96. Classification/Diagnosis

Question 1

Mental Disorder: 5 principles

Answer 1

1. behavioral/psychological syndrome/pattern within individual
2. causing clinically significant distress/impairment
3. NOT just expectable response to stressor
4. reflects underlying psych DYSFX
5. NOT result of social deviance/conflicts with society

Question 2

What are the two key purposes of Psych Dx

Answer 2

1. Clinical Utility: communication b/w pt and dr, tx choice, predict outcome, classify
2. Research Facilitation: communication b/w scientists, pathology elucidation, discovering tx

Question 3

What is the difference between reliability and validity?

Answer 3

Reliability: 2 psychiatrists make SAME dx - dx criteria is CONSISTENT (necessary but not sufficient for validity)

Validity: agreement between diff psychiatrists, same pt at diff times (test-retest), and longitudinal (for chronic validity); tests for sensitivity and specificity
achieved by:
1. Clinical Description
2. Delimitation from other disorders
3. Follow-up Study (tx response)
4. Family Study
5. Lab Study

Question 4

What is the difference between categorical dx and dimensional dx

Answer 4

Categorical: sets of rules/criteria, glossary of descriptions, Y/N answers, less gray area: zones of rarity with discrete clustering

Dimensional: ratings on a variety of dimensions/scales, cut off points, “how severe? How many?”, less extremes, more blurring/less discrete

Question 5

What was the main difference between DSM II and DSM III?

Answer 5

shift to atheoretical and polythetical

• no etiological considerations
• many characteristics and pts do not need to meet all of them
• emphasized reliability of dx