Chapter 5 Psych 4176 PDF

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Chapter 5: Classification, Assessment, and Treatment - Processes of classification and diagnosis - DSM and empirical approaches to classifying psychological problems of youth - How assessment is conducted and various approaches to assessment - Various approached to prevention of childhood problems - Various models and strategies of treatment for children Definitions - Assessment: term used when evaluating youth; goals include classification, establishing treatment goals, and evaluating treatment outcomes = establish preventative methods - Ability and achievement tests: a form of testing used to assess a child or adolescent’s functioning in a given skill area o How they differ from IQ - Broadband syndromes: general clusters of behavior or characteristics classified by clinical consensus - Clinically derived classification: DSM and ICD (WHO) systems – based on the consensus of clinicians that certain characteristics occur together* - Co-occurrence – also called comorbidity: 2 or more disorders occur at once - Clinical utility: adequacy of a classification, diagnosis, or assessment method – how well observed phenomena are described and how useful the descriptions are used - Categorical approach: conceptualize behavior into qualitatively different groups o Person displays or does not display the behavior/disorder o Binary: now out of facro - Category: a discrete grouping - Diagnosis: assignment of a classification system for an individual o Rule Out - Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood- Revised: classification system created to cover disorders in younger children which does not receive significant attention in the DSM - Diagnostic and Statistical Manual of Mental Disorders (DSM): most widely used diagnostic system in North America o Developed by the American Psychiatric Association o History - Diagnostic label: classification of an individual based on a clinical diagnosis - Developmental Index: provides a criteria by which a child can be measured against peers (a norm group) on a range of motor and cognitive milestones - Dimension: in describing an attribute, it means that said attribute is continuous and can occur to various degrees o Refers to a quantitative rather than qualitative approach to thinking about disorders - Evidence based treatments: assessment and treatments with empirical support

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Empirical approach to classification: uses statistical methods to identify patterns of behavior that are interrelated – e.g., factor analysis Externalizing: broad term covering a number of specific problems such as fighting, temper tantrums, disobedience, and destructive behaviors Internalizing: broad term covering specific problems such as anxious, shy, withdrawn, and depressed General clinical interview: most common method of assessment where information on all areas of functioning is obtained by interview Multiaxial system: DSM method were dimensions are used to score/classify behavior Normative samples: allows for the comparison of an individual against a standard group Neurological assessment: all encompassing term meaning the use of tests to evaluate the functioning of various aspects of the nervous system o Halstead-Reitan Battery Narrowband syndromes: empirical, less general, and more dimensional approach to classification Prevention: interventions targeting individuals who are not yet experiencing a clinical disorder; targets general population or those most at risk o E.g., type I and II diabetes, Headstart, EarlySteps Psychophysiological Assessments: medical tests to examine the external and internal problems that come from changes in the physiological system o Often these tests are more commonly found in research vs. clinical settings o Cost and level of tester training o Heart rate, skin temperature, blood pressure, muscle tension, etc. Problem checklist: classification tool which provides valuable information to researchers and clinicians – helping identify and assess problems Syndrome: behaviors that tend to occur together o E.g., Bipolar: manic symptoms, mood swings, etc. Self-report measures: researchers or clinicians make/ask an individual to complete, focus on self-expression, and obtaining client perspectives on a problem Spectrum: term used to describe groups of disorders thought to share psychological or biological qualities Secondary prevention: effort to shorten the duration of existing cases through early referral, diagnosis, and treatment Stigmatization: stereotyping, prejudice, discrimination, and self-degradation that may be associated with membership in a devalued group Structured diagnostic interviews: a type of interview that is more structured than common clinical interviews – follows a set of specific questions and guidelines for recording and scoring – Schedule of Affective Disorders (SADS) Treatment: description of treatments used for clinical problems Play therapy: a therapeutic tool used by therapist – play is used as a means to communicate

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Parent training: child’s behavior is changed by focusing on parent management skills o Gerald Patterson: measuring interactions Psychotropic drugs: medications that affect mood, thought processes, or overt behavior; also know as psychoactive drugs Pharmacological treatment: drug treatment Selective prevention strategies: targets people who are at a higher than average risk for a disorder

Psychotropic drugs o Antipsychotics o Antidepressants o Antianxiety o Stimulants o Antiepileptic drugs (AEDs) Brain Imaging - Methods of studying the brain structure or functioning o PET o MRI o etc. Tom Insel, MD – Director of the NIMH - NIMH calls DSM a dictionary - They do not support the DSM-5 - NIMH supports a disease model of psychopathology, thus they are looking for biomarkers o Biomarkers: genetic and/or chemical traits that identify a condition - They are looking for genetic markers, brain pathways, and nervous system functions - They state: o A diagnostic approach based on the biology as well as the symptoms must be constrained by the current DSM categories o Mental disorders are biological disorders involving brain circuits that implicate specific domains of cognition, emotion, or behavior – maybe, sort of o Mapping the cognitive, circuit, ad genetic aspects of mental disorders will yield new and better targets for treatment o Discard DSM since new conditions may arise that cut across existing disorders o They refer to this new approach as Research Domain Criteria (RDoC) o Relationship problems, inadvertent shaping of problem behaviors, adjustment to life changes, grief, etc. do not have biological origins  So it will be better in some ways but not a total solution

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o This model is based on what is going on in general medicine – e.g., the effects of cell biology, genomics and pathophysiology is revolutionizing the diagnosis and diseases as diverse as heart disease, cancer, diabetes, and inflammatory bowel disease o The genetic conditions and how problem behaviors associated with them map on to this NIMH model of psychopathology RDoC has 3 guiding concepts o Dimension from normal to abnormal behavior o RDoC is agnostic about current disorder categories o RDoC will use several units of measurement (imaging, physiological activity, overt behavior, and self-report of symptoms) – I would add history...