Year 2 Psychology Revision
Clinical Psychology -
The 4D’s
Deviance:
*Mention social norms (unwritten rules which are based on what society expects and deems as normal)
and what that means in the exam.
Statistical Deviance – Falling outside a numerical bracket of what is seen as normal by society,
if you are 0 behind the mean, that suggests that you are normal, however if u fall over 2 or 3,
you are deviant statistically
Social Deviance- Social Deviance is behaviour that is considered abnormal by current social
norms and social groups. For example, homosexuality has been in the past considered as
deviating from what is considered as socially acceptable, whilst in current society,
homosexuality is considered as that of socially normal.
Cultural Deviance- Cultural Deviance is behaviour that is considered abnormal by cultural
groups. For example, Psychotic disorders like Schizophrenia are treated as a mental disorder in
western society whilst often praised by Asian cultures.
Dysfunction - an individual showing dysfunction can be described as not being able to do normal day
to day tasks for themselves, such as taking showers. May not always be shown, hard to pick out. They
may need support because of this.
Distress - distress in psychology can be describes as abnormal long-term feelings of sadness, for
example, Queen Victoria and her grief of her late husband lasting the rest of her lifetime. Failure to
acknowledge the present and hung up the past.
Danger - danger in psychology can be described as an individual causing unjustified harm to
themselves or others around them, such as ignoring things that are risks, which is abnormal.
Unjustified risk and unaware of the harm you are causing to yourself and others.
Strengths for 4D’s:
1. Holistic as it considers personal factors, no objective criteria that need to be met.
2. They are very straightforward and can be easily recognised = easily application, so clinicians
can easily determine an individual’s symptoms and needing help.
Good for early intervention because of that also.
Weaknesses for 4D’s:
1. Deviation is very subjective as it is not defined the same for all cultures, for example
experiences psychosis. Therapists themselves may have their own beliefs about what is
deviant
2. Reductionist, because they oversimplify mental health conditions and overlook biological
factors, ignores individual differences such as culture as built on western society.
The ICD and the DSM
ICD - international classification of diseases
DSM - diagnostic and statistical manual of mental disorders
ICD features:
⁃ Used worldwide
⁃ Published by WHO making it free and able to accesses online
⁃ Updated every 10-25 years
⁃ When using it to diagnose, you start with the symptoms then come to a disorder.
Structure of ICD:
, ⁃ Has a prevalence section, e.g. 0.32% of individuals worldwide have schizophrenia.
⁃ The ICD is split into alphanumerical coding symptoms, e.g. F20 is schizophrenia
DSM features:
⁃ Used mainly in North America
⁃ Costs over 150$ for a second-hand copy
⁃ Updated every 10-20 years
⁃ When using to diagnose, start with the disorder, then go through the symptoms.
Structure of DSM:
⁃ Has a prevalence section, e.g. 0.32% of individuals worldwide have schizophrenia.
⁃ Split into categories that can be split into subsections e.g. psychotic disorders split into
schizophrenia
Validity in Clinical Psychology - a true (correct diagnosis) and accurate (considered everything)
diagnosis that leads to successful treatments
Reliability in Clinical Psychology - whether the results found are stable (cannot change) and consistent
(repeatable) with 2 or more clinicians that have used the same classification system on the same
person.
Kappa values – test validity and reliability, 0.7+ = good agreement rate. Closer numbers to one mean
increased validity/reliability.
Reliability of the ICD:
Strengths:
⁃ Hiller et al (1992) - found that the ICD has high inter-rater reliability and stems from the fact
clinicians agreed on a kappa value of 0.59 when diagnosing bipolar based disorders.
• Abroya et al (2006) - found that the ICD is very reliable when clinicians use the diagnostic
manual correctly and follow it up with a structured interview. = concurrent reliability.
Weaknesses:
• Rhi et al (1995) - had 179 Korean participants and found that the ICD is not reliable as it
attempts to measure emotions, which are not a stable measuring source.
• Chineaux et al (2009) - found that the ICD is not reliable as for schizophrenia, symptoms only
need to be shown for 1 month or less, meaning there is no consistency.
Validity of the ICD:
Strengths:
• Phijlama et al - 807 participants were diagnosed with schizophrenia and there was a 78%
agreement rate, showing high accuracy levels.
• Rautio et al - the Swedish ICD is used correctly as all 600 participants were accurately
diagnosed with dysmorphophobia
Weaknesses:
• Buckley et al- half of the people diagnosed with schizophrenia have depression, so are
clinicians accurately distinguishing between the 2 correctly.
• Jansson et al (2002) - 155 people with schizophrenia were diagnosed because of their negative
symptoms, so the ICD-10 and ICD-9 are reductionist as they ignore positive symptoms.
Reliability of the DSM:
Strengths:
• Reiger et al- has high kappa values 0.6-0.79 for 3 disorders, one being PTSD.
• Hasin et al- found that the DSM-4 has good test-retest reliability and there was an agreement
rate of 0.94 between several clinicians when looking at substance issues.
Weaknesses:
• Freedman et al- found that the DSM is only consistent in diagnosis for English natives.
, • Cooper et al - although kappa values are high for other disorders, the kappa value for major
depressive disorders is 0.28.
Validity of the DSM:
Strengths:
• Hymen et al - good predictive validity for the DSM, which is good for early intervention.
• Kimcohen et al - sample of 2232 children and were all diagnosed with conduct disorders and
showed symptoms they were diagnosed with e.g. swearing and hitting, suggests good
construct validity as the DSM did what it was meant to.
Weaknesses:
• Brown et al - invalid as it attempts to measure anorexia symptoms with only broad definitions.
• Hoffman et al - although it has high construct validity in some areas, in others it is low as it
fails to understand extremity e.g. for heavy alcohol disorders, it puts them as mild.
Research methods:
Primary data - data you collect you collect yourself, carry out study/research.
Secondary data - studies and research gathered by someone else
⁃ however, both still manage to form conclusions about the data collected.
All the positives for primary data are the negative points for secondary data and vice versa.
Positives for primary data:
1. Reliable as you do it yourself, no bias.
2. Usually up to date, making it accurate and therefore valid
Negatives for secondary data:
1. Unreliable as you don’t do it yourself, so bias included
2. May not be up to date, inaccurate, so invalid.
Negatives for primary data
1. Time consuming and expensive
2. Sometimes can lack applicability to society as there are limited use of the data beyond the
study.
Positives for secondary data
1. Fast and cheap
2. High applicability into society as is not limited to one study.
Types of primary data:
• Longitudinal studies - studies conducted over a long period of time, done more than twice. In
clinical psychology used to look at development of symptoms in certain disorders.
Weaknesses:
⁃ Has a high dropout rate so reduces the generalisability of the study.
⁃ Can be very expensive.
Strengths:
⁃ Has construct validity as it measures variables over a long period of time.
⁃ Helps establish cause and effect, so more reliable as it creates stability in the study
• Cross-sectional design - when researchers use a large sample size in the study and draw
conclusions from what happened in the large sample. For example, to see or learn about
schizophrenia experiences at different ages, using multiple ppl at diff ages rather than one
throughout their life.
Weaknesses
⁃ Does not acknowledge individual differences which reduces the generalisability in the study.
⁃ Reductionist as it ignores factors such as temporal biases (temporary biases).
Clinical Psychology -
The 4D’s
Deviance:
*Mention social norms (unwritten rules which are based on what society expects and deems as normal)
and what that means in the exam.
Statistical Deviance – Falling outside a numerical bracket of what is seen as normal by society,
if you are 0 behind the mean, that suggests that you are normal, however if u fall over 2 or 3,
you are deviant statistically
Social Deviance- Social Deviance is behaviour that is considered abnormal by current social
norms and social groups. For example, homosexuality has been in the past considered as
deviating from what is considered as socially acceptable, whilst in current society,
homosexuality is considered as that of socially normal.
Cultural Deviance- Cultural Deviance is behaviour that is considered abnormal by cultural
groups. For example, Psychotic disorders like Schizophrenia are treated as a mental disorder in
western society whilst often praised by Asian cultures.
Dysfunction - an individual showing dysfunction can be described as not being able to do normal day
to day tasks for themselves, such as taking showers. May not always be shown, hard to pick out. They
may need support because of this.
Distress - distress in psychology can be describes as abnormal long-term feelings of sadness, for
example, Queen Victoria and her grief of her late husband lasting the rest of her lifetime. Failure to
acknowledge the present and hung up the past.
Danger - danger in psychology can be described as an individual causing unjustified harm to
themselves or others around them, such as ignoring things that are risks, which is abnormal.
Unjustified risk and unaware of the harm you are causing to yourself and others.
Strengths for 4D’s:
1. Holistic as it considers personal factors, no objective criteria that need to be met.
2. They are very straightforward and can be easily recognised = easily application, so clinicians
can easily determine an individual’s symptoms and needing help.
Good for early intervention because of that also.
Weaknesses for 4D’s:
1. Deviation is very subjective as it is not defined the same for all cultures, for example
experiences psychosis. Therapists themselves may have their own beliefs about what is
deviant
2. Reductionist, because they oversimplify mental health conditions and overlook biological
factors, ignores individual differences such as culture as built on western society.
The ICD and the DSM
ICD - international classification of diseases
DSM - diagnostic and statistical manual of mental disorders
ICD features:
⁃ Used worldwide
⁃ Published by WHO making it free and able to accesses online
⁃ Updated every 10-25 years
⁃ When using it to diagnose, you start with the symptoms then come to a disorder.
Structure of ICD:
, ⁃ Has a prevalence section, e.g. 0.32% of individuals worldwide have schizophrenia.
⁃ The ICD is split into alphanumerical coding symptoms, e.g. F20 is schizophrenia
DSM features:
⁃ Used mainly in North America
⁃ Costs over 150$ for a second-hand copy
⁃ Updated every 10-20 years
⁃ When using to diagnose, start with the disorder, then go through the symptoms.
Structure of DSM:
⁃ Has a prevalence section, e.g. 0.32% of individuals worldwide have schizophrenia.
⁃ Split into categories that can be split into subsections e.g. psychotic disorders split into
schizophrenia
Validity in Clinical Psychology - a true (correct diagnosis) and accurate (considered everything)
diagnosis that leads to successful treatments
Reliability in Clinical Psychology - whether the results found are stable (cannot change) and consistent
(repeatable) with 2 or more clinicians that have used the same classification system on the same
person.
Kappa values – test validity and reliability, 0.7+ = good agreement rate. Closer numbers to one mean
increased validity/reliability.
Reliability of the ICD:
Strengths:
⁃ Hiller et al (1992) - found that the ICD has high inter-rater reliability and stems from the fact
clinicians agreed on a kappa value of 0.59 when diagnosing bipolar based disorders.
• Abroya et al (2006) - found that the ICD is very reliable when clinicians use the diagnostic
manual correctly and follow it up with a structured interview. = concurrent reliability.
Weaknesses:
• Rhi et al (1995) - had 179 Korean participants and found that the ICD is not reliable as it
attempts to measure emotions, which are not a stable measuring source.
• Chineaux et al (2009) - found that the ICD is not reliable as for schizophrenia, symptoms only
need to be shown for 1 month or less, meaning there is no consistency.
Validity of the ICD:
Strengths:
• Phijlama et al - 807 participants were diagnosed with schizophrenia and there was a 78%
agreement rate, showing high accuracy levels.
• Rautio et al - the Swedish ICD is used correctly as all 600 participants were accurately
diagnosed with dysmorphophobia
Weaknesses:
• Buckley et al- half of the people diagnosed with schizophrenia have depression, so are
clinicians accurately distinguishing between the 2 correctly.
• Jansson et al (2002) - 155 people with schizophrenia were diagnosed because of their negative
symptoms, so the ICD-10 and ICD-9 are reductionist as they ignore positive symptoms.
Reliability of the DSM:
Strengths:
• Reiger et al- has high kappa values 0.6-0.79 for 3 disorders, one being PTSD.
• Hasin et al- found that the DSM-4 has good test-retest reliability and there was an agreement
rate of 0.94 between several clinicians when looking at substance issues.
Weaknesses:
• Freedman et al- found that the DSM is only consistent in diagnosis for English natives.
, • Cooper et al - although kappa values are high for other disorders, the kappa value for major
depressive disorders is 0.28.
Validity of the DSM:
Strengths:
• Hymen et al - good predictive validity for the DSM, which is good for early intervention.
• Kimcohen et al - sample of 2232 children and were all diagnosed with conduct disorders and
showed symptoms they were diagnosed with e.g. swearing and hitting, suggests good
construct validity as the DSM did what it was meant to.
Weaknesses:
• Brown et al - invalid as it attempts to measure anorexia symptoms with only broad definitions.
• Hoffman et al - although it has high construct validity in some areas, in others it is low as it
fails to understand extremity e.g. for heavy alcohol disorders, it puts them as mild.
Research methods:
Primary data - data you collect you collect yourself, carry out study/research.
Secondary data - studies and research gathered by someone else
⁃ however, both still manage to form conclusions about the data collected.
All the positives for primary data are the negative points for secondary data and vice versa.
Positives for primary data:
1. Reliable as you do it yourself, no bias.
2. Usually up to date, making it accurate and therefore valid
Negatives for secondary data:
1. Unreliable as you don’t do it yourself, so bias included
2. May not be up to date, inaccurate, so invalid.
Negatives for primary data
1. Time consuming and expensive
2. Sometimes can lack applicability to society as there are limited use of the data beyond the
study.
Positives for secondary data
1. Fast and cheap
2. High applicability into society as is not limited to one study.
Types of primary data:
• Longitudinal studies - studies conducted over a long period of time, done more than twice. In
clinical psychology used to look at development of symptoms in certain disorders.
Weaknesses:
⁃ Has a high dropout rate so reduces the generalisability of the study.
⁃ Can be very expensive.
Strengths:
⁃ Has construct validity as it measures variables over a long period of time.
⁃ Helps establish cause and effect, so more reliable as it creates stability in the study
• Cross-sectional design - when researchers use a large sample size in the study and draw
conclusions from what happened in the large sample. For example, to see or learn about
schizophrenia experiences at different ages, using multiple ppl at diff ages rather than one
throughout their life.
Weaknesses
⁃ Does not acknowledge individual differences which reduces the generalisability in the study.
⁃ Reductionist as it ignores factors such as temporal biases (temporary biases).
