SPECIFICATION: Case Studies

NON-EXPERIMENTAL METHODS IN PSYCHOLOGY

CASE STUDY

DEFINITION

A case study is a research method used in psychology to investigate a particular individual, group, or situation in depth. It involves a detailed analysis of the subject, gathering information from various sources such as interviews, observations, and documents. Researchers aim to understand the complexities and nuances of the subject, exploring thoughts, feelings, behaviours, and experiences to gain insights into specific psychological phenomena.

Case studies are particularly valuable for examining rare or unique situations that may not be easily replicated in a laboratory setting. For example, the case study of Genie Wiley focused on her development following extreme social isolation, offering insights into the effects of neglect on language acquisition and cognitive growth. By analysing individual cases, researchers can generate hypotheses, develop theories, and contribute to the existing body of knowledge in psychology.

This type of research provides a holistic view of the subject by considering various factors influencing behaviour or mental processes. For instance, Goffman’s study of asylums explored not only the patients' experiences but also the institutional culture and its psychological impact. Case studies are often utilised in clinical psychology, where they can provide valuable insights into the diagnosis, treatment, and outcomes of specific psychological disorders.

Case studies are not limited to single observations; they often involve longitudinal tracking, allowing researchers to observe changes over time. For example, HM (Henry Molaison) was studied for decades to understand the role of the hippocampus in memory formation. These studies can also involve cross-case research, comparing multiple cases to identify patterns, or within-case research, focusing exclusively on a single case.

A strength of case studies is their ability to provide detailed and in-depth information that allows researchers to examine psychological phenomena in their real-world context. This approach is especially useful for exploring complex and multifaceted issues. For instance, John Money’s study of David Reimer, though controversial, explored the psychological impact of gender reassignment in infancy, highlighting the interplay between biology, identity, and upbringing.

However, case studies are not limited to clinical contexts; they can explore organisational settings, belief systems, or specific events. Yin’s comparative organisational case studies, for example, identified patterns in successful management practices across businesses.

By examining individual cases, researchers can inform theory, practice, and future research. The information gathered can serve as a foundation for more extensive investigations or inspire novel approaches to psychological questions. While case studies often focus on rare or exceptional phenomena, they can also contribute to understanding broader psychological principles.

Bullet Summary

• Definition and scope: Case studies analyse an individual, group, or situation in depth, using data from multiple sources like interviews, observations, and documents.

  • Example: Genie Wiley's case provided insights into language and cognitive development following social isolation.

• Purpose: To understand the complexities and nuances of thoughts, feelings, behaviours, and experiences, often focusing on unique or rare phenomena.

  • Example: HM’s case revealed the hippocampus's role in memory formation.

• Holistic view: Case studies consider various factors influencing behaviour or mental processes, offering a comprehensive understanding.

  • Example: Goffman’s study of asylums examined the psychological impact of institutional culture.

• Value in clinical psychology: Case studies provide insights into diagnosis, treatment, and outcomes for specific psychological disorders.

  • Example: Studies on PTSD treatment outcomes in unique trauma cases.

• Longitudinal and cross-case research: Case studies often track changes over time (longitudinal) or compare multiple cases to identify patterns (cross-case).

  • Example: Yin’s organisational research compared management practices across companies.

• Theory and hypothesis generation: Case studies serve as a foundation for developing theories or hypotheses and inspire future research.

  • Example: John Money’s study of David Reimer contributed to understanding gender identity development

EXAMPLES

Clive Wearing, HM, KF, S, Genie Wiley, Czech twins, Anna O, Little Albert, Little Hans, Phineas Gage, Louis Leborgne, Charles Whitman.

ADVANTAGES

They provide a wide variety of in-depth and detailed information that would be impossible to acquire using heavily controlled situations such as experiments (idiographic).  They can provide a real feel for suffering from a particular disorder or being involved in a certain situation.

Allows detailed investigation into situations. They often provide the only method possible for studying a certain condition or event.  It would not be possible to re-create situations such as Genie or HM experimentally artificially, so our only access to information about privation or severe amnesia is through case studies.

A strength of the case study approach is that it offers the opportunity to unveil rich, detailed information about a situation. These unique insights can often be overlooked in situations where only one variable is manipulated to measure its effect on another. Further, case studies can be used in circumstances that would not be ethical to examine experimentally.

DISADVANTAGES

Often, case studies require retrospective data collection, with parents, friends, etc., being asked to think back to the participants’ earlier years.  Retrospective data collection is not reliable.

Objectivity and researcher bias can be difficult, with psychologists getting too close to patients, as in the case of David Rigler and Jean Butler and their research/fostering of Genie.

Confidentiality can be an issue, though some can be overcome using pseudonyms or initials. 

There are methodological issues associated with the use of case studies. By only studying one individual, an isolated event or a small group of people, it isn't easy to generalise any findings to the wider population since results are likely unique. Therefore, this creates issues with external validity as psychologists cannot confidently conclude that anyone beyond the ‘case’ will behave in the same way under similar circumstances, thus lowering population validity. Case studies, by their very nature, are one-offs or unusual and often involve people who are not themselves representative of the general population.  The case of Genie and the Czech twins shows this nicely.  Both suffered severe deprivation over a prolonged period, but their outcomes are very different; the Czech twins seemed to make a full recovery, whereas, as far as we know, Genie never recovered from her early problems.

An issue in case studies, particularly where qualitative methods are used, is that the researcher’s subjectivity may pose a problem. For example, in the case study of Little Hans, Freud developed an entire theory based on what he observed. No scientific or experimental evidence from his case study supported his suggestions. A major problem with his research is that we cannot be sure he objectively reported his findings. Consequently, a major limitation of case studies is that research bias and subjectivity can interfere with the validity of the findings/conclusions.

CASE STUDIES DON’T SHOW CAUSE-AND-EFFECT RELATIONSHIPS

• Phineus Gage - We can’t assume that all individuals will suffer the same cognitive defects after frontal lobe injury as Phineus Gage did.

• Genie - We can’t assume all privated babies will behave like Genie.

• David Reimer Twins - We can’t assume that all individuals will reject the gender they were not assigned at birth.

• Charles Witman - We can’t assume that all individuals with tumours on the amygdala will go on a psychopathic killing spree.

• Paul Leborgne - We can’t assume all individuals will lose speech if they damage the left frontal lobe.

EXAM QUESTIONS

1. Researchers often use various techniques to gather information in case studies of individuals, institutions or events. Suggest one technique which the psychologist could use in a case study. (1 mark) Exam Hint: Referring to the use of meta‐analysis here would not be appropriate: be specific and name an

experimental or non‐experimental research method (e.g. interview).

2. Define the key term ‘case study’. (2 marks)

Exam Hint: Better answers will refer to the fact that a case study is an in‐depth investigation of a single person, usually over time, using various methods to collect data. Students can also illustrate their answers with relevant examples, such as Freud’s Little Hans Case Study.

3. Explain one limitation of using a case study as a method of investigation. (2 marks)
Exam Hint: Most students will explain a lack of population validity here: since a case study is of a unique person, it is difficult to generalise the results to the wider population as they may not behave in the same way.

1. Explain one strength of using a case study methodology in psychology. (3 marks)

2. Scarlett has an incredible memory. She can see a pack of playing cards only once and then recall the order correctly. A psychologist was interested in investigating this phenomenon further by focusing on Scarlett and her amazing memory in different situations and contexts.

   The scenario illustrated above is an example of a case study methodology. Explain one strength and

   one weakness of this research method. (4 marks)

Exam Hint: For this question, there is one mark each for identifying one appropriate strength and one appropriate weakness, and the third and fourth marks come from suitable elaboration of these points. For example, a strength of using a case study to study memory is that the data gathered will be rich in detail, which will give a unique insight into the individual case of Scarlett and her memory.

6. Evaluate the use of case studies in psychological research. Refer to evidence in your answer. (6 marks)

Case study DWS

Case Study Research: Clive Wearing, H.M., and K.F.

Instructions: For each of the three case studies (Clive Wearing, H.M., and K.F.), answer the following ten questions. Research the terms anterograde amnesia and retrograde amnesia to help you answer some of the questions.

Questions

1. Background Information

   • What caused the memory impairment in each case study (e.g., illness, injury, surgery)?

   • What were the main symptoms experienced by each individual?

2. Memory Processes

   • How was short-term memory (STM) affected in each case?

   • How was long-term memory (LTM) affected in each case?

   • Which types of LTM (e.g., episodic, semantic, procedural) were preserved or impaired?

3. Types of Amnesia

   • Define anterograde amnesia and retrograde amnesia.

   • For each case study, identify whether the individual experienced anterograde amnesia, retrograde amnesia, or both. Provide examples to support your answer.

4. Impact on Daily Life

   • How did the memory impairments affect the daily lives of Clive Wearing, H.M., and K.F.?

5. Insights into Memory

   • What does each case study reveal about the different types of memory (e.g., STM vs. LTM, or different types of LTM such as procedural memory)?

6. Advantages of Case Studies

   • What unique insights did each case study provide about memory that could not have been gained from laboratory experiments or other research methods?

7. Limitations of Case Studies

   • What are the main limitations of using case studies like these for understanding memory?

8. Ethical Considerations

   • What ethical issues might arise when working with individuals like Clive Wearing, H.M., and K.F. in psychological research?

9. Comparing Cases

   • Compare and contrast the memory impairments in the three case studies. How are they similar, and how are they different?

10. Applications of Findings

• How might the findings from these case studies be applied to help individuals with memory impairments today?

This set of questions will guide students to explore the key aspects of each case while understanding broader concepts such as types of amnesia, memory systems, and the strengths and limitations of case studies in psychological research.

DESCRIPTIONS OF CLIVE WEARING, H.M., AND K.F.

CLIVE WEARING

• Background: Clive Wearing was a successful musician and conductor who contracted herpes simplex encephalitis in 1985. The virus caused severe damage to his hippocampus and parts of the frontal lobe, resulting in profound memory impairments.

• Memory Impairments:

  • Anterograde amnesia: He cannot form new memories, with a memory span lasting only a few seconds.

  • Retrograde amnesia: He lost most of his past memories, although some emotional memories (e.g., his love for his wife) remain.

  • Preserved memory: His procedural memory is intact, allowing him to play the piano and conduct music, though he has no recollection of learning these skills.

• Daily Life: Clive constantly feels as though he is "waking up" for the first time, requiring round-the-clock care. He recognises his wife but forgets her visits almost immediately.

• Significance: Clive Wearing's case highlights the role of the hippocampus in transferring short-term memories into long-term storage and demonstrates the independence of procedural memory from other memory systems.

H.M. (HENRY MOLAISON)

• Background: H.M. underwent experimental brain surgery in 1953 to treat severe epilepsy. The surgery involved removing parts of the medial temporal lobes, including the hippocampus, on both sides of his brain. Although the surgery controlled his seizures, it caused profound memory deficits.

• Memory Impairments:

  • Anterograde amnesia: H.M. was unable to form new long-term memories. He could hold information in short-term memory but could not transfer it into long-term storage.

  • Retrograde amnesia: He also experienced mild retrograde amnesia, losing memories of the years immediately before the surgery, but retained older memories from his childhood.

  • Preserved memory: His procedural memory remained intact, allowing him to learn new motor skills (e.g., tracing a star in a mirror), though he had no recollection of practising the skill.

• Daily Life: H.M. required care for most of his life, as he could not live independently or remember recent events. He frequently repeated conversations and lacked awareness of ongoing activities.

• Significance: H.M.'s case provided critical evidence for the role of the hippocampus in memory formation and the distinction between declarative and procedural memory.

K.F.

• Background: K.F. sustained brain damage following a motorcycle accident, which affected the left parietal-occipital region of his brain. Unlike Clive Wearing and H.M., his memory impairments were specific to short-term memory.

• Memory Impairments:

  • Short-term memory: K.F. had severely impaired verbal short-term memory, with a digit span of only 1-2 items. However, his visual-spatial short-term memory was relatively unaffected.

  • Long-term memory: His long-term memory remained intact, and he was able to form and retrieve new long-term memories without difficulty.

• Daily Life: K.F. was less affected in daily life compared to Clive Wearing and H.M., as his ability to form and recall long-term memories allowed him to function relatively normally, despite issues with processing verbal information.

• Significance: K.F.’s case challenged the Multi-Store Model of Memory, which suggested that information must pass through short-term memory to reach long-term memory. His case also provided evidence for separate verbal and visual-spatial memory systems.

SUMMARY

These three case studies collectively highlight the complexity of memory systems and their dependence on different brain structures. They demonstrate distinctions between short-term and long-term memory, different types of long-term memory (e.g., procedural, episodic), and how damage to specific brain areas can produce distinct patterns of memory impairment.

CASE STUDY RESEARCH: CLIVE WEARING, H.M., AND K.F.

Below are the answers to the questions about the three case studies: Clive Wearing, H.M., and K.F.

1. BACKGROUND INFORMATION

Clive Wearing:

• Cause: Viral encephalitis severely damaged his hippocampus and parts of the frontal lobe.

• Symptoms: Profound memory loss, including both anterograde amnesia (inability to form new memories) and retrograde amnesia (loss of some past memories). He retains a memory span of only a few seconds and constantly feels as though he is "waking up."

H.M. (Henry Molaison):

• Cause: Surgical removal of the medial temporal lobes, including the hippocampus, to treat severe epilepsy.

• Symptoms: Severe anterograde amnesia (unable to form new memories). He also experienced mild retrograde amnesia, forgetting events from a few years before the surgery, but retained childhood memories.

K.F.:

• Cause: Brain damage due to a motorcycle accident, primarily affecting the left parietal-occipital region.

• Symptoms: Impaired short-term memory (STM) for verbal information (e.g., numbers and words). His long-term memory (LTM) remained intact, and he could form new memories. He showed a very limited digit span (1-2 items).

2. MEMORY PROCESSES

Clive Wearing:

• STM: Functionally intact but extremely brief (a few seconds).

• LTM: Severely impaired for both episodic and semantic memories. However, his procedural memory (e.g., playing the piano) remains intact.

H.M.:

• STM: Intact, able to hold information for short periods but unable to transfer it to LTM.

• LTM: Severely impaired episodic and semantic memory for events after surgery. Procedural memory was intact, as he could learn new motor skills without recalling the learning process.

K.F.:

• STM: Severely impaired for verbal information but relatively intact for visual-spatial information.

• LTM: Intact, showing that information does not need to pass through STM to reach LTM.

3. TYPES OF AMNESIA

• Anterograde Amnesia: Inability to form new memories after the onset of brain damage.

• Retrograde Amnesia: Loss of memories formed before the brain damage.

Clive Wearing: Both anterograde and retrograde amnesia. He cannot form new memories and has limited recall of past events.

H.M.: Primarily anterograde amnesia, with mild retrograde amnesia for the years leading up to his surgery.

K.F.: No significant anterograde or retrograde amnesia was reported. His impairment was specific to STM, especially for verbal information.

4. IMPACT ON DAILY LIFE

Clive Wearing:

• He constantly feels as though he is waking up for the first time. He requires full-time care and has no awareness of his ongoing condition. He can still play the piano but has no memory of doing so.

H.M.:

• He needed continuous care and could not live independently. He repeatedly forgot conversations and could not recall recent events but retained childhood memories and learned motor skills.

K.F.:

• His daily life was less affected compared to Clive Wearing and H.M. He struggled with processing verbal information but could live relatively independently and form new long-term memories.

5. INSIGHTS INTO MEMORY

• Clive Wearing: Highlights the role of the hippocampus in both episodic and semantic memory while showing procedural memory relies on different brain areas.

• H.M.: Demonstrates that the hippocampus is critical for transferring STM into LTM and distinguishes between declarative and procedural memory.

• K.F.: Challenges the idea that STM is necessary for information to transfer to LTM, as his LTM was intact despite impaired STM.

6. ADVANTAGES OF CASE STUDIES

• Clive Wearing: Demonstrates the importance of the hippocampus in memory. His preserved procedural memory highlights the independence of memory systems.

• H.M.: Provided evidence for the distinction between different types of LTM (declarative vs. procedural) and the role of the hippocampus.

• K.F.: Helped refine memory models by showing STM is not a single system and that verbal and visual STM are distinct.

7. LIMITATIONS OF CASE STUDIES

• Case studies focus on unique individuals, limiting generalisability to the broader population.

• Findings might not apply to people without similar brain damage or conditions.

• Ethical concerns arise, as participants like Clive Wearing and H.M. could not provide fully informed consent due to their memory impairments.

8. ETHICAL CONSIDERATIONS

• Researchers must ensure participants' dignity and well-being are maintained.

• In cases like H.M. and Clive Wearing, informed consent was a challenge due to their inability to fully understand their involvement.

• Privacy concerns are significant since the individuals’ personal stories are shared widely in the scientific community.

9. COMPARING CASES

• Similarities: All three cases highlight the complexity of memory systems, particularly the independence of STM and LTM and the role of specific brain regions.

• Differences:

  • Clive Wearing experienced both anterograde and retrograde amnesia, while H.M. primarily had anterograde amnesia.

  • K.F.’s impairment was specific to STM, with LTM remaining functional.

10. APPLICATIONS OF FINDINGS

• Understanding the role of the hippocampus and other brain regions in memory helps in developing treatments for memory-related conditions, such as Alzheimer’s disease or brain injuries.

• Insights from procedural memory studies (e.g., Clive Wearing and H.M.) inform rehabilitation strategies for patients with memory impairments.

• K.F.’s case has helped refine working memory models, improving our understanding of verbal and visual memory processes