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PSY240 > Chapter 3: Classification & Diagnosis > Flashcards

Chapter 3: Classification & Diagnosis Flashcards

1
Q

Why do we need a classification system for mental disorders?

A
  • common vocabulary for professionals
  • provides information that is necessary when making decisions about treatment
  • needed to conduct research on disorders and treatment
  • need diagnostic systems in order to estimate the prevalence of disorders in the population
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2
Q

What is an assessment?

A
  • procedure through which information is gathered systematically in the evaluation of a condition
  • yields information that serves as the basis for a diagnosis
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3
Q

What would be the perfect diagnostic system?

A

Classify disorders on the basis of:

  • presenting symptoms (pattern of behaviours)
  • etiology (history of the development of the symptoms and underlying causes)
  • prognosis
  • response to treatment
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4
Q

What are syndromes?

A
  • set of symptoms representing the observable manifestation of an underlying disorder
  • patient will not manifest all symptoms associated with any given syndrome
  • may be overlap
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5
Q

What is reliability?

A
  • consistency in which measurement is given
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6
Q

What is inter-rater reliability?

A
  • extent to which two clinicians agree on the diagnosis of a particular patient
  • affected mainly by the inadequacy of the diagnostic system itself rather than personal differences between clinicians
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7
Q

What is diagnostic validity?

A
  • whether a diagnostic category is able to predict behavioural and psychiatric disorders accurately
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8
Q

What is concurrent validity?

A
  • ability of a diagnostic category to estimate an individual’s present standing on factors related to the disorder but not part of the criteria
  • i.e., academic underachievement and downward drift in socioeconomic status are linked with schizophrenia onset but not part of the main diagnosis
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9
Q

What is predictive validity?

A
  • ability of test to predict future course of an individual’s development
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10
Q

What are the functions of a good classification system?

A 
1 - Organization of clinical information
2 - Shorthand communication
3 - Prediction of natural development
4 - Treatment reccommendations
5 - Heuristic value
6 - Guidelines for financial support
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11
Q

What are the three sections of the DSM-5?

A

SECTION I: Introduction and Use
- historical background and guidelines for proper use

SECTION II: Clinical Disorders

  • recognized psychological disorders
  • personality disorders newly added
  • collects information about patient’s life circumstances

SECTION III: Experimental Measures

  • optional measures and models in need of further study
  • Outline for Cultural Formulation
  • intended primarily for research purposes
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12
Q

What are the positive changes made to the DSM-5?

A
  • broad collaboration
  • inclusion of cultural considerations
  • more descriptive diagnosis
  • reorganized to reflect etiology and shared factors
  • recognition of life span issues related to specific disorder
  • gender & cultural notes for individual diagnosis
  • removal of diagnostic criterion not relevant across cultural groups
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13
Q

What are some examples of Section II disorders of the DSM-5?

A
  • neurodevelopmental
  • schizophrenia/psychotic
  • mood
  • anxiety
  • somatic
  • feeding & eating
  • sexual and gender
  • personality
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14
Q

What are arguments against classification?

A

MEDICAL MODEL
- psychological disorders aren’t as legitimate because they don’t seem to show deviations from anatomical structure of brain or anything
→ but we may find these physical deviations one day

STIGMATIZATION
- labels have major social and occupational impact
→ but that’s more a problem with society than the classification system

LOSS OF INFORMATION

  • label gives false sense of confidence in understanding person and forcing assumptions on them
  • not enough attention paid to uniqueness of individual
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15
Q

What symptoms and history are investigated when diagnosing a patient?

A
  • current symptoms
    → interfere with ability to function?
    → coping strategies?
  • recent events
  • personal and family history of psychological disorders
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16
Q

What physical and neuropsychological factors are investigated when diagnosing a patient?

A
  • physical condition
  • drug and alcohol use
  • intellectual and cognitive functioning
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17
Q

What is a differential diagnosis?

A
  • process of ruling out potential disorders (or determining which of a number of possible diagnoses is correct)
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18
Q

What sociocultural factors are investigated when diagnosing a patient?

A
  • social resources
    → any friends or family and the quality of these relationships
  • sociocultural background
  • acculturation
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19
Q

How are unstructured interviews conducted?

A
  • open-ended
  • concentrate on person’s unique style or on certain aspects of the presenting problem
  • no script
  • avoids sensitive topics and builds rapport, mutual trust, and respect
20
Q

What are the limitations of unstructured interviews?

A
  • poor reliability and validity

- clinicians tend to focus only on whatever their field of interest is and justify their own hypotheses

21
Q

How is a structured interview conducted?

A
  • read from script
  • can be done by trained layperson
  • i.e. Diagnostic Interview Schedule
22
Q

What are the limitations of structured interviews?

A
  • increased validity but poor rapport
23
Q

What are general limitations of interviews as an assessment tool?

A
  • clients may be resistant

- clients select information to present

24
Q

What is face validity?

A
  • test appears to measure what it is supposed to measure
25
Q

What is content validity?

A
  • test assesses all important aspects of phenomenon
26
Q

What is concurrent validity?

A
  • test yields the same results as other measures of the same behaviour, thoughts, or feelings
27
Q

What is construct validity?

A
  • test measures what it is supposed to measure
28
Q

What is test-retest reliability?

A
  • test produces similar results when given at two points in time
29
Q

What is alternate form validity?

A
  • two versions of the same test produce similar results
30
Q

What is internal validity?

A
  • different parts of the same test produce similar results
31
Q

When are neuropsychological tests used?

A
  • used when neurological impairment or dysfunction is suspected (e.g., brain
    injury, or potential brain injury, sustained during a car crash; diagnosing or demonstrating effects of organically-based problems such as the dementia associated with Alzheimer’s disease)
32
Q

Compare and contrast the clinical approach and the actuarial approach.

A

CLINICAL:

  • no substitute for clinician’s experience and personal judgment
  • prefer to draw on all available data in their own manner
  • guided by intuition honed by experience

ACTUARIAL:

  • more objective standard needed
  • unbiased and scientifically validated approach needed
  • rely on statistical procedures, empirical methods, and formal rules
33
Q

What are the different types of brain-imaging techniques?

A 
Computerized tomography (CT)
- X-Ray 
beams are passed through the brain and images formed by the amount of radiation absorbed and reflected. 
- Addresses brain structure but not brain function.

Positron-emission tomography (PET)
- Assesses brain activity by measuring movement of photons through the injection of a radioactive isotope.

Magnetic resonance imaging (MRI)

  • Provides finely detailed pictures and does not expose the person to radiation
  • Relies on magnetically affecting hydrogen atoms in a way that provides 3D images of the brain
34
Q

What is the Bender Visual-Motor Gestalt Test?

A
  • series of nine cards with lines and shapes drawn on
  • respondents asked to copy images on another card and then draw them from memory
  • errors in reproducing lines may indicate neuropsychological problems
35
Q

When are intelligence tests used in a clinical context?

A
  • used to determine intellectual strengths and weaknesses especially when mental retardation or brain damage is suspected
36
Q

Which are the two most used IQ tests?

A
  • Stanford-Binet

- Wechslet family of scales

37
Q

What are the criticisms of intelligence tests?

A
  • little agreement of what it is to be “intelligent”
  • most only assess verbal and analytical abilities
  • biased toward middle and upper-class educated European Americans
38
Q

What are symptom questionnaires?

A
  • cover wide variety of symptoms representing several different disorders
  • e.g., 21-item Beck Depression Inventory
39
Q

What are personality inventories?

A
  • meant to assess people’s typical ways of thinking, feeling, and behaving
40
Q

What is the Minnesota Multiphasic Personality Inventory (MMPI)?

A
  • most widely used personality inventory
  • 10 clinical scales, 4 validity scales to help determine legitimacy of what is learned across clinical scales

Scales include:

  • L (Lie, denial of small flaws people would readily admit to means they could be hiding something else)
  • F (Frequency, high on this score probably means the test was filled out carelessly)
  • K (Defensiveness, conceals real feelings on controversial topics to seem better)
41
Q

What is the Rorschach Inkblot Test?

A
  • oldest and best known projective test
  • based on idea people see different things in same inkblot and that what they see reflects their personality
  • cards separated and handed in a certain sequence
  • Exner system developed to standardize scoring of responses
42
Q

What is a projective test?

A
  • person is presented with an ambiguous stimulus and projects onto it their unconscious motives, desires, needs, drives, etc.
  • use to help form hypotheses about an individual’s personality
43
Q

What is the Thematic Apperception Test?

A
  • drawings on cards depicting ambiguous social interactions
  • respondents asked what they believe is happening and what lead up to it and stuff like that
  • assumption that client identifies with protagonist
44
Q

What are gender bias concerns about the DSM?

A
  • societal gender bias is reflected in DSM descriptions of many psychiatric disorders
  • diagnosis more likely for women even with no pathology present
45
Q

What are cultural bias concerns in the DSM?

A
  • “normal” v. “abnormal” is fraught with cultural and professional assumptions
46
Q

What are concerns about the politics of the DSM?

A
  • secrecy of revision process

- composition of the membership of the committees e.g., ties to pharmaceutical companies

PSY240 (16 decks)

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