Exam 2 Lecture Notes - Clinical Diagnosis Overview History...

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Clinical Diagnosis 20:02 Overview: History of clinical diagnosis Criticisms of clinical diagnosis Objectives of our current diagnostic system Basic features of the DSM-IV Major classes of mental disorders Alternatives to the DSM-IV History Pre DSM DSM-I (1952) DSM-II (1968) DSM-III (1980) o Real breakthrough – the first time where the manual actually laid out clear  guidelines, diagnostic criteria, of what was required to meet the  descriptions. Allowed for more accuracy o Many hierarchical exclusions – More extreme diagnosis gave precedent  over less extreme diagnosis. DSM-III-R (1987) o Some hierarchical exclusions were dropped DSM-IV (1994) o Still have a couple hierarchical exclusions were dropped
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Criticisms of Psychiatric Diagnoses Confusing categorization with explanation  Problem with clinical consensus Concerns about reliability and validity Reinforces the medical model view of psychopathology Objectives of the Current Diagnostic System Enhance diagnosis Facilitate agreement among clinicians Enhance communication among clinical researchers Definitional Features The syndrome must not be merely an expected response to an event The syndrome must not be merely deviant behavior or conflicts between the  person and society. Does not assume that people with a mental disorder are alike in all ways. Classifies mental disorders not people Basic Features of DSM-IV Uses a descriptive (as opposed to theoretical) approach to diagnosis. o Clinical features associated with the disorder
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o Specific predisposing factors o Differential diagnostic considerations o Typical onset, clinical course, impairment, and complications o Specific diagnostic criteria Uses a specific criteria for each disorder Uses a polythetic approach to diagnostic criteria o There is more than one way to meet a feature Uses some hierarchical organization of diagnostic classes Uses a Multiaxial system of classification Example of Diagnostic Criteria A. Preoccupation with fears of having, or the idea that one has, a serious  disease based on the person’s misinterpretation of bodily symptoms B. The preoccupation persists despite appropriate medical evaluation and  reassurance C. The belief in A is not of delusional intensity and is not restricted to a  circumscribed concern about appearance D. The preoccupation causes clinically significant distress or impairment in  social, or occupational functioning.
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