Adult Psychopathology Exam 2

what is the importance of research methods?

there are important unanswered questions about the causes and treatments of disorders

goals of psychologists conducting research are

• provide the most efficacious treatment

• prevent disorders

descriptive research method

• case study

• survey 

• epidemiological 

  • cross-sectional 

  • longitudinal 

• genetics 

epidemiological 

research study method examining the prevalence, distribution, and consequences of disorders in populations

cross-sectional

researchers take a cross section of a population across the different age groups and compare them on some characteristic

longitudinal designs

researchers may follow one group over time and assess change in its members directly

• allow researcher to assess individual change

experimental

• single-case

• group

  • randomized controlled trial 

first step in the research process 

theory; develop a question 

second step in the research process

conduct literature searches

third step in the research process

create a hypothesis

fourth step in the research process

define and measure variable

fifth step in the research process

identify participants of interest 

sixth step in the research process

select an approach/design

seventh step in the research process

conduct the study

eighth step in the research proces  

data analysis 

ninth step in the research process

interpret findings

tenth step in the research process

create or refine theory

eleventh step in the research process 

share the findings 

what research step(s) take the longest

step 5: identify participants of interest

step 7: conduct the study

also the hardest

for step 11 (share the findings) in the research process how does one share their findings?

• presenting work at conferences

• getting work published

• the media

are single-case experiments case studies?

no they are not 

key aspects in experiments 

• cause and effect

• participants vs. subjects 

what are the key aspects in all experiments (group and single-case)

• hypothesis

• independent variable

• dependent variable

• internal validity 

• external validity 

• confounds 

hypothesis

expected outcome from manipulating the IV

independent variable (IV) 

factors thought to affect the dependent variables and may be directly manipulated by the researchers 

dependent variable (DV)

aspects that you want to measure in the people you are studying; what is measured 

internal validity

the extent to which you can be confident that the independent variable is causing the dependent variable to change; did the independent variable produce the outcomes?

external validity 

how well the results relate to things outside the study; are the findings generalizable? 

• how well does the findings describe similar individuals who were not among the study participants 

confound

any factor occurring in a study that makes the results uninterpretable because a variable other than the independent variable may also affect the dependent variable

how do researchers make sure internal validity is preserved?

• randomization

• control groups

single-case experiment 

the systematic study of individuals under a variety of experimental conditions

• better to know a lot about the behavior of one individual than to make only a few observations of a large group for the sake of presenting the average response

• improve internal validity, thereby reducing the number of confounding variables

key factors in a randomized controlled trial

• random assignment

• at least one treatment condition and one control condition

  • wait list

  • alternative treatment

  • treatment as usual

  • no treatment

wait list control group

waiting until a later time to be treated

alternative treatment

something we know is working for people

• want this one because you are in control of it

treatment as usual

something we know that works, but not in control

• partnering up with someone else who control that treatment

• closer to external validity

no treatment 

do not want this one because you are giving the participants nothing

what are some issues in a randomized controlled trial?

• single-blind studies

• double-blind studies

• partial blinding

single-blind studies

the participants are unaware of what group they are in or what treatment they are given 

double blind control

the participants in the study are “blind” or unaware of what group they are in or what treatment they are given and so are the researchers or therapists providing treatment

partial blinding

assessors are blinded to participants 

what are some additional factors in a randomized controlled trial?

• recruitment

• screening

  • telephone screening

  • in-person screening

  • inclusion/exclusion criteria

• treatment fidelity

• training of interventionists

• supervision of interventionists

  • fidelity checks

treatment fidelity 

• operationalize the intervention 

• manuals 

• What kind of skills are people getting 

• defining the intervention 

• this is about cognitive therapy

therapist drift 

train the clinicians to do protocol, but its human nature to move away from things and go back to what we usually do; drifting away from the manual 

• dont want this in a research setting it could affect results

what is the best way to see therapist drift?

to observe it 

fidelity checks

a checklist to see if research clinicians are doing what they should be doing in the manual for the research section

intent to treat analysis

All participants should be analyzed in the group to which they had been randomized as if they had received the intervention which they were supposed to receive, irrespective of the treatment actually received

per protocol analysis 

Inclusion in the analysis of only those patients who strictly adhered to the protocol

• provides an estimate of the true efficacy of an intervention among those who completed the treatment as planned

• do not represent the real-life situation, and it is likely to show an exaggerated treatment effect

why do people drop out of a RCT?

• death

• other things going on in their lives

• time consuming

• people move

benefits to a randomized controlled trial? 

if there are signification findings, the researcher can say they are due to the intervention 

what are some limitations to a randomized controlled trials?

• time consuming

  • takes a long time to analyze and publish the data

• labor intensive

• costly

  • To do it right, you need money

  • money for studies that go on for 3-5 years

how long could a RCT take?

8-10 years

inferential statistics purpose

to interpret data and draw conclusions

statistical significance

a mathematical calculation about the difference between groups; occurs when the probability is very low that the observed findings are due to chance

• Very low is defined as less than 5 chances in 100 (p<.05)

  • The lower the better

• numerical data

• does not imply clinical meaningfulness

what kind of test is correlated with statistical significance? 

questionnaires 

clinical significance

Whether or not the difference was meaningful for those affected in a study, Are the results clinically meaningful?

• qualitative data

what kind of follow up is associated with clinical significance? 

Interviews 

• can be brief

• see the quality of life, and write about it in the article

• Did their life really change? What does it really mean for people?

does every article have statistical significance and clinical significance?

no; most articles do not have clinical significance, but all articles have statistical significance

what is the role of human subjects institutional review board? (IRBs)

• board of people consisting of faculty, medical professionals, lawyers, and regular people (community members)

• scrutinized depending on what the study is

• how ethical a research study is

side effects

more likely to occur, but not serious

• ex] upset stomach as a side effect to medication

adverse event 

rare things that will happen during the study that are more intense 

• ex] risk for seizure due to a new medication that is being researched 

competence

a person has the cognitive ability to provide consent

• determine it by how they communicate (or not), there is a clear channel of communication, do they have someone to help them if needed?

  • tend to know if they have the cognitive ability by interacting

comprehension

a person must understand what participation involves, including the benefits and risks of the study

full information 

a person must have all relevant information to make the right decision about whether or not to participate 

voluntarism

a person is truly a volunteer, which means they have not been coerced or forced into participating

what is the process of informed consent?

competence, comprehension, full information, and voluntarism

confidentiality 

• In the consent form, which only the research team has access to 

• expectation includes harm to oneself or others 

  • Safety is number 1

withdrawal 

a participant dropouts and notifies the researcher 

• participant has the right to withdraw their data and researcher has to respect that 

if a participant doesn’t notify that they are dropping out:

researcher can keep their data

what are some issues with payment and coercion in a research study?

• dont want participants to feel coerced or that they are doing it just for the money

  • Have to watch how much you pay people, keep it under $50

  • However, it depends on how invasive and what you are asking the participants to do

• pay for assessments and maybe incentives

cross-generational effect

trying to generalize the findings to groups whose experiences are different from those of the study participants

sequential design

involves repeated study of different cohort over time

informed consent

a research participants formal agreement to cooperate in a study

analogue models

create in the controlled conditions of the laboratory aspects that are comparable (analogous) to the phenomenon under study

case study method

investigating intensively one or more individuals who display the behavioral and physical patterns

• relies on a clinicians observations of differences among one person or one group with a disorder, people with other disorders, and people with no psychological disorders

experiment 

the manipulation of an independent variable and the observation of its effects 

• manipulate the independent variable to answer the question of causality 

placebo control groups

the placebo is given to members of the control group to make them believe they are getting treatment

randomization

the process of assigning people to different research groups in such a way that each person has an equal chance of being placed in any group

control group

people are similar to the experimental group in every way except that members of the experimental group are exposed to the independent variable and those in the control group are not

BMI category for underweight

below 18.5

BMI category for normal weight 

18.5-24.9

BMI category for overwright

25-29.9

BMI category for obese

30 and higher

BMI category for class I obese 

30-34.9

BMI category for class II obese

35-39.9

BMI category for class III obese/extreme obesity

40 and higher

what does BMI stand for?

body mass inde

diagnostic criteria for anorexia nervosa

restriction of energy intake leading to low body weight in the context of age, sex, development, and physical health

• intense fear of gaining weight or becoming fat

• distorted body image

• lack of recognition of the seriousness of the current low body weight

  • BMI requirement

diagnostic criteria for anorexia: restricting type

during the last 3 months they have not engaged in recurrent episodes of binge eating or purging behavior

• weight loss is accomplished through dieting, fasting, and/or excessive exercise

diagnostic criteria for anorexia: binge-eating/purging type

during the last 3 months they have engaged in recurrent episodes of binge eating or purging behavior 

• self-induced vomiting, misuse of laxatives, diuretics, or enemas 

what is the mild BMI for anorexia severity?

more than or equal to 17 kg/m2

what is the moderate BMI for anorexia severity? 

16-16.99 kg/m2

what is the severe BMI for anorexia severity?

15-15.99 kg/m2

what is the extreme BMI for anorexia severity?

less than 15 kg/m2

medical consequences for anorexia

decline in bone mass, skin becomes dried out, brittle nails, change in hormones (loss of menstrual cycle), amenorrhea, low BP and HR, fine hair all over the body, low iron levels 

what is the result of repeating vomiting?

tooth erosion (enamel worn off), salivatory gland enlargement, esophageal tears (rare) w

what are some results of laxative abuse?

electrolyte imbalance, constipation, colon damage

what is the lifetime prevalence for anorexia?

0.6%-0.8%

what is the prevalence for females for anorexia? 

up to 1.42% vs up to 0.3%

what is the typical age of onset for anorexia?

adolescence or young adulthood

what are some rare age onsets for anorexia?

before puberty or after the age of 40

• if client is after 40, you need to rule out medical conditions (GI disease, hyperthyroidism) major depressive disorder, substance use disorders, etc