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Gareth Treharne

Lecture 2- SM-V- classicifications and evidence based practice Classifying disorders - Dimensional o Everyone possesses all characteristics to varying degrees. o People are rated as above or below average o Rank someone on a type of scale for different symptoms/behaviour. o There is no yes or no, but a degree of ranking o Experiences differ in degree from those of the ‘normal’ population but are not categorically different o On a continuum o Issues  Sampling × Where was the average taken from? × You would try to get a random sample of age/ethnicity etc.  Insensitive to contextual effects × Context settings × Children behave differently in different contexts  Issues on what is considered to be the norm? × E.g. ‘he acts too young’ × How children behave, relatively to other children × Teacher would be better to see this than a parent because they are around children more often. - Categorical o DSM is categorical o Distinctive categories that are “black and white” o Either meet the criteria or you don’t o It can be hard for people to meet all of the criteria. o People differ in number of symptoms and degree of symptoms o Based on presence of symptoms o Issues  Behaviours seldom falls neatly into categories  Dichotomous diagnosis process in which they have it or not  Sub-threshold but impaired? Sub-threshold – ADHD, what if you meet only 5 out of the 9 symptoms and the symptoms still affects your everyday life?  Different causes and therefore different treatments  Different disorders can have similar symptoms. E.G. ADHD and anxiety. Different treatments DSM-5 - Categorical - Diagnoses of mental health conditions, such as DSM classifications, largely follow biological or disease/medical model of mental health - According to this model, accurate diagnosing is important to ensure consistent treatment and research in relation to mental health disorders - Based on research and field trainings o Strongly evidence based - Criticisms o Overlap between disorders  People are diagnosed with multiple disorders  Children usually have another disorder along with ADHD  ADHD and anxiety, a lot of overlap o Individualistic  Sometimes it can be more of an environmental issue, it’s not that the individual has a problem but it’s because of environmental causes  The environment is dysfunctional o Access to treatment - DSM makes it easier to write a report so others understand the lingo. - Assessment techniques o We look at more of a holistic way.  Each person is individual.  Clinical do case formulations. o 1st start with what problem is. Try to get a holistic image of what’s going on. o Interview  Developmental history × With children it’s easier than adults. × Children remember more about their past than adults. E.G. When they learned to eat walk talk at normal developmental stages. × Oppositional compliant behaviours are linked to speech problems. × Also medical issues when child was young. × Trouble at school can cause problems to mental health.  Family characteristics × Number of parents × single or not × Number of siblings will cause diff environments for children to be brought up in. × Family systems, children all feed off each other, so what one does others may do.
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