Ch. 4

Categories:

An approach to defining a mental disorder by examining large classes of behaviors.

Can be thought of as a ‘yes-no’ approach.

Yes-No Approach:

One either has or does not have a mental disorder.

Derived from a medical model of diagnosing a disease, you have it or you don’t.

Dimensions:

An approach to defining mental disorder along a continuum.

Dimensional Approach:

Defining abnormal behavior along a continuum or spectrum

  1. Behavior that deviates from the norm

  2. Behavior associated with difficulty adapting to life’s demands

  3. Behavior accompanied by personal distress

Abnormal behavior consists of emotional states, cognitive styles, and physical behavior.

Types of Dimensional Assessment:

  1. Rating a person’s symptoms as mild, moderate, or severe.

  2. A person’s degree of insight into, or recognition of, their mental condition.

  3. Impact of symptoms on different areas of their life

Diagnosis:

A category of mental disorder defined by certain rules that outline how many and what features of a disorder must be present.

DSM-5:

The Diagnostic and Statistical Manual of Mental Disorders

General Features:

  1. A group of emotional, cognitive, or behavioral symptoms, called a syndrome, that occur within a person.

  2. These symptoms are usually associated with emotional distress or disability (impairment) in life activities.

  3. The syndrome is not simply an expected or culturally approved response to a specific event, such as grief and sadness following the death of a loved one.

  4. The symptoms are considered to reflect dysfunction in psychological, biological, or developmental processes.

Advantages of Diagnosis:

  1. Communication

    1. A wealth of information can be conveyed in a single term

  2. Standard rules are provided for defining mental disorders and for seeking the cause of these disorders.

  3. Because everyone uses the same system, clinicians can find useful assessment strategies, such as questionnaires for depression, and researchers can examine prevalence rates of a certain mental disorder at local, state, and national levels.

    1. They may suggest which treatment is most effective.

Classification:

Arranging mental disorders into broad categories or classes based on similar features.

Clinical Assessment:

Evaluating a person’s strengths and weaknesses and formulating a problem to develop a treatment plan.

Reliability:

Consistency of test scores or diagnoses.

3 Ways of Evaluating Reliability:

  1. Test-Retest:

    1. Extent to which a person provides similar answers to the same test items across time.

    2. If a diagnosis changes from week to week, that would be a poor test-retest reliability.

    3. If the diagnosis is consistent from week to week, that would be a strong test-retest reliability.

  2. Interrater Reliability:

    1. Agreement between two or more raters or judges about the level of a trait or presence/absence of a feature or diagnosis.

    2. Used to examine the usefulness of a diagnostic interview.

    3. Two mental professionals may give a person the same diagnostic interview on the same day and arrive at the same diagnosis; that would be a strong interrater reliability.

  3. Internal Consistency Reliability:

    1. Relationship among test items that measure the same variable.

Validity:

Extent to which an assessment technique measures what it is supposed to measure.

4 Types of Validity:

  1. Content Validity:

    1. The degree to which test or interview items actually cover aspects of the variable or diagnoses under study.

    2. If a test of depression contained items only about sad mood, the test would not have a high content validity because depression also involves problematic thinking patterns and withdrawn behavior.

  2. Predictive Validity:

    1. Whether a test or interview results accurately depict some behavior or event in the future.

    2. A test of school success has good predictive validity if current scores can relate to children’s school achievement 2 years from now.

  3. Concurrent Validity:

    1. Whether current test or interview results relate to an important feature or characteristic at the present time.

    2. A child’s diagnosis of conduct disorder should reflect his current level of misbehavior.

  4. Construct Validity:

    1. Whether test or interview results relate to other measures or behaviors in a logical, theoretically, expected fashion.

Standardization:

Administering or conducting clinical assessment measures in the same way for all examinees.