Practice manual
Containing numerous areas, research psychology comprises the study of human behavior for application in academic settings. The fields of study in psychology include those of abnormal psychology, biological psychology, cognitive psychology, comparative psychology, developmental psychology, personality psychology, social psychology among others (Alexander & Craig, 2003). With research psychology being contrasted to applied psychology, each branch of psychology has a research component attached to it.
With that in mind, the research focus of this applied project is abnormal psychology, which is the study of the human behavior that is considered to be maladaptive or deviant by the social culture in which it occurs. The project specifically focuses on the application of attribution theory to staff caring for individuals with a mild learning disability and diagnosis of schizophrenia, a chronic severe brain disorder that makes one hear voices, believe media are broadcasting their thoughts to the world or believe that someone is trying to harm them.
It proposes to critically examine the relationships between staff carers’ attributions about schizophrenia and the associated symptomatology as well as their current coping styles. This applied project applies qualitative research to be used in conducting the investigation. Qualitative research is the term for the investigative methodologies described as ethnographic, naturalistic, anthropological, field, or participant-observer in conducting research (Alexander & Craig, 2003).
This mode of study in abnormal psychology emphasizes the importance of viewing variables in the natural setting in which they are found. In qualitative research, researchers seek to understand, by means of exploration, human experience, perceptions, motivations, the intentions and their behavior. It is therefore interactive, inductive, flexile, holistic and reflexive method of data collection and analysis. Exploration, the main feature of qualitative research, helps researchers understand the perceptions and actions of participants.
It needs to be inductive, interactive, reflexive and holistic. The inductive approach is useful in developing concepts and generating hypothesis and is especially important when little is known about the topics of study. Comparatively, (Ann et al. , 2007) the interactive and reflexive nature of the approach helps avoid bias by studying phenomena in a detached way. Herein, researchers probe, facilitate, and note tone, hesitations and repetition in participants’ responses.
Despite existing disagreements regarding which particular behaviors should be classified as abnormal, psychologists have defined several criteria for purposes of classification, one being that the behavior occurs infrequently and as such deviates from statistical norms. Another criterion is that the mode of behavior deviates from social norms of acceptable behavior; the third is that the behavioral pattern is maladaptive, that it has adverse effects on the individual and/or the individual’s social group.
Lastly, abnormal psychology may be explained based on subjective feelings of misery, depression, or anxiety of an individual rather than any behavior he/she exhibits (Ann et al. , 2007). This branch of research psychology focuses on the study of psychopathology, which comprises socially abnormal behaviors and emotions, bipolar disorders, schizophrenia, borderline personality disorder and many other psychological disorders.
In psychology, research is conducted in broad accord with the standards of the scientific method, encompassing both qualitative ethological and quantitative statistical modalities to generate and evaluate explanatory theories and hypotheses regarding the psychological phenomena studied. Behavioral scientists, in particular, explore human behavior using scientific methods to explain the challenging complexity of human interactions of biological and psychological dimensions.
To examine the aspects of abnormal behavior, it is important to find out what problems cause the distress or impaired functioning, why the affected people behave in unusual ways, and how to help them behave in some adaptive manners. This complex research question seeks to reveal the nature of the problems exhibited by people by exploring the research strategies that help explain the abnormal behavior; it considers the causes, or etiology, of the maladaptive behavior by exploring strategies for discovering why the behavioral disorder occurred (Ann et al. , 2007).
Finally, the study focuses on the research processes and analyzes the components of the research to bring out suggestions and recommendations to help those with the disorders and describe how the researchers evaluate treatments of psychological abnormalities. Abnormal psychology, being eclectic, draws on scientific knowledge from other fields to help explain and understand anti-social psychological phenomena. Where the ethics of research and the state of development in a given research domain allow, the investigations may be pursued by experimental protocols.
QQ psychological research puts into application a wide range of observational methods, including action research, ethnography, exploratory statistics, structured interviews, and participant observation, to help gather rich information unattainable by classic experimentation. Research in humanistic psychology especially that regarding abnormal behavior is more typically approached by ethnographic, historical, and histographic methods. Background information and primary research question
Epidemiological studies carried out by scientists have demonstrated that the prevalence of psychiatric disorders among people with learning disabilities is significantly higher than in the general population, and that those with learning disabilities are probably at greater risk of developing mental health problems. It is estimated that the prevalence rate for schizophrenia in people with learning disabilities is about 3%, which is three times higher than in the general population (Ann et al. , 2007).
However, research in this field has been fairly limited and primarily concentrated on epidemiology, assessment, description of clinical phenomena, links with clinical phenomena, and diagnoses in hospitals and psychiatric centers. Research in abnormal psychology regarding these individuals and their carers has for long been neglected, possibly due to the fact that only until recently has a large number of people with learning disabilities have lived in segregated hospitals and as they have moved into smaller community homes, their psychological and mental health needs have become more visible.
For one, the community carers who act as the support staff receive little or no education or training on the mental health needs of this group of individuals and have been reported to possess low-level knowledge regarding psychotic problems. As a result, they may have great difficulty recognizing the signs and symptoms of schizophrenia, understanding their significance and obtaining appropriate support for the person they care for and for themselves.
It is valid to argue that research examining the experience of staff caring for individuals with a mild learning disability and a diagnosis of schizophrenia, including the relationship between attributions about its cause and their coping responses, has been overlooked. The evidence from schizophrenia, as well as the learning disabilities research, which has investigated carers’ causal contributions, would suggest that this is a significant omission as will be categorically highlighted in this study.
In the research on schizophrenia, attributional models have been used to investigate how the attributions of caring relatives about the cause of the disorder and associated symptomatology might help elaborate the varied coping mechanisms towards their relatives’ illness (Tracy, 2002). This study has in its biggest part focused on relatives expressed emotion (EE) taking the form of critism, hostility, emotional over involvement, and warmth, due to the significant body of literature.
This has indicated that the course and outcome of schizophrenia is highly responsive to the psychosocial environment and emotional atmosphere within the family unit. As for the influential attribution theory, different casual beliefs about other people’s problems can be argued to be instrumental in producing specific emotional states, which in turn play a role in motivated behavior. Internal controllable attributions such as the lack of effort or drunkenness, lead to negative effects such as anger and disgust and result in negative behavioral responses including avoidance, neglect, and judgments about not giving help.
Expressed emotion (EE) researchers might conceptualize this as a critical and/or hostile response, while external, uncontrollable attributions (such as an individual’s ability level or restricted opportunities) may generate positive effects such as sympathy and pity and lead to positive behavioral responses such as approach behavior, support and judgments about giving help. This is taken as low expressed emotion warmth in which case the relatives have been found to respond to the symptoms associated with a diagnosis of schizophrenia with greater patience, understanding, and a tolerant non-intrusive approach to coping.
In fact, this has been thought to contribute to less stress and a more favorable outcome for the patient. Sampling and variables/concepts addressed Survey sampling involves methods for selecting and observing a part of a population with the goal of making statistical inferences about the whole population. In this applied project, the participants will be community staffs who care for clients with dual diagnosis of a mild learning disability and schizophrenia (Tracy, 2002).
The clients being cared for are to have a diagnosis of schizophrenia as assessed by their Consultant Psychiatrist, to have a premorbid learning disability prior to the onset of the illness, and to be aged between 18 and 65 years. The consultant psychiatrists are to recruit the participants by sending information booklets and a covering letter explaining the purpose of the study to 21 clients and their staff cares who meet the inclusion criteria. These participants are expected to express their interest in taking part in the research by returning a tear-off slip to their consultant psychiatrist.
At this juncture, an appointment will be made for the researcher to meet the client and a staff carer who knows them well enough to explain the nature of the research further. With respect to the professional practice guidelines in place, (Tracy, 2002) an informed consent will be obtained from each individual with a dual diagnosis and then from each staff carer, hence two information booklets will be developed for the research. As far as variable and concepts to be addressed are concerned, the following measures are to be taken: demographic questionnaires; knowledge about schizophrenia; causal attributions; and coping styles.
All staff carers are to complete a demographic questionnaire each. One key staff carer will be asked to complete a demographic questionnaire for the individual with the dual diagnosis. The knowledge about schizophrenia questionnaire will be used to assess the carers’ knowledge and understanding about the illness. This will be a 23-item multiple choice questionnaire incorporating six subscales namely demography, etiology, symptoms, treatment, hospital procedures, and coping. It will be described as being easy to complete, can be rated reliably, and will have face-validity for the carer.
The attributions for schizophrenia questionnaire will be designed to measure staff carers’ attributions regarding the symptoms associated with a diagnosis of schizophrenia and will include seven attributional dimensions (Tracy, 2002). The variables to make up this section will be five brief descriptions and examples of the main characteristic symptoms of the illness, namely delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior and negative symptoms.
Staff carers will be asked to read each of the five descriptions in relation to the person they care for and relate how frequently their client had these experiences in the past month on a 5-point scale ranging from not present (0) to present all the time (5). They are then to write down the main causes of the experience and rate their attributions on a 7-point bipolar scale for each dimension of attribution. These dimensions will include internal-external, controllable-uncontrollable, personal-universal, global-specific, and stable-unstable for staff carers’ perception of the individuals’ causal role in the events.
Higher scores on these dimensions will indicate greater internality, uncontrability, universality, globality, and stability. The care coping style questionnaire will be a self-report measure of carer coping style and will be developed to mirror comments that are typically made by carers of people to have diagnosis schizophrenia in order to enhance face validity. This will be designed to assess the four dimensions of expressed emotion and the seven coping styles.
It will be a 91-item questionnaire measuring nine coping styles: emotional over involvement, collusion, critism/coercion, passive, resgnation, and overprotectiveness (unhelpful coping styles), and constructive, reassurance, and warmth (helpful coping styles). Each item here will be scored on a 5-point scale where 5 is the highest score. Measurements and analysis The means and standard deviations of each of the above measures will be presented in a structured table to enable efficient data processing and analysis.
The twenty-three items on Knowledge questionnaire will be summated to obtain a total knowledge score for each staff carer. The mean knowledge score for all the interviewed staff will be expressed both as a percentage and as a mean score (Fredrick, 2006). Since this questionnaire will not be used with carers in learning disability settings, the only means of comparison will be with family carers in non-learning settings of disabled populations. An educational intervention for two groups of family carers of patients with schizophrenia, whose mean per-intervention knowledge scores will lay between 50% and 60% will be recommended.
Moreover, a single score for each of the seven attributional dimensions will be calculated for each of the staff carers. This will be obtained by dividing their total score on each of the attributional dimensions by the number of ratable attributions contributing to the total score. The result of this will indicate the staff carer’s causal attributions and help determine whether they tend to be internal, uncontrollable, personal, global and stable, or otherwise, to the client, and whether external and uncontrollable by the staff carer.
The mean scores of the Carer Coping Style Questionnaire will be used to investigate whether the staff carers in this applied project will tend to cope by using the helpful coping styles such as warmth, reassurance and constructiveness, or whether they will tend to use the unhelpful coping styles of critism, coercion, collusion, passiveness, resignation, emotional over-involvement, or over-protectiveness.
The relationship between situational variables and causal attributions will be evaluated using the seven attribution dimensions sought by the proposed study. In this case, the correlation coefficients will be computed between the situational variables and each of the seven dimensions of attribution as tabulated in the study. For the purpose of the applied project, a 1% level of significance will be set in order to reduce the number of type one errors in this investigation (Fredrick, 2006).
No statistically significant variables are expected to be found between the variables mentioned in this study. However, there will be an unexpected trend for staff carers to make causal attributions that are more uncontrollable by the client in case they will have received training and/or support for schizophrenia or mental illness- related issues. A trend of male staff carers is also expected where they make attributions that are more personal to the client.
The coping subscales and each of the seven causal attributional dimensions will also be computed with correlation coefficients with the aim of exploring the relationship between these groups of variables. The results are expected to indicate three statistically significant findings: external and uncontrollable attributions to the staff carers themselves will be statistically significantly correlated with higher scores on the emotional over-involvement coping scale.
The staff carers; uncontrollable attributions will as well be statistically significant when correlated with higher scores on the resignation coping scale (Fredrick, 2006). There will also be, as expected, a trend for internal attributions to the client to be correlated with a higher score on the emotional over-involvement coping scale, and a trend for stable attributions to be correlated with a higher score on the coping scale of critism/coercion. Observations and conclusions
This applied project is expected to identify some unexpected yet interesting relationships between staff carers’ causal attributions and their coping styles (Jean, 2010). The results should therefore show a significant correlation between the external and controllable attributions about staff carers’ own role in the cause of the symptoms associated with a diagnosis of schizophrenia and emotionally over-involved and resignated coping styles (Jeffrey, 2010).
These attribution dimensions may be interpreted as reflecting the underlying feelings of helplessness and hopelessness, which may be experienced by these staff carers. The emotional quality of the relationship represented by the over-involved style of coping appears to reflect the difficulties frequently reported by the staff carers in dealing with schizophrenic clients and putting up with their behavior (Jean, 2010).
Higher levels of resignation on the other hand seem to reflect the perceptions of the staff carers that such behaviors are inevitable and that any action they may take will definitely be futile. For hypotheses testing, two attributional dimensions need to be created. This will involve summing the internal-external and controllable-uncontrollable attributional dimensions for both the clients and the staff carers. Higher scorers on these dimensions will be indicative of greater internal, controllable attributions and vice versa.
The means and standard deviations of these attributional dimensions are expected to correspond to the score results of the computation. Computation of the new attributional dimensions and the coping styles to generate correlation coefficients are expected to confirm the hypotheses proposed (Jean, 2010). In case there is no significant correlation between the internal, controllable attribution dimensions for the clients’ cause and in any of the helpful or unhelpful coping strategies, the hypotheses will not be confirmed in this applied project.
The other hypothesis states that the internal, controllable attributions to the staff carers themselves would be significantly positively correlated with the emotionally over-involved and over-protective coping scales (Jeffrey, 2010). On the contrary, if the results indicate that external, uncontrollable attributions to the staff are significantly correlated with higher scores on the emotional over-involvement scale, the hypothesis will be nullified. The pattern of attributions is expected to be significantly correlated with higher scores on the resignation coping scale.
It is expected that the results of the proposal will provide some evidence that the attributions of the staff carers may play a major role in determining their coping styles (Jean, 2010). It will be surprising if the results indicate no significant correlation between the staff carers’ attributions about the clients’ role in the event of their symptoms associated with a diagnosis of schizophrenia and either helpful or unhelpful coping styles, as predicted in the hypotheses.
The results, however, may indicate a number of trends such as higher scores on the emotional over-involvement scale correlating with making attributions that are more internal to the client; or higher scores on the critism/coercion coping scale correlating with making more stable attributions and male members of staff tending to make more client-centered attributions. Because of the small sample size proposed in this applied project, the research findings and clinical implications of the study need to treated with caution and require replication with larger numbers of participants.
In fact, further research should focus on developing a better understanding of the influence of staff carers’ causal attributions on a range of coping responses (Jean, 2010). It also seems, however, that research in future might benefit a great deal from exploring a more complex picture of the experience of caring for individuals with a dual diagnosis. In that case, there will be need for examining a range of other variables on staff carers cognitive, emotional, and behavioral responses to clients with a dual diagnosis.
These include the perceived severity of psychotic symptoms, different types of symptoms or behaviors, including positive or negative symptoms, as well as more externally directed behaviors, such as aggressiveness or destructiveness, and the formal and informal aspects of service culture. This applied project is designed to adopt a cross-sectional and correlational design, which makes it necessary to employ longitudinal research as well in order to interpret the direction of the relationship found between staff carers attributions and their coping styles and also assist in evaluating and examining these relationships over time.
To sum up, given that the significant body literature, which shows that the course and outcome of schizophrenia is highly responsive to the psychosocial environment and emotional atmosphere within the family, it is of paramount importance to continue pursuing similar lines of research with staff carers and individuals with a dual diagnosis.
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