Ch5 Diagnostic and Classification of Disorders

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Ch. 5: Diagnosis/Classification of Psychological Disorders

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Defining Abnormal Behavior Pros/Cons of Diagnostic Criteria Formal Classification Systems Issues in Classification Ch. 5: Diagnosis/Classification of Psychological Disorders

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Ch. 5: Diagnosis/Classification of Psychological Disorders

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Stat Infrequency or Violation of Social Norms Subjective Distress (I hurt) Disability or Dysfunction Some Criteria for Defining Abnormal Behavior

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Stat Infrequency or Violation of Social Norms Some Criteria for Defining Abnormal Behavior Schizophrenia (1%)

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Stat Infrequency or Violation of Social Norms Some Criteria for Defining Abnormal Behavior

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Stat Infrequency or Violation of Social Norms Some Criteria for Defining Abnormal Behavior

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Stat Infrequency or Violation of Social Norms Some Criteria for Defining Abnormal Behavior

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Subjective Distress (I hurt) Some Criteria for Defining Abnormal Behavior

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Subjective Distress (I hurt) Some Criteria for Defining Abnormal Behavior

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Subjective Distress Some Criteria for Defining Abnormal Behavior

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Disability or Dysfunction Some Criteria for Defining Abnormal Behavior

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Disability or Dysfunction Some Criteria for Defining Abnormal Behavior

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Disability or Dysfunction Some Criteria for Defining Abnormal Behavior

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Stat Infrequency or Violation of Social Norms Subjective Distress (I hurt) Disability or Dysfunction Some Criteria for Defining Abnormal Behavior: A Recap

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Choice of Quantitative Cut-off Points (Mr/Miss Right vs. Good Enough) Statistical Infrequency or Violation of Social Norms Cultural Relativity (deviant for culture/not necessarily others) Number of Deviations

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Awareness of and Ability to Report Distress in a Direct, Honest, and Culture-Consistent Manner Amount of Distress to be Abnormal Cultural Relativity (deviant for culture/not necessarily others) Subjective Distress

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Problems in occupation, academic, or social functioning Determining Relative Standards for these problems Disability or Dysfunction

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Broader Mental Disorder Definition DSM-IV-TR General Criteria

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A clinically significant behavioral or psychological syndrome or pattern Associated with distress or disability Not merely an expectable and culturally sanctioned response to a particular even Considered to reflect behavioral, psychological, or biological dysfunction in the individual Broader Mental Disorder Definition DSM-IV-TR General Criteria

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DSM-I (1952)

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DSM-IV-TR (2000)

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Bipolar I Disorder: Outpatient Adult - Intake http://www.youtube.com/watch?v=kKm526pnMSg

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Bipolar I Disorder: Outpatient Adult - Intake 38 y.o., African American man; College graduate - Business “Bernie” Married to Ellen 10 yrs; plays in a band on the weekends Intake Altercation after a gig at a bar with owner – client assaulted owner and was arrested. He/wife noticed the following changes over past 1-month: ?energy and activity level, impulsiveness, racing thoughts, on-the-go, moving constantly. ? sleep, social awareness, social appropriate behavior

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Broader Mental Disorder Definition: DSM-IV-TR General Criteria “Bernie’s” Multiaxial diagnosis Axis I: 296.42 Bipolar I Disorder, Recurrent, Most Recent Episode Manic, Moderate Axis II: No diagnosis on Axis II. Axis III: 250.00 Diabetes mellitus, type II Axis IV: legal difficulties, interpersonal conflict Axis V: GAF current = 55; past year 80

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Broader Mental Disorder Definition: DSM-IV-TR General Criteria DSM–IV-TR is a Multiaxial system for diagnosis Axis I: Clinical Disorders Axis II: Personality Disorders and Mental Retardation. Axis III: Disorders due to a General Medical Condition. Axis IV: Psychosocial and Environmental Problems Axis V: Global Assessment of Functioning (GAF)

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Advantages of Diagnosis Communication- client-therapist; therapist-MH personnel Treatment selection and Treatment Planning Promotes Research in Understanding Diagnosis Promotes Research into Etiology of Disorder

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General Issues in Classification/Diagnosis Categorical/Dimensional Model of Diagnosis Bases of Categorization– single vs. multiple methods Pragmatics of Inclusion into Diagnostic System Reliability of Diagnostic Judgments Validity or Prediction Based on Diagnosis Diagnostic Bias of individual factors or diagnoses Narrow/Broad coverage of diagnostic system

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End of Chapter 5