Chapter 3 - Classification and Assessment of Mental Disorders Flashcards
What characterizes a mental disorder?
- 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.
Why classify mental disorders?
- To make sense of things
- To assist in treatment decisions
- To organize the search for new knowledge
What are some of the major features of the DSM-5?
- 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
What are provisional diagnoses?
- Potential diagnoses that can be helpful, but not completely supported by science
What were some of the major innovations of the DSM-5 (2013)?
- 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
What were some of the major innovations of the DSM-5-TR (2022)?
- Addition of prolonged grief disorder
- Includes info from most recent literature
WHat does a DSM-5 diagnosis look like?
- 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)
What characterizes the syndrome of mental disorders?
- 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
Inter-rater reliability vs. test-retest reliability?
- 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
What’s internal consistency?
- When you’re measuring what you claim to be measuring
Concurrent validity vs. predictive validity?
- Concurrent - whether the symptoms match the actual disorder
- Predictive - the extent to which a diagnostic category will predict outcomes
Criterion validity vs. face validity?
- 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?
What’s construct validity?
- How well the tests measure what they’re supposed to
What are some major criticisms of the DSM-5?
- 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
What’s dimensional classification?
- 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)
What are the three major goals of psychological assessment?
1) Making predictions
2) Planning interventions
3) Evaluating interventions
What are the six major forms of gathering info on a patient’s personality?
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
What are some of the most common personality tests?
- 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
What are the different types of projective tests?
- 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
Statistical significance vs. Clinical significance?
- Statistical significance - determined by alpha levels and effect sizes
- Clinical - how well does it improve the person’s well-being?
What are normative comparisons?
- Help determine whether or not a person has a mental disorder
- Look at how many standard deviations they are from the mean
What does the term prognosis refer to?
- Future development or maintenance of symptoms
T/F: Neurodevelopmental disorders typically begin before maturity.
- TRUE
- These can include ADHD, intellectual disability, ASD, learning disorders, communication disorders, motor skill disorders, tic disorders
T/F: Hoarding disorder is not new to the DSM-5.
- FALSE, it is new
