Class Notes (808,198)
Canada (493,072)
Psychology (3,455)
PSY341H1 (55)

Lecture 03.pdf

7 Pages
Unlock Document

University of Toronto St. George
Hywel Morgan

PSY341 Lecture 03  chronological order : assessment , diagnosis and treatments ( somewhat like adult but during assessment and diagnosis is somewhat diff in child)  classification & assessment ( today lecture)  Diagnosis – uses the same tool (medical tool) that you would w/ adult = DSM-IV  2 profession : physicians and psychologist – can use it legal to provide diagnosis  DSM-IV –TR  tool used in North America(Canada & US)  American Psychiatric Association  group of physicians, mostly psychiatrist  medical tool – devise for this by Psychiatric Association ( but there were psychologist involved) o rest of world don’t use it they use ICD ( International Classification Disease) - is version 10 as and version 11 is coming out as the DSM-V is coming out o w/ goal to make it very similar to each other  goal since 1995 – to make these 2 system completely compatible  which is not right now- there is only overlap o report of Canadian insurance and such  need to ICD diagnosis  ICD – is published by WHO ( division of UN)  there are disorders in DSM that not recognized in ICD and vice versa  diagnosis  moving away from describing ppl w/ schizoid as schizophrenia  in mental health it tend to stick w/ you and tend to stigmatize  is the #1 harm of diagnosis in mental healt  major disadvantage of DMS-IV  is poor validity ( can lead to misdiagnosis – is pretty high)  there is benefit to using DSM  it has utility – although validity is not great, it is useful selection of treatment is great if diagnosis is correct which is the major advantage of DSM  DSM-IV – is great  each of diagnostic category w/ last category is called NOS ( not otherwise specified)  is easy identify behaviour but not easy to define it – so this is good ( also for good for insurance purpose – because need to diagnosis)  problem w/ this again is validity// misdiagnosis DMS  5 things consider criteria of good classification system: o 1) Categories are clearly defined  does DSM ? yes it does – it is specific and clear on what symptoms need to be there to get diagnosis of that categories  significant overlap b/w categorical symptoms from one disorder to another in DSM  again can lead to misdiagnosis o 2) Categories exist  person giving diagnosis have those sets of symptoms , features are observed and occurred together regularly ( stats can do this (factor analysis)  but not done on DSM  DSM is based on consensus from experts o 3) Reliability  test & retest and inter-rater reliability  because categories are clearly defined  it adds to reliability  making DSM quite reliable o 4) Validity  categories are clearly discriminable from one and other  DSM is poor in this w/ greater reliability than validity  have significant overlap b/w syndrome o 5) Clinical utility  DSM-IV is useful  but validity poor can lead to misdiagnosis  e.g. polygraph  is utility on arousal but poor validity of testing of lying or not  2 types of diagnostic system: o Clinically derived - these are systems derived from conseus o Empirically derived  which comes from stats (from numbers) Clinically derived system  DSM – 1 in 50s  had 2 categories related to children which were expanded on each new reincarnation  toady DSM IV-TR has 10 categories relating mental issues regarding children  there will be significant change in childhood disorders in DSM-V o e.g. Autism – similar to it are Asperger’s and Rex’s disorders  DSM-IV – one reason that is most useful because it has lot of utility  it provides diagnosis on 5 axis/ dimensions  examine on those dimension  to get a diagnosis o Axis 1: primary presenting complaint ( e.g. Anxiety)  what you are going to treat & in context of other axis  allow co-morbid o Axis 2 – disorders – that are relatively permanent  these disorders are acknowledged by psychiatric and psychologist that while treatable it is relatively permanent conditions  For adults- these are personality disorders (can be treated but don’t go away – have to struggle w/ it)  e.g. condut disorder  can lead to anti-social disorder  one childhood disorder  in axis 2  mental retardation o Axis 3 – super important – to look at relevant physical condition  frequent misdiagnosis in infants autism is misdiagnosis w/ physical diagnosis ( e.g. deafness) o Axis 4 – providing contexts  to look severity of psychosocial stress  Interaction of biology & environment –eg. Stress is one of the reason leading causes of mental disorders w/ biologically vulnerable person  #1 condition of expression of vulnerability is STRESS  in axis 4 assess specifically what those stressors are  number 1 stressful environment in infants is the removal of caregiver  primary psychological job of infants to attach itself to caregiver o Axis 5 – Global assessment of Functioning  very specific in this – look at how are functioning in your environment ( how your responding to your stressors) & how your functioning in every aspect your life ( which is another aspect to defining abnormal behaviour)  1 year period  what their global functioning look like  occupationally. Recreationally, in social  is very specific  scale of 1 to 100  lower the number  the poorer the prognosis ( dia – is current functioning vs. pro- is outcome  support from environment means better prognosis)  assessment should be ongoing process because conditions changes  some diagnostic system is totally based on empirically e.g. factor analysis)  unfortunately they have very poorer utility because lot of these symptoms (syndromes) have lot in common o E.g. - look at empirically derived symptoms for children  factor analysis  only 2 : introvert and extrovert  not lot of utility to that  factor analysis is not sophisticated yet Advantage of Diagnosis  Selection of treatment is advantage to diagnosis available treatments based on diagnosis  2 - diagnosis system, it helps in research of mental disorders rd  3 – there is comfort in knowing ( explanation) , that you are not alone  that there is reason for why you act the way you do Disadvantage of Diagnosis  Stigmatize  constrictive esp. given that validity is not great & there is significant amount of misdiagnosis which is the reason why NOS is given before further analysis Diagnosis  it should not be static  can change and assessment should be ongoing o e.g. ADHD used to think remit in adulthood  not the case  children diagnosis w/ this will likely to adults w/ ADHD  the changes changed in frontal lobe is growing bring better resources to handle it/ compensate for ADH in adult)  lot of psychologist don’t acknowledge this  need to get more info to get diagnosis that is w/ greater validity Types of Assessment 1. Interview  verbal Q & A  two types of Question: structured and unstructured 2. Testing – more formal than interview  2 types of tests : cognitive and projective tests 3. Observational  can be structured or unstructured  First step in assessment  Referral – often case parents don’t want admit their children have problem & seeking help o seeking help is easier to avoid if it doesn’t affect other people e.g. social withdrawal – goes unrefered  nature of referral  is important because it give clues about the client  referral can come from hospital, physiological medical  so parent can bring child to physician’s office & indicate symptoms - Doc can refer to psychologist and psychiatrist  they can tailor specific test and question to that specific referral  child motivation level is important to note in referral  child can often feel as faulty good, unloved  anger and anxiety – important to note in referral  can affect the relationship b/w psychologist , client, child
More Less

Related notes for PSY341H1

Log In


Don't have an account?

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.