Lecture 2- DSM-V Classifications and Evidence Based Practice Flashcards
What is the dimensional way to classify?
- Everyone possesses all characteristics to varying degrees. People rated as above or below average.
- Behaviours exist on a continuum
What are some issues with the dimensional way of classifying mental disorders?
- Sampling
- Insensitive to contextual effects (different settings)
- Dependent on understanding of normal
What is the categorical way of classifying mental disorders?
- Distinctive categories that are “black & white”
- Either meet specific criteria or not.
What some issues with categorical classification of mental disorders?
- Behavior seldom falls neatly into categories.
- Subthreshold but impaired?
- Different causes & treatments: often just looking superficially but lots of mental disorders in childhood present the same and will respond differently to different treatments
Who was the DSM-5 published by?
The American Psychiatric association
Is the DSM-5 categorical or dimensional?
Categorical, so has the critics that come along with that
What are some critics of the DSM-5?
- Categorical (people don’t fit into neat boxes)
- Interrelationships and overlap (many disorders share similar symptoms, instead define by problems rather than lots of separate diagnose)
- Individualistic (doesn’t look at strengths + everyone is different)
- Access to treatment (limit individuals access to funding if they don’t tick very set boxes)
What is the primary technique used to see if individuals meet DSM-5 categories? What do we try and investigate using this technique?
Interview
- Developmental history (did things develop at normal times)
- Family characteristics (siblings, how much attention parents payed, socio-economic status)
- Family history (history or mental health often makes it more likely for child to have same mental illness as genetic component)
- Collateral information from other sources as sometimes the individual is not the most reliable source (bias)
How are children viewed in relation to their families and how does this relate to mental health issues?
Take a systems approach in diagnosing psychiatric disorders. Individuals are part of a wider family/ situation that results in their behaviour/ issues
What questions are important to ask in assessing the current problem?
- When did it start?
- How severe is it?
- How often does it occur?
- What makes it worse/better?
- How has it changed/developed over time?
- Impact of the problem on others?
What do we have to keep in mind when assessing patients in relation to the purpose of our questioning?
-Ultimately we are trying to treat the individual/ make a difference in their lives
What are some types of psychological tests that are used in conjunction with interviews to determine the meeting of DSM-5 criteria?
- Screening (e.g., CBCL) – multiple sources
- Checklists (e.g., CDI)
- Developmental (e.g., Vinelands)
- Personality/Temperament (e.g., CBQ)
- IQ (e.g., WISC-IV)
- Achievement (e.g., WRAT)
- Neuropsychological functioning (e.g., NEPSY)
How is evidence-based practice in relation to diagnosing mental health disorders?
- Psychological assessment and treatment techniques must be evidence based.
- Ask yourself: can I justify what I am doing in a court of law?
- “What evidence do I have that this is the best possible intervention for this particular patient?”
Just because something is evidence based, does that mean it is the best action for the individual?
No, we are not following a computeristic medical model. All individuals are different and will respond differently to treatment approaches.
Keeping in mind individual differences what is evidence based approach?
The integration of the best available
research with clinical experience in the
context of patient characteristics,
culture, and preferences.
