Ch 3: Classification and Diagnosis Flashcards
Why is classification/categorization useful? Who did it begin with?
- important in all science and social science
- helps us manage complexities of life by organizing phenomena into patterns
- attempts to classify and diagnose abnormal human behaviour started with Kraepelin
What is validity and utility?
- validity: does the classification scheme capture the nature of the entity
- utility: how useful is the classification scheme
What are the purposes of a diagnostic Classification System?
- reflects current scientific knowledge
- common language
- info on etiology, comorbidity and prognosis
- guidance on treatment
- key terms for searching literature
- eligibility for costs of services
What are the drawbacks of diagnostic systems?
- stigmatization
- misdiagnoses
- prototype model (people may differ and require different treatments)
- questionable inter-rater reliability
- overdiagnosis
How do we define normal and abnormal behaviour?
- study of the range of normal behaviour
- anything that falls outside of norm, is likely causing difficulties
What factors must be considered when looking at norms?
- developmental phase
- culture
- prevailing norms (slavery, domestic violence, sexual orientation)
What is the Developmental Psychopathology approach?
- examines problem behaviours in relation to developmental tasks specific to each stage of development
- assumes that biological and psychological systems are constantly changing
How are mental disorders diagnosed? How does this compare to physical disorders?
- based on cluster of symptoms
- etiology less clear than physical disorders
- no clear physical markers
- diagnosis relies on observation of symptoms
How does the DSM-5 outline the core components of mental disorder?
- clinically significant disturbance in cognition, emotion regulation or behaviour
- dysfunction in psychological, biological or developmental processses
- significant distress or disability
What is harmful dysfunction?
- behaviours associated with a mental disorder cause harm to the individual or those around them
What is dyscontrol?
- suggested component of mental disorder definition that posits impairment resulting from a disorder must be involuntary or not readily controlled
- related to the law and if someone is not criminally responsible
- behaviours or distress is out of clients control
What can increase vulnerability to mental disorders?
- biological vulnerability
- exposure to stressors
- absence of or disruption of protective factors
- none of these alone ‘cause’ mental disorders but increase the risk altogether
How do developmental periods and vulnerability interact?
- the incidence of certain disorders rise during certain developmental periods
- ex. depressive symptoms are highest in young adulthood and older adulthood
What has been found in research on vulnerability following disaster?
- majority of people do not develop PTSD
- those with pre-existing disorders are at the greatest risk
- resilience is the norm
What are the two basic approaches to classification schemes?
- categorical: have or do not have diagnosis, traditional approach, DSM-5
- dimensional: spectrum, common in assessing children, ASEBA, can compare before and after treatment
How does the ASEBA work?
- if below dashed lines: functioning at normal range
- between: at higher risk
- cue us or allow us to administer more measures to come up with a possible diagnosis
What characterizes DSM-1?
- largely psychodynamic
- limited impact on treament because only one type commonly available
What characterizes DSM-2?
- more precision
- greater choice among treatments
What characterizes DSM-3?
- atheoretical (not tied to a specific type of theory)
- behavioural descriptors
- focus on inter-rater reliability (consistency)
- described as changing the entire focus of the mental health field
What characterizes DSM-4?
- scientifically informed via work groups (health professionals doing research on specific disorder) and literature reviews
What characterizes DSM-5?
- expanded
- consultation (1 psychologist in work groups)
- unprecedented criticism
- categorical in diagnosis
- dimensional in organization (prevalence, course, familial pattern)
Why was the DSM-5 heavily criticized?
- lack of openness and transparency
- growth in new disorders planned for inclusion
- over-representation of biological views
- 70% of task force members with links to pharmaceutical companies
- poor reliability of diagnoses (no-better-than-chance)
- Saving normal: about how normal people are diagnosed and given medication
What is the ICD?
- by the World Health Organization
- covers all health conditions, including mental and behavioural disorders
- good compatibility with DSM-5
- 42 languages
- free on-line
What are the challenges with diagnosis?
- keeping up with science
- medicalization
- inadequate reliability and validity
- polythetic nature of disorders (people with same diagnosis and different symptoms)
- dimensional may be more useful than categorical
- comorbidity
