Chapter 7: Psychopathology Flashcards
Diagnostic and Statistical Manual (DSM)
Based on a medical model of behavior and emotional problems
Multiaxial approach – 5 axes or dimensions
- Clinical syndromes
- Developmental disorders and personality disorders
- Physical disorders
- Severity of psychosocial stressors
- Level of adaptive functioning
New categories in DSM-5
- Hoarding Disorder
- Binge Eating Disorder
- Excoriation Disorder
- Mild Neurocognitive Disorder
- Disruptive Mood Dysregulation Disorder
- Premenstrual Dysphoric Disorder
- Social Communication Disorder
- Somatic Symptom Disorder
Future DSM’s Ideas
- Dimensional Model for Personality Disorders
- Caffeine Use Disorder
- Internet Use Gaming Disorder
- Suicidal Behavior Disorder
- Nonsuicidal Self-Injury
- Attenuated Psychosis Syndrome
What is the problem with comorbidity?
Comorbidity = 2 or more disorders for the same person
How does the book define mental disorder?
a psychological pattern associated with distress
and/or impairment of functioning that reflects dysfunction in the person. (p. 162)
What are the four ways of assessing mental disorders?
- Ask person directly - Use an interview or a self-report inventory
- Ask someone who knows the person – interview or rating scale
- Observe the person in their natural environment
- Observe the person in a standardized-test situation
What is the purpose of having tests for psychopathology?
- Answer a focused or specific diagnostic question
- Explain in a broad way the client’s dynamics, psychological functioning, and personality structure
How is a clinical interview described?
a conversation with a purpose
Structured vs. unstructured clinical interviews
Structured: follows interview schedule (series of questions)
Unstructured: open questions, “how do you feel about…”
For clinical interviews, what are some of the things the Mental Status Exam (MSE) look at?
- Appearance
- Behavior
- Orientation
- Memory
- Sensorium
- Mood and affect
- Intellectual functioning
- Perceptual processes
- Thought content
- Thought process
Describe the Structured Clinical Interview for DSM-III (SCID)
- Semi-structured interview
- Covers nine diagnostic areas
- Trained interviewers
Describe the Symptom Checklist 90R (SCL-90R)
A commonly used screening inventory
Brief self-report measure to evaluate psychopathological problems and symptoms, as well as outcomes of treatment
90 items
assess degree of distress over the past 7 days
ages 13 and older
10-15 min
5-point scale
High validity, reliability, and utility
Describe the Psychological Screening Inventory (PSI)
Developed empirically to differentiate between normal subjects and psychiatric patients
a screening device not a diagnostic instrument
130 true-false items
Five scales: alienation, social nonconformity, discomfort, expression, defensiveness
Describe the five scales of Psychological Screening Inventory (PSI)
alienation:
social nonconformity:
discomfort:
expression:
defensiveness:
Minnesota Multiphasic Personality Inventory (MMPI) and MMPI-2
What was the original purpose?
Name some Characteristics.
Original Purpose: Clinical prediction and personality description
Widely used objective personality measure
Assesses both personality structure and psychopathology—used more in clinical settings than as a fun, one-off personality test
Characteristics
* Easily administered and scored
* 6th grade reading level (MMPI)
* 8th grade reading level (MMPI-2)
* 60-90 minutes
* Interpretation
o Pattern or configuration of scales is important
* Reliability
o Test-retest is adequate
o Stability of configuration – not great
* Validity
o Compared MMPI profiles to relevant criterion groups
o Identify reliable nontest behavioral correlates
o Accuracy of interpretations of MMPI with clinicians
Minnesota Multiphasic Personality Inventory (MMPI) and MMPI-2
Current version? Items? Scales?
Currently using the MMPI-2-RF (2008)
338 items over 51 scales
Items are nonredundant—this is actually a shorter version of the test!
Recommended for administration on the computer
Includes possibility of comparing to reference groups
Minnesota Multiphasic Personality Inventory (MMPI) and MMPI-2
What are the 10 Clinical Scales?
- Hypochondriasis
- Depression
- Hysteria
- Psychopathic Deviate
- Masculinity/Femininity
- Paranoia
- Psychasthenia
- Schizophrenia
- Hypomania
10.Social Introversion
Minnesota Multiphasic Personality Inventory (MMPI) and MMPI-2
What are the 4 validity scales in the original and what are the 3 that were added in the second?
4 Validity Scales
1. Lie (L) – “Faking good” – items most people would not endorse
2. Infrequency (F) – Fewer than 10% of normal samples would endorse
3. Cannot say (CNS) – non-responding; items left blank
4. K – clinical defensiveness; differentiated between normal and psychiatric patients with normal profiles; suppressor variable
Added to the MMPI-2
5. Backpage Infrequency (Fb) – random responses on the back half of questions
6. Variable inconsistency (VRIN) – responses to item pairs with similar or opposite content
7. True response inconsistency (TRIN) – responses to item pairs with
Minnesota Multiphasic Personality Inventory (MMPI) and MMPI-2
Criterion keying, who was it based on?
Developers determined whether an item differentiated two groups: psychiatric group versus “normal” group
MMPI History: How were norms developed? What were some problems with the norms?
1943: developed at University of Minnesota using empirical keying approach–NOT psychodynamic
* Major validity and generalizability issues
* Reference group was small and mostly consisted of people with the same/similar SES
Norms represent late-1930s to early-1940s Minnesotans
* Terminology being used was not relevant to population being tested
* Many disorders were eluded
MMPI History: MMPI-2
What improvements were made?
- Standardized on a large, more representative sample (collected in mid 1980s)
- Clinical Scales left intact
- New items introduced via Content Scales
- New Validity Scales (VRIN, TRIN, Fb)
- Initial Skepticism
- Relatively quick acceptance by clinicians
- Disappointment by (some of) the scholarly community
MMPI History: MMPI-2
What were the new validity scales added?
MMPI History: MMPI-2