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Chapter 3

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Mark Schmuckler

th Abnormal Psychology – 4 Canadian Edition Chapter 3 – Classification and Diagnosis - Diagnosis is critical to abnormal psychology; a disorder has to be classified correctly before its causes or best treatments can be found - Official diagnostic system employed by mental health professionals – Diagnostic and Statistical Manual of Mental Disorders (DSM) A Brief History of Classification - Gradually, people recognized different illnesses require different treatments - Early Effoths at Clthsification o 19 -early 20 century, great inconsistency in classification of abnormal behaviour - Development of the WHO and DSM systems o American Psychiatric Association. 1952 – published DSM o WHO, 1969 – published different classification system that was more widely accepted, similar to the DSM-II (1968) o Even with these publications, information was still missing o DSM-III (1980) and a revised version, DSM-III-R (1987) were published as practices still varied widely o DSM-IV (1994), text revision with some rewritten sections DSM-IV-TR (2000) o Criticisms of the DSM: classification is irrelevant to the field of abnormal behaviour; specific deficiencies in how diagnoses are made in the DSM o DSM is not universally embraced by all professionals in the field; originally developed by physicians who employed the medical model to their practices Current Diagnostic System of the American Psychiatric Assoc. (DSM-IV and DSM-IV-TR) - Definition of Mental Disorder o Although “no definition adequately specifies precise boundaries for the concept”. DSM- IV-TR’s definition: a clinically significant behaviour or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom o However, the syndrome or pattern should not be an expectable or culturally sanctioned response to an event o Pattern must be considered a manifestation of behavioural, psychological, or biological dysfunction in the individual - Five Dimensions of Classification o Multiaxial classification: system in DSM where the individual is rated on 5 dimensions o Axis I: all diagnostic categories except personality disorders and mental retardation o Axis II: personality disorders and mental retardation o Axes I and II compose classification of abnormal behaviour o Axes III to V are not needed in the actual diagnosis, but they are included so that the individual’s overall life situation can be better understood o Axis III: general medical conditions o Axis IV: psychosocial and environmental problems that may contribute (i.e. occupational, economic problems) o Axis V: current level of adaptive functioning; Global Assessment of Functioning (GAF) - Diagnostic Categories o DSM indicates that a disorder may be due to a medical condition or substance abuse o Disorders usually first diagnosed in infancy, childhood, or adolescence  Intellectual, emotional, and physical disorders that usually begin in infancy, childhood, or adolescence  Disorders that fall into this category: separation anxiety disorder, conduct disorder, ADHD, mental retardation, pervasive development disorders, learning disorders o Substance-related Disorders  Diagnosed when the ingestion of a substance changes behaviour enough to impair social or occupational functioning  May contribute to other axis I disorders o Schizophrenia  Individuals have faulty contact with reality, experience delusions, hallucinations o Mood Disorders  Experience moods of extreme high or low  Includes: major depressive disorder (deeply sad), mania (extremely euphoric), bipolar disorder (episodes of both) o Anxiety Disorders  Have an irrational or overblown fear as their central disturbance  Includes: phobias, panic disorder (panic attacks), agoraphobia (fearful of leaving home because of possibility of panic attack), anxiety disorder (worry constantly), OCD (urge to perform certain task with the impossible purpose of warding off feared situation, traumatic stress disorder , acute stress disorder (similar to traumatic stress but symptoms do not last as long) o Somatoform Disorders  No known physiological cause  Includes: somatization disorder (multiple physical complaints), conversion disorder (report loss of motor function, sensation, or blindness), pain disorder (suffer from severe and prolonged pain), hypochondriasis (interpret minor sensations as illness), dysmorphic disorder (preoccupied with imagined defect) o Dissociative Disorders  Sudden alteration in consciousness that affects memory and identity  Includes: dissociative amnesia (forget entire past or particular time period), dissociative fugue (suddenly starts new life in a new place and can’t remember old identity), dissociative identity disorder (2 or more distinct personalities), depersonalization disorder (severe and disruptive feeling of self-estrangement and unreality) o Sexual and Gender Identity Disorders  3 major subcategories: paraphilias (have unconventional sources of sexual gratification), sexual dysfunction (incomplete sexual response cycle), gender identity disorder (extremely uncomfortable with anatomical sex) o Sleep Disorders  2 major subcategories: dyssomnias (amount or timing of sleep is abnormal), parasomnias (unusual events during sleep) o Eating Disorders  2 major categories: anorexia nervosa (avoids eating), bulimia nervosa (binge eating and compensatory activities) o Factitious Disorder  Have psychological need to assume role of sick person, produce or complain of symptoms o Adjustment Disorders  Emotional/behavioural symptoms after a major life stressor o Impulse-Control Disorders  Inappropriate and seemingly out of control behaviour  Includes: intermittent explosive disorder (episodes of violent behaviour towar
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