Module 3 - classification, assessment, and diagnosis

Question 1

what is classification? [L3]

Answer 1

a system for describing important categories, groups that have similar patterns or dimensions of a behaviour –> seeing the patterns of emotion, behaviours etc. that we see together, and then classifying those behaviours into a group that is easier to understand

Question 2

what is diagnosis? [L3]

Answer 2

assigning children to specific classification categories

Question 3

why is classification helpful?

Answer 3

2 senses/contexts (at least):
- clinical use: to clarify and understand the presentation and emergence of disorders, prognosis, and treatment
- research use: to develop theories

Question 4

what are 2 key assumptions about the medical model? [L3[

Answer 4

1) disorders are categorical (there is a clear distinction between healthy and disordered adjustments)
2) disorders are endogenous (having an internal cause) –> come from characteristics of the individual rather than the result of individual-environment interactions

Question 5

Achenbach emphasized an empirical approach to classification as a bottom-up processing involving..?

Answer 5

1) collecting data from individuals with typical and atypical adjustments
1) attempts to group the distresses and dysfunctions statistically into meaningful dimensions/characteristics of disorder

Question 6

Achenbachs (dimensional classification) view is different from the DSM (top-down) how?

Answer 6

we see characteristics in each child, but where along the continuum of the factor does that child fit? vs the DSM - we have a disorder then specifying the symptoms of the disorders

Question 7

the two most identified dimensions of disorder include:

Answer 7

1) an externalizing dimension with under controlled behaviours like aggressive behaviours often directed at others (less inhibition, more rule breaking)
2) an internalizing dimension with overcontrolled behaviours like anxiety or social isolation often directed toward the self (dimension that came up in Achenbach view)

(it’s possible to have both dimensions )

Question 8

what is heterogeneity?

Answer 8

being diverse (within categories or groups of disorders) - individuals with the same disorder can present very differently with different symptoms

Question 9

what is comorbidity?

Answer 9

the co-occurrence of two or more disorders in one individual.
happens for several reasons:
- some people will not match up with strictly defined categories
- diagnostic categories are too vaguely defined
- transdiagnostic symptoms are patterns of emotion, though, behaviour that cut across traditional diagnostic boundaries

Question 10

what implications does symptom overlap within! chapters have for diagnosis?

Answer 10

• makes it more difficult to narrow down diagnosis and exact disorder
• won’t need as many treatments because it will be effective for multiple disorders

Question 11

what implications does symptom overlap across! chapters have for diagnosis?

Answer 11

• makes it easy to misdiagnose something
• could be a reason why we see so much comorbidity

Question 12

what is assessment?

Answer 12

it involves the systematic collection of relevant information

Question 13

what are 3 types of assessment?

Answer 13

• psychodiagnostic assessment: involves clinical interviews, personality tests, emotional and behavioural rating scales. the aim is for diagnosis
• psychoeducational assessment: involves intelligence and academic achievement tests, more standardized testing. aim is to determine areas of strength and weakness, and diagnosis
• neuropsychological assessment: involves cognitive, memory, language, learning, motor, executive functioning tests (tend to assess cognitive skill). aim is to determine areas of strength and dysfunction, diagnosis, prognosis (forecast)

Question 14

what was the presenting problem for Annie? [L3]

Answer 14

being referred for an assessment because of her behaviours

Question 15

what are the differential diagnoses for Annie?

Answer 15

• autism spectrum disorder
• OCD, perfectionist tendencies

Question 16

can pink flags alone be the basis of clinicians making diagnosis?

Answer 16

no, because they are not actual criteria of the DSM, but they are useful in understanding what symptoms lead to and can lead us in the right direction

Question 17

what does it mean for clinical assessments to be multi-method? and why is that important?

Answer 17

this includes:
- different informants (or people)
- across a variety of settings (home, school)
- variety of procedures (assessment tools)
include 1) clinical interviews
2) behavioural observation
3)standardized testing; cogntive, personality tests; checklist questionnaires

• with only one environment it could be an external factor, and with only one informant, you could miss information/signs

Question 18

explain a clinical interview

Answer 18

• consent/confidentiality
• rapport building with parents and children
  -information gathering (structured, semi-structured, unstructured)
• developmental considerations: approach would change based on the age of the child

Question 19

explain a behavioural observation

Answer 19

• can help inform decisions you make about the assessment and diagnosis, and can provide people who read the report with a good idea of what it is like to be in the room with that child
• observe things like how the child observes you, what they are like in conversations, how do they seem to be feeling during assessment, what is their attention like, etc.
• ABC’s –> Antecedents (teased at school, feelings of anxiety at school)
  –> behaviours (physical complaints, school refusal, depressive symptoms)
  –> consequences (stays home, no teasing, confirms low self-opinion, reduction in anxiety)

Question 20

explain standardized tests

Answer 20

• intelligence testing
• academic achievement testing
• projective testing
• rating checklists/questionnaires (behavioural assessments, personality)