6. Classification and Assessment Flashcards
What is the taxonomic approach?
A way of classifying disorders.
There is a higher order category, with more specific disorders within it.
What do classification systems help us do?
Help us understand things related to each other.
Help us understand things different to each other.
Why do we classify psychological disorders?
- understand causes
- identify most appropriate treatment
- determine effectiveness of treatment
- practical consequences e.g are they fit to stand trial?
What are the 4 objectives of classification systems?
- provide diagnostic criteria for correct differential diagnosis
- allow distinction between psychopathology and non-disordered problems in living
- generalisability: provide by different clinicians
- theoretically neutral: just explain symptoms
How many categories of mental disorders are there in DSM 5?
19
How does the ICD vary to the DSM 5?
- much broader: also includes physical diseases
- much older
What are 5 problems with classification approaches?
- describes symptoms instead of causes
- labels can be stigmatising
- categorical: however severity can be quantified
- broad categories: homogeneity of sufferers
- disorders are distinct however comorbidity is the norm
What are 4 specific criticisms of DSM 5?
- proliferation of disorders with each revision (always more)
- gradual lowering of thresholds which leads to things such as over prescription due to more diagnoses
- disproportionally influenced by biological models when supposed to be theoretically neutral
- most disorders are dimensional: continuum is not acknowledged
What are the three goals of assessment?
- what problems does the person have?
- which psychological disorder(s) does the person have?
- did the treatment work?
What are the methods of assessment?
- clinical interviews
- clinical observation
- psychological tests: IQ, questionnaires, projective tests
- biologically based assessments: neuroimaging
What 2 methods are usually used in assessment?
subjective methods:
- clinical interviews
- clinical observation
by clinician
How is reliability measured?
- test-retest reliability
- inter-rater reliability
- internal consistency: self report is answered consistently
How is validity measured?
- concurrent validity
- face validity
- predictive validity
- construct validity
What is concurrent validity?
measure of how highly correlated scores of one assessment are with another
What is predictive validity?
the degree to which an assessment method is able to help the clinician predict future behaviour and or symptoms
Explain clinical interviews
structured = gold standard
- predetermined questions
- response to one question determines the next
- higher inter-rater reliability for many disorders: diagnoses are highly correlated
What are the limitations of clinical interviews?
- if unstructured, reliability is low
- some disorders are characterised by poor self awareness therefore no insight to report
- some clients may intentionally mislead
- interviewers are prone to biases e.g primacy effect
Explain clinical observation
systematic and structured
e.g in a school observer could use ABC chart to identify
What are the uses and advantages of clinical observation?
- can capture frequency of target behaviours
- better ecological validity than self report
- can identify practical treatment options
What are the disadvantages of clinical observation?
- time consuming
- observer needs lots of training
- observations often limited to one context
- presence of observer may influence behaviour
- inter-observer reliability can be poor unless both are intensely trained
How are self report questionnaires used in diagnosing disorders?
e.g personality test
- assess specific characteristic/trait
- not open ended questions, can be scored objectively
- statistical norms can be established
What are limitations of self report questionnaires?
- time consuming
- can be faked: however some have lie scales
What are examples of projective tests?
- rorschach inkblot test
- thematic appreciation test
- sentence completion task
What are the issues with projective tests?
low inter-rater reliability and validity due to lack of structure
What are issues with intelligence tests?
- what are we actually measuring?: hypothetical constructs
- culturally biased
- don’t capture other types of intelligence e.g emotional
What are strengths of intelligence tests?
- standardised
- high internal consistency, test-retest reliability and predictive validity
What are examples of psychophysiology assessments?
- skin conductance: electrodermal responding
- electromyogram (muscle activity)
- ECG (heart activity)
- EEG (brain activity)
- neuroimaging e.g fMRI
What are the issues with neuroimaging such as fMRI and PET scans?
major differences between individuals so cannot be used for things such as Sz
- however can be used for neurodegenerative disorders e.g dementia
What are the cultural biases in assessment?
- most are tested and validated on white European/Amerian ppl
- in the USA differential rates of diagnosis in different ethnic groups
- Carribean immigrants in UK in 1970s more likely to be dignosed with Sz due to norms
How can cultural bias in assessment be explained?
- symptoms manifest differently in varying cultures
- language differences between client and clinician
- cultural and religious differences in expression and perception of MH issues
- client and clinician relationships are hierarchal
- cultural stereotypes
What is case formulation?
Clinicians gather info about patient-draw up a psychological explanation of clients problem.
Then, develop a unique plan for therapy.
Individualised approach.
What are the strentghs of case formulation?
- no need for diagnosis therefore reduced stigma
- collaborative: gives client input
- client is seen as unique: not a label
- based on theoretical understanding of the causes and consequences of a disorder
