Dx Variation in Clinical Psych Flashcards
Scope of Clinical Psychology
#1. Scope of adjustment and suffering
Activity: think of different populations and where they may be on a normal distribution.
Looking at a normal distribution there is a point in which psychologists decided what classifies as a disorder or not. (A line vertical on the right side of a normal distribution).
Scope of Clinical Psychology #2 Spectrum of public health interventions.
Activity: Choose one spectrum or disorder and apply the activity to it
What is promotion?
What is Prevention and three types?
What is treatment and 2 categories?
What is maintenance and it’s two categories?
What is the difference between promotion and universal prevention?
Promotion Section
Includes targets/society as a whole- general population
Health Promotion: enhance good things (not treat pathology)
Ex: quilting focused on positive (not pathology)
Prevention Section
Before someone has diagnosable condition (intervention)
Goal: prevent a disorder or to lower the risk for the development of a disorder.
Prevention types (Universal, Selective, Indicated)
Universal: everyone in the population has access to (if everyone at OSU has access to tutoring)
Selective: targets group of people who may have risk factors for developing problem, chosen on basis of being part of a group known to be at risk. Ex: OSU prevents drop out by reaching out to nontraditional students, transfer students. Or implementing workshops for children whose parents are divorcing. Sometimes selective is known as “At Risk:
Indicated Prevention: person selected because they have early signs of the problem.
Aimed toward high-risk individuals: people with risk factors that make them highly vulnerable for development of a disorder, but are not recognized as clinical cases (currently/yet).
Minimal/subthreshold symptoms (don‘t meet the diagnostic levels), markers of possible development of mental, emotional or behavioral disorder or biological predisposition for the disorder.
E.g. interventions for children with early (subthreshold level) symptoms of depression or other disorders
Treatment Section
Case Identification:
Early recognition of disorders who may need a service. Link people to services/ treatment which require..
In order for this to occur, need valid assessments.
To have valid assessments, need instruments (like interviews) and valid procedures and processes. (e.g., human or computerized interviewers; self-assessment)
Valid classification systems.
We also need effective referral processes. (Sometimes known as chain of care). Parent concerned kid has ADHD, parent takes them in, therapist diagnosis them, but then says there no care in Corvallis… this would be missing link in chain of care.
Standard Treatment for Known Disorders:
Early recognition of diseases/disorders and referral to standard treatment
Interventions with individuals with diagnosed diseases/disorders
Maintenance Section
Compliance with long term treatment (Goal: reduction in relapse and reoccurrence, , health and well-being maintenance, long-term treatment)
After Care (including rehabilitation)
Aim of treatment and maintenance?
Aims at these two levels: to treat the disorder; to decrease the seriousness of the symptoms; to alleviate the consequences of the disorder (also worsening, invalidity, secondary problems etc.)
Ecological Perspective
In clinical psych –> we remove person from their environment to room and treat them there. Don’t necessarily see family, peer relations…
Racism, sexism etc. is imbedded and directly impacts person
Ecological Quote
“Part of the extension of the work you will do is, yes, focused on our young leaders and our young people, but understanding we also then have to be clear about the needs of their parents and their grandparents and their teachers and their communities because none of us just live in a silo. Everything is in context.
My mother used to — she would give us a hard time sometimes, and she would say to us, ‘I don’t know what’s wrong with you young people. You think you just fell out of a coconut tree?’ You exist in the context of all in which you live and what came before you.”
Classification and diagnosis in clinical Psychology.
Think about: purpose of diagnostic system, positive consequences, negative consequences, and human variation.
Structure of DSM
What is a mental disorder?
Signs and symptoms
Diagnostic criteria (symptoms, duration, distress and impairment, exclusions)
Structure of DSM
What is a mental disorder
A mental disorder involves significant disturbances in cognition, emotion, or behavior due to underlying dysfunction, causing distress or impairment in daily life. Normal stress responses and socially deviant behavior or societal conflicts, aren’t considered disorders unless linked to individual dysfunction (listed above).
Signs (what clinician sees, or others) “
Symptoms: what client reports (we tend to identify disorders on the ability for individuals to explain their suffering).
Diagnostic criteria:
Starts with symptoms, typically cardinal symptoms (ex: depressed mood or anhedonia) that has to be there in order for them to be diagnoses.
Duration: helps us to distinguish from normal human experiences.
Typically need to have Distress/Impairment, helps us to distinguish from normal human experience.
Types of Exclusions: if disorder is not better accounted for by substance use, culturally approved responses, better explained by medical condition, or another mental disorder.
Subtypes and specifiers
Add to above card Subtypes:
ADHD: inattentive and hyperactive
Specifiers:
Add to above Diagnostic features vs associative features
Diagnostic Features:
Associative features: commonly observed but not officially symptoms
Prevalence
Point prevalence: what percent of population meets this disorder right now
Annual prevalence: how many people in past year qualified for this
Lifetime prevalence: % of individuals who have ever met this disorder
Point prevalence: When is prevalence of disorder at it’s highest (substance use: perhaps young adults)?
Often presented differently by self reported gender. Distinct gender difference in prevelance
Incidence: new cases
Development and Course
Alztimers: linear line goes down
Depression: episodes (episodes and no episode)
Seasonal affective disorder: needs to be tracked over time
Premenstrual depression: needs to be tracked
Risk and Prognostic Factors
Risk: individual, community
Prognostic: predicts responsiveness to treatment (can be positive or negative). Expected outcome. Women have better prognosis for schitophrenia
Culture-sex and gender related issues
Are there some cultural groups that express distress differently?
Are there ways criteria could be bias against gender or other groups?
Associations with suicidal thoughts and behaviors
Section in DSM
Functional consequences
How disorder interferes with daily living. Might give hint about type of impairment
