...The DSM-IV is the Diagnostic and Statistical Manual of Mental Health Disorders, published by the American Psychiatric Association. It provides a holistic approach to mental health by categorising disorders into five axes, that provide a broad range of information about the individual’s functioning, (Sue, Wing-Sue, Sue & Sue, 2012). In distinguishing abnormal from normal, the behaviour must be clinically significant and associated with intensive distress, impairment, social dysfunction or increased personal or public risk, however it must be unrelated to grief caused by recent personal loss, (4th ed., text rev.; DSM–IV–TR; American Psychiatric Association, 2000; Holt et al, 2012). The distinct criteria and descriptive information in the DSM-IV, enables clinicians to make quick diagnoses based on an individual’s symptoms. It can also be used in legal proceedings, to determine the mental state of individuals and ensure they receive appropriate sentencing in psychiatric care rather than prison. It is versatile and the only manual that strictly focuses on mental health which is why it is referred to as the Gold Standard of clinical diagnosis. The DSM-IV has also played a vital role in the development of research and treatments for mental health, which has improved many patients’ quality of life. Keenan et al. (2007) examined the reliability of the DSM-IV oppositional defiant and conduct disorder symptoms, in 3-5 year old children. The mothers were interviewed about their...
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...The most appropriate DSM-5 Diagnosis for the client would be schizophrenia. This diagnosis is based in the client’s display of all five major symptomatic criteria, with substantial symptom bases found in criteria A1, A3, and A4 – that is, delusions, disorganized thinking / speech, and grossly disorganized / abnormal behavior. The delusions experienced by the patient may be described as both grandiose and persecutory; these are not found simultaneously in a singular thought pattern, but rather run concurrently. The client’s grandiose delusions form the basis of her self-concept, as she is convinced of her being on the verge of a major philosophical and spiritual discovery. This delusion may serve as the primary element in motivating all other...
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...Axia College Material Appendix G The DSM-IV The DSM-IV is an important tool for clinicians. It provides a standard for diagnoses to be standardized across psychology; however, the DSM-IV is not as precise for diagnosing personality disorders as some psychologists would like. Give an example of each of the following problems identified in your readings and explain how these problems could negatively affect a diagnosis. 1. Some criteria used for reaching a diagnosis cannot be observed directly. The DSM-IV has been criticized for diagnosing patients with disorders because of their reliability. A patient is diagnosed by a clinician based on the patient telling them their symptoms, when it is possible that the patient is exaggerating and this can result in a patient being mis diagnosed because the clinician may not have paid close attention to body language and actions from the patient. 2. Personality disorders can be similar to each other. A person can be diagnosed with one or more personality disorders because symptoms are related to one another according to the DSM-IV. With the symptoms of personality disorders being similar in nature to one another it does make it hard to diagnose a person with a single personality disorder according to the DSM-IV. 3. People with different personalities can be given the same diagnosis. Each person is different so therefore one person’s symptoms may not be the same as another person. The DSM-IV does not account for a person’s individuality...
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...Symptoms and Diagnosing of Autism Spectrum Disorder Stephanie R. South University of Cincinnati Abstract This paper explores the symptoms and how to accurately diagnosis of Autism Spectrum Disorder. Autism is classified as a psychological condition that starts in adolescence. Psychology classes, specifically an introductory course, briefly cover this condition and its diagnosis. This paper will provide a great knowledge and understanding of diagnosing Autism. There are many symptoms and signs exhibited in children diagnosed with Autism. There is no clear answer for why or how this disorder occurs, making it hard to properly diagnose those afflicted. It is extremely important for the child’s caregiver to be proactive and seek out medical expertise at the onset of behavioral issues in their child. Diagnosing the child at a younger age can ensure proper treatment and interventions for him/her. I have chosen to write my paper on the symptoms and diagnosing of Autism. This disorder is mysterious, but also fascinating. Being a mother, I worry all the time about new and strange afflictions that are attacking our children. To be proactive in our children’s lives, we must be knowledgeable and observant for the early warning signs or symptoms. Throughout the research process of preparing my paper, I have gained a greater comprehension of this disorder and the first indicators that has prepared me to act promptly for the sake of my children. In the last decade, Autism has gained...
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...Discuss issues of reliability and validity associated with the classification and diagnosis of schizophrenia (8+16) One issue related to classification and diagnosis is reliability. Reliability refers to the consistency of a measuring instrument like DSM that is used when diagnosing schizophrenia. It can be measured by the extent to which psychiatrists can agree on the same diagnosis when independently assessing patients (inter rater reliability). The use of DSM III in 1990 was believed by Carson to have fixed any problems of IRR. Therefore the system is now more advanced with the DSM 5, there would be much greater agreement over who did and didn’t have schizophrenia by comparing the diagnosis which would make it reliable. However there is little evidence that DSM is routinely used with high reliability by mental health clinicians. For example Whaley found that IRR between health professionals were low as .11 between different raters. This suggests that when independently assessing patients the diagnosis was rarely consistent between them, meaning the DSM tool is unreliable in accurately and consistently diagnosing schizophrenia. There are also cultural differences about the interpretations of schizophrenia which poses a threat to reliability of the diagnosis of schizophrenia. For example Copeland et al gave a description of a patient showing clinical characteristics associated with schizophrenia to US and UK psychiatrists. From the US psychiatrists 69% diagnosed the patients...
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...Discuss issues surrounding the classification and diagnosis of depression (24 marks) A key concern regarding the diagnosis of depression is the reliability of the diagnosis; reliability refers to the consistency of a test or results. In order to increase the reliability of this, the test-retest method can be used to assess consistency. Within this, a patient is tested for depression twice over a period of time in order to establish whether or not the scores on the classification measure stay consistent; this would show a high concordance rate between test results. A strength of using the test retest method is that, if results have a low concordance rate from the two tests, it signposts that the patient is either getting better or worse in terms of their depression as their results have changed. For example, if a patient’s depression score decreases over time, it could signal to the psychiatrist that the treatment is working, and vice versa, if scores increase it can indicate that treatment is not working or the patient’s depression is getting worse, which tells them that they may need to make changes to help the patient. However, the problem with this is that some assessments have been shown to not consistently have good test-retest ability; predominantly this is the DSM-IV. This statement has been supported by research. For instance, Keller et al (1995) assessed 524 people with depression from inpatient, outpatient and community settings at 5 different sites. Within the study...
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...Suggest 2 improvements that could be made to the Griffiths study and outline any implications these changes may have. (8) One change would be to replicate the study in different countries. Pseudo patients could see if they would be diagnosed as having schizophrenia by doctors in England, France and Canada. The pseudo patients would provide the same symptoms as in the original study (thud, hollow and empty). This would allow the researcher to investigate any cross cultural differences in diagnosis and the treatment of patents (if admitted to a hospital). An implication of this may be that doctors in the other countries may make the same mistakes with diagnosis thus showing practitioners to be bias cross cultural. This would give further support for the need of the DSM to be updates and would mean that the results form Rosenhan's study could be generalised to other countries. In addition to this it would provide insight into treatments used in the different countries, they may find that the type of care/ standard of care differ from country to country (possibly worse in counties with lower economy) Another improvement could be to set up CCTV cameras into the hospitals to record the behaviours of the staff towards the patients. This would be overt at first as the staff would be aware the cameras are being brought in, however they would soon forget they are there. This would allow Rosenhan to have a record of staff patient interaction and the treatment of the pseudo patients...
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...The DSM-IV is an important tool for clinicians. It provides a standard for diagnoses to be standardized across psychology; however, the DSM-IV is not as precise for diagnosing personality disorders as some psychologists would like. Give an example of each of the following problems identified in your readings and explain how these problems could negatively affect a diagnosis. 1) Some criteria used for reaching a diagnosis cannot be observed directly. A patient analysis could take place in most cases so that a clinician could gain information about the patient’s symptoms that may be immediately observable in the clinical setting. If this information is not gathered by the clinician a misdiagnosis could be made. Subjective data may include information about the patient’s personality, behaviors or a patient’s reaction to information that cannot be directly from the patient due their inability or reluctance to speak with clinician directly. As an example, if a patient who did not present personality disorders in fear might be diagnosed as having a social phobia. A patient not being truthful has very serious consequences and one could not get the appropriate treatment needed. 2) Personality disorders can be similar to each other. There are several symptoms that overlap between different disorders in DSM listings. A clinician’s personal observation could misdiagnosis between one of these two disorders if the clinician relies only on information gathered in a clinical...
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...these activities? Why does she not want to go to school? What was Clara’s life pre-adoption? When was she adopted? How did the process go? How specifically have her eating and sleeping patterns changed? What is she throwing tantrums over? Describe the tantrums and situations during and before they happen. 2. In addition to the clinical interview, what other clinical assessment tools should you consider? Why? Which ones would you not consider? Why? I’d start off with observation of the family in a natural environment concentrating on not only Clara but her parents as well. 3. If you were preparing to diagnose Clara, you would refer to the DSM-IV classification system to evaluate her condition on five separate axes. What type of information would go into each axis? Note: You are not asked to enter a diagnosis, only describe the kind of information that would be entered in each axis.) Clara is a child who is adopted. She’s having control and/or anger issues in the form of tantrums and her natural sleeping and eating patterns have been disturbed 4. Do you...
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...University of Phoenix Material Appendix G The DSM-IV The DSM-IV is an important tool for clinicians. It provides a standard for diagnoses to be standardized across psychology; however, the DSM-IV is not as precise for diagnosing personality disorders as some psychologists would like. Give an example of each of the following problems identified in your readings and explain how these problems could negatively affect a diagnosis. 1. Some criteria used for reaching a diagnosis cannot be observed directly. Diagnosing a patient is very difficult face to face depending on their problems and not being able to observe them you cannot gather all issues that need help/treating. If information about the patient gathered by another party or clinician it may be documented differently or some things may not be pick up on. All of this can lead to a misdiagnosis and worsening of the primary problem(s). A prime example would be autism. Many children have been misdiagnosed in the past because of some going by other’s general and/or comments about behavior. 2. Personality disorders can be similar to each other. There are several symptoms that can overlap with other disorders. These are so similar those misdiagnoses are very possible especially if diagnosis is dependent on the information from one source in one setting. Misdiagnosis of these symptoms is even more prone if the information is second hand. For example: Schizophrenia and bipolar disorder have some symptoms that are...
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...Discuss issues of reliability and validity associated with the classification and diagnosis of schizophrenia. Classification systems are essential in diagnosing schizophrenia, with two of the most important classification systems being the 'Diagnostic and Statistical Manual of Mental Disorders' (DSM) and the 'International Classification System for Diseases' (ICD). However for these systems to work effectively, they must be both valid and reliable. Reliability in the context of classification systems means that each time a classification system is used (to diagnose a particular cluster of symptoms) then it should produce the same outcome each time. For DSM and ICD to be classed as reliable, those using it must be able to agree when a patient should or should not be given a particular diagnosis, which is also known as 'inter-rater reliability'. Recent research by Whaley have found have found inter-rater reliability correlations as low as +0.11, this may be to so with cultural differences in classification. Copeland gave 134 US and 194 British psychiatrists a description of a patient, 69% of US psychiatrists diagnosed the patient as suffering from schizophrenia, but only 2% of British psychiatrists gave the same diagnosis. Therefore showing there are cultural differences in diagnosing schizophrenia, thus making the classification systems lacking in reliability. Another reliability issue concerned with the classification of schizophrenia is whether the psychiatrists are diagnosing...
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...Clinical Assessment Mary J House University of Phoenix Psy 270 Rhettman Mullis, Jr. November 25, 2012 What other information would you like to learn during the interview with the family? What questions would you ask? I would ask Mr. and Mrs. Lawson if they knew what kind of home life Clara had before she was adopted. I would ask them how old Clara was at the time of the adoption. I would want to know if they knew Clara’s biological family’s medical history. Was there any known of mental illness in the biological family? Did the Lawson’s know if Clara had been abused before she came to live with them? What was the environment in the Lawson home and Clara’s preschool like? Had Clara recently had an accident or been traumatized in any way that they were aware of? Had they heard of any incidents at Clara’s school that may have made her start misbehaving? Was there anything in specific they noticed that triggered Clara’s tantrums? When did the change occur in her eating and sleeping habits? Was Clara their only child? Did they have other biological or adopted children living at home. Was Clara of a different race than Mr. and Mrs. Lawson? Does Clara know that she adopted, and if she does have they just recently told her this? Has Clara mentioned being picked on, teased or bullied at school? Have they had a conference with her teacher to see how her behavior is at school? In addition to the clinical interview, what other...
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...Clinical Assessment Psychology 270 May 20, 2012 Mr. and Mrs. Lawson brought their 4-year-old adopted daughter, Clara, to see Dr. Mason, a psychiatrist. Clara was polite in greeting Dr. Mason, but did not smile and kept her gaze down as she took a seat. Mr. and Mrs. Lawson sat next to Clara and began explaining their concerns. They described Clara as a quiet child who has recently begun throwing temper tantrums, during which she is inconsolable. Her sleep and eating patterns have changed, and she no longer wants to go to preschool. 1. What other information would you like to learn during the interview with the family? What questions would you ask? Have there been any changes in Clara’s home life that might have triggered the tantrums’? Do you know about her birth family? Do you know if any kind of mental disabilities such as bi-polar or schizophrenia? How does Clara throw the tantrum? Is it that she is just acting out or is something really wrong? This is important to know because a parent can tell if a child is just trying to get attention. How long now has Clara been attending this preschool? Did the parents do research on the school’s employees or did they just pick the first preschool they found? Have there been any new staff members to start working at the preschool since Clara has been throwing these tantrums? Have there been any deaths in the family human or animal? 2. In addition to the clinical interview, what other clinical assessment tools...
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...for the rise in the incidence of eating disorders due to the fact that media images of idealized slim physical shape of people such as models and celebrities motivate or even force people to attempt to achieve slimness themselves. The media are accused of distorting reality, in the sense that people portrayed in the media are either naturally thin and thus unrepresentative of normality or unnaturally thin by forcing their bodies to look like the ideal image by putting excessive pressure on themselves to look a certain way. Eating disorders are classified as Axis I disorders in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-IV) published by the American Psychiatric Association. There are various other psychological issues that may factor into eating disorders, some fulfill the criteria for a separate Axis I diagnosis or a personality disorder which is coded Axis II and thus are...
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...Clinical Assessment Short Answers PSY/270 1/26/14 Clinical Assessment Short Answers 1. What other information would you like to learn during the interview with the family? Why? Provide a list of the specific questions you would ask. I would ask the parents what dates did the change start, time of day and how often. I would like to know if the family have started any new activity in the home. I would have concerns about changes that may have taken place in school such as new teachers new classmates or any new changes in the school. I would like to know what Jake is watching on TV and, I like to know if Jake have a sitter. I would also like to know the natural parents history (if possible). Knowing the history to the questions that I have listed will help give me a better understanding of what could be going in Jake’s life. In addition to the clinical interview, what other clinical assessment tools should you consider? Why? Assessments is simply the collecting of relevant information in an effort to reach a conclusion (Comer 2011) The standardize is common steps that should be taken when an assessment is performed, a good assessment tool will always yields the same results (Comer, 2011) Reliability this assessment yields that same scores each time when the assessment is done on the same person. The validity is the most accurately measure (Comer, 2011) I think the key is to found out as much information from Jake’s parent before getting into the assessments...
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