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Abnormal Psychology Lecture 2.docx

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PSYC 3140
Joel Goldberg

Abnormal Psychology Lecture 2 Diagnosis and Classification Week 1 review: • Film shown in class (Debbie) • Parents seemed overly concerned in her life • They seemed shut out from the review board’s decisions and proceedings • This is a reflection of an overall system: when someone has a mental illness, family thinks they’re helping but come out as overbearing • Symptoms of psychosis described in the interview: -thought broadcasting -ideas of reference -auditory hallucination -paranoid delusions Transinstitutionalization (hospital -> jail) • Efforts to protect the rights of the mentally ill can unfortunately result at times in individuals being incarcerated in jails instead of getting the help they need in psychiatric institutions Case Vignette • Teenage girl admitted to hospital for a 30-day forensic (psycho-legal) psychiatric assessment. • “Symptoms” she displayed: impulsive, running away from home, skipping classes – she was living in a foster home and struck her foster mother with a lamp. Foster mother sustained concussion. Court wanted to assess to what extend is she making her choices willingly • Is the temper tantrum she threw over smokes normal or abnormal behavior? • Temper tantrum is a behavior that is an unreasonable coping strategy, a sign of regression, how regressed the behavior is • She does not use self-monitoring, or awareness in the face of observation • No impulse control Dangers of labeling • Rosenhan (1973) on Being Sane in Insane Places (on youtube) • Faked symptoms to gain access to psychiatric hospital. • Would anyone detect that they were sane? No. they dropped their “Symptoms” as soon as they got in, released as “schizophrenia” in remission. • Dehumanizing, no contact. 6 minutes a day of contact, no visits. “psychiatric houses are storehouses for people you do not want, do not care for, and have lost sympathy for” • Attendants need to understand that the people there are not just collection of symptoms • Issues -making and knowing a mental health diagnosis is important, y/n? it can help understand but it can also lead to labeling -question: is their study demonstrating a diagnosis problem? -careless diagnosis practices – lack of follow-up to reconfirm condition -criticism of staff contact need to humanize treatment Vignette – student therapist • Issue: Do you need a diagnosis? (Psychologist of the day: Paul Meehl sp?) • One aspect of reliable diagnosis: predicted (recording) • Paul Meehl o 1920-2002 (Died of leukemia) o Obtained his phd in the university of Minnesota 1945 and became faculty member there o Strong interest in psychometrics (test development) o 1962 – president of the APA o Article titles: • Meehl’s predictions – factors that will remain important for abnormal psychology o Psychometrics: test, the MMPI (week 3 content) o Applied learning theory: works well with autism o Behavior genetics: importance of understanding genetic aspects of behavior o Descriptive clinical psychiatry: early classification systems, if a good description is reached the behavior is better seen, being able to describe behavior accurately and vividly o Psychodynamic theory: helpful in understanding behavior. There is more to behavior than what we see on the surface, underlying sources of behavior. This theory allows us to find and understand things that are outside someone’s immediate awareness. Goals of classification • Point Peele – bird watching spot • Basis of communication: characteristics agreed upon, information can be shared more easily • Information retrieval • Descriptive system • Make predictions • Source of concepts within scientific theory: both for the sake of science and the individual case Classification is limited by unreliability. What are sources of inconsistencies? • Subject variance – different conditions at different times, what if person acts differently on different occasions.** • Occasion variance – person is in different stages of same condition***. Could be same disorder but showing different facets. These differences are part of the condition • Information variance – different sources of information can lead to different diagnosis. • Observation variance – inter-rater reliability. Selective attention video example of the gorilla. Researchers can get caught up in numbers, IQ scores, and miss underlying fundamental signs. • Criterion variance – due to vagueness of classification system Validity – reasons for making diagnoses • In order to have validity you need • Predictive validity – useful because people diagnosed with classified condition respond to particular treatments • Concurrent validity – useful because people with diagnosed condition have other attributes not used in diagnosi
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