a case study psychology

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• Perspective
• Published: 22 November 2022

Single case studies are a powerful tool for developing, testing and extending theories

• Lyndsey Nickels   ORCID: orcid.org/0000-0002-0311-3524 1 , 2 ,
• Simon Fischer-Baum   ORCID: orcid.org/0000-0002-6067-0538 3 &
• Wendy Best   ORCID: orcid.org/0000-0001-8375-5916 4  

Nature Reviews Psychology volume  1 ,  pages 733–747 ( 2022 ) Cite this article

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Psychology embraces a diverse range of methodologies. However, most rely on averaging group data to draw conclusions. In this Perspective, we argue that single case methodology is a valuable tool for developing and extending psychological theories. We stress the importance of single case and case series research, drawing on classic and contemporary cases in which cognitive and perceptual deficits provide insights into typical cognitive processes in domains such as memory, delusions, reading and face perception. We unpack the key features of single case methodology, describe its strengths, its value in adjudicating between theories, and outline its benefits for a better understanding of deficits and hence more appropriate interventions. The unique insights that single case studies have provided illustrate the value of in-depth investigation within an individual. Single case methodology has an important place in the psychologist’s toolkit and it should be valued as a primary research tool.

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Acknowledgements

The authors thank all of those pioneers of and advocates for single case study research who have mentored, inspired and encouraged us over the years, and the many other colleagues with whom we have discussed these issues.

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Nickels, L., Fischer-Baum, S. & Best, W. Single case studies are a powerful tool for developing, testing and extending theories. Nat Rev Psychol 1 , 733–747 (2022). https://doi.org/10.1038/s44159-022-00127-y

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What Is a Case Study in Psychology?

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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.

In a case study, researchers aim to understand the complexities and nuances of the subject under investigation. They explore the individual’s thoughts, feelings, behaviors, and experiences to gain insights into specific psychological phenomena. 

This type of research can provide great detail regarding a particular case, allowing researchers to examine rare or unique situations that may not be easily replicated in a laboratory setting. They offer a holistic view of the subject, considering various factors influencing their behavior or mental processes. 

By examining individual cases, researchers can generate hypotheses, develop theories, and contribute to the existing body of knowledge in psychology. Case studies are often utilized in clinical psychology, where they can provide valuable insights into the diagnosis, treatment, and outcomes of specific psychological disorders. 

Case studies offer a comprehensive and in-depth understanding of complex psychological phenomena, providing researchers with valuable information to inform theory, practice, and future research.

Table of Contents

Examples of Case Studies in Psychology

Case studies in psychology provide real-life examples that illustrate psychological concepts and theories. They offer a detailed analysis of specific individuals, groups, or situations, allowing researchers to understand psychological phenomena better. Here are a few examples of case studies in psychology: 

Phineas Gage

This famous case study explores the effects of a traumatic brain injury on personality and behavior. A railroad construction worker, Phineas Gage survived a severe brain injury that dramatically changed his personality.

This case study helped researchers understand the role of the frontal lobe in personality and social behavior. 

Little Albert

Conducted by behaviorist John B. Watson, the Little Albert case study aimed to demonstrate classical conditioning. In this study, a young boy named Albert was conditioned to fear a white rat by pairing it with a loud noise.

This case study provided insights into the process of fear conditioning and the impact of early experiences on behavior. 

Genie’s case study focused on a girl who experienced extreme social isolation and deprivation during her childhood. This study shed light on the critical period for language development and the effects of severe neglect on cognitive and social functioning. 

These case studies highlight the value of in-depth analysis and provide researchers with valuable insights into various psychological phenomena. By examining specific cases, psychologists can uncover unique aspects of human behavior and contribute to the field’s knowledge and understanding.

Types of Case Studies in Psychology

Psychology case studies come in various forms, each serving a specific purpose in research and analysis. Understanding the different types of case studies can help researchers choose the most appropriate approach. 

Descriptive Case Studies

These studies aim to describe a particular individual, group, or situation. Researchers use descriptive case studies to explore and document specific characteristics, behaviors, or experiences.

For example, a descriptive case study may examine the life and experiences of a person with a rare psychological disorder. 

Exploratory Case Studies

Exploratory case studies are conducted when there is limited existing knowledge or understanding of a particular phenomenon. Researchers use these studies to gather preliminary information and generate hypotheses for further investigation.

Exploratory case studies often involve in-depth interviews, observations, and analysis of existing data. 

Explanatory Case Studies

These studies aim to explain the causal relationship between variables or events. Researchers use these studies to understand why certain outcomes occur and to identify the underlying mechanisms or processes.

Explanatory case studies often involve comparing multiple cases to identify common patterns or factors. 

Instrumental Case Studies

Instrumental case studies focus on using a particular case to gain insights into a broader issue or theory. Researchers select cases that are representative or critical in understanding the phenomenon of interest.

Instrumental case studies help researchers develop or refine theories and contribute to the general knowledge in the field. 

By utilizing different types of case studies, psychologists can explore various aspects of human behavior and gain a deeper understanding of psychological phenomena. Each type of case study offers unique advantages and contributes to the overall body of knowledge in psychology.

How to Collect Data for a Case Study

There are a variety of ways that researchers gather the data they need for a case study. Some sources include:

• Directly observing the subject
• Collecting information from archival records
• Conducting interviews
• Examining artifacts related to the subject
• Examining documents that provide information about the subject

The way that this information is collected depends on the nature of the study itself

Prospective Research

In a prospective study, researchers observe the individual or group in question. These observations typically occur over a period of time and may be used to track the progress or progression of a phenomenon or treatment.

Retrospective Research

A retrospective case study involves looking back on a phenomenon. Researchers typically look at the outcome and then gather data to help them understand how the individual or group reached that point.

Benefits of a Case Study

Case studies offer several benefits in the field of psychology. They provide researchers with a unique opportunity to delve deep into specific individuals, groups, or situations, allowing for a comprehensive understanding of complex phenomena.

Case studies offer valuable insights that can inform theory development and practical applications by examining real-life examples. 

Complex Data

One of the key benefits of case studies is their ability to provide complex and detailed data. Researchers can gather in-depth information through various methods such as interviews, observations, and analysis of existing records.

This depth of data allows for a thorough exploration of the factors influencing behavior and the underlying mechanisms at play. 

Unique Data

Additionally, case studies allow researchers to study rare or unique cases that may not be easily replicated in experimental settings. This enables the examination of phenomena that are difficult to study through other psychology research methods . 

By focusing on specific cases, researchers can uncover patterns, identify causal relationships, and generate hypotheses for further investigation.

General Knowledge

Case studies can also contribute to the general knowledge of psychology by providing real-world examples that can be used to support or challenge existing theories. They offer a bridge between theory and practice, allowing researchers to apply theoretical concepts to real-life situations and vice versa. 

Case studies offer a range of benefits in psychology, including providing rich and detailed data, studying unique cases, and contributing to theory development. These benefits make case studies valuable in understanding human behavior and psychological phenomena.

Limitations of a Case Study

While case studies offer numerous benefits in the field of psychology, they also have certain limitations that researchers need to consider. Understanding these limitations is crucial for interpreting the findings and generalizing the results. 

Lack of Generalizability

One limitation of case studies is the issue of generalizability. Since case studies focus on specific individuals, groups, and situations, applying the findings to a larger population can be challenging. The unique characteristics and circumstances of the case may not be representative of the broader population, making it difficult to draw universal conclusions. 

Researcher bias is another possible limitation. The researcher’s subjective interpretation and personal beliefs can influence the data collection, analysis, and interpretation process. This bias can affect the objectivity and reliability of the findings, raising questions about the study’s validity. 

Case studies are often time-consuming and resource-intensive. They require extensive data collection, analysis, and interpretation, which can be lengthy. This can limit the number of cases that can be studied and may result in a smaller sample size, reducing the study’s statistical power. 

Case studies are retrospective in nature, relying on past events and experiences. This reliance on memory and self-reporting can introduce recall bias and inaccuracies in the data. Participants may forget or misinterpret certain details, leading to incomplete or unreliable information.

Despite these limitations, case studies remain a valuable research tool in psychology. By acknowledging and addressing these limitations, researchers can enhance the validity and reliability of their findings, contributing to a more comprehensive understanding of human behavior and psychological phenomena. 

While case studies have limitations, they remain valuable when researchers acknowledge and address these concerns, leading to more reliable and valid findings in psychology.

Alpi, K. M., & Evans, J. J. (2019). Distinguishing case study as a research method from case reports as a publication type. Journal of the Medical Library Association , 107(1). https://doi.org/10.5195/jmla.2019.615

Crowe, S., Cresswell, K., Robertson, A., Huby, G., Avery, A., & Sheikh, A. (2011). The case study approach. BMC Medical Research Methodology , 11(1), 100. https://doi.org/10.1186/1471-2288-11-100

Paparini, S., Green, J., Papoutsi, C., Murdoch, J., Petticrew, M., Greenhalgh, T., Hanckel, B., & Shaw, S. (2020). Case study research for better evaluations of complex interventions: Rationale and challenges. BMC Medicine , 18(1), 301. https://doi.org/10.1186/s12916-020-01777-6

Willemsen, J. (2023). What is preventing psychotherapy case studies from having a greater impact on evidence-based practice, and how to address the challenges? Frontiers in Psychiatry , 13, 1101090. https://doi.org/10.3389/fpsyt.2022.1101090

Yin, Robert K. Case Study Research and Applications: Design and Methods . United States, SAGE Publications, 2017.

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Topics for Psychology Case Studies

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Cara Lustik is a fact-checker and copywriter.

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In one of your psychology classes, you might be asked to write a  case study  of an individual. What exactly is a case study? A case study is an in-depth psychological investigation of a single person or a group of people.

Case studies are commonly used in medicine and psychology. For example, these studies often focus on people with an illness (for example, one that is rare) or people with experiences that cannot be replicated in a lab.

Here are some ideas and inspiration to help you come up with a fascinating psychological case study.

What Should Your Case Study Be About?

Your instructor will give you directions and guidelines for your case study project. Make sure you have their permission to go ahead with your subject before you get started.

The format of your case study may vary depending on the class requirements and your instructor's expectations. Most psychological case studies include a detailed background of the person, a description of the problem the person is facing, a diagnosis, and a description of an intervention using one or more therapeutic approaches.

The first step in writing a case study is to select a subject. You might be allowed to conduct a case study on a volunteer or someone you know in real life, such as a friend or family member.

However, your instructor may prefer that you select a less personal subject, such as an individual from history, a famous literary figure, or even a fictional character.

Psychology Case Study Ideas

Want to find an interesting subject for your case study? Here are just a few ideas that might inspire you.

A Pioneering Psychologist

Famous or exceptional people can make great case study topics. There are plenty of fascinating figures in the history of psychology who would be interesting subjects for a case study.

Here are some of the most well-known thinkers in psychology whose interesting lives could make a great case study:

• Sigmund Freud
• Harry Harlow
• Mary Ainsworth
• Erik Erikson
• Ivan Pavlov
• Jean Piaget
• Abraham Maslow
• William James
• B. F. Skinner

Examining these individuals’ upbringings, experiences, and lives can provide insight into how they developed their theories and approached the study of psychology.

A Famous Patient in Psychology

The best-known people in psychology aren’t always professionals. The people that psychologists have worked with are among some of the most fascinating people in the history of psychology.

Here are a few examples of famous psychology patients who would make great case studies:

• Anna O.  (Bertha Pappenheim)
• Phineas Gage
• Genie (Susan Wiley)
• Kitty Genovese
• Little Albert
• David Reimer
• Chris Costner Sizemore (Eve White/Eve Black)
• Dora (Ida Bauer)
• Patient H.M. (Henry Molaison)

By taking a closer look at the lives of these psychology patients, you can gain greater insight into their experiences. You’ll also get to see how diagnosis and treatment were different in the past compared to today.

A Historical Figure

Historical figures—famous and infamous—can be excellent subjects for case studies. Here are just a few influential people from history that you might consider doing a case study on:

• Eleanor Roosevelt
• George Washington
• Abraham Lincoln
• Elizabeth I
• Margaret Thatcher
• Walt Disney
• Benjamin Franklin
• Charles Darwin
• Howard Hughes
• Catherine the Great
• Pablo Picasso
• Vincent van Gogh
• Edvard Munch
• Marilyn Monroe
• Andy Warhol
• Salvador Dali

You’ll need to do a lot of reading and research on your chosen subject's life to figure out why they became influential forces in history. When thinking about their psychology, you’ll also want to consider what life was like in the times that they lived.

A Fictional Character or a Literary Figure

Your instructor might allow you to take a more fun approach to a case study by doing a deep dive into the psychology of a fictional character.

Here are a few examples of fictional characters who could make great case studies:

• Macbeth/Lady Macbeth
• Romeo/Juliet
• Sherlock Holmes
• Norman Bates
• Elizabeth Bennet/Fitzwilliam Darcy
• Katniss Everdeen
• Harry Potter/Hermione Granger/Ron Weasley/Severus Snape
• Batman/The Joker
• Atticus Finch
• Mrs. Dalloway
• Dexter Morgan
• Hannibal Lecter/Clarice Starling
• Fox Mulder/Dana Scully
• Forrest Gump
• Patrick Bateman
• Anakin Skywalker/Darth Vader
• Ellen Ripley
• Michael Corleone
• Randle McMurphy/Nurse Ratched
• Miss Havisham

The people who bring characters to life on the page can also be fascinating. Here are some literary figures who could be interesting case studies:

• Shakespeare
• Virginia Woolf
• Jane Austen
• Stephen King
• Emily Dickinson
• Sylvia Plath
• JRR Tolkien
• Louisa May Alcott
• Edgar Allan Poe
• Charles Dickens
• Ernest Hemingway
• F. Scott Fitzgerald
• George Orwell
• Maya Angelou
• Kurt Vonnegut
• Agatha Christie
• Toni Morrison
• Daphne du Maurier
• Franz Kafka
• Herman Melville

Can I Write About Someone I Know?

Your instructor may allow you to write your case study on a person that you know. However, you might need to get special permission from your school's Institutional Review Board to do a psychological case study on a real person.

You might not be able to use the person’s real name, though. Even if it’s not required, you may want to use a pseudonym for them to make sure that their identity and privacy are protected.

To do a case study on a real person you know, you’ll need to interview them and possibly talk to other people who know them well, like friends and family.

If you choose to do a case study on a real person, make sure that you fully understand the ethics and best practices, especially informed consent. Work closely with your instructor throughout your project to ensure that you’re following all the rules and handling the project professionally.

APA. Guidelines for submitting case reports .

American Psychological Association.  Ethical principles of psychologists and code of conduct, including 2010 and 2016 amendments .

Rolls, G. (2019). Classic Case Studies in Psychology: Fourth Edition . United Kingdom: Taylor & Francis.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Psychology Case Study Examples: A Deep Dive into Real-life Scenarios

Peeling back the layers of the human mind is no easy task, but psychology case studies can help us do just that. Through these detailed analyses, we’re able to gain a deeper understanding of human behavior, emotions, and cognitive processes. I’ve always found it fascinating how a single person’s experience can shed light on broader psychological principles.

Over the years, psychologists have conducted numerous case studies—each with their own unique insights and implications. These investigations range from Phineas Gage’s accidental lobotomy to Genie Wiley’s tragic tale of isolation. Such examples not only enlighten us about specific disorders or occurrences but also continue to shape our overall understanding of psychology .

As we delve into some noteworthy examples , I assure you’ll appreciate how varied and intricate the field of psychology truly is. Whether you’re a budding psychologist or simply an eager learner, brace yourself for an intriguing exploration into the intricacies of the human psyche.

Understanding Psychology Case Studies

Diving headfirst into the world of psychology, it’s easy to come upon a valuable tool used by psychologists and researchers alike – case studies. I’m here to shed some light on these fascinating tools.

Psychology case studies, for those unfamiliar with them, are in-depth investigations carried out to gain a profound understanding of the subject – whether it’s an individual, group or phenomenon. They’re powerful because they provide detailed insights that other research methods might miss.

Let me share a few examples to clarify this concept further:

• One notable example is Freud’s study on Little Hans. This case study explored a 5-year-old boy’s fear of horses and related it back to Freud’s theories about psychosexual stages.
• Another classic example is Genie Wiley (a pseudonym), a feral child who was subjected to severe social isolation during her early years. Her heartbreaking story provided invaluable insights into language acquisition and critical periods in development.

You see, what sets psychology case studies apart is their focus on the ‘why’ and ‘how’. While surveys or experiments might tell us ‘what’, they often don’t dig deep enough into the inner workings behind human behavior.

It’s important though not to take these psychology case studies at face value. As enlightening as they can be, we must remember that they usually focus on one specific instance or individual. Thus, generalizing findings from single-case studies should be done cautiously.

To illustrate my point using numbers: let’s say we have 1 million people suffering from condition X worldwide; if only 20 unique cases have been studied so far (which would be quite typical for rare conditions), then our understanding is based on just 0.002% of the total cases! That’s why multiple sources and types of research are vital when trying to understand complex psychological phenomena fully.

In the grand scheme of things, psychology case studies are just one piece of the puzzle – albeit an essential one. They provide rich, detailed data that can form the foundation for further research and understanding. As we delve deeper into this fascinating field, it’s crucial to appreciate all the tools at our disposal – from surveys and experiments to these insightful case studies.

Importance of Case Studies in Psychology

I’ve always been fascinated by the human mind, and if you’re here, I bet you are too. Let’s dive right into why case studies play such a pivotal role in psychology.

One of the key reasons they matter so much is because they provide detailed insights into specific psychological phenomena. Unlike other research methods that might use large samples but only offer surface-level findings, case studies allow us to study complex behaviors, disorders, and even treatments at an intimate level. They often serve as a catalyst for new theories or help refine existing ones.

To illustrate this point, let’s look at one of psychology’s most famous case studies – Phineas Gage. He was a railroad construction foreman who survived a severe brain injury when an iron rod shot through his skull during an explosion in 1848. The dramatic personality changes he experienced after his accident led to significant advancements in our understanding of the brain’s role in personality and behavior.

Moreover, it’s worth noting that some rare conditions can only be studied through individual cases due to their uncommon nature. For instance, consider Genie Wiley – a girl discovered at age 13 having spent most of her life locked away from society by her parents. Her tragic story gave psychologists valuable insights into language acquisition and critical periods for learning.

Finally yet importantly, case studies also have practical applications for clinicians and therapists. Studying real-life examples can inform treatment plans and provide guidance on how theoretical concepts might apply to actual client situations.

• Detailed insights: Case studies offer comprehensive views on specific psychological phenomena.
• Catalyst for new theories: Real-life scenarios help shape our understanding of psychology .
• Study rare conditions: Unique cases can offer invaluable lessons about uncommon disorders.
• Practical applications: Clinicians benefit from studying real-world examples.

In short (but without wrapping up), it’s clear that case studies hold immense value within psychology – they illuminate what textbooks often can’t, offering a more nuanced understanding of human behavior.

Different Types of Psychology Case Studies

Diving headfirst into the world of psychology, I can’t help but be fascinated by the myriad types of case studies that revolve around this subject. Let’s take a closer look at some of them.

Firstly, we’ve got what’s known as ‘Explanatory Case Studies’. These are often used when a researcher wants to clarify complex phenomena or concepts. For example, a psychologist might use an explanatory case study to explore the reasons behind aggressive behavior in children.

Second on our list are ‘Exploratory Case Studies’, typically utilized when new and unexplored areas of research come up. They’re like pioneers; they pave the way for future studies. In psychological terms, exploratory case studies could be conducted to investigate emerging mental health conditions or under-researched therapeutic approaches.

Next up are ‘Descriptive Case Studies’. As the name suggests, these focus on depicting comprehensive and detailed profiles about a particular individual, group, or event within its natural context. A well-known example would be Sigmund Freud’s analysis of “Anna O”, which provided unique insights into hysteria.

Then there are ‘Intrinsic Case Studies’, which delve deep into one specific case because it is intrinsically interesting or unique in some way. It’s sorta like shining a spotlight onto an exceptional phenomenon. An instance would be studying savants—individuals with extraordinary abilities despite significant mental disabilities.

Lastly, we have ‘Instrumental Case Studies’. These aren’t focused on understanding a particular case per se but use it as an instrument to understand something else altogether—a bit like using one puzzle piece to make sense of the whole picture!

So there you have it! From explanatory to instrumental, each type serves its own unique purpose and adds another intriguing layer to our understanding of human behavior and cognition.

Exploring Real-Life Psychology Case Study Examples

Let’s roll up our sleeves and delve into some real-life psychology case study examples. By digging deep, we can glean valuable insights from these studies that have significantly contributed to our understanding of human behavior and mental processes.

First off, let me share the fascinating case of Phineas Gage. This gentleman was a 19th-century railroad construction foreman who survived an accident where a large iron rod was accidentally driven through his skull, damaging his frontal lobes. Astonishingly, he could walk and talk immediately after the accident but underwent dramatic personality changes, becoming impulsive and irresponsible. This case is often referenced in discussions about brain injury and personality change.

Next on my list is Genie Wiley’s heart-wrenching story. She was a victim of severe abuse and neglect resulting in her being socially isolated until she was 13 years old. Due to this horrific experience, Genie couldn’t acquire language skills typically as other children would do during their developmental stages. Her tragic story offers invaluable insight into the critical periods for language development in children.

Then there’s ‘Little Hans’, a classic Freudian case that delves into child psychology. At just five years old, Little Hans developed an irrational fear of horses -or so it seemed- which Sigmund Freud interpreted as symbolic anxiety stemming from suppressed sexual desires towards his mother—quite an interpretation! The study gave us Freud’s Oedipus Complex theory.

Lastly, I’d like to mention Patient H.M., an individual who became amnesiac following surgery to control seizures by removing parts of his hippocampus bilaterally. His inability to form new memories post-operation shed light on how different areas of our brains contribute to memory formation.

Each one of these real-life psychology case studies gives us a unique window into understanding complex human behaviors better – whether it’s dissecting the role our brain plays in shaping personality or unraveling the mysteries of fear, language acquisition, and memory.

How to Analyze a Psychology Case Study

Diving headfirst into a psychology case study, I understand it can seem like an intimidating task. But don’t worry, I’m here to guide you through the process.

First off, it’s essential to go through the case study thoroughly. Read it multiple times if needed. Each reading will likely reveal new information or perspectives you may have missed initially. Look out for any patterns or inconsistencies in the subject’s behavior and make note of them.

Next on your agenda should be understanding the theoretical frameworks that might be applicable in this scenario. Is there a cognitive-behavioral approach at play? Or does psychoanalysis provide better insights? Comparing these theories with observed behavior and symptoms can help shed light on underlying psychological issues.

Now, let’s talk data interpretation. If your case study includes raw data like surveys or diagnostic tests results, you’ll need to analyze them carefully. Here are some steps that could help:

• Identify what each piece of data represents
• Look for correlations between different pieces of data
• Compute statistics (mean, median, mode) if necessary
• Use graphs or charts for visual representation

Keep in mind; interpreting raw data requires both statistical knowledge and intuition about human behavior.

Finally, drafting conclusions is key in analyzing a psychology case study. Based on your observations, evaluations of theoretical approaches and interpretations of any given data – what do you conclude about the subject’s mental health status? Remember not to jump to conclusions hastily but instead base them solidly on evidence from your analysis.

In all this journey of analysis remember one thing: every person is unique and so are their experiences! So while theories and previous studies guide us, they never define an individual completely.

Applying Lessons from Psychology Case Studies

Let’s dive into how we can apply the lessons learned from psychology case studies. If you’ve ever studied psychology, you’ll know that case studies offer rich insights. They shed light on human behavior, mental health issues, and therapeutic techniques. But it’s not just about understanding theory. It’s also about implementing these valuable lessons in real-world situations.

One of the most famous psychological case studies is Phineas Gage’s story. This 19th-century railroad worker survived a severe brain injury which dramatically altered his personality. From this study, we gained crucial insight into how different brain areas are responsible for various aspects of our personality and behavior.

• Lesson: Recognizing that damage to specific brain areas can result in personality changes, enabling us to better understand certain mental conditions.

Sigmund Freud’s work with a patient known as ‘Anna O.’ is another landmark psychology case study. Anna displayed what was then called hysteria – symptoms included hallucinations and disturbances in speech and physical coordination – which Freud linked back to repressed memories of traumatic events.

• Lesson: The importance of exploring an individual’s history for understanding their current psychological problems – a principle at the heart of psychoanalysis.

Then there’s Genie Wiley’s case – a girl who suffered extreme neglect resulting in impaired social and linguistic development. Researchers used her tragic circumstances as an opportunity to explore theories around language acquisition and socialization.

• Lesson: Reinforcing the critical role early childhood experiences play in shaping cognitive development.

Lastly, let’s consider the Stanford Prison Experiment led by Philip Zimbardo examining how people conform to societal roles even when they lead to immoral actions.

• Lesson: Highlighting that situational forces can drastically impact human behavior beyond personal characteristics or morality.

These examples demonstrate that psychology case studies aren’t just academic exercises isolated from daily life. Instead, they provide profound lessons that help us make sense of complex human behaviors, mental health issues, and therapeutic strategies. By understanding these studies, we’re better equipped to apply their lessons in our own lives – whether it’s navigating personal relationships, working with diverse teams at work or even self-improvement.

Challenges and Critiques of Psychological Case Studies

Delving into the world of psychological case studies, it’s not all rosy. Sure, they offer an in-depth understanding of individual behavior and mental processes. Yet, they’re not without their share of challenges and criticisms.

One common critique is the lack of generalizability. Each case study is unique to its subject. We can’t always apply what we learn from one person to everyone else. I’ve come across instances where results varied dramatically between similar subjects, highlighting the inherent unpredictability in human behavior.

Another challenge lies within ethical boundaries. Often, sensitive information surfaces during these studies that could potentially harm the subject if disclosed improperly. To put it plainly, maintaining confidentiality while delivering a comprehensive account isn’t always easy.

Distortion due to subjective interpretations also poses substantial difficulties for psychologists conducting case studies. The researcher’s own bias may color their observations and conclusions – leading to skewed outcomes or misleading findings.

Moreover, there’s an ongoing debate about the scientific validity of case studies because they rely heavily on qualitative data rather than quantitative analysis. Some argue this makes them less reliable or objective when compared with other research methods such as experiments or surveys.

To summarize:

• Lack of generalizability
• Ethical dilemmas concerning privacy
• Potential distortion through subjective interpretation
• Questions about scientific validity

While these critiques present significant challenges, they do not diminish the value that psychological case studies bring to our understanding of human behavior and mental health struggles.

Conclusion: The Impact of Case Studies in Understanding Human Behavior

Case studies play a pivotal role in shedding light on human behavior. Throughout this article, I’ve discussed numerous examples that illustrate just how powerful these studies can be. Yet it’s the impact they have on our understanding of human psychology where their true value lies.

Take for instance the iconic study of Phineas Gage. It was through his tragic accident and subsequent personality change that we began to grasp the profound influence our frontal lobes have on our behavior. Without such a case study, we might still be in the dark about this crucial aspect of our neurology.

Let’s also consider Genie, the feral child who showed us the critical importance of social interaction during early development. Her heartbreaking story underscores just how vital appropriate nurturing is for healthy mental and emotional growth.

Here are some key takeaways from these case studies:

• Our brain structure significantly influences our behavior.
• Social interaction during formative years is vital for normal psychological development.
• Studying individual cases can reveal universal truths about human nature.

What stands out though, is not merely what these case studies teach us individually but collectively. They remind us that each person constitutes a unique combination of various factors—biological, psychological, and environmental—that shape their behavior.

One cannot overstate the significance of case studies in psychology—they are more than mere stories or isolated incidents; they’re windows into the complexities and nuances of human nature itself.

In wrapping up, I’d say that while statistics give us patterns and trends to understand groups, it’s these detailed narratives offered by case studies that help us comprehend individuals’ unique experiences within those groups—making them an invaluable part of psychological research.

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Henry Gustav Molaison: The Curious Case of Patient H.M. 

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Erin Heaning, a holder of a BA (Hons) in Psychology from Princeton University, has experienced as a research assistant at the Princeton Baby Lab.

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Henry Gustav Molaison, known as Patient H.M., is a landmark case study in psychology. After a surgery to alleviate severe epilepsy, which removed large portions of his hippocampus , he was left with anterograde amnesia , unable to form new explicit memories , thus offering crucial insights into the role of the hippocampus in memory formation.

• Henry Gustav Molaison (often referred to as H.M.) is a famous case of anterograde and retrograde amnesia in psychology.
• H. M. underwent brain surgery to remove his hippocampus and amygdala to control his seizures. As a result of his surgery, H.M.’s seizures decreased, but he could no longer form new memories or remember the prior 11 years of his life.
• He lost his ability to form many types of new memories (anterograde amnesia), such as new facts or faces, and the surgery also caused retrograde amnesia as he was able to recall childhood events but lost the ability to recall experiences a few years before his surgery.
• The case of H.M. and his life-long participation in studies gave researchers valuable insight into how memory functions and is organized in the brain. He is considered one of the most studied medical and psychological history cases.

Who is H.M.?

Henry Gustav Molaison, or “H.M” as he is commonly referred to by psychology and neuroscience textbooks, lost his memory on an operating table in 1953.

For years before his neurosurgery, H.M. suffered from epileptic seizures believed to be caused by a bicycle accident that occurred in his childhood. The seizures started out as minor at age ten, but they developed in severity when H.M. was a teenager.

Continuing to worsen in severity throughout his young adulthood, H.M. was eventually too disabled to work. Throughout this period, treatments continued to turn out unsuccessful, and epilepsy proved a major handicap and strain on H.M.’s quality of life.

And so, at age 27, H.M. agreed to undergo a radical surgery that would involve removing a part of his brain called the hippocampus — the region believed to be the source of his epileptic seizures (Squire, 2009).

For epilepsy patients, brain resection surgery refers to removing small portions of brain tissue responsible for causing seizures. Although resection is still a surgical procedure used today to treat epilepsy, the use of lasers and detailed brain scans help ensure valuable brain regions are not impacted.

In 1953, H.M.’s neurosurgeon did not have these tools, nor was he or the rest of the scientific or medical community fully aware of the true function of the hippocampus and its specific role in memory. In one regard, the surgery was successful, as H.M. did, in fact, experience fewer seizures.

However, family and doctors soon noticed he also suffered from severe amnesia, which persisted well past when he should have recovered. In addition to struggling to remember the years leading up to his surgery, H.M. also had gaps in his memory of the 11 years prior.

Furthermore, he lacked the ability to form new memories — causing him to perpetually live an existence of moment-to-moment forgetfulness for decades to come.

In one famous quote, he famously and somberly described his state as “like waking from a dream…. every day is alone in itself” (Squire et al., 2009).

H.M. soon became a major case study of interest for psychologists and neuroscientists who studied his memory deficits and cognitive abilities to better understand the hippocampus and its function.

When H.M. died on December 2, 2008, at the age of 82, he left behind a lifelong legacy of scientific contribution.

Surgical Procedure

Neurosurgeon William Beecher Scoville performed H.M.’s surgery in Hartford, Connecticut, in August 1953 when H.M. was 27 years old.

During the procedure, Scoville removed parts of H.M.’s temporal lobe which refers to the portion of the brain that sits behind both ears and is associated with auditory and memory processing.

More specifically, the surgery involved what was called a “partial medial temporal lobe resection” (Scoville & Milner, 1957). In this resection, Scoville removed 8 cm of brain tissue from the hippocampus — a seahorse-shaped structure located deep in the temporal lobe .

Bilateral resection of the anterior temporal lobe in patient HM.

Further research conducted after this removal showed Scoville also probably destroyed the brain structures known as the “uncus” (theorized to play a role in the sense of smell and forming new memories) and the “amygdala” (theorized to play a crucial role in controlling our emotional responses such as fear and sadness).

As previously mentioned, the removal surgery partially reduced H.M.’s seizures; however, he also lost the ability to form new memories.

At the time, Scoville’s experimental procedure had previously only been performed on patients with psychosis, so H.M. was the first epileptic patient and showed no sign of mental illness. In the original case study of H.M., which is discussed in further detail below, nine of Scoville’s patients from this experimental surgery were described.

However, because these patients had disorders such as schizophrenia, their symptoms were not removed after surgery. In this regard, H.M. was the only patient with “clean” amnesia along with no other apparent mental problems.

H.M’s Amnesia

H.M.’s apparent amnesia after waking from surgery presented in multiple forms. For starters, H.M. suffered from retrograde amnesia for the 11-year period prior to his surgery.

Retrograde describes amnesia, where you can’t recall memories that were formed before the event that caused the amnesia. Important to note, current research theorizes that H.M.’s retrograde amnesia was not actually caused by the loss of his hippocampus, but rather from a combination of antiepileptic drugs and frequent seizures prior to his surgery (Shrader 2012).

In contrast, H.M.’s inability to form new memories after his operation, known as anterograde amnesia, was the result of the loss of the hippocampus.

This meant that H.M. could not learn new words, facts, or faces after his surgery, and he would even forget who he was talking to the moment he walked away.

However, H.M. could perform tasks, and he could even perform those tasks easier after practice. This important finding represented a major scientific discovery when it comes to memory and the hippocampus. The memory that H.M. was missing in his life included the recall of facts, life events, and other experiences.

This type of long-term memory is referred to as “explicit” or “ declarative ” memories and they require conscious thinking.

In contrast, H.M.’s ability to improve in tasks after practice (even if he didn’t recall that practice) showed his “implicit” or “ procedural ” memory remained intact (Scoville & Milner, 1957). This type of long-term memory is unconscious, and examples include riding a bike, brushing your teeth, or typing on a keyboard.

Most importantly, after removing his hippocampus, H.M. lost his explicit memory but not his implicit memory — establishing that implicit memory must be controlled by some other area of the brain and not the hippocampus.

After the severity of the side effects of H.M.’s operation became clear, H.M. was referred to neurosurgeon Dr. Wilder Penfield and neuropsychologist Dr. Brenda Milner of Montreal Neurological Institute (MNI) for further testing.

As discussed, H.M. was not the only patient who underwent this experimental surgery, but he was the only non-psychotic patient with such a degree of memory impairment. As a result, he became a major study and interest for Milner and the rest of the scientific community.

Since Penfield and Milner had already been conducting memory experiments on other patients at the time, they quickly realized H.M.’s “dense amnesia, intact intelligence, and precise neurosurgical lesions made him a perfect experimental subject” (Shrader 2012).

Milner continued to conduct cognitive testing on H.M. for the next fifty years, primarily at the Massachusetts Institute of Technology (MIT). Her longitudinal case study of H.M.’s amnesia quickly became a sensation and is still one of the most widely-cited psychology studies.

In publishing her work, she protected Henry’s identity by first referring to him as the patient H.M. (Shrader 2012).

In the famous “star tracing task,” Milner tested if H.M.’s procedural memory was affected by the removal of the hippocampus during surgery.

In this task, H.M. had to trace an outline of a star, but he could only trace the star based on the mirrored reflection. H.M. then repeated this task once a day over a period of multiple days.

Over the course of these multiple days, Milner observed that H.M. performed the test faster and with fewer errors after continued practice. Although each time he performed the task, he had no memory of having participated in the task before, his performance improved immensely (Shrader 2012).

As this task showed, H.M. had lost his declarative/explicit memory, but his unconscious procedural/implicit memory remained intact. Given the damage to his hippocampus in surgery, researchers concluded from tasks such as these that the hippocampus must play a role in declarative but not procedural memory.

Therefore, procedural memory must be localized somewhere else in the brain and not in the hippocampus.

H.M’s Legacy

Milner’s and hundreds of other researchers’ work with H.M. established fundamental principles about how memory functions and is organized in the brain.

Without the contribution of H.M. in volunteering the study of his mind to science, our knowledge today regarding the separation of memory function in the brain would certainly not be as strong.

Until H.M.’s watershed surgery, it was not known that the hippocampus was essential for making memories and that if we lost this valuable part of our brain, we would be forced to live only in the moment-to-moment constraints of our short-term memory .

Once this was realized, the findings regarding H.M. were widely publicized so that this operation to remove the hippocampus would never be done again (Shrader 2012).

H.M.’s case study represents a historical time period for neuroscience in which most brain research and findings were the result of brain dissections, lesioning certain sections, and seeing how different experimental procedures impacted different patients.

Therefore, it is paramount we recognize the contribution of patients like H.M., who underwent these dangerous operations in the mid-twentieth century and then went on to allow researchers to study them for the rest of their lives.

Even after his death, H.M. donated his brain to science. Researchers then took his unique brain, froze it, and then in a 53-hour procedure, sliced it into 2,401 slices which were then individually photographed and digitized as a three-dimensional map.

Through this map, H.M.’s brain could be preserved for posterity (Wb et al., 2014). As neuroscience researcher Suzanne Corkin once said it best, “H.M. was a pleasant, engaging, docile man with a keen sense of humor, who knew he had a poor memory but accepted his fate.

There was a man behind the data. Henry often told me that he hoped that research into his condition would help others live better lives. He would have been proud to know how much his tragedy has benefitted science and medicine” (Corkin, 2014).

Corkin, S. (2014). Permanent present tense: The man with no memory and what he taught the world. Penguin Books.

Hardt, O., Einarsson, E. Ö., & Nader, K. (2010). A bridge over troubled water: Reconsolidation as a link between cognitive and neuroscientific memory research traditions. Annual Review of Psychology, 61, 141–167.

Scoville, W. B., & Milner, B. (1957). Loss of recent memory after bilateral hippocampal lesions . Journal of neurology, neurosurgery, and psychiatry, 20 (1), 11.

Shrader, J. (2012, January). HM, the man with no memory | Psychology Today. Retrieved from, https://www.psychologytoday.com/us/blog/trouble-in-mind/201201/hm-the-man-no-memory

Squire, L. R. (2009). The legacy of patient H. M. for neuroscience . Neuron, 61 , 6–9.

15 Famous Experiments and Case Studies in Psychology

Psychology has seen thousands upon thousands of research studies over the years. Most of these studies have helped shape our current understanding of human thoughts, behavior, and feelings.

The psychology case studies in this list are considered classic examples of psychological case studies and experiments, which are still being taught in introductory psychology courses up to this day.

Some studies, however, were downright shocking and controversial that you’d probably wonder why such studies were conducted back in the day. Imagine participating in an experiment for a small reward or extra class credit, only to be left scarred for life. These kinds of studies, however, paved the way for a more ethical approach to studying psychology and implementation of research standards such as the use of debriefing in psychology research .

Case Study vs. Experiment

Before we dive into the list of the most famous studies in psychology, let us first review the difference between case studies and experiments.

• It is an in-depth study and analysis of an individual, group, community, or phenomenon. The results of a case study cannot be applied to the whole population, but they can provide insights for further studies.
• It often uses qualitative research methods such as observations, surveys, and interviews.
• It is often conducted in real-life settings rather than in controlled environments.
• An experiment is a type of study done on a sample or group of random participants, the results of which can be generalized to the whole population.
• It often uses quantitative research methods that rely on numbers and statistics.
• It is conducted in controlled environments, wherein some things or situations are manipulated.

See Also: Experimental vs Observational Studies

Famous Experiments in Psychology

1. the marshmallow experiment.

Psychologist Walter Mischel conducted the marshmallow experiment at Stanford University in the 1960s to early 1970s. It was a simple test that aimed to define the connection between delayed gratification and success in life.

The instructions were fairly straightforward: children ages 4-6 were presented a piece of marshmallow on a table and they were told that they would receive a second piece if they could wait for 15 minutes without eating the first marshmallow.

About one-third of the 600 participants succeeded in delaying gratification to receive the second marshmallow. Mischel and his team followed up on these participants in the 1990s, learning that those who had the willpower to wait for a larger reward experienced more success in life in terms of SAT scores and other metrics.

This case study also supported self-control theory , a theory in criminology that holds that people with greater self-control are less likely to end up in trouble with the law!

The classic marshmallow experiment, however, was debunked in a 2018 replication study done by Tyler Watts and colleagues.

This more recent experiment had a larger group of participants (900) and a better representation of the general population when it comes to race and ethnicity. In this study, the researchers found out that the ability to wait for a second marshmallow does not depend on willpower alone but more so on the economic background and social status of the participants.

2. The Bystander Effect

In 1694, Kitty Genovese was murdered in the neighborhood of Kew Gardens, New York. It was told that there were up to 38 witnesses and onlookers in the vicinity of the crime scene, but nobody did anything to stop the murder or call for help.

Such tragedy was the catalyst that inspired social psychologists Bibb Latane and John Darley to formulate the phenomenon called bystander effect or bystander apathy .

Subsequent investigations showed that this story was exaggerated and inaccurate, as there were actually only about a dozen witnesses, at least two of whom called the police. But the case of Kitty Genovese led to various studies that aim to shed light on the bystander phenomenon.

Latane and Darley tested bystander intervention in an experimental study . Participants were asked to answer a questionnaire inside a room, and they would either be alone or with two other participants (who were actually actors or confederates in the study). Smoke would then come out from under the door. The reaction time of participants was tested — how long would it take them to report the smoke to the authorities or the experimenters?

The results showed that participants who were alone in the room reported the smoke faster than participants who were with two passive others. The study suggests that the more onlookers are present in an emergency situation, the less likely someone would step up to help, a social phenomenon now popularly called the bystander effect.

3. Asch Conformity Study

Have you ever made a decision against your better judgment just to fit in with your friends or family? The Asch Conformity Studies will help you understand this kind of situation better.

In this experiment, a group of participants were shown three numbered lines of different lengths and asked to identify the longest of them all. However, only one true participant was present in every group and the rest were actors, most of whom told the wrong answer.

Results showed that the participants went for the wrong answer, even though they knew which line was the longest one in the first place. When the participants were asked why they identified the wrong one, they said that they didn’t want to be branded as strange or peculiar.

This study goes to show that there are situations in life when people prefer fitting in than being right. It also tells that there is power in numbers — a group’s decision can overwhelm a person and make them doubt their judgment.

4. The Bobo Doll Experiment

The Bobo Doll Experiment was conducted by Dr. Albert Bandura, the proponent of social learning theory .

Back in the 1960s, the Nature vs. Nurture debate was a popular topic among psychologists. Bandura contributed to this discussion by proposing that human behavior is mostly influenced by environmental rather than genetic factors.

In the Bobo Doll Experiment, children were divided into three groups: one group was shown a video in which an adult acted aggressively toward the Bobo Doll, the second group was shown a video in which an adult play with the Bobo Doll, and the third group served as the control group where no video was shown.

The children were then led to a room with different kinds of toys, including the Bobo Doll they’ve seen in the video. Results showed that children tend to imitate the adults in the video. Those who were presented the aggressive model acted aggressively toward the Bobo Doll while those who were presented the passive model showed less aggression.

While the Bobo Doll Experiment can no longer be replicated because of ethical concerns, it has laid out the foundations of social learning theory and helped us understand the degree of influence adult behavior has on children.

5. Blue Eye / Brown Eye Experiment

Following the assassination of Martin Luther King Jr. in 1968, third-grade teacher Jane Elliott conducted an experiment in her class. Although not a formal experiment in controlled settings, A Class Divided is a good example of a social experiment to help children understand the concept of racism and discrimination.

The class was divided into two groups: blue-eyed children and brown-eyed children. For one day, Elliott gave preferential treatment to her blue-eyed students, giving them more attention and pampering them with rewards. The next day, it was the brown-eyed students’ turn to receive extra favors and privileges.

As a result, whichever group of students was given preferential treatment performed exceptionally well in class, had higher quiz scores, and recited more frequently; students who were discriminated against felt humiliated, answered poorly in tests, and became uncertain with their answers in class.

This study is now widely taught in sociocultural psychology classes.

6. Stanford Prison Experiment

One of the most controversial and widely-cited studies in psychology is the Stanford Prison Experiment , conducted by Philip Zimbardo at the basement of the Stanford psychology building in 1971. The hypothesis was that abusive behavior in prisons is influenced by the personality traits of the prisoners and prison guards.

The participants in the experiment were college students who were randomly assigned as either a prisoner or a prison guard. The prison guards were then told to run the simulated prison for two weeks. However, the experiment had to be stopped in just 6 days.

The prison guards abused their authority and harassed the prisoners through verbal and physical means. The prisoners, on the other hand, showed submissive behavior. Zimbardo decided to stop the experiment because the prisoners were showing signs of emotional and physical breakdown.

Although the experiment wasn’t completed, the results strongly showed that people can easily get into a social role when others expect them to, especially when it’s highly stereotyped .

7. The Halo Effect

Have you ever wondered why toothpastes and other dental products are endorsed in advertisements by celebrities more often than dentists? The Halo Effect is one of the reasons!

The Halo Effect shows how one favorable attribute of a person can gain them positive perceptions in other attributes. In the case of product advertisements, attractive celebrities are also perceived as intelligent and knowledgeable of a certain subject matter even though they’re not technically experts.

The Halo Effect originated in a classic study done by Edward Thorndike in the early 1900s. He asked military commanding officers to rate their subordinates based on different qualities, such as physical appearance, leadership, dependability, and intelligence.

The results showed that high ratings of a particular quality influences the ratings of other qualities, producing a halo effect of overall high ratings. The opposite also applied, which means that a negative rating in one quality also correlated to negative ratings in other qualities.

Experiments on the Halo Effect came in various formats as well, supporting Thorndike’s original theory. This phenomenon suggests that our perception of other people’s overall personality is hugely influenced by a quality that we focus on.

8. Cognitive Dissonance

There are experiences in our lives when our beliefs and behaviors do not align with each other and we try to justify them in our minds. This is cognitive dissonance , which was studied in an experiment by Leon Festinger and James Carlsmith back in 1959.

In this experiment, participants had to go through a series of boring and repetitive tasks, such as spending an hour turning pegs in a wooden knob. After completing the tasks, they were then paid either $1 or $20 to tell the next participants that the tasks were extremely fun and enjoyable. Afterwards, participants were asked to rate the experiment. Those who were given $1 rated the experiment as more interesting and fun than those who received $20.

The results showed that those who received a smaller incentive to lie experienced cognitive dissonance — $1 wasn’t enough incentive for that one hour of painstakingly boring activity, so the participants had to justify that they had fun anyway.

Famous Case Studies in Psychology

9. little albert.

In 1920, behaviourist theorists John Watson and Rosalie Rayner experimented on a 9-month-old baby to test the effects of classical conditioning in instilling fear in humans.

This was such a controversial study that it gained popularity in psychology textbooks and syllabi because it is a classic example of unethical research studies done in the name of science.

In one of the experiments, Little Albert was presented with a harmless stimulus or object, a white rat, which he wasn’t scared of at first. But every time Little Albert would see the white rat, the researchers would play a scary sound of hammer and steel. After about 6 pairings, Little Albert learned to fear the rat even without the scary sound.

Little Albert developed signs of fear to different objects presented to him through classical conditioning . He even generalized his fear to other stimuli not present in the course of the experiment.

10. Phineas Gage

Phineas Gage is such a celebrity in Psych 101 classes, even though the way he rose to popularity began with a tragic accident. He was a resident of Central Vermont and worked in the construction of a new railway line in the mid-1800s. One day, an explosive went off prematurely, sending a tamping iron straight into his face and through his brain.

Gage survived the accident, fortunately, something that is considered a feat even up to this day. He managed to find a job as a stagecoach after the accident. However, his family and friends reported that his personality changed so much that “he was no longer Gage” (Harlow, 1868).

New evidence on the case of Phineas Gage has since come to light, thanks to modern scientific studies and medical tests. However, there are still plenty of mysteries revolving around his brain damage and subsequent recovery.

11. Anna O.

Anna O., a social worker and feminist of German Jewish descent, was one of the first patients to receive psychoanalytic treatment.

Her real name was Bertha Pappenheim and she inspired much of Sigmund Freud’s works and books on psychoanalytic theory, although they hadn’t met in person. Their connection was through Joseph Breuer, Freud’s mentor when he was still starting his clinical practice.

Anna O. suffered from paralysis, personality changes, hallucinations, and rambling speech, but her doctors could not find the cause. Joseph Breuer was then called to her house for intervention and he performed psychoanalysis, also called the “talking cure”, on her.

Breuer would tell Anna O. to say anything that came to her mind, such as her thoughts, feelings, and childhood experiences. It was noted that her symptoms subsided by talking things out.

However, Breuer later referred Anna O. to the Bellevue Sanatorium, where she recovered and set out to be a renowned writer and advocate of women and children.

12. Patient HM

H.M., or Henry Gustav Molaison, was a severe amnesiac who had been the subject of countless psychological and neurological studies.

Henry was 27 when he underwent brain surgery to cure the epilepsy that he had been experiencing since childhood. In an unfortunate turn of events, he lost his memory because of the surgery and his brain also became unable to store long-term memories.

He was then regarded as someone living solely in the present, forgetting an experience as soon as it happened and only remembering bits and pieces of his past. Over the years, his amnesia and the structure of his brain had helped neuropsychologists learn more about cognitive functions .

Suzanne Corkin, a researcher, writer, and good friend of H.M., recently published a book about his life. Entitled Permanent Present Tense , this book is both a memoir and a case study following the struggles and joys of Henry Gustav Molaison.

13. Chris Sizemore

Chris Sizemore gained celebrity status in the psychology community when she was diagnosed with multiple personality disorder, now known as dissociative identity disorder.

Sizemore has several alter egos, which included Eve Black, Eve White, and Jane. Various papers about her stated that these alter egos were formed as a coping mechanism against the traumatic experiences she underwent in her childhood.

Sizemore said that although she has succeeded in unifying her alter egos into one dominant personality, there were periods in the past experienced by only one of her alter egos. For example, her husband married her Eve White alter ego and not her.

Her story inspired her psychiatrists to write a book about her, entitled The Three Faces of Eve , which was then turned into a 1957 movie of the same title.

14. David Reimer

When David was just 8 months old, he lost his penis because of a botched circumcision operation.

Psychologist John Money then advised Reimer’s parents to raise him as a girl instead, naming him Brenda. His gender reassignment was supported by subsequent surgery and hormonal therapy.

Money described Reimer’s gender reassignment as a success, but problems started to arise as Reimer was growing up. His boyishness was not completely subdued by the hormonal therapy. When he was 14 years old, he learned about the secrets of his past and he underwent gender reassignment to become male again.

Reimer became an advocate for children undergoing the same difficult situation he had been. His life story ended when he was 38 as he took his own life.

15. Kim Peek

Kim Peek was the inspiration behind Rain Man , an Oscar-winning movie about an autistic savant character played by Dustin Hoffman.

The movie was released in 1988, a time when autism wasn’t widely known and acknowledged yet. So it was an eye-opener for many people who watched the film.

In reality, Kim Peek was a non-autistic savant. He was exceptionally intelligent despite the brain abnormalities he was born with. He was like a walking encyclopedia, knowledgeable about travel routes, US zip codes, historical facts, and classical music. He also read and memorized approximately 12,000 books in his lifetime.

This list of experiments and case studies in psychology is just the tip of the iceberg! There are still countless interesting psychology studies that you can explore if you want to learn more about human behavior and dynamics.

You can also conduct your own mini-experiment or participate in a study conducted in your school or neighborhood. Just remember that there are ethical standards to follow so as not to repeat the lasting physical and emotional harm done to Little Albert or the Stanford Prison Experiment participants.

Asch, S. E. (1956). Studies of independence and conformity: I. A minority of one against a unanimous majority. Psychological Monographs: General and Applied, 70 (9), 1–70. https://doi.org/10.1037/h0093718

Bandura, A., Ross, D., & Ross, S. A. (1961). Transmission of aggression through imitation of aggressive models. The Journal of Abnormal and Social Psychology, 63 (3), 575–582. https://doi.org/10.1037/h0045925

Elliott, J., Yale University., WGBH (Television station : Boston, Mass.), & PBS DVD (Firm). (2003). A class divided. New Haven, Conn.: Yale University Films.

Festinger, L., & Carlsmith, J. M. (1959). Cognitive consequences of forced compliance. The Journal of Abnormal and Social Psychology, 58 (2), 203–210. https://doi.org/10.1037/h0041593

Haney, C., Banks, W. C., & Zimbardo, P. G. (1973). A study of prisoners and guards in a simulated prison. Naval Research Review , 30 , 4-17.

Latane, B., & Darley, J. M. (1968). Group inhibition of bystander intervention in emergencies. Journal of Personality and Social Psychology, 10 (3), 215–221. https://doi.org/10.1037/h0026570

Mischel, W. (2014). The Marshmallow Test: Mastering self-control. Little, Brown and Co.

Thorndike, E. (1920) A Constant Error in Psychological Ratings. Journal of Applied Psychology , 4 , 25-29. http://dx.doi.org/10.1037/h0071663

Watson, J. B., & Rayner, R. (1920). Conditioned emotional reactions. Journal of experimental psychology , 3 (1), 1.

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Psychology Case Study Examples

Experiments are often used to help researchers understand how the human mind works. There have been many famous examples in psychology over the years. Some have shown how phenomena like memory and personality work. Others have been disproven over time. Understanding the study design, data, content, and analytical approach of case studies is important to verifying the validity of each study.

In considering case studies, researchers continuously test and reevaluate the conclusions made by past psychologists to continue offering the most up-to-date and effective care to modern clients. Prospective case studies are continually being developed based on previous findings and multiple case studies done in one area can lend credence to the findings. Learning about the famous psychology case studies can help you understand how research continues to shape what psychologists know about the human experience and mind. 

Examples of the most famous case study in psychology

Hundreds of thousands of case studies have been done in psychology, and narrowing a list of the most ground-breaking studies can be challenging. However, the following seven case studies present findings that have defied expectations, achieved positive outcomes for humanity, and launched further research into existing knowledge gaps within the niche.

Phineas Gage

The case of Phineas Gage is perhaps the  most cited study  in psychology. This famous case study showed how different areas of the brain affect personality and cognitive ability. While working as a construction foreman on a railroad, Phineas Gage was involved in an accident in which a rod was pushed through his cheek and brain. He survived, but because of the accident, both his personality and his ability to learn new skills were affected.

Although the case is frequently cited and referenced in psychology, relatively little information about Gage's life before and after the accident is known. Researchers have discovered that the last two decades of his life were spent in his original job, which may have been unlikely to have been possible if the extent of his injuries were as severe as initially believed. Still, his case was a starting point for psychology research on how memory and personality work in the brain, and it is a seminal study for that reason.

Genie the "feral child"

Although an outdated term, "feral children" referred to children raised without human interaction, often due to abuse or neglect. One  famous case study of a neglected child was done with a child known as Genie. She was raised in a single bedroom with little human interaction. She never gained the cognitive ability of an average adult, even though she was found at age 13. Later in life, she regressed and stopped speaking altogether. Her case has been studied extensively by psychologists who want to understand how enculturation affects cognitive development. It's one of many cognitive psychology examples that have had an impact on this field.

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Henry Molaison

The case study  of Henry Molaison has helped psychologists understand memory. It is one of the most famous case studies in neuroscience. Henry Molaison was in a childhood accident that left him with debilitating seizures. Doctors could stop the seizures by removing slivers of his brain's hippocampus, though they did not fully understand what they were doing at the time. As a result, scientists learned how important the hippocampus is to forming long-term memories. After the surgery, Molaison could no longer form long-term memories, and his short-term memory was brief. The case study started further research into memory and the brain.

Jill Price had one of a few documented cases of hyperthymesia, a term for an overactive memory that allowed her to remember such mundane things as what she had for dinner on an average day in August 20th years previously. Her  case study  was used as a jumping-off point to research how memory works and why some people have exceptional memories. 

However, through more research, it was discovered that her overall memory was not exceptional. Rather, she only remembered details of her own life. She was diagnosed with obsessive-compulsive disorder (OCD), with memories being part of her obsession. This case study is still relevant because it has helped modern psychologists understand how mental illness affects memory.

In the John/Joan  case study , a reputable sexologist tested his theory that nurture, not nature, determined gender. The case study has been cited extensively and laid the groundwork for other research into gender identity. However, the case study was not legitimate. In this study, Dr. John Money performed surgery on an infant whose genitals were damaged during circumcision. 

The boy was raised as a girl; however, he never identified as female and eventually underwent gender-affirming surgery as an adult. Because Dr. Money didn't follow up with the patient appropriately and did not report adverse findings, the case study is still often cited as successful.

Anna O. was the pseudonym given to a German woman who was one of the first to undergo psychoanalysis. Her case inspired many of the theories of Freud and other prominent psychologists of the time. It was determined at the time that Anna's symptoms of depression were eliminated through talk therapy. More recently, it has been suggested that Anna O. had another illness, such as epilepsy, from which she may have recovered during the therapy. This  case study is still cited as a reason psychologists believe that psychotherapy, or talk therapy, can be helpful to many patients. 

Victor the "wild boy" of Aveyron

Another study done on a child that had grown up without parents was done with a boy named "Victor" who had been found wandering in the wilderness and was thought to have been living alone for years. The boy could not speak, use the bathroom, or connect with others. However, through the study of his condition, he was able to learn bathroom habits, how to dress, writing, and primary language. Psychologists today speculate that he may have been autistic. 

Ethical concerns for doing a case study

When case studies are flawed through not having enough information or having the wrong information, they can be harmful. Valuable research hours and other resources can be wasted while theories are used for inappropriate treatment. Case studies can therefore cause as much harm as benefit, and psychologists are often careful about how and when they are used.

Those who are not psychologists and are interacting with studies can also practice caution. Psychologists and doctors often disagree on how case studies should be applied. In addition, people without education in psychology may struggle to know whether a case study is built on a faulty premise or misinformation. It can also be possible to generalize case studies to situations they do not apply. If you think a case study might apply to your case or that of a loved one, consider asking a therapist for guidance. 

Case studies are descriptions of real people. The individuals in the studies are studied intensively and often written about in medical journals and textbooks. While some clients may be comfortable being studied for science, others may not have consented due to the inability or lack of consent laws at the time. In addition, some subjects may not have been treated with dignity and respect. 

When considering case study content and findings from psychology, it can be helpful to think of the cases as stories of real individuals. When you strip away the science and look at the case as a whole person in a unique situation, you may get more out of the study than if you look at it as research that proves a theory. 

Therapeutic implications of a case study

Case examples are sometimes used in therapy to determine the best course of treatment. If a typical case study from psychology aligns with your situation, your therapist may use the treatment methods outlined in the study. Psychiatrists and other mental health professionals also use case examples to understand mental illness and its treatment.

Researchers have reviewed the role of case studies in counseling and psychotherapy. In  one study , the authors discussed how reading case studies benefits therapists, providing a conceptual guide for clinical work and an understanding of the theory behind the practice. They also stressed the importance of teaching psychotherapy trainees to do better case study research. They encouraged practitioners to publish more case studies documenting the methods they use in their practice.

How a case study is used in counseling

If you want to meet with a psychologist, counseling may benefit you. Therapists often use theories behind popular case studies and can discuss their implications with you. In addition, you may be able to participate in case studies in your area, as psychologists and psychiatrists often perform clinical trials to understand treatments on a deeper level.

Online therapy can also be beneficial if you cannot find a therapist in your area. Through a platform like BetterHelp , you can get matched with a provider meeting your needs and choose between phone, video, or live chat sessions. When experiencing symptoms of a mental health condition, it can sometimes be hard to leave home for therapy. You can use many online therapy platforms from the comfort and safe space of your own home. 

Therapy is a personal experience; not everyone will go into it seeking the same outcomes. Keeping this in mind may ensure you get the most out of online therapy, regardless of your specific goals. If you're interested in learning more about the effectiveness of online therapy, you can look into various clinical studies that have shown it can be as effective , if not more effective, than in-person options. 

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Case study definition

Case study, a term which some of you may know from the "Case Study of Vanitas" anime and manga, is a thorough examination of a particular subject, such as a person, group, location, occasion, establishment, phenomena, etc. They are most frequently utilized in research of business, medicine, education and social behaviour. There are a different types of case studies that researchers might use:

• Collective case studies

• Descriptive case studies

• Explanatory case studies

• Exploratory case studies

• Instrumental case studies

• Intrinsic case studies

Case studies are usually much more sophisticated and professional than regular essays and courseworks, as they require a lot of verified data, are research-oriented and not necessarily designed to be read by the general public.

How to write a case study?

It very much depends on the topic of your case study, as a medical case study and a coffee business case study have completely different sources, outlines, target demographics, etc. But just for this example, let's outline a coffee roaster case study. Firstly, it's likely going to be a problem-solving case study, like most in the business and economics field are. Here are some tips for these types of case studies:

• Your case scenario should be precisely defined in terms of your unique assessment criteria.

• Determine the primary issues by analyzing the scenario. Think about how they connect to the main ideas and theories in your piece.

• Find and investigate any theories or methods that might be relevant to your case.

• Keep your audience in mind. Exactly who are your stakeholder(s)? If writing a case study on coffee roasters, it's probably gonna be suppliers, landlords, investors, customers, etc.

• Indicate the best solution(s) and how they should be implemented. Make sure your suggestions are grounded in pertinent theories and useful resources, as well as being realistic, practical, and attainable.

• Carefully proofread your case study. Keep in mind these four principles when editing: clarity, honesty, reality and relevance.

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#97675 - INFANCY

• Open access
• Published: 15 April 2024

Complex PTSD symptom clusters and executive function in UK Armed Forces veterans: a cross-sectional study

• Natasha Biscoe   ORCID: orcid.org/0000-0003-3471-6472 1 ,
• Emma New 2 &
• Dominic Murphy   ORCID: orcid.org/0000-0002-9530-2743 1 , 3  

BMC Psychology volume  12 , Article number:  209 ( 2024 ) Cite this article

139 Accesses

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Less is known about complex posttraumatic stress disorder (CPTSD) than postrraumatic stress disorder (PTSD) in military veterans, yet this population may be at greater risk of the former diagnosis. Executive function impairment has been linked to PTSD treatment outcomes. The current study therefore aimed to explore possible associations between each CPTSD symptom cluster and executive function to understand if similar treatment trajectories might be observed with the disorder.

A total of 428 veterans from a national charity responded to a self-report questionnaire which measured CPTSD symptom clusters using the International Trauma Questionnaire, and executive function using the Adult Executive Function Inventory. Single and multiple linear regression models were used to analyse the relationship between CPTSD symptom clusters and executive function, including working memory and inhibition.

Each CPTSD symptom cluster was significantly associated with higher executive function impairment, even after controlling for possible mental health confounding variables. Emotion dysregulation was the CPTSD symptom cluster most strongly associated with executive function impairment.

Conclusions

This is the first study to explore the relationship between executive function and CPTSD symptom clusters. The study builds on previous findings and suggests that executive function could be relevant to CPTSD treatment trajectories, as is the case with PTSD alone. Future research should further explore such clinical implications.

Peer Review reports

Military veterans face a greater risk of experiencing PTSD than the general UK population [ 1 ] and are more likely to meet criteria for Complex PTSD (CPTSD) than PTSD [ 2 ]. PTSD encompasses a set of symptoms which may be experienced following a traumatic event, including hyperarousal, re-experiencing (nightmares, intrusions), cognitive and behavioural avoidance and negative alterations in mood (DSM-V; [ 3 ]). CPTSD was added to the International Classification of Diseases in 2011 [ 4 ] as a distinct disorder. A diagnosis of CPTSD includes experiencing clusters of symptoms that encompass PTSD, as well as symptom clusters referred to as Disturbances in Self-Organisation (DSO), which are: emotion dysregulation, interpersonal difficulties, and negative self-concept, as well as functional impairment connected to both PTSD and DSO symptoms.

CPTSD has been linked with sustained and multiple traumas [ 5 ] as well as interpersonal trauma [ 6 ]. Military veterans appear to be at greater risk of CPTSD than PTSD [ 7 ]. Indeed, CPTSD appears to be more prevalent in UK treatment-seeking veterans than PTSD (with 80% meeting criteria for CPTSD compared to 20% for PTSD; [ 2 , 8 ]. Additionally, proportionally higher treatment dropout rates are reported for veterans with CPTSD [ 9 ]. It is therefore clinically important to understand factors which may be relevant to both PTSD and CPTSD, as interventions may need to be tailored to each disorder respectively.

PTSD and executive function

An association between impairments in executive function (EF), and posttraumatic stress disorder (PTSD) is well-established in the literature (for review see: [ 10 , 11 , 12 ]). EFs are a collection of abilities grouped together for their relevance to planning and executing complex, goal-directed behaviour [ 13 , 14 , 15 ]. There is significant variation in both definitions of the concept and how the construct is operationalised, although the current study follows Miyake and colleagues [ 16 ] as this conceptualisation aligns well with the self-report measure of executive function used in this study. These authors identify cognitive flexibility, working memory and inhibition as core EFs, deficits in all of which may be relevant to PTSD [ 17 , 18 , 19 , 20 , 21 ]. Furthermore, one study has reported that greater inhibitory control is associated with a better improvement in PTSD symptoms following psychological treatment, indicating the possible relevance of EF in PTSD recovery trajectories [ 22 ]. Less is known about whether similar trajectories would be observed in those with CPTSD. However, insight may be drawn from neurocognitive explanations of the observed associations between EF and PTSD.

Neurocognitive models of PTSD and EF

Several meta-analyses of lesion and neuroimaging studies implicate the prefrontal cortex (PFC) as key in supporting EF [ 23 , 24 , 25 ]. The PFC has been theorised as a control centre, mediating between sensory inputs and behavioural outputs via regulation of brain systems central to emotion processing such as the amygdala [ 26 ]. The PFC is also structurally associated with PTSD, as well as the amygdala, hippocampus, and cingulate cortex [ 27 ], with this system key to attaching emotional valence to memories relevant to the fear-based experiences that lead to PTSD [ 19 ].

The shared relevance of these brain systems to both EF and PTSD suggests a neurocognitive explanation for the overlap observed between the two constructs. For example, one neurocognitive model of PTSD posits that PFC (and associated deficits in EF) may be ineffectively regulating hyperarousal of the amygdala in individuals with PTSD when a perceive threat is observed in a safe environment [ 28 , 29 , 30 ]. Furthermore, elevated arousal – a symptom of PTSD – may deplete cognitive resources leading to deficits in EF as attention is focused instead on regulating hyperarousal [ 20 , 31 , 32 , 33 ].

EFs and CPTSD

Neuroimaging studies reinforce this theory and suggest functional connectivity between the PFC and brain regions relevant to emotion regulation are key to supporting EF [ 34 , 35 ]. Emotion dysregulation therefore may be pertinent to the observed overlap between PTSD and EF. Given emotion dysregulation is a DSO symptom of CPTSD, exploring associations between CPTSD and EFs could inform understanding of the disorder and how existing PTSD interventions could be tailored to improve treatment response in veterans seeking treatment for CPTSD. In a study using an adolescent sample, deficits in EFs were associated with greater CPTSD severity [ 36 ]. However, less is known about the relationship between CPTSD and EFs in veteran populations.

The current study

Given the potential relevance of EF to PTSD treatment outcomes in veterans, and the need to further understand CPTSD in this population, the current study explores the relationship between both PTSD and CPTSD and a self-report measure of EF (inhibition and working memory) in a clinical sample of UK veterans. Associations between each PTSD symptom cluster and EFs are separately investigated, including the DSO clusters that encompass CPTSD. In line with previous studies [ 36 ], it is hypothesised that lower executive functioning scores (both working memory and inhibition) will be associated with greater severity of CPTSD symptoms.

This study was approved by [blinded for review].

Participants

Of the veterans seeking treatment UK charity, a 20% random sample was selected to assess whether they met study inclusion criteria: (1) having a valid email address; (2) having provided consent to contact from the research team about studies; (3) had attended one or more appointments (classed as treatment-seeking). In total 989 veterans were emailed with the study link, to which 428/989 responded (43.3% response rate; M age =50.4, SD age =10.9). Participation was voluntary. No differences were found between those who returned completed questionnaires and non-responders [ 2 ]. We determined this by analysing predictors of returning a completed survey, including age, sex and service branch.

Eligible and consenting veterans were emailed the link to a self-report questionnaire hosted on Survey Monkey, which included demographic questions and the measures described below. Responses were collected between August and October 2020 and participants were emailed not more than five times. The questionnaire took approximately 20 min to complete. Full study procedure has been described previously [ 2 ].

The Adult Executive Function Inventory (ADEXI; [ 37 ]), measures EF on a 14-item self-report scale, with responses on a five-point Likert scale ranging from zero (definitely not true) to four (definitely true). Items 1, 2, 5, 7, 8, 9, 11, 12 and 13 comprise the working memory subscale, e.g.: “I have difficulty remembering lengthy instructions” and “when someone asks me to do several things, I sometimes only remember the first or last”. The remaining items make up the inhibition subscale, e.g.: “I have a tendency to do things without first thinking about what could happen” and “I sometimes have difficulty stopping myself from doing something that I like even though someone tells me that it is not allowed”. A higher score on the scale or each of the subscales indicates greater impairment. The ADEXI has good internal consistency and test-retest reliability, but poor convergent validity with neuropsychological tests of EF [ 37 ]. The ADEXI has good internal consistency (α = 0.68–0.72; [ 37 ]).

Symptoms of PTSD and CPTSD were measured using the International Trauma Questionnaire [ 38 ], an 18-item scale with responses on a 5-point Likert scale ranging from zero (not at all) to four (extremely). Two items measure each of the three PTSD symptom clusters: hyperarousal, re-experiencing and avoidance. Two items measure each of the three disturbances in self-organisation (DSO) symptom clusters that comprise CPTSD: negative self-concept, interpersonal relationships and affect dysregulation. Three identical items then measure functional impairment related to the PTSD and DSO symptom clusters respectively. The ITQ has strong psychometric properties [ 39 ]. Possible caseness for PTSD is indicated by a score of two or higher on at least one of each item measuring each PTSD symptom cluster, as well scoring two or higher on one of the three functional impairment items relating to PTSD symptom clusters. Possible caseness for CPTSD is indicated by meeting the criteria for PTSD, as well as scoring two or higher on at least one of the two items for each DSO symptom cluster, and at least a two on one of the functional impairment items relating to DSO symptoms. The ITQ has good internal consistency (α = 0.90; [ 39 ]).

Symptoms of generalised anxiety and depression were measured with the General Health Questionnaire (GHQ-12; [ 40 ]), a 12-item scale where a score of four or higher is indicative of potential caseness for common mental health difficulties (CMDs). The GHQ-9 has good internal consistency (α = 0.72; [ 41 ]).

Somatic symptoms were measured using the Patient Health Questionnaire (PHQ-15; [ 41 ]), a 15-item scale where a score above 15 indicates higher severity of somatic symptoms. The PHQ-15 has good internal consistency (α = 0.80; [ 42 ]).

Symptoms of poor sleep quality were measured using the Sleep Condition Indicator (SCI; [ 43 ]), an eight-item scale where a score below 16 is indicative of a potential insomnia disorder. The SCI has good internal consistency (α = 0.86; [ 44 ]).

Symptoms of difficulties with anger were measured using the Dimensions of Anger Reactions (DAR-5; [ 45 ]), a five-item scale where a score higher than 12 is indicative of possible anger difficulties. The DAR-5 has good internal consistency (α = 0.89–0.90; [ 46 ]).

Symptoms of alcohol misuse were measured using the Alcohol Use Disorders Identification Test (AUDIT; [ 47 ]), a 10-item scale where scores higher than eight and 16 respectively are classified as possible hazardous and harmful alcohol use. The AUDIT has good internal consistency (α = 0.60–0.80; [ 48 ]).

Data analysis

Data were prepared in STATA 13.0 and analysed in SPSS v.26. Continuous variables were ADEXI scores and subscale scores. These were averaged so that comparisons could be made across scores calculated from different numbers of items. All other variables were categorical, divided into case and no case or high severity and lower severity for each health outcome, and no PTSD, PTSD, and CPTSD for the ITQ variable. To understand the relationship between mental health variables, including PTSD and EF, single linear regression models were used with demographic and mental health caseness variables as predictors, and ADEXI and inhibition and working memory subscale scores as outcome variables in separate analyses. This was to understand possible confounding variables for any relationship between PTSD and CPTSD with EF. Multiple linear regression models were then used with PTSD and CPTSD caseness as predictor variables, and ADEXI score, and subscale scores as outcome variables. Those variables which were significant in the single linear regression models were included in the multiple regression models to adjust for possible confounding factors. Single linear regression models explored the relationships between individual PTSD and DSO symptom clusters with EF. ‘Caseness’ for each symptom cluster was calculated as a score of two or higher on at least one of the two items measuring each cluster. The sample met assumptions for multiple linear regression: the data were normally distributed (W = 0.96, p  = 0.23), there was low multicollinearity and there is a linear relationship between the variables used in the regression models. As described in [ 2 ], analyses were restricted to responders only and missing data were not included in the models due to the assumption that data were missing at random. A power analysis was not conducted for the present study as the analysis was exploratory and data were collected through convenience sampling [ 49 ]. In regression analysis, B values below 0.1. between 0.1 and 0.5 and above 0.5 are broadly considered small, medium and high respectively [ 50 ].

Demographic characteristics are described in Table  1 , as well as descriptive statistics for the variables included in regression models.

Single regression models

Single linear regression models for demographic and mental health factors are presented in Table  2 . Being unemployed and having an ethnicity other than white were significantly associated with higher overall EF, inhibition and working memory impairment. Having high somatic symptoms and meeting caseness for probable common mental health difficulties were also associated with higher overall EF, inhibition and working memory impairment. In addition, scores indicating hazardous alcohol use were associated with working memory and inhibition impairment, and sleep disturbances were associated with a higher working memory impairment.

Multiple regression models

Multiple regression models for PTSD adjusted for all other significant variables besides CPTSD caseness observed in the single regression models. The same models were analysed including CPTSD as a predictor and not PTSD caseness. These models are displayed in Table  3 . Across all adjusted models, both PTSD and CPTSD remained significant predictors for EF, inhibition and working memory.

PTSD and DSO symptom clusters

Linear regression models for each of the PTSD and DSO symptom clusters and EF, inhibition and working memory are displayed in Table  4 . In line with our hypothesis, each symptom cluster was significantly associated with EF, as well as inhibition and working memory subscales.

The aim of the current study was to explore the associations between CPTSD symptom clusters and EF in a clinical sample of UK veterans. Both PTSD and CPTSD caseness were significantly associated with greater impairment in inhibition and working memory, in line with our hypothesis. All PTSD symptom clusters, and the DSO symptom clusters which encompass CPTSD, were associated with inhibition and working memory. In particular, the DSO symptom emotion dysregulation was most strongly associated with EF impairment. PTSD encompasses symptoms hyperarousal, re-experiencing and avoidance. CPTSD is a relatively new separate diagnosis which includes PTSD symptoms as well as DSO symptoms: emotion dysregulation, negative self-concept and interpersonal difficulties, as well as functional impairment relating to these domains [ 4 ].

These associations remained after controlling for the following possible confounders, which were also found to be associated with greater EF impairment: employment status, ethnicity, somatisation severity, common mental health disorders, alcohol misuse and for working memory, sleep function. The finding that EF impairment is associated with worse health coheres with previous research, which has observed relationships between EF deficits and both depression [ 51 ] and somatisation disorder [ 52 ]. Additionally, sleep deprivation is consistently associated with impairments in working memory [ 53 , 54 ].

Emotion dysregulation and EF impairment

Our finding that emotion dysregulation was the CPTSD symptom cluster most associated with EF coheres with and builds on neurocognitive models espoused in the literature. Previous research has suggested functional connectivity between the PFC and limbic system is key in the overlap observed between PTSD chronicity, severity, and EF impairment [ 10 , 55 ]. In one study, those with greater functional connectivity in this system - termed the frontal parietal control and limbic network (FPCN) - were observed to have less chronicity of and greater reduction in PTSD symptoms [ 56 ]. The FPCN underlies emotion processing [ 57 ], mind wandering [ 58 ] and is neurally connected with the default mode network (DMN; [ 59 ]), all of which are associated with PTSD [ 60 ]. Moreover, the development of the DMN is particularly sensitive during childhood, with research suggesting its development could be affected by early and prolonged trauma [ 61 , 62 ]. Given these factors are more strongly associated with CPTSD than PTSD [ 5 ], the finding that DSO symptom cluster emotion dysregulation was most related to EF suggests similar neurobiological mechanisms may be involved in CPTSD as those espoused for the overlap between EF and PTSD.

Limitations

A number of limitations to the present study should be noted. Firstly, whilst the self-report measure of EF facilitated the collection of data from a larger sample, it has limited convergent validity with neuropsychological measures of EF [ 37 ]. However, as a self-report measure, the scale has strong psychometric properties [ 37 ] and self-report EF measures are strongly related to functional impairment [ 63 ]. Secondly, the scale does not include items measuring cognitive flexibility, although this would be difficult to capture on a self-report measure. Data were collected during the Covid-19 pandemic, and environmental factors related to restrictive measures at the time could have affected participants’ responses. However, our research suggests veterans’ mental health difficulties remained relatively stable throughout the pandemic. Finally, no causal relationships can be interpreted from the current findings due to the cross-sectional design of the study. However, the observed finding of an association between DSO symptom clusters and EF impairment builds on previous findings of similar association with PTSD clusters and this can inform future research and clinical studies.

Implications for treatment

Taken together, the findings of the present study suggest that CPTSD interventions may – as observed with PTSD treatment outcomes [ 22 ] – result in better symptom improvement in patients who display greater inhibitory control in neuropsychological tests. By separately analysing both PTSD and DSO symptom clusters, the current study has highlighted the potential role of emotion dysregulation in the overlap between EF impairment and PTSD observed in previous studies [ 10 , 11 , 12 ]. Future research might explore whether veterans with better inhibitory control and working memory respond better to CPTSD interventions. For example, Enhanced Skills Training in Affective and Interpersonal Regulation (ESTAIR; [ 64 ]) is a modular CPTSD treatment which sequentially targets each DSO symptom – including emotion dysregulation. Future studies might explore whether building skills in emotion regulation reduces impairment in EF and subsequently improves recovery trajectories.

This was the first study to explore the relationship between EF and CPTSD symptom clusters in a clinical sample of UK Armed Forces veterans. That DSO symptom clusters, in addition to PTSD clusters, were associated with EF builds on previous findings and suggests that CPTSD treatment outcomes could similarly be affected by levels of EF impairment in veteran patients. Future research should explore the clinical implications of these findings further.

Data availability

The datasets analysed during the current study are not publicly available due to patient confidentiality.

Abbreviations

Complex posttraumatic stress disorder

Default mode network

Disturbances in self-organisation

• Executive function

Posttraumatic stress disorder

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Biscoe, N., New, E. & Murphy, D. Complex PTSD symptom clusters and executive function in UK Armed Forces veterans: a cross-sectional study. BMC Psychol 12 , 209 (2024). https://doi.org/10.1186/s40359-024-01713-w

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