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7/30/2019 -Lect 4 Classifying Abnormal Behavior - Copy.ppt
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Why a System of Diagnosis?
Communication
Etiology
Treatment
Aid to Scientific Investigation
Insurance Reasons
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Progress of Clinical Treatment
Assessment
Diagnosis
Treatment
A diagnosis is the mental disorder a client
has.
Assessment allows a clinician to make a
diagnosis, the diagnosis tells the clinician
how to treat the client. 2
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Diagnosis - Etiology
Often time, a diagnostic category will
have a specific etiology
The cause of the mental problem may bethe same for every disorder in the
category Diagnosis thus may explain
known causes
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Diagnosis - Communication
Clients often have a large number of
Symptoms
Communication among mental healthprofessionals is difficult if they have to
list symptoms
It is much easier to communicate asyndrome, a set of related symptoms
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Diagnosis Aid to Science
Diagnosis groups people together with
like syndromes
This allows for systematic investigation
Can examine what syndromes have in
common in terms of etiology and
treatment
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Diagnosis - Treatment
Diagnosis allows clinicians to focus on
effective treatments
For example, paranoid symptoms arenot alleviated through talk therapy
- Antipsychotics are the treatment
of choice in this case
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Diagnosis Third Party Payments
People with mental disorders often
require treatment
This treatment is costly
People need to be assigned some sort of
diagnosis in order for costs to be paid by
a third party
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Diagnostic Systems
Categorical
A person either meets the criteria for
diagnosis, or the persons symptoms are
subclincal
Dimensional
A person is rated on a continuum for their
symptoms For example, instead of saying that a
person is depressed or not, the depression
would be rated 8
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Classification Systems
ICD The International Classification of
Diseases
DSM The Diagnostic and StatisticalManual of Mental Disorders
History not relevant
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Other Classification Issues
Chronic vs. acute problem
chronic problem persists over a long period
An acute problem arises in response to a
significant life change
Continuous vs. episodic
A continuous problem maintains itsintensity
Episodic symptoms fluctuate
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The Diagnostic and Statistical Manual of
Mental Disorders (DSM-IV-TR):
DSM-IV is the Diagnostic and Statistical
Manual of Mental Disorders(4th edition)
published by the American PsychiatricAssociation.
Psychologists know the American
Psychiatric Association as "the other APA."(When psychologists say APA, they mean
the American PsychologicalAssociation).11
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DSM IV DiagnosticStatistical Manual
of MentalDisorders:.
DSM will classifydisorders anddescribe thesymptoms.
DSM will NOTexplain the causes
or possible cures. 12
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Goals of DSM
1. Describe (400) disorders.2. Determine how prevalent thedisorder is.
Disorders outlined by DSM-IV arereliable. Therefore, diagnoses bydifferent professionals are similar.
Others criticize DSM-IV forputting any kind of behavior withinthe compass of psychiatry.
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DSM IV
Definition of a mental disorder clinicallysignificant behavioural or psychological
syndrome associated with distress or
disability in an individual excluded are conditions such as expected
responses to a particular event, and
deviant behaviour that is not a symptomof dysfunctional behaviour
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Two Major Classifications in theDSM
Neurotic Disorders
Distressing but
one can stillfunction in societyand act rationally.
Psychotic Disorders
Person loses
contact withreality,experiences
distortedperceptions.
John Wayne Gacy 15
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DSM IV
Five dimensions of classification Axis IClinical Syndromes
Axis IIPersonality disorders and
retardation
Axis III General medical conditions
Axis IV
Psychosocial and environmentalproblems
Axis VCurrent level of functioning
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Axis I
describes clinical disorders and "other
conditions which may be a focus of
clinical attention." These are typicallyproblems that require immediate
attention from a clinician.
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Axis II
Axis 2 focuses on personality disordersand contains a rating scale for mentalretardation.
These problems may not requireimmediate care, but they can complicatetreatment and should be taken into
account by any clinician who treats apatient.
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Axis III
labels any general medical conditions.
These are important even when a
problem seems to be mental orbehavioral, because sometimes
psychological problems are the
byproduct of an illness such as diabetesor heart disease.
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Axis IV
specifies "psychosocial and
environmental problems" such as
poverty, dysfunctional families, and otherfactors in the patient's environment that
might have some impact on the person's
ability to function.
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Axis V
is labeled the "Global Assessment of
Functioning Scale." It is an overall rating
of a person's ability to cope with normal
life.
The rating goes from low scores such as
10 ("Persistent danger of severelyhurting self or others") to 100 ("Superior
functioning in a wide range of
activities"). 21
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Criticism of all Classification Systems
Classifying someone reduces information
(uniqueness) of the person being studied
Cant say what information is or is notimportant
Also, classifying increases social stigma
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Labeling Psychological Disorders
1. Critics of the DSM-IV argue thatlabels may stigmatize individuals.
2. Labels may be helpful for healthcare
professionals when communicatingwith one another and establishingtherapy.
3. Insanity labels raise moral andethical questions about how societyshould treat people who have
disorders and have committed crimes