Psy3032 - Abnormal Psychology - Week 1A Diagnosis & Classification

Front 1

What does reliability refer to?

Back 1

the consistency of measurement

Front 2

What type of reliability refers to the degree to which two independent observers agree on what they have observed?

Back 2

interrater reliability

Front 3

What type of reliability refers to the extent to which people being observed twice or taking the same test twice receive similar scores?

Back 3

test-retest reliability

Front 4

What type of reliability refers to the extent to which scores on the two forms of the test are consistent?

Back 4

alternate-form reliability

Front 5

What type of reliability refers to the assessment of whether items on a test are related to one another?

Back 5

internal consistency reliability

Front 6

What does validity refer to?

Back 6

whether a measure measures what is it is supposed to measure

Front 7

What type of validity refers to whether a measure adequately samples the domain of interest?

Back 7

content validity

Front 8

What type of validity refers to determining whether a measure is adequately associated in an expected way with some other measure?

Back 8

criterion validity

Front 9

If two variables are measured at the same point in time what is the resulting validity referred to as?

Back 9

concurrent validity

Front 10

What type of validity refers to evaluating the ability of the measure to predict some other variable that is measured at some point in the future?

Back 10

predictive validity

Front 11

What type of validity is centrally important to diagnostic categories, and why?

Back 11

construct validity, because we want to interpret a test as a measure of some construct that is not overtly observed.

Front 12

What does DSM stand for?

Back 12

Diagnostic and Statistical Manual of Mental Disorders

Front 13

Name the editions and publication dates of the DSM.

Back 13

DSM-I - 1952
DSM-II - 1968
DSM-III - 1980
DSM-III-R - 1987
DSM-IV - 1994
DSM-IV-TR - 2000
DSM-5 - expected mid 2013

Front 14

Describe the DSM-I

Back 14

Published in 1952, 100 pages describing major psychiatric illnesses

Front 15

Describe DSM-II

Back 15

Published in 1968, contained vague descriptions, low interrater reliability, and had a psychoanalytic approach (not scientific)

Front 16

Describe DSM-III

Back 16

Published in 1980, radical change in mental illness diagnosis. Contained detailed guidelines and algorithmic rules for diagnosis, specific diagnostic criteria, introduced the multiaxial system, and included scientific research findings.

Front 17

Describe the DSM-III-R

Back 17

Published in 1987, retained features of DSM-III but included more detail and diagnosis, over 900 pages ling and 350 diagnosis

Front 18

Describe the DSM-IV

Back 18

Published in 1994, retained features of DSM-III-R but included a focus on cultural issues

Front 19

Describe the DSM-IV-TR

Back 19

Published in 2000, categorical information mostly remained unchanged, extra information on specific diagnosis were updated as was information on ICD coding.

Front 20

What 8 major changes are being considered for the DSM-5?

Back 20

1. Changes tot he Multiaxial system (5 to 2)
2. Chapters reorganised to reflect patterns of comorbidity and shared etiology
3. Although categorical diagnosis remains instead of dimensional, a severity rating scale for each disorder replaces the GAF on axis V.
4. Chamges to the diagnossi of personality disorders
5. Inclusion on new diagnosis
6. Combining diagnosis such as mixed anxiety and depression and substance use disorder
7. Clearer criteria
8. Ethnic and cultural considerations in diagnosis through the inclusion of 25 culture bound syndromes in the appendix

Front 21

What is the DSM-IV definition of a mental disorder?

Back 21

a clinically significant behavioural or psycholgical syndrome or pattern that occurs in an individual that is associated with:
1. Distress - painful sympton; or
2. Disability - impairment in 1 + important areas of functioning; or
3. A significantly increased risk of suffering death, pain, and/or disability; or
4. An important loss of freedom
3.

Front 22

Why was an important loss of freedom added into the DSM-IV definition of a mental disorder?

Back 22

To account for diagnosis such as antisocial PD or paraphilia

Front 23

In the DSM-IV definition of mental disorder, From which paradigm does the inclusion of "a significant increased risk of suffering death, pain, and/or disability" originate from?

Back 23

Biological Paradigm

Front 24

Identify the 4 steps in the assessment process?

Back 24

1. Identify specific differences from normal functioning
2. Compare problems with commonly seen problems (diagnosis)
3. Consider interactions between persons experience, behaviour, environment (formulation)
4. Use models and formulation to advise of treatment options

Front 25

Is the assessment process what to diagnoses and formulation inform?

Back 25

treatment options

Front 26

What are the main seven reasons that we classify or diagnose?

Back 26

1. Enables clinicians for identify signs and symptoms that cluster together
2. Enables communication between health professionals (simplifies complex data)
3. Provides information about the likely course of a particular mental disorder with or without treatment.
4. Assist in the selection of treatment options
5. Enables clinical research to develop improved clinical strategies
6. Enables epidemiological studies
7. Can help people make sense of their symptoms

Front 27

What type of reliability or validity is tested when a group of high school students are given the same IQ test 2 years in a row?

Back 27

test-retest reliability

Front 28

What type of reliability or validity is tested when a group of high school students are given an IQ test, and their scores are correlated with a different IQ test they took the year before?

Back 28

criterion validity

Front 29

What type of reliability or validity is tested when a measure of the tendency to blame oneself is developed, and researchers then test whether it predicts depression, whether it is related to childhood abuse, and whether it is related to less assertiveness in the workplace?

Back 29

construct validity

Front 30

What type of reliability or validity is tested when patients are interviewed by two different doctors, and researchers then examine whether the doctors agree about the diagnosis?

Back 30

interrater reliability

Front 31

What is the assumption underlying the DSM enabling identify signs and symptoms that cluster together?

Back 31

that the symptoms being clustered have a common cause

Front 32

Explain the three different approaches to classifying a mental disorder?

Back 32

1. Statistical Model - core feature statistically rare
2. Subjective Distress Model - core feature psychological distress
3. Biological Model - core feature biological disadvantage

Front 33

What is the limitation of the statistical approach to classifying mental disorders?

Back 33

- Some behaviours are rare but are not a disorder i.e. giftedness, altruism Mother Theresa)
- Some relatively commons behaviours are regarded as disorders i.e. depression and anxiety

Front 34

What is the limitation of the subjective distress approach to classifying mental disorders?

Back 34

It does not distinguish between ego-dystonic and ego-syntonic conditions for example grandiosity in people with Narcissistic PD cause distress to others but experience no subjective distress as a result

Front 35

What is the limitation of the biological approach to classifying mental disorders?

Back 35

It is concerned only with impairment in lifespan ability to reproduce or increased morbidity which excludes disorders that don't reduce ability to reproduce or increase morbidity such as adjustment disorder

Front 36

What are the two classification systems that are broadly used?

Back 36

ICD-10 & DSM-IV-TR

Front 37

What does ICD stand for?

Back 37

International Classification of Diseases, Injuries and Causes of Death

Front 38

When was the ICD-10 published?

Back 38

1992

Front 39

Explain the use of ICD-10 and DSM in Australia?

Back 39

Clinicians use the DSM-IV-TR in health care system to diagnose but convert to ICD-10 coding.

Front 40

Which form of coding for mental disorders in used in the Australian health care system?

Back 40

ICD-10 because of a signed treaty between Australia and the World Health Organisation.

Front 41

Which classification system is mostly used in research?

Back 41

DSM

Front 42

What is the difference in diagnosis between the ICD and the DSM?

Back 42

ICD contains diagnostic guidelines whereas the DSM contains explicit diagnostic criteria

Front 43

What is circular about the use ICD and the DSM in Australia?

Back 43

The ICD was developed on research which used the DSM, clinicians are trained to use the DSM, clinicians in the health care system diagnose using the DSM and then convert to the ICD for coding.

Front 44

What are the four features of the DSM-IV-TR?

Back 44

1. Atheoretical - decisions made by work groups and based on scientific data (controversial)
2. Resource Book - criteria, trends, prevalence, risk etc (useful but becomes outdated)
3. Categorical - not dimensional but not purely categorical as it contains prototypes
4. Multiaxial - several different axis on which a diagnosis is made

Front 45

Who released the DSM-I?

Back 45

American Psychiatric Association

Front 46

What are the five axis contained in the DSM-IV-TR?

Back 46

Axis I - Clinical/Mental disorders
Axis II - Pervasive disorders (PD, ID)
Axis III - Medical Disorders
Axis IV - Psychosocial stressors
Axis V - Overall level of adaptive function (GAF - 0-100)

Front 47

What are three qualifications considered in the diagnosis of a mental disorder?

Back 47

1. must not be merely an acceptable and culturally sanctioned response to a particular event
2. regardless of the original cause it must be currently considered a manifestation of a behavioural, psychological or biological dysfunction in the individual
3. Neither deviant nor conflicts that are primarily between the individual and society are mental disorders unless the deviance or conflict is a symptom of a dysfunction in the individual.

Front 48

What are the nine factors considered in Axis IV psychosocial and environment?

Back 48

1. Primary support groups
2. Social environment
3. Educational
4. Occupational
5. Housing
6. Economic
7. Access to health care services
8. Legal system/crime
9. Other psychosocial and environmental problems

Front 49

What are the four main statistical issues with the DSM-IV classification?

Back 49

1. Co-morbidity - high likelihood if diagnosed with one disorder will be diagnosed with another ie depression/anxiety
2. Heterogeneity within disorders
3. Overlap with normal - subclinical
4. Distinction between axis I and axis II not clear

Front 50

What are the four main social issues with the DSM-IV classification?

Back 50

1. Problems with Labelling - ie person with schizophrenia not schizophrenic and self fulfilling nature of labelling
2. Reflects social/cultural/political bias ie homosexuality and gender bias
3. Over pathologisation - the inclusion of everyday issues such as sadness
4. Illusion of explanation - ie pyromaniac why? because he lights fires. Why? because he is a pyromaniac. Similarly with ODD.

Front 51

What was important about the study by Rosenham in 1973?

Back 51

Researchers presented to psychiatric clinic only reporting hearing voices all were diagnosed with schizophrenia and admitted to the psychiatric hospital

Front 52

What are the four broad types of characteristics that a valid diagnosis should help predict?

Back 52

1. Etiology
2. Course (prognosis)
3. Social functioning
4. Treatment