ESE 670
Getting Started Syllabus Class communicate library help

 

Module Five

Reading Four – The Diagnostic Piece

Review the Kaufman material on the DSM-IV if that is your text. If it is not, please do a quick literature review by pulling up and browsing at least four articles about the DSM-IV classification system.

 

You are just learning how to use the process and it is actually quite an advanced way of looking at behaviors and emotional states and moods. It has a long history and a quick review of those steps and how we developed the current paradigm is outlined below.

 

Explaining Abnormal Behavior

From http://home.epix.net/~tcannon1/diagnosis.html

 

Medical Model

 

Psychodynamic Perspective

 

Cognitive Perspective

 

Brief History of Diagnosis

 

Kraepelin-1898:  2 Varieties of Psychopathology

 

1917-APiA With Census Bureau

 

APiA and NY Medical Center

 

Armed Forces and VA developed their own system

 

1948 - World Health Organization

Added section on mental disorders to the international classification of diseases and health related problems (ICD)

Excluded dementia, adjustment disorders, and many personality disorders

 

In 1948 There Were 3 Different Systems Being Used in the USA:

1)  APiA and NY Medical Center

2)  Armed Forces and VA

3)  ICD

      As late as 1970, France and Russia had their own classification systems

 

History of Diagnostic and Statistical Manual

 

DSM-I

group of symptoms

 

DSM-II in 1968

 

DSM-III

 

Axes

 

DSM-III-R

 

DSM-IV

 

Changes From DSM-IIIR

 

DSM-IV-TR

 

CRITICISMS OF DSM-IV

 

(see Carson article)

 

1)  Problem With Multiple dxs:

 

2)  Disorders Are Interactions of Multiple Factors: 

 

3)  Excessive Focus on Reliability

 

Other DSM Issues Raised by Carson

 

Carson Recommends

 

Disadvantages of DX:

 

Benefits of DX:

From http://home.epix.net/~tcannon1/diagnosis.html

 

Sample criticisms of the DSM-IV

 

* Acton, G. S. and Jason J. Zodda, Rochester Institute of Technology Classification of Psychopathology: Goals and Methods in an Empirical Approach. Many have criticized the Diagnostic and Statistical Manual of Mental Disorders ( DSM-IV; American Psychiatric Association, 1994), and few regard it as a vehicle of truth, yet its most serious limitation is that its frank operationism in defining manifest categories has distracted attention from theories about what is going on at the latent level. We sketch a Generalized Interpersonal Theory of Personality and Psychopathology and apply it to interpersonal aspects of depression to illustrate how structural individual differences combine with functional dynamic processes to cause interpersonal behavior and affect. Such a causal account relies on a realist ontology in which manifest diagnoses are only a means to learning about the latent distribution, whether categorical or dimensional. Comorbidity of DSM diagnoses suggests that dimensionality will be the rule, not the exception, with internalization and externalization describing common diagnoses.

 

* This article criticizes the approach to language underlying the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-IV; American Psychiatric Association, 1994). Concepts from the philosophy of language illuminate taxonomic problems that vex users of the DSM nosology: lack of coverage, comorbidity, and within-category heterogeneity. Exception is taken to the operationism that results in a highly artificial DSM nomenclature, raising the specter of non-referential criterion sets. A dimensional approach is recommended because it would better correspond to an objectively seamless reality.

 

 

Now that you have a sense of the history and a couple of the issues, it is time to try your own hand at using the tool. Go to activity four and give it a whirl.

 

GO to Activity Four