DSM-5 & the Classification of Mental Disorders Questions And Answers Rated A+ New Update Assured Satisfaction
Categories, Dimensions, and Prototypes - Classical (or pure) categorical approach -Strict categories and rigid criteria Dimensional approach -Continuous dimensions and scores Prototypal approach -Uses categories but permits flexible criteria (and crude dimensions) Characteristics of Abnormal Behavior - -Atypical (statistically uncommon) -Violates social/cultural norms -Causes personal discomfort (distress) -Maladaptive (impairment) Clinical Significance - Most diagnoses require that "the disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning" (p. 21). Defining "Mental Disorder" - "A syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning" (p. 20). "Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities" (p. 20). Exclusions:-Culturally sanctioned responses -"Socially deviant behavior and conflicts between an individual and society...unless...the deviance or conflict results from a dysfunction in the individual..." (p. 20) -Note that diagnosis of mental disorder is NOT synonymous with need for treatment. -Also note that anything we identify as a mental disorder must meet the definition on page 20 as well as the various diagnostic criteria. Diagnostic Classification - -Classification is central to all sciences. -Assignment to categories based on shared attributes or relations -Psychiatric diagnosis, using the DSM-5, defines what our profession considers normal vs. abnormal. Diagnostic Issues - Limitations of the categorical/prototypal approach: -Two people with the same disorder may experience very different symptoms and/or differing levels of distress. -Dimensional systems may be superior in cases where boundaries are unclear and traits are distributed continuously. Use of clinical judgment: -"Diagnostic criteria are offered as guidelines for making diagnoses, and their use should be informed by clinical judgment" (p. 21). -Diagnostic criteria serve as guidelines to be informed by clinical judgment and cannot be used like a cookbook. -The diagnostic criteria are designed to enhance reliability, but evaluating their severity and overall contribution to a diagnosis requires clinical judgment. Forensic contexts: -Meeting DSM criteria is NOT the same thing as having a mental disorder in the eyes of the court.-Legal standards require much more information than diagnosis (e.g., degree of functional impairment and how it affected someone at a particular point in time). Cultural considerations: -"Mental disorders are defined in relation to cultural, social, and familial norms and values" (p. 14). -Accurate diagnosis of a person from another culture requires familiarity with that person's culture. DSM-5 - -Empirically grounded prototypal system with increasing use of dimensional information -Clear inclusion and exclusion criteria for disorders -Subtypes and specifiers The Prototype of Major Depression - -Diagnoses reflect different forms of depression (categorical) and different levels of severity (dimensional). -Within the prototype, crude dimensional information may be indicated via specifiers. -Criterion overlap is common. What about the environment? - In DSM-5, the focus is on the individual. -The syndromes are assumed to occur in an individual. This makes many psychologists uncomfortable because environmental factors receive less emphasis. Should ask if there are any environments in which the symptoms don't occur.
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