Abnormal PsychologyAbnormal Psychology

Dr. David M. McCordDr. David M. McCord

Assessment and DiagnosisAssessment and Diagnosis

• Assessment – What are the problems, what caused them,

what are we going to do about them

• Diagnosis– The art and science of determining the nature

of a disorder and differentiating it from other disorders

• Purposes– To gather info that will help explain etiology– To predict progress and outcome (prognosis)– To plan the most appropriate methods of

treatment

Symptoms, Syndromes (patterns of symptoms)

Brief History of Diagnostic SystemsBrief History of Diagnostic Systems

• Hippocrates – mania, melancholia, phrenitis, hysteria

• Paracelsus – “insanity” – 1500’s• Morel (1809-1873) – Dementia Praecox• Kraepelin (1855-1925) 1st major diagnostic

system• Meyer (1866-1950) introduced Kraepelin’s

system to America• Eugen Bleuler (1857-1939) -

schizophrenia

• DSM – 1952

• DSM II – 1968

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• DSM III – 1980

• DSM III R – 1987

• DSM IV – 1994

• Axis I – Clinical disorders

• Axis II – Personality Disorders and Mental Retardation

• Axis III – General medical conditions

• Axis IV – Psychosocial and Environmental Problems

• Axis V - Global Assessment of Functioning

• Axis I – Clinical disorders – Disorders Usually First Diagnosed in Infancy,

Childhood, or Adolescence– Substance-Related Disorders– Schizophrenias and other Psychoses– Mood Disorders– Somatoform, Factitious, & Dissociative– Sexual and Gender Identity– Eating, Sleep, Impulse Control Disorders– Adjustment Disorders

• Axis II– Personality Disorders

• Paranoid, Schizoid, Schizotypal• Antisocial, Borderline, Histrionic, Narcissistic• Avoidant, Dependent, Obsessive-Compulsive

– Mental Retardation• Mild, Moderate, Severe, Profound

• Axis III – General Medical Conditions

– Examples: infectious and parasitic diseases,– Tumors and cancers– Blood, circulatory, respiratory diseases– Digestive system disorders– Genitourinary system disorders– Skin, musculoskeletal, joint problems– Congenital anomalies

• Axis IV – Psychosocial and environmental problems– With primary support group– Related to social environment– Educational problems– Occupational problems– Housing problems– Economic problems– Access to health care services– Related to interaction with legal system

• Axis V – Global Assessment of Functioning

Consider psychological, social, and occupational functioning on a hypothetical continuum of mental health – illness: 0 to 100. Don’t include problems due to physical or environmental limitations.

Axis I 296.23 Major Depressive Disorder, Single Episode, Severe Without Psychotic Features

305.00 Alcohol Abuse

Axis II 301.6 Dependent Personality Disorder

Axis III None

Axis IV Threat of job loss

Axis V GAF = 35 (current)

Axis I 300.40 Dysthymic Disorder

315.00 Reading Disorder

Axis II V71.09 No diagnosis

Axis III Otitis media, recurrent

Axis IV Victim of child neglect

Axis V GAF = 53 (current)

• Problems with labeling

• Advantages

• The Rosenhan study 1973– “On being sane in insane places”

• Introduction and Reason for Referral• Background history

– Intelligence testing (cognitive abilities)– Achievement testing– Neuropsychological screening– Personality traits– Emotional characteristics– Behavioral tendencies

• Summary and Conclusions• Recommendations

• Projective tests– Projective hypothesis– TAT, Rorschach, DAP

• Personality Inventories– MMPI-2

• (Research chapter from website)