-lect 4 classifying abnormal behavior - copy.ppt

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

-lect 4 classifying abnormal behavior - copy.ppt

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