Part 2: Classification and Assessment Flashcards
Reliability
(Consistency)
ASSUMPTION: the thing we are measuring is stable/static/constant/doesn’t vary (EX: silly puddy ruler)
-Interrater: reliability between raters (do the raters agree and come up with the same conclusion)
-Test Retest: give a test multiple times; if it is reliable the different scores will be one and the same (see ^ assumption)
Validity
Does your test measure what you claim you are measuring?
-Face: the appearance of what you are using to measure (we get the stamp of approval from colleagues). If it is important that your subjects “buy” into your methods, face value is important.
-Content: two pieces 1) does each and every item on the test measure what it claims to measure & 2) do all the items together (combined) tap into and measure the full width/depth/breadth of the thing you are trying to measure?
-Criterion: serves as a benchmark or standard to what you are going to compare against.
-Concurrent (Criterion): using a method that has “been through the fire” and proven itself. Give both tests to your subjects. If your test is valid, the scores between the two test should be very similar
-Predictive (Criterion): use the score of a subject on your test to predict the score on another criteria (EX: someone scores high on an aggression test, we could predict that they will have an extensive record of assaults)
-Construct: “where the railroad meets the road” you determine your measure…now you find other tests that have “been through the fire” and have proven themselves for other constructs (outside of your own). Then, do theory building.
EX: our measure-aggression//other constructs– assertiveness and selflessness
theory building: we would predict that high scores in aggressiveness would probably result in high assertiveness, and low selflessness. we would also predict that low scores in aggressiveness will not correlate with assertiveness, and low aggression probably doesn’t result in correlation with selflessness.
Standardization
Is your test the same every time it is given?
DSM—I
(1952): Meyer contributed due to his psychobiologic theory, later he retracted it. His theory was seeded in Freud’s work. No childhood disorders—all adult focused
DSM—II
(1968): [136 pgs. & 182 disorders] Added in childhood disorders; Focus was to make it Atheoretical (which means without theory); W/O theory, all professionals could use it
DSM—III
(1980): [494 pgs. & 265 disorders] multi-axial [5]/hierarchical (some conditions rank higher than others); this system allowed for a patient to have more than one disorder—the one causing the most problems comes first; operationalize definitions (made things more clear and more interratibly reliable)
5 Axis
- Clinical Disorders
- Personality Disorders
- General Medical Disorders
- Psychosocial Disorders
- Global Assessment of Function
DSM—III-R
(1987): (R=Revised) it was only revised because 1) new research needed to be included, rather than waiting for a full review & 2) addition of NOS categories (biggest reason); NOS—not otherwise specified (because a lot of people didn’t qualify into the extremely specific definitions and weren’t able to receive a valid diagnosis and treatment due to insurance companies restrictions); fix what DSM-III did
DSM—IV
(1994): due to technology society became much more mobile—multi-cultural push; included disorders unique to different cultures; has 886 pages & 365 diagnoses
DSM—IV-TR
(2000): (text revision) some changes that needed to me made due to research to bring it up to date; changes with Tourette’s syndrome (TS), sexual disorders, and cognitive disorders (dementia and Alzheimer’s)
DSM—V
(2013): supposed to make big changes in personality disorders, but it didn’t; however, some of the “thinking” about personality disorders is included; 5 Axis are gone;
shuffled around a lot +new disorders and took some out; VERY CONTROVERSIAL—the National Institution of Mental Health (NIMH) does not accept DSM-V
DSM Issues: Types of Classification
¬Categorical: assumes clear & distinct boundaries between disorders
Dimensional: number of different dimensions (usually 5) on a continuum; open VS closed/agreeable VS disagreeable/introverted VS extroverted; this method would be best for personality disorders because of overlap of common symptoms; the differences are more important than the commonalities;
Prototypical: compare to a prototype (model/standard/classic/epitome) compare clients to the prototype—the closer they match, the more confident we are in our diagnostics (DSM—IV-TR was prototypical in nature)
DSM—V is mostly prototypical with elements of dimensional and categorical.
DSM Issues: Sociopolitical Document
has social and political trends (in more ways than we’d like to admit). The main issue is that ultimately the decision depends on the acceptance by the general population (also, DSM developers vote on the final decision). EX: homosexuality, PMS (PMS was pulled out because of the female reaction, not due to lack of data)
DSM Limitations:
Label: everybody gets a label (especially with NOS)
Limited R/V: reliability and validity is still an issue
Describes: DSM describes but doesn’t explain (can tell you what, but can’t tell you how)
Assumes Clear Boundaries: haven’t completely conformed to the dimensional design
Individual Focus: haven’t incorporated System’s Theory—environment and relationships could contribute
Value of Classification
Communication: diagnosis tells professionals a lot about the patient, what to expect, the life struggles of the patients, what treatments won’t work, and the treatments that have shown the most promise and best results
Research: most important reason why classification is valuable
