PSY1003 WEEK 5

Question 1

what use is classification systems

Answer 1

helps us understands relations between different conditions, understand cause and identify appropriate treatments, determine if effective, real-world applications (compensation, fit to stand on trial)

Question 2

state 4 goals of classification systems

Answer 2

1. provide necessary and sufficiant criteria for differential diagnosis
2. permit distinction of ‘true’ psychopathology from non-disordeded normal behaviours
3. diagnostic criteria can be systemically applied by different clinicians in settings
4. it should be theoretically neutral

Question 3

what are the 3 goals of assessment

Answer 3

1. current problems
2. diagnosis/none of a psychological disorder
3. did the treatment work

Question 4

what are some problems with diagnostic manuals which impact in real world

Answer 4

leads to stigma, carries historical baggage which may no longer be true such as idea all mentally ill are severely distressed (not applicable to ASPD)

Question 5

give some weaknesses for diagnostic manuals

Answer 5

1. describes observable symptoms but not cause
2. categorical (depressed or not) - however severity of disorders cannot be quantified
3. homogeneity - many different symptom combinations can warrant multiple conditions diagnosis
4. comorbidity is norm despite disorders being very distinct - GAD and depression usually co-exist, so are they actually 1 condition?

Question 6

what does the DSM-5 attempt to do (also, what info can DSM provide)

Answer 6

classify psychopathology using emphasis of distress and disability, providing =
a) essential defining features of disorders
b) associative features
c) diagnostic criteria
d) differential diagnosisw

Question 7

what does DSM-5 avoid

Answer 7

suggestions about causes of disorders unless cause has definitely been established so diagnosis is fully based on observable physical symptoms, meaning DSM categories are descriptive construct

Question 8

give some specific weaknesses for just DSM

Answer 8

1. proliferation of disorders (keep on adding)
2. lowering thresholds - favour overdiagnosis, medicalises normality, overprescribing
3. disproportionate influence from biological model, ignoring socio-cultural factor
4. many disorders have a severity continuum (cut-off is subjective)
5. introduced categories designed to identify future populations at risk (attenuated psychosis syndrome - precursor for a psychotic episode) risks medicalising normality

Question 9

give criticisms of the DSM development process

Answer 9

1. many experts developing DSM are worried about false negatives (missed diagnosis, patient not fitting boxes exactly) meaning more inclusive diagnostic criteria, over-diagnosing
2. political and economic factors can shape medical model (pharmaceutical industries/sales) meaning profit depends on medical model influence

Question 10

state 4 alternatives to diagnostic manuals

Answer 10

Research domains criteria
hierarchical taxonomy of psychopathology
network analysis
power threat meaning framework

Question 11

explain research domain criteria

Answer 11

2009 US National Institute of Mental Health
classify via cause, then relate to an observable symptom,
units of analysis: cells, circuits, genes, physiology, behaviour
corresponding to constructs like negative (threat, loss) and positive valence (responsiveness to reward), social process, arousal

Question 12

give limitations of research domains criteria

Answer 12

based on psychopathology as brain circuit disorder - reductionism
focuses on intra-individual variables ignoring social, developmental, cultural contexts

Question 13

explain Hierarchical taxonomies of psychopathology

Answer 13

evidence-based taxonomy model for symptoms, predicting comorbity using higher-order dimensions to reflect association with lower-order dimension
5 levels: specific symptoms on bottom to broad heterogeneous constructs at top

Question 14

explain network analysis (alternative to diagnostic)

Answer 14

explains symptom cooccurance by assuming there is a underlying connecting cause
assumes disorders emerge from causal symptom interactions (depression not causal entity, just name for symptom network interacting to cause depressions)
interacting symptom network identified via stat methods measuring association strengths and codependence

Question 15

explain power threat meaning framework

Answer 15

BPS 2018: promote discussion and debate by providing different POV of origin, experience, expression of MHI
not medical model, people inseparable from material, social, environmental and cultural context
a natural reaction to stress
event indicative of ‘Powers’ that can pose ‘threat’
ask what has happened, how it affected and what sense was made, what they had to do to survive event

Question 16

explain structured clinical interview (assessment method)

Answer 16

predetermined question with response determining next
questions relate to symptom nature, past history, current living and working circumstances
clinician gains trust and rapport, convince clients of value of clinicians theoretical stance, emphathise, encourage elaborating
high-inter rater reliability for many disorders

Question 17

give limitations of clinical interviews (assessment method)

Answer 17

low reliability for unstructured interview
depends on clinicians views - psychodynamic asks about childhoods
some disorders results in low self-awareness
some client intentionally mislead
biased clinican - primacy effect meaning first info shapes rest of perspectives

Question 18

explain clinical observation (assessment method)

Answer 18

ABC Charts:
Antecendent: what happened before target behaviour
Behaviour
Consequences

Question 19

what are strengths of clinical observations (assessment method)

Answer 19

captures frequency of target behaviours, better ecological validity than self-report, can identify practical treatment options

Question 20

give 3 examples of psychological test (assessment method)

Answer 20

questionnaires, projective tests, intelligence tests

Question 20

give limitations of clinical observations (assessment method)

Answer 20

time consuming, alot of training, observation limited to single context, observer presence influences behaviour, poor inter-observers reliability

Question 21

what does self-report do (assessment method)

Answer 21

assesses specific characteristics, rigid response requirement allows objective, easy and non-biased scoring
establish statistical norm to standardise and allow clinican to see if client meets diagnoses

Question 22

give strengths of self-reports (assessment method)

Answer 22

high internal reliability and concurrent validity with diagnostic status and others observations

Question 23

give weaknesses of self-reports (assessment method)

Answer 23

time consuming, social desirability bias

Question 24

give some examples of projective tests

Answer 24

Inkblot, Thematic Apperception, Sentence Completion tasks

Question 25

give weakness for projection tests (assessment method)

Answer 25

low inter-rater reliability and validity - doesn’t reveal more than self-report or clinical interview
unlikely to be interpreted same by 2 clinician

Question 26

give one strength for projective tests (assessment method)

Answer 26

may have validity in some circumstances eg: detecting thought disorder in Sz

Question 27

give positives of intelligence tests (assessment method)

Answer 27

have been studied and developed over decade
very standardised (using mean 100 scores)
high internal consistencies

Question 28

give weaknesses of intelligence tests (assessment method)

Answer 28

underlying constructs hypothetical
culturally biased
ignores other intelligent aspects (emotional intelligence, musical ability, motor skills)

Question 29

give some examples of biologically based assessment (assessment method)

Answer 29

psychophysiology: electrodermal response, EMG, EEG
neuroimaging: CAT, MRI, fMRI, PET, SPECT

Question 30

give a weakness of biologically based assessment in general (assessment method)

Answer 30

any biological test alone cannot be used for diagnosis as there is little hetergeneity (difference) between ppts
Sz causes most brain changes in structure but cannot use scans to diagnose
one exception is in dementia

Question 31

summarise a case formulation

Answer 31

clinician gathers info and draws up psychological problems explanation, develops therapeutic plans
assumes client as unique so needs an individualised approach
no need of psychiatric diagnosis

Question 32

give an example for a CBT case formulations

Answer 32

ANTECEDENTS, BELIEF, CONSEQUENCE
1. create problems list
2. identify describe underlying psychological mechanism
3. understand how this generates problems
4. identify events precipitates problem
5. identify how psychological mechanisms mediate A-C link
6. draw up treatment plans

Question 33

give advantages of case formualtion

Answer 33

no diagnosis, reduce stigma
collaborative (patient contribute)
unique to client, tailored solution
based on theoretical cause/consequence understanding
empirical research finds good therapeutic benefit

Question 34

give limitations of case formulation

Answer 34

subjective: based on clinician background
relies on untested assumption
how can we share knowledge to learn from experience

Question 35

what are some cultural bias in assessment

Answer 35

mostly developed and tested on European pop
USA has differential diagnostic rate in different ethnicities
clinicians view lower socio-economic status as greater disturbed due to stereotype

Question 36

define test-retest reliability

Answer 36

extent test will produce roughly similar results when given to same ppt on different occasion

Question 37

define inter-rater reliabiliy

Answer 37

the degree to which two independent clinician agree interpreting tests

Question 38

define internal consistency

Answer 38

extent to which all items in test consistently relate to one another - Cronbach alpha

Question 39

define Cronbachs alpha

Answer 39

statistical test used to assess internal consistency of questionnaires or inventory

Question 40

define concurrent validity

Answer 40

measure of how highly correlated scores of one test are with scores from other types of assessment that we know also measure specific attribute

Question 41

define predictive validity

Answer 41

a degree to which the assessment method helps clinican predict future behaviour

Question 42

define construct validity

Answer 42

independent evidence showing measure of construct relates to other similar measure6