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Ψ  Social Psychology
in the Clinic

Click here to go to another Chapter 14 outline.

Clinical Judgments are Social Judgments!

    Ψ  Illusory correlation is the phenomenon of seeing the relationship one expects in a set of data even when no such relationship exists. We often mistakenly assume things are correlated when they are not. When we make this mistake, we will find ways to ‘prove’ it or simply believe & assert the correlation.
   The opposite of Illusory correlation is an invisible correlation where an actual correlation is missed, for example the link between smoking & cancer was not realized for a long time.

    Ψ  Hindsight Bias - the tendency to exaggerate, after learning an outcome, one's ability to have foreseen how something turned out. a.k.a. as the I-knew-it-all-along phenomenon. Conductive to arrogance.

    Clinicians are particularly vulnerable to the hindsight bias, to confirm their "after-the-fact analyses" &/or finding justification in patient’s histories for diagnosis they have already made.

Self-Confirming Diagnoses = Conformation Bias = Confirmation Bias! (as discussed in mod. 7)

     In psychology, there is a concept known as conformation bias. This concept says that because we like to be right, humans will instinctually seek out information to confirm what they believe to be true, even if the evidence may be flawed.

     Conformation bias confirms one's preconceptions by looking for examples that are in line with our own viewpoint, but ignoring any information that might disprove those misconceptions.

     Conformation bias: a tendency to search for information that confirms ones pre conceptions - a major obstacle to problem solving.

    Ψ  Re: Self-Confirming Diagnoses:

  “As is your sort of mind,
   So is your sort of search;
   You’ll find
   What you desire.”
                 Robert Browning

It's a Mickey Mouse World , isn't it?

Ψ  Statistical predictions are unreliable, human predictions are more so.

    Ψ  Clinicians are vulnerable to errors & biases because they

        •  are often the victims of Illusory correlations.
         •  are to easily convinced of their own after-the-fact analyses.
          •  often fail too take into account self-confirming issues.
           •  overestimate the predictive powers of clinical intuition.

- The Power of Social Cognition -

     Ψ  Depression is the most heavily researched psychological disorder. Depression affects 10% of men & nearly twice that many women.

     Ψ  Depressive Realism is the tendency for mildly depressed people to make judgments that are typically more accurate than people who are not depressed. Those who are not depressed often make judgments & attributions that are self-serving. For example, if you did well on a psychology test you might say that you did so because you're a genius & know everything about psychology. This would be a pretty self-serving attribution, wouldn't you say? But a mildly depressed person who got an A might make a more accurate attribution such as saying it was not because she is a genius, but because she studied well or the test was particularly easy. Your way might make you feel better, but it also might be less accurate.

     Ψ  Explanatory style is a psychological attribute that indicates how people explain to themselves why they experience a particular event, either positive or negative.

     Ψ  Psychologists have identified three components in explanatory style:

        •  Permanent (stable). People may see the situation as unchangeable, e.g., "I always lose my keys" or "I never forget a face".
         •  Pervasive (global). People may see the situation as affecting all aspects of life, e.g., "I can't do anything right" or "Everything I touch seems to turn to gold".
          •  Personal. People experiencing events may see themselves as the cause; that is, they have internalized the cause for the event. Example: "I always forget to make that turn" (internal) as opposed to "That turn can sure sneak up on you" (external).

The madness of depression is the antithesis of violence. It is a storm indeed, but a storm of murk. Soon evident are the slowed-down responses, near paralysis, psychic energy throttled back close to zero. Ultimately, the body is affected and feels sapped, drained. - William Styron

     Ψ  The vicious cycle of depression loops negative experiences, self-focus & self-blame, depressed mood, and cognitive & behavioral consequences in continuous feedback.

     Ψ  Loneliness is an emotional state in which a person experiences a powerful feeling of emptiness & isolation. Loneliness does not conincide with being alone (solitude). Loneliness is a feeling of being cut off, disconnected & alienated from other people. The lonely person may find it difficult or even impossible to have any form of meaningful human contact. Lonely people often experience a subjective sense of inner emptiness or hollowness, with feelings of separation or isolation from the world.

     Ψ Shyness reinforces loneliness, both produce depression. Depression directly feeds back into both the shyness & loneliness which further increase the depression which ....

     Ψ Common symptoms of loneliness:

        •  Believing that 'everyone else' has friends
         •  Feeling unloved by those around you
          •  Feeling socially inadequate & unskilled
           •  Feeling unloved by those around you
            •  Being convinced there is something wrong with you
             •  Being unable to share your private concerns
              •  Feeling that no one understands one's situation
               •  Feeling different & alienated from those in your surroundings
                •  Feeling reluctant to attempt to change, or try new things
                 •  Feeling 'empty', depressed, or even contemplating suicide

     Ψ  Self Presentation Theory assumes that our behavior aims to create a desired impression. We feel anxious when we try to impress others but doubt our ability to do so. We feel most anxious when we are;

        •  self-conscious.
         •  in novel or unstructured situations.
          •  focused on something central to our self-image.
           •  with powerful, high-status people, e.g. upper management.

     Ψ  Self-handicapping involves hindering one's own performance in order to have an excuse for failing. Labeling oneself as anxious, shy, depressed, or under the influence of alcohol can provide an excuse for failure.

     Ψ  Social-Psychological Approaches to Treatment

        •  Induce internal change through external behavior
        •  Break vicious cycles with:
             •  Social Skills Training Social skills training is a general term for instruction
                conducted in (behavioral) areas that promotes more productive/positive
                interaction with others.
             •  Explanatory Style Therapy  Cognitive Therapy can be used to modify
                explanatory style.

Social Psychology
  Robert C. Gates

New  “It is a strange fact that freedom and equality, the two basic ideas of democracy, are to some extent contradictory. Logically considered, freedom and equality are mutually exclusive, just as society and the individual are mutually exclusive.”

- Thomas Mann