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Psyc 385 > Classification and Assessment > Flashcards

Classification and Assessment Flashcards

1
Q

What causes the access of mental health services to be difficult?

A

Stigma

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2
Q

What is diagnosis?

A

Identification of a disorder on the basis of characteristic symptoms (reliability varies)

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3
Q

What does the DSM-5 use to define mental disorders and why?

A

A series of descriptors-used because a lot of mental disorders are subjective and have no core or sure reality.

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4
Q

What is the only mental disorder with sure reality and diagnosis?

A

Dementia

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5
Q

Why do we classify? (4 Reasons)

A

1) To make sense of things (nosology precedes etiology)- we prefer classification before we can understand them
2) To assist in treatment decisions
3) To organize the search for new knowledge-helps us understand disorders more specifically
4) To organize epidemiological research.

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6
Q

What are the 2 classification systems we have?

A

Diagnostic and Statistical Manual (DSM)

International Classification of Diseases from WHO

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7
Q

What does a patient receive when a psychiatrist gives a formal diagnosis?

A

DSM number and ICD number

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8
Q

Is the DSM categorical or continuous?

A

Categorical

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9
Q

What kinds of disorders did the DSM 5 add?

A

Hoarding as a type of anxiety

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10
Q

What modifications did the DSM 5 make?

A

Added Schizophrenia as a Spectrum

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11
Q

What category changes did the DSM 5 make?

A

Created OCD as a category of its own

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12
Q

What category did Body Dysmorphic disorder go to in the DSM 5?

A

Switched to an anxiety disorder from a somatoform disorder

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13
Q

What other innovations did the DSM 5 make?

A

Greater alignment with ICD
Greater recognition of age, gender, culture
50 disorders as spectrum/non-spectrum
“not otherwise specified” replaced with other specified and unspecified
Emphasis on clinical utility

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14
Q

What does a typical DSM-5 Diagnosis look like?

A

Most severe disorder (medical or mental) presented first
Other diagnoses follow in severity and/or implication for quality of life and functioning
Psychosocial, cultural, and other issues follow as comments

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15
Q

What are syndromes?

A

Clusters of symptoms (these are what mental disorders are)

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16
Q

What are syndromes determined by?

A 
Symptom clusters
Exclusion criteria
Duration
Certain level of distress
Level of dysfunction
Type of etiology
Statistical Deviation
Chemistry involved
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17
Q

What is an example of a symptom cluster?

A

Have to have 5/9 symptoms of depression INCLUDING either or persistent sadness on most days, and/or anhedonia (loss of pleasure in activities)

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18
Q

What is an example of exclusion criteria?

A

Disturbance cannot be attributed to substance abuse, medications, conditions.

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19
Q

What is an example of a level of duration?

A

Have to have persistent stress for 3+ weeks to have PTSD.

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20
Q

What determines distress?

A

How much a person cares or not (essential for sex dysfunctions)

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21
Q

What are the diagnostic criteria for schizophrenia?

A 
A-Characteristic Symptoms
B-Social Occupations/Dysfunctions
C-Duration
D-Exclusion of Certain Disorders
E-Exclusion of conditions
F-Criteria if another disorder is present
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22
Q

What are some characteristic symptoms of schizophrenia?

A

1.Delusions. 2.Hallucinations. 3. Disorganized Speech. 4. Disorganized or Catatonic Behaviour. 5.Negative symptoms (have to have two or more of the following, for one month (less if treated)

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23
Q

What is the duration of schizophrenia symptoms?

A

Continuous signs of disturbance for 6 months, 6 month period must include at least one month of symptoms

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24
Q

What are some of the disorders that must be excluded from the diagnosis of schizophrenia?

A

Schizoaffective disorder and bipolar disorder.

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25
Q

What is reliability?

A

Makes classifications and tests reliable across people-classification consistency.

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26
Q

What is inter-rater reliability used for and how does it work?

A

Classifications-when classifying a disorder, have one interviewer and the raters watching behind a 1 way mirror. Raters rate what is happening and arrive at a diagnosis-correlation then done between raters

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27
Q

What is an example of a disorder with high inter-rater reliability and one with low?

A

High-Major Depressive Disorder

Low-Personality disorders

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28
Q

What is test-retest reliability used for?

A

If the diagnosis is supposed to last over a period of time, have 2+ interviews to see if they still have the diagnosis (around 8wks later without intervention)

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29
Q

What is internal consistency?

A

When you divide the questionnaire into 2 parts and expect the coefficient to be .70 between both parts. No matter how you divide the test, should be the same.

30
Q

What is internal consistency used for (disorder)?

A

Personality disorders strictly

31
Q

What is validity?

A

The extent to which a test measures what it’s supposed to-comes ahead of reliability

32
Q

What is criterion validity and the 2 parts of it?

A

Does the test actually meet certain criterion? Includes concurrent validity and predictive validity

33
Q

What is concurrent validity?

A

In two different contexts, do we arrive at the same results?

34
Q

What is predictive validity?

A

Are we able to accurately predict the disorder? If they still have the diagnosis in a few months then we predicted it right, if no improvement with intervention, have to ask if there’s something more.

35
Q

What is face validity?

A

Used on tests-are you asking questions relative to disorders?

36
Q

What can peer and significant other reports help with?

A

Giving more information, and helps with child evaluations as children are UNRELIABLE.

37
Q

What are some of the unresolved issues with the classification of mental disorders?

A
  • Definitions and criteria are not uniformly scientifically based
  • Research underpinning categories in DSM has been severely criticized
  • Number of symptoms needed for diagnosis often poorly justified
  • Time periods vary arbitrarily.
  • Inter-rater reliability is inconsistent
  • Dimensional classification based on quantitative deviations from health data better?
  • Is comorbidity the result of splitting disorders or is it valid?
  • Poor use of longitudinal (historical) info.
38
Q

What is one of the big, overarching issues associated with the classification of mental disorders?

A

Pathologizing of behaviour seen as acceptable by some individuals or cultures, and the stigma surrounding classification of mental disorders.

39
Q

What is a psychological assessment?

A

The process of collecting and interpreting information that will be used to understand another person

40
Q

What is construct validity?

A

Does your test follow the theory you’re testing? Is your test following what it says it does? Compare yours with someone elses.

41
Q

What do most researchers classify mental disorders on?

A

Severity rather than category

42
Q

How did the biological perspective attempt to remedy stigma and did it work?

A

By classifying mental disorders as chemical imbalances. Did not work.

43
Q

What are the three major goals of psychological assessment?

A

1) Making predictions
2) Planning interventions
3) Evaluating interventions

44
Q

What are some assumptions made about behaviour?

A

Behaviour is consistent- but consistency over time or setting?
Different levels of analysis used depending on questions needed to be addressed
Assessment procedures vary in usefulness depending on causes.

45
Q

What are the six possible sources on an individuals personality?

A
  1. Psychological Interviews
  2. Peer and significant other reports
  3. Behavioural and observational ratings
  4. Cognitive and neuropsychological testing
  5. Personality tests and self-report inventories
  6. Projective tests
46
Q

What are the 3 major interviewing styles associated with psychological interviews?

A

Unstructured, semi-structured, and structured

47
Q

What are unstructured interviews?

A

When have the freedom to ask whatever you want-have to be aware of bias and the thing you’re looking for (can be unreliable)

48
Q

What are semi-structured interviews?

A

Has a set of questions but there is freedom to ask for clarification

49
Q

What are structured interviews?

A

Used for more precise diagnosis, specific questions with branches for specific answers-not useful for more information about lifestyle.

50
Q

What is behavioural observation and ratings used for?

A

Used on the psychiatric ward and in behaviour modification for adolescents-looks at patterns to see if person is better or worse.

51
Q

What was the first cognitive and neuropsychological test done?

A

Asked how can we put children of different abilities into education that is best for them (France, 1910)

52
Q

What is cognitive and neuropsychological testing?

A

Intelligence and cognition testing

53
Q

What is the intelligence battery?

A

Measures verbal and non-verbal skills, memory, language, puzzles, executive functioning, impulsivity, reaction time

54
Q

What do personality tests and self-report inventories measure?

A

What personality “should” look like using a distribution of responses and clinical scales.

55
Q

What is the logic behind projective tests?

A

When confronted with vague and imprecise stimuli, people will project what is going on in their lives.

56
Q

What are some types of projective techniques?

A

Association, construction, sentence completion, free expression

57
Q

What is an association test?

A

An example would be the Ink blot test-associate a random inkblot with a concrete object

58
Q

What is a type of construction test?

A

Thematic Apperception- Using a specific deck of cards that show relationships and have people tell a story about it. Good for pulling information out of people who have difficulty expressing themselves.

59
Q

What is a sentence completion test?

A

Where you start a sentence and the person is asked to complete it (ex: when I was young, my mother…) in the beginning, people will give trivial information, but at some point you’ll find something.

60
Q

What is a free expression test?

A

Ask people to draw things (ex: ask kids to draw their family before cancer and after). Some cases without change and some with HUGE. Gives ideas of preoccupation.

61
Q

What can we do to assess biological systems?

A

Psychophysiological tests, brain imaging etc

62
Q

What can controlled experimental research tell us?

A

Causality.

63
Q

What is quasi-experimental research in abnormal psych?

A

Measuring a population after an event (ex: PTSD levels after Fort Mac fires).

64
Q

What type of research method is most commonly used in abnormal psych?

A

Non-experimental, specifically correlational: looks at conditions that relate with disorders, new relationships, case studies, single-subject

65
Q

What does epidemiological research look at?

A

Factors in overall population that might influence disorders, segments of population, prevention methods, where government can put money to help.

66
Q

What do heritability studies look at?

A

Families, adoption studies, twin studies..

67
Q

What is one example of a heritability study done at a level of an entire population?

A

Danish twin study: found that a large proportion of monozygotic twins would commit suicide if the other had also committed.

68
Q

What are some of the ways that we evaluate research in clinical psych?

A

Statistical significance
Clinical Significance
Normative comparisons

69
Q

Where do we do statistical significance?

A

Moreso at group levels and in research-have to be careful with how it’s applied at individual level (Ex: people of lower SES have more mental health issues BUT this doesn’t mean that high SES people don’t have issues)

70
Q

What do we look at with Clinical Significance?

A

Look at treatment, differences between treatments, and how large they are (effect size). Also more research based

71
Q

What are normative comparisons used for?

A

Clinical treatments-helpful at both individual and group levels, shows the distribution of scores on a test depending on personal factors (age, gender etc)-helps diagnosis and treatment for people in those groups.

72
Q

What is one thing that is essential with diagnosing in clinical psych?

A

Interviews

Psyc 385 (12 decks)

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