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Lecture

Assessment and Diagnosis

7 Pages
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Department
Psychology
Course Code
PSY240H1
Professor
S.Cassin

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PSY240 January 18th
Assessment and Diagnosis
Diagnosis of abnormality
Advantages of classification
Ability to label is important for statistical purposes, governments can then collect
information about incidence rates over time, e.g. ADHD diagnosis increases, what is
going on?
Etiology why did it develop? Need to know what it is to research why it develops
Without treatment, assessment is irrelevant; classification helps determine
appropriate treatments
Allows prediction/prognosis how will symptoms pan out? E.g. adjustment disorder
(caused by specific stressors) only lasts 6 months at most, others must be managed
over time (e.g. schizophrenia, personality disorders)
Communication in field/research research should apply to people everywhere, not
just a single hospital, so should make sure everyone is talking about the same
disorder/symptoms
Knowing there is a name and treatments can be relieving, not feeling alone, not as
chaotic
Disadvantages of classification
Arbitrary distinction between normal and abnormal, ignores continuum (categorical)
Have to draw lines and decide what makes it into the DSM, can be influenced by
social factors
E.g. Diagnosis of depression 5 of 9 symptoms for at least 2 weeks
Assumes disorders are distinct, when really they overlap in symptomology
Some people are diagnosed with multiple disorders, assumes these are discrete when
really there may be something at the root of many problems (e.g. perfectionism 
major depressive disorder, social phobia, body dysmorphic disorder, OCD)
People have argued the DSM is too categorical
www.notesolution.com
oCan assess normal variations in personality with NEO personality inventory
(five factors)
Misuse can see psychopathology where none exists, overdiagnosis; once given a
diagnosis, it tends to stick, affects future interpretation of behaviours
Heterogeneity within diagnostic categories people in the same category should
have similar symptoms to each other, different symptoms from others in reality,
many symptoms fit multiple diagnoses and people with the same diagnosis can
present in very different ways
E.g. depression requires 5 of 9 symptoms, two people may only have one symptom in
common and others can be opposite (e.g. increased or reduced sleep or eating)
Reliability and Validity
Reliability consistency across examiners, time, patients
Symptoms may be perceived in a different way for different patients
Inter-rater reliability - would two clinicians give the same diagnosis to the same
patient, given the same observation?
Test-retest would the same clinician give the same patient the same diagnosis a
few weeks later?
Easier to get higher reliability for broader categories
Easier for some symptoms, e.g. hallucinations, pretty distinct, compulsive behaviour,
observable, behavioural symptoms in general, which are overt; depressed mood more
difficult, more subjective
Easier to get higher reliability for observable symptoms
Can be low due to inconsistencies in patients report between clinicians, may be more
comfortable with one (patient factors)
Some clinicians may focus on impact on functioning over meeting criteria
Clinicians may work from different theoretical models, prone to see some symptoms
more than others, based on their expertise
Confirmation bias (ambiguous symptoms interpreted in light of provisional
diagnosis)
www.notesolution.com

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Description
th PSY240 January 18 Assessment and Diagnosis Diagnosis of abnormality Advantages of classification Ability to label is important for statistical purposes, governments can then collect information about incidence rates over time, e.g. ADHD diagnosis increases, what is going on? Etiology why did it develop? Need to know what it is to research why it develops Without treatment, assessment is irrelevant; classification helps determine appropriate treatments Allows predictionprognosis how will symptoms pan out? E.g. adjustment disorder (caused by specific stressors) only lasts 6 months at most, others must be managed over time (e.g. schizophrenia, personality disorders) Communication in fieldresearch research should apply to people everywhere, not just a single hospital, so should make sure everyone is talking about the same disordersymptoms Knowing there is a name and treatments can be relieving, not feeling alone, not as chaotic Disadvantages of classification Arbitrary distinction between normal and abnormal, ignores continuum (categorical) Have to draw lines and decide what makes it into the DSM, can be influenced by social factors E.g. Diagnosis of depression 5 of 9 symptoms for at least 2 weeks Assumes disorders are distinct, when really they overlap in symptomology Some people are diagnosed with multiple disorders, assumes these are discrete when really there may be something at the root of many problems (e.g. perfectionism major depressive disorder, social phobia, body dysmorphic disorder, OCD) People have argued the DSM is too categorical www.notesolution.com
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