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88 Cards in this Set

  • Front
  • Back
Types of Mental Health Professionals
Clinical psychologists – Ph.D.; research; 6 years grad school; 1 year internship
Psychiatrists – M.D.; medication; 4 years med school; 3 or more years residency
Social workers – MSW, DSW; community focus; 2 years (more for DSW)
Counselors – usually education schools; specializations (e.g., marriage/family); 2 years
School psychologists, nurse practitioners etc
Scientist-Practitioner Model
Academic psychologists are researchers and teachers first (developmental, social etc.)
Clinical psychologists as scientist-practitioners
Science informs practice (at least is should)
Practice source of hypotheses for science
Practice should be like science (develop hypotheses, test them) Detective work!
Goals of Class
Learn about abnormal child behavior (including better understanding of self, friends, family)
Learn about psychological research and research methods
Learn to think like a psychological scientist
Become an inquiring skeptic (for scientific, intellectual, and practical reasons)
Others call this critical thinking
Masturbatory Insanity
Idea arose about 300 years ago
Accepted fact 150 years ago
Still around in the 1930s
Lessons to be learned…
Development
Sexuality, Catholic Church in Europe
Onania or the Heinous Sin of Self-Pollution
Tissot and other authorities – Benjamin Rush, William Maudesly, Sigmund Freud
A theory: Blood drawn away from the brain!!
Research evidence
Case studies
Treatments – castration, clitorectomy
Prevention! Little Siggy…??
Decline
Treatments failed
Theory failed.
Logic. Correlation and causation. Comparison groups (normal behavior).
Perfect symmetry: Now psychologists reassure parents/youth that masturbation is normal!
But not always…
Lessons
Don’t be smug – about Europe in 1890, China in 1980, or the U.S. in 2004
Be alert for today’s sacred (but maybe wrong) beliefs – Biology? Abuse/victimization?
Challenge authority – Be an inquiring skeptic. Use your head!
Remember how the stakes can influence conclusions – false positives and false negatives
Reality and predic
True pos (really true and predic as true); False pos (really false, predic as true); False neg (predic as false but really true); True neg (false in reality and predic)
Lessons (continued)
Need reasonable, testable theories and hypotheses
Burden of proof is on proponents of any hypothesis
Need data and scientific methods
Be skeptical, objective, and humble
Specific Problems
Problem: Adults, not children, identify children’s psychological problems.
Problem: Adults disagree with each other and with children
Problem: Children are “involuntary” patients
Problem: Is this the child’s problem… Or the adult’s problem?
Challenge for assessment (our main focus today)
Challenge for treatment too
Assessment: Three Sources of Potential Bias
Does the adult’s view of the child’s problem tell us more about the child or more about…
Characteristics of the adult (e.g., strict teachers)
The child’s (lack of) prosocial skills (e.g., likeable kids can get away with more)
Contextual influences (e.g., minorities are often judged more negatively)
Characteristics of Adults
Who sees Huck differently?
The Widow Douglas
Griest et al. 1979; young boys in clinic
Mother’s ratings of problem behavior
Mother’s ratings of their own depression
Observer’s ratings of children in home
What find?
Method variance? Reactivity to being observed?
Lie scale for parent measures (like MMPI has)
Prosocial skills
Tom is so clever (whitewashing fence)
And he loves Becky …
Werner et al., 1975 – Police officers arrest patterns (a huge issue)
Officers like
Facial orientiation
Polite short answers
Expression of understanding/cooperation
Expression of reform
Trained delinquents in skills and videotaped before and after
Prosocial skills (cont)
Less likely to arrest trained delinquents
Point is not to make better criminals
But… have you ever gotten out of a speeding ticket??
Adaptive to get away with some things
Treatment should focus on increasing positive not just reducing negative behavior
Influence of Context
Huck’s dad was… Tom’s Aunt Polly was…
Labels, ethnicity, gender, physical attractiveness
Stevens-Long 1973 -- Labeling
Parents watched videotapes
Over, average, under active
Who like better, punish less?
Labels can help (sometimes)
Attributions important
Cause
Responsibility for change
Abnormal Child Behavior Certainly Exists
But deciding what is abnormal is, in part, a social judgment
Pottick reading for next Tuesday addresses all these issues in a recent study
Important for Treatment as Well as Assessment
Who is your client?
Sexual activity in adolescents
Parents in conflict… “His and her” children
Confidentiality – who “owns” it?
Is psychologist serving parents, school, court… or child?
Laumann-Billings & Emery
Substantive: Debate about effects of divorce
Judith Harris: The Nurture Assumption (Newsweek cover story, September 7, 1998)
'Heredity . . . makes the children of divorce more likely to fail in their own marriages. Parental divorce has no lasting effects on the way children behave when they're not at home.'
Long term damage greater than expected
Case studies, not very reliable. Different methods and conclusions.
Laumann-Billings and Emery
Methodological
Do not accept null hypothesis; fail to reject it. (Analogy: Innocent vs not guilty). Burden of proof.
Methodological
Assessment. Limits of objective assessment, problems with case studies.
Method.
College students. Community sample.
Parents divorced/married.
New objective, measure of “pain.”
Findings?
Beliefs about divorce
73% would be a diff person if no divorce; 65% life diff if together (How emotionally charged??); 49% worry about events like graduation***; 29% wonder if dad loves them. Three times as likely in divorce to belief harder childhood; 10% if dad loves me when parents married.
Hawley & Weisz
Substantive: A prerequisite for treatment is agreement about child’s problem.
Methodological: Adult assessment relies on adult report; child assessment more complicated
Method: Parent, child, therapist of clinic treated child; interview about target problem
All 3 disagree > 75%; more agree externalizing, more agree parent-therapist
Both studies: Explain to a friend (not necessarily from class)
Psychological Research
Burden of proof (null hypothesis)
Measurement – reliability and validity
Basic research methods
Experiment
Correlational study
Case study
Statistics (Independent replication)
Research ethics
Is It Normal to Cry, Kick, and Scream if You Don’t Get Your Way?
Not if you’re 20, but certainly if you’re 2
Developmental context
Physical development
Cognitive development
Social development
Developmental norms …and deviation from norms
Normative development versus individual differences
Developmental psychopathology
Other Key Contexts
School – one size doesn’t fit all (ex ADHD)
Peer – increasingly important with age
Popular, rejected, neglected, controversial
Is popularity a risk factor?
Is one friend all it takes?
Socioeconomic background/poverty
Costello’s natural experiment
Cultural and ethnic background
Family context (today’s focus)
Median Age at Marriage, U.S. Women
Median age in 1890 was 22; Divorce peak in eaerly '80s and after WWII (stationed overseas); 25 in 1990.
Risk of divorce in 20 yrs of marriage
All races: 1/2 will divorce; lowest for Asian (not hispanic) 30%; black (highest, 63%).
US births to unmarried women
34% of children; less than 5% in 1950, better contracep today! Shotgun wedding in 1950s, teen preg rates were higher than today. Ethnic diff: 2/3 of black children born outside marriage; 1/2 of hispanic; 27% of white; 33.2% of all. [Having children is a bigger committment than marriage...]
Cohabitation before age 25
Later born cohorts were more likely to live together; more likely for less educ. 1/2 will live together before marriage (today); INC likelihood to get divorce (correl, not exp). At least the same when differences like religion are controlled.
Summary
Children grow up in many kinds of families
Families types differ by ethnicity
Family change isn’t recent and isn’t just U.S.
What does this mean for YOU? (e.g., cohabitation)
What does this mean for children?
Consequences of Divorce for Children
Risk
Resilience
Pain
Stress
Individual differences
Chances of receiving psy help, 12-16 yr old children
Married: 10% every rec help; divorced: 25%
Chances of never rec help, 12-16 yr old children
Married: 80%; divorced 70%
Risk of dropping out of high school for children from one and two parent homes
Two parent: 8%; Mother only: 16%
Chances of completing high school of children from one and two parent homes
Two parents: 81%; mother only, 79%
Poverty in US by ethnic group and martial status
All: less than 1/2 for mother only; 40% for mother divorced; 20% for father only; 15% father divorced; 1-% two parents. Same for European; African: 70% for mother only and same for Hispanic, other combinations slightly higher.
Father-child contact after separation: by length of time since sep
Not at all: 20% by 11 yrs since sep. 40% once a yr by 11 yrs since; 60% several/yr; 83% once/three times/month. ??
Percentage of children with poor relat with mothers and fathers married vs divorced aged 18-22
Married: 15% w/ mother; 22% with mother if divorced. With father and married: 25% and with father but divorced, 70%.
The Mediation Study
High conflict families – filing for contested custody hearing
Random assignment (the magic of science) to mediation or adversary settlement
Young, low income sample
Longitudinal study – 12 years
Short-term (5-6 hr average)
problem-focused emotionally-informed
Case settlement following random assignment
Adversary group: 70% of cases had custory hearing, and 30% mediated settlement. Mediation group: 10% custody hearing, 10% attorney settlement; 80% mediated settlement.
12 Yrs follow up: outcomes of mediation and litigation; contact w/ nonresid parent
1x yr or less: under 40% litigation, 18% mediation, 48% national. Several times per yr: 25% mediation, less for litigation and national in middle. Higher litigation for 1-3 times per month. 1x a wk or more: 25% mediation; 5% litig; 7% national.
12 yr follow up, follow-up
Telephone calls once a wk or more, highest for mediation (49%) and lowest for mediation (11%)
Nonres parent-child involvment
Mediation, higher for discipline, dress, religion, errands, holidays, sig events, school, church, rec, discussing problems, vacations.
Summary: Divorce and Children
Divorce is stressful
Increases risk for psychological problems
But most children are resilient
Many problems begin in two-parent family
Divorce is still painful for resilient children
Pain is not pathology, but it’s important…
Individual differences based on what parents do after divorce. Mediation (parents being parents; kids being kids) is hope for maintaining family even after divorce
Paradigms: The Traditional (Outdated) Approach
Biological
Psychodynamic/psychoanalytic
Behavioral/cognitive behavioral
Humanistic
Etc
One of these approaches will NEVER be proven right
The future of psychology is integration of ideas
Systems I: Levels of Analysis
Biological
Psychological
Social
Biopsychosocial model
(Not very good/theoretical model – a better theory is coming in psychology, one that is richly evolutionary…)
Systems II: Nonlinear Systems Processes
Holism (versus reductionism)
Reciprocal or circular causality (versus linear causality)
Subsystems in complex systems
Boundaries between subsystems (boundaries by rules of relat; parents do not discuss sex in front of kids)
Homeostasis (feedback loops) (mech in families)
Change comes… when?
A Case Study
Info before starting session: 10 yr old Billy; father a nurse, mom part time consultant. Parents startign a business, 11 yr old sister (great child). Billy is stuborn, doesn't blend w/ family, misbehaved in school. Your job is to generate hypoth to test when session begins. Who to invite first from waiting room? both? Emery invites both to watch relat, then parents 1st if child is under 12. Otherwise all children first. Mom is irrationally upset...Mom has rage b/c of sexual abuse from father, Billy looked like grandpa. Rage shifted from billy to dad.
Case study:
Holism: need to see family as a whole. Casaulity; subsys: mom, dad, daugther, then billy alone. Boundary violated when mom and billy went to therapy together, which is why dad joined. Homeostasis: dad's repeated efforts to put billy back as scapegoat.
Behavior Genetics
(Controversial, US history/Europe interp genetics; appreciating vs misusing)
Study of genetic contributions to complex behavior
**Focus = individual differences**
But people share 99.9% of genes with each other…
[[Different from:
Evolutionary psychology = normative genetic contributions to (species typical) behavior]]
People share 98% of genes with chimpanzees
Common (and controversial) to conclude that psychological disorders are “genetic”
Psychological Disorders Rarely Show Mendelian Inheritance
Exception: Huntington’s disease (dominant gene)
Exception: Phenylketonuria PKU) (recessive genes; environment too)
Polygenic Inheritance
Most disorders (and psych characteristics are polygenic (multiple genes)
Examples: ADHD, depression, intelligence etc
Height of peas is polygenic
Mendel’s experiments wouldn’t have worked if he studied height
Polygenic
Quantitative not qualitative differences
Dimensions not categories
Dimensions vs. Categories
Dimension = quantitative difference, e.g., height
Category = qualitative difference, e.g., pregnancy
Our tendency to think in categories can be misleading
“Genetic” does not mean: “You have it or you don’t.” You can be “a little bit hyperactive”
With categories, key issue is where to put line dividing normal and abnormal (e.g., ADHD, depression, eating disorders)
Many treatment decisions are categorical (e.g., take medication) which pushes us to think of disorders as categorical
Still, categories can be useful even if underlying construct is dimensional
Night and day
Grades
Behavior Genetic Methods
Family studies (families share genes and environment)
Adoption studies (important but harder)
Twins studies – compare MZ and DZ
All genes MZ = 1; DZ = .5
All shared environment MZ, DZ = 1
All nonshared environment MZ, DZ = 0
Divorce is Genetic (?!)
McGue & Lykken – twin study
722 MZ twins; 794 DZ twins
Risk of divorce if MZ divorced = .45
Risk of divorce if DZ divorced = .30
Heritability of divorce = .525
What Does This Mean?
Divorce probably is genetic
But what is the mechanism?
A divorce gene? No!
A personality characteristic? In part (antisocial behavior and rule violation)
Many factors, maybe including things like age a menarche, physical appearance, etc
Our study of menarche and stepfather presence
Genes and Environment
Mechanism – think about same issue for depression, eating disorders etc; not necessarily a “gene for X disorder”
Heritability ratio – proportion of variance in a sample attributable to genetic variation
False dichotomy
What % of PKU is genetic? Environmental?
What Does This Mean?
(India has 1% divorce risk, culture allows less expression of divorce risk - culture det threshold)
Divorce rates differ across history and across cultures
Reaction range – culture sets limits for divorce
Reaction range – genes more influential when environment changes less (IQ & poverty)
False dichotomy – not genes or environment but genes and environment
Equal environments assumption
Do MZ and DZ experience the same trait-relevant environment?
For example, maybe experience of MZ divorce is different than experience of DZ divorce. This is known to be the case with conduct disorder/juvenile delinquency (MZ co-twin has greater social influence than DZ co-twin).
B/c you think your MZ co-twin is so similar, you will get divorced too.
Gene-Environment Correlation
Experience is not random – correlated with various background factors, including genes
Pervasive and important: Divorce, teen pregnancy, parent, peers etc
A major challenge for research
Example: Early teen intercourse
Early Teen Intercourse
Higher delinquency when having sex before mean age. But later than co-twin means more delinquency! Due to: strong intimate attachment, another nonshared exp like jealousy. Controlled previous delin, comparison of beforehand.
Understanding and Facing Controversies
“Genetic” does not mean “predetermined” it means predisposition
The American Dream (equal environments) would lead to GREATER genetic effects
Sexist/racist concerns (The Bell Curve – Murray spoke here a few years ago…)
Eugenics – Our History of Shame
Promotion of “good breeding” in the human stock
Dates to Frances Galton – 1883; strongly influenced by Darwin’s idea
Positive eugenics – encourage desirables to bear children
Negative eugenics – prevent undesirables from having children; genocide – Nazi Germany; U.S. Social policy
Eugenics – Right Here in Cville
Three generations of imbeciles is enough!” Supreme Court Justice Oliver Wendell Holmes in Buck v Bell, 1927
60,000 forced sterilizations
Assessment
Process of evaluating individuals for different purposes including diagnosis
Assessment imperfect for psychological conditions including mental disorders
Especially for children/families
Assessment Methods
Clinical interview/structured interviews
Behavioral assessment
Parent/teacher rating scales
Psychological Tests
IQ tests
Projective “tests”
This is outline of text headings; use outline to study. Learn terms too.
Classification
Grouping into categories (or dimensions) based on shared characteristics
Diagnosis = professional identification of a disorder
Classification based on parent/teacher rating scales
Externalizing
Internalizing
DSM-IV-TR – the diagnostic “bible” of mental health professionals
Categorical classification system
Descriptive diagnosis to maximize reliability
Multiaxial system (disorders; PD/MR; physical; stress; global functioning)
DSM IV: Childhood Disorders
Adult disorders can be applied to children (depression/anxiety)
Attention deficit and disruptive behavior disorders
Eating disorders (separate category)
Learning disorders
Mental retardation
Pervasive developmental disorders
Communication, feeding, elimination, others
Concepts/Concerns
Criteria for grouping
Appearance is only one basis for classification, perhaps not the most useful one
Reliability – repeatability
Inter-rater reliability key for diagnosis
Validity – accuracy/value in relation to some criterion
Etiological validity
Concurrent validity
Predictive validity (treatment response, course)
Concepts/Concerns
Coverage – include everything? Include too much?
Developmental coordination disorder
Family diagnoses
Pain/distress – disorders aren’t everything
What is theory about abnormal child behavior?
Dimensions versus categories
Are psychological disorders qualitative or quantitatively different from normal experience?
One of many issues – where to draw the line dividing normal/abnormal on dimensions
Concepts/Concerns
Should we classify people?
Labeling – a bad thing and a good thing
Self-fulfilling prophesy, stigmatizing, label disorder not individual
Common language, value for treatment, having a diagnosis can be reassuring
Bottom Line
DSM is a useful if imperfect system of classification
Future surely will bring many changes and refinements, that’s why understanding principles is important
Whatever the system, we need to be sensitive to fact that we’re classifying people not things
Behavior Genetics
(Controversial, US history/Europe interp genetics; appreciating vs misusing)
Study of genetic contributions to complex behavior
**Focus = individual differences**
But people share 99.9% of genes with each other…
[[Different from:
Evolutionary psychology = normative genetic contributions to (species typical) behavior]]
People share 98% of genes with chimpanzees
Common (and controversial) to conclude that psychological disorders are “genetic”
Psychological Disorders Rarely Show Mendelian Inheritance
Exception: Huntington’s disease (dominant gene)
Exception: Phenylketonuria PKU) (recessive genes; environment too)
Polygenic Inheritance
Most disorders (and psych characteristics are polygenic (multiple genes)
Examples: ADHD, depression, intelligence etc
Height of peas is polygenic
Mendel’s experiments wouldn’t have worked if he studied height
Polygenic
Quantitative not qualitative differences
Dimensions not categories
Dimensions vs. Categories
Dimension = quantitative difference, e.g., height
Category = qualitative difference, e.g., pregnancy
Our tendency to think in categories can be misleading
“Genetic” does not mean: “You have it or you don’t.” You can be “a little bit hyperactive”
With categories, key issue is where to put line dividing normal and abnormal (e.g., ADHD, depression, eating disorders)
Many treatment decisions are categorical (e.g., take medication) which pushes us to think of disorders as categorical
Still, categories can be useful even if underlying construct is dimensional
Night and day
Grades
Behavior Genetic Methods
Family studies (families share genes and environment)
Adoption studies (important but harder)
Twins studies – compare MZ and DZ
All genes MZ = 1; DZ = .5
All shared environment MZ, DZ = 1
All nonshared environment MZ, DZ = 0
Divorce is Genetic (?!)
McGue & Lykken – twin study
722 MZ twins; 794 DZ twins
Risk of divorce if MZ divorced = .45
Risk of divorce if DZ divorced = .30
Heritability of divorce = .525
What Does This Mean?
Divorce probably is genetic
But what is the mechanism?
A divorce gene? No!
A personality characteristic? In part (antisocial behavior and rule violation)
Many factors, maybe including things like age a menarche, physical appearance, etc
Our study of menarche and stepfather presence
Genes and Environment
Mechanism – think about same issue for depression, eating disorders etc; not necessarily a “gene for X disorder”
Heritability ratio – proportion of variance in a sample attributable to genetic variation
False dichotomy
What % of PKU is genetic? Environmental?
What Does This Mean?
(India has 1% divorce risk, culture allows less expression of divorce risk - culture det threshold)
Divorce rates differ across history and across cultures
Reaction range – culture sets limits for divorce
Reaction range – genes more influential when environment changes less (IQ & poverty)
False dichotomy – not genes or environment but genes and environment
Equal environments assumption
Do MZ and DZ experience the same trait-relevant environment?
For example, maybe experience of MZ divorce is different than experience of DZ divorce. This is known to be the case with conduct disorder/juvenile delinquency (MZ co-twin has greater social influence than DZ co-twin).
B/c you think your MZ co-twin is so similar, you will get divorced too.
Gene-Environment Correlation
Experience is not random – correlated with various background factors, including genes
Pervasive and important: Divorce, teen pregnancy, parent, peers etc
A major challenge for research
Example: Early teen intercourse
Early Teen Intercourse
Higher delinquency when having sex before mean age. But later than co-twin means more delinquency! Due to: strong intimate attachment, another nonshared exp like jealousy. Controlled previous delin, comparison of beforehand.
Understanding and Facing Controversies
“Genetic” does not mean “predetermined” it means predisposition
The American Dream (equal environments) would lead to GREATER genetic effects
Sexist/racist concerns (The Bell Curve – Murray spoke here a few years ago…)
Eugenics – Our History of Shame
Promotion of “good breeding” in the human stock
Dates to Frances Galton – 1883; strongly influenced by Darwin’s idea
Positive eugenics – encourage desirables to bear children
Negative eugenics – prevent undesirables from having children; genocide – Nazi Germany; U.S. Social policy
Eugenics – Right Here in Cville
Three generations of imbeciles is enough!” Supreme Court Justice Oliver Wendell Holmes in Buck v Bell, 1927
60,000 forced sterilizations
Etiological validity vs predictive and concurrent
Cause (ex, excess chromomosome in down syn) Past. Predictive: trtmt response and course: future. Concurrent: other life events, Present.