Some great short videos on clinical disorders

If you're anything like me, by this point in your revision looking at past papers and studies have started to get so monotonous you aren't sure it's going in. So, try a different approach.

Here's a link to a website some of you might find really useful. It's full of videos and short summaries of characteristics of disorders, explanations and treatments. Just use the search bar at the top to navigate yourself around. 

Enjoy!

What the examiners are looking for

Obviously, you need to answer 4 questions from 2 sections. You need to answer them well, describe and evaluate research and studies, and show the examiners what you know.

Sometimes though, the mark schemes are less than clear about how to reach that top band (the As and A*s). Here are some generic tips I've found in the mark schemes that are important in getting as close to full marks as you can:

January 2013

• Relevant research should be applied to part a)
• Must address “how” if the question asks for this
• “Discussion” may involve a comparison and following/challenging a viewpoint
• Detail is beneficial in part a)
• Usefulness, application, ecological validity, reductionism, reliability and ethics are all good evaluation points for interviewing witnesses
• A good way to “assess strengths and weaknesses” is to discuss whether or not an apparent “weakness” may actually be desirable or necessary in order to fulfil a function

June 2012

• Responses should be clear, precise and explicit
• To what extent implies a degree of judgement is necessary
• Responses should directly answer the question rather than simply describing research when this is not asked for. Research can be used to illustrate responses but this should be linked to the question.
• Usefulness can be examined in terms of validity, reliability, ethnocentrism, etc.
• Stronger answers with regards to treatments will be contextualised
• Comparison invites similarities as well as differences
• Reliability can be affected by mood, interviewee, social desirability bias, lying and misjudgement 

Effectiveness and Appropriateness

These two seem to catch a lot of people out, because they're pretty hard to define and apply to different areas. Here's some generic tips, with an example to help. 

Effectiveness - the extent to which something brings about an effect, usually a positive one.

(Example question: Assess the effectiveness of offender treatment programmes)

Introduction - define effectiveness

1. Who is it effective for?
(e.g. anger management is only effective for non-psychopathic males, who have an anger problem so it isn't effective for a wide audience, whilst cognitive skills programmes are effective for most offenders as they target the cognitions believed to result in criminality, such as taking a social perspective, self-control and morality)

2. To what extent does it make a difference?
(e.g. to what extent do the treatments reduce recidivism or improve behaviour? Anger management is believed to be somewhat effective, but not in all cases. Ireland et al found it did reduce some angry behaviours. Ear acupuncture appears to make a significant difference to aspects of an addicts life such as improving mood and sleep as well as cravings and withdrawal symptoms. Cognitive skills programmes found to reduce recidivism rates by 14% which is positive, but it's obviously not effective enough to reduce it by more)

3. Is it time and cost effective?
(e.g. therapy treatments tend not to be because they require several sessions, whilst biological treatments such as acupuncture are quick and easy to administer)

Conclusion: summary
Somewhat effective, but a holistic approach where two or more methods are combined would be most effective. 

Appropriateness

Appropriateness refers to the extent to which something is suitable, usually in terms of population or situation.

To what extent are treatments for your chosen disorder (e.g. depression) appropriate?

You could answer this by looking at the population: people with depression. Personally, I'd break it down into biological treatments and therapies. 

Biological treatment: drug therapy.
Yes it's appropriate because... it requires little participation from the client, who is likely to feel apathetic, lack motivation, etc. 
No it's not appropriate because... treating a disorder that does not necessarily have a biological cause with drugs may not be treating the real issue, but actually just reducing the symptoms of low serotonin levels.

Cognitive/behavioural therapies: CBT
Yes it's appropriate because... the relationship between the client and therapist may boost confidence in the client and in others and give them a sense of purpose. The behaviourist element to CBT also encourages and rewards self-motivation and non-depressed activities, which helps to teach the client to overcome possible future relapses.
No it's not appropriate because... it requires a LOT of motivation on behalf of the client, it's often quite a lengthy process which people suffering with depression are unlikely to have the energy to go through, etc.

And my conclusion would probably be that drug therapy is appropriate for those with short-term, reactive depression because they need a "quick fix", but if depression is long-term or recurring, therapy enables skills to deal with depression more effectively and thus this may be more appropriate in the long run. 

All the studies and theories for G543 (the ones I'm using)

Some people have been asking how many studies I've learnt, so I've put them all down here. It's also a bit of a reference point to see whether you're familiar with them or if you need to revise some sections more than others.

Forensic Psychology

Turning to crime

Upbringing - disrupted families [Juby and Farrington], differential association theory (learning from others) [Akers], poverty and disadvantaged neighbourhoods [Wikstrom and Tafel]

Cognition – criminal thinking patterns, [Yochelson and Samenow] moral development, social cognition (attribution) [both use Palmer and Hollin]

Biology – brain dysfunction [Raine], genes and serotonin [Brunner], gender [Daly and Wilson]

Making a case

Interviewing witnesses – recognising faces [Bruce], influencing factors (weapon focus)[Loftus] , cognitive interview [Fisher]

Interviewing suspects – detecting lies [Mann], interrogation techniques [Inbau], false confessions [Gudjonsson]

Creating a profile – top down [Mokros and Alison], bottom up [Copson], case study of John Duffy [Canter]

After a Guilty Verdict

Imprisonment – Planned behaviours [Gillis and Nafekh], depression/suicide risk [Dooley], prison situation and roles [Haney and Zimbardo]

Alternatives to imprisonment – probation [Mair and May], restorative justice [Sherman and Strang], looking death worthy [Eberhardt]

Treatment programmes – cognitive skills [Friendship], anger management [Ireland] and ear acupuncture [Wheatley]

Health and Clinical Psychology

Stress

Causes of stress – work [Johansson], hassles [Kanner], lack of control [Geer and Maisel]

Measures of stress – self report [Kanner], physiological [Geer and Maisel], combined approach [Johansson]

Managing stress – stress inoculation therapy [Meichenbaum], biofeedback [Budzynski], social support [Waxler-Morrison]

Dysfunctional behaviour/Disorders

Diagnosing dysfunctional behaviour – definitions [Rosenhan and Seligman], DSM, gender bias [Ford and Widiger]

Explanations of dysfunctional behaviour/disorders – faulty thinking (cognitive) [Beck], learned/positive reinforcements (behavioural) [Lewinson], serotonin and genes (biological) [Wender]

Treatments of dysfunctional behaviour/disorders – rational emotive therapy (cognitive) [Beck], CBT/behavioural activation (behavioural) [Lewinson], drug therapy (biological) [Karp and Frank]

Note that the two Beck studies and two Lewinson studies are different studies. The explanations one refers to studies where Beck interviewed patients with depression to see what cognitive distortions they shared, and Lewinson looked at positive reinforcements in the lives of depressed participants. In the treatments studies, Beck compares drug therapy and cognitive therapies, whilst Lewinson sees whether a "coping with depression" course coupled with parents being taught how to reinforce good behaviour is studied. 

IMPRISONMENT: Theory of Planned Behaviour

Some of the main factors that influence recidivism rates are outlined by the theory of planned behaviour.

It was developed from the theory of planned action, which essentially describes how if intentions are positive towards an action, and attitudes are positive towards an action, then someone is likely to act in that way. The theory of planned behaviour developed this, by suggesting that perceived behavioural control is an important factor too; this refers to whether the individual believes they can actually do the action, which is essentially the same as self-efficacy. 

This theory can be applied to offenders and recidivism rates because if an offender has positive attitudes and intentions towards rehabilitation/getting a job/staying out of trouble, and they believe that they can do so, it's more likely that they'll be successful. This theory emphasises the role of self-belief and attitudes, and thus is a cognitive theory.

The main application of this theory is looking at ways to improve attitudes, intentions and beliefs relating to the outside world. One of the ways thought to help people get used to the outside world and feel more positive towards rehabilitation is getting a job inside prison, as it allows them to gain work experience and be more employable. 

Study: Gillis and Nafekh conducted a content analysis using retrospective data of over 23000 released offenders. The independent variable was whether the offender was employed prior to his or her release, and the dependant variable was the recidivism rates. 

Results were positive, and showed that those on employment schemes were more likely to remain on conditional release and less likely to commit a new offence. 15% less of the "employed"condition went back to prison, and the average time of returning to prison was greater. 

Thus, employment may be one way to help reduce recidivism rates as it encourages positive attitudes, beliefs and intentions for release. 

Gender as a cause of crime

Evolutionary psychology, a branch of biological psychology, attempts to explain our behaviour in terms of evolved survival instincts, often revolving around reproduction.

Daly and Wilson were the first to refer to evolution as an explanation for why some turn to crime. They found that most murders are of young males and committed by young males, and explained this in terms of it being the result of extreme competition for women and status between young, unmarried and unemployed men; they were competing for survival. They claimed this explained why this demographic formed a disproportionate amount of the prison population, especially for violent crimes – that males committed more crimes because their ancestors’ role of hunter and protector predisposes them to more risky behaviour than females. 

Study: Daly and Wilson conducted a study, based on their initial findings and theories, which aimed to investigate the link between homicide rates and life expectancy in different areas of Chicago. They conducted a cross-sectional correlation study using data from police records, government records, school records and local demographic records. Daly and Wilson found much variation between homicide rates in different areas of Chicago, with a strong negative correlation between life expectancy and homicide rates. Another key finding was that school absenteeism also negatively correlated with life expectancy, and thus Daly and Wilson concluded that young men from disadvantaged neighbourhoods were expected to live shorter lives, and thus became more likely to engage in risky behaviour such as crime.

Genes and Serotonin

Crime has been found to run in families, but this does not necessarily mean that nurture is responsible for crime. 

One biological explanation of crime is that some people may be predisposed to crime as they differ in terms of genes and serotonin levels. Low levels of serotonin have been associated with mood disorders and aggressive impulsive acts, as serotonin is involved in brain development, whilst some psychologists have claimed that inheriting certain genes or combinations may predispose someone to crime. 


Study: Brunner et al. conducted a case study of a Dutch family upon request of females in the family who were concerned about the behaviour of the males.

5 affected males were involved in the case study, all of whom were affected by borderline mental retardation and tendencies of abnormal violent behaviour including attempted rape and arson.  Urine samples were taken and analysed from the sample, from which Brunner et al found disturbed monoamine metabolism associated with a deficit of MAO A. A mutation in the X chromosome was also identified, which explained why no females were affected as the XX genetic make-up counteracted the mutation. 

MAO A is involved in serotonin metabolism, and thus Brunner et al concluded that the impairment of this gene was the cause of the mental retardation as well as their aggressive behaviour. 

What is the cognitive interview (CIT)?

The cognitive interview is a major part of interviewing witnesses. It's essentially an interview between a witness and detective where the detective uses cognitive techniques in the form of CIT to "extract" information from the witness in as much depth and accuracy as possible.

There are four stages of CIT:

1. Report everything. The witness is asked to recall everything they can remember about the event, regardless of how insignificant they perceive it to be. 
2. Context reinstatement. The witness is asked to give details on the context of the event, including where they were, what time of the day it was, what they'd been doing before that led them to this situation, etc.
3. Recall in a different order. The detective asks the witness to start from one point in the day and recall backwards or forwards from that point. It helps to reduce the "story-telling" tendencies we have when recalling information about a previous event. 
4. Recall from a different perspective. The detective asks the witness to say what they think others could have seen from a different point of view.

Usefulness

Like many of the issues and key terms in psychology, we know the gist of this term but it's one that is pretty hard to answer in an exam situation. What does it mean, and what points can we make on usefulness?

Usefulness refers to whether a piece of research or a theory is useful, practical or applicable. A useful piece of research is one that can be accurately generalised to a wide population or the target population and benefit a number of people or causes.

Accurately generalised to a wide population. You can actually split this definition pretty cleanly into three evaluative points: internal validity, external validity (including population and ecological) and to what extent it takes a nomothetic approach. 

Internal validity
It encompasses a number of individual factors, and you'll have to really think about it in terms of the question to know what part is relevant to evaluate. Most of the time, it's either face validity (is it measuring what it intends to measure?) or construct validity (is the definition in the research actually accurate? Often a problem with stress is that it's hard to define stress, and often it's operationalised in a way that isn't truly accurate). If either are poor, a study isn't going to be very useful.

External validity
There are three main types: ecological validity (conducted in a real-life situation, i.e. has mundane realism), population validity (representative, large sample) and temporal validity (whether the research is only really applicable at one time). If any of these are poor, it's not going to be as useful as we would ideally like.

Nomothetic
Nomothetic in psychology refers to a theory which can be assumed to be a general law or principle of behaviour. If it is, it's more likely to be useful. The more "exceptions to the rule" there are, the less it's going to be useful. For example, Loftus et al's theory about weapon focus is pretty nomothetic, as is the theory about hassles causing more stress than life events. Findings from research that aren't nomothetic and can only be applied to a small number of people or situations aren't very useful. 

Issues and Debates in Psychology: How to answer "Compare..."

A lot of the part b) questions ask you to "compare" research, methods and theories. It's actually one of the easiest forms of question to answer because you can apply the issues you know best to the question, but it can be pretty daunting to think of them at first. 

Good issues to mention are:

• reductionism/holism
• to what extent do the theories/studies support psychology as a science?
• nomothetic/idiographic
• situational/dispositional
• to what extent are they subjective/objective?
• nature/nurture
• ethics
• application of research
• usefulness
• validity
• reliability
• approach
• determinism/freewill
• research methods

Some people use the GRAVER STANDERS acronym to help them but there's a few extra ones above just for good measure.

Personally, I think the most important ones are reductionism, validity, reliability, usefulness and situational/dispositional because you can apply them to most questions, but it's worth learning them all.

With regards to how to answer compare questions, here's an example:

b. Compare techniques for managing stress [15]

Intro: outline the three main approaches (cognitive, behaviourist and social support)

Main body: compare the approaches on the basis of (for example) whether they take a situational or dispositional approach, how useful they are, and how easily they can be applied. Use evidence from studies to support your arguments, and then evaluate one or two strengths or weaknesses. E.g. social support is situational which may be harder to change and may cause additional stress so may not be appropriate, but cognitive therapy is expensive and requires dedication, but the support offered may help to reduce stress more quickly and thus may be more efficient. Make sure you include similarities and differences and evaluate them on this basis. 

Conclusion: summarize the main points from each paragraph

What is Reliability?

Reliability is probably one of the most difficult concepts to get a handle on that you have to understand at A-level psychology. So I'll ease you in gently.

Reliability refers to the extent to which something is consistent. It does not imply validity, as something may consistently give incorrect measures, though both can be affected by factors such as participant variables, observer bias, subjectivity and standardisation. 

You can be asked to assess reliability of a number of things, most commonly:

- reliability of a measure
- reliability of research
- reliability of a method

There are two main types of reliability: external reliability and internal reliability. Internal reliability refers to the extent to which a measure is consistent within itself whilst external reliability is consistency over time (i.e. it is externally reliable if the measure taken in similar circumstances would produce similar results).

Generally, the factors that affect reliability are:
- the level of control over confounding variables. The higher the control, the less chance there is of inconsistencies over time and thus the more externally reliable it is likely to be
- standardisation. If research into an area tends to use experiments with standardised procedures, or a manual is used, it's more likely that reliability will be high.
- population and ecological validity (research). If a study has poor generalisability due to an ethnocentric or biased sample, or poor mundane realism (as in the case of many lab experiments) findings when applied to real life cannot be expected to be consistent with that of the research.
-subjectivity. If a measure or study relies on subjectivity to give results, as with all qualitative data, self-reports or observations and much research done in cognitive/psychodynamic psychology, it's unlikely to produce consistent results and will probably lack in internal reliability because interpretation becomes a confounding variable and thus may change from measure to measure.

Tips on revising for G543

People revise in different ways, but here are some tried-and-tested methods that have worked for me and may work for you:

The best, most reliable way to revise and to check your progress is to do past papers. Obviously, this step is only applicable once you've learned your studies and theories, but it's the best way to test how much you really know. Start with your notes beside you, and looking every so often to check you're writing the correct material, regardless of how long it takes. Once you've done that a few times with different questions, try to reduce how many times you look at the answers and highlight bits you keep forgetting and focus on learning these. Gradually, you need to be able to write the answers in the time limit (15-20 mins per 15 mark question, and 10 mins for the 10 mark questions) and then check your answers against the mark scheme. 

For those of us who learn by writing it out:

- Flashcards (name of study and topic on one side, details - sample, method, results conclusion and main evaluation points - on the back). Test yourself, or get anyone you can to test you.

- Plan out how you'd answer questions. It's virtually impossible to do EVERY past paper question, and often the most difficult part isn't writing it; it's knowing what to write and being able to think of the points (especially for part b) questions) instantaneously. Bullet point what you would write for each kind of question, such as for validity you could write about internal validity, population validity and ecological validity. 

- Keep rewriting your notes. This may not work for everyone, but personally I find that if I keep writing out my studies and theories, trying to remember all the details and getting it condensed into the best format I can, then I won't forget it when it comes to the exam.


Visual learners:

- make posters about each topic, sub-topic and study; include pictures, bubble-writing, little symbols, anything you like to make sure you remember it. 

- play Pictionary with the studies! Grab a friend who's taking the same exam, and all you have to do is take it in turns drawing clues about a study and get the other to guess what study it is (bonus points for every detail about the study each of you can recall!). For example, to guess Fisher et al's CIT study you could draw a police officer, Florida (or an American flag), a burglar, a desk, etc. 

- give each study in a section a different colour/font combination, and whenever you revise it  make sure you stick with that combination as colour aids memory and recall. But make sure it's readable!

Other tips on revising:

- Try listening to music. Make a playlist of music you like, but won't get distracted by. This might be classical or instrumental, but I like listening to music with lyrics so long as it's not too loud. When I was doing my Core Studies paper, I made a playlist with one song per study and I'd try to remember everything I can about the study when its song was on. It'd work for this unit too and is a pretty fun way to revise a lot all at once. Just don't spend too long finding a song for the study. Relevant ones work best for me, such as Memories by Panic! at the Disco for Loftus et al's weapon focus study or Old Grey Face by Twin Atlantic for Bruce et al's facial recognition study.

- Move about. This includes physical exercise at least every couple of days (preferably a walk or more everyday), as well as working in different environments. Being cooped up in your room at the desk for hours on end isn't healthy and you'll start to get really bored. Try working in the kitchen one day, the dining room another, your sofa, outside, in the library... literally anywhere for a change of scenery when you're struggling to concentrate.

- Talk to people. I don't find study groups helpful as I prefer independent revision, but when you're struggling, real people are a lot more reassuring and helpful than searching through the internet for hours on end just getting stressed out. Check here for why social support is definitely good for you!

- Try different modes of revising. Revising gets boring; after all, you're looking at the same information for hours on end. So try to make it somewhat interesting by combining visual methods, note-making, flashcards and past paper questions. 

- Make up your own practice questions. This'll get your brain working, help you to practice and even means you can target specific areas of weakness. For example, if you struggle with reliability, write yourself a reliability question on every topic. You never know, it might come up.

- Take breaks. I'm rubbish at this, because I tend to work at something until I'm utterly shattered but so much research has shown our concentration lapses sometime after half an hour of work. I'd suggest working periods of 50 minutes followed by a ten minute break, and then every couple of hours, take an hour break. During your breaks, make sure you get a drink, maybe a snack, and leave your work area. Even just wandering around your living room is better than surfing the internet at the laptop you'll be staring at all afternoon as it'll keep you energised. 


Good luck, let me know if you have any tips for me to add!

MANAGING STRESS: Social support networks [Waxler-Morrison et al.]

Many forms of dysfunctional behaviour are treated in group therapy and support sessions, such as alcoholism, drug addiction and anger management. Some stress management also emphasises the need for social support in coping with stressful situations.

Cohen and Willis argue that there are four types of social support (all of which we need):

1. Instrumental support; practical support such as help with taking care of loved ones or help with getting to where you need to be.

2. Informational support; advice on what to do and how to cope with different situations.

3. Esteem support; emotional support from friends, colleagues, loved ones and others which makes you feel valued, safe, loved and respected. 

4. Social companionship; general interaction with others for its own sake rather than functional relationships such as at work.

Study: Waxler-Morrison et al. 

Waxler-Morrison et al conducted a study on the impact someone's social support networks had on their ability to cope with the stress of and survive cancer. It used a sample of 133 Canadian women under the age of 55 who had been diagnosed with breast cancer. Data was taken from medical records as well as self-report methods (largely questionnaires but also some interviews). The findings suggested six aspects of social support were most closely associated with cancer survival:

1. Marital status (married women who survived tended to report supportive husbands)

2. Support from friends

3. Contact with friends

4. Employment (employed women found this important in coping with cancer as it was a source of information and social support).

5. Social network

6. Total support

A strong social support system was concluded to reduce the stress associated with life-threatening but not necessarily terminal illnesses such as breast cancer, and thus make survival more likely. Though, obviously the most important factor in survival is the diagnosis of the cancer (i.e. how developed the cancer is).

MANAGING STRESS: Behaviourist Approach and biofeedback [Budzynski et al]

The behaviourist approach to psychology assumes that we are all born as a blank slate, and we learn all of our behaviour. It's a very reductionist approach as it is purely on the nurture side of the nature-nurture debate, the situational side of the situational-dispositional debate, and deterministic on the freewill-determinism debate. 

It essentially works on the basis of three concepts: classical conditioning (learning via association), operant conditioning (learning via punishment and reinforcement) and social learning theory (learning via imitation and interaction with others).

In terms of stress management, the behaviourist approach takes the view that as behaviour is learned, you can be taught to manage stress through the same processes. Stress is often dealt with in behavioural therapies through the use of CBT (mentioned in this post on cognitive therapies) or through the use of positive reinforcements. This often involves direct positive reinforcement in terms of improved relaxation and reduced stress combined with feedback from a biodot (which shows you reducing your stress) or a monitor such as a heart rate monitor.

Study: Budzynski et al 

Budzynski et al conducted a study on the role of biofeedback in reducing stress management. It was a field experiment using 18 volunteers who had responded to an advert asking for people with tension headaches. They were split into 3 conditions. Group 1 were taught relaxation techniques during two weekly sessions for eight weeks, during which they had their muscle tension measured by an EMG machine. They were informed about the biofeedback in terms of clicks, (more clicks = more tension) and encouraged to relax. Group 2 had the same relaxation training but didn't know about the biofeedback and were given a false soundtrack of clicks, whilst Group 3 were not trained in the relaxation techniques nor taught about the biofeedback and so acted as a control group. The study showed that Group 1 had the lowest muscle tension, lowest levels of hysteria and depression and the fewest tension headaches by the end of the study, concluding that biofeedback combined with relaxation techniques help to significantly reduce stress-related illness. 

MANAGING STRESS: Cognitive Approach and SIT [Meichenbaum]

The cognitive approach works on the assumption that it is necessary to refer to internal mental processes such as thought, perception and language in order to understand and explain behaviour. 

It would thus view stress as the result of faulty thinking and poor perceptions, and as a form of dysfunctional and maladaptive behaviour which can be improved or cured via cognitive restructuring. This is the fundamental concept behind all forms of cognitive behavioural therapy (CBT).

One form of CBT specifically targeted at coping with stress is Stress Inoculation Therapy (or SIT). It was developed in the 1970s by Meichenbaum, and has three stages which aim to help clients to replace "self-defeating thoughts" which cause stress with more positive ones, which can help to reduce the effect of potential stressors, and thus reduce the overall stress response.

The three stages of SIT are:

1. Conceptualisation - the client and therapist work together to identify the nature of stress, and the therapist educates the client on the general effects of stress to help them understand what stress is and thus how it can be overcome

2. Skills acquisition - the therapist helps to train the client in relevant skills which will aid them to cope with and reduce their stress. This often includes monitoring their own internal dialogue and reassuring themselves that things are okay if not everything goes to plan.

3. Follow through/application - the patient has to apply their skills to real-life situations, and the therapist helps them with this. 

Study: Meichenbaum: comparing SIT to systematic desensitisation and a control group in reducing test anxiety (a major cause of stress)

The study consisted of 21 students aged 17 to 25, who had responded to an advert asking for participants in a study on test anxiety. It was a field experiment, where the IV was the type of therapy (if any) the participant received, and the DV was reduction in test anxiety, which was measured through the use of grade averages and self-reported measures. It was a matched pairs design with three conditions. Group 1 received eight therapy sessions where they were taught to identify stress, learn how to reduce thoughts which increased their stress, monitoring their internal dialogue, etc. Group 2 received the same number of sessions but were given the behavioural therapy of systematic desensitisation, whilst Group 3 were put on a waiting list. Both therapy groups had improved results, but Group 1 (SIT group) performed better in test conditions and had reduced anxiety levels than both other groups, and thus it was concluded that SIT helped to reduce the test-associated stress people felt and enabled them to perform better.