Chapter 5: Classification, Assessment & Intervention Flashcards
Classification/taxonomy
Major categories or dimensions of behavioural disorders
Diagnosis
Assigning a category of a classification system to an individual
Assesment
Evaluating individual’s to assist in the process of classification and diagnosis and also to act as intervention.
Category
Discrete grouping (ex: anxiety disorder)
Dimension
An attribute is continuous and can occur to various degrees
Interrater Reliability
Whether different diagnosticians use the same category to describe a person’s behaviour.
Test-retest reliability
Wether the use of a category is stable over some reasonable period of time.
Validity
Diagnosis should give further info on the:
- etiology of the disorder
- course of development the disorder is expected to take
- response to treatments
- additional clinical features of the problem.
Clinical utility
Classifications systems are judged based on how complete and useful it is.
APA: DSM (Diagnostic and statistical manual of mental disorders)
AKA: clinically derived classification - based on consensus of clinicians that certain characteristics occur together :
Top down approaches
Committees of experts propose
concepts of disorders and then choose diagnostic criteria for defining disorders.
It is from these criteria that the development of assessments and evaluations
proceed.
Categorical Approach
An idividual either HAS or does NOT have the disorder.
Difference between normal and pathological in a categorical approach is one ‘kind’ rather than one ‘degree’.
Distinctions can be made between qualitively different types of disorders.
Comorbidity : co-occurence
When an individual meets criteria for more than one disorder: simultaneous existence of two or more disorders in the same individual
Empirical approach to classification
Using statistical techniques to identify patterns of behavior that are interrelated.
Syndrome
Describes behaviour that tend to occur simultaneously together
Spectrum
Groups of disorders thought to hare certain psychological or biological qualities.
Dimension
Quantitative rather than qualitative approach to viewing disorders. Can be adressed using a cross-cutting assessment: adresses areas of clinical importance that are not necessary to the diagnosis of a disroder, but are iportant to the prognosis, treatment planning and treatment outcome.
Broadband syndromes
general clusters of behaviour or characteristic
Broadband syndrome: Internalizing
Internalizing: overcontrolled/
anxiety-withdrawal.
Descriptions include: anxious, shy, withdrawing, depressed.
Broadband syndrome: Externalizing
Externalizing; Under-controlled & conduct disorder.
Descriptions include; Fighting, temper tantrums, disobedience, destructiveness.
Anchebach Instruments used to measure two broadband syndromes
6 - 18 years:
The Child Behavior Checklist (CBCL)
The Teacher Report Form (TRF) is a parallel instrument completed by
teachers
11 - 18 years
The Youth Self-Report (YSR) is
Parallel measures for younger children: CBCL 1.5 - 5
and the C-TRF (Caregiver–Teacher
Report Form)
Narrowband syndromes
Evaluates each youth for several dimensions of syndromes: gives a score for each (3 categories: internalizing, mixed and externalizing syndromes)
Table : 5.1
Normative samples
Frame of reference used in empirically based classifications.
Stigmatization
- Negative stereotypes; viewed negatively
- Devaluation: Lead to separation from others and loss of status
- Discrimination; actions that limit the person’s rights & power.
Evidence based-assessment
Procedures that rely on empirical evidence and theory to guide their select to and support their validity.
The general clinical interview
Information on all areas of functioning is obtained by interviewing the child or
adolescent and various other people in the social environment.
Structured diagnostic interviews
More reliable than unstructured interviews
Problem Checklists
Self report measures
Behavioural Observations
Observations can
include reports of;
single, relatively simple, and discrete behaviors of the child; interactions of the child and peers; and complex systems of interactions among
family members.
in either the child’s natural environment or through artificially stimulated environments (clinical/lab) similar to the child’s natural environment.
Projective tests
One way the ego deals with unacceptable impulses is
to project them onto some external object. It is assumed that the impulses cannot be expressed directly.
Projective tests present an ambiguous stimulus, allowing the individual to project “unacceptable” thoughts and
impulses, as well as other defense mechanisms onto the stimulus.
Examples:
- Rorschach test: what the person seas in 10 inkblots
(blot: location, colour: determinants, what: content)
-House-tree-Person Technique
- Kinetic family
IQ score
Avg: 100
an individual
score reflects how far above/below the avg. person of his or he age n individual has scored.
Developmental Index
Special instrumental measures for assessing infants and very young children, yields a performance index.
Ability and Achievement Tests
To assess a child’s general intellectual functioning or functioning a particular area.
Psychophysiological assessments
Conducted when a child/adolescent’s arousal levels are of concern: physical test measures (ex: muscle tensons, heart rate, respiration rate…).
More common in a research than clinical setting.
Neurological Assessment
Directly assesses integrity of the nervous system.
- EEG
- Brain imaging techniques
- MRI
- fMRI
- pet
Intervention
Umbrella term for both systematic intervention and treatment of a psychological difficulty.
Prevention
Interventions targeting individuals who are not yet experiencing a clinical disorder.
Treatment
Interventions for individuals already experiencing clinical levels of some
problem
Caplan’s (1964) 3-prong Prevention model
Primary:
- Prevention of disorder onset/specific dysfunction.
Secondary :
- Effort to shorten the duration of existing cases through early referral, diagnosis, and treatment : nipping in the bud strategy.
Tertiary :
- After-the-fact strategy: that aims to reduce problems that are residual to disorders: reduce; minimalize; rehabilitate, avoid relapse.
- Universal prevention strategies
Targeted to entire populations for
which greater than average risk has not been identified in individuals.
Hypothetical examples are encouraging parents to read to their children
to avoid learning problems, and promoting exercise and proper diet to
avoid obesity.
- Selective prevention strategies/High risk prevention strategies
Targeted to individuals who are at higher than average risk for disorder.
Intervention might be directed toward individuals or subgroups with biological risks, high stress, family dysfunction, or
poverty.
- Indicated Prevention Strategies
Targeted to high-risk individuals
who show minimal symptoms or signs forecasting a disorder, or who
have biological markers for a disorder but do not meet the criteria for
the disorder.
Anna Freud; Play Therapy
Early psychoanalytic therapists agreed that child patients required a
different mode of treatment than the highly verbal, free association mode used in
adult psychoanalysis.
