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88 Cards in this Set
- Front
- Back
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Types of Mental Health Professionals
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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 |
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Scientist-Practitioner Model
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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! |
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Goals of Class
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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 |
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Masturbatory Insanity
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Idea arose about 300 years ago
Accepted fact 150 years ago Still around in the 1930s Lessons to be learned… |
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Development
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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…?? |
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Decline
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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… |
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Lessons
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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 |
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Reality and predic
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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)
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Lessons (continued)
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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 |
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Specific Problems
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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 |
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Assessment: Three Sources of Potential Bias
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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) |
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Characteristics of Adults
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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) |
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Prosocial skills
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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 |
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Prosocial skills (cont)
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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 |
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Influence of Context
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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 |
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Abnormal Child Behavior Certainly Exists
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But deciding what is abnormal is, in part, a social judgment
Pottick reading for next Tuesday addresses all these issues in a recent study |
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Important for Treatment as Well as Assessment
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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? |
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Laumann-Billings & Emery
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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.' |
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Long term damage greater than expected
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Case studies, not very reliable. Different methods and conclusions.
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Laumann-Billings and Emery
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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? |
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Beliefs about divorce
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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.
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Hawley & Weisz
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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) |
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Psychological Research
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Burden of proof (null hypothesis)
Measurement – reliability and validity Basic research methods Experiment Correlational study Case study Statistics (Independent replication) Research ethics |
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Is It Normal to Cry, Kick, and Scream if You Don’t Get Your Way?
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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 |
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Other Key Contexts
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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) |
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Median Age at Marriage, U.S. Women
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Median age in 1890 was 22; Divorce peak in eaerly '80s and after WWII (stationed overseas); 25 in 1990.
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Risk of divorce in 20 yrs of marriage
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All races: 1/2 will divorce; lowest for Asian (not hispanic) 30%; black (highest, 63%).
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US births to unmarried women
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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...]
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Cohabitation before age 25
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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.
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Summary
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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? |
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Consequences of Divorce for Children
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Risk
Resilience Pain Stress Individual differences |
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Chances of receiving psy help, 12-16 yr old children
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Married: 10% every rec help; divorced: 25%
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Chances of never rec help, 12-16 yr old children
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Married: 80%; divorced 70%
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Risk of dropping out of high school for children from one and two parent homes
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Two parent: 8%; Mother only: 16%
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Chances of completing high school of children from one and two parent homes
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Two parents: 81%; mother only, 79%
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Poverty in US by ethnic group and martial status
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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.
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Father-child contact after separation: by length of time since sep
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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. ??
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Percentage of children with poor relat with mothers and fathers married vs divorced aged 18-22
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Married: 15% w/ mother; 22% with mother if divorced. With father and married: 25% and with father but divorced, 70%.
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The Mediation Study
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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 |
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Case settlement following random assignment
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Adversary group: 70% of cases had custory hearing, and 30% mediated settlement. Mediation group: 10% custody hearing, 10% attorney settlement; 80% mediated settlement.
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12 Yrs follow up: outcomes of mediation and litigation; contact w/ nonresid parent
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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.
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12 yr follow up, follow-up
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Telephone calls once a wk or more, highest for mediation (49%) and lowest for mediation (11%)
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Nonres parent-child involvment
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Mediation, higher for discipline, dress, religion, errands, holidays, sig events, school, church, rec, discussing problems, vacations.
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Summary: Divorce and Children
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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 |
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Paradigms: The Traditional (Outdated) Approach
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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 |
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Systems I: Levels of Analysis
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Biological
Psychological Social Biopsychosocial model (Not very good/theoretical model – a better theory is coming in psychology, one that is richly evolutionary…) |
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Systems II: Nonlinear Systems Processes
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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? |
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A Case Study
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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.
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Case study:
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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.
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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” |
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Psychological Disorders Rarely Show Mendelian Inheritance
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Exception: Huntington’s disease (dominant gene)
Exception: Phenylketonuria PKU) (recessive genes; environment too) |
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Polygenic Inheritance
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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 |
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Dimensions vs. Categories
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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 |
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Behavior Genetic Methods
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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 |
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Divorce is Genetic (?!)
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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 |
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What Does This Mean?
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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 |
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Genes and Environment
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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? |
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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 |
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Equal environments assumption
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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. |
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Gene-Environment Correlation
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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 |
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Early Teen Intercourse
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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.
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Understanding and Facing Controversies
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“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…) |
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Eugenics – Our History of Shame
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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 |
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Eugenics – Right Here in Cville
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Three generations of imbeciles is enough!” Supreme Court Justice Oliver Wendell Holmes in Buck v Bell, 1927
60,000 forced sterilizations |
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Assessment
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Process of evaluating individuals for different purposes including diagnosis
Assessment imperfect for psychological conditions including mental disorders Especially for children/families |
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Assessment Methods
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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. |
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Classification
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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) |
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DSM IV: Childhood Disorders
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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 |
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Concepts/Concerns
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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) |
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Concepts/Concerns
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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 |
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Concepts/Concerns
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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 |
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Bottom Line
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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 |
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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” |
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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 |
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Dimensions vs. Categories
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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 |
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Behavior Genetic Methods
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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 |
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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 |
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|
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 |
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Genes and Environment
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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? |
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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 |
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Equal environments assumption
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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. |
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Gene-Environment Correlation
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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 |
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Etiological validity vs predictive and concurrent
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Cause (ex, excess chromomosome in down syn) Past. Predictive: trtmt response and course: future. Concurrent: other life events, Present.
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