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Chapter 4

PSYB32H3 Chapter Notes - Chapter 4: American Psychiatric Association, Major Depressive Disorder, Hunger Strike


Department
Psychology
Course Code
PSYB32H3
Professor
Konstantine Zakzanis
Chapter
4

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PSYB32
Chapter 4 Research Methods in the Study of Abnormal Psychology
Classification and Diagnosis
Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
o American Psychiatric Association
o It might present some statistics with respect to prevalence and other kinds of statistics-founded research,
but it’s not telling you anything that’s statistical in a way in which we go about determining whether or
not a patient needs criteria for a certain disorder.
o Fifth edition is the latest edition, and it came out a few years ago. Read what the changes were in the
textbook, but not gonna be tested on any previous DSM versions
o The debate: whether or not we need to be more dimensional in diagnosing these disorders rather than so
caught up in vote-counting symptoms
o It’s important to be able to describe a disorder by its name because it’s not easy to describe a disorder by
all of its symptoms and because a lot of the symptoms are not specific to a certain disorder.
It helps communicate the diagnosis
DSM-5 Definition of Mental Disorder
“A syndrome characterized by clinically significant disturbance in individual’s cognition, emotion regulation, or
behavior that reflects a dysfunction in the psychological, biological or developmental processes underlying mental
functioning. Mental disorders are usually associated with significant distress or disability in social, occupational
or other important activities.”
o Syndrome cannot be defined by a single symptom.
Controversy?
o Normal people are being diagnosed with mental disorders they do not have.
o Many changes without scientific reviews or risk involves.
o You may qualify for a major depressive disorder or if show depressive symptoms for 2 weeks after you
lose someone
o There was also an expansion of a category called sympatric symptom disorder. If you have a medical
illness and you are worried about it, it becomes a disorder
o Normality is impossible to define. It is a cultural problem, not a medical one
o Society has a problem with medication, 1/5 people take medication for a mental illness.
o Most people needing treatment are not getting it, the people who least need treatment are getting too
much of it.
o We need to stop the overdiagnosis of people who do not need it and focus our attention on those who do.
Excludes
o An expectable and culturally sanctioned response to a particular event, it would not qualify as a mental
illness
Examples: Anxiety before midterm, People’s responses to LGBTQ+ people, A myth that is
culturally appropriate
o Deviant behavior (e.g., political, religious, or sexual) that does not qualify a person to have a mental
illness
Deviant is statistically infrequent, and just because something is statistically infrequent doesn’t
mean it’s a mental illness
Examples: Fasting for a religious reason, A fan who follows a band everywhere, A hunger strike
o Conflicts that are primarily between the individual and society (unless the deviance or conflict is a
symptom of a dysfunction in the individual)
Someone who locks themselves to a tree to protest
Hunger strike
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Reliability and Validity in Assessment
Reliability
o Test-Retest Reliability
Getting same results after rounds of tests
This only works if what you are measuring does not change between time.
o Alternate-Form Reliability
Creating a different version of a test that should give same results
o Inter-Rater Reliability
Same results from different testers/raters
Validity
o Content Validity
Content validity is achieved if the construct you are trying to achieve is measured by a wide array
of measurements.
o Criterion Validity (concurrent, predictive, ecological validity)
Whether or not the test that is employed has any relevance in the real-world. This can also be
called predictive validity or ecological
Concurrent Validity is when we have two measures of depression and both should have similar
results.
o Construct Validity
Reliability
Refers to consistency of measurement
Two components of reliability:
o Sensitivity: agreement regarding the presence of a particular diagnosis
If you give a test to someone who was diagnosed with depression, but they did not score high on
the test, this lacks sensitivity.
o Specificity: agreement concerning the absence of a particular diagnosis
Trying to rule out a diagnosis.
Reliability is measured by correlation (how closely two variables are related; the stronger the correlation the better
the reliability
Validity
Central question to validity:
o Does a measure fulfill its intended purpose?
This depends on what the question is. We need to consider what test we are going to use
Validity is related to reliability:
o Unreliable measures will not have good validity
o It is impossible to have a valid test measure if the measure is not reliable
Types of Evidence
Case Study
o Historical and biographical information on a single individual
o Providing detailed description
o Case study as evidence
o Generating hypotheses
o Example: John Harlow and Executive Disorder, 1848
In place of the diligent, dependable worker stood a foulmouthed and ill-mannered liar given to
extravagant schemes that were never followed through. "Gage," said his friends, "was no longer
Gage.”
This is how we discover new kinds of disorders.
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