Paper 2: Clinical Psychology (AJW)



Killing two birds with one stone: A paper 2 contemporary study and Paper 3 Methods SkillsWilliams (2013) In-class Closed Book AssessmentThis test should take you 54 minutes; there are 40 marks.Williams et al (2013) used many different self-report questionnaires to gather quantitative data in their study on internet-delivered CBT. With reference to data collected in this study, give one strength and one weakness of the use of quantitative data. (4)One strength of the quantitative data collected in standardised questionnaires such as the Beck Depression Inventory and the Patient Health Questionnaire is that data is easily analysed through counting up boxes ticked and numbers circled for example; this requires no interpretation on the part of the researcher. This means that the data analysis process is should be more objective and replicable and the findings can be checked for reliability. This said, a weakness of the use of this type of data to assess of the severity of someone’s depressive symptoms and distress is that the researcher is unable to collect data about contextual details, for example the person is unable to expand upon when and why they may feel certain symptoms. Had an interview been used, the ability to collect this data through the use of open questions may have been beneficial in addressing the extent to which the cognitive bias modification and CBT had actually been effective.Williams et al (2013) gathered primary data in their study from 69 participants. Compare the use of primary and secondary data in clinical psychology (3)Primary data is collected by the researcher for the purpose of exploring the specific hypothesis they have in mind, in this case whether a course of cognitive bias modification that is completed before computer delivered CBT enhances the success of the CBT whereas secondary data is data collected by other researchers potentially for an alternative purpose. If Williams had used secondary data, he would not have had the opportunity to assess whether the Pps actually hit the criteria for depression in the first place and have to rely on the diagnosis provided in the first set of data which may have been erroneous. This means the validity of the conclusions of studies using secondary data may not be as good as those that collect primary data. However the use of secondary data in a meta-analysis for example often allows for much larger data sets (Williams only had 69 Pps) to be analysed and this can improve the overall generalisability of the findings in contrast to primary data collection which use smaller samples due to the time it takes to carry out the data collection as well as analysis.Evaluate the sample used in Williams et al (2013) (2)One weakness of Williams sample is that they were recruited from .au and as such were a volunteer sample as people who have chosen to sign up for an online clinic may not be representative of people who would prefer to use face-to-face services and this means the findings that computer delivered CBT is effective may not be generalizable to people who prefer face to face services. Furthermore the study was conducted in Sydney Australia suggesting most Pps were probably Australian, potentially meaning that online CBT may be less effective for Pps from cultures which are less individualistic and this cultural dimension has been shown to be relevant with regard to the experience of depression and cultural factors will also doubtless influence the efficacy of this form of treatment.Williams et al (2013) had a complex experimental design combining elements of independent (between subjects) and repeated measures (within subjects) designs. This is known as a “mixed design”. Describe the design of Williams study and explain how it uses both experimental designs. (2)The aspect of the study which is repeated measures relates to the fact that Pps completed questionnaires relating to the severity of their depressive symptoms and distress before the interventions as well as afterwards. The aspect which relates to independent measures is the fact that there were two groups, randomly allocated by an independent person; the experimental group participated in the 11 week intervention (n=38) and the waiting list group (n=31) who did not participate in the intervention until after the other group had finished. (NB. This was in order to see how much people’s severity of symptoms and distress might be alleviated over the course of 11 weeks without intervention.Write a suitable directional experimental hypothesis for Williams looking at any element of the study that you like. (3)Participants who have been diagnosed with depression who complete the 11 week computer delivered iCBT “Sadness Program” will experience less severe depressive symptoms as measured by the Beck Depression Inventory than depressed participants who do not complete the 11 week intervention.Write a suitable non-directional null hypothesis for another element of the study. (3)There will be no significant difference in the severity of depressive symptoms, (measured using the Beck Depression Inventory) experienced by people with depression in the 11 week iCBT intervention group compared with those in the waiting group condition who did not participate in the computer delivered intervention and any difference that does arise will be due to chance alone.Give one limitation of the use of self-reports in this study (2)One limitation with regard to the use of self-reports is the data could be deemed to lack validity as people may give socially desirable responses believing that the researchers expect them to feel better after the intervention and therefore demonstrating with demand characteristics. This means that the use of self-reports may make iCBT appear more effective than it actually is. This may be particularly true of those in the intervention group who believe that they should be feeling better after giving up their time over the 11 weeks to engaging with the iCBT lessons and completing their HW exercises. This study used questionnaires to gather the data. If Williams et al (2013) had used interviews instead, how might this have affected the analysis of the data (3)Interview data is usually in the form of a transcript or written verbatim record of exactly what was said in answer to open question, thus resulting in qualitative data. Instead of counting up answers as in the quantitative analysis of data, a thematic analysis may follow, using the conventional inductive method whereby the researchers use ‘close reading’ to extract ‘coding units’ until they reach ‘data saturation’, at which point the codes are sorted into meaningful categories and the researcher attempts to explore how these categories are inter-related. This technique is sometimes criticised as some researchers believe that the analysis is subjective and open to the interpretation of the researcher.Williams et al (2013) state that they randomly allocated their participants to either the intervention group or the waiting list control group. Explain how this is a strength of their design (2)This is a strength of the study as it should improve the internal validity as it is a technique that is commonly used eliminate the effect of participant variables on the data. For example, if all the Pps in the intervention group happened to have higher levels of social support available to them than all of those in the waiting list group and ended up with less severe symptoms over the course of 11 weeks it would not be possible to know whether it was the intervention or the socialsupport that had helped. Random allocation of Pps across the two groups should ensure that other factors relating to the Pps that might affect the severity of their symptoms should be equally distributed allowing for a clearer cause and effect statement to be drawn about the way the IV impacts the DV. Williams et al (2013) required their Pps to complete the battery of self-report questionnaires three times, once at baseline, then post CBM-I and then again at the end of the study after the iCBT. Explain a potential weakness of this aspect of the design (2)This aspect of the study has a repeated measures design and the results of studies of this nature can be subject to order effects which weaken internal validity. This means that the way that the questionnaire is filled in at time point 2 (after CBM –I) is affected the fact they have already filled the same questionnaire in one at time point 1 (the baseline), similarly at the end of the iCBT when they complete the questionnaire for the third time this may be affected by the fact they have already completed it at time 1 and 2. This means that measure of severity of symptoms might not simply be being affected by the interventions but that the measure is affected by the order in which the data has been gathered. The following table shows the findings of the study. Determine three conclusions regarding the efficacy of CBM-I and iCBT that could be drawn from this data set (6)From the data table it can be concluded that the CBMi was effective in reducing depressive symptoms after just 7 days as the Beck Depression Inventory scores had decreased by approx. 9 points for the intervention group whereas the waiting list group only experienced a decline of just over 3 points.You need to do this twice more! Evaluate Williams et al (2013) ensuring that you refer to at least one ethical issue in your answer (8) (think GRAVESOC) ................
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