Diagnosing Psychological Disorders

Classification Diagnosing Psychological Disorders: Foundations in diagnostic Classification - Classification is central to all Sciences - assignment to groups or categories based on Shared attributes or relations Two Widely Used Classification Systems • ICD-10: international Classification of diseases and health related problems • DSM-V - published by the world health organization (1993) diagnostic and Statistical manual of mental disorders, 5th edition Published by the american psychiatric association (2013) Classification Issues distinguishing normal from abnormal can be difficult Categorical vs. dimensional approaches Classical (or pure) categorical approach Strict categories dimensional approach: classification along dimensions - Prototypical approach: combines Classical and dimensional views Classical (pure) Categorical approach an individual falls in the "yes" or "no" category for having a particular symptom "black & white" approach - Checklist method: do you meet criteria for a disorder? assumes each disorder is unique and has one set of defining Criteria Commonly used in medicine ex: diabetes -• dimensional approach "Shades of gray" rather than Baw place clients symptoms on a Continuum (instead of discrete diagnostic categories) considers degree of impairment rather than number of symptoms prototypical approach - DSM 5 - Categorical and dimensional allows for variations of disorder - different Symptoms, same disorder The DSM-v: Basic Characteristics • must meet diagnostic "Criteria" • example: major depressive disorder 5 Symptoms (I must be sad mood or annedonia): difficulty Concentrating insomnia or hypersomnia →lack of energy Feelings of worthlessness Suicidal thoughts/morbid thoughts sad mood lack of pleasure (annedonia) ↳ weight loss/gain psychomotor agitation Severity and Course Specifiers only when full criteria are met: mild few if any symproms required for dx minor impairment in Social or Occupational fx moderate: Symptoms or fx impairment between "mild" and "severe" Severe: many Symptoms in excess of those required for dx marked impairment in Social or occupational fx • in partial remission •Full Criteria previously met, but Currently only some symptoms remain in full remission no longer any Symptoms of d/o, but clinically relevant information prior history - may be useful to note even after recovery Other Categories or Specifications •"Other "Category - presentation fits general guidelines of dlo, but not all criteria are met - Symptom pattern does not cleanly fit a DSM Classification but causes Clinically Significant distress and/or impairment rule-out (12/0) - have Suspicion, Still in assessment phase facilitates Communication for future +x Unresolved Issues in the DSM-V "Fuzzy" Categories make it difficult to diagnose, contributing to comorbidity presence of 2 or more disorders in person at the same time ex: ADHD, Oppositional defiant disorder often the rule, not the exception Categories may change with new knowledge, thus not set in stone Labeling Issues and Stigmatization labeling: giving a name to a phenomenon or pattern of behavior "psychological labels have negative connotations and tend to become pejorative identification with label con affect self esteem Self fulfilling prophecy • label behavior, NOT the person!! "tom is diagnosed with Schizophrenia vs. Tom is "Schizophrenic" or a "Schizzo"