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Lecture 5

Psychology 46-333 Lecture 5: Notes on Clinical Assessment

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Kenneth Hart

Lecture 5 on Clinical Assessment Clinical Assessment: Diagnosis and Classification Video  Bias in Diagnosis: Is Premenstrual Dysphoric Disorder a Mental Disorder?  PMDD  whether to continue to be listed on the official disorder diagnosis o Controversial in sufficient evidence to prove that PMS to be classified as a disorder o Men have mood swings too; why should women be diagnosed as a disorder Diagnosing Psychological Disorders: Foundations of Classification  What is "Abnormal" Behaviour?  High level of definitional controversy  Hard to judge what is normal and abnormal  Confusion and controversies in labeling stem from: o Disagreement as to proper criteria for differentiating between "normal" and "abnormal" o Disagreement in regards which standards or yardstick to use 4 General Criteria for Judging Abnormal Behaviour 1. Psychological Dysfunction 2. Role Impairment 3. Subjective Distress 4. Atypical or unexpected "behaviour" Psychological Dysfunction  Breakdown or dysfunction in: o Cognitive functioning (malfunctioning)  ex. beliefs, thoughts, o Emotional functioning  ex. inappropriate feelings or exaggerated in certain situations o Behavioural functioning  doing things that defeat your goals o Biomedical functioning  ex. impair vision for no reason, stress-related o Spiritual functioning  meaninglessness (people who feels life as meaningless; nothing they do has values, they know they feel aimless and they feel they're wasting their time)  existential Role Impairment  Abnormality impacts others and the society  To what extent to which they have difficulty performing appropriate and expected roles  Violating "norms" of expected behaviour (deviating from the social norms)  Disability refers to problems or difficulties in following life domains of functioning: interpersonal, occupational, educational, etc. Subjective Distress  Someone feels troubled by the abnormal symptoms  Exception: Psychopaths don’t feel abnormal or alcoholics might be in denial of their symptoms  Feelings of fear/anxiety, anger, etc.  Either client or significant others Atypical or Unexpected "Behaviour"  The behaviours or symptoms that are outside of the cultural norms  Statistically rare given the context Mental Illness  Like "abnormality", mental illness is difficult to define conceptually and assess in clinical settings  4th edition of DSM is the official diagnostic system for judging the presence or absence of mental illness Psychiatric Diagnostic Classification  Classification is central to all sciences  Basic principle is grouping together like phenomena; patterns of symptoms grouped in clusters  Assignment of client symptoms to pre-established categories based on shared common attributes  Prototype matching  assigning client to a disorders by matching his/her symptoms Examples of Non-DSM Classification Schemes  International Classification of Diseases and Health Related Problems (ICD)  a combination of mental health illnesses and physical illnesses o Contains a "Mental & Behavioural Disorders" (MBD) section o Not used in the US/Canada for clinical purposes o Mental Behavioural Disorder (MBD) section differs from DSM  International Classification of Functioning, Disability and Health (ICF) o Published by World Health Organization (WHO) o Focus on disability rather than psychiatric clinical diagnosis o Is used by clinical psychologists who work in medical rehabilitation treatment centres
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