PSY B 322 1st Edition Exam 2 Study Guide Book and Lectures Notes Chapter 7 Lecture DX and Classification What is Classification The systematic grouping in a series of increasingly specialized groups or classes because of similarities in structure origin behavior etc that indicates a common relationship between the members of that group Emil Kraplin Created first recognized categorical system of mental disorders 1990s What is a mental disorder A mental disorder is a syndrome characterized by clinically significant disturbance in an individual s cognition emotional regulation or behavior that reflects a dysfunction in the psychological biological or developmental processes underlying mental functioning An expectable or culturally approved response to a common stressor or loss such as the death of a loved one is not a mental disorder What is Dx Diagnosis Base diagnosis on observable behavior and what patients tell us as opposed to blood test or some other definitive test as in medicine What is DSM Diagnostic and Statistical Manual of Mental Disorders First DSM born from need to document what therapists were seeing Why is Diagnosis and Classification Important Affects professionals Facilitate research awareness and treatment Affects clients Acknowledge significance of problem Access treatment Legal Consequences DSM I 1952 Categories reactions not categories Based on War exposure DSM II 1968 not rxns of the personality now divided into neurosis and psychosis Not empirically based No specific criteria Based on clinical wisdom of small of psychiatrists working on DSM taskforces Book says Psychoanalytic Freudian influence NOT TRUE DSM III 1980 Very different from DSM I and DSM II Atheoretical More reliant on empirical data Less reliant on clinical consensus Introduction to many new Dx diagnosis categories Shortened descriptive word Multi axial assessment 5 axes DSM III R 1987 Minor changes from DSK III DSM Overview Categories increased from 106 dx categories to now 300 over last 50 years 80 new categories added from II III Some categories have been removed masturbatory insanity some over sighted like Autism prior to 1980 40 different substance abuse dependence categories now Decreased number of patients diagnosed with schizophrenia by 10 DSM IV tr included significant cultural advances Criticisms Too many disorders stigmas mental illness trivialized some not actually forms of mental illness how many symptoms necessary for a particular disorder Gender Bias non empirical factors limitations on objectivity DSM 5 2013 Task force led project each focusing on particular area of mental disorders Attempted greater consistency between DSM and ICD International Classifications of Diseases Changes considered BUT NOT MADE o Considered emphasizing neuropsychology biological roots o Considered removing 5 of 10 personality disorders o Proposed disorders like internet gaming disorder New Features o Shift from Roman numerals to Arabic numerals elimination of multiaxial assessment system New disorders such as hoarding disorder and binge eating Multi axial Dx Eliminated Axis I Clinical Syndrome Purpose of the visit Axis II Personality disorders Intellectual Disability Axis III Medical Problems Axis IV Environmental or Psychosocial Axis V Global Assessment of Functioning 1 100 Key criticisms Diagnostic over expansion Questionable transparency of the revision process Work groups prominently composed of researchers instead of clinicians Field trial problems Price of DSM 5 Categorical Approach versus Dimensional Approach Categorical DSM s approach yes or no category black and white approach may correspond well with human tendency to think categorically facilitates communication Dimensional approach Shades of gray place clients symptoms on a continuum fivefactor model of personality each of our personalities contains the same five basic factors neuroticism extraversion openness to experience agreeableness and conscientiousness more difficult to communicate effectively better suited for different disorders like personality disorders READ BOX 7 4 IN BOOK PAGE 178 Chapter 8 Lecture Psychotherapy and Clinical Interview Psychological Assessment I Planning the assessment o Why is the person being assessed II Data collection our focus o Clinical interview Tests Observations Informal Assessment Examination IV Data processing o Organize and Interpret Data V Communicating findings o Typical Report identify info reason for referral background behavioral observations assessment results diagnosis interpretation summary and recommendations Goals Description of problem Classification Dx Prediction Clinical Interview Vs Social Conversation Participants have different social roles interview usually in professional setting onesided Other types of interviews Intake case history diagnostic mental status exam crisis Essential elements of clinical interview RAPPORT EFFECTIVE COMMUNICATION What is Rapport The sense of mutual trust and harmony that characterizes a good relationship rapport involves a comfortable atmosphere and a mutual understanding of the purpose of the interview How do you establish rapport Convey acceptance understanding and respect for patient Open Questions Versus Closed Questions Open What did you think of the movie ELICT INFO Closed Did you like the movie GATHER SPECIFIC INSIGHT Four Types of Responses that Convey Listening Clarification Encourages elaboration checks for accuracy clears up vaugeness Paraphrase Describing content thoughts of client s message allows for clarification helps client to focus on content of their message Reflection Describing the feelings of the client s message encourages expression of feelings Summarization Two or more paraphrases or reflections that condense the client s message or the session identifies common theme interrupts excessive talking reviews progress Overview planning the assessment why is person being assessed Data collection interviews tests observations etc Data processing clinical vs statistical prediction Communicating findings written reports Book Info Pages 184 205 Assessments closely and uniquely associated with the identity of clinical psychology no other mental health professionals incorporate into their training and work to the extent that clinical psychologists do Any assessment technique used should possess qualities of validity reliability and clinical utility Validity Measures what it claims to measure Reliability Yields consistent repeatable results