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Clinical Psychology
Week 3 Powerpoints
| Question | Answer |
|---|---|
| Classifying people is not the same as... | "lumping" or "forcing" a bunch of unique people into a group that does not define them |
| Research starts with (blank) | Research starts with classifying phenomena being studied Clinical psychology also needs classification |
| What makes a good classification system? | Validity and Utility |
| Validity | Question whether the classification reflects reality |
| Utility | If the system is useful for making classification decisions. Questions whether psychologists are making better decisions by using the system |
| What are the two kinds of classification systems? | Categorical and Dimensional |
| Categorical Classification | Qualitative difference between objects that are members of a category |
| Dimensional Classification | Objects can be arranged on a continuum to indicate "degree of membership in a category" |
| Dimensional classification is used to indicate: | degree of membership in a category |
| Diagnostic System | Classification based on rules for organizing, identifying, and understanding diseases and disorders |
| How do Clinical Psychologists use diagnostic system (rules) as a guide | For making diagnosis to explain a person's abnormal behavior |
| Two key factors in abnormal behavior | Age and Context |
| Age as factor for Abnormal Behavior | Abnormal at one age and not another (overt aggression) |
| Context as factor for Abnormal Behavior | Abnormal behavior during some sets of situations and not others (death of a loved one) |
| Developmental Psychopathology | Biological and behavioral systems change across development |
| Utility of Developmental Psychopathology | Allows you to predict what problems might look like if left untreated |
| Two key conditions for defining "Disorder" | (1) Presence of set of statistically rare symptoms or behaviors (2) Evidence that this set of symptoms cause harm or impaired functioning to person or others |
| Widiger (2008) and dyscontrol | Impairment must be involuntary, outside of the person's immediate control |
| Prevalence of Mental Disorders | 4.3% in Shanghai 26.4% in U.S Most common mental disorder is anxiety |
| Low Income and mental disorders | 53% have mental disorders, but only 8% are treated |
| Biopsychosocial Model | Blending: Biological, psychological, and social |
| DSM I | Vague in disorder descriptions |
| DSM II | Biological neurological focus, de-emphasized psychodynamics |
| DSM III | Improved organization of classification. Criteria made more explicit, listing of symptoms for each diagnosis Multiaxial system |
| DSM IV | Categorical approach. Addition of Mood disorders and substance-related disorders |
| Widiger (2008) and dyscontrol | Impairment must be involuntary, outside of the person's immediate control |
| Prevalence of Mental Disorders | 4.3% in Shanghai 26.4% in U.S Most common mental disorder is anxiety |
| Low Income and mental disorders | 53% have mental disorders, but only 8% are treated |
| Biopsychosocial Model | Blending: Biological, psychological, and social |
| DSM I | Vague in disorder descriptions |
| DSM II | Biological neurological focus, de-emphasized psychodynamics |
| DSM III | Improved organization of classification. Criteria made more explicit, listing of symptoms for each diagnosis Multiaxial system |
| DSM IV | Categorical approach. Addition of Mood disorders and substance-related disorders |
| The DSM IV has (blank) system | Multiaxial System |
| What are the different axis in the DSM IV? | 1. Clinical disorders 2. Personality disorders/ Mental Retardation 3. General Medical Condition 4. Psychosocial/ Environmental 5. Global assessment of functioning |
| Comorbidity | Two or more diagnoses at the same time More impairment, more services needed; chronic history |
| Abnormal Behavior according to DSM IV | Mental disorders often develop as maladaptive reactions to life stressors |
| Wakefield (1997) | Some disorder criteria allow for "exceptions" for some life stressors and not others |
| Major Depressive Disorder | 1 year of bereavement (mourning). There is no exception for chronic illness, loss of job, or divorce. Yet the symptom patterns for these events have no differences from bereavement. |
| Diagnostic Reliability in DSM | Aim is to improve reliability of diagnostic decisions. Using "field tests" of reliability. |
| Diagnostic Reliability | reliability of diagnostic decisions within the same general diagnostic category |
| Diagnostic Validity | Disorder is a discrete entity with clear boundaries between it and other disorders |
| Few DSM IV conditions can "pass" the (blank) | "Bar." The "bar" is to have clear biological causes of disorders |
| Symptom Patterns | Disorders in the DSM include multiple symptoms, not all need to be "met" to warrant diagnosis. |
| Treatment usually not linked to any particular kind of (blank) | Symptom profile, instead treatment is linked to diagnostic category |
| Clark (1995) | Developing subtypes within diagnoses has not helped to solve issues of multiple symptom patterns, and subtypes don't have strong empirical support. Except purging bulemia |
| Classification Approach of DSM IV | DSM IV conceptualizes disorder categories as mutually exclusive. *But patients typically meet criteria for more than one disorder. |
| Need for Dimensional Approach (vs. Classification Approach) | Disorders are categorized as mutually exclusive, yet patients typically meet criteria for more than one disorder. |
| Use of Dimensional AND Categorical Approach | E.g. Depression self-reports "Distress" (discouragement, etc) items appear dimensional. "Somatic" (weight loss) items appear categorical. |
| Other Classification Systems besides DSM | International Statistical Classification of Diseases and Related Health Problems (ICD-10) AND Achenbach System of Empirically Based Assessment (ASEBA) |
| ICD-10 | Includes all health conditions of World Health Organization |
| ASEBA | Multi-informant assessments used across lifespan Looks at problem behavior in academic, social, and work environment. Internalizing and Externalizing behavior |
| Widiger & Samuel (2005) | Diagnostic categories are not qualitatively distinct from each other or from absence of mental health concerns. But in practice, researchers and clinicians do treat categories like this. |
| Widiger & Samuel (2005) and Categorical Approaches | There are limitations to using categorical approaches: frequent comorbidity. There are efforts to fill "gaps" between related yet conceptually distinct disorders with "bridge" disorders. |
| Sanislow (2010) | Diagnostic classification systems have not "come through" on their promise |
| Sanislow (2010) and Mutual Exclusivity | They believe that disorders are not mutually exclusive of each other |
| Sanislow (2010) and Assessments | Diagnostic assessments raise more questions then answering clinical referral questions. |
| Sanislow (2010) and Neuroscience | Much of the neuroscience research indicates that symptoms of psychopathology are more common than they are different. |
| Sanislow (2010) and RDoC | Study psychopathology along five domains: 1. Negative Affect 2. Positive Affect 3. Cognition 4. Social Processes 5. Regulatory Systems |
| Sanislow (2010) and Multiple Units of Analysis | Study of multiple units of analysis along the domains 1. Self-Report 2. Behavior 3. Physiology 4. Circuits 5. Cells 6. Molecules 7. Genes |
| Sanislow (2010) Outcomes | Research and practice should be defined by they processes and mechanisms underlying psychopathology, rather than multiple diagnoses |
| Sanislow (2010) and Services | With the emphasis on underlying mechanisms, there will be greater ability to personalize clinical services "match" treatments to patients |
Created by:
roxandsocks
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