Ab Week 4 Flashcards
The labeling model
- Abnormality depends on context.
2. Effects what you and others do who label you.
Dsm v article
Dsm v lowers prevalence slightly of autism. Definition changed again, unlikely to influence trend up. Minor results for geo’s and controls.
Can’t rely on individual, poor introspection. Study. Of feedback
And felt good or better, payed attention to them. Frequency increased. Bad decreEzed. Positive conditioning, B So who's healthy or sicker? Depends on definition, Problem with personal labeling Statistical labeling, way from norm. Abnormal intellectual functioning. Iq, treat either end differently,
Statistical labeling problems
Not always normal.
Definitions and predictability
Poor procedures
Consequences of labeling
Patients and others effected.
Those labeled, spend longer in hospital, less likely to seek help or help themselves. Profound detrimental effects of labeling. Abnormal transiet, label is permanent.
Blind, partially sighted. Do better,
Why label?
Comfort, think we understand
Scientific reasons: description, prediction, measurement control
Related to validity: do something about it very particularly
Rio to clinically label
1 High reliability in label use, different dr same results. R should be .90 but do not come close
- Advantage must exceed disadvantages, cost benefit analysis.
Cancer cost not diagnosing quite high,
Has to be done for all interventions. Not just side effects.
Diagnostically
Account for the lawfulness of the behaviour, the WHY it is happening being done
Account for the label,
Labeling means. Classification.
Is classification an imperialistic, control freak of dsm
Repackaging human sorrow, with billable disease,
Answer is it is both
The psychiatrist bible
Now since 2013, dsm v
Should have red ink, not to be taken literally.
“Billable bible”
Definition of a mental disorder
- Clinically significant disturbance which mens
Drawn to attention of a physician,
Conseq of syndrome,
Note: majority are not treated! Uh oh
Therfore, shows that we control the problem, - A syndrome
Collection of things, series add to problem.
Physical and operational definitions. Therefore can be used. - Dysfunction
Problem IN the individual def. circular reasoning, what is dysfunction in individual. How do you know. - Significant distress
Almost all have distress, has to have consequences -ve effect life, personal, interaction,occupation etc, - Death loved one not mental disorder, grief. 2 weeks limit, from 2 months. Jeeze child grief is years!
- Not socielral Deviant behViour, not disorder, unless dysfunction in individual
Due to the simple illness model
Mental health vs legal business but heads.
History of dsm
Classifications not new, Composition of fluids phlegm, Dsm 1 Myers, Ppl reacting to stress more vulnerable Ditch dsm 1. In favor of psychoanalysis. Iii physical and operational.
Why develop new dsm?
1. Tmi Change warranted Problems with the system Reliability Competition with who Tried to harmonize the two in dsm v Extend role of psychiTry, problems living, to billable hours More disorders created, natural behaviour called mental illness.
Shifted disorder
Disrupted mood, temper tantrum disorder now!
How to develop dsm
Trustees, chair person and guiding comittee sub comittee, assigned each chapter heading, meets extensively, make proposed changed, reviewed task force, edit, board can change, sent to other groups. Draft 25 000 comments, filed tests, reliVility, newsletter,reviewed, published.
Dsm IV 5 million
Dsm v 25 million dollar cost
Issues of c of I , x = 69% financial ties to pharmaceutical industry
Committees psychiTry and big pharma, rgue same thing
Pms is now a mental illness
There because see, Eli Lilly drug company Prozac off patent,
Seraphin, for pmdd, is Prozac! Needs a disorder, drug salesman smust sell for a specific drug to specific disorder.
Many drugs used off label.
Dsm theories are
Unreliable, untestable. now just dealing with behaviours.
So dsm, more strict, multimodel approach. WITH HISTORY.
Not a list of other things!
Try to achieve gate reliability.
But what about field studies, well they sucked. For dsm v
Studies probably bad, hopefully. But could be dsm is bad.
To get reliability
Increase specificity, checklist
Training affects reliability
Differs geographically
Amount of information: normal curve, success info, optimal curve
Specific as possible but
100% coverage needed! impossible to have excellent reliability.
Need term for every patient, so they get paid!
Need nos, garbage can category.
Added mild category , remove nos.
Serve two competing goals, no good if scientific, if need word for every disorder that exists. Omg.
Bipolar article
Emotions issues, positive emotions and sensitive to rewards. Shown in neuroscience.
Less white matter and grey matter, difficult emotional regulation. Expressin.
Resting state changes dependant on mood, ?
We want high eeliability so we
Make things more specific, but system serves reliability and coverage, 100% coverage!
Then need categories loose and by definition unrealiabel.
Psychologists often use
Unreliable diagnoses, rather than the reliable specific disease.
Borderline personality disorder
Reliability, .55, 20% of diagnoses though.
Multi axial assessment
OUT of dsm v! Gone that is.
Required Clinical diagnosis, Personality General medical conditions Psychosocial and environmental problems Global assessment functioning: scale of severity of problems.
Omg almost holistic approach.
Depression need medication and therpay to prevent relapse,
Example of impotence guy medication. Need simple q’s
Lack of reliability and what has been found
Does not reflect dsm
Problem with genetic biological things,
Symptoms sets differ. Behaviours. Biology overlapse.
Rdoc guiding prinicples
Ts a DIMENSIONAL SYSTEM from normal to abnormal so on a continuum.
- Agnostic about dsm,
- Different units of analysis are used, holstic multifunctional interaction all system.
See human behaviour as
Negative positive valence systems,
Socail process,
Perception self other
Arousal systems, regulatory systems,
EDPC idealistic
Costly, we’ll see
Names are browsed not found,
Nosology precedes,
Walling quote
To classify and diagnose, u need a method.
Methods of evaluation
Interview,
rating scales
Psychological tests
Biological methods.
Interview (diagnostic)
Differ from helping rela interview
Most used,
Least reliability, and validity
3 stages,
exploration, understanding, action no?
Well…
note judge ppl in milliseconds, another limitation of interview
Rapport, Data collection stage, Attend to what, room for error, continuum directiveness. Hypothesis testing. Testing ideas Refferal letter influences
Treatment you get depends wha door you walk through. Biased. !
Prescription things underlying 1/3 don’t fill , 1/3 fill barely use, 1/3 use
Rapport building!
Aggressive male seen as
Situational disturbance,
Whereas passive male more likely told depressed or psychotic
For wormen, more likely depressed, but bod and psychotic happen for 1/4 each.
Different treatments though!
Rating scales
Line,
Ex. hemmelton rating scale for depression often used.
Really a structured interview and lots of errors,
Error of leniency, non normal distributed
Error central tendency.
Halo effect, context imp.
Quantify difficul to measure things, meanings unclear
Psychological tests
Long histroy
What is a good test (MEASURE
Reliable, valid, applicable
Reliability
Respeatability,
Problem is learning set,
Equivalent form
^split half, ordered difficulty. Correlate odds with evens,
Internal consistancy.
Error in reliability
Subjects
Tester
Situation
Article on performance and self image
CorrelTe low at .3
Depends on tasks, more accurate for more specific ones.
