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Lecture 3

Psychology 2320A/B Lecture Notes - Lecture 3: Biological Psychiatry, Psychoanalytic Theory, Abnormal Psychology

Course Code
Elizabeth Hayden

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What is classification?
Classification of mental disorders: Branch of psychiatry/clinical psychology concerned
with description of disorder
oBased on symptoms; course
Advantages of classification
oEssential for research of any kind
Drawbacks of classification
Expectancy fulfilment/self-fulfilling prophecy
Loss of information or uniqueness
Boundary cases
Classification systems such as the DSM-IV are sometimes described as “procrustean”
Marked by arbitrary often ruthless disregard of individual differences or special
oThe guy had a special bed that fit everyone… cut off peoples legs/stretched them
out to make them fit
Evolution of DSM
DSM – classification system for mental disorders
Five major versions
oDSM-I (1952)
oDSM-II (1968)
Big shift here

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oDSM-III (1980)
oDSM-III-R (1987)
oDSM-IV (1994)
Pre-1970, most clinicians uninterested in diagnosis
Psychoanalytic theory predominant
Rise of biological psychiatry, attempts to make psychopathology a “modern” science
Diagnosis increasingly viewed as important, but reliability was low
Inter-rater reliability = agreement between raters on a diagnosis
Often measured using Kappa, which accounts for chance agreement
o>.75 is good, <.40 is poor
Prior to DSM-III, reliability was low
oUS/UK cross-national project
Why was agreement so low? How to fix it?
Problem #1 – poor diagnostic criteria/criteria variance
oDevelop specific diagnostic criteria
oChoose criteria that optimize reliability
Problem #2 – inconsistencies in interviewing practices/information variance
oDevelop structured interviews
Evolution of DSM, continued
Mid-70’s – Spitzer spearheads group to revise DSM-II
Result - DSM-III (all diagnoses had inclusion, exclusion, and duration criteria) in 1980
oCriteria variance addressed
Resistance to the change was high at first, but became widely accepted
Multiaxial system added in III – read in textbook
Goal – provide holistic assessment
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