Tag: schizophrenia

Categories
A2 - Clinical Psychology

North et.al. (2003) – Key Study

Synopsis

● To investigate whether nonclinical individuals have persecutory thoughts in virtual reality;

● The study was conducted in a restaurant in a small, affluent town in Leicestershire, UK.

● The independent variable was the type of background music played in the restaurant: classical music, pop music, or no music.

●The dependent variables were the mean spend per person for starters, main courses, desserts, coffee, bar drinks, wine, overall drinks bill, overall food bill, and total spend.

●The results showed that classical music significantly increased the mean spend per person for starters, coffee, total spend on food, and overall spend.

●There were no significant differences in spending for desserts, drinks from the bar, wine, main courses, or total spend on drinks.

● The total mean spend per person was £32.51 for classical music, £29.46 for pop music, and £29.73 for no music.

● The researchers concluded that classical music can increase customer spending, mainly on starters and coffee

Methodological Evaluation

Sampling

Sample Characteristics

Strengths

1. The study had a large number of participants.

● It had a sample size of 393 customers, which is a relatively large sample size. 

● This means that the results of the study are more likely to be accurate and reliable, as they are based on a large number of participants.

2. The study had a representative sample.

● The sample was representative of the population of interest, which was customers in an upscale restaurant in Leicestershire, UK.

● This means that the results of the study are more likely to be generalizable to other customers in similar restaurants.

Weaknesses

1. The sample of customers who ate in the restaurant during the study is not representative of the population of all customers who might visit a restaurant.

The study took place in a small, affluent town in Leicestershire, UK, where the menu was quite expensive.

This means that the findings may not apply to less affluent restaurants or restaurants in different types of locations.

2. Another weakness is that the study only spanned three weeks.

This limited time frame might not capture the full range of customer behavior over an extended period.

For example, people’s responses to classical music may change over time, and a longer study would provide a more comprehensive understanding of how background music influences consumer behavior.

Sampling Technique

● The North et al. (2003) study supports opportunity sampling.

● It involved observing and collecting data from the 393 customers who naturally dined in the upscale restaurant in Leicestershire, UK restaurant during February and March 2002.

Strengths

1. It captured a realistic sample. 

● 393 customers who ate in the restaurant between February and March 2002 were recruited for the study.

● This sample represents real-world restaurant-goers, enhancing the ecological validity of the findings.

2. Another strength is that the researchers managed to obtain a large number of participants.

● They had a sample size of 393 customers, which is a relatively large sample size. 

● This means that the results of the study are more likely to be accurate and reliable, as they are based on a large number of participants.

Weaknesses

1. One weakness is the lack of representativeness in the North et al. (2003) study. 

● The sample consisted of 393 customers from a single restaurant in a small, affluent town in Leicestershire, UK. 

● This means that the findings may not apply to less affluent restaurants or restaurants in different types of locations.

2. Another weakness is potential researcher bias in sample selection.

● The choice of a single restaurant, which served expensive à la carte food, could introduce bias because it may not be representative of typical dining establishments.

● It is possible that the selection was influenced by convenience or personal preferences, introducing bias into the study.

Operationalization of Variables

Independent Variable

  • Type of Background Music

Levels of the Independent Variable

  1. Classical Music;
  2. Pop Music;
  3. No Music

Operationalized Independent Variable

  • Specific genre of music played in the restaurant during the study.

Operationalized Levels of the Independent Variable

  1. Classical Music – Background music consisting of classical compositions by renowned classical artists, including pieces by Vivaldi, Handel, and Strauss
  1. Pop Music – Background music featuring popular music tracks from artists like Britney Spears, Culture Club, and Ricky Martin.
  1. No Music – The absence of any background music during the dining experience, creating a silent environment in the restaurant.
  • Strengths

The operationalization was well-defined, increasing validity

  • Classical music included pieces by Vivaldi, Handel, and Strauss, while pop music included tracks by Britney Spears, Culture Club, and Ricky Martin. 
  • This clear distinction ensured that the independent variable was clearly distinguishable during the experiment.

2. A counterbalanced order of music styles was presented, increasing validity.

  • The order of music styles varied from week to week.
  •  Counterbalancing the order minimized the potential influence of external factors that might vary with time, such as customer preferences or seasonal effects
  • Weaknesses

1. It lacked variation in music genres, limiting scope of findings.

  • The study only compared classical music to pop music and a control condition of no music, which limited the range of musical genres considered. 
  • This limited scope might not have captured the full range of how different types of music can affect consumer behavior. 

2. It did not account for individual music preferences, making the independent variable reductionist.

  • The research assumed that all customers have the same response to classical or pop music, without considering individual musical tastes. 

This oversimplification overlooked the possibility that some customers might have strong preferences for one genre over the other, which could significantly influence their spending behavior.

Dependent Variable

  • The (opsrationalized) dependent variables in the North et al. (2003) study were:
  1.  Mean spend per person for starters;
  2. Mean spend per person for main courses;
  3. Mean spend per person for desserts;
  4. Mean spend per person for coffee;
  5. Mean spend per person for bar drinks;
  6. Mean spend per person for wine;
  7. Mean spend per person for the overall drinks bill;
  8. Mean spend per person for the overall food bill;
  9. Mean total spend per person

Strengths

1. The operationalization of the dependent variable was precise, allowing for valid assessment.

  • It measured various aspects of spending, including starters, coffee, total food spend, and overall spend, with specific numerical values, that is,  mean spend per person. 

2. The study operationalized multiple dependent variables, increasing the scope of findings. 

  • This provided a comprehensive view of how music influences customer behavior. It covers various categories like starters, coffee, and overall food spend, enabling a thorough analysis of consumer responses to different types of music.

Examples of Controls

1. The researchers included a control condition with no music

  • This control was maintained to establish a baseline for comparison, allowing the researchers to assess the impact of different types of music on customer spending.

2. The researchers used an independent measures design. 

  • This design choice ensured that participants’ experiences were not influenced by exposure to multiple music types, reducing potential confounding variables.

3. The researchers maintained a consistent volume of music.

  • Maintaining consistent volume levels helped ensure that variations in customer spending were due to the music genre and not differences in music volume.

4. The researchers counterbalanced the order of music styles. That is, the order of music styles varied from week to week.

  • Counterbalancing the order minimized the potential influence of external factors that might vary with time, such as customer preferences or seasonal effects.

5. The researchers recorded the total time customers spent in the restaurant.

  • Tracking the time spent allowed the researchers to assess whether the type of music influenced the length of customer stays, which could, in turn, impact spending.

Research Method (Correlational Study)

Justification

  • The study conducted was a field experiment.
  • It took place in a real-world setting, specifically in a restaurant in Leicestershire, UK, rather than a controlled laboratory environment. 
  • This naturalistic context allowed the researchers to observe and manipulate the independent variable (type of music) within the restaurant’s actual operational conditions, making it a field experiment.
  • Strengths

1. It increased ecological validity. 

  • The experiment took place in an actual restaurant in a small, affluent town in the UK, with a menu that offered individual items and was quite expensive.
  • This setting closely resembled a typical dining experience.

2. It increased the ease of obtaining a sample, increasing practical viability. 

  • The researchers collected data from 393 customers who ate in the restaurant over a specific period, between February and March 2002. 
  • The sample size was large, and none of the customers were aware they were participating in a study, reducing demand characteristics. 
  • Weaknesses

1. The study lacked control over various factors that could have influenced customer behavior beyond the background music, reducing validity. 

  • For example, situational variables like lighting, menu, and temperature were kept constant, but other variables such as the quality of service, the day of the week, or special promotions were not controlled. 
  • This lack of control makes it challenging to attribute the changes in customer spending solely to the type of music played.

2. North et al. did not employ random selection of participants, reducing generalizability. 

  • The sample consisted of 393 customers who ate at the restaurant between February and March 2002. 
  • If, for example, the researchers inadvertently selected more affluent or music-sensitive individuals, it could lead to an overestimation of the effect of classical music on customer spending.

Ethical Evaluation

  • Informed Consent: The study did not explicitly mention obtaining informed consent from the 393 customers who dined in the restaurant. 
  • Since none of the participants were aware they were part of a study, it lacked informed consent as the customers were not informed about the research and did not provide their consent.
  • Right to Withdraw: The study did not mention whether the participants had the right to withdraw from the study at any point. 
  • Since the customers were not aware of their participation, they were not given the opportunity to exercise their right to withdraw.
  • Lack of Deception: The study did not involve any deception other than hiding its purpose. 
  • The customers were not misled or given false information about the purpose of the study, and they dined naturally without any hidden agendas.
  • Confidentiality: The study did not provide details about how it ensured the confidentiality of the participants’ data. 
  • Since it collected data without the customers’ knowledge, there is a lack of information on whether their personal spending habits and dining preferences were protected and kept anonymous, raising concerns about the handling of sensitive customer information.
  • Privacy: Privacy concerns are evident in this study as it collected data from unsuspecting customers without their knowledge or consent. 
  • 1They were not given the opportunity to decide whether they wanted to participate in a study that involved tracking their dining behavior.
  • Debriefing: The study did not mention any debriefing process for the participants since they were unaware of their participation. 
  • Debriefing could have been important to inform participants about the study and its objectives after their dining experience.
  • Lack of Physical Harm: The study did not pose any physical harm to the participants.
  • It involved playing music in a restaurant setting, which is generally harmless.
  • Lack of Psychological Harm: The study did not mention any psychological harm inflicted on the participants. 

It focused on the impact of music on customer spending, which is not expected to cause psychological harm.

Issues and Debates

Individual and Situational Explanations

The study provides a strong situational explanation for the impact of music on consumer behavior.The research found that classical music significantly increased the mean spend per person for starters, coffee, total spend on food, and overall spend. This indicates that the situational factor of playing classical music in the restaurant had a direct influence on customer spending.

1. The situational explanation reduces individual blame on customers for their spending behavior.

  • In the study, customers were not aware they were part of an experiment, and the restaurant did not collect data on their musical preferences. 
  • This lack of individual data supports the idea that the situational factor of music was the driving force behind increased spending.

2. The situational explanation offers a practical approach to changing consumer behavior.

  • Since the study identifies that changing the background music to classical can increase customer spending, it provides a straightforward strategy for restaurants and businesses to increase customer spending. 
  • Weaknesses of Individual Explanation

1. The situational explanation reduces individual blame on customers for their spending behavior.

  • In the study, customers were not aware they were part of an experiment, and the restaurant did not collect data on their musical preferences. 
  • This lack of individual data supports the idea that the situational factor of music was the driving force behind increased spending.

2. The situational explanation offers a practical approach to changing consumer behavior.

  • Since the study identifies that changing the background music to classical can increase customer spending, it provides a straightforward strategy for restaurants and businesses to increase customer spending. 

Reductionism versus Holism

  • The study supports a reductionist explanation because it isolates the influence of background music (classical vs. pop vs. no music) as the independent variable, simplifying the factors that could affect customer spending.
  • This reductionist approach is evident as the study solely focuses on the impact of music type on spending while keeping situational variables like lighting and menu constant.

Strengths

1. The reductionist explanation offers a practical approach to changing consumer behavior.

  • Since the study identifies that changing the background music to classical can increase customer spending, it provides a straightforward strategy for restaurants and businesses to increase customer spending. 

2. It offers a straightforward and easily replicable framework for future research in this field.

  • The methodology used in this study, involving playing different types of music in a restaurant setting and measuring customer spending, can be easily replicated in other contexts or with variations. 
  • This simplicity in design allows researchers to investigate the impact of background music on consumer behavior in various settings, like malls, retail stores, etc. making it an ideal foundation for further studies..

  • Weaknesses of Nomothetic Approach

1. The study’s focus on the impact of classical music on customer spending ignores other potential influences on spending.

  • This includes personal preferences, demographics, and social factors. 
  • The quality of service, the menu presentation, or the restaurant’s ambiance, could have also influence spending behavior in the restaurant.

2. The study’s findings may not be generalizable to everyone.

  • The study only included 393 customers from one particular restaurant during a short time frame.

This sample may not represent the diverse range of consumers found in different locations and types of restaurants.

Determinism versus Free Will

Justification

  • The study supports a deterministic explanation.
  • It demonstrated that the type of background music (classical or pop), had a significant influence on customer spending. 
  • Classical music significantly increased the mean spend per person for starters, coffee, total food spend, and overall spend, regardless of individual preferences or intentions. 

Strengths

1. The deterministic explanation offers an easy controllable approach to changing consumer behavior.

  • Since the study identifies that changing the background music to classical can increase customer spending, it provides a straightforward strategy for restaurants and businesses to increase customer spending. 

2. The deterministic explanation reduces individual blame on customers for their spending behavior.

  • In the study, customers were not aware they were part of an experiment, and the restaurant did not collect data on their musical preferences. 
  • This lack of free-will data supports the idea that the deterministic factor of music was the driving force behind increased spending.

Weaknesses

1. The deterministic explanation does not encourage personal responsibility in explaining spending behavior.

  • It focuses on external factors like classical music’s influence, but doesn’t consider personal responsibility in managing one’s spending habits. 
  • For instance, an individual’s budgeting skills, and self-control also play a significant role in their spending behavior, which this study doesn’t address.

2. This study’s deterministic explanation overlooks the influence of free-will choices, making it reductionist. 

  • It assumes that playing classical music directly causes higher customer spending.
  • For example, the study doesn’t take into account that some diners might have a personal preference for classical music, which could have influenced their willingness to spend more.

Generalizability of Findings

Strengths

1. It captured a realistic sample. 

  • 393 customers who ate in the restaurant between February and March 2002 were recruited for the study. 
  • This sample represents real-world restaurant-goers, enhancing the ecological validity of the findings.

2. Another strength is that the researchers managed to obtain a large number of participants.

  • They had a sample size of 393 customers, which is a relatively large sample size. 
  • This means that the results of the study are more likely to be accurate and reliable, as they are based on a large number of participants.

Weaknesses

1. One weakness is the lack of representativeness of the sample in the North et al. (2003) study. 

  • The sample consisted of 393 customers from a single restaurant in a small, affluent town in Leicestershire, UK. 
  • This means that the findings may not apply to less affluent restaurants or restaurants in different types of locations.

Another weakness is potential researcher bias in sample selection.

  • The choice of a single restaurant, which served expensive à la carte food, could introduce bias because it may not be representative of typical dining establishments.
  • It is possible that the selection was influenced by convenience or personal preferences, introducing bias into the study.

Validity

Strengths

1. A counterbalanced order of music styles was presented, increasing validity.

  • The order of music styles varied from week to week.
  •  Counterbalancing the order minimized the potential influence of external factors that might vary with time, such as customer preferences or seasonal effects

2. The use of an independent groups design in the study minimised order effects, increasing validity. 

  • Since each table of diners experienced only one type of music or no music, there was no chance for participants to be influenced by the order in which they heard classical or pop music.
  • This design helped ensure that the differences in spending were due to the music type itself rather than any order-related biases.

Weaknesses

1. The study lacked control over various factors that could have influenced customer behavior beyond the background music, reducing validity. 

  • For example, situational variables like lighting, menu, and temperature were kept constant, but other variables such as the quality of service, the day of the week, or special promotions were not controlled. 
  • This lack of control makes it challenging to attribute the changes in customer spending solely to the type of music played.

2. It didn’t control for individual differences between participants, reducing validity. 

  • Each participant experienced only one type of music or no music, which means that there could have been inherent differences between the groups that influenced their spending behavior. 
  • For example, some participants might have had higher incomes or different spending habits, which could have skewed the results.

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Categories
A2 - Clinical Psychology

Case Study of Schizophrenia (Aneja et.al.)

________ = most important text;

________ = important text;

________ = illustrative text (examples);

________ = text to memorise as is (facts and figures)

Description of the Case

The case study involves a boy who experienced a troubled upbringing and had a history of aggression. He had unusual physical features like an elongated face and big ears. After his parents’ divorce, he lived with his grandparents, and his academic performance deteriorated. The boy exhibited symptoms of schizophrenia such as hearing voices, suspicion towards his mother, muttering and shouting at unseen individuals, social withdrawal, poor sleep, and lack of self-care. He was initially prescribed sodium valproate, a drug used for bipolar disorder, which temporarily improved his mood and behavior but later worsened. Eventually, he received a diagnosis of very early-onset schizophrenia (VEOS), leading to increased aggression and frequent hospital admissions for safety reasons.

Relevant Issues and Debates

Case Studies

The Aneja et. al. is a case study because it is a detailed investigation of a single case because it examines the life and experiences of a specific boy with a troubled upbringing and a history of aggression. It provides a comprehensive account of his background, symptoms, treatment, and outcomes. Furthermore, it qualifies as a long-term investigation as it follows the boy’s progression over time, documenting his changing symptoms, the effects of different medications, and his frequent hospital admissions for safety concerns.

Strengths of Case Studies

1. The use of a case study in the Aneja et.al. study allows for a detailed investigation of the boy’s background, experiences, and symptoms. For example, the study provides specific information about the boy’s troubled home, his parents’ divorce, living with his grandparents, deteriorating academic performance, and a range of symptoms including hearing voices, suspicion towards his mother, and social withdrawal. This level of detail helps researchers and readers gain a comprehensive understanding of the case and its complexities.

2. The case study in the Aneja et.al. study offers insights from multiple perspectives, enabling a more comprehensive analysis of the boy’s condition. For instance, it highlights the observations and assessments made by different professionals involved in his treatment, such as psychologists, psychiatrists, and other healthcare providers.

Weaknesses of Case Studies

1. The case study of the boy’s experience cannot be generalized to the entire population due to its specific and unique circumstances. The study focuses on an individual case with a troubled upbringing, aggression, and a specific diagnosis of very early-onset schizophrenia (VEOS). This limits the generalizability of the findings to other individuals with different backgrounds, behaviors, and mental health conditions.

2. The qualitative nature of the case study introduces subjectivity and potential bias in interpreting and reporting the boy’s symptoms and responses to treatment. The study relies on subjective observations, interpretations, and narratives from the researchers, which may vary between different observers or researchers. 

Individual and Situational Approach

This case study supports both an individual and a situational explanation. Individually, his physical features, such as a long face and elongated ears suggest some genetic or neurological damage. Situational factors like his parents’ divorce, living with his grandparents, and academic decline also played a role in his deteriorating mental health. 

Strengths of Individual and Situational Approaches

1. Determining that the source of the boy’s aggressive behavior and mental health issues is situational can help reduce blame on individuals and increase responsibility of society in preventing schizophrenia. For example, the boy’s troubled upbringing, including his aggressive father and the disruption caused by his parents’ divorce, contributed to his behavioral problems. 

2. Determining that the source of the boy’s behavior is an interplay of individual and situational factors can help develop multifaceted interventions to tackle complex problems. For instance, understanding the boy’s genetic predisposition for very early-onset schizophrenia (VEOS) along with the environmental factors such as his troubled upbringing and disrupted schooling allowed for a holistic approach to treatment. For example, he was given medication to manage very early-onset schizophrenia (VEOS), therapy to develop coping strategies and address family dynamics, social support and education to reduce stigma and increase awareness.

Weaknesses of Individual and Situational Approaches

1. It is challenging to separate the influence of individual factors, such as the boy’s genetic predisposition to schizophrenia, from situational factors, such as his troubled upbringing and parental aggression. Both likely interacted and contributed to the development and worsening of the boy’s condition. 

2. The study exhibits a weakness in adequately addressing situational factors. Although the study highlights the boy’s troubled upbringing and its potential impact on his behavior, it fails to delve deeper into the specific situational factors that may have contributed to his symptoms of VEOS. For example, the study does not extensively explore the influence of the boy’s school environment, peer interactions, or social support systems, which could play a significant role in his condition.

Use of Children

Strengths of Use of Children

1. One strength of using children in the Aneja et al study is that it provides valuable insights into understanding very early-onset schizophrenia (VEOS). The case study illustrates the progression of symptoms in a young boy, showcasing the challenges faced by children with VEOS. For example, the boy’s aggressive and violent outbursts increased over time, leading to frequent hospital admissions for his safety. 

2. Another strength of the study is its contribution to understanding the development of schizophrenia in children. By examining the case history, researchers can identify potential risk factors and early signs of the disorder. In this case, the boy’s troubled upbringing, parental divorce, academic decline, and the presence of specific symptoms (e.g., hearing voices, social withdrawal) offer insights into the complex interplay between environmental factors and the emergence of schizophrenia at a young age. 

Weaknesses of Use of Children

1. The study may raise ethical concerns regarding the well-being and consent of the child participant. In the case study, the child’s aggressive and violent outbursts increased after being diagnosed with very early-onset schizophrenia. The study’s involvement could have potentially caused additional emotional and psychological harm to the child, as they were already vulnerable due to their difficult upbringing.

2. Aneja et al’s study may face methodological limitations when studying children, such as potential biases and challenges in data collection. However, due to the child’s young age and limited verbal abilities, it may have been challenging for the researchers to accurately assess the frequency, intensity, and content of these hallucinations. 

Idiographic versus Nomothetic Approach

The case study by Aneja et al. supports an idiographic approach because it provides a detailed and individualized account of a specific case of schizophrenia. The description includes specific details about the boy’s troubled home, his symptoms, and the treatments he received, offering a unique understanding of his condition.

Strengths of Idiographic Approach

1. The idiographic approach in the study is more realistic as it accounts for the complexity of human behavior. By examining the specific details of the boy’s troubled upbringing, family dynamics, and personal experiences, the study captures the complex factors that contribute to his behavior, providing a more comprehensive understanding of his condition.

2.  The idiographic approach in the study can help design personalized interventions to resolve the problems of patients. By uncovering the unique factors contributing to the boy’s aggressive behavior, social withdrawal, and poor sleep, personalized interventions can be tailored to address his specific needs, such as therapy focused on trauma from his troubled home and implementing strategies to improve his sleep hygiene.

Weaknesses of Idiographic Approach

1. The idiographic approach in the Aneja et al study focuses on a single case history of a boy with very early-onset schizophrenia (VEOS). This individual case provides detailed insights into the boy’s experiences and symptoms. However, because it focuses on a specific individual, the findings may not be generalizable to a larger population. For example, the boy’s aggressive behavior and response to medication may be unique to his circumstances and condition.

2. Although the idiographic approach provides rich details about an individual’s experiences, it does not offer guidance on designing interventions that can be applied to larger groups facing similar issues. For example, the study does not explore broader treatment strategies, such as cognitive-behavioral therapy or group interventions, which could be beneficial for individuals with schizophrenia beyond the specific case examined in the study.

Generalizability of Findings

Strengths of Generalizability of Findings

1. The study demonstrates ecological validity by providing a detailed case study that reflects real-life circumstances and contexts. For example, the study includes information about the boy’s troubled upbringing, his living arrangements, and his academic struggles, which are common factors that can influence a child’s mental health. 

2. The study holds generalizability to Indian culture to an extent by focusing on a case from India and examining the specific challenges faced by individuals in this cultural context. For instance, the study discusses the boy’s experience of living with his grandparents after his parents’ divorce, which is a common arrangement in Indian families. Thus, the study’s findings can be applied to similar cases within the Indian cultural context, enhancing their generalizability.

Weaknesses of Generalizability of Findings

1. A potential weakness of the study is the small sample size, as it focuses on a single case study. This limits the generalizability of the findings, as the results may not be applicable to a larger population. For example, the study does not consider factors such as age, gender, or comorbidities that may impact treatment outcomes in a larger sample of individuals with VEOS.

2. The study by may not be generalizable because the boy’s aggressive behavior and family dynamics in the case study are unique and may not be representative of the general population with very early-onset schizophrenia (VEOS) who come from different family backgrounds or have different environmental factors For instance, the boy’s aggressive behavior may be influenced by the specific dynamics of his troubled home environment, such as the presence of an aggressive father. 

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Categories
A2 - Clinical Psychology

Freeman et.al. (2003) – Key Study

The Study

Aims

  • To investigate whether nonclinical individuals have persecutory thoughts in virtual reality;
  • To investigate cognitive factors that predict the occurrence of persecutory ideation in virtual reality, with a particular focus on emotional processes.

Method

Sample
  • 24 individuals;
  • all without a history of mental illness;
  • recruited by advertising;
  • all from University College London;
  • 21 were students;
  • 3 were administrative staff;
  • 12 males and 12 females;
  • paid volunteers

Procedure

Step-by-step outline-

  • Consent and Information:
    • Consent obtained from participants for their participation in the study:
    • Participants are not informed that the study specifically examines persecutory thoughts to prevent priming of reactions.

  • VR Equipment Training:
    • Participants then received training on how to use the virtual reality (VR) equipment.

  • Entering the Virtual Environment:
    • Participants were then asked to enter the virtual environment which was a virtual ;
    • Instructions given: “Please explore the room and try to form some impression of what you think about the people in the room and what they think about you.”

  • Selection of Virtual Scene:
    • A neutral library scene was chosen for the study, considering the university population;
    • The virtual room was designed as a library, but participants were not informed of this during the study to allow them to form their own impressions.

  • Avatars in the Library:
    • There are 5 avatars in the library scene;
    • 3 avatars sat at one desk, while 2 avatars sat at another desk on the opposite side of the room.

  • Ambiguous Avatar Behavior:
    • Occasionally, the avatars showed potentially ambiguous behavior such as smiling, looking around, and talking to each other.

  • Duration in the Virtual Room:
    • Participants spent 5 minutes in the virtual room.

  • Exiting the Virtual Room:
    • Participants were instructed to leave the virtual room after the allotted time.

  • Questionnaire and Interview:
    • All participants then completed a questionnaire and a short semi-structured interview regarding their experiences in the virtual environment;
    • The interviews were video recorded and later rated by an expert clinical psychologist on a 6-point scale for persecutory ideation

  • Handling Priming of Persecutory Thoughts:
    • The study design addressed the possibility of priming persecutory thoughts through the questionnaires measuring cognitive processes (see measures section below);
    • Half of the participants completed the questionnaires after exiting the virtual environment;
    • The other half completed the questionnaires both before and after entering the virtual environment.

  • Participant Balance and Compensation:
    • Male and female participants were balanced in each of the two conditions (pre- and post-virtual environment completion of questionnaires);
    • Participants were compensated for their participation in the study.

Measures
  1. Brief Symptom Inventory (BSI):
  • A 53-item self-report measure to assess 9 symptom dimensions over the past 7 days;
    • 9 dimensions include Somatization, Obsessive-Compulsive, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic Anxiety, Paranoid Ideation, and Psychoticism;
  • Each item is rated on a 5-point distress scale (0–4);
  • Total score obtained is the Global Severity Index.

2. Paranoia Scale:

  • A 20-item self-report scale to measure paranoia in college students;
  • Measures both ideas of persecution and reference;
  • Each item is rated on a 5-point scale;
  • Scores range from 20 to 100, with higher scores indicating greater paranoid ideation.

3. Spielberger State Anxiety Questionnaire:

  • A 20-item self-report measure of state anxiety;
  • Each item is rated on a 1–4 scale;
  • Scores range from 20 to 80, with higher scores indicating higher levels of anxiety.

4. VR-Paranoia Questionnaire:

  • A 15-item self-report questionnaire specifically devised for the study;
  • Assesses participants’ views of the avatars in the virtual environment;
  • 3 areas assessed –
    • persecutory thoughts about the avatars (VR-Persecution),
    • ideas of reference about the avatars (VR-Reference), and
    • positive beliefs about the avatars (VR-Positive)
  • Each item is rated on a 4-point scale (0–3);
  • Scores can range from 0 to 15 for each subscale, with higher scores indicating greater endorsement of items.

5. Sense of Presence Questionnaire:

  • Assesses the extent to which participants experience a sense of being in the virtual world;
  • Consists of 6 questions rated on a scale of 1 to 7;
  • Higher numbers indicate greater reported presence;
  • A score of 6 or 7 on a question is coded as 1, while all other scores are coded as 0;
  • Total score can range between 0 and 6.

Results

  • General:
    • Mean score on the Paranoia Scale: 31.8, SD = 10.8, minimum = 20, maximum = 61.
    • No significant difference in Paranoia Scale scores between males and females.

  • Persecutory Ideation in the Virtual Library:
    • VR-Persecution scores were positively correlated with VR-Reference scores (r = +0.48) and negatively correlated with VR-Positive scores (-0.54);
    • Persecutory ideation in VR was also positively correlated with blind ratings of persecutory ideation from recorded interviews (r = +0.59).

  • Sense of Presence in VR:
    • Participants reported a moderate sense of presence in the virtual library;
    • Anxiety levels did not increase after entering the virtual environment.

Predictors of Persecutory Ideation in VR:

  • VR Persecution did not significantly correlated with scores on the Paranoia Scale;
  • Higher VR-Persecution scores tended to be associated with higher BSI-Paranoia scores;
  • VR Persecution scores correlated with other BSI dimension scores, Spielberger State Anxiety score, and sense of presence score;
  • Higher levels of interpersonal sensitivity and anxiety were associated with higher levels of persecutory ideation in virtual reality.

Conclusions

  • Nonclinical individuals have persecutory thoughts in virtual reality;
  • The cognitive and emotional processes of paranoia, reference and anxiety predict the occurrence of persecutory ideation in virtual reality.

Methodological Evaluation

Sampling

Sample Characteristics
  • Strengths
    • Study involved non-clinical individuals, broadening understanding of persecutory ideation beyond diagnosed mental health patients;
    • Equal gender recruitment ensured representative sample and minimized gender biases in study findings.
  • Weaknesses
    • With only 24 individuals, findings may lack generalizability. A larger sample ensures stronger results;
    • Mainly university students and staff were included, limiting generalization to non-university  populations.
Sampling Technique
  • Paid Volunteer
  • Strengths
    • Participants easier to recruit as too many people would be fearful of VR or find the experiment too time consuming and refuse to participate;
    • Participants more cooperative for a lengthy study that required many self report questionnaires to be answered sincerely.
  • Weaknesses
    • Participant recruitment introduced bias as those interested in virtual reality were more likely to participate;
    • Participants knew about participating in a virtual environment beforehand, potentially changing their behaviour to watch the avatars too closely

Operationalization of Variables

  • Strengths
    • The study employs recognized and validated tools (BSI, Paranoia Scale, etc.) for accurate assessment, increasing validity;
    • Combining semi-structured interviews and observer ratings added qualitative depth to quantitative measures, increasing scope of findings
  • Weaknesses
    • No standard questionnaire for measuring paranoia in virtual reality; researchers created their own, challenging reliability;
    • Study used ambiguous avatars in a library scene, potentially influencing participants’ perceptions of persecution, reducing ecological validity

Examples of Controls

  1. Non-clinical individuals were recruited to study persecutory ideation in virtual reality without preexisting mental illness;
  2. A neutral library scene was used to explore persecutory thoughts without explicit hostility;
  3. Questionnaires were completed before and after the virtual environment to assess potential priming effects;
  4. An expert clinical psychologist conducted a semi-structured interview and rated participants’ responses for persecutory content.

Research Method (Correlational Study)

  • Strengths
    • Study used multiple measures like surveys, interviews, and observations to understand worry and sadness, increasing validity;
    • Study looks at how personality and emotions relate to persectory thoughts, offering new insights for research
  • Weaknesses
    • Only 24 people were part of the study, who were not mentally ill. Results may not apply widely;
    • Participants weren’t randomly assigned for different groups, making it harder to conclude that paranoia causes persecutory ideation.

Ethical Evaluation

  1. Informed consent: Participants consented but knowledge of study was unclear;
  2. Right to withdraw: not explicitly mentioned;
  3. Deception: Researchers hid their focus on persecutory thoughts;
  4. Protection from physical harm: No apparent physical harm mentioned;
  5. Protection from psychological harm: Potential distress to people having persecutory ideation in relation to the avatars in the virtual library;
  6. Debriefing: Questionnaire and interview, but debriefing not mentioned;
  7. Privacy: Virtual environment privacy measures not specified;
  8. Confidentiality: Handling of personal data and identity not addressed.

Issues and Debates

Individual and Situational Explanations

Both explanations supported

  • Individual Explanation
    • Paranoia as explaining persecutory ideation
  • Situational Explanation
    • VR environment explaining persecutory ideation

  • Strengths of Individual Explanation
    • Encourages treatment of paranoia to stop persecutory delusions;
    • Encourages delusional patients to take responsibility for reducing their paranoid thinking.

  • Weaknesses of Individual Explanation
    • Use of self-report methods to understand paranoid thinking, subject to social desirability, reducing validity
    • Separating the influence of individual and situational factors is difficult – whether VR environment causes persecutory ideation or paranoia

  • Strengths of Situational Explanation
    • The study used a special computer room with lifelike characters to simulate real-life situations, increasing ecological validity;
    • Psychologists indirectly encouraged to look at behaviours of people around a patient also while diagnosing and treating schizophrenia, increasing social responsibility 

  • Weaknesses of Situational Explanation
    • People only used the virtual world for 5 minutes, so it may not show long-term effect of situation;
    • The study didn’t compare virtual experiences with real-life situations, which could confirm paranoid thoughts in the real world.

Idiographic versus Nomothetic

Both approaches explanation supported

  • Idiographic Approach
    • Study included individual comments (qualitative data) to understand unique experiences and subjective perspectives of participants;
  • Nomothetic Approach
    • Study examined correlations (quantitative data) between variables to identify general patterns and trends applicable to a broader population.

  • Strengths of Idiographic Approach
    • Provided rich qualitative data through semi-structured interviews, capturing individual experiences and perceptions;
    • Allowed for personalized assessment of persecutory thoughts and beliefs, providing a detailed understanding of participants’ unique perspectives

  • Weaknesses of Idiographic Approach
    • Subjectivity in scoring and interpreting qualitative data may introduce bias and affect the reliability of the findings;
    • Limited generalizability due to the small sample size and specific characteristics of the participants from one university.

  • Strengths of Nomothetic Approach
    • Provides quantitative data for statistical analysis, allowing for generalization and comparison between participants;
    • Allows for identification of correlations between variables, such as persecutory thoughts and emotional distress.

  • Weaknesses of Nomothetic Approach
    • Limited depth of understanding due to reliance on quantitative measures, potentially missing nuanced experiences and perspectives;
    • Lack of contextual information and individual variability might overlook important factors influencing persecutory thoughts and emotional distress.

Generalizability of Findings

  • Strengths of Generalizability
    • The use of virtual reality (VR) creates a realistic environment, increasing the ecological validity of findings;
    • The study included an equal number of male and female participants, allowing for potential gender-related differences to be considered in the generalizability of the findings

  • Weaknesses of Generalizability
    • With only 24 participants, the findings may not fully represent the broader population, limiting generalizability;
    • The study took place in a virtual reality setting with avatars, which may not fully reflect real-life interactions and situations.

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Categories
A2 - Clinical Psychology

Genetic Explanation of Schizophrenia

The Explanation

  • Schizophrenia has a strong genetic component.

  • Monozygotic (identical) twins have a higher concordance rate for schizophrenia as compared to dizygotic (fraternal) twins.
    • Gottesman and Shields analyzed 24 sets of MZ twins and 33 sets of DZ twins from a sample of 467 twins registered at a hospital in London. They found that around 50% of MZ twins shared a schizophrenic status, while only about 9% of DZ twins did.

  • Genome-wide association studies (GWAS) have identified multiple gene variants associated with schizophrenia.

  • Schizophrenia is a polygenic condition, meaning it involves thousands of gene variants.

  • Many of the genes linked to schizophrenia are involved in the synthesis, transportation, and breakdown of neurotransmitters like dopamine.

  • DiGeorge syndrome, which involves a deletion on chromosome 22, increases the risk of developing schizophrenia.
    • In this syndrome, the COMT gene, which codes for an enzyme involved in dopamine breakdown is found to be deleted.

  • Another gene, the DISC1 gene may increase the risk of schizophrenia by affecting the neurotransmitter GABA, which regulates dopamine activity.

Relevant Issues and Debates

Individual and Situational Explanations

  • Genetic explanation is purely individual

  • Strengths
    • When comparing identical and non-identical twins, higher schizophrenia rates in identical twins suggest genetic influence, guiding prevention of the disorder;
    • DiGeorge syndrome with COMT gene deletion links to increased risk of schizophrenia, encouraging genetic testing for early identification

  • Weaknesses
    • Genes are important, but not enough to explain schizophrenia. Other factors are involved too, such as cognitive style;
    • Schizophrenia genetics are complicated, with many genes involved, making it hard to understand the disorder through genes  alone

Nature versus Nurture

Genetic explanation supports only nature

  • Strengths
    • When comparing identical and non-identical twins, higher schizophrenia rates in identical twins suggest genetic influence, guiding prevention of the disorder;
    • DiGeorge syndrome with COMT gene deletion links to increased risk of schizophrenia, encouraging genetic testing for early identification.

  • Weaknesses
    • Genes and the environment work together. Genetic differences can be affected by environmental factors like stress or trauma;
    • MZ twins are treated more similarly than DZ twins by parents because of their same gender and appearance, so it’s hard to tell if differences are from genes or environment

Reductionism versus Holism

Genetic explanation is reductionist

  • Strengths
    • Focusing on specific genes such as COMT in schizophrenia helps us understand its genetic causes better and find targeted treatments such as those reducing dopamine levels;
    • Finding specific genes for measurement like COMT and DISC1 helps scientific investigation and knowledge advancement about role of genes in schizophrenia

  • Weaknesses
    • Focusing on genes and chemicals oversimplifies schizophrenia, ignoring its complexity with cognitive,environmental and social factors;
    • Reducing schizophrenia to genes overlooks the impact of stress, trauma, substance abuse, and social factors on the disorder, reducing generalizability

Determinism versus Free Will

  • Genetic Explanation is determinist

  • Strengths
    • Genes play a big role in schizophrenia based on studies of families and twins. DNA determines susceptibility, reducing the tendency to blame the individual;
    • COMT and DISC  gene variations are linked to schizophrenia, showing a genetic tendency for the disorder. Thus, genetic risk can be controlled to prevent the disorder

  • Weaknesses
    • Schizophrenia is caused by many genes working together, but no single gene determines it completely. This challenges the deterministic explanation;
    • Schizophrenia is not only influenced by genes but also by environmental factors like stress or trauma, making the explanation reductionist.

Idiographic versus Nomothetic

  • Strengths
    • Large-scale studies like family, twin, and genome-wide association studies have found strong evidence for role of genes in schizophrenia, increasing validity;
    • Data has been gathered in these studies from very large and diverse samples, increasing generalizability to populations.

  • Weaknesses
    • Nomothetic approach ignores personal experiences and individual differences in schizophrenia’s development and symptoms;
    • Nomothetic approach oversimplifies complex factors in schizophrenia, ignoring how genetics, environment, and psychology interact to cause the disorder.

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Categories
A2 - Clinical Psychology

ICD-11 Criteria for Schizophrenia

________ = most important text;

________ = important text;

________ = illustrative text (examples);

________ = text to memorise as is (facts and figures)

Description of Criteria

The ICD-11 criteria for schizophrenia include a set of symptoms and duration requirements for diagnosis. First, there must be characteristic symptoms such as delusions, hallucinations, disorganized thinking, and negative symptoms. Second, these symptoms must be present for a significant portion of time during a one-month period. Third, continuous signs of the disorder must be observed for at least six months, which includes prodromal or residual symptoms. Fourth, other potential causes for the symptoms must be ruled out, such as substance abuse or medical conditions. Finally, the diagnosis requires significant impairment in social, occupational, or personal functioning.

Relevant Issues and Debates

Individual and Situational Explanations

The ICD-11 criteria for schizophrenia primarily support an individual explanation. It focuses on the presence of characteristic symptoms like delusions, hallucinations, and disorganized thinking in the affected person, rather than situational factors.

Strengths of Individual Explanation

1. The individual explanation in the ICD-11 criteria for schizophrenia allows for practical application to everyday life. For example, it emphasizes the presence of symptoms like delusions and hallucinations that are experienced by the affected person, enabling clinicians to assess and provide appropriate interventions tailored to the individual’s needs.

2. The individual explanation in the ICD-11 criteria for schizophrenia promotes the notion of personal responsibility. By emphasizing the presence of symptoms like disorganized thinking, it recognizes that the affected person plays a crucial role in managing their symptoms and seeking appropriate treatment.

Weaknesses of Individual Explanation

1. The ICD-11 does not explicitly consider how external stressors, such as trauma or social circumstances, may contribute to the development or exacerbation of symptoms. This limitation hinders a comprehensive understanding of the complex interplay between individual and situational influences.

2. The individual-focused perspective in the ICD-11 criteria for schizophrenia tends to reduce the disorder by overlooking the broader societal and cultural contexts that shape an individual’s experiences. For example, the criteria do not extensively explore the influence of cultural beliefs, discrimination, or socioeconomic factors, which are relevant in understanding schizophrenia holistically.

Idiographic versus Nomothetic Approach

The ICD-11 criteria for schizophrenia primarily support a nomothetic approach. It provides a standardized set of symptoms and diagnostic guidelines that emphasize the presence of specific symptoms such as delusions, hallucinations, etc. shared across different cases.

Strengths of Nomothetic Approach

1. The nomothetic perspective allows for the identification of widespread principles of human behavior. For example, it outlines specific symptom criteria such as delusions, hallucinations, and disorganized thinking that are commonly observed across individuals with schizophrenia, providing a framework to understand and classify their experiences.


2. The criteria demonstrate strength in psychometrics by providing a minimum duration of symptoms and specifying the number and types of symptoms needed for diagnosis, enhancing the reliability and validity of assessments and diagnoses.

Weaknesses of Nomothetic Approach

1. The nomothetic perspective has a weakness in terms of reductionism. The criteria does not fully capture the unique subjective experiences and variations in symptom manifestation among different individuals with schizophrenia. For example, some patients may have more negative than positive symptoms, making their diagnosis difficults.

2. Another weakness is that it can restrict the tailoring of treatments based on a person’s specific circumstances. For example, the criteria do not account for factors such as co-occurring conditions, personal preferences, or social support systems that may significantly influence treatment outcomes.

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Categories
A2 - Clinical Psychology

A Case Study of Schizophrenia – Aneja et.al. (2018)

Case Description

Demographics

  • 14 year old boy;
  • remarkable physical features – elongated face, large ears;
  • middle SES;
  • residing in urban area;
  • attained age-appropriate developmental milestones;
  • born from unplanned but wanted pregnancy

Background

  • exposed to father’s aggression from childhood;
  • boy 10 years old when parents divorced over domestic violence issues;
  • started living with maternal grandparents from when he was 11 years old

Early Symptoms

  • not specific to schizophrenia
  • declining academic performance and handwriting starting at 12 years of age;
  • fist fights and other undesirable behaviour at school;
  • preference for solitary activities, particularly eating alone at home

Early Treatment

  • consultation with private psychiatrist;
  • medicine given which reduced aggression and irritability;
  • medicine gradually stopped

Intermediate Symptoms

  • after 1 year of early treatment, schizophrenia-specific symptoms seen;
  • auditory hallucinations, hearing commanding voices;
  • paranoia of mother conspiring with those talking in commanding voices to tease him;
  • eventual drop out from school;
  • talking to self and shouting at imaginary persons till late night;
  • declining socialization and self-care

Intermediate Treatment

  • consultation with a different psychiatrist;
  • diagnosis of schizophrenia now achieved;
  • prescription of antipsychotic medicines;
  • some improvement in symptoms;
  • poor compliance due to side effect of weight gain;
  • relapse within 3 months

Hospitalization

  • Hospitalization due to frequent aggressive episodes;
  • diagnosis of very early onset schizophrenia (VEOS) achieved;
  • initial improvement with antipsychotic medicines and subsequent discharge;
  • readmission to hospital after return of hallucinations and aggression after two weeks;
  • ECT (electro-convulsive therapy) now administered;
  • psychoeducation regarding schizophrenia and supportive psychotherapy provided to family;
  • activity schedule, occupational therapy and modifications for diet also provided to boy;

Recovery

  • resolved issues post hospitalization – violence, hallucinations
  • unresolved issues – irritability, socialization, apathy, avolition, weight gain, aversion to start school, bone marrow function

Relevant Issues and Debates

Case Studies

  • Justification
    • in-depth exploration of symptoms, treatment and recovery of schizophrenia in the body;
    • longitudinal investigation of the progress of schizophrenia in the boy – right from birth and childhood circumstances to treatment and recovery in the present day

  • Strengths
    • Comprehensive understanding of schizophrenia;
      • investigation of aspects like difficulties in school, academic decline, challenges in the family, treatment using outpatient and inpatient treatment, use of medication and ECT, etc.
    • Understanding of Progression of schizophrenia
      • changes in behaviours of boy noted overtime such as declining academic performance, increasing social withdrawal, increasing aggression and violence, etc.

  • Weaknesses
    • Limited generalizability of findings;
      • the boy’s case had peculiar features, including his facial appearance, relationship with father, history of domestic violence at home, etc. which integrate to form a unique case that might not apply to child cases of schizophrenia;
    • Subjectivity of Findings
      • diagnosis and treatment of the boy was subject to the clinical judgment of different psychiatrists

Individual and Situational Explanations

  • Case supports both explanations–
    • Individual explanation supported by peculiar appearance of boy and temperament;
    • Situational explanation supported by aggressive behaviour of father and divorce during childhood and exposure to various treatments

  • Strengths
    • Holistic perspective;
      • inclusion of both individual and situational aspects gives a more comprehensive understanding of the disorder
    • Increased Potential for Treatment;
      • consideration of individual and situational factors enables psychiatrists better opportunity to treat patients as they can target multiple factors for improvement

  • Weaknesses
    • Limited exploration of Situational Explanation
      • more situational factors such as the boy’s school environment, relationship with teachers and fellow students, etc. could be investigated further for even better understanding of the disorder
    • Limited exploration of Interaction of Individual and Situational Explanations
      • while both explanations have been investigated – their interaction – or how each compounds with the other in the progression of the disorder is not sufficiently explored, limiting understanding

Use of Children

  • Strengths
    • Developmental Perspective of Schizophrenia;
      • gradual development of schizophrenia from general symptoms in childhood to specific progression in adolescence explored
    • Early Identification and Intervention
      • a VEOS case is presented by using a child, showcasing the impact of schizophrenia in near adolescence, its identification and intervention

  • Weaknesses
    • Ethical Considerations
      • the boy was too disturbed to provide informed consent to his diagnosis and treatment – and to withdraw even when he experienced severe side effects and many interventions proved ineffective
    • Practical Challenges
      • the boy was too young especially during the early phase to self-report his experiences and he might have been selected in the first place due to availability which is not the case with many children, limiting generalizability

Idiographic versus Nomothetic

  • Study largely supports an idiographic approach since it is a single case study

  • Strengths
    • Individualized Understanding
      • unique factors to the boy – his family background, symptoms at school, physical appearance, response to medications, improvement of symptoms in response to various treatments, etc. explored to provide a deeper understanding
    • Personalised Treatment
      • boy provided with treatments specific to his symptoms at various stages – first general medication, then antipsychotic medication, then ECT and tailored therapy, etc. resulting in probably the best outcomes

  • Weaknesses
    • Restricted Generalizability
      • since specific investigation and treatment was conducted, the understanding and application may not generalize beyond the boy’s case
    • Extensive use of Resources
      • customization of treatment to the boy meant consultation with various psychiatrists, trial of different treatments, etc. over the course of several years – which is not practicable beyond research investigation

Generalizability of Findings

  • Strengths
    • Longitudinal Investigation
      • the case shows possibility of recovery from several intense symptoms of schizophrenia over the course of long-term treatments
    • Multidisciplinary Approach
      • use of a variety of methods borrowed from psychiatry, psychology and occupational therapy to treat the boy brings about the role of complex factors in schizophrenia treatment

  • Weaknesses
    • Focus on Single Case of Schizophrenia
      • only the case of one boy of a very specific age, nationality, etc. was investigated; restricting generalizability to adults, children of other nationalities, etc.
    • Limited Followup of Treatment Outcomes
      • only a 6-month long follow-up was done to study which symptoms of the disorder still persisted or did not in the boy, limiting understanding to longer term outcomes

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