Psychology
Diagnosing Psychological Disorders
Diagnosing psychological disorders involves the systematic assessment of an individual's thoughts, emotions, and behaviors to identify the presence of a mental health condition. This process often includes clinical interviews, psychological testing, and observation of the individual's functioning. The goal is to accurately classify and understand the nature of the disorder, which can guide treatment and support.
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10 Key excerpts on "Diagnosing Psychological Disorders"
eBook - PDFAbnormal Psychology
An Integrative Approach
- David Barlow, V. Durand, Stefan Hofmann, , David Barlow, V. Durand, Stefan Hofmann(Authors)
- 2017(Publication Date)
- Cengage Learning EMEA(Publisher)
74 C H A P T E R O U T L I N E Assessing Psychological Disorders Key Concepts in Assessment The Clinical Interview Physical Examination Behavioral Assessment Psychological Testing Neuropsychological Testing Neuroimaging: Pictures of the Brain Psychophysiological Assessment Diagnosing Psychological Disorders Classification Issues Diagnosis before 1980 DSM-III and DSM-III-R DSM-IV and DSM-IV-TR DSM-5 Creating a Diagnosis Beyond DSM-5: Dimensions and Spectra 3 Clinical Assessment and Diagnosis iStockPhoto.com/bowdenimages Copyright 2018 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-200-208 ASSESSING PSYCHOLOGICAL DISORDERS 75 Assessing Psychological Disorders The processes of clinical assessment and diagnosis are central to the study of psychopathology and, ultimately, to the treatment of psychological disorders. Clinical assessment is the systematic evaluation and measurement of psychological, biological, and social factors in an individual presenting with a possible psycho-logical disorder. Diagnosis is the process of determining whether the particular problem afflicting the individual meets all criteria for a psychological disorder, as set forth in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5 (American Psychiatric Association, 2013). In this chapter, after demonstrating assessment and diagnosis within the context of an actual case, we examine the development of the DSM into a widely used classification system for abnormal behavior. Then we review the many assessment techniques available to the clinician. Finally, we turn to diagnostic issues and the related challenges of classification. STUDENT LEARNING OUTCOMES* * Portions of this chapter cover learning outcomes suggested by the American Psychological Association (2013) in their guidelines for the undergraduate psychology major.
eBook - PDF- Ronald Comer, Elizabeth Gould, Adrian Furnham(Authors)
- 2014(Publication Date)
- Wiley(Publisher)
Eccentric? Yes. Mentally disordered? Probably not. Source: ©Sukree Sukplang/Reuters/Corbis. CHAPTER 19 PSYCHOLOGICAL DISORDERS 544 To ascertain whether abnormality requires intervention or treatment three criteria are commonly applied throughout Europe: • Significant distress or dysfunction in the individual concerned. • Significant distress or disruption to those around them. • Behaviour that warrants the attention of health or legal authorities. To determine the exact form of an abnormality and thus its specific treatment requires the application of classification and diagnosis. Classifying and Diagnosing Psychological Disorders A symptom is a physical, behavioural or mental feature presented by a client that helps indicate a condition, ill- ness or disorder. Fatigue is often a symptom of depression, for example. Similarly, poor concentration can be a symp- tom of anxiety, and hallucinations may indicate schizo- phrenia. When certain symptoms regularly occur together and follow a particular course, clinicians agree that those symptoms make up a particular mental disorder. A list of such disorders, with descriptions of the symptoms and guidelines for determining when individuals should be assigned to the categories, is known as a classification system. The classification system that is used by most countries throughout the world is the International Classification of Diseases (ICD) , published by the World Health Organization. ICD is now in its tenth edition (ICD-10). In the United States, the Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association and largely adopted across the United Kingdom and the rest of Europe as well. The current version is called DSM-IV Text Revision (DSM-IV-TR) (APA, 2000) but a new version called DSM-5, due in 2013, has many changes to the categories, symptoms and criteria (Regier et al., 2011).
- Lorelle J. Burton, Drew Westen, Robin M. Kowalski(Authors)
- 2022(Publication Date)
- Wiley(Publisher)
For example, in a depressive syndrome, depressed mood is often accompanied by loss of interest in pleasurable activities, insomnia, loss of appetite, poor concentration and decreased self-esteem. Pdf_Folio:930 930 Psychology Until the early 1950s, psychologists and psychiatrists lacked a standard set of diagnoses. Psychologists from each school of thought used their own preferred terms, and systematic empirical investigation of most psychiatric disorders was impossible (see Nathan, 1998). That changed when the American Psychiatric Association (1994) published the manual of clinical syndromes that researchers and clinicians use to make diagnoses, called the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), now in its fifth edition. Released in 2013, DSM-5 has brought with it major changes to diagnostic categories. DSM-5 has three sections. The first section offers instructions on how to use the manual; the second offers classifications for mental disorders (including those listed in table 18.1); and the third section is based on other disorders for which there is preliminary scientific evidence but more research is required before formal classification (see also Cook, 2017; Pelling & Burton, 2017).
- Susan Whiston(Author)
- 2020(Publication Date)
- Cengage Learning EMEA(Publisher)
Diagnos-tic systems attempt to provide a nosology, or nomenclature, for counselors, psychiatrists, psychologists, social workers, and other health and mental health professionals. Diagnosis should not be viewed as providing a punitive label but rather as providing a description of the client’s symptoms that others can understand. In the United States, the most commonly used diagnostic system for mental disorders is the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders, which is in the fifth edition and is commonly referred to as the DSM-5 (APA, 2013). The DSM-5 is not the only diagnostic system for mental disorders available as much of the world uses the World Health Organization’s International Classification of Diseases (ICD). In fact, there is a direct connection between the DSM-5 and the ICD-9-CM and the ICD-10-CM. In the DSM-5 , both the ICD-9-CM and the ICD-10-CM codes are usually attached to relevant disorders. In the United States, clinicians will have used the ICD-9-CM L01 L02 Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 302 Section III Applications and Issues codes through October 2015, and then after that all healthcare professionals will use the ICD-10-CM codes. The DSM-5 lists both the ICD-9-CM and the ICD-10-CM codes; the ICD-9-CM codes are listed first and then the ICD-10-CM codes follow and are enclosed in parentheses. For example, the codes in the DSM-5 for autism spectrum disorder are 299.00 (F84.0).
eBook - PDFIntroduction to Clinical Psychology
An Evidence-Based Approach
- John Hunsley, Catherine M. Lee(Authors)
- 2014(Publication Date)
- Wiley(Publisher)
Exhibit 3.1 lists some of the purposes of diagnostic systems used by psychologists and psychiatrists. Most health care practitioners find diagnostic systems useful, for all the reasons listed in the exhibit. Despite the advantages of diagnosis, there are also possible drawbacks, such as stigmatization of the person receiving the diagnosis and the potential for an inaccurate diagnosis to result in harmful or inappropriate treatment. Most clinical psychologists (whether practicing in an institutional setting such as a hospital or in a private practice setting) are required to diagnose a patient to determine if the patient is eligible for certain services (e.g., extra academic support for students with learning disabilities). Furthermore, many insurance companies require a diagnosis before authorizing reimbursement of the charges for psychological services. As you learned in Chapter 1, modern attempts to classify and diagnose abnormal human behavior began with the work of Emil Kraepelin, whose initial examination of dementia praecox (now called schizophrenia) and manic-depressive insanity (now called bipolar disorder) laid the foundation for current psychiatric diagnostic systems. The so-called neo-Kraepelinian approach to classification has several specific characteristics. These include viewing each diagnosis as a medical illness, using specific criteria to define a category, and emphasizing the importance of diagnostic reliability (Blashfield, 1991).
eBook - PDF- Douglas Bernstein, , , (Authors)
- 2015(Publication Date)
- Cengage Learning EMEA(Publisher)
Explaining Psychological Disorders What causes abnormality? At various times and places, abnormal behavior has been attrib-uted to the action of gods or the devil. Mental health profes-sionals in Western cultures rely on a biopsychosocial approach , which attributes mental disorders to the interaction of biological, psychological, and sociocultural factors . Biological factors, such as brain chemistry, are highlighted by the medical or neurobiolog-ical model of disorder. The psychological model focuses on pro-cesses such as inner conflicts, maladaptive learning experiences, or blocked personal growth. The sociocultural perspective helps explain disorder by focusing on the social relations, social sup-port, and cultural and subcultural factors that form the context of abnormality. The diathesis-stress model suggests that biological, psychological, and sociocultural characteristics create predispo-sitions for disorder that are translated into symptoms in the face of sufficient amounts of stress. Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Mental Illness and the Law 535 Classifying Psychological Disorders How many psychological disorders have been identified? The dominant system for classifying abnormal behavior in North America is the fifth edition of the Diagnostic and Statistical Man-ual of Mental Disorders ( DSM-5 ) of the American Psychiatric As-sociation. It includes more than 300 specific categories of mental disorder. Diagnosis helps identify the features, causes, and most effective methods of treating various psychological disorders.
eBook - PDF- V. Durand, David Barlow, Stefan Hofmann, , V. Durand, David Barlow, Stefan Hofmann(Authors)
- 2018(Publication Date)
- Cengage Learning EMEA(Publisher)
Identify each of the following statements related to Diagnosing Psychological Disorders as either true (T) or false (F). 1. __________ The classical categorical approach to classi- fication assumes there is only one set of causative fac- tors per disorder with no overlap between disorders, and the prototypical approach uses essential, defining features, as well as a range of other characteristics. 2. __________ As in earlier versions, DSM-5 retains a distinction between organically and psychologically based disorders. 3. __________ The DSM-5 eradicated the problem of comorbidity, the identification of two or more disor- ders in an individual at one time, which was previ- ously caused by imprecise categories. 4. __________ If two or more clinicians agree on a patient’s classification, the assessments are said to be valid. 5. __________ A danger in psychological classification is that a diagnostic label might be used to characterize personally the total individual. Concept CHECK 3.2 labeling Applying a name to a phenomenon or a pattern of behavior. The label may acquire negative connotations or be applied erroneously to the person rather than that person’s behaviors. Copyright 2019 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. 92 • CHAPTER 3 Clinical Assessment, Diagnosis, and Research in Psychopathology As you’ve already seen, abnormal behavior is a challenging subject because of the interaction of biological and psycho- logical dimensions.
eBook - PDF- Nancy Ogden, Michael Boyes, Evelyn Field, Ronald Comer, Elizabeth Gould(Authors)
- 2021(Publication Date)
- Wiley(Publisher)
Of course, we have to also consider that individuals respond to stress- ful events with quite different trajectories. That is to say, you may have experienced the same adverse event as your brother, but might have responded quite differently and thereby would not have triggered a psychiatric disorder (Monroe & Cummins, 2014). Neuroscience and the Diagnostic and Statistical Manual (DSM) and International Classification of Diseases (ICD) The discoveries of drugs that affected the symptoms of mental disorders, as will be dis- cussed in Chapter 16, gave a strong push to the idea that mental disorders are, at least in part, brain-based and reflect ways in which our neurochemistry relates to our adaptive, and sometimes to our maladaptive, behaviour. Despite this, the role that neuroscience research has played in the development of the criteria and manuals for diagnosing—the Diagnostic and Statistical Manual (DSM) and International Classification of Diseases (ICD)—and the plans for treating mental disorders has been limited (Cuthbert, 2014; Kozak & Cuthbert, 2016). The work on the new edition of the DSM (DSM-5), for example, was conducted by large committees of clinicians and clinical researchers working in each diagnostic area of the manual. While there has been acknowledgement that it would be of great benefit to have clearer neurological assessment tools and research mapping the brain-based links of symptom patterns associated with one or more diagnostic category, it is generally felt that neuroscience has not yet provided needed clarity for sharp diagnostic decisions. In other 628 CHAPTER 15 Psychological Disorders words: We just need more research. The problem, as stated by Thomas Insel, the former director of the American National Institute of Mental Health, is that research-granting cri- teria and reviewing standards are based on the existing diagnostic categories of the DSM and ICD.
eBook - PDF- John Hunsley, Catherine M. Lee(Authors)
- 2017(Publication Date)
- Wiley(Publisher)
Subsequent research by Wright et al. (2013) replicated these findings using epidemiological data from over 8,800 adult Australians. The dimensions of internalizing and externalizing disorders—with the addition of a dimension representing psychotic experiences—appeared to underlie the range of psychological symptoms reported in the survey. Taking the process one step further, many research groups have been examining the possibility that a more complex factor model may provide the best way to understand 74 CHAPTER 3 Classification and Diagnosis mental disorders. Using longitudinal designs and very large samples, these researchers have determined the existence of a single general psychopathology factor (labelled “p”) that under- lies all mental disorders (Caspi et al., 2014; Kim & Eaton, 2015; Patalay et al., 2015). Internal- izing, externalizing, and psychotic factors are still evident and relevant, but the common factor of “p” appears to exert an influence on these three factors. Indeed, “p” has been found to be predictive of poor developmental histories, poorer academic achievement, greater adult psy- chopathology, and more life impairment. Based on studies such as these, it is obvious that dimensions, rather than categories, are likely to provide a better way to describe and under- stand mental disorders. Summary and Conclusions Classification is a fundamental human activity. The classification of mental disorders draws on both a neo-Kraepelinian tradition as well as on a more recent developmental psychopathology approach that takes into account contextual variables such as developmental stage. The definition of a mental disorder requires not only that behaviours are abnormal but also that they cause harm to the individual and are outside the individual’s control. In North America, the most commonly used system has been the Diagnostic and Statistical Manual of Mental Disorders.
eBook - PDFPersonality Disorder and Serious Offending
Hospital treatment models
- Christopher Newrith, Clive Meux, Pamela Taylor(Authors)
- 2006(Publication Date)
- CRC Press(Publisher)
This additional information will also shed light on which areas of a patient’s life are affected. DESCRIBING PERSONALITY DISORDER IN CLINICAL PRACTICE The psychiatric classification systems (ICD-10 and DSM-IV) divide personality disorders into various discrete categories (see Chapter 4). Trying to pigeonhole individuals into cate-gories is useful for research purposes to ensure like is being compared with like. It may also provide a convenient shorthand for communicating in very broad terms the sorts of problems an individual is likely to have. However, the categories have been criticized for their lack of specificity, the fact that they overlap and because reliability between clin-icians is very poor in identifying the individual categories (Perry, 1992; Livesley et al., 1994). In addition, providing personality disorder category labels does not provide the accurate information about the individual’s actual dif-ficulties and circumstances that is required to plan and prioritize interventions. Everyone has to develop their own way of organizing the information they collect about personality disorders. Allnutt and Links (1996) have suggested that clinicians be aware of the factors that raise suspicion that there might be a personality disorder and then ask a few brief screening questions to establish whether the individual has any features suggestive of each type of personality disorder. However, research has confirmed that clin-icians do not find a checklist of direct ques-tions about particular traits very useful in the clinical setting (Westen, 1997). For practical purposes, it has been suggested that it is more useful to undertake a functional assessment of personality. This is essentially a case for-mulation addressing the relevant areas of abnormal functioning (Gunn, 1993; Westen and Arkowitz-Westen, 1998).
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