1. Chapter 5 Classification, Assessment, and Intervention Bilge Yağmurlu
PSYC 430
Developmental Psychopathology

2. Assessment of Psychopathology
Developmental approach aims to advance our understanding in relation to developmental tasks and processes
Assessment must take into account indivdual differences that occur within developmental periods
Patterns that persist vs change
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3. Terminology
Sign
Symptom
Syndrome
Classification
Diagnosis

4. Terminology Etiology (aetiology, aitiology) Prognosis Comorbidity
Epidemiology

5. Assessment
Value of assessment: Ability to identify characteristics important for decision making
Different procedures and sources of data:
Interviews
Structured diagnostic interviews
Interviews are organized to provide information for diagnosis (DSM)
Projective tests: ideographic portraits
Tabulations of overt behaviors
Personality inventories

6. Taxonomic Targets for Assessment
Which characteristics will be assessed?
Reliably assessable
Valid indices of variables that play key roles in diagnosis

7. Are Assessment Procedures Perfect?
Variability in a measure’s results over brief intervals
Test-retest
Inter-rater reliability
Different informants (modest corr)
Assessment procedures
Questionnaires
Observation
Targeted time intervals

8. Approaches to Conceptualize Child Psychopathology
Types of Problem Behaviors
Enumerates symptoms
Dimensions
Symptom clusters
Categories
Diagnostic criteria

9. Empirically Based Paradigm
Starts with data obtained on specific problems, analysis
Frequency and intensity ratings
Correlations, factor analysis, cluster
“Bottom up”

10. Empirically Based Paradigm
Cross-Informant Syndrome (multi informants) Constructs
Parents: CBCL
Teachers: TRF
Child: YSR
Constructs:
Aggressive beh,attention problems, delinquent beh, social problems
anxious/depressed, somatic complaints, thought problems, & withdrawn

11. “Syndromes” or symptom clusters
Undercontrolled
Other-directed
Overcontrolled
Inner-directed
Common dimensions
Withdrawn
Social problems
Delinquent behavior
Aggressive behavior
Somatic complaints
Thought problems
Attention problems
Anxious/depressed

12. Empirically Based Paradigm
Norm-referenced profiles
Separate norms for each gender within each developmental level
E.g., aggressive behavior is more frequent, cut-off score is different
Even if the child does not meet criteria for a particular disorder (for eg. ADHD), the child may score higher than the norm for that gender or age (developmental level)

13. DSM Approach Assessment procedures
Each category reflects a taxonomic construct and involves explicit criteria
How are criteria deriven?
Not deriven by data from assessment procedures
Negotiated among the committees
Field trials: affect some criteria and cutpoints but did not base the constructs in DSM
Assessment procedures
Diagnostic interviews

14. DSM Diagnostic Interviews
Diagnostic Interview Schedule for Children-Child Version (DISC-C)
DISC-P
Test-retest reliability
Large test-retest attenuation effect
Problem of threshold
Yes-No

15. DSM Diagnostic Interviews
Test-retest reliability:
Problem of threshold
Difficulty in understanding
Breton et al. (1995):
9 year-olds understand 16% of questions for depression
11 year-olds 31%

16. Major Depressive Disorder (MDD)
Depressed or irritable mood
Loss of interest or pleasure
Weight changes
Sleep problems
Motor agitation or retardation
Loss of energy
Feeling worthless or guilty
Poor concentration
Thoughts of death or suicide
Need 5 symptoms in the same 2-week period

17. Structured Diagnostic Interviews
Child & Adolescent Psychiatric Assessment (CAPA)
Interviewer based: has a major role in clearing information of behaviors and feelings relevant to each symptom
(DISC: more respondent based)
400 pages and 300 pages glossary
Disadvantages

18. Diagnostic Efficiency
Determining indicators
which maximize our diagnostic “hits”
which minimize our diagnostic “misses”
true positive
false positive
true negative
false negative

19. Classification Systems
ICD: International Classification of Diseases
WHO
DSM
APA
DC: Diagnostic Classification 0-3
National Center for Clinical Infant Programs
Multi-axial system
Desgined from a developmental perspective

20. Intervention Prevention Treatment
Figure 5-3 demonstrates how intervention overlaps

21. Treatment Individual Alterations according to developmental level
Group
Play
Psychodynamic and client-centered
Family therapy/Parenting interventions
Context-related
Pharmacological