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Main contents of medical psychology---clinical psychology
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Psychological test
The major categories of tests
1. Mental ability tests
n Memory, spatial visualization,
n creative thinking
n Intelligence Wechsler Adult Intelligence WAIS
n Stanford Binet Intelligence Scale
2.Achievement tests
Attempt to assess a person’s level of knowledge or skill in a particular domain.
[1]Achievement batteries used in elementary and secondary schools(Stanford achievement test SAT)
All batteries consist of a series of tests in such areas as reading, mathematics , language, science and social studies.
[2] single-subject tests
It covers only one area, such as psychology, or geometry
An example of such a test:
Graduate Record Examinations (GRE) :
SUBJECT TEST IN PSYCHOLOGY
[3] the third subdivision
n An incredible variety of tests used for purposes of certification and licensing in some fields
such as: nursing, teaching, physical therapy, airline piloting
They have important consequences for people in specific vocational fields.
[4] Statewide achievement testing programs
test reading, writing, and mathematics abilities.
National assessment of educational progress NAEP
Government-sponsored programs
These four types of achievement tests are typically group administered.
[5]Individual achievement tests
It aids in the diagnosis of such conditions as learning disabilities
3、personality test
[1] objective personality tests
Objective: the tests are objectively scored based on items answered in a true-false or similar format.
Minnesota Multiphasic Personality Inventory (MMPI)
Eating Disorder Inventory EDI
Beck Depression Inventory BDI
[2]Projective techniques
The examinee encounters a relatively simple but unstructured task.
n Rorschach Inkblot Test
n Human figure drawings,
n Sentence completion
4. Vocational interest measures
n Encompasses measures of interests, values, attitudes.
n Wildly used in high schools and colleges to help individuals explore jobs relevant to their interests.
n Strong Interest Inventory SII
n Kuder Occupational Interest Survey KOIS
5. Neuropsychological tests
n Designed to yield information about the functioning of the central nervous system, especially the brain.、
n Much neuropsychological testing employs ability tests and often uses personality tests
Uses and users of tests
Four major uses
n ①Clinical
n Clinical psychology
n Counseling
n School psychology
n neuropsychology
n Testing helps to identify the nature and severity of the problem and provides some suggestions about how to deal with the problem.
②Educational
Group-administered tests of ability and achievement
The actual users of the test include teachers, educational administrators, parents, and the general public
③Personnel
primary users : Businesses and military
The first task: select individuals most qualified to fill a position
The second task: provide useful information about the optimum allocation of the human resources in this scenario
④ research
Used in every conceivable area of research in psychology, education, and other social /behavior science.
The research usage was identified three subcategories
Fundamental questions about tests
Reliability :
Refers to the stability of test scores.
Validity;
refers to what the test is actually measuring.
n Norms:
n Norms are based on the test scores of large groups of individuals who have taken the test in the past.
n Exercise：
n 1. Here are three traits: height, intelligence, friendliness. In which of these traits do you think people differ the most?
n 2. See if you can remember the full names for each of these sets of initials.
n GRE
n EDI
n SII
n MMPI
psychotherapy
The systematic application of techniques derived from psychological principles by a trained and experienced professional therapist, for the purpose of aiding psychologically troubled individuals
Individual psychotherapy
One therapist treats one client at any one time
Psychoanalysis:
An attempt to induce ego-weakness so that repressed material can be uncovered
The client can achieve insight into his or her inner motivations and desires
Resolved childhood conflicts can be controlled
It may not be appropriate for certain types of individuals:
1 Nonverbal adults
2 young children who cannot be verbally articulate or reasonable
3 Schizoid persons
4 Those with urgent problems requiring immediate reduction of symptoms and the feeble-minded.
Four methods of psychoanalysis
1 Free association
2 Analysis of resistance
3 Transference
4 interpretation
Hypnotherapy
The use of hypnosis as an adjunct to psychotherapy.
Person-centered therapy
Accept clients as persons, empathic and respectful and unconditionally positive in their regard for client.
A therapist should not control, inhibit, threaten, or interpret a client’s behaviors.
l A therapist should be in the therapeutic relationship rather than the precise techniques to use in therapy.
Cognitive-behavioral therapy
Helping clients develop perceptual skills with which to interpret environmental inputs and internal stimulation.
Techniques of Cognitive-behavioral therapy
l Cognitive restructuring
The client’s cognitions are changed from irrational, self-defeating, and distorted thoughts and attitudes to more rational, positive and appropriate ones.
Coping skills training
Help clients learn to manage or overcome stress.
Group therapy
A form of therapy that involves the simultaneous treatment of two or more clients.
Commonalities of group therapy
1. Allow each client to become involved in a social situation and to see how his or her behavior affects others.
2. The therapist can see how clients respond in a real-life social and interpersonal context.
3. Group members can develop new communication skills, social skills and insights
4. Groups often help their members to feel less isolated and fearful about their problems.
5. Groups can provide their members with strong social and emotional support.
Some types of therapy groups
l Sensitivity training groups (T-groups)
l Assertiveness training groups
l Psychodrama
Compliance
Effective treatment depends on two aspects:
Correct treatment and The patient’s following through with treatment
Causes of Noncompliance
The cause of non-compliance
The chief cause: communication problems between physicians and patients The second source : the characteristics of treatment itself. Behavioral and environment factors may reduce compliance.Compliance:
The extent to which patients behavior (in terms of taking medications, following diets or other lifestyle changes) coincides with medical or health advice.
Try to illustratee How to improve the compliance according to the theory and your own view.
Oral information1 primacy effect
2 to stress the importance of compliance
3 to simplify the information
4 to use repetition
5 to be specific
6 to follow up the consultation with additional interviews.
Written informationWritten information about medication increased knowledge in 90 per cent of the studies,
Increased compliance in 60 per cent of the studies
Improved outcome in 57 per cent of the studies
Intervention to improve compliance
Three general approaches:
1.education:
Give patients clear, explicit, written instructions about how treatment is to proceed.
2. Modification of treatment plan.
Reorganize the treatment in ways that facilitate an individual’s adherence to it.
tailoring the taking of medication to existing daily habits
Giving the treatment in one or two injections rather than in several doses per day
Packaging medicine in dosage strips or with pill calendars
Scheduling more frequent follow-up visits to supervise compliance
3.behavior modification
①Environmental cues: such as
postcard reminders
telephone calls
wristwatches set to emit a tone at the time a pill should be taken
②self-monitoring
③contingency contracts between patient and physician
④token economies
Try to explain HBM.
Originated by Rosenstock, focused by Becker and Maiman on the specific question of noncompliance. HBM is a social-psychological theory 1. How susceptible to a given illness individuals perceive themselves to be and how severe the consequences of the illness are thought to be
2. How effective and feasible versus how costly and difficult the
prescribed treatment is perceived to be.
3. The influence of internal cues plus external cues in triggering health behaviors
4. Demographic and personality variables as well as structural and social characteristics that modify the influences on the other variables.
placebo
Which case is the one for illustrating the function of placebo?
My headache went away after having a sugar pill
After I had my hip operation I stopped getting headaches
I had a bath and my headache went away
Placebo:
Inert substances which cause symptom relief.
Substances that cause changes in a symptom not directly attributable to specific or real pharmacological action of a drug or operation
Any therapy that is deliberately used for its non-specific psychological or physiological effects.
The use of placebos
n 1. increase performance on a cognitive task
n 2.to be effective in reducing anxiety
n 3. have effect on series of areas: allergies, asthma, cancer, diabetes, enuresis, epilepsy, insomnia, ulcers, obesity .
n 4.reduce the pain which is one of the most studied areas in relation to placebo effects
How do placebos work
1.Non-interactive theories
Characteristics of the individual
Certain individuals have characteristics that make them susceptible to placebo effects.
Emotional dependency,
extraversion,
neurosis and being highly suggestible.
Characteristics of the treatment
The characteristics of the actual process involved in the placebo treatment relates to the effectiveness or degree of the placebo effect.
For example: if a treatment is perceived by the individual as being serious, the placebo effect will be greater.
n Characteristics of the health professional
The kind of professional administering the placebo treatment may determine the degree of the placebo effect.
For example:
Higher professional status and higher concern have been shown to increase the placebo effect
Interactive theories
n Placebo effects should be conceptualized as a multi-dimensional process that depends on an interaction between a multitude of different factors
Physiological theories
Physiologists focus on pain reduction.
Levine: placebos increase endorphin release-the brain’s natural painkillers-which therefore decreases pain.
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