Midterm (Classificatjon) Flashcards
Diagnosis is?
Method of assigning individuals to categories
DSM
DSM - 1952, meant to be atheiretical despite prevailing psychoanalytic theory. One child category - adjustment reaction of childhood/adolescence
DSM II 1968 - 9 disorders. Schiz,
MR 285) child sections
DSM III 1980 - 44 kid teen. More focus on dx in early Dev
DSM IV 1994 - 350 categories (TR no new categories? But more detail)
DSM 5 - significant reorganization and revision, bye bye axes. Identifies rule and specifies symptom
Key assumptions of medical model?
Disorders are categorical
Disorders are associated with constitutional dysfunction (fails to display natural functioning)
Disorders are endogenous - characteristics of individuals rather than individual-environment transaction
Reliability and validity
Reliability - whether different clinicians put kids in same categories.
Interrater plus cross time
Validity - whether classification gives meaningful information
Internal - etiology, core patterns
External - implications of disorder
Characteristics of empirically based systems?
Statistically based, gives key dimensions of functioning and dysfunction
All children can be described along these dimensions
Dimensional classification - difs in degree, rather than differences in types
Two clinically useful and researched dimensions
Externalizations - under control (aggression)
Internalizing - over control (anxiety)
dx if certain number of symptoms and significant impairments
Gender and age influence manifestation
0-3 Association?
Contributions of many disciplines
Focus on earliest manifestations of psychopathology
Child caregiver relationship focus of understanding disorders
Behavioral quality (nurturing, controlling, inattentive)
Emotional tone (energy, depressed, interactive, warmth)
Psychological involvement (synchronicity, engaging, scaffolding vs neglectful)
PUTS OUT DIAGNOSTIC CLASSICIATION OF MENTAL HEALTH AND DEVELOPMENTAL DISORDERS OF INFANCY AND EARLY CHILDHOOD
Comorbidity?
2+ disorders in one person
Homotypic comorbidity - same CLASSICIATION group
Heterotypic comorbidity - different
Concurrent and successive
Etiology for inaccurate decisions:
Some kids don’t match categories
Clinical picture may include mix symptoms from different dx
May dx 2, neither right or wrong
Categories don’t allow for individual or cultural variation
Loosely defined and vague categories overlap and lead to appearance of comorbidity
Different assessment options?
Should be strength based, not problem centered
Dx Efficiency - hits vs misses. Moment in time, assessment ongoing. Impact on child and family
Interview formats: structured play, planned questions, conversations. Age determines.
Interview allows parents and kids to explain concerns and stories, see places of agreement and dis, asses milestones, family hx, culture
Outcome vs process research
Process - measure theoretical constructs that underlie tx and determine progress
Different types of prevention?
Primary - reduce or eliminate risks and reduce Dev or incidence of disorder in children
Universal preventative - mandatory immunizations
Selective - selected groups (head start)
Indicated - specific risk factors that include extensive intervention
Secondary - after early signs of distress, before disorder
Tertiary - responding to already pleasant and significant disorders
Secondary and tertiary restore functioning and minimize futur impairment
Classification is?
A system for describing important categories, groups, dimensions of disorder
Information about expression, etiology, emergence,’course, tx implications
Allows for common communication
Effective: organize into groups, facilitate communication and inform research and Tx efforts
Categorical - groups with relatively similar patterns
