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Chapter 5

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Psychology 2320A/B
Alvin Segal

Psychology Chapter 5 - Classification, taxonomy, diagnosis are used to refer to the process of description and grouping - Classification and taxonomy are the description of major categories or dimensions of behavioural disorders - Diagnosis refers to assigning a category of a classification system to a person - Assessment refers to evaluating youngsters, assist classification/diagnosis and in part to direct intervention Classification and Diagnosis - employed systematically to describe phenomenon - systems exist to classify psychological dysfunction - systems describe categories or dimensions of problem behaviours, emotions/cognitions - category is a discrete grouping (ex. Anxiety disorder) into which persons symptoms are judged to fit or not fit - dimension implies that an attribute is continuous and can occur to various degrees o high, moderate, or low levels of anxiety - any classification system must have clearly defined categories or dimensions - criteria for defining a category/dimension must be stated - features used to describe a category or dimension must occur together regularly, hence demonstrated it exists , in one or more situations or as measured by one or more methods - classification systems must be reliable and valid - when applied to classification or diagnosis, the terms retain the general meanings of consistency and correctness but are used in different ways - interrater reliability refers to whether different diagnosticians use the same category to describe a person’s behaviour o is maria’s behaviour called separation anxiety by two or more professionals who observe it? - Test-retest reliability asks whether the use of a category is stable over some reasonable period of time o Diagnosed as same disorder when he returns? - Validity of diagnostic systems o To be valid, diagnosis should provide us with more information than we had when we originally defined the category o Diagnoses should give us information about the etiology of a disorder , course of development, response to treatment or some additional clinical features of the problem o Does the diagnosis of conduct disorder tell something different from other disorders, what causes this problem, happen to youngsters who have disorder and what treatments? o Question of validity is one of whether we know anything we did not already know when we defined the category o Way we have described and classified this disorder the way it actually exists? - Clinical utility judged by how complete and useful it is DSM approach - most widely used classification system in US is APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM) - International Classiciation of Diseases (ICD) developed by WHO is alternative system - Concern that DSM coverage has not given sufficient attention to younger children - Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised (DC:0-3) o Response to this concern o System developed to classify mental disorders of very young children - DSM referred to as 1. clinically derived classification system - CDC are based on consensus of clinicians that certain characteristics occur together o Top down approaches o Propose concepts of disorders and choose diagnostic criteria, assessments and evaluations proceed 2. categorical approach - person either meets or does not meet criteria for diagnosis - difference between normal and pathological is one of kind rather than one of degree - distincitions can be made between qualitatively different types of disorders - DSM-IV-TR version includes info about features, cultural, age, gender, course of disorder, family patterns - DSM-II,III,III-R expanded to children and adolescents Multiaxial System - DSM-IV-TR all disorders are classified in one of two major groups called axis - Axis 1: Conduct Disorder o Clinician indicates any existing disorder, or other condition that may be a focus of treatment - Axis 2: Intellectual disability or personality disorder o Core of DSM - Axis 3: Current medical conditions - Axis 4: Psychosocial or environmental problems that may affect diagnosis, treatment or prognosis o Death of family member etc. - Axis 5: numerical (0-100) judgment of the youngster’s overall level of adaptive functioning (global assessment of functioning—GAF) o 100 = superior functioning in wide range of activities o 70=good functioning, difficulty in social/school o 50=serious impairment in social/school o 30=serious impairment in communication or judgment or inability to function in all areas - comorbidity: used to describe situation in which youths meet criteria for more than one disorder o TERM IS CONTROVERSIAL, some prefer co-occurrence o Solution to issue remains unclear o Concern about proliferation of categories and comprehensiveness o Overdefined pathological behaviour? Too broadly defined children’d behaviour as deviant  Designating common misbehaviours or problems in academic skills as mental disorders o Reliability: interrater reliability resulted from inadequate criteria for making a diagnosis  Efforts made starting with DSM-III, improve in
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