Abnormal Psychology Dr. David M. McCord Assessment and Diagnosis

Assessment –What are the problems, what caused them, what are we going to do about them Diagnosis –The art and science of determining the nature of a disorder and differentiating it from other disorders

Purposes –To gather info that will help explain etiology –To predict progress and outcome (prognosis) –To plan the most appropriate methods of treatment Symptoms, Syndromes (patterns of symptoms)

Brief History of Diagnostic Systems Hippocrates – mania, melancholia, phrenitis, hysteria Paracelsus – “insanity” – 1500’s Morel ( ) – Dementia Praecox Kraepelin ( ) 1 st major diagnostic system Meyer ( ) introduced Kraepelin’s system to America Eugen Bleuler ( ) - schizophrenia

DSM – 1952 DSM II – DSM III – 1980 DSM III R – 1987 DSM IV – 1994

Axis I – Clinical disorders Axis II – Personality Disorders and Mental Retardation Axis III – General medical conditions Axis IV – Psychosocial and Environmental Problems Axis V - Global Assessment of Functioning

Axis I – Clinical disorders –Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence –Substance-Related Disorders –Schizophrenias and other Psychoses –Mood Disorders –Somatoform, Factitious, & Dissociative –Sexual and Gender Identity –Eating, Sleep, Impulse Control Disorders –Adjustment Disorders

Axis II –Personality Disorders Paranoid, Schizoid, Schizotypal Antisocial, Borderline, Histrionic, Narcissistic Avoidant, Dependent, Obsessive-Compulsive –Mental Retardation Mild, Moderate, Severe, Profound

Axis III – General Medical Conditions –Examples: infectious and parasitic diseases, –Tumors and cancers –Blood, circulatory, respiratory diseases –Digestive system disorders –Genitourinary system disorders –Skin, musculoskeletal, joint problems –Congenital anomalies

Axis IV – Psychosocial and environmental problems –With primary support group –Related to social environment –Educational problems –Occupational problems –Housing problems –Economic problems –Access to health care services –Related to interaction with legal system

Axis V – Global Assessment of Functioning Consider psychological, social, and occupational functioning on a hypothetical continuum of mental health – illness: 0 to 100. Don’t include problems due to physical or environmental limitations.

Axis I296.23Major Depressive Disorder, Single Episode, Severe Without Psychotic Features Alcohol Abuse Axis II301.6Dependent Personality Disorder Axis IIINone Axis IVThreat of job loss Axis VGAF = 35 (current)

Axis I300.40Dysthymic Disorder Reading Disorder Axis IIV71.09No diagnosis Axis IIIOtitis media, recurrent Axis IVVictim of child neglect Axis VGAF = 53 (current)

Problems with labeling Advantages The Rosenhan study 1973 –“On being sane in insane places”

Introduction and Reason for Referral Background history –Intelligence testing (cognitive abilities) –Achievement testing –Neuropsychological screening –Personality traits –Emotional characteristics –Behavioral tendencies Summary and Conclusions Recommendations

Projective tests –Projective hypothesis –TAT, Rorschach, DAP Personality Inventories –MMPI-2 (Research chapter from website)