Textbook Notes (378,778)
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PSYB32H3 (1,181)
Chapter 3

Chapter 3

8 Pages
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Department
Psychology
Course Code
PSYB32H3
Professor
Konstantine Zakzanis

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Chapter 3: Classification and Diagnosis
Diagnostic system widely employed by mental health professions: Diagnostic and Statistical Manual of
Mental Disorder (DSM)
[BRIEF HISTORY OF CLASSIFICATION]
Early Efforts of Classification:
oDuring 1800 and early 1900 there was great inconsistency in classification of abnormal behaviour
oBy end of 1900 the diversity of classification recognized as serious problem that impeded
communication among people in the field and several attempts were made to produce a system of
classification that would be widely adopted
Development of the WHO and DSM systems:
o1939: World Health Organization(WHO) added mental disorders to the International List of Causes
of Death
o1948: list expanded to become International Statistical Classification of Diseases, Injuries and
Causes of Death (ICD): list of all diseases including classification of abnormal behaviour
o1952: American Psychiatric Association published its own Diagnostic and Statistical Manual (DSM)
oWHO classification simply a listing of diagnostic categories; actual behaviour or symptoms that were
the bases of diagnoses were not specified
oDSM-II and the British Glossary of Mental Disorders provided some of the crucial info but did not
specify the same symptoms for a given disorder
oDSM-IV used throughout USA and Canada and accepted around much of the world
[Diagnostic System of the American Psychiatric Association (DSM-IV and DSM-IV-TR)]
Definition of mental disorder:
oA clinically significant behavioural or psychological syndrome or pattern that occurs in an individual
and that is associated with present distress (painful symptom) or disability (impairment in one or
more important areas of functioning) or with a significantly increased risk of suffering death, pain,
disability or an important loss of freedom
oSyndrome or pattern must not be an expectable and culturally sanctioned response to a particular
event (death of a loved one); it must be a manifestation of a behavioural, psychological or biological
dysfunction in the individual
Five Dimensions of Classification:
oMultiaxial Classification (MAC): each individual is rated on five separate dimensions or axes
Axis I: all diagnostic categories except personality disorder and mental retardation
Axis II: Personality disorders and mental retardation
Axis III: general medical conditions
Axis IV: psychosocial and environmental problems
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Occupational problems, economic problems, interpersonal difficulties with family members and a
variety of problems in other life areas that may influence psychological functioning
Axis V: current levels of adaptive functioning
Life areas considered are social relationships, occupational functioning and use of leisure time
Give info about need of treatment
oThe MAC forces diagnostician to consider broad range of info
oAxis I and II are separated to ensure that the presence of long-term disturbances is not overlooked
oAxis III-V are not needed to make actual diagnosis but they are invaded to indicate that factors other
than a persons symptoms should be considered in an assessment so that persons overall life
situation can be better understood
Diagnostic Categories:
oDSM indicates that disorder for axis I and II may be due to medical conditions or substance
oClinicians must be sensitive not only to the symptoms of their patients, but also to the
possible medical causes of their patients conditions
Disorders usually first diagnosed in infancy, childhood or adolescence:
oSeparation anxiety disorder: excessive anxiety about being away from home or patents
oConduct disorder: repeatedly violate social norms and rules
oAttention-deficit/hyperactivity disorder: difficulty sustaining attention and are unable to
control their activity when the situation calls for it
oMental retardation: subnormal intellectual functioning and deficits in adaptive functioning
oPervasive developmental disorders: autistic disorder, severe condition in which individual
has problems in acquiring communication skills and deficits in relating to other people
oLearning disorder: refers to delay in acquisition of speech, reading, arithmetic and writing
Substance-related disorders
oDiagnosed when ingestion of some substance (alcohol, opiates, cocaine, amphetamine) has
changed behaviour enough to impair social or occupational functioning
oIndividual unable to control or discontinue ingestion of the substance and my develop
withdrawal symptoms if they stop using it
oContribute to development of other Axis I disorders i.e. mood or anxiety disorder
Schizophrenia:
oContact with reality is faulty
oLanguage and communication is disordered, may shift from one subject to another in ways
that make them difficult to understand
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oExperience delusions (believing that thoughts that are not their own have been placed in
their head)
oPlagued by hallucinations (hearing voices that come from outside themselves)
oEmotions are blunted, flattened or inappropriate and social relationships and ability to work
show marked deterioration
Mood disorders: applied to people whose moods are extremely high or low
oMajor depressive disorder: person is deeply sad and discouraged and likely to lose weird and
energy and have suicidal thoughts ad feelings of self-reproach
oMania: exceedingly euphoric, irritable, more active than usual, distractible and possessed of
unrealistically high self-esteem
oBipolar disorder: diagnosed if person experiences episodes of mania or of both mania and
depression
Anxiety disorders: have some form of irrational or overblown fear as the central disturbance
oPhobia: fear an object or situation so intensely that they must avoid it, even though they
know that their fear is unwarranted and unreasonable and disrupts their lives
oPanic disorder: person is subject to sudden brig attacks of intense apprehension, so
upsetting that he or she is likely to tremble, shake, feel dizzy and have trouble breathing;
can be accompanied by agoraphobia when person is also fearful of leaving familiar
surroundings
oGeneral anxiety disorder: fear and apprehension are pervasive, persistent and
uncontrollable; worry constantly, feel generally on edge and are easily tired
oOCD: subject to persistent obsessions or compulsions; attempts to resist a compulsion
create so much tension that individual usually yields to it
oPosttraumatic stress disorder (PTSD): experiencing anxiety and emotional numbness in
aftermath of very traumatic event; individual has painful, intrusive recollections by day and
bad dreams by night; difficult to concentrate and feel detached from others and from on
going affairs
oAcute stress disorder: similar to PTSD but symptoms do not last as long
Somatoform disorders:
oSomatisation disorder; Long history of multiple physical complaints for which they have
taken medicine or consulted doctor
oConversion disorder: report loss of motor or sensory function such as paralysis and
anaesthesia or blindness
oPain disorder: suffer from severe and prolonged pain
oHypochondriasis: misinterpretation of minor physical sensations as serious illness
oBody Dysmorphic disorder: preoccupied with an imaged defect in their appearance
Dissociative disorders: sudden alteration in consciousness that affects memory and identity
oDissociative amnesia: may forget their entire past or lose their memory for particular time
period
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Description
Chapter 3: Classification and Diagnosis Diagnostic system widely employed by mental health professions: Diagnostic and Statistical Manual of Mental Disorder (DSM) [BRIEF HISTORY OF CLASSIFICATION] Early Efforts of Classification: o During 1800 and early 1900 there was great inconsistency in classification of abnormal behaviour o By end of 1900 the diversity of classification recognized as serious problem that impeded communication among people in the field and several attempts were made to produce a system of classification that would be widely adopted Development of the WHO and DSM systems: o 1939: World Health Organization(WHO) added mental disorders to the International List of Causes of Death o 1948: list expanded to become International Statistical Classification of Diseases, Injuries and Causes of Death (ICD): list of all diseases including classification of abnormal behaviour o 1952: American Psychiatric Association published its own Diagnostic and Statistical Manual (DSM) o WHO classification simply a listing of diagnostic categories; actual behaviour or symptoms that were the bases of diagnoses were not specified o DSM-II and the British Glossary of Mental Disorders provided some of the crucial info but did not specify the same symptoms for a given disorder o DSM-IV used throughout USA and Canada and accepted around much of the world [Diagnostic System of the American Psychiatric Association (DSM-IV and DSM-IV-TR)] Definition of mental disorder: o A clinically significant behavioural or psychological syndrome or pattern that occurs in an individual and that is associated with present distress (painful symptom) or disability (impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability or an important loss of freedom o Syndrome or pattern must not be an expectable and culturally sanctioned response to a particular event (death of a loved one); it must be a manifestation of a behavioural, psychological or biological dysfunction in the individual Five Dimensions of Classification: o Multiaxial Classification (MAC): each individual is rated on five separate dimensions or axes Axis I: all diagnostic categories except personality disorder and mental retardation Axis II: Personality disorders and mental retardation Axis III: general medical conditions Axis IV: psychosocial and environmental problems www.notesolution.com
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