Chapter 4 Flashcards
(37 cards)
Classification def?
Subdividing or organizing a set of related objects
Classification benefits? (3)
- Facilitates description & communication
- Aids treatment decisions & prognosis
- Facilitates research on etiology, treatment, & outcome
- Facilitates 3rd party reimbursements (insurance)
Classification concerns? (3)
- May lead to stigmatization
- Unrelated problems may be misattributed to the disorder
- Expectations for behavior may change
Categorical approach def/meaning?
- Reflects a difference in kind or quality
- Discrete groups (normal vs abnormal)
- Schizophrenia & depression are qualitatively different
Problems with categorical approach?
- Assumes bimodal distribution (that the diff. between groups is very clear –> think big vs small ants)
- Requires you to have 5 symptoms, so only having 4 means you don’t qualify for the disorder… even tho you’re experiencing symptoms
Dimensional approach def / meaning
- Focuses on the amount of a particular characteristic that something possesses
- Everything has the characteristic at different amounts
- Uses continuum
DSM-5 uses mostly… a) categorical or b) quantitative?
a) categorical
What are the 2 important diagnostic systems for mental disorders? Who developed them? Where are they used?
DSM (5)
- American Psychiatric Association
- used in the US and parts of Europe
ICD
- World Health Organization
- most other countries around the world
** includes mental & physical disorders
Important things about DSM 1:
- First official manual of mental disorders
- Introduced post WW2
- Relied heavily on psychodynamic concepts
Important things about DSM 2:
- Still uses psychodynamic perspective
- Included behavior disorder of childhood and adolescence
- Removed homosexuality in 7th printing
Important things/changes about DSM 3:
- FIRST TIME you see symptom based
- Introduced multi-axial system
–> clients evaluated in 5 different areas - Added new diagnostic categories
Important things/changes about DSM 4:
- Extremely conservative, stringent, empirical standards for changes to diagnostic categories/requirements
- still used multi-axial system
Multi-axial system –> what were the 5 axes?
1: Clinical disorders of mental illness
- Episodic / temporary disorders
2: Recurrent / chronic disorders
- Personality disorders, mental retardation
3: General medical conditions
- Hyperthyroidism
4: Psychosocial & environmental problems
- Homelessness, loss of loved one, just broken up
5: Global assessment of function
- Rating 1-100, lower number is worse
Important things/changes about DSM 5:
- Still symptom based system
- Very few disorders with causes
–> ex. ptsd
Major changes:**
- Elimination of multi-axial system
- Increase in dimensional focus
- Comorbidity rating
- Greater emphasis on cultural differences
2 big limitations / problems with the DSM?
Boundaries between normal and abnormal can seem arbitrary
- cutoff points not always empirically justified
- reliant on subjective judgment
- time periods in diagnoses
Problem of comorbidity:
- 56% of people with 1 disorder meet criteria for at least one other
- affects validity of system and reliability of diagnoses
- are diagnoses even naturally distinct if theres so much overlap?
Reliability def?
- does an assessment produce the same result each time it is used to assess the same thing
- CONSISTENCY
(not accuracy)
Validity def?
- does a measuring instrument actually measure what it is supposed to?
- continuum of more to less useful
- ACCURACY
(not consistency)
Types of reliability measures?
- Test-retest reliability
- Inter-rater reliability
Test-retest reliability def?
- refers to consistency between 2 repeated assessment of tests
- if you test now and again later, do you get the same results?
Inter-rater reliability def?
- refers to agreement of raters about observations
- 2 providers watch the same client interview. do they give the same diagnosis?
3 types of validity measures?
- Etiological validity
- Concurrent validity
- Predictive validity
Etiological validity def?
- Looking for causal associations between factors and disorders
- Usually over time
- Concerned with the specific factors that are regularly and perhaps uniquely associated with a particular disorder
Concurrent validity def?
- concerned with the association between disorder and other symptoms, life circumstances/life events, and test performance
- Ex. schizophrenia patients will usually have poor test performance and disrupted life circumstances at the same time
Predictive validity def?
- concerned with the accuracy of predicting future outcomes
- Does knowing the disorder give us a good chance of knowing which treatment would be most effective?
