Transcript File - vce psychology 2014

UNIT 4
BRAIN, BEHAVIOUR &
EXPERIENCE
AREA OF STUDY 2
MENTAL HEALTH
SYSTEMS OF CLASSIFICATION OF
MENTAL CONDITIONS &
DISORDERS
A CATEGORY is a group of items that share a particular set of
properties
The process of classification places one of these items into a
category
TWO APPROACHES ARE USED TO CLASSIFY
MENTAL DISORDERS:
CATEGORICAL APPROACH:
classification
symptoms
category
‘belong’ to
A yes/no approach to
that classifies a person’s
in terms of which specific
of mental disorder they
DIMENSIONAL APPROACH: classifies a person’s symptoms
or
other characteristics of interest in
CATEGORICAL & DIMENSIONAL
APPROACHES
The choice between whether a psychologist would use a
categorical or a dimensional approach to diagnose a patient is
not as clear-cut as it may seem
Health professional will generally merge the two and use
both approaches to properly diagnose a patient
1.The mental health professional will more than likely
begin using a categorical approach to firstly classify the
patient’s symptoms as a mental disorder
2.They would then use a dimensional approach to
determine the severity of the symptoms
CATEGORICAL
APPROACHES
CATEGORICAL APPROACH:
organises and describes
mental
conditions and
disorders in terms of
different
categories and subcategories, each with symptoms
and characteristics that are typical
of specific mental disorders
‘YES OR NO’
Categorical approaches are based on a number of
assumptions:
•A mental disorder can be diagnosed from specific symptoms
•Thoughts, feelings and behaviour can be organised into categories
representing disorders
•Within each disorder category there are distinct (different) and discrete
(separate) sub-categories of the disorder, each with a pattern of symptoms
CATEGORICAL
APPROACHES
in terms of
subsymptoms
are typical
disorders
organises and describes mental
conditions and disorders
different categories and
categories, each with
and characteristics that
of specific mental
‘YES OR NO’
A large assumption of a categorical approach is that it must
be:
VAILD: the classification system actually organises mental disorders into
discrete and distinct disorders. The disorder must therefore accurately
represent
the symptoms that have been assessed
RELIABLE: the classification system produces the same diagnosis each
time it is used in the same situation
CATEGORICAL
APPROACHES
DIAGNOSTIC & STATISTICAL MANUAL OF MENTAL DISORDERS
(DSM)
A categorical system for diagnosing and classifying mental disorders
based on recognisable symptoms that are precisely described for each
disorder
First developed in 1952 it is now in its fifth edition (DSM-V). All
explanations in the text-book, however, still relate to DSM-IV
16 MAJOR
CATEGORIES
(see page 486-487 in text-book)
CATEGORICAL
APPROACHES
DIAGNOSTIC & STATISTICAL MANUAL OF MENTAL DISORDERS
(DSM)
DIAGNOSTIC CRITERIA:
the symptoms that are
characteristic of a
enable assessment
disorder
particular disorder and
of the presence of a
- INCLUSION CRITERIA: Identify the symptoms that must be
present
in order for the disorder to be
diagnosed
- EXCLUSION CRITERIA: identify the symptoms, conditions or
circumstances that must not
be present in
order for the disorder to be
diagnosed
- POLYTHETIC CRITERIA SETS: a list of diagnostic criteria in
which only
some symptoms, not all, need
to be present
in order for the disorder to be
diagnosed
THE DSM also contains:
CATEGORICAL
APPROACHES
DIAGNOSTIC & STATISTICAL MANUAL OF MENTAL DISORDERS
(DSM)
AXIS NAME OF AXIS
1
Clinical disorders
II
Personality disorders
Mental retardation
III
General medical conditions
IV
Psychosocial &
Environmental problems
V
Global Assessment of
functioning
All of the mental disorders in DSM
Medical conditions related to
disorder
Potential stressors in life
Overall level of psychological
function
• All 5 axes must be considered in order to completely
evaluate an individual’s mental condition
• Each axis refers to different information about a person
• Together the 5 axes provide comprehensive and useful
information, allowing planning for treatment
HOMEWORK
LEARNING ACTIVITY 12.5 (pg.491)
CATEGORICAL
APPROACHES
INTERNATIONAL CLASSIFICATION OF DISEASES & RELATED
HEALTH PROBLEMS (ICD)
A categorical system for diagnosing and classifying diseases and mental
disorders based on recognisable symptoms that are precisely described
for each disease and disorder
First developed in 1893 it is now in its tenth edition. Primarily used in
Europe, most psychologists prefer use of the DSM-V
CHAPTER V (5) is the one that psychologists use for diagnosing
and classifying mental disorders. All other chapters of the book refer
to a range of mental and behavioural disorders
This is used just like the DSM, a set of diagnostic guidelines identify
the symptoms that are characteristic of each disorder
HOMEWORK
LEARNING ACTIVITY 12.7 (pg.494)
CATEGORICAL
APPROACHES
STRENGTHS & LIMITATIONS
OF CATEGORICAL APPROACHES
STRENGTHS
LIMITATIONS
Based on ongoing scientific research and
regularly revised on the basis of research
findings
In the past, low inter-rater reliability was
reported, however, this has improved with
the latest editions to 70%
Very comprehensive in terms of the number
of disorders they include and the amount of
information presented on each disorder
Large degree of overlap with symptoms in
the DSM and ICD, making a discrete diagnosis
sometimes difficult
Promote the growth of a body of expert
knowledge about mental disorders
Loss of valuable clinical information. Labels
mean that uniqueness of case is overlooked
Allows professionals to diagnose and then
devise a treatment and management plan for
those who require it
Labels can have a negative effect on the
individual who is labelled with a mental
disorder
Considered to be very ‘user-friendly’
Enhance communication among mental health
professionals by providing a common
language, the labels in the manual convey a
large amount of information quickly and
conveniently
Can create a ‘stigma’ around someone who is
labelled. Friends can treat you differently, you
think of yourself differently and employment
could be difficult
DIMENSIONAL
APPROACHES
A DIMENSIONAL APPROACH QUANTIFIES A PERSON’S
SYMPTOMS OR OTHER CHARACTERISTICS OF
INTEREST AND REPRESENTS THEM WITH NUMERICAL
VALUES ON ONE OR MORE SCALES OR CONTINUUMS
A DIMENSION = a cluster of related psychological and
behavioural
characteristics that tend to occur
together and can
be measured
A person will get a score on each of the dimensions of interest
INVENTORY:
this is a ‘test’, typically comprising closed-ended
questions
requiring a ‘yes or no’ answer, or
statements requiring a rating
about the extent of agreement
or disagreement
2 Assumptions:
•Normality and abnormality are end points on the same continuum
•Many independent dimensions exist and that all people possess them to
•
DIMENSIONAL
APPROACHES
Eysenck Personality Questionnaire-Revised (EPQ-R)
Designed to measure three dimensions
- Extraversion/Introversion
- Neuroticism/Emotional Stability
- Psychoticism
Each of these dimensions is made up of a number of personality
traits
It is assumed that each individual possesses each of these
dimensions in
varying amounts
• Big Five Personality Inventory
Big Five Traits
- Agreeableness
- Openess To Experience
- Conscientiousness
- Extraversion
- Neuroticism
• Minnesota Multiphasic Personality Inventory (MMPI-2)
Ten different dimensions
DIMENSIONAL
APPROACHES
Can also be applied at a more specific level:
scale
scale
- an individual’s functioning or impairment is measured on a
of 1-100
- The severity of a symptom could be graded using a 3 point
such as 1=absent, 2=mild, 3=severe
The focus is on grading a person on the magnitude, degree or
severity on particular dimensions, rather than assigning them to a
diagnostic category
Mental health professionals can then monitor their client at different
time levels and measure their transition, or change over time
Standardised inventories can also be used to produce a profile
DIMENSIONAL
APPROACHES
STRENGTHS & LIMITATIONS OF DIMENSIONAL APPROACHES
STRENGTHS
LIMITATIONS
Single diagnostic labels (categorical
approaches) result in a loss of information
whereas dimensional approaches retain that
information
There is no widely accepted standardised
inventory or system that can be used
Dimensional approaches take into a wide
range of a person’s symptoms and
characteristics
It is difficult for mental health professionals
to know which dimensions are relevant or
useful for their clients
Provides a richer and more detailed
description of an individual’s mental
condition in the form of a profile
Disagreement on the number of dimensions
that would suitably represent the wide range
of mental disorder symptoms
Helps to reduce the stigma usually associated If there are too many dimensions to assess,
with the diagnosis of a specific mental
then a mental health assessment could
disorder
become overcomplicated
HOMEWORK
LEARNING ACTIVITY 12.9 (pg.502)
LEARNING ACTIVITY 12.10 (pg.502)