University:
University of California, Berkeley
Course:
PSYCH N1 | General Psychology
Academic year:

2020
Views:

52

Pages:

11
Author:

InterstellarInnovator

Diagnosis as Categorization • Diagnosis Classifies Patient – Symptoms are Features – Syndromes are Categories • Diagnosis as Feature-Matching – Match Patient’s Symptoms to Syndrome • Diagnostic & Statistical Manual (DSM) – American Psychiatric Association – “Official” List of Syndromes, Features • Used for Classifying Mental Illnesses 23 19th-Century Psychiatric Diagnosis • Jean-Etienne Dominique Esquirol (1772-1840) – Insane – Mentally Deficient – Criminal • Emil Kraepelin (1856-1926) – Dementia Praecox (Schizophrenia) – Manic-Depressive Illness (Affective Disorder) • Pierre Janet (1859-1947) – Hysteria (Dissociative Disorders) – Psychasthenia (Anxiety, Depression) 24 Growth of the Psychiatric Nosology American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders DSM-5 400 DSM-IV 350 DSM-III 300 DSM-III-R 250 DSM-II 200 150 DSM-I 100 50 0 1952 1968 1980 1987 1994 2013 25 Diagnoses as Proper Sets Symptoms as Defining Features Bleuler (1911) • • • • The “4 As” of Schizophrenia Association Disturbance Anhedonia Ambivalence Autism • • • • Schizophrenic Subtypes Simple Hebephrenic Catatonic Paranoid 26 Hierarchical Organization of Psychopathology Mental Illness Psychosis ManicDepressive Illness Neurosis Schizophrenia Simple Hebephrenic Catatonic Paranoid 27 Problems with Diagnoses as Proper Sets • Partial Expression – Schizoid Personality Disorder – Schizotypal Personality Disorder – Paranoid Personality Disorder • Combined Expression – Pseudoneurotic Schizophrenia – Pseudopsychopathic Schizophrenia – Schizoaffective Disorder – Borderline Personality Disorder 28 Diagnoses as Fuzzy Sets DSM-III (1980), DSM- IV (1994), DSM-5 (2013) • Characteristic Symptoms – Textbook Cases as Prototypes • Heterogeneity within Category – Family Resemblance • No Clear Boundaries 29 Schizophrenia DSM-5 (2013) • • • • • 2 or More Symptoms Plus Delusions • Postmorbid Decline – Occupational Hallucinations – Social Disorganized Speech – Self-Care Grossly Disorganized or • Duration 6+ Months Catatonic Behavior • Subtypes? Negative Symptoms – Diminished Emotional Expression – Avolition – Acute vs. Chronic – First vs. Multiple Episodes – Type I vs. Type II • Positive vs. Negative Symptoms 30 Major Depressive Disorder DSM-5 (2013) 5+ Symptoms Over 2 Weeks • Depressed Mood and/or • Diminished Interest • Weight Loss • Insomnia or Hypersomnia • Psychomotor Agitation or Retardation • Loss of Energy or Fatigue • Worthlessness or Guilt • Inability to Concentrate or Indecisiveness • Thoughts of Death or Suicide 31 Psychiatric Diagnosis as Judgment Under Uncertainty Cantor et al. (1980), Cantor & Genero (1986) • Balance of Symptoms – Characteristic of Target Category – Characteristic of Alternative Categories • Textbook Cases as Category Prototypes 32 Psychiatric Diagnosis Beyond Symptoms and Signs Kihlstrom (2002); Cuthbert & Insel (2010) • Neural Structure and Function – Subtle Lesions in Brain Tissue – Abnormalities in Neurotransmitter Function – Dysregulation in Activity of Neural Circuitry • Psychopathology – Deficits in Psychological Function • Basic Cognitive, Emotional, Motivational Processes – Beliefs, Expectations, Behaviors • Acquired Through Experience 33