Psychology
Clinical
4Ds+
4Ds
Define deviance
• Extent to which behaviour is rare, uncommon and breaks social norms. (Hearing
voices).
• Refers to thoughts, emotions and behaviours that don't fit in accepted norms of
society or specific culture
• Failure to comform with social norms = negative attention and social exclusion.
(Burping loudly next to a stranger).
Define distress
• Extent to which behaviour causes psychological harm. (Hearing voices may be
upsetting to individual)
• Abnormality in mental health is accompanied by negative feelings (depression - you
tend to be anxious), thus distress is strong indicator to abnormalities/ mental health
issues.
• Includes pains, aches, fatigue, etc. Normal after losing a job or bereavement
• Clinicians consider intensity/duration of distress, using quantitative self-report
measures (K10 - focusing on experiences in past 4 weeks).
Define dysfunction
• Extent to which behaviour interferes with daily functioning. (Hearing voices may
give insomnia; prevents you from getting typical sleep patterns).
• Important in defining abnormality and diagnoses as dysfunction must occur in more
than one part of person's life for diagnosis.
• Psychologists use variety of objective measures (WHODAS II questionnaire), looking
at factors like decrease in self-care.
• But, dysfunctional behaviour can be deliberate and doesn't own its own signal
disorders.
Define danger
• Extent to which behaviour causes harm to individual or to others. (Hearing voices
telling you to hurt yourself/others).
, • In UK, if a person is perceived to be dangerous in public or private places, they can
be detained under Mental Health Act. Requires agreement of 3 professionals.
• Clients can be taken without consent; taken to a mental health hospital for
treatment.
Evaluation
Strengths of the 4Ds
• Has practical applications, useful for professionals when considering when a
patient's symptoms or issues become a clinical diagnosis. Less mistakes = high
reliability.
• Different combinations of 4Ds can lead to useful diagnosis, model is flexible
Weaknesses of 4Ds
• Distress is hard to mesaure as a person may be unable to function, but doesn't
experience feelings of distress.
• Subjective - reliability issues, if 4Ds used by different professionals, they may not
come to same conclusion
• Davis - discusses 5th D - duration, referring to length the individual has symptoms.
5th D = 4Ds insuffcient in themselves, which is a criticism.
Carlsson et al.
Aim of the study
• To present a review of evidence for/against dopamine hypothesis of SZ.
• Explore new antipsychotics for ppl who are 'treatment-resistant'
Results of study
• Evidence from PET support dopamine hypo
• Scans show amphetamine enhances SZ-like symptoms in ppl with SZ more than
healthy controls.
• Laurelle et al - found SZ patients in remission only had normal dopamine activity.
• Dopamine neurons are affectedc by glutamatergic neurons acting as 'accelerators'
or a 'brake'. Shows dopamine and glutamate interact
Conclusions of the study
• There may be different groups of Sz patients whose symptoms have different bio
causes.
• It may be lack of glutamate that leads to more responsiveness to dopamine.
, Strengths of the study
• + Representative - Carlsson partook in 14/34 studies cited.
• + Reliable - all studies cited are lab exps - used brain scans, many on animals which
are objective, standardised and replicable.
• + Can be used for development of new antipsychotics.
Weaknesses of the study
• - Low generalisability - several studies were animal exps, can't be generalised to
humans
• - Time-locked - no longer generalisable to today's society as scientific knowledge
had advanced since 2000
• - Brain scans may not have valid results. Being scanned is stresseful and affects
'normal' functioning
• - Mice are being injected with drugs to bring psychotic symptoms
Case studies
Describe case studies
• Explores one event, group of ppl or person in depth
• In-depth data is collected
• Qualitative data is main data collected
• Qualitative data can be turned into quantitative by counting instances of certain
themes
• May include case history, record of individual's previous experiences
Strengths of case studies
• + Useful for studying unusual behaviour
• + Produces rich, in-depth data - complex interactions of many factors can be studied
Weaknesses of case studies
• - Difficult to generalise from individuals/groups since each one has unique
characteristics
• - Recollection of past events may be unreliable due to inaccuracy of ppl's memories
Describe Lavarenne et al study
• Aim - to describe how a group can provide a firm boundary within which individuals
can explore their own fragile ego boundaries
• Conclusion - therapists observed that the session report showed impressive amount
of tolerance, acceptance, and containment from group members.
Clinical
4Ds+
4Ds
Define deviance
• Extent to which behaviour is rare, uncommon and breaks social norms. (Hearing
voices).
• Refers to thoughts, emotions and behaviours that don't fit in accepted norms of
society or specific culture
• Failure to comform with social norms = negative attention and social exclusion.
(Burping loudly next to a stranger).
Define distress
• Extent to which behaviour causes psychological harm. (Hearing voices may be
upsetting to individual)
• Abnormality in mental health is accompanied by negative feelings (depression - you
tend to be anxious), thus distress is strong indicator to abnormalities/ mental health
issues.
• Includes pains, aches, fatigue, etc. Normal after losing a job or bereavement
• Clinicians consider intensity/duration of distress, using quantitative self-report
measures (K10 - focusing on experiences in past 4 weeks).
Define dysfunction
• Extent to which behaviour interferes with daily functioning. (Hearing voices may
give insomnia; prevents you from getting typical sleep patterns).
• Important in defining abnormality and diagnoses as dysfunction must occur in more
than one part of person's life for diagnosis.
• Psychologists use variety of objective measures (WHODAS II questionnaire), looking
at factors like decrease in self-care.
• But, dysfunctional behaviour can be deliberate and doesn't own its own signal
disorders.
Define danger
• Extent to which behaviour causes harm to individual or to others. (Hearing voices
telling you to hurt yourself/others).
, • In UK, if a person is perceived to be dangerous in public or private places, they can
be detained under Mental Health Act. Requires agreement of 3 professionals.
• Clients can be taken without consent; taken to a mental health hospital for
treatment.
Evaluation
Strengths of the 4Ds
• Has practical applications, useful for professionals when considering when a
patient's symptoms or issues become a clinical diagnosis. Less mistakes = high
reliability.
• Different combinations of 4Ds can lead to useful diagnosis, model is flexible
Weaknesses of 4Ds
• Distress is hard to mesaure as a person may be unable to function, but doesn't
experience feelings of distress.
• Subjective - reliability issues, if 4Ds used by different professionals, they may not
come to same conclusion
• Davis - discusses 5th D - duration, referring to length the individual has symptoms.
5th D = 4Ds insuffcient in themselves, which is a criticism.
Carlsson et al.
Aim of the study
• To present a review of evidence for/against dopamine hypothesis of SZ.
• Explore new antipsychotics for ppl who are 'treatment-resistant'
Results of study
• Evidence from PET support dopamine hypo
• Scans show amphetamine enhances SZ-like symptoms in ppl with SZ more than
healthy controls.
• Laurelle et al - found SZ patients in remission only had normal dopamine activity.
• Dopamine neurons are affectedc by glutamatergic neurons acting as 'accelerators'
or a 'brake'. Shows dopamine and glutamate interact
Conclusions of the study
• There may be different groups of Sz patients whose symptoms have different bio
causes.
• It may be lack of glutamate that leads to more responsiveness to dopamine.
, Strengths of the study
• + Representative - Carlsson partook in 14/34 studies cited.
• + Reliable - all studies cited are lab exps - used brain scans, many on animals which
are objective, standardised and replicable.
• + Can be used for development of new antipsychotics.
Weaknesses of the study
• - Low generalisability - several studies were animal exps, can't be generalised to
humans
• - Time-locked - no longer generalisable to today's society as scientific knowledge
had advanced since 2000
• - Brain scans may not have valid results. Being scanned is stresseful and affects
'normal' functioning
• - Mice are being injected with drugs to bring psychotic symptoms
Case studies
Describe case studies
• Explores one event, group of ppl or person in depth
• In-depth data is collected
• Qualitative data is main data collected
• Qualitative data can be turned into quantitative by counting instances of certain
themes
• May include case history, record of individual's previous experiences
Strengths of case studies
• + Useful for studying unusual behaviour
• + Produces rich, in-depth data - complex interactions of many factors can be studied
Weaknesses of case studies
• - Difficult to generalise from individuals/groups since each one has unique
characteristics
• - Recollection of past events may be unreliable due to inaccuracy of ppl's memories
Describe Lavarenne et al study
• Aim - to describe how a group can provide a firm boundary within which individuals
can explore their own fragile ego boundaries
• Conclusion - therapists observed that the session report showed impressive amount
of tolerance, acceptance, and containment from group members.
