W1 - intro to classification and diagnosis Flashcards
Abnormality
- thought of by the three D’s and statistical rarity
- distress, deviance and dysfunction
- none of these elements alone determine abnormality, they work together
- change with society
- no universal definition has been established yet
Statistical rarity
- how likely the characteristic is to occur in society
- statistical rarity means that it is out of the ordinary for particular traits or characteristics to present
- this can mean positive characteristics as well, therefore statistical rarity alone does not equate to abnormality
Deviance and norm violation
- the value component
- what society deems acceptable and unacceptable behaviour
- this weeds out positive characteristics from abnormality (being an elite athlete or gifted musician)
- however, this does not alone determine abnormality
Distress
- abnormal behaviour causes distress to the person
- this allows individuals to self-define their behaviour as abnormal or not, rather than be labelled by the majority of society as seen in deviance or be considered in relation to the rest of society as seen in statistical rarity
- behaviour causing distress cannot solely define abnormality -> distress can be brought upon oneself for religious or political reasons
- the presence of distress may not always be necessary -> manic episode of bipolar disorder
Maladaptive
- behaviour that interferes with a person’s ability to meet the requirements of everyday life
Dysfunction
- also known as maladaptive
- behaviour is abnormal if it impacts the functioning of one’s everyday life
- functioning in everyday life considered in terms of financial stability, keeping employment, maintaining relationships and perhaps a household
- where distress doesn’t appear in a manic episode, dysfunction can
- dysfunction can be tricky -> extreme phobia of snakes may not impact a person in the city however may prevent a person in the country from leaving their home
- largely dependent on the expectations of society also
Why bother diagnosing abnormal behaviour
- improves communication concerning mental illness
- clarifies essential features and boundaries
- may guide information gathering
- to guide treatment
- to determine if treatment is effective
- for financial, health and legal reasons
Assessing disorders
Clinical interview
- structured interviews
- unstructured interviews
Psychological testing
- Beck Depression Inventory II
Observations
- Behaviour assessments
Psychophysiological assessment
- heart rate
Neuroimaging
- CAT, PET, MRI, fMRI
Syndromes
- certain symptoms are known to co-occur
- a syndrome refers to a collection of symptoms that frequently are observed together
- this helps predict symptoms that may occur, after observing symptoms that are already occurring
Comorbidity
- the presence of one diagnosis increases the likelihood of additional diagnoses
- ex, high comorbidity for anxiety and depression
Problems with diagnosis
Problems with reliability
- assessments may be inconsistent in detecting disorder
Problems with validity
- assessments may not be detecting intended disorder
Self-fulfilling prophecy
- if the client believes it, the assessment may mirror this belief
Diagnostic bias
- we see what we want to see at the time
Categorical
- discrete syndromes
- distinct boundaries with other disorders
- distinct boundaries between normal and abnormal
Dimensional
- traits occur along a spectrum of intensity
- traits occur in a finite proportion of the general population
Case formulation
- integrates information
- explanation of current and historic problems
- provides a blueprint for guiding therapy
- provides predictions about future challenges
- enhances understanding and empathy
What’s included in formulation
Presentation - symptoms and problems
Predisposing factors - past traumas
Precipitating factors - triggering events
Perpetuating factors - maintaining factors
Protective factors - reduces the problem or distress
