Chapter 3 Flashcards
assessment
An assessment is a procedure
through which information is gathered systematically in the evaluation of a condition; this assessment procedure yields information that serves as the basis for a diagnosis.
- A mental health assessment may include interviews with the patient
or the patient’s family, medical testing, psychophysiological or psychological testing, and the completion of self-report scales or other report rating scales
diagnostic systems
A diagnostic system provides a number of criteria for a disorder. If a certain number of these criteria or indications are present, the person is diagnosed as having that particular disorder
reliability
must give the same measurement for a
given thing every time
- needed for a useful diagnostic system
Inter-rater reliability
refers to the extent to which two clinicians agree on the diagnosis of
a particular patient
validity
validity is determined by whether a diagnostic category is able to predict behavioural and psychiatric disorders accurately
Concurrent validity
the ability of a diagnostic category to estimate an individual’s present standing on factors related to the disorder but not themselves part of the
diagnostic criteria
eg. For example, although significant academic underachievement and a downward drift in socioeconomic status are not diagnostic items for schizophrenia, they are clearly found in most people with schizophrenia.
If an assessment of siblings without schizophrenia of people diagnosed with schizophrenia revealed that they had better education and higher income, this would be an indication of
concurrent validity
predictive validity
the ability of a test to predict the
future course of an individual’s development.
atheoretical
that is, they (DSM) moved away from
endorsing any one theory of abnormal psychology, becoming more pragmatic as they moved to more precise behavioural descriptions
polythetic
meaning that an individual could be diagnosed with a certain subset of symptoms without having to meet all criteria. It also introduced a multiaxial requirement
Neurodevelopmental disorders
- attention deficit hyperactive disorder - maladaptive levels of inattention, hyperactivity, or impulsivity, or a combination of these
- intellectual disability - deficits in intellectual and adaptive functioning with impairments in social adjustment, identified at an early age
- autism spectrum disorder - in
which the child shows severe impediments in several areas
of development, including social interactions and communication - learning disorder - in which the person’s functioning in particular academic skill areas is significantly below what is expected based on his or her intelligence
- communications disorder - in which the individual experiences significant difficulty with the reception, expression, or social use of language
- motor skills disorder - the individual
experiences developmental problems with coordination and which include the tic disorders, in which the body moves
repeatedly, quickly, suddenly, and/or uncontrollably
Scizophrenia (psychotic disorder)
marked by severe debilitation in thinking and perception. People with schizophrenia suffer from a state of psychosis, often characterized by delusions (false beliefs, such as believing that people are trying to hurt
them when there is no evidence of this) and hallucinations (false perceptions, such as hearing voices that comment on ongoing activity)
major depressive disorder (mood disorder)
characterized by the occurrence of depressive mood episodes in which a person is extremely sad and discouraged, and displays a marked loss of pleasure in usual activities
people with clinical depression can:
- have severe problems sleeping
- experiencing weight loss or gain
- lack energy to do things
- difficulty concentrating
- feeling worthless, hopeless and suicidal
thought disorder (psychotic disorder)
demonstrated by incoherent speech, loose associations (unconnected pieces of thought), inappropriate affect (such as smiling and laughing while watching an upsetting or violent scene in a movie), and disorganized behaviour (such as public masturbation).
Mania (mood disorder) (mood episode)
in which a person is extremely elated,
more active, and in less need of sleep, and displays flights of somewhat disconnected ideas, grandiosity (an illusion of personal importance), and impairment in functioning
bipolar disorders
mania, and often depression, is exhibited. Moreover, severity of mood disorders can vary. Less severe variants of these mood disorders include Persistent Depressive Disorder (or dysthymia), which is a more chronic low-grade depression, and cyclothymia, in which the person fluctuates between more mild bouts of mania and less severe depressive symptoms
Anxiety
Individuals who suffer from an anxiety disorder experience excessive fear, worry, or apprehension; the excessive fear usually produces a maladaptive pattern of avoidance
phobia
A person can have an intense fear
of a specific object or situation, which is referred to as a phobia. . Some individuals have an extreme fear of social situations (social phobia); experience panic attacks and fear that they will go crazy, have a heart attack, or die (panic disorder); or have difficulty controlling excessive worry (generalized anxiety disorder).
Obsessive Compulsive Disorder
characterized by obsessions
(recurrent, unwanted, and intrusive thoughts) and compulsions
(strongly repetitive behaviours), which, when not performed, cause overwhelming distress.
body dysmorphic disorder
overly preoccupied with an imagined defect in their appearance.
acute stress disorder and post traumatic stress disorder
Individuals may also experience long-standing anxiety subsequent to extraordinarily traumatic events
dissociative amnesia
may forget their entire past or, more selectively, lose their memory for a particular time period and may suddenly and unexpectedly leave their
home and travel to a new locale, start a new life, and forget their previous identity
dissociative identity disorder
possess two or more distinct personality states, each
with unique memories, behaviour patterns, preferences,
and social relationships
Depersonalization/derealization disorder
involves a severe and disruptive feeling of self-estrangement or unreality
Somatic symptom disorder
characterized by the experience
of one or more persistent physical symptoms accompanied
by excessive thoughts, feelings, or behaviours related to the
symptom(s)
conversion disorder
the person reports the loss of
motor or sensory function, for example, a paralysis or blindness.
Illness anxiety disorder
involves extreme anxiety about health in the absence of somatic symptoms; individuals become preoccupied with the fear that they have a serious illness
Factitious disorders
diagnosed when individuals intentionally produce or complain of either physical or psychological symptoms, due to a psychological need to assume the role of a sick person.
Eating disorders
characterized by disturbances in eating behaviour. This can mean eating too much, not eating enough, or eating in an extremely unhealthy manner
anorexia nervosa
a, the individual refuses to maintain a
minimally normal weight for her or his age and height. Such people avoid eating and become emaciated, often due to an intense fear of becoming fat.
bulemia nervosa
frequent episodes of binge eating coupled with compensatory activities such as self-induced vomiting or the use of laxatives.
binge-eating disorder
there are frequent episodes of eating large amounts of food in a discrete period of time.
elimination disorders
These disorders are usually diagnosed in childhood or adolescence. Enuresis involves the repeated voiding of urine in inappropriate places, and encopresis is the repeated passage of feces in inappropriate places. Both can occur voluntarily or involuntarily.
sleep-wake disorders
insomnia (not getting enough sleep)
hypersomnolence (excessive sleepiness)
narcolepsy (suddenly lapsing into sleep)
breathing-related sleep disorders (disorders relating to the amount, quality and timing of sleep)
Parasomnias (abnormal behaviour or physiological events that occur
during the process of sleep or sleep–wake transitions eg. sleepwalking)
Sexual disorders
sexual dysfunction - characterised by disturbance in sexual desire or in the psychophysiological changes that accompany the sexual response cycle.
paraphilic disorders - characterized by sexual urges, fantasies, or behaviours that involve unusual objects or activities, such as exhibitionism, voyeurism, sadism, and masochism; and that cause significant distress or impairment
gender dysphoria - feel extreme and overwhelming distress associated with their anatomical sex and an incongruity between their biological sex and expressed gender.
disruptive, impulse-control and conduct disorders
This category involves disorders characterized by failure or extreme difficulty in controlling impulses, despite the negative consequences
- intermittent explosive disorder, the person has episodes of violent behaviour that result in the destruction of property or injury to others
- oppositional defiant disorder, there is a recurrent pattern of negativistic, defiant, disobedient, and hostile behaviour toward authority figures
- conduct disorder, children persistently violate societal norms, rules, or the basic rights of others.
- trichotillomania experience intense urges to pull out their own hair
substance related and addictive disorders
These disorders are brought about by the excessive use of a substance, which can be defined as anything that is ingested in order to produce a high, alter one’s senses, or otherwise
affect functioning.
Neurocognitive disorders
The Neurocognitive Disorders refer to conditions in which there is a decline in cognitive functioning
- delirium - clouding of consciousness
personality disorders
characterized by an enduring, pervasive, inflexible, and maladaptive pattern of behaviour that has existed since adolescence or early
adulthood, markedly impairs functioning, and/or causes
subjective stress
categorical approach
an individual is deemed to either have a disorder or not have a disorder, with no in-between
historical reason - this is also done by physicians for physical problems
dimensional approach
based on a continuum for mental disorders from non-existent or
mild to severe
Clinical utility
the extent to which a diagnostic system assists clinicians in performing functions such as communicating clinical information to patients, their families, and other health care providers; selecting effective interventions; and predicting the course
of a disorder
against classification: medical model
A substantial number of professionals
argue that the whole diagnostic endeavour is flawed because
of its adherence to the medical model.
- Medical disorders are legitimate, they argue, because they have a clear indication, such as a lesion, that serves as a recognizable deviation in anatomical structure, whereas most mental disorders involve no such anatomical deviations
against classification: stigmatization
Another argument against diagnosis is
that it unfairly stigmatizes individuals
against classification: loss of information
A frequent charge against diagnosis is that inherent in any label is a loss of information
- an individual with depression is characterized by many other
qualities, not just her or his depression. The label alone can give us a false sense of confidence in understanding the person and making assumptions about his or her personhood
and life that are not valid.
