Clinical Psychological Science Final Exam
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2. Based on the book chapter, you should be able to describe and critically comment on:
a. Sensory Integration Therapy -
kids with sensory integration dysfunction have difficulty organizing and interpreting information from the environment for the planning and exectuion of interaction with the environment. It's used for autism because it is thought that kids with autism have sensory abnormalities. The goal of SI is to remediate perceived sensory difficulties to help the child better deal with the world.
Sensory integration theory lacks empirical support. Sensory integration is a broad concept that cannot be measured directly, it must be inferred from a wide assortment of behaviors. Explanations of sensory integration use nonspecific terms, do not correspond to known CNS research, and are circuitous in their definition. -
2. Based on the book chapter, you should be able to describe and critically comment on:
ab. Secretin -
Secretin is a hormone thought to improve gastric functioning. Children with autism who have gastrointestinal symptoms show a greater gastrointestinal response to secretin than do typically developing children matched on age and gastrointestinal symptoms. The authors suggested that a possible absence of typical secretin stimulation in the autistic group may result in upregulation of secretin receptors in the pancreas.
The results of experimental studies are negative. -
2. Based on the book chapter, you should be able to describe and critically comment on:
a
c. Dolphin-Assisted Therapy -
Dolphins are said to posess an uncanny ability to "understand and respond to the needs of special people"; DAT has been likened to a peak experience, in which there is a feeling of "being permenantly changed or enlighted by the experience"
"There have been no independent, well-controlled research studies to support claims of DAT's effectiveness. There is also no empirical support for the claim that dolphin echolocation produces beneficial cellular metabolic changes. -
2. Based on the book chapter, you should be able to describe and critically comment on:
d. Therapeutic Diets -
The most popular theraputic diets eliminate either gluten or casein. Gluten and casein produce peptides that affect opiate receptors in the brain. According to proponents of gluten and casein free diets, the peptides can cause a neurotransmitter imbalance that produces the symptoms of autism
There is no evidence to support this hypothesis, and very little research has been done. -
D. Empirically-supported treatments for autism
1. Applied Behavior Analysis
a. Be able to describe it -
In various sections of this chapter, many references were made to the (Satc
weak measurement methodologies utilized to assess behavior change. In
contrast, Applied Behavior Analysis (ABA), which has strong historical ties to behavior therapy and behavior modification, features the direct and oh-
jective measurement of performance and behavior. ABA refers to an approach for educational and treatment intervention that derives
from research in basic learning principles from experimental psycho1ogy
It requires the precise quantification and analysis of behavior and learning patterns and the conditions that serve to elicit and maintain them. This approach, which is known as functional analysis, focuses on the “ABCs†(antecedents, behaviors, consequences) as
well as the individual’s learning history. ABA is characterized by use of sin-
gle-subject research methodology to determine den
intervention effectiveness,
There are approximately 500 published reports documenting the efficacy of this approach. - 1. What is the basic rationale underlying the presumed efficacy of FC?
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it hinges on apraxia – specifically, the view that autistic individuals cannot communicate because of motor control problems)
-movement disorders limit their communication abilities - What is FC?
- -it is a means of facilitating language expression for those with absent or limited communicative abilites. Supporting the arm, slowing down movements and assistance in isolating the index finger.
- 2. What do controlled experiments show regarding the efficacy of FC?
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Wheeler, Jacobson, Paglieri, and Schwartz (1992) assessed differences in performance when the facilitator was able to see or not see what was being presented. This study used a table with a divider in the middle that permitted the facilitator and child to see different views, while allowing the facilitator to provide FC for the child. The results of this study revealed no support for FC and suggested a strong facilitator influence on the children’s responses.
M. D. Smith, Haas, and Belcher (1994) investigated the effects of facilitator knowledge and level of assistance with amount of facilitator influence. In half of the trials the facilitator was aware of the stimulus that the child had seen. Three levels of facilitator support were examined. They were no help, hand-over-hand assistance without prevention of errors, and hand-over-hand with preventing errors. The authors found that correct responses occurred only when the facilitator was aware of the stimulus and full support was given. - 3. How do believers in FC explain the negative findings of experimental studies, which have consistently failed to find that FC works?
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Proponents claim that experiemental studies are inappropriately designed and do not accurately measure performance.
Studies are conducted out of the subjects normals social context, creating an enviro that hinders performance. - 4. What is the most damning piece of evidence that makes it clear that the experimental results cannot be explained away as being due to things like “word finding difficulties�
- , the most damning piece of evidence that the negative findings are not merely due to word finding difficulties is the fact that the autistic individuals “typed†what the facilitator saw. Word finding difficulties would mean they come up with other words, but it beggars belief that they coincidentally come up with what the facilitator saw.
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B. Do vaccinations cause autism?
1. Be able to summarize Rimland’s argument that vaccinations cause autism.
2. Be able to rebut that argument based on today’s class -
?Consistent with the diathesis stress model, the genetic factor is the diathesis and the vaccine is the stressor.
The MMR argument says that administration of the vaccine preceeds the development of the regressive pattern of autism. However, the increase in autism prevelance is uncorrelated with the introduction of the vaccine. They may recieve the vaccine prior to a diagnosis of autism, but the age of ONSET was actually much earlier (before administration of the vaccine). -
A. Is there an epidemic of autism?
1. No – be able to explain why the big increases in rates of autism reported in recent years are not evidence of an epidemic (see Gernsbacher et al., 2005) -
The new dsm 4 criteria has been broadened to the extent that it is easier to meet diagnostic criteria for autism. These new criteria have high sensitivity but low specificity (we'll catch people who don't actually have it).
Individuals with less severe forms of autism are being IDed by the new criteria, so the overall rate of mental retardation has gone down
All cohorts have shown increased rates of prevelance (uniformity). - 6 arguments of Support for the Sociocognitive model cited by Lilienfeld and Lynn
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1. Suggestive treatment practices
2. Clinical features before and after therapy
3. Cases are unequally distributed across clinicians
4. Role playing studies suggest that DID may be a product of suggestion
5. DID is rare in other countries
6. Doubts about the presumed link between abuse and DID/MPD - Be able to describe the limitations of hypnosis as a memory recovery technique (as discussed in class and, in greater depth, in the book)
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hypnosis generates a wealth of information, but not all of it is true. Hypnosis increases confidence in recall, not accuracy.
Hypnosis:
1. increases volume of material recalled
2. increases errors and false memories
3. does not accurately reinstate past experiences
4. highly hypnotizable people are prone to fase memories in general and memory errors in response to misleading info
5.Hypnosis incr confidence in recall, but not accuracy
6. Warnings about false memories don't eliminate them - Be able to list and discuss the assumptions underlying the memory recovery approach to therapy as covered in class
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1. sexual abuse has reached epidemic proportions
2. many (if not most) victims repress all memory of the abuse
3. childhood sexual abuse explains much of the psychological suffering of adults (SEXUAL ABUSE MAY BE A PATH TO THESE PROBLEMS, BUT IT CERTAINLY ISN'T THE ONLY WAY TO GET TO THEM)
4. Because it is often repressed, sexual abuse should be considered a likely explanation for many psych probs, even if the person can recall no such abuse
5. To heal, the person must uncover all repressed memories and deal with them - Be able to explain why the assumptions underlying this type of therapy are likely to lead to “uncovering†ever more bizarre “memories†as therapy progresses
- *The essence is that the patient will get better when all the memories are uncovered so if the patient is not better, there must be even worse things still repressed.*
- Be able to explain why the supposed indicators of possible repressed abuse histories are ludicrous
- they describe everyone
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Dissociative Identity Disorder (MPD)
History of the diagnosis
Early conceptions
The epidemic of the late 20th century - after 1980s, prevelance incr dramatically.
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DSM-IV criteria
for dissociative identity disorder (4) -
Presence of 2 or more distinct identities or personality states, each with their own relatively enduring character.
At least 2 of these identities or personality states recurrently take control of the person’s behavior.
Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
The disturbance is not due to substance use (e.g., blackouts) or a general medical condition - Facts about DID/MPD for which any explanation must account (5)
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Considered rare prior to 1980 or so
Much more commonly diagnosed in US than elsewhere in the world
Dramatic increase in number of personalities
DID/MPD patients rarely if ever present with overt signs, symptoms, or complaints of the disorder.
(Average patient is first diagnosed after 7 years in therapy).
Few DID/MPD patients prior to Sybil reported a history of abuse, whereas most do now
However, this varies by country:
Lilienfeld & Lynn report that only 46% of Canadian MPD patients report abuse history whereas 81% do in the US - What are correlates of Correlates of DID/MPD
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Marked predominance of females in DID/MPD patient populations (estimates range from 3:1 to 9:1)
But some authors argue this is due to referral bias and many male DID patients are unidentified and end up in prison. - corelates of DID
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Marked predominance of females in DID/MPD patient populations (estimates range from 3:1 to 9:1)
But some authors argue this is due to referral bias and many male DID patients are unidentified and end up in prison. -
Alters
What are they?
Are they full blown personalities or mere fragments? -
Some authors now assert that the personalities are not truly independentt – that they are merely personality fragments.
But DSM-IV remains committed to the idea of truly distinct personalities - Why do Lilienfeld and Lynn (2003) describe the question of DID’s existence as a pseudo-controversy?
- ? because people don't doubt whether DID exists or not. The question is whether DID develops naturally or as a consequence of treatment.
- Competing models of DID etiology
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1. the PTSD model
2. the sociocognitive model -
The Posttraumatic Model
Names to associate with this view -
Braun & Sachs
Kluft
Hammond
Putnam - The basic element of this posttraumatic model explanation
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Severe abuse causes dissociation
Also, abuse is the cause of the high hypnotizability shown by MPD patients - explanations that the PTSD model provides for DID
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they think that incidence has increased because incidence of absue has increased
they think that its most common in the US be/c we have the experts
they think that there's a dramatic increase in alters be/c we've gotten better at detecting them
* - names to associate with the soiciocognitive model
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Spanos
Lilienfeld & Lynn - The Sociocognitive view in a nutshell:
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MPD is a consequence of the ability of people to assume roles in response to situational cues/demands.
Therapists who look hard for MPD end up finding it because they look with confirmatory bias and use techniques likely to produce alters, especially among highly hypnotizable patients. - Support for the Sociocognitive model cited by Lilienfeld and Lynn (2003
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Suggestive treatment practices
Typical treatment practices reveal clear avenues by which treatment may iatrogenically create the disorder.
Clinical features before and after therapy
DID/MPD signs and symptoms emerge during therapy.
Example: at least 80% of patients show no awareness of alters prior to treatment
Cases are unequally distributed across clinicians
Most therapists a skeptical about DID and never see any patients
A few “experts†account for the vast majority of cases
Example: Braun and Sachs
Role playing studies suggest that DID may be a product of suggestion
Spanos’ research shows that highly hypnotizable people are likely to produce alters in response to typical hypnotic interview questions.
DID is rare in other countries
Doubts about the presumed link between abuse and DID/MPD - Be sure to scan in old exam questions because the finally is partially cummulative!!!!
- Be sure to scan in old exam questions because the finally is partially cummulative!!!!