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Clinical Psychology - Coggle Diagram

- - - - STRENGTHS- 1. Access to large data sets, for example, records kept by psychiatric hospitals provide info on diagnosis rates in close relatives. 2. It is less time consuming than designing an experiment and collecting data yourself and also more validating. If somoene has carried out a very similar study before the data is already checked for validity.
      - WEAKNESSES 1. This data may be out of date and not fit the needs of the researcher's aims so could provide analysis of poor quality. 2. Using secondary data may waste valuable time because if it turns out not to be directly relevant to the aims of the current study, that time could have been better spent designing a primary data investigation instead of analysing out-of-date data.
  - - - PROCEDURE 42 males in Broadmoor high-security hospital in a psycho-educational group, most of which have schizophrenia. Recorded semi-structured interviews of the patients and then did a thematic analysis of their answers on the helpfulness of the psych-educational group finding key themes from their responses. used the CORE-OM to assess the effectiveness of therapies and a self-report questionnaire to assess self-esteem. No. incidence of violence were noted, changes in medication and in staff and in other therapies also recorded. The aim of the group was to help them understand their diagnosis and cope with their illness.
      - RESULTS - 4 core themes identified, 'What participants valued and why', 'What was helpful/unhelpful' and 'clinical implications' which participants said 'gave you piece of mind' while it also made them feel guilty about their past.
      - AIM: to study the usefulness of pscyh-education group work for offendor patients in a high-security forensic hospital setting.
      - CONCLUSIONS showed there were postive and negative changes in the various measures taken after the psycho=educational group took place.
      - EVALUATION: STRENGTH: semi-structured/unstructured interviews gave more detailed information to be gained from patients, qualitative data recorded WEAKNESS: lack of reliability no standardsied questions
  - - - AIM- to investigate the fragile ego boundaries of a single group case study
      - PROCEDURE- support group of 6 patients do a session with a trained therapist before their break for Christmas 45 minute session on a 'Thursday' group, session was not recorded at the time but summarised in a report by a therapist, fragile ego boundaries are a breakdown in the line between real and unreal, their thoughts and others thoughts.
      - RESULTS- one patient gave out Christmas cards and calendar wants the group to be linked together the group's solidify enforces his fragile ego boundary, Earl has grandiose delusions of working on running an oil pipeline linked to his father's job as an engineer, another has out of body experiences like hallucinations of spirits taking over their body showing his fragile ego boundary being unable to differentiate between real and unreal.
      - CONCLUSIONS- therapists role as allies to the patients as a buffer to prevent psychological crisis, stronger relationship 'self' and 'others'.
      - EVALUATION OF CASE STUDY- STRENGTHS: hollistic inter-rater reliability- 3 therapists data, rich qualitative data WEAKNESSES: low generalisability because of small sample (one woman androcentric), researcher bias (less objective as recorded after 45 minute session may forget what happened/be more accustomed to patients and not make objective observations),
- - - - Exam Question: What are the cultural issues with diagnosis? One, the DSM is made by the American Psychiatric Association so may only apply to mental illnesses in the US, what is considered an abnormal behaviour in one culture may be completely normal in another leading to misinterpretation and wrong diagnosis like hearing voices may be a feature of schizophrenia in Western countries, but being possessed in others. In addition, other disorders may appear only in one region like in China Koro Disorder makes men believe that their sexual organs with shrink and disappear into their abdomen causing them to die.
    - - STRENGTHS- Kim Kohen (2005) experiment high validity children with conduct disorder more likely to be disruptive during assessment, Lee (2006) ADHD questionnaire of teacher and DSM-IV-TR diagnosis matched children's behaviour. Hoffman (2002) found that diagnosis of alcohol and cocaine dependency had high concurrent validity since automated interview and diagnosis from DSM4 matched.
      - WEAKNESSES- Rosenhan (1973) able to fool DSM II, predictive validity could be in doubt as not every individual shows the same symptoms so there is no recognisable pattern so the disorders may not be the same for every person Lee (2006) found that DSM IVTR criteria fit boys better than girls,
    - - STRENGTHS Daniel Regier Cohen Kappas decimal proportional rating system to see reliability of diagnosis of disorders. PTSD was highly reliable 0.7 so symptoms and features of PTSD as well as duration clear to all psychologists, 0.5 for schizophrenia diagnosis Goldstein (1988) Using the DSM 3 Goldstein re-diagnosed patients originally diagnosed using the DSM 2 and found similarities in diagnosis, she asked experts to do the same single blind technique, and found a high level of agreement and inter-rater reliability, the DSM 5 & IV-TR built of DSM 3 and so is likely to be reliable.
      - WEAKNESSES Racheal Cooper (2014) acceptable level of agreement has plummeted over the years 0.2 -0.4 seen as 'acceptable' reliability with DSM 5. Major Depressive Disorder Kappa score was 0.28 extremely low reliability with DSM-5 compared to DSM-3 suggests may be less reliable than other versions. However this may be unsurprising since DSM3 experts given strict instructions and screened 'test' clients while DSM 5 were told to mirror normal practice. However, the inadequacy of classification systems account for 62.5% of misdiagnosis.
      - ICD Galeazzi et al. (2004) arranged for two researcher to conduct a joint interview to assess 100 consecutive clients for psychosomatic symptoms. Found 0.69-0.97 kappa values showing ICD-10 has high inter-rater reliability. Mason et al (1997) They compared different ways of making a diagnosis. ICD-9 and ICD-10 were reasonably good at predicting disability in 99
        people with SZ 13 years later high predictive validity.