Starter: Reflecting upon previous work

Starter: Reflecting upon previous work Read through the work I have given back and read my comments Complete the feedback sheet and put your work with it We will then discuss common errors

13 A and 13 C Reliability and Validity Essays
A reminder: P – make your point E.g. The fundamental attribution error may suggest a tendency to attribute mental illness to dispositional, rather than situational factors. E – The F.A.E explains how people are more likely to attribute negative situations (e.g. mental health issues), with something intrinsic to the individual. This ignores the situational factors that may exert influence on behaviour or illness. Szaz’s unwillingness to define something as mental illness without biological evidence exemplifies how often when someone ‘has a problem with living’ they are diagnosed as mentally ill, as opposed to coping with the environment in which they find themselves. C – This shows how due to the biases of some psychiatrists may influence their diagnosis of a person, thus making the diagnosis more subjective and less valid.

Reliability and Validity Essays
Other general points: Use the PEC format wherever possible Back up with RELEVANT evidence (it is tempting to rely only on AS studies, but they don’t always make sense in the context) Link back to the Q to ensure you are actually focusing on the issue in hand Use the resources provided to you and seek support if required

13E Experiment 22 mark hwk Generally done extremely well
Make sure that your study is fully replicable – could you pass your paper to someone and have them carry it out Less than or equal to when talking about p values Make sure you use the table to check which test to use and you must learn before exam Make sure hypotheses are fully operationalised Be really specific with your materials

13 E Observation Classwork
GENERAL POINTS: You do not always have to have an IV and Dv – merely observing and recording behaviours is sufficient Not all of the points in your booklet will apply to observation e.g. things that are specifically linked to experiments Make sure that the observation is fully replicable – could you give it to someone else and have them repeat it without your help? DON’T PANIC!

Things you must include:
Observation Selection of sample (Sampling technique)(Who and How) and the way the behaviour is observed (also known as a Sampling technique) (How) Observation schedule and criteria. (When and what) Where was it conducted? Any inter-rater reliability? Validity of criteria? Reliability? (These are evaluative issues) Ethics of observing people.

Examiner’s Report The method was clearly described although it was not always fully replicable. Most candidates knew how to use event sampling and gave some good examples of behavioural categories. Some responses specified careful and precise criteria for particular behaviour categories, whereas others gave lists without comment. Some candidates suggested pilot studies in order to identify appropriate observational categories and that pairs of observers should pre-check consistency in use of categories in order to ensure inter-observer reliability. Most observations were carried out within the candidates’ own environment and these were better explained in a practical way than candidates who used shopping centres and parks, where impractical scenarios were often described. More care should be given to thinking about practicalities. Common room observations proposed over a fixed time period, such as school break or lunch-hour failed to consider the problems of keeping track of large numbers of people coming and going and failed to make it clear how multiple incidences of the behaviour (eg use of a mobile phone) by the same individual during the specified time slot would be scored. It is important that candidates describe research that falls within BPS ethical guidelines. Although some research was described using year olds, most candidates are aware of the need to use participants over 16 years of age.

Dysfunctional Behaviour
Diagnosis (1), Definition (2), Bias (3) Explanations Treatments HEALTH & CLINICAL PSYCHOLOGY G543

EXAM STYLE QUESTIONS (ESQ) Diagnosis
Categorising June 2010 Describe one way (eg. classification system) in which dysfunctional behaviour can be categorised. (10) Discuss the limitations of diagnosing dysfunctional behaviour (15) January 2013 How has dysfunctional behaviour been categorised (e.g. a classification system)? (10) Evaluate the validity of diagnosis of dysfunctional behaviour (15) bias June 2012 How has dysfunctional behaviour been defined [10] To what extent may diagnosis of dysfunctional behaviour be considered ethnocentric? [15] definitions January 2012 Describe research into biases in diagnosis [10] Evaluate the reliability of diagnosis of dysfunctional behaviour [15]

1. Diagnosis, Definitions & Bias
1- Diagnosis: DSM & ICD 2a - Definitions of Abnormality: Rosenhan & Seligman) 2b - Evaluation of definitions 3 - Bias: Ford & Widiger

1. Recapping the DSM and ICD-10
What is the aim of a classification system? Why are the two classification systems under review? What are the current diagnostic manuals used in the USA and the UK? Who published the ICD? What is the major difference between ICD-10 and DSM-IV? Name and advantage and disadvantage to giving an individual a diagnosis? When using these is the diagnosis reliable?

1. Summary Information: DIAGNOSIS
Aim To find a way of categorising mental illness that could be applied by any psychiatrist Background Two main classification systems are used to diagnose mental illness in most of the world. Both systems are now under revision and both are very controversial. As yet there are no biological tests for mental illness, although some are in development. Why is it important to have a ‘universal’ measurement of dysfunctional or disordered behaviour? What issues do you think exist in the pursuit of such a thing?

1. Summary Information: Diagnosis
DSM-IV ICD-10 Axis 1: Clinical disorders, e.g. Alcohol abuse Axis 2: Personality disorders, e.g. Histrionic Axis 3: General medical conditions, e.g. Cancer or diabetes Axis 4: Psychosocial and environmental problems e.g. Stressful events like divorce Axis 5: Global assessment of functioning, e.g. How well is the patient working? Each disorder is listed in one of 11 categories Personality disorders are category 9 Medical conditions are covered in the first category Built into the groupings of the disorders are the causal factors such as organic cause, substance abuse and stress There is no global assessment of functioning separately

1. Summary Information Requirements for a valid classification system
It should provide an exhaustive system (including all types of dysfunctional behaviour) The categories used to classify a disorder should be mutually exclusive It should be reliable (consistency and inter-rater reliability) It should be valid Content validity (ask the right questions) Criterion validity (ensuring one criterion is associated with another criterion) Construct validity

1b. Evaluation Questions: Diagnosis
Do psychiatrists always agree when using the same system? Diagnosis is dependent on the clinical interview, are self-reports reliable? Is it problematic that both the ICD & DSM have ‘misc’ categories? Do you think cultural changes affect symptom listings? Are mental illness inherited or learnt? At what point does a mentally ill person loose free will? Where is the science in diagnosis? Is the DSM/ICD useful?

1b. Debate Questions: diagnosis
Are mental illness inherited or learnt? At what point does a mentally ill person loose free will? Where is the science in diagnosis? Is the DSM/ICD useful?

1b. Evaluation & Debates: DIAGNOSIS
Psychiatrists do not always agree on a diagnosis using the same systems. This is because symptoms overlap and occur in clusters with no clear boundaries. Diagnosis depended on the clinical interview and this in turns depends on how honest and open the patient is about their symptoms. A high proportion of mental illness are diagnosed ‘unspecified’ in ICD-10 or not otherwise specified in DSM IV. This suggest that the criteria are not working well. Cultural changes affect inclusion of symptoms, e.g homosexuality has been removed. Nature-Nurture: Are mental illness inherited or learned? Free Will Vs Determinism: at what point does a mentally ill person loose free will? Psychology as a science: where is the science in diagnosis? Why no hard and fast tests? Usefulness: New categories are being discussed globally

Homework Research bias in diagnosis
You have a week for this so I expect a summary of the research and an explanation of how it shows bias. You could look into: culture, gender, ethnicity, age, any others you are interested in

Sort the following behaviour into two columns: (fill in table on next slide)
Hearing voices Having multiple wives Showing 4 times a day Being on Facebook Having a pet rat Being intelligent Having multiple wives Being intelligent Being vegetarian Listening to classical music Having to check things are off multiple times before leaving house.

‘Normal’ ‘Abnormal’

Activity 1: Reflecting on Task 1
What made this exercise either easier or harder to complete? ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ How do you think this relates to the diagnosis of dysfunctional behaviour? How would you define dysfunctional behaviour?

2a. Definitions What is the aim of defining dysfunctional behaviour?
What are the four definitions of abnormality according to Rosenhan and Seligman? What does Jahoda suggest you should have for ideal mental health? How might a person be considered to function inadequately? Which culture is more likely to be diagnosed with dysfunctional behaviour according to The Mental Health Act Commission’s ‘Count Me In Census’ (2005)? What factors affect the reliability and validity of defining dysfunctional behaviour?

2a. Summary Information: DEFINITIONS
Aim To try to define what we mean by someone who is abnormal generally Background Rosenhan has attempted to define what we mean by abnormality using the following terms: Statistical Infrequency Violation of social norms Failure to function adequately Deviation from ideal mental heath

KEY TERM Statistical infrequency/deviation from statistical norms: Certain behaviours are statistically rare Violation from social norms: Behaviour that is socially deviant is regarded as abnormal Failure to function adequately: Psychological distress or discomfort Deviation from ideal mental health: Lack of a “contented existence” Think back to the starter activity – can you find any that would be deemed abnormal according to one definition, but not another?

Statistical Infrequency
Under this definition, a person’s trait, thinking or behaviour is classified as abnormal if it is rare or statistically unusual. With this definition it is necessary to be clear about how rare a trait or behaviour needs to be before we class it as abnormal

Average IQ in the population is 100pts. The further from 100 you look, the fewer people you find frequency IQ Scores

A very small subset of the population (<2.25%) have an IQ below 70pts. Such people are statistically rare. We regard them as having abnormally low IQs frequency IQ Scores

Deviation from Social Norms
2a. Summary Information: DEFINITIONS Deviation from Social Norms Standards are set by society A norm is an accepted set of behaviours constructed by a social group Behaviour which is anti-social or undesirable Socially deviant behaviour

Under this definition, a person’s thinking or behaviour is classified as abnormal if it violates the (unwritten) rules about what is expected or acceptable behaviour in a particular social group. Their behaviour may: Be incomprehensible to others Make others feel threatened or uncomfortable

With this definition, it is necessary to consider: The degree to which a norm is violated, the importance of that norm and the value attached by the social group to different sorts of violation. E.g. is the violation rude, eccentric, abnormal or criminal?

2a.Summary Information: DEFINITIONS
Failure to Function Adequately Abnormality can be judged in terms of not being able to cope. For example, if you are feeling depressed this is acceptable as long as you can continue to go to work, eat meals, wash your clothes, and generally go about day-to-day living. Rosenhan & Seligman: suffering, danger to self, stands out, loss of control, irrational, violates moral social standard.

Failure to Function Adequately
Under this definition, a person is considered abnormal if they are unable to cope with the demands of everyday life. They may be unable to perform the behaviours necessary for day-to-day living e.g. self-care, hold down a job, interact meaningfully with others, make themselves understood etc.

KEY TERM Rosenhan & Seligman Any issues that may arise with these definitions or criteria? Suffering: distress or discomfort? Maladaptivness: Engage in behaviours that make it difficult to get on. Irrationality Unpredictability Unconventionality Observer discomfort Violation of moral/ideal standards. ‘normal’ people suffer distress and discomfort Those with personality disorders may not experience distress or discomfort Where to we draw the line with ‘unconventionality’? Often seen as desirable/cultural variations Some behaviours will make some feel uncomfortable e.g. in different cultures/times – does this make the behaviour dysfunctional? Doesn’t take into account different morals Too broad?

Deviation from Ideal Mental Health We define physical illness in part by looking at the absence of signs of physical health. Physical health is indicated by having the correct body temperature, normal weight, normal blood pressure, and so on. This is different from how we check mental health.

Deviation from Ideal Mental health
Under this definition, rather than defining what is abnormal, we define what is normal/ideal and anything that deviates from this is regarded as abnormal This requires us to decide on the characteristics we consider necessary to mental health

Deviation from Ideal Mental Health
Psychologists vary, but usual characteristics include: Positive view of the self Capability for growth and development Autonomy and independence Accurate perception of reality Positive friendships and relationships Environmental mastery – able to meet the varying demands of day-to-day situations

KEY TERM Deviation from ideal mental health Jahoda Effective self perception Realistic self-esteem Voluntary control of behaviour True perception Sustain relationships Self-direction and productivity

2a.Summary Information: DEFINITIONS
Failure to Function Adequately Abnormality can be judged in terms of not being able to cope. For example, if you are feeling depressed this is acceptable as long as you can continue to go to work, eat meals, wash your clothes, and generally go about day-to-day living. Rosenhan & Seligman: suffering, danger to self, stands out, loss of control, irrational, violates moral social standard.

Failure to Function Adequately
Under this definition, a person is considered abnormal if they are unable to cope with the demands of everyday life. They may be unable to perform the behaviours necessary for day-to-day living e.g. self-care, hold down a job, interact meaningfully with others, make themselves understood etc.

KEY TERM Rosenhan & Seligman Any issues that may arise with these definitions or criteria? Suffering: distress or discomfort? Maladaptivness: Engage in behaviours that make it difficult to get on. Irrationality Unpredictability Unconventionality Observer discomfort Violation of moral/ideal standards. ‘normal’ people suffer distress and discomfort Those with personality disorders may not experience distress or discomfort Where to we draw the line with ‘unconventionality’? Often seen as desirable/cultural variations Some behaviours will make some feel uncomfortable e.g. in different cultures/times – does this make the behaviour dysfunctional? Doesn’t take into account different morals Too broad?

2 b: Evaluation -Activity
In pairs – think of one strength and one weakness for each means of defining abnormality. Definition Strength Weakness 1. 2. 3. 4.

2b. Evaluation Questions: definitions
Are people who are extremely intelligent ‘abnormal’? Is feeling down an ‘infrequent’ behaviour? Is there any behaviour is society that was considered unacceptable and now is acceptable? Or vice versa? Is training as a marathon runner or cage fighter harming oneself? If there is no agreement on a definition of abnormality, can it be deemed scientific? Is this view of abnormality ‘westernised’? Is it useful to offer a definition of abnormality?

2b. Debate Questions: definitions
If there is no agreement on a definition of abnormality, can it be deemed scientific? Is this view of abnormality ‘westernised’? Is it useful to offer a definition of abnormality?

2b. Evaluation & Debates: DEFINITIONS
Many very gifted individuals could easily be classified as abnormal using this definition. Some characteristics are regarded as abnormal even though they are quite frequent. This would make it common. Many people engage in behaviour that is maladaptive/harmful or threatening to oneself, but we do not class them as abnormal. Is Psychology as a science: Why are there no agreed biological or clinical tests for abnormality yet? No definitive agreement between practitioners weakens the credibility of the subject. Ethnocentricism: is abnormality as we know it a westernised idea? Are mentally ill people seen differently in other parts of the world? Usefulness: there are problems with every definition and some people argue that we are all in the continuum for most behaviour.

3. Bias in diagnosis and definitions of dysfunctional behaviour
We have covered this to an extent with disorders Recap: what types of bias might influence our view of ‘dysfunction’? BIAS

3. biAS Ford & Widiger (1989) Aims Method & Procedures Background
What was the aim of this study? What method did the researchers use? If appropriate, what was the design? If appropriate, what were the IVs? What were the DVs? How was data collected? Where there any control measures? What happened? Background What information was available from previous research/knowledge Results Sample What were the main findings? What can we conclude from this study? What are the details of the sample?

2c.Summary Questions: biAS Ford & Widiger (1989)
Aims & Hypothesis Background What was the aim of this study? What information was available from previous research/knowledge Sample What are the details of the sample?

Aim What was the aim of this study? To assess whether sex bias is prevalent in diagnosis of mental disorder and if this can be minimized by the explicit criteria in the DSM-III manual.

Background What information was available from previous research/knowledge There is a difference in the number of males and females diagnosed with histrionic personality disorder (HPD) and anti social personality disorder (APD). This has been attributed to sex bias.

Sample What are the details of the sample? 354 psychologists. Of these 76% were men with an average of15.6yrs experience using a variety of therapies.

2c.QUESTIONS: biAS Ford & Widiger (1989)
Method & Procedure What method did the researchers use? If appropriate, what was the design? If appropriate, what were the IVs? What were the DVs? How was data collected? Where there any control measures? What happened? Results What were the main findings? What can we conclude from this study?

Method What method did the researchers use? If appropriate, what was the design? If appropriate, what were the IVs? What were the DVs? How was data collected? Where there any control measures? This was a self report where psychologists responded to a series of case histories and made a diagnosis using DSM-III criteria IV – gender DV – diagnosis

Procedure What happened?
The 266 psychologists were given one of nine case histories involving a female, a male or a sex-unspecified patient each time. The case histories included the symptoms needed by the DSM-III for the unique diagnosis of APD or HPD or they were mixed together in the ‘balanced’ histories. The -psychologists used 7-point scales to say how confident they were the patient had each condition. An independent panel of 88 psychologists rated how closely the case histories were examples of a histrionic or antisocial condition.

Results What were the main findings?
What can we conclude from this study? The sex-unspecified group was mostly diagnosed with borderline personality disorder and not HPD or ADP. The individual list of symptoms were found to be 80% representative of APD and HPD by the panel of 88 and there were no male/female differences found in the lists. With HPD, males were 44% and females were 76% more likely to be diagnosed with the condition. With APD, females were 15% and males 42% more likely to be diagnosed with the condition. Male & female psychologists were equally likely to make these diagnosis. This clearly shows the bias in diagnosis when all else was controlled.

3c. Evaluation Questions: BIAS
Is the sample representative? Is the method ecological valid? Is this study reflective of today’s society? Is the difficulty in agreement a threat to the scientific nature of diagnosis? Do cultural beliefs about gender roles affect diagnosis? What is the bigger stereotype gender or the label of personality disorder?

3c. Debate Questions: BIAS
Is the difficulty in agreement a threat to the scientific nature of diagnosis? Do cultural beliefs about gender roles affect diagnosis? What is the bigger stereotype gender or the label of personality disorder?

3c. Evaluation & Debates: BIAS
The unbalanced sample of 24% female could be a problem for calculating male/female differences in clinicians themselves. Usually clinicians would diagnose a disorder from face-face interviews. The study took place 25yrs ago. It does not reflect today’s approach to abnormality. Psychology as a science: Process of diagnosis is not scientific Ethnocentricism: clearly cultural beliefs about the roles of men and women affected diagnosis in this study. Usefulness: The label of illness causes stereotyping more than gender.

Worksheet : Essay Plans
Activity Worksheet : Essay Plans 10 Mark Questions 15 Mark Questions

EXAM STYLE QUESTIONS (ESQ) Diagnosis
Categorising June 2010 Describe one way (eg. classification system) in which dysfunctional behaviour can be categorised. (10) Discuss the limitations of diagnosing dysfunctional behaviour (15) January 2013 How has dysfunctional behaviour been categorised (e.g. a classification system)? (10) Evaluate the validity of diagnosis of dysfunctional behaviour (15) bias June 2012 How has dysfunctional behaviour been defined [10] To what extent may diagnosis of dysfunctional behaviour be considered ethnocentric? [15] definitions January 2012 Describe research into biases in diagnosis [10] Evaluate the reliability of diagnosis of dysfunctional behaviour [15]

Categorising Dysfunctional Behaviour [10]
One way for 10 marks or two ways for 10 marks Introduction: DSM-IV: ICD-10: Conclusion:

How has dysfunctional behaviour been defined [10]
Introduction: SI: DSN: F2F: DFIMH: Conclusion:

Describe research into biases in diagnosis [10]
Introduction: Ford & Widiger Rosenhan: Conclusion:

Starter: Reflecting upon previous work

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