Abnormal Psychology Week 3 Lecture Notes: Clinical Assessment, Diagnosis, and Treatment- Chapter 4Diagnostic Classification -What is the purpose of diagnoses?-Identification: help us pinpoint psychological problems a person is experiencing-Research: empirically studying disorders and gaining a deeper understanding of them -Facilitates communication among clinicians, researchers, and society-Once we have identified a problem it is easier to treat it-practical matters of billing and communication -like to categorize things and it serves some functions -the function is serves and the consequences-misdiagnosing DSM History -DSM-I (1952)-DSM-II (1968)-Seventh printing of the DSM-II, 1974-DSM-III (1980)-DSM-III-R (1987)-DSM-IV (1994)-DSM-IV-TR(2000)-DSM-5 2013-Steady progression of more disorders -Removed sexual orientation in seventh printing of DSM-11Classification Systems -Lists of categories, disorders, and symptom descriptions with guidelines for assignment -Focus on clusters of symptoms (syndromes)-In current use in the U.S. : DSM-5-Diagnostic and Statistical Manual of Mental Disorders (5th edition)-focus on clusters of symptoms- symptoms that cluster together=syndromes=collection of symptoms that occur together -ex. HIV became an issue, before it was HIV it was called AIDS-s=syndrome, a lot of symptoms in the deficiency of the immune systemDSM-5-Published in 2013-Features a number of changes from the previous edition-DSM-IV-TR- and the editions prior to that -It lists approximately 400 disorders -Describes criteria for diagnoses, key clinical features, and related features that are often, but not always present -one or two changes: hoarding disorder, caffeine dependence Lifetime Prevalence of DSM Diagnoses -How common it is to receive a diagnoses-1/2 of us will at least receive one psychiatric diagnosesDSM-5-Requires clinicians to provide two types of information:-Categorical- the name of the category (disorder) indicated by the client’s symptoms -Dimensional- a rating of severity (the number of symptoms, how severe symptoms are, and how much impairment is associated with the symptoms)-one of the changes deals with categorical and dimensional data -2 ways to think of these collections of symptoms-Debate: issue with every version of the DSM- make them dimensional or categorical -Medical framework: puts things in categories-> psychiatry -Dimensions- being pregnant is not a dimension, how much you weigh or how tall you are is a dimension, how depressed you are -Resisted from moving in a categorical system -Categorical Information -The clinician must decide whether the person is displaying one of the hundreds of disorders listen in the manual -Some of the most frequently diagnosed are the anxiety disorders and depressive disorders -The DSM is still a predominantly categorical system -Additional Information -Clinicians also have the opportunity to provide other information, including relevant medical conditions and special psychosocial problems Reliability and Validity of the DSM-Both have to have reliability and validity-Reliable- does it give you consistently the same info everytime, around many ppl, do they make the same conclusion -Validity- do you get what you are suppose to measure, is it telling you what you think it should be tellingyou, if you think its depression, the person is actually depressed Is DSM-5 and Effective Classification System?-A classification system, like an assessment method, is judged by its reliability and validity -Here, reliability means that different clinicians are likely to agree on a diagnosis using the system to diagnose the same client -The framers of DSM-5 followed certain procedures to help ensure greater reliability than any previous edition -The validity of a classification system is the accuracy of the information that its diagnostic categories provide -Predictive validity is of the most use clinically -DSM-5 framers also tried to ensure the validity of this edition by conducting extensive literature reviews and running field studies-However, many are still concerned about its validity Can Diagnosis and Labeling Cause Harm?-Misdiagnosis is always a concern -Major issue is the reliance on clinical judgment -Also present is the issue of labeling and stigma -Diagnosis may be a self-fulfilling prophecy -Because of these problems, some clinicians would like to do away with the practice of diagnosis -May add some value for labeling these disorders- allow you to build efficiency -Downsides: what is use the wrong label?-> get it wrong -Self-fulfilling prophecy-ADD overdiagnoses, if put kids in special class- they identify themselves like that, and may actually doing poorly in school b/c of the disease they were diagnosed with Clinical Assessment: How and Why Does the Client Behave Abnormally?-Assessment is collecting relevant information in an effort to reach a conclusion-Clinical assessment is used to determine how and why a person is behaving abnormally and how that person may be helped -also may be used to evaluate treatment progress -The specific tools used in an assessment depend on the clinician’s theoretical orientation -Hundreds of clinical assessment tools have been developed and fall into three categories:-Clinical interviews -Tests-Observations -psychologists are the only ones trained to do assessment Characteristics of Assessment Tools -Reliability refers to the consistency of an assessment measure -A good tool will always yield the same results in the same situation -Two main types:-Test-retest reliability- yields the same results every time it is given to the same people -Interrater reliability- different judges independently agree on how to score and interpret a particular tool -on any assessment tool that is good needs to be reliable -test-retest reliability- test on Tuesday and then test again on Friday- get the same results-interrater-do you get the same answers if two different ppl give out the test -Validity refers to the accuracy of a tool’s results -a good assessment tool must accurately measure what it is supposed to measure -Three specific types:-Face validity- a tool appears to measure what it is supposed to measure; does not necessarily indicate true validity-Predictive validity- a tool accurately predicts future characteristics or behavior -Concurrent validity- a tool’s results agree with independent measures assessing similar characteristics or behavior - face-does the tool or question you are asking- is it