Oxford Text pg 269-279

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25 Terms

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diagnosis

relating a pattern of behaviour to a certain category

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reliablility

precision - being consistent across clinicians

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validity

accuracy - corresponding to the actual disorder

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inter-rater reliablity

different clinicians using the same classification system should arrive at the same diagnosis for the same patient

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audio-/video recording method

way to establish inter-rater reliability - clinical interview gets recorded, other clinician must come to the same results

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test-retest reliability

way to establish inter-rater reliability - tow separate interviews with two separate clinicians

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predictive validity

the ability to predict how the disorder will respond to the treatment

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inverse

reliability and validity have an _______ relationship

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Beck et al (1962)

found 54% reliability for DSM-I

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Kendall (1974)

found consistency of diagnoses are poor over time - maybe due to changes in patients’ patterns of behaviour or inconsistent psychiatrists

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Carl Hempel

philosopher of science influential in suggesting a shift to observational criteria

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Di Nardo et al (1993)

found excellent inter-rater reliability for OCD and phobias, but low for GAD

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structured clinical interview for DSM (SCID)

diagnostic interview that included a standardized set of questions for clinicians to ask

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Williams et al (1992)

conducted test-retest reliability study - found reliability coefficients for different disorders vary within the same diagnostic manual

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Chmielewski et al (2015)

claims reliability to a large extent depends on the method with which it was established

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Regier et al (2013)

summarized the results of field trials of the DSM-5 in the US and Canada, finding “mixed” results - but DSM-5 has improved reliability

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heterogeneity of clinical presentation

key problem related to validity of diagnosis: the same disorder can manifest itself differently in different patients

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symptomological rather than etrological classification

key problem related to validity of diagnosis: relying on symptoms means there will be overlaps between disorders

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comorbidity

key problem related to validity of diagnosis: co-occurrence of diagnoses (anxiety and depression frequently co-occur)

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stability

key problem related to validity of diagnosis: diagnoses are valid if inferred disorder is stable over time

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cut-off point

key problem related to validity of diagnosis: when is something “clinically significant” vs “clinically insignificant”

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selecting treatment

key problem related to validity of diagnosis: the type of treatment depends on the type of disorder

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Cooper (1972)

compared diagnoses between American and British psychiatrists - Americans more likely to diagnose depression, British more for schizophrenia

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systematic bias in clinical judgement

a way to assess validity - compare two sets of diagnoses that should not differ if diagnosis is valid

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objectively known

way to assess validity - disorder is established but not known to psychiatrists