Transcript Defining and Diagnosing Disorder

Defining and Diagnosing Disorder
Mood (depression)anxiety (phobia)
food (anorexia) impulse control
(kleptomania, pyromania,
gambling).personality (paranoid)
Objectives
• Describe and summarize what a disorder is
AND why it is so hard to diagnose
• Describe the DSM (disorder book)
• Describe the advantages and disadvantages of
the DSM ( T chart)
• Compare and contrast projective and
objective tests
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Dilemmas of definition
Possible models for defining disorders
As the violation of cultural standards
As emotional distress
As behavior harmful to oneself or others
Basic definition- level 1
• Mental disorder is any behavior or emotional
state that causes a person great suffering, is
self-destructive, seriously impairs the persons
ability to work or get along with others, or
endangers others or the community
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Mental disorder
Any behavior or emotional
state that causes a person to
suffer, is self-destructive;
seriously impairs the
person’s ability to work or
get along with others; or
endangers others or the
community
chapter 11
Your turn
Psychopaths are often happy, functional people, but
they manipulate and harm others without
conscience. On what basis are psychopaths said to
have a mental disorder?
A mental disorder is any behavior or mental state that
(1) causes a person to suffer, is self-destructive;
(2) seriously impairs the person’s ability to work or get along
with others;
(3) or endangers others or the community.
chapter 11
Your turn
Psychopaths are often happy, functional people, but
they manipulate and harm others without
conscience. On what basis are psychopaths said to
have a mental disorder?
A mental disorder is any behavior or mental state that
(1) causes a person to suffer, is self-destructive;
(2) seriously impairs the person’s ability to work or get along
with others;
(3) or endangers others or the community.
Dilemmas of Diagnosis
• Classifying is not an easy task
• DSM standard reference manual to diagnose
disorders
• Categorizes by behavior
• Diagnostic and statistical manual of mental
disorders
• Referenced by judges, attorneys
• 1952- 86 pages long
• DSM-IV 1994-2000, 900 pages long, 400
diagnosis
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Diagnostic and Statistical Manual
Axis I: Primary clinical problem
Axis II: Personality disorders
Axis III: General medical conditions
Axis IV: Social and environmental
stressors
Axis V: Global assessment of overall
functioning
DSM
• Disorders usually first diagnosed in infancy,
childhood, or adolescence
• Delirium, dementia, amnesia, and other
cognitive disorders
• Substance-related disorders
• Schizophrenia and other psychotic disorders
DSM
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Mood disorders
Anxiety disorders
Eating disorders
Dissociative disorders- 2 or more identities
DSM
• Sexual and gender identity disorders=
transsexualism(want to be other sex,
erformance, premature ejaculation, lack of
Orgasim, paraphilias (unusual or bisare
imagry)
• Impulse control disorders
• Personality disorders
• Additional conditions that may be a focus of
clinical attention
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Explosion of mental
disorders
Supporters of new
categories answer that it
is important to
distinguish disorders
precisely.
Critics point to
economics: diagnoses are
needed for insurance
reasons for therapists to
be compensated.
Problems with the DSM=objective 3
• The danger of over diagnosis
• “give a small boy a hammer, everything needs
pounding”
• ADHD- impulsive, restless, easily frustrated
• Since added to DSM= Fastest growing disorder
in America
• 10 x’s more than in Europe
problems
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The power of diagnostic labels
Reassuring emotional symptoms, problems
“ whew that’s what I got”
Also label sticks to person
Oppositional defiant disorder
problems
• The confusion of serious mental disorders
with normal problems
• “disorder of written expression” (can’t write
clearly)
• “ mathematics disorder” (not doing well in
math)
• “ caffeine induced sleep disorder” (switch to
decafe)
problems
• The illusion of objectivity and universality
• Not empirical evidence but group consensus
• Samuel Cartwright- drapetomania (urge to
escape from slavery)
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Concerns about diagnostic
system
The danger of over-diagnosis
The power of diagnostic labels
Confusion of serious mental disorders
with normal problems
The illusion of objectivity and
universality
advantages
• Mild to severe
• When used correctly, with tests, ultra effective
• Culture-bound syndromes- specific to cultures
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Advantages of the DSM
When the manual is used correctly and
diagnoses are made with valid objective
tests, the DSM improves the reliability of
and agreement between clinicians.
The DSM-IV included for the first time a
list of culture-bound syndromes.
Objective 4
• Projective tests are psychological tests used to
infer a persons motives, conflicts, and
unconscious dynamics on the basis of the
persons interpretations of ambiguous stimuli.
• Rorschach Inkblot test is a projective
personality test that requires respondents to
interpret abstract, symmetrical inkblots
• Objective tests (inventories) are standardized
objective questionnaires requiring written
responses; they typically include scales on
which people are asked to rate themselves.
• Minnesota Multiphase Personality Inventory
(MMPI) is a widely used objective personality
test.
chapter 11
Projective tests
Projective tests
Psychological tests used to
infer a person’s motives,
conflicts, and unconscious
dynamics on the basis of the
person’s interpretation of
ambiguous stimuli
Rorschach inkblot test
A projective personality test
that asks respondents to
interpret abstract,
symmetrical inkblots
What do you see?
What does this appear to be?
chapter 11
Objective tests
Inventories
Standardized objective questionnaires requiring written
responses
Typically include scales on which people are asked to rate
themselves
MMPI
Most widely used personality instrument
Clinical and employment settings
Measures aspects of personality that, if extreme, suggest
a problem
Summary
• DSM
• Positives/negatives
• Tests