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Module 22 Assessment & Anxiety Disorders Virginia Union University Introduction to Psychology Diagnosing Mental Disorders • An individuals must be formally diagnosed as having a mental disorder to receive appropriate treatment • Clinical diagnosis ▫ A process of matching an individual’s specific symptoms to those that define a particular mental disorder • American Psychological Association (APA) developed a uniform diagnostic system in 1952 ▫ Diagnostic & Statistical Manual of Mental Disorders IV Text Revision (DSM IV TR) Uniform system for assessing specific symptoms and matching them to almost 300 different mental disorders DSM IV TR • Describes 297 mental disorders (compared to 106 in the first addition published in the 1950s) • Improvement compared to past additions ▫ Criteria/symptoms based more on research findings than clinical opinions • Next version likely to use findings from genetics & neuroscience research to better understand underlying causes of mental disorders DSM IV TR – Making a Diagnosis • In making a clinical diagnosis, client symptoms assessed & matched with symptoms described in the DSM IV TR ▫ Sample ADHD exercise • DSM IV TR has 5 axes that serve as guidelines to make diagnoses DSM IV TR Axis 1: Nine Major Clinical Syndromes 1. Disorders usually 1st diagnosed in infancy, childhood or adolescence includes ADHD, autism, mental retardation (i.e. intellectual disabilities), enuresis & stuttering 2. Organic mental disorders includes disorders that are temporary or permanent dysfunctions of brain tissue caused by diseases or chemicals, such as dementia (Alzheimer’s) 3. Substance-related disorders includes maladaptive (& abnormal pattern) use of drugs & alcohol difference b/t use & abuse DSM IV TR Axis 1: Nine Major Clinical Syndromes 4. Schizophrenia & other psychotic disorders schizophrenias characterized by psychotic symptoms (i.e., grossly disorganized behavior, delusions & hallucinations) & by over 6 months of behavioral deterioration also includes delusional & schizoaffective disorders 5. Mood disorders characterized by emotional disturbance includes major depression, bipolar disorder, dysthymic disorder & cyclothymic disorder DSM IV TR Axis 1: Nine Major Clinical Syndromes 6. Anxiety disorders characterized by physiological signs of anxiety and subjective feelings of tension, apprehension or fear. may be acute & focused (i.e. phobias) or continual & diffuse (i.e. generalized anxiety disorder) 7. Somatoform disorders characterized by somatic symptoms that resemble physical illness but that cannot be accounted by organic damage. includes hypochondriasis DSM IV TR Axis 1: Nine Major Clinical Syndromes 6. Dissociative disorders feature a sudden, temporary alteration or dysfunction of memory, consciousness, identity, and behavior. includes dissociative amnesia & multiple personality disorder 7. Sexual & gender-identity disorders includes gender-identity disorders, paraphilias and sexual dysfunctions DSM IV TR Axis 2: Personality Disorders • Disorders that involve patterns of personality traits that are long-standing, maladaptive & inflexible and involve impaired functioning or subjective distress • Includes borderline, schizoid & antisocial personality disorders DSM IV TR Axis 3: Physical Disorders • Physical disorders or conditions that have an influence on someone’s mental disorder ▫ Includes diabetes, arthritis, and hemophilia DSM IV TR Axis 4: Psychosocial & Environmental Problems • Psychosocial and & environmental problems that may affect the diagnosis, treatment, and prognosis of mental disorders in Axes 1 & 2. ▫ Includes negative life events, an environmental difficulty or deficiency, a familial or interpersonal stress, and inadequacy of social support or personal resources, or another problem that involves the context ▫ E.g. Post-traumatic Stress Disorder DSM IV TR Axis 5: Global Assessment of Functioning Scale • Axis used to rate the overall psychological, social, and occupational functioning of the individual on a scale Usefulness of DSM IV TR • Arriving at a diagnosis ▫ Clinical interviews - Psychological tests - Neurological tests - Clinical assessment - DSM IV TR • All 5 axes of the DSM IV TR used to make a clinical diagnosis • 3 advantages to using the DSM IV TR ▫ Professionals use the classification system to communicate with one another & discuss client problems ▫ Researchers use the classification system to study & explain mental disorders ▫ Therapists use the classification system to design treatment programs Potential Problems with using DSM IV TR • Labeling Mental Disorders ▫ Labeling: identifying & naming differences among individuals. The label places individuals into specific categories which have either positive or negative associations ▫ Advantage of diagnostic label – easy to communicate information about disorder ▫ Disadvantage of diagnostic label – label has negative associations • Social & Political Implications ▫ Can influence diagnosis & likelihood to seek treatment Homosexuality listed in the DSM in the 1970s, later dropped Sexist self-defeating personality disorder listed in the DSM in the 1980s, later dropped Japanese less likely to seek professional help b/c of stigma associated with mental illness (same with African Americans) Class Announcements • Cross Cultural Project • Class Study Groups