Chapter 1.1

Identifying Psychological Disorders in Children

Big Picture: psychological health/illness is imperfect

  • In order to receive diagnosis you have to show harm/dysfunction

  • We don't have to agree to the DSM-5 definition

Defining Psychological Health

  • No consensus

  • Group for the Advancement of Psychiatry (1974): a certain degree of or some capacity for cognitive, social, and emotional functioning

Defining Psychological Illness

  • No consensus

  • (Imperfect) Criteria ~ know why it’s imperfect

    • Deviancy : statistical deviation

      • Idea that something is rare it must be wrong

      • Freq behaviors don’t necessarily prove psych well being

    • Disability : impairment of functioning (social/academic)

      • Don't be quick to diagnose when child may be developing at a slower/faster pace – hard to assess if not given time to develop

    • Distress

      • No subjective measure

      • May not know the levels/existence of their distress

Harmful Dysfunction (Jerome Wakefield, 1992)

  • Dysfunction: failure of an internal mechanism to perform function for which it was elected

  • Harmful: limits or threatens the person’s current or previous level of functioning

  • Characterize psychological illness as dysfunctional/harmful

Diagnostic and Statistical Manual (DSM 5-TR, 2022)

  • A mental disorder is a syndrome characterized by clinically significant1 disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction2 in the … processes underlying mental

Definitional Issues

  • Unidentified biological causes

  • Unassociated with significant distress, disability

To diagnose means to

  • Describe

    • Signs : observational behavior (overt)

    • Symptoms : thought or feelings you don’t see (covert)

  • Distinguish (typical from atypical development)

    • Research

    • Clinical practice

Approaches

  • Categorial (mutually exclusive) : must show specific signs/symptoms

  • Prototypical (map to an ideal) : must show essential criteria & any additional

  • Dimensional (continuum of severity) : track severity of signs/symptoms

Shared Features

  • Risks (antecedents)

  • Correlates (signs and symptoms)

  • Outcomes (prognosis)

Types of Disorders (focus on bolded)

  • Neurodevelopmental : ADHD & ASD

  • Internalizing : anxiety & PTSD

  • Somatic

  • Externalizing : ODD & CD

  • Neurocognitive

  • Personality

Changes to the DSM - dates peoples knowledge to assess credibility

  • More precise criteria

  • Updated terms

    • Create appropriate changes to better classify

  • Reflect development of disorders

    • Starts taking into age / developmental stage of a child

  • Acknowledge cultural influences

    • Attempt to begin including cultural settings

  • Integrate neuroscience

    • Add to exponential growth of new findings

  • Eliminate NOS (not otherwise specified) language

    • Some but not enough signs/symptoms to properly diagnose, so instead better utilizing the existing criteria