Classification and Assessment of Psychopathology (Exam 1) Flashcards Preview

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1

What is the foundation of clinical psychology?

on assessment of psychopathology

2

classification

organization of group of phenomena around specified principles (naming)

ex: DSM system -> diagnosis of major depressive disorder

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assessment

-process of determining a set of problems
-larger process with different goals
-may lead to classification (may not)

4

What is the issue of paradigm used for classification and assessment?

assessment and classification depend entirely on the paradigm employed

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statistical basis for abnormality pros (classification)

-looks scientific
-appears unbiased and objective

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statistical bases for abnormality cons (classification)

-sometimes unbalanced (ex: low IQ = treatment, high IQ = no treatment)
-stats give no guidance in determining which infrequent behavior is psychopathological
-feels more arbitrary

7

What is the physiological paradigm?

systems of classifications were developed which argued that mental illness has a biological cause

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What are the other names for the physiological paradigm?

-medical model
-disease model

9

What did Emil Kraepelin suggest about a syndrome?

clusters of symptoms form a syndrome which can be attributed to a biological dysfunction (foundation os DSM)

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syndrome characteristics

-has its own unique cause, course, symptoms, treatment and outcome

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What does an assessment of a syndrome require?

assessment process looking for the symptoms of these syndromes

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Disease Model (classification)

abnormal behavior is given a classification based on symptoms

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How do you arrive to a diagnosis?

classification based on symptoms (disease model)

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Does debate exist on the applicability of biological models to psychological systems?

yes

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When is the medical model useful?

cases of genetic causes or enzyme imbalances (PKU, Alzheimer's)

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What are the problems with the disease model?

-not always useful in psychology
-identification (or creation) of disease requires creation of a cure specific to that disease
-behavior should be labeled separately from disease
-labels are value judgements

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Not always useful in psychology (problems with disease model)

-Confuses the symptoms with the disease (problems with disease model)

-symptoms are given a label and this label is the disease
(ex: post-didactic Preparatory Distress Syndrome, PDPDS)

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Identification (or creation) of disease requires creation of a cure specific to that disease (problems with disease model)

unique disease entity will have unique course and cure
(ex: discovery of bacteria -> antibiotics)

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Behavior should be labeled separately from disease (problems with disease model)

ex: person has schizophrenic symptoms but not necessarily schizophrenic person

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Labels are value judgements (problems with disease model)

Thomas Szasz

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What is Thomas Szasz known for?

The Myth of Mental Illness

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The Myth of Mental Illness

-no such thing as mental illness
-lack of tolerance for non-conformity that shows up as persecution against non-conforming person

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What is the DSM?

Diagnostic and Statistical Manual of Mental Disorders

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Who published the DSM?

American Psychiatric Association

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Which model does the DSM assume?

medical model

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What are the positive aspects of the DSM?

-clear inclusion/exclusion criteria for disorders
-disorders are categorized under broad headings
-allows for comorbidity

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What are the negative aspects of the DSM?

-information about an individual is lost
-labels are stigmatizing (can affect the way a person views themselves)
-creating a new disorder requires a corresponding new treatment

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reliability

consistency of an assessment system

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validity

truth of an assessment system

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What is diagnostic reliability?

-"consistency" of a measure
-correlation coefficient (looking for agreement and stability)

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What is test-retest reliability?

arriving at same or similar results after a span of time

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What is inter-rater reliability?

determined by two independent users of a system arriving at the same diagnosis

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Is the reliability of the DSM system problematic?

yes

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What are the problems with reliability for the DSM system?

-better for some disorders than others
-fair correlation for broad distinctions
-not good for PDs, subtypes of some disorders
-not so good for distinctions that are conceptually difficult to make

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What are the factors which decrease reliability for the DSM system?

-inconsistent information about clients
-differences in interviewing techniques
-inadequacies in the diagnostic or classification system

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How can we improve the reliability for the DSM system?

-push to standardize the interview process (SCID system)
-refining and specifying diagnosis (increase # of distinctions)

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What is construct validity?

degree to which the phenomenon is shown to be unique and separate from others related to it

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How else can we assess construct validity?

-convergent validity
-discriminant validity
-predictive validity

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What is convergent validity?

construct may converge with other measures of the same construct

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What is discriminant validity?

extent to which one label can be discriminated from another label

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What is predictive validity?

extent to which people with the same label have the same future

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Can you have reliability without validity or vice versa?

we can have reliability without validity
we cannot have validity without reliability

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How does the NIMH reject DSM-5?

will not use it and will not support research on it

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What are the criticisms of the DSM-5 by the NIMH?

-DSM system is not functional (doesn't guide/tell therapists how to treat clients)
-too many people have disorders (not specific enough)

45

What is the percentage of people who have disorders in their lifetime?

-21% one disorder
-13% two disorders
-14% three or more disorders

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What is a sub-syndromal problem?

not meeting criteria for disorder (have less criteria than needed)
ex: minor depression

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What is the cause of the sub-syndromal problem?

High number of people who seek treatment can't be diagnosed using current system

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What are the possible alternative to the DSM?

-make system more theoretical
-create more functional system rooted in behaviors rather than unspecified constructs
-dimensional approaches

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What are the challenges to the possible alternative to the DSM?

-DSM is in place and now powerful
-Research has been organized around DSM
-Insurance companies use DSM categories
-Not one strongly held theory to organize psychology

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How are problems created for the possible alternatives to DSM?

problems are created by doing this related to infrastructure

51

What is the goal of psychological assessment?

determine cognitive, emotional, personality, and behavioral factors in psychopathology

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What happens during the clinical interview?

any interpersonal encounter in which language is used to gather information about a client

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What does the clinical interviewer pay attention to?

-how the client answers questions
-look at the style and process

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What are psychological tests?

standardized procedures designed to measure performance or task or assess aspects of his or her personality

55

What are the projective personality tests called?

-Rorschach Inkblot test
-Thematic Appreciation Test

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What are the personality inventories?

Minnesota Multiphasic Personality Inventory

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What is the Rorschach Inkblot test?

-give unstructured or ambiguous stimuli to which the patient responds
-allows access to conscious material (in theory)

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What is the Thematic Appreciation Test?

-shows a story card and asks the client "Whats going on in this picture?"
-allows access to unconscious motives and personality style (in theory)

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What are the problems for the projective personality tests?

reliability and validity (faking good and bad answers)

60

What is the Minnesota Multiphasic Personality Inventory-I (MMPI-II) test?

-most widely used objective test
-empirically derived test
-most widely used test in research
-patterns of scores are interpreted

61

What are the two most important parts of the MMPI-II test?

-validity scales
-clinical scales

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What are validity scales?

-tells whether profile is accurate measure of taker
-tells whether subject answered honestly

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What are clinical scales?

-tells what is going on for subject clinically
-cannot make a diagnosis (can help process)

64

What is behavioral assessment?

assessment to determine behaviors that are problematic and how to intervene

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What should you remember for behavioral assessment?

stimulus, response, consequences in behaviorism

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What is the SORC model?

-S = stimuli
-O = organismic variables
-R = response
-C = consequences

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S = stimuli

stimuli that precede the problem

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O = organismic variables

factors in the individual (ex: high blood pressure)

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R = response

response that the person makes

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C = consequences

consequences of the behavior

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What should you do when setting individual target behaviors and goals with a person?

-work with person towards these tailored goals
-remember single subject designs

72

What populations are behavioral assessment commonly used in?

-therapy
-school settings for problem behavior
-autism work
-severe mental illness (SMI) population
-vocational rehab
-occupational therapy

73

What is medical student syndrome?

as they read about diseases, medical students are susceptible to believing that they exhibit symptoms of those diseases

74

What are the symptoms for the medical student syndrome?

-noticing presence of disorders as you read about them
-deciding you have a disorder you just read about

75

What is the pathognomonic signs?

one symptom equals presence of a particular disease (none in psychology)