Download PPT Unit 9

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Symptom - refers to an observable behavior or
state
Syndrome - term applied to a cluster of symptoms
that occur together or co-vary over time
Disorder - a syndrome that is not accounted for by
a more pervasive condition
Disease - a disorder where the underlying etiology
is known
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“Pseudo-patients” try to get themselves admitted
to mental hospitals
Told psychiatrists they were hearing voices that
said “empty”, “hollow”, or “thud.”
All were admitted, 11 of 12 diagnosed with
schizophrenia
Despite stopping symptom complaints, none were
suspected of faking by hospital staff
Real patients did suspect pseudo-patients were
faking.
How to interpret these findings? (Class discussion)
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Seven real patients (with histories of chronic
schizophrenia) in acute exacerbation of
their illness present at intake interview at
outpatient managed behavioral healthcare
clinics, describing their real symptoms
truthfully
Six of the seven were denied treatment
Details of their experiences
How do we interpret these findings? (Class
Discussion)
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False Positive - incorrectly accepting a false
instance as true (Type II error)
False Negative - incorrectly rejecting a true
instance as false (Type I error)
True Positive - correctly accepting a true instance
True Negative - correctly rejecting a false instance
Importance of carefully specifying diagnostic
decision rules to identify homogeneous disorders
Examples: Autism (Volkmar et al., 1988);
schizophrenia (Fenton et al., 1988)
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Diagnostic systems assume that
abnormality can be detected and classified
by clusters of symptoms and signs
◦ Each cluster is thought to reflect a different
disorder
◦ Each cluster may require a different treatment
Ch 3.1
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DSM-IV (Diagnostic and Statistical Manual) is
a revised diagnostic classification system
created by the American Psychiatric
Association
DSM-IV makes use of 5 distinct axes to
classify a disorder
DSM-IV was designed to more accurately
classify psychiatric disorder (relative to
earlier DSM versions)
Ch 3.2
AXIS DESCRIPTION
I
All categories except personality disorder and
mental retardation
II
Personality disorders and mental retardation
III
General medical conditions
IV
Psychosocial and environmental problems
V
Current level of functioning
Ch 3.3
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Disorders usually first diagnosed in
infancy, childhood or adolescence
◦ Involve early emotional/intellectual disorder
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Substance-related disorders
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Schizophrenia
◦ Ingestion of a drug impairs social/occupational
functioning
◦ Involves faulty contact with reality
◦ May involve delusions (disordered thoughts)
Ch 3.4a
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Mood disorders
◦ Involve large swings in emotional affect
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Anxiety disorders
◦ Involve some form of irrational or overblown fear
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Somatoform disorders
◦ Involve physical symptoms that have no known
physiological cause
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Dissociative disorders
◦ Involve a sudden alteration of consciousness that affects
memory and identity
Ch 3.4b
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Sexual/gender identity disorders
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Sleep disorders
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Eating disorders
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Factitious disorder
◦ Involve dysfunction or discomfort with sexual function or
identity
◦ Involve disturbance in amount of sleep or events during
sleep
◦ Involve under- or over-eating
◦ Involved in persons who produce or complain of
psychological symptoms (sick role)
Ch 3.4c
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Impulse control disorder
◦ Involve several conditions in which a person’s
behavior is inappropriate or out of control
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Personality disorders
◦ Involve enduring, inflexible and maladaptive
patterns of behavior and inner experience
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Other conditions that may be the focus of
clinical attention
Ch 3.4d
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Classification systems do not always
capture the uniqueness of a person
Classification systems may emphasize
trivial similarities between abnormal
conditions
Classification may result in a label that is
harmful to the person
Ch 3.5
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Scribner, C. M. (2001). Rosenhan revisited.
Professional Psychology: Research and
Practice, 32(2), 215-216. doi:10.1037/07357028.32.2.215, psycARTICLES database.