example of an instance of over-diagnosis?

A recently stretched diagnostic definition led to inflated prevalence estimates.

A college student visits a psychiatrist for an evaluation, wanting to be prescribed stimulant medication (e.g., Adderall) because he hopes to sell the pills for profit. While the student aims to receive a diagnosis of ADHD (which could grant him access to the medication presciption), he does not truly experience inattentiveness or hyperactivity to clinically significant levels. The
psychiatrist collaborates with a neuropsychologist and together they complete a comprehensive assessment of cognitive functioning. The final report claims that no diagnosis is warranted. What sort of finding was this?

true negative

In chapter 11 of The Book of Woe, Dr. Greenberg explores the “noble lie” perpetuated by the psychiatry / clinical psychology fields. Specifically, he discusses how promoting the lie may be beneficent, but illuminating the truth may provide autonomy, so there is an ethical dilemma. What exactly is this “noble lie” he’s referring to? The lie is...

that diagnostic labels of mental disorders and their classifications are valid, truthful, and accurate ways for clients to understand their woes; the truth is that they’re social constructs.

The term used to describe tests such as the Rorschach Inkblot Test, Thematic Apperception Test, and Incomplete Sentences Blank is _____, because these tests rely upon ambiguous stimuli, to which a client responds and theoretically places subconscious content of self onto the task.
Meanwhile, the term used to describe tests such as the WAIS, Stanford-Binet, Beck Depression Inventory, and MMPI is _____, because these tests rely upon clear/exact stimuli and a quantitative scoring structure to yield specific numerical results.

projective / objective

Which of the following is the best definition of reliability?

the degree to which a test yields true and accurate scores, free of error

While all (or most) psychological tests can add some value to an assessment procedure, there are certainly those which are better fitted to specific situations than others. Imagine that a research team is running a study on treatments for Social Anxiety Disorder, and is assessing participants at the beginning of the study (to establish baseline symptom levels and ensure they are appropriate to be included in the large dataset). Which test sounds the most helpful to the researchers?

a brief social anxiety symptom rating form

Explain the parts of the stress diathesis model?

-models the likelihood of a disorder occurring based on
one’s combination of stress level and diathesis level
-combines nature and nurture in etiological modeling

Stress

-means what we typically use it to mean (demand,
challenge, difficulty, taxing, strain)
-refers to proximal contributory causes
-e.g., losing a job; divorce; military service; illness

Diathesis

-means a genetic, early-life, or lifelong predisposition
-refers to distal contributory causes
-e.g., Schizophrenia runs in the family; child abuse;
early life neglect; prenatal infection

Diagnostics Classifications

“true”: clinician made the correct decision
“false”: clinician made wrong decision
“positive”: clinician deemed the disorder present
“negative”: clinician deemed the disorder absent

-Callie is mentally healthy but her clinician misreads her chart and gives a diagnosis.

Explain Overdiagnosing

We broadened the definition for depression too much, so cases where someone felt grief from a loss, which is normal, was deemed to have depression. Many people who didn’t actually have depression were being diagnosed. It wasn’t a clinician mistake, it was more of a societal, large-scale, field-wide problem.

What did Greenberg argue about ethics?

Greenberg argues further that not only is the overdiagnosis of depression unethical, but nearly all diagnostic labeling is essentially a lie and therefore unethical.

What did Allen Frances believe about ethics?

He believed that sometimes we need to give a noble lie to patients

Why might the “noble lie” be okay?

• Diagnoses can impart trust, knowledge that one isn’t alone, and boost trust in the system and its credibility.
• Maybe use of the noble lie is “beneficent.”

What is benefiecience?

Beneficence = medical ethical value, obligation to act in best interest of patients

Why might the noble lie NOT be okay?

This lie prevents patients from having full autonomy over their treatment.

What is “autonomy”?

Autonomy = medical ethical value, right of patient to make independent decisions

Types of assessment

Neurological tests

Neuropsychological tests

Psychosocial tests

Neurological tests

designed to measure physical brain issues (PET, CAT, EEG, MRI, fMRI)

Neuropsychological tests

designed to measure brain issues via psychological performance

Examples: Finger tapping test, grooved pegboard test, trail making test

Psychosocial tests

designed to measure various psychological constructs

• Interviews, observations, tests of ability/capacity (IQ, Memory), Tests of personality/symptoms

Tests of Capacity/Ability

• Wechsler intelligence tests (WAIS for adults and WISC for children)
• Stanford-Binet Intelligence Test

Objective Personality Tests

• Minnesota Multiphasic Personality Inventory (MMPI-II)
• Hospital Anxiety and Depression Scale
• NEO-PI
• Beck Depression Inventory