Psych 2510 – Trull Chapter 4: Diagnosis, Assessment, and Study of Mental DisordersDefining Abnormal Behavior and Mental Disorder- Mental health professionals often focus on dimensions and categories to define abnormal behavior and mental disorder.- Dimensional approach: defining abnormal behavior along a continuum.- Category: large class of frequently observed syndromes or mental disorders.- Diagnosis: defined by rules that outline how many and what features of a mental disorder must be present- Categorical approach: derived from a medical model whereby a “yes/no” approach to diagnosis is used.o Syndromes composed of abnormal behaviors or features that occur within a persono This approach suggests that a mental disorder is either present or absent - Advantages of diagnosiso Enhanced communicationo Improved definition and understanding of mental disorder Standardized rules help coordinate researcho Determining treatment  Ideas about which treatment is likely to be most effective for a given disorder. Classifying Abnormal Behavior and Mental Disorder- Classification: refers to arranging mental disorders into broad categories or classes based on similar features. - DSM-5: encourages clinicians to use dimensional assessments in addition to diagnosis o EX: mild, moderate, severeAssessing Abnormal Behavior and Mental Disorder- Purpose of clinical assessment:o Understand the individualo Predict behavioro Plan treatmento Evaluate treatment outcome1Psych 2510 – Trull - Clinical assessment: evaluating a person’s strengths and weaknesses and understanding a problem to develop treatment.o First step: the Referralo Next: choosing the right assessment measure - Reliability refers to consistency of scores or responses and includes test-retest, interrater, and internal consistency reliability.o Test-retest: consistency of test scores or diagnoses across some period of time o Interrater: agreement between two or more raters or judges about level of a trait or presence/absence of a feature or diagnosis o Internal consistency: relationship among test items that measure the same variable - Validity: the extent to which an assessment technique measures what it is supposed to measure o Content validity: how well test or interview items adequately measure various aspects of a variable,construct, or diagnosis o Predictive validity: how well test scores or diagnoses predict and correlate with behavior or test scores that are observed or obtained at some future pointo Concurrent validity: how well test scores or diagnoses predict and correlate with a related but independent set of test scores or behaviors o Construct validity: how well test scores or diagnoses correlate with other measures or behaviors in a logical and theoretically consistent way - Standardization: refers to administering and conducting clinical assessment measures in the same way for everyone. - Methods of Assessment: o Interviews:  Purpose (intake, crisis, family history) Structured interviews: certain questions that are asked of every client in a certain order and rate the client’s answers - Mental status exam  Unstructured interviews: ask anything in any order - Most unreliable type - Create more problems 2Psych 2510 – Trull o Intelligence tests: commonly used to assess cognitive aspects of mental disorders but must be viewed with caution, especially when comparing scores across cultures. Example of an item from the Wechsler Adult Intelligence Scale. o Objective personality measures: involve administering a standard set of questions or statements to which a person responds using set options. Objective personality measures such as the MMPI-2 are economical, relatively simple to administer and score, and reliable.o Projective tests: Rorschach Test  Thematic Apperception Test (TAT) o These tests on the assumption that people project their needs, conflicts, and personality when responding to ambiguous stimuli.- Behavioral assessment: measures overt behaviors or responses and is often conducted via functional analysis of antecedents and consequences of behavior.o Focus is more on the presento Direct observation of behavior – environment relationso Purpose is to identify problematic behaviors and situationso Identify antecedents, behaviors, and consequences o Behavioral observation and assessment Can be either formal or informal Self-monitoring vs. being observed by others  Problem of reactivity using direct observation - Reactivity: if you know you’re being observed, will change behavior from what you typically do EX: Handheld computers, can be used for self-monitoring thoughts, emotions, and behaviors as they occur- Biological assessmento Neuroimaging techniques as well as procedures for assessing neurochemistry and body physiology Magnetic resonance imaging (MRI) Functional MRI Positron emission tomography (PET)3Psych 2510 – Trull o Neuropsychological assessment indirectly evaluates brain function via performance on standardizedtests and tasks that indicate brain-behavior relationships.- Example from the Benton Visual Retention Test, which measures memory for designs. These tests assess immediate memory, spatial perception, and perceptual-motor coordination. Culture and Clinical Assessment- Culture may cause stress and psychological problems.- Culture may also influence a person’s reaction to stress, which symptoms of a disorder are expressed, and the content of the symptoms.- It may also reinforce certain forms of mental disorder.o For example, societies that emphasize thinness are more likely to produce individuals with anorexia.- Mental health professionals must overcome a language barrier if one exists, obtain information about a client’s culture, be culturally sensitive, and be aware of cultural variations in psychological problems Studying Abnormal Behavior and Mental Disorder- Research Designo Method to test hypotheses- Internal validity vs. External validity o Internal: the extent to which a researcher can be confident that changes in the dependent variable truly resulted from manipulation of the independent variable o External: degree to which we can generalizes findings into real world scenarios o Ways to increase internal validity by minimizing confounds  Use of control groups Use of random assignment procedures Use of analog models o Relation between internal and external validity - Scientific method: involves generating a hypothesis,