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chapter3part2 - III General medical conditions IV...

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CHAPTER 3 Part 2: Diagnosis
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Assessment and Classification ideographic versus nomothetic strategies Classification central to science
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Two Approaches to Classification Categorical You are either in then category or not One either has the disorder or not
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Two Approaches to Classification Dimensional People have difficulties along a number of dimensions or areas of functioning and those difficulties vary across a broad range
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Categorical/Prototypical Approach Diagnostic and Statistical Manual: * DSM-IV-TR (I, II, III, IV) You are either in the category or not Inclusion depends on having some specified number of difficulties described in the category
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Categorical/Prototypical Approach DSM also assesses some dimensional features—but these dimensional features do not play a role in diagnosing the psychological disorder—they add additional info to the diagnosis
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Five Axis Diagnoses I. Clinical syndromes II. Personality disorders and mental retardation
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Unformatted text preview: III. General medical conditions IV. Psychosocial/environmental problems V. Global assessment of functioning (1-100) Typical Diagnostic Criteria Set for a Disorder A. Two or more for a significant time during a 1 month period Delusions Hallucinations Disorganized speech Grossly disorganized behavior Negative symptoms Signs and Symptoms Duration Typical Diagnostic Criteria Set A. At least 6 months of active/prodromal/residual symptoms B. Social/occupational function markedly below norm prior to onset Diagnostic Issues Communication tool There is considerable controversy about diagnoses What is the best system? What are the effects of “labeling?” Labeling Over-interpretation based on label Social stigmatization Self-fulfilling prophecy Failure of labels to tell as much as we would like about functioning (treatment utility, economics) HMO’s, PPO’s, MCO’s...
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