Chapter 4 - Classification, Assessment, and Treatment Flashcards Preview

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Flashcards in Chapter 4 - Classification, Assessment, and Treatment Deck (18):
1

Advantages of classification

1) Predictions - can predict future behavior, know what to expect
2) Communication - means to communicate among clinicians
3) Research - provides research categories
4) Stats - provide basis for epidemiological records -> increase understanding

2

Disadvantages of classification

1) Puts label on people, produces social stigma, can be self-fulfilling prophecy
2) Categories not perfect - much overlap across categories
3) Diagnoses may not be reliable/consistent - diff clinicians -> diff conclusions, variations in client behavs over time
4) Subjectivity of diagnostic categories

3

Examples of subjectivity of diagnostic categories

*Drapetomania
*Homosexuality
*Passive Aggressive Personality Disorder
*Road Rage disorder

4

Changes in DSM-5

*Categorical -> Dimensional
*Move away from distinct categories
*Scales: none, slight, mild, moderate, severe
*Purpose: increase reliability and validity
*Criticisms: may decrease reliability/validity, pathologizing behavior that would not be previously diagnosed, more patients treatable -> can be medicated -> $$$$
*Collapsed across 3 axes: diagnoses, severity, additional info
*Added causal specifiers - biological, genetic, environmental, developmental, social, cultural, behavioral
*Cultural section - symptoms vary across cultures

5

Evolution of DSM

Early editions: psychodynamically oriented
Version III: more medical approach -> multiaxial, 5 axes (primary diagnosis, personality disorders, relevant physical disorders, psychosocial/environmental stressors, global assessment of functioning)

6

Reliability of classification

Diagnosis on same client consistent over different clinicians, consistent over time

7

Validity of classification

Does it group people together with the same cause of symptoms and same effective treatments

8

Types of interview assessments

*Therapeutic: include both assessment and therapy
*Assessment: get overall picture of person, assess both verbal and nonverbal
*Structured: preestablished questions/format, standardized, closed-ended answers

9

"Intelligence" tests

Measure intellectual functioning and speed of cog functioning
*Highly standardized, admin and scoring
*Verbal and spatial reasoning/functioning

10

Personality Assessments

*Objective test: MMPI
*Projective test: psychodynamic orientation - assumes that given an ambiguous stimulus, individual will project unconscious elements of personality onto stimulus (Rorschach, TAT, CAT)

11

Behavioral Assessment

Observe/record frequency/duration of target behavior

12

Cognitive assessment

Measure thoughts/beliefs, attitudes, etc. Questionnaires, self-measuring, interviews

13

Relational assessment

Context of behavior

14

Bodily assessment

Measure physiological functioning - skin conductance, BP, arousal, brain imaging

15

Reliability of assessment instruments

Consistency of measure
*Test/Retest: scores at t1 consistent with t2
*Internal consistency: consistency within measure - confident that all items in measure yield similar results. Rules out "rogue" items

16

Validity of assessment instruments

Is the test measuring what I want it to?
*Predictive: predict behavior measured?
*Construct: depict complex phenomenon set out to measure
*Content: cover all important facets/aspects of what you are measuring
*Face: does it look like it will measure what it measures

17

Cultural issues in assessment

Constructs not equivalent cross-culturally (like intelligence) - scores on some measures may not be equivalent/comparable to same scores on different cultural samples

18

Cultural issues in diagnosis

Behavior associated with disorder in 1 culture may not be abnormal in another culture