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Chapter 3

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Western University
Psychology 3301F/G

Chapter 3Classification and DiagnosisDiagnosis determinationidentification of the nature of a disease condition or statement of that finding often confused with assessmentDiagnostic System diagnosis made on the basis of this systemis a set of rules for recognizing and grouping various types of abnormalities Assessment procedure through which info is gathered systematically in the evaluation of a condition yields information that serves the basis for a diagnosis Practicalities preclude us from being able to systematically observe and measure many aspects of functioning in large numbers of people in a controlled way over long periods of time The History of ClassificationModern interest in psychological classification WHOs decision to include mental health disorders in the international list of Causes of Deathin 1948 expanded to the International statistical classification of diseases injuries and causes of death ICD listing all diseasesWhich further branched off to the DSM The first and second DSM editions were highly unsatisfactory brief and only vague descriptions DSMI only 106 categories under 3 major categories Greatly influenced by psychoanalytic theory focused on unobservableinternal processes not empirically based few objective criteriaeg Common use of neuroses DSMIIDSMIIIR to improve reliability field tries conducted placed greater emphasis on empirical research 12500 patients and 550 clinicians involved in trials Moving towards an atheoretical approach ie Not endorsing any one theory Polythetic can be diagnosed with subset of symptoms without having to meet all criteria Developed the multiaxial requirement in addition to primary diagnosis required substantial patient info evaluating rating of 5 different axes or areas of functioning DSMIV Comprehensive literature reviews 12 multisite field tries conducted to collect new data Tried to represent diverse socioeconomic cultural ethnic backgroundsAssessed validity of diagnosesimprove criteria Minor text revision released in 2000 DSMIVTRTo facilitate use of DSMIVTR internationally includes diagnostic criteria with ICD10 codesDSMIVTR A Multiaxial ApproachClinicians assess patients under five different axes or aspects of a persons condition Axis I psychological disorders that have been recognized for centuries because of bizarre behaviour or difficulty the pose for everyday functioning eg SchizophreniaAxis II less severe longterm disturbancesproblems in this axes usually allow everyday functioning however with significant difficulty Allows for a full range of evaluation eg Without axis II less dramatic behaviour patters were often missed by presence of more prominent axis I symptoms eg Alcoholism did personality disorder lead to severe alcohol disorderwithout axis II may have missed this whole range of symptoms Axis III any medical disorder that might be relevant to understanding or managing the case which can cause psychological disorders or affect treatmentcourse
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