Home > SparkCharts > Psychology > Abnormal Psychology > Classification of Mental Disorders

Abnormal Psychology


 
 

Classification of Mental Disorders

 

Classification

  1. DSM-IV-TR: Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision (DSM-IV-TR), published by the American Psychiatric Association (2000).

    1. This is the current classification system of mental disorders used for insurance, research, and record-keeping. Researchers use the DSM-IV-TR to classify:

      1. Dimensions: quantitative (e.g., a matter of degree of the disorder)

      2. Categories: qualitative (e.g., presence vs. absence of a disorder)

    2. Contains information on inclusion criteria, exclusion criteria, duration of disorder, and associated features

    3. Includes a classification system that classifies via five axes

    4. Each axis includes categories that describe syndromes— sets of symptoms. Each general category consists of a number of subcategories.

 

Axis I

  All categories of clinical syndromes (a configuration of symptoms), except personality disorders and mental retardation
 

Axis II

  Personality disorders (long-standing patterns of maladaptive behavior) and mental retardation (deficient cognitive functioning)
 

Axis III

  General medical conditions
 

Axis IV

  Psychosocial stressors (recent stressors, social resources, sociocultural background) and environmental problems
 

Axis V

  Global level of current functioning (overall clinical rating of degree of impairment)


 
 

Diagnosis

Clinical Assessment: sampling of behavior in different domains to arrive at a diagnosis, case formulation, and treatment plan.

  1. Methods of assessment

    1. Interview

      1. Structured: pre-set format of questions

      2. Unstructured: open-ended set of questions. Format depends on purpose of interviewer (i.e., research vs. treatment) and on the theoretical orientation of the interviewer.

    2. Psychological tests and questionnaires

      1. Performance-based measures

        1. Intelligence tests (e.g., Wechsler Adult Intelligence Scale-Revised, or WAIS-R): used to derive Intelligence Quotient (IQ) based on verbal (e.g., abstract thinking, vocabulary) and nonverbal (e.g., visual-spatial ability, information processing speed) functioning. IQ of 90–110 is considered average.

        2. Neuropsychological tests (e.g., Halstead-Reitan Test): used to assess cognitive/perceptual, emotional, and behavioral deficits and disturbances caused by brain dysfunctions (e.g., the Bender Visual-Motor Gestalt Test requires the reconstruction of and memory for designs, and can aid in the diagnosis of organic brain impairment)

      2. Psychosocial/affective measures

        1. Projective Tests (e.g., Rorschach; Thematic Apperception Test, or TAT): tests are based on the theory that the person’s interpretation of ambiguous stimuli is a good way to uncover feelings and conflicts, particularly unconscious ones.

        2. Self-report inventories: structured questionnaires and rating scales

          • BDI (Beck Depression Inventory): 21-item questionnaire; responses indicate severity of depressive symptoms.

          • MMPI (Minnesota Multiphasic Personality Inventory): most popular personality inventory; tests for symptoms of personality disorders

      3. Behavioral assessments

        1. Observation by others: observations of nonverbal or verbal behaviors

        2. Self-observation: patient tracks aspects of own behavior (e.g., eating, smoking), a process called self-monitoring

      4. Physical assessments

        1. Physiological (EEG, EKG, EMG)

          • EEG: electrodes on the scalp record the electrical activity of brain areas

        2. Neuroimaging

          • Structural imaging (e.g., CT scan, MRI)

          • Functional imaging (e.g., fMRI, PET, SPECT): provide a picture of the structure and functioning of the brain

      5. Multi-method assessment: integration of several or all other types of assessments

Pros and cons of formal diagnosis using DSM-IV-R:

  1. Pros:

    1. Facilitates research, record-keeping, and statistical information

    2. Helps one search for etiology, implications for treatment and case management decisions, and prognosis

    3. Provides a common language for clinicians

  2. Cons:

    1. Stigmatizing

    2. Categories not homogeneous

    3. Condensed format leads to a loss of information

 
 

Research Methods

  1. Case study: a detailed history of an individual’s life and psychological problems

  2. Correlational study: examines strength of the relationship between events or characteristics

  3. Epidemiological studies: study of the frequency and distribution of disorders within a population in relation to demographic factors

    1. Incidence: number of new cases of a disorder that appear in a population in a specific time period

    2. Prevalence: number of active cases in a population at a specific time

      1. Lifetime prevalence: proportion of people in population affected at some point in their lives

      2. Point prevalence: number of people who have the disorder at one given point in time

  4. Experiment: controlled manipulation of a variable and the observation of its effect