Chapter 3 - Classification and Assessment of Mental Disorders

Question 1

What characterizes a mental disorder?

Answer 1

• The identification of a disorder depends on the presence of symptoms
• Symptoms are not directly observable
• Signs are directly observable, like those found in an x-ray.

Question 2

Why classify mental disorders?

Answer 2

• To make sense of things
• To assist in treatment decisions
• To organize the search for new knowledge

Question 3

What are some of the major features of the DSM-5?

Answer 3

• Tries to keep classification very atheoretical
• Divided into three sections: (intro, broad categories of mental disorders, and emerging measures and models)
• Harmonization with the ICD system
• Contains provisional diagnoses

Question 4

What are provisional diagnoses?

Answer 4

• Potential diagnoses that can be helpful, but not completely supported by science

Question 5

What were some of the major innovations of the DSM-5 (2013)?

Answer 5

• Addition of some disorders
• More alignment with ICD system
• More recognition of age, gender, and culture
• Spectrum and non-spectrum disorders
• Emphasis on clinical utility

Question 6

What were some of the major innovations of the DSM-5-TR (2022)?

Answer 6

• Addition of prolonged grief disorder
• Includes info from most recent literature

Question 7

WHat does a DSM-5 diagnosis look like?

Answer 7

• Most severe disorder (medical or mental) is listed first
• When there are multiple diagnoses, other diagnoses follow in order of severity and/or implications for quality of life and functioning
• Psychosocial, cultural, and other issues follow as comments (ex. experienced divorced 3 months ago)

Question 8

What characterizes the syndrome of mental disorders?

Answer 8

• Syndromes = collection of symptoms
  1) Contains a specific symptom cluster
  2) Exclusion criteria (i.e., behaviour cannot be attributed to medications, drugs, or a medical condition)
  3) Duration (ex. acute stress disorder vs. PTSD)
  4) A certain level of distress
  5) A level of etiology
  6) A statistical deviation
  7) A level of dysfunction
  8) The chemistry involved

Question 9

Inter-rater reliability vs. test-retest reliability?

Answer 9

• Inter-rater reliability - multiple clinicians come to the same conclusion/results from a single patient
• Test-retest reliability - Psychological tests/evaluations should provide the same results when administered repeatedly to the same patient, or else they aren’t reliable

Question 10

What’s internal consistency?

Answer 10

• When you’re measuring what you claim to be measuring

Question 11

Concurrent validity vs. predictive validity?

Answer 11

• Concurrent - whether the symptoms match the actual disorder
• Predictive - the extent to which a diagnostic category will predict outcomes

Question 12

Criterion validity vs. face validity?

Answer 12

• Criterion - How accurately does the test allow for the prediction of outcomes it’s supposed to show?
• Face - Does the psychological test look effective? Does it make sense?

Question 13

What’s construct validity?

Answer 13

• How well the tests measure what they’re supposed to

Question 14

What are some major criticisms of the DSM-5?

Answer 14

• Some definitions or criteria for disorders are not uniformly based
• The categories are severely criticized
• Number of symptoms needed to diagnose a disorder is often poorly justified (determined by committee)
• Time periods can also seem arbitrary
• Inter-rater reliability appears inconsistent

Question 15

What’s dimensional classification?

Answer 15

• A potentially alternative way of diagnosing mental disorders
• Based on quantitative deviations from health norms
• Developed because there is very high comorbidity found among different categories of mental disorders, potentially the result of too much splitting (another criticism of the DSM-5)

Question 16

What are the three major goals of psychological assessment?

Answer 16

1) Making predictions
2) Planning interventions
3) Evaluating interventions

Question 17

What are the six major forms of gathering info on a patient’s personality?

Answer 17

1) The psychological interview (structured, semi-structured, or non-structured)
2) Peer and significant other’s reports
3) Behavioural observation (may be good for kids)
4) Cognitive and neuropsychological testing
5) Personality tests
6) Projective tests

Question 18

What are some of the most common personality tests?

Answer 18

• The Minnesota Multiphasic Inventory (MMPI-3) - based on a contrasted-groups method, raw scores converted into standardized scores
• Millon Clinical Multiaxial Inventory (MCMI) - T/F items
• Personality Assessment Inventory - Uses a 4-point Likert scale

Question 19

What are the different types of projective tests?

Answer 19

• The Rorschach Inkblot test - Patients associate images in their head to what they see in the inkblots, developed during the 1920s
• Thematic Apperception Test, TAT - Psychologist chooses among 30 ambiguous paintings. Goal is to have the patient depict a story from the painting.
• Completion of sentences or stories - around 50 format sentences, want filled-in info to be from past experiences
• Free expression - best used with kids and adolescents, usually accompanied by a code to understand/interpret the images

Question 20

Statistical significance vs. Clinical significance?

Answer 20

• Statistical significance - determined by alpha levels and effect sizes
• Clinical - how well does it improve the person’s well-being?

Question 21

What are normative comparisons?

Answer 21

• Help determine whether or not a person has a mental disorder
• Look at how many standard deviations they are from the mean

Question 22

What does the term prognosis refer to?

Answer 22

• Future development or maintenance of symptoms

Question 23

T/F: Neurodevelopmental disorders typically begin before maturity.

Answer 23

• TRUE
• These can include ADHD, intellectual disability, ASD, learning disorders, communication disorders, motor skill disorders, tic disorders

Question 24

T/F: Hoarding disorder is not new to the DSM-5.

Answer 24

• FALSE, it is new

Question 25

What’s a major criticism that has been made against intelligence testing?

Answer 25

• It often depends on the culture since many of the tests are based on academic achievement, which can be very cultural

Question 26

T/F: Mental disorders represent the leading cause of disability in Canada and are associated with premature death.

Answer 26

• TRUE