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Lecture 3

PSY341H1S Lecture 3.docx

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University of Toronto St. George
Hywel Morgan

PSY341H1S Lecture 3: Assessment  There are only two professions that can use the DSM-IV TR: physicians and psychiatrists  DSM-IV TR is the assessment used in Canada and the United States, published by American Psychiatric Association, a group of physicians (mainly psychiatrists)  There is a significant overlap. If you are getting diagnosed in Ontario, for i.e., you need to get diagnosed by ICD as well  In each of the categories of DSM-IV TR is called NOS (not otherwise specified) it is very easy to ID abnormal behavior but it is hard to categorize with definitions  NOS decreases validity and increases misdiagnosis, however  What would you want to consider when making a good categorization system for mental disease? 1. Categorizes are clearly defined  One problem with this is that here is a significant overlap in categorical symptoms from one disorder to another 2. The categories exist  Meaning symptoms are seen to occur together all the time; we can use factor analysis or consensus opinion from experts to decide whether they do or don’t 3. Reliability  Test-retest and inter-rater 4. Validity  Categories are clearly defined from one another; not so with DSM-IV TR because there is significant symptom overlap 5. Clinical utility  Polygraph has good utility but poor validity, therefore it would not be good to use in disorder assessment  DSM-IV TR and IC are derived from consensus and other systems are statistically derived  DSM-IV TR first had only 2 categories relating to child disorders, but expanded later; today it has 10  The categories of disorders will not be on the test; they will be introduced after the first midterm  DSM-IV TR provides diagnosis on 5 dimensions/axis  Advantages of diagnosis: a. selection of treatment b. helps in the research of mental disorders c. comfort in knowing that you have something others have and act the way that you do  Disadvantages of diagnosis: a. restricted b. misdiagnosis  A diagnosis should not be static, because it could change due to the fact that an assessment should be ongoing (unfortunately, many do not acknowledge this) 3 Types of Assessment: 1. The interview  Utilizes verbal questions and replies. Structured and unstructured questions are used as well.  Most common in adults  Questions asked based on the referral: a big problem with the interview, and thus will ask more detailed questions about compliant and little/no questions about history  Establishing rapport with children is much harder than it is for adults, therefore they prefer to do interviews in non-stressful environments, i.e. a playful environment that provides play materials and movement to assess child’s anxiety levels  Not good for assessing mental retardation, autism, and other conditions wherein children may not be verbal  Clinician must listen carefully and only note the important information 2. Testing  More formal, and there are 2 types of tests: cognitive tests and projective tests  The psychological assessment  Looks at cognitive functio
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