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PSY3171 (33)
Chapter 3

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Department
Psychology
Course
PSY3171
Professor
Mark Coates
Semester
Fall

Description
Chapter 3 ­ Research and Diagnosis Significance • Statistical significance – unlikely to have occurred by chance • Clinical significance – whether the intervention has practical utility • Clinical significance: is the effect that treatment has big enough to use this treatment • If you have enough people in your group you will find statistical significance – huge sample sizes not always good Error • Every measurement contains error – Polling, weight, depression, IQ • Reliable measures contain less error, but there will always be some • We can never control all the factors that could be influencing someone's performance on a given test • In experiments, we try to cut down the error as much as realistically possible • Always going to have some error in the data – Little fluctuations from day to day – Someone reading question wrong – Entering data wrong • Did you sleep good last night? Did you eat breakfast this morning? Do you drink coffee? – Ask questions to try and lower error • Control by manipulating who’s in your study – Only having people in the study that dont drink coffee • Cant do these things in a clinical setting – dealing with one person and wanting to know their diagnosis Exclusion criteria • We often exclude certain people from the study if they could throw off the results • Say you were studying the role of blood sugar on Alzheimer's, you wouldn't want to run you study with patient who had suffered brain injury • Sometimes too much internal validity can compromise the results, since people in the real world often have multiple disorders • Exclusion criteria – going to exclude everyone with a certain disorder or experience • Helps you control for that variable so you know that it doesnt have any effect on the study • Have to do this often, no other way • If you are doing a study on depression and you exclude people with anxiety, most people with depression have some anxiety, you just cut out half the people you are trying to treat External validity • YAVIS and WEIRDOs • How well do the results of the study generalize to the population as a whole? • Many studies are done on undergraduates • WEIRDOs – people who make up most studies • Undergraduates • Distinct demographic group • Not well representative of the population • Western educated industrialized rich democratic • YAVIS – people who do best in therapy • Young attractive verbal intelligent successful • People willing to talk, comfortable talking • Undergradutates • The people that do better in treatment, are the ones we do the research on • ex: if class had a disorder and all the parents had a disorder, the class would do a bit better in the treatment • Inflates our estimates on just how effective treatments are Control groups • Having one group that does not receive the treatment is essential • Otherwise, you don't know if the results are due to the intervention or to: – The passage of time – Practice effect – Placebo effect – Regression to the mean (the Sports Illustrated Cover curse) • In time people just get better even if the treatment does nothing • Without a control group you wouldnt know if this is the case • Practive effect – get better at doing things with practice • Ex: IQ test, given the same test twice, going to do better the second time • Regression to the mean – if you get on the cover, you start playing worse • Do a bit better than you normally would, not usual for you, eventually you will go back down to normal • Important bc when they go into therapy/ studies are at their worst, worse stress than they would normally feel • Not reflective of how you usually feel Research on therapy • How do you measure things like selfactualization, catharsis, or transference? • If you just measure symptoms, what are you missing? • Who does research on therapy? • Common factors vs comparing types of therapy • Common factors – what makes therapy useful to this person • Number 1 thing that makes therapy effective = therapist and patients relationship • How well they trust eachother, open up with eachother • Accounts for most variance in outcomes • As long as you have a good relationship with patient they will prob do good in therapy, doesnt matter what kind of therapy • Which therapy works better? Measurement • Questionnaires • Interview • Objective measures • Projective measures • Background information Questionnaires • Self-report measures – Beck Depression Inventory – NEO-Personality Inventory – Youth Self-Report – Impact of Event Scale • With self-report measures, patients can try to present themselves in an unrealistically favourable (or unfavourable) light • Many measures have validity indices to determine whether patients are responding honestly • Objective questionnaires (MMPI, PAI) compare an individual's responses to known groups • A lot of informatin in a cost effective way • Try to minimize doing this • Why would you want to use a questionnaire instead of just talking? – Might be more comfortble at first – Costs a lot of money for therapist, can get a lot more info in short time from questionnaire, more practical – Disadvantages to interviews – people will respond differently on a questionnaire • Would not diagnose from a questionnaire • There are certain questions that if you answer them a certain way, you are lying • If you answer a bunch of questions that way means you prob lied on the whole test • Objective questionnaires – Compare results to a known group (ex: with depression) – Based on the results, your pattern of responding is similar to those with depression Interviews • Considered more accurate than questionnaires; people are less likely to lie to a living person than to a piece of paper • Interviewer can follow up questions • But interviewer can also influence the patient – Leading questions – Double-barreled questions • Harder to lie in person • Hard to open up at first sometimes • Questionnaires better for hard topics such as suicide • Leading questions: – Can you tell me why your upset today? • They might not have been realy upset but now that you’ve mentioned it they go off in that direction • Double-barreled questions: – Asking two questions at once – Confuse patient and therapist – Only answer half the question but forgot to come back to the second one Objective measures • Neuropsychological tests – Usually paper/pencil or verbal tests that isolate a certain cognitive function (attention, memory, visualspatial reasoning, executive functioning) • Imaging – Functional or structural images of the brain – Excellent understanding the brain areas involved in a disorder, but often poor single subject validity • Isolated particular brain function • Know there strengths and weaknesses • If you think they have a tumor or something you use imaging to rule that out • Using imaging to determine what disorder they have not so effective • Single subject validity: whats true for one subject might not be true for another • Have to say the color its printed in, not read the words • People slow down to do this • People with certain disorders perform much worse than normal people Projective measures • Rorschach inkblot test • TAT • Projective drawing tests • Allowed to respond anyway they want • Ambigous stimulus, open ended response • Interpret what their responses mean • People with same disorders, answer roughly the same • House, tree, person test is a real test • Good at establising rapport • Some good realable differences • Themactic a perception test • Could mean multiple things • Everytime women answered the test they answered women is dead and he is sad • Men answer he is sad bc they just had sex • Men always mention the nudity Background information • Medical charts • Report cards • Police reports Prevalence vs Incidence • Prevalence: – Frequency of a condition at a specific point in time • Incidence: – Number of new cases of a condition in a population over a specified period, often one year • Be able to tell the difference between the two terms • Prevalence – for a specific time, how common is that disease? One year prevalence or point prevalence (at this very moment), life time prevalence (probably the one we are going to use most) – at some point in there life how many people will have this disorder • Incidence: how many new cases are there of a specific disorder at a certain time, used more in medicine Diagnosis • Diagnosis in the real world is quite different from what you see on House MD (the show) • Very often a specific hypothesis or question informs the assessment – Did he suffer a head injury? – Is he depressed? – Does she need to be in a special class? – Sometimes we only get "Please assess” • Using numerous measures, we test hypotheses, compare the results to the diagnostic criteria, and determine what diagnosis (or combination of diagnoses) fits best • Interview • Interview with family member • Background info – pol
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