PSY341 JULY 11.docx

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University of Toronto St. George

PSY341 JULY 11, 2012 Assement then diagnosis then treatment Inchild clinical psychology This process is somewhat like used in adults, but assessment process changes And diagnoses separate section that can be used in dsm for disorders that usually show up in childhood, not mean adults cant have and that children cant show diagnoses outside Diagnoses - Uses same tool is a tool a medical tool that would use with adults exept different section, only two use this prof physicians and psychologists legally profeesional manner in Ontario to make diagnostic, can use it but to diagnose someone break the law - Tool used in north America dsm 4 roman numerals TR, Canada and the us, published by American psycjiratic association, not apa, psych. Apsya is psychi, group of physicans mostly pscyhiratirst mostly a medical tool - Devised for amreican psychiratic ass - Tool widely used in north America in Canada in the us rest of world doesnt use this tool, to diagnose, the rest of world used the icd international classification of diseases icd-10, 11 is coming out soon. Goal to make both dsm and icd completely compatible, still sig overalp, Ontario gov for ohip for disorder requeries icd-10 - Goal since 1995, has been to make both tools, classification systems or tool compatible, dsm 5 in 2012 delayed at least one year to make compatible with icd 10, icd 10 11 come out 2015 once again incompatioble, icd published by who which is a divison of the united nations - Disorders dsm recognizr icd doesnt and vice versa - Dsm4 used widely in can and us, icd published who rest of world and plus in the united states and Canada, insurance report mental disorders in icd 10 categories actually codes - Move people away from describing people as schizophrenic, diagnoses contentious issue, in mental health a label sticks with you and can be stigmatizing, number one harm of diagnoses bc it can be stigmatizing - Disadvantage with dsm4 is poor validity misdiagnose chance with mis with dsm 4 is pretty high - Validity not great, realibilyt very good, decrease validity to increase misdiagnoses it is a negative correlation - However dsm 4 does have utility it is useful, what is usefulness selection of treatment - Disadvantages of diagnoses is stigmatize, pro treatment, con stigmatization - Dsm 4 is a classification system gives list of symptoms for particular disorder that must be met to be diagnosed with disorder - Dsm each category with similar symptoms, last category is called nos not otherwise specified, easily to identify abnormal behavviour however define it, dsm says quaks duck is duck - To get insurance need diagnoses to see how much money they give to it, well not meet all of criteria but professionally I think it is this so say nos problem is decrease validity or misdiagnoses - Number of efforts to classify two must used - Some class system solely for children not widely used - Dsm most widely used in canda and us Class system - What consider, 5 criteria - 1. Categories are clearly defined - Does dsm do good job and answer is yes clear what ymptoms necessary to provide diagnose for this category - Problem with dsm 4 and icd 10, significant overalp of categorical symptoms, from one disorder to another can lead to misdiagnoses - 2. Categories exist means person given diagnoses has set of symptoms - Symptoms occur together regualry - Statisictally can do this not done on dsm 4, what behaviorls occur together called factor analysis another way is opinion or consenus or opinion get together and these go together - 3. Reliability test retest and interater bc categories clearly defined must be this and this adds reliability makes dsm quite reliable - 4. Validity categories clearly discrimianbale from one another, dsm not good, bc sig symptom overlap - 5. Clinical utlilty that It is useful dsm 4 is useful - Polygraph measure phys arousal it has utiliuty tells emotional state tells shift does tell lying or not no doesnt poor validity has utility but when asked to diagnose spec disorder can have misdiagnose not good validity - Two types of system (diagnostic ones) clinically derived dsm and icd belong to derived from consensus - Other types empiracly derived and derived from statistics or numbers Clinically dereived systems - Intro in 50s - 2 categories to childhood disorders which were expanded each time - To date 10 cate relating to mental health issue categories each cateh number disorders similar to each other, autistic like dioders aspergers, autism, and rect - 10 categories of disorder in dsm 4 will have sig change in childhood disorders sig change in dsm 5 - Will look at each category and disorders - Categories of disorders not be on midterm ++++++++++++++++++++++++++++++++== - Dsm 4 reason utility for psychiratris and psychologist bc provides diagnoses on 5 axis or dimensions- One reason utlilty provides diagnoses 4 axis, 4 things psych must look at to provide diagnoses - Not pick particular syndrome its this and done five dimensios - Called axis - 1. Primary presenting complaint what are you here for today I think I have anxiety problem axiety axis one at top what probably treat - In context in other axis does not prevent comorbid disorder with another disease dsm allows for cormorbid disorders on axis one what cormorbid with anxiety is depression axis one treat on context other axis - 2. Disorders that generally in psychiratiry and psychologu that are usually permament depression will go away with or without treatment axis 2 acknowlgded not go away but can still be treated but permanent - Adults usually refered to as personality disorders stuck with them acknowledgment struggle for rest of life can be treated dont go away conduct to antisocial personality disorder once with antisocial ant int going anywhere - One childhood disorder axis 2 mental reatardation - Lovace method cure autism not new and controversial bc of misdiagnose - 3. Relevant physical conditions saw in the film first class, behavioral abnormal childerns show symptoms of autism bc behavioural of autsitc children what phsy misdiagnosed with could be deaf - 4. Provide context f
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