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Defining and Diagnosing Disorder

Defining and Diagnosing Disorder. Mood (depression)anxiety (phobia) food (anorexia) impulse control (kleptomania, pyromania, gambling).personality (paranoid). Objectives . Describe and summarize what a disorder is AND why it is so hard to diagnose Describe the DSM (disorder book)

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Defining and Diagnosing Disorder

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  1. Defining and Diagnosing Disorder Mood (depression)anxiety (phobia) food (anorexia) impulse control (kleptomania, pyromania, gambling).personality (paranoid)

  2. Objectives • Describeand summarize what a disorder is AND why it is so hard to diagnose • Describe the DSM (disorder book) • Describe the advantages and disadvantages of the DSM ( T chart) • Compare and contrast projective and objective tests

  3. chapter 11 Dilemmas of definition Possible models for defining disorders As the violation of cultural standards As emotional distress As behavior harmful to oneself or others

  4. Basic definition- level 1 • Mental disorder is any behavior or emotional state that causes a person great suffering, is self-destructive, seriously impairs the persons ability to work or get along with others, or endangers others or the community

  5. chapter 11 Mental disorder Any behavior or emotional state that causes a person to suffer, is self-destructive; seriously impairs the person’s ability to work or get along with others; or endangers others or the community

  6. chapter 11 Your turn Psychopaths are often happy, functional people, but they manipulate and harm others without conscience. On what basis are psychopaths said to have a mental disorder? A mental disorder is any behavior or mental state that (1) causes a person to suffer, is self-destructive; (2) seriously impairs the person’s ability to work or get along with others; (3) or endangers others or the community.

  7. chapter 11 Your turn Psychopaths are often happy, functional people, but they manipulate and harm others without conscience. On what basis are psychopaths said to have a mental disorder? A mental disorder is any behavior or mental state that (1) causes a person to suffer, is self-destructive; (2) seriously impairs the person’s ability to work or get along with others; (3) or endangers others or the community.

  8. Dilemmas of Diagnosis • Classifying is not an easy task • DSM standard reference manual to diagnose disorders • Categorizes by behavior • Diagnostic and statistical manual of mental disorders • Referenced by judges, attorneys • 1952- 86 pages long • DSM-IV 1994-2000, 900 pages long, 400 diagnosis

  9. chapter 11 Diagnostic and Statistical Manual Axis I: Primary clinical problem Axis II: Personality disorders Axis III: General medical conditions Axis IV: Social and environmental stressors Axis V: Global assessment of overall functioning

  10. DSM • Disorders usually first diagnosed in infancy, childhood, or adolescence • Delirium, dementia, amnesia, and other cognitive disorders • Substance-related disorders • Schizophrenia and other psychotic disorders

  11. DSM • Mood disorders • Anxiety disorders • Eating disorders • Dissociative disorders- 2 or more identities

  12. DSM • Sexual and gender identity disorders= transsexualism(want to be other sex, erformance, premature ejaculation, lack of Orgasim, paraphilias (unusual or bisare imagry) • Impulse control disorders • Personality disorders • Additional conditions that may be a focus of clinical attention

  13. chapter 11 Explosion of mental disorders Supporters of new categories answer that it is important to distinguish disorders precisely. Critics point to economics: diagnoses are needed for insurance reasons for therapists to be compensated.

  14. Problems with the DSM=objective 3 • The danger of over diagnosis • “give a small boy a hammer, everything needs pounding” • ADHD- impulsive, restless, easily frustrated • Since added to DSM= Fastest growing disorder in America • 10 x’s more than in Europe

  15. problems • The power of diagnostic labels • Reassuring emotional symptoms, problems • “ whew that’s what I got” • Also label sticks to person • Oppositional defiant disorder

  16. problems • The confusion of serious mental disorders with normal problems • “disorder of written expression” (can’t write clearly) • “ mathematics disorder” (not doing well in math) • “ caffeine induced sleep disorder” (switch to decafe)

  17. problems • The illusion of objectivity and universality • Not empirical evidence but group consensus • Samuel Cartwright- drapetomania (urge to escape from slavery)

  18. chapter 11 Concerns about diagnostic system The danger of over-diagnosis The power of diagnostic labels Confusion of serious mental disorders with normal problems The illusion of objectivity and universality

  19. advantages • Mild to severe • When used correctly, with tests, ultra effective • Culture-bound syndromes- specific to cultures

  20. chapter 11 Advantages of the DSM When the manual is used correctly and diagnoses are made with valid objective tests, the DSM improves the reliability of and agreement between clinicians. The DSM-IV included for the first time a list of culture-bound syndromes.

  21. Objective 4 • Projective tests are psychological tests used to infer a persons motives, conflicts, and unconscious dynamics on the basis of the persons interpretations of ambiguous stimuli. • Rorschach Inkblot test is a projective personality test that requires respondents to interpret abstract, symmetrical inkblots

  22. Objective tests (inventories) are standardized objective questionnaires requiring written responses; they typically include scales on which people are asked to rate themselves. • Minnesota Multiphase Personality Inventory (MMPI) is a widely used objective personality test.

  23. chapter 11 Projective tests Projective tests Psychological tests used to infer a person’s motives, conflicts, and unconscious dynamics on the basis of the person’s interpretation of ambiguous stimuli Rorschach inkblot test A projective personality test that asks respondents to interpret abstract, symmetrical inkblots

  24. What do you see?

  25. What does this appear to be?

  26. chapter 11 Objective tests Inventories Standardized objective questionnaires requiring written responses Typically include scales on which people are asked to rate themselves MMPI Most widely used personality instrument Clinical and employment settings Measures aspects of personality that, if extreme, suggest a problem

  27. Summary • DSM • Positives/negatives • Tests

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