Chapter 3 - Classification and Diagnosis

Question 1

Functions of a Good Classification System

Answer 1

Organization of clinical information

Shorthand communication

Prediction of natural development

Treatment recommendations

Heuristic value
Build theories and test relationships

Guidelines for financial support

Question 2

DSM-I and DSM-II

Answer 2

Theoretically driven

106 disorders

Question 3

DSM-III

Answer 3

Emphasis on empirical research to improve reliability

Atheoretical – more precise behavioural descriptions

Operationally define symptoms

Polythetic and multiaxial

Question 4

DSM-IV

Answer 4

Multiaxial system
Axis I: clinical disorder
Axis II: personality disorder
Axis III: medical conditions
Axis IV: psychosocial and environmental factors
Axis V: global assessment of functioning

Question 5

DSM-5

Answer 5

New empirical evidence

300+ disorders, 22 categories

Criticism: categorical approach

Question 6

DSM-5-TR

Answer 6

Text revision – changes to text accompanying description of disorder
Creation, revisions, eliminations

Based on updates to scientific literature

Racism and discrimination taken into account

Question 7

Criticisms of Classification Systems

Answer 7

Adherence to medical model flawed
Argument: medical disorders clear indication, mental disorders do not
Rebuttal: many medical disorders do not have clear causes either

Diagnosis stigmatizes individual
Argument: labels impact social and occupational aspects, discourages seeking help
Rebuttal: people more than their disorders

Unreliable diagnosis
Rebuttal: interrater reliability

Invalid diagnosis
Rebuttal: concurrent validity

Categorical diagnosis leads to loss of information
Patients report knowing disorder name helpful
Use of labels in educated manner

Question 8

Main Issues of DSM-5

Answer 8

Polythetic – various combinations of symptoms, rare to have necessary/sufficient criterion

Comorbidity – presence of more than one disorder

Gender bias

Cultural bias