Philosophy Research Proposal
The research question chosen for this paper is the determination of the existence of a relationship between the type of therapeutic intervention and self-harming behaviors in adolescent girls. The author of this paper has hypothesized that there is indeed a correlation between the type of therapeutic intervention and the resulting self-harming behaviors among adolescent girls. This means that adolescent girls receiving a certain therapeutic intervention will display a more significant decrease in self-harming behaviors as opposed to adolescent girls who do not receive a therapeutic intervention.
For the null, hypothesis, it would basically suggest that there is no correlation between the presence of any therapeutic intervention and self-harming behaviors in adolescent girls.
Considering the nature of the research question and the research hypothesis, it would be safe to say that this is a non-directional hypothesis. A non-directional hypothesis is a type of research hypothesis that does not necessarily predict whether the variable or parameter being used is going to be smaller or larger than an established referenced value that may be specified in the alternative or null hypothesis. In this case, the direction of the variable’s leveling analysis may go in any direction. This directly applies to this case because the author of this paper basically wants to determine if there is a correlation between the type (and existence of) therapy intervention and either a decease or increase in adolescent participants’ self-harming behaviors. The main determinant that was used in determining the directional or non-directional nature of the hypothesis was the decrease or increase in adolescent participants’ self-harming behaviors. This is because the outcomes of the study can go either way; specifically, it is uncertain whether the researchers would be able to observe a research outcome that would show that there is an increase or decrease in the occurrence of self-harming behaviors among the participants. The same principle can be applied for the non-directional hypothesis.
Independent and Dependent Variables
Independent Variable – Type (and existence) of therapy intervention
Dependent Variable – Increase or Decrease in Self-Harming Behaviors
Literature Review and Critique
In a study published by Slee, Garnefski, Leeden, Arensman, and Spinhoven (2008), they investigated patients who received cognitive behavioral therapy in addition to usual treatments and how they developed self-harm behaviors. They used 3, 6, and 9 month follow up assessments to examine their 90 adolescent respondents. They came up with the conclusion that there is a “time-limited” correlation between the type of therapy intervention and existence of self-harming behavior. Other studies where a similar framework was used showed same type of confirmation . To highlight the method used in measuring self-harm behaviors among their participants in Slee, Garnefski, Leeden, Arensman, and Spinhoven’s (2008) study, they used a structured clinical interview that was aimed at examining the number of times the participants exhibited behaviors of self-harm for a period of three months. This was the main outcome measure used in their study and this also turned out to be their dependent variable. It is important to note that they operationally defined self-harm as “including both deliberate poisoning (overdose) and self-injury” . More specific signs of self-harm behaviors that they focused on in their structured clinical interview—their main means of determining whether an individual (i.e. a respondent) has exhibited self-harm-behaviors or not, were suicidal cognitions, depression, anxiety, self-esteem, other measures, and psychiatric condition. All in all, that constitutes for about six individual sections that they had to screen (for every participant) in order to come up with a bigger picture on how each of them has turned out to develop self-harm behaviors for the set observation period of three months.
It is worth noting that unlike in other studies where only one index or questionnaire was used to quantify or describe self-harm behaviors, Slee, Garnefski, Leeden, Arensman, and Spinhoven (2008) used one index or questionnaire (or in some cases structured clinical examination procedures) for each section. This means that they used a total of six self-harm determining tools, from a technical perspective. For depression, they used the Beck Depression Inventory II (BDI II), a 21 question depression scale that had a high level of internal consistency at 0.91 . For anxiety, they used the Symptom Checklist 90, “a self-report clinical rating scale of psychiatric symptoms” that “consist of ten items, assessing whether and to what extent participants reported symptoms of anxiety” . It also had a high level of alpha coefficients from previous studies ranging from 0.71 to 0.91 . For self-esteem, the used the Robson Self-Concept Questionnaire Short Version which was an eight item questionnaire that deals with the beliefs and attitudes of people about themselves, with a good level of validity and reliability as well with an alpha coefficient of 0.82 . Suicidal cognition was measured using the Suicide Cognition Scale, a scale that contains 20 items about the individual participant’s core beliefs of perceived burdensomeness, with a good level of validity and reliability as evidenced by an alpha coefficient ranging from 0.74 to 0.96 in various sub-scales . The problem solving secondary outcome measure was systematically studied using the Coping Inventory for Stressful Situations scale which is a 16 item scale that aims to describe the way how people make use of their problem solving abilities and techniques to face stress. This measure also exhibited a high level of validity and reliability with an alpha coefficient rating of anywhere between 0.85 and 0.93. Other specific measures were studied using the Suicide Intent Scale (SIS), a 20-item scale that focuses specifically on episodes wherein an individual may harm himself. Just like the other outcome measuring tools used in the study, the SIS also had a good or high enough level of validity and reliability rating. It is worth noting that the outcomes of an individual’s tests using these measures (for each secondary outcome measure) were collated and analyzed individually by the researchers to generate a larger picture on how the individuals tend (from a theoretical perspective) to develop or exhibit self-harm behaviors.
In another study, by Wood, Trainor, Rothwell, Moore, & Harrington, (2001), they focused on the same indepdendent and dependent variable. They were able to interview some 62 adolescents over a 29 week period. They concluded that there is not any significant correlation between self-harm behaviors and existence of therapy intervention.
Wood, Trainor, Rothwell, Moore, & Harrington (2001) used a similar approach but they used a different set of outcome measuring tools. They also wanted to examine the way how certain psychiatric interventions tend to affect an individual’s tendency to develop and exhibit self-harming behaviors. The intervention they chose to focus on was the group therapy termed Developmental Group Psychotherapy. They used a total of three measures namely psychosocial adversity, psychosocial stresses, and likelihood of abuse. Among the three, the first two outcome measures were their main focus. They also made it a point to assess the demographic characteristics of their participants. For the demographics, they used the K-SADS-PL (Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version). It has a high level of reliability and validity according to previous studies . For the psychosocial stresses, they used the International Classification of Diseases Axis V Scheme which also had a high level of validity and reliability, considering the fact that it was one of the recommended tools by the World Health Organization. For instances of abuse, it was categorized as either definite or probable. An abuse episode was considered “definite” when the individual’s decisions has already led to any form of court order (i.e. conviction) and probable “when the charts or other records contained a clear statement by the child or other professional that abuse had occurred” .
All in all, the reliability and validity tests used in these two studies show that all of the tools described have good reliability and validity ratings. Because of this, the author of this paper can choose any one of these in the proposed study.
Planning for Proposed Study
A quantitative research design will be used in the study. A total of 100 respondents will be recruited (i.e. target sample population size). A questionnaire named Suicide Intent Scale will be used to determine the likelihood of an individual to commit self-harm behaviors. The validity and reliability of this tool has been assessed by a study authored by Slee, Garnefski, Leeden, Arensman, & Spinhoven (2008) and they concluded that this is an effective tool to use for its objectives because of its high reliability and validity ratings. Mroeover, it is easier to use because it does not have any primary or secondary outcome measures. The outcome measure that the researchers have to focus on would only be one, which simplifies the entire process of data analysis and discussing the results. After all, the nature of the research hypothesis being proposed is non-directinoal.
This questionnaire will measure the dependent variable of the study which is the increase or decrease in self-harm behavior. This means that it will be measured at a nominal level, i.e. using numbers. The independent behavior will mainly be measured based on a yes or no answer (indicating the presence of an existing therapy intervention and what type); this means it will be measured using an interval level or method. The determination of whether these variables are going to be internal or nominal is not chosen, it is in the nature of these variables whether they are going to be interval or nominally described. Questionnaires, for example, are typically described nominally because that is simply the way how questionnaires are analyzed.
Discussion of any pertinent issues
So far, the literatures show mixed results about the accuracy of the research hypothesis. This is why it would be more important to confirm this by means of primary research that is through the one that is being proposed right now. This study makes use of a research and evidence-based approach in determining which outcome measuring tool to use. The primary objective is to select the tool that may be applicable to the research question and hypothesis. For the research question, the researcher has to make sure that the chosen questionnaire or any tool for that matter would be able to answer it directly. It must also be able to directly address the validity or falsehood of the research hypothesis. The one chosen for this purpose is the SIS; mainly because of these two criteria.
References
Arindell, W., & Ettema, J. (1986). Dutch Translation of the SCL 90. Swets and Zeitlinger.
Beck, A., Steer, R., & Brown, G. (1996). Manual for the Beck Depression Inventory II . Psychological Corporation.
Hawton, K., Saunders, K., & O'Connor, R. (2012). Self-Harm and Suicide in Adolescents. The Lancet, 2373-2382.
Lauth, B., Amkelsson, G., Magnusson, P., Skarpheoinsson, G., Ferrari, P., & Petursson, H. (2010). Validity of K-SADS-PL (Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime Version) depression diagnoses in an adolescent clinical population. Nord J Psychiatry, 409-420.
Rossouw, T., & Fonagy, P. (2012). Mentalization-based treatment for self-harm in adolescents: a randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 1304-1313.
Sansone, R., & Sansone, L. (2010). Measuring Self-Harm Behavior with the Self-Harm Inventory. Psychiatry.
Slee, N., Garnefski, N., Leeden, R., Arensman, E., & Spinhoven, P. (2008). Cognitive Behavioral Intervention for Self-Harm; Randomized Controlled Trial. The British Journal of Psychiatry, 202-211.
Wood, A., Trainor, G., Rothwell, J., Moore, A., & Harrington, R. (2001). Randomized Trial of Group Therapy for Repeated Deliberate Self-Harm in Adolescents. J Am Acad Child Adolesc Psychiatry, 1246-2454.
