ABNORMAL PSYCHOLOGY/2e

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1 LECTURE GUIDE to accompany ABNORMAL PSYCHOLOGY/2e Brian L. Burke Fort Lewis College Sarah E. Trost Cardinal Stritch University Terri A. deroon-cassini Medical College of Wisconsin Douglas A. Bernstein University of South Florida

2 Chapter 1 Identifying, Detecting, and Classifying Mental Disorders: M.A.P.S. of the Territory

3 Identifying Mental Disorders: What Are They? Mental disorders have been defined as: Deviations from social expectations Conditions that mental health professionals treat Labels for disliked actions Subjective distress or unhappiness Dysfunctions that cause harm

4 Identifying Mental Disorders: What Are They? The DSM-5 Definition Cultural context Distress/disability Individual dysfunction of psychological, biological or developmental processes Cognition Emotion regulation Behavior

5 Section Review: Identifying Mental Disorders 1. How have mental disorders been defined throughout history? 2. How does the DSM-5 define mental disorders?

6 Three Steps 1. Gather information Assessment and Diagnosis 2. Organize and process information to form a clinical description 3. Compare description using a nosology to arrive at a diagnosis

7 Reliability and Validity Reliability Test-retest reliability Internal consistency Interrater reliability Validity Content validity Predictive validity Concurrent validity Construct validity Assessment and Diagnosis

8 Assessment and Diagnosis Correct Diagnosis vs. Diagnostic Errors True positive Sensitivity True negative Specificity False positive False negative

9 Section Review: Assessment and Diagnosis 1. What are the three major steps in assessment and diagnosis? 2. What kinds of reliability and validity are especially important when using assessment tools? 3. What are the two kinds of correct diagnostic conclusions? 4. What are the two kinds of diagnostic errors?

10 Assessment Tools: How Do Health Professionals Detect Mental Disorders? 1. Life Records E.g., school grades, court records, police reports, medical records 2. Interviews Structured interview Mental Status Examination (MSE) Social history

11 Assessment Tools: How Do Health Professionals Detect Mental Disorders? 1. Life Records 2. Interviews 3. Psychological Tests Intelligence tests Neuropsychological tests Personality tests

12 Assessment Tools: How Do Health Professionals Detect Mental Disorders? 1. Life Records 2. Interviews 3. Psychological Tests 4. Observations 5. Biological Measures Neurodiagnostic procedures

13 Table 1.4 Some Neurodiagnostic Procedures (p. 19)

14 Figure 1.5 Mapping the Geography of the Brain (p. 20) (a) CT scan (b) MRI Sources: (a) Santibhavanak P/Shutterstock.com. (b) Triff/Shutterstock.com.

15 Figure 1.5 Mapping the Geography of the Brain (p. 20) (c) PET scan (d) fmri Sources: (c) Jens Maus (Langner) ( (d) John Graner, Neuroimaging Department, National Intrepid Center of Excellence, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889, USA..

16 Section Review: Assessment Tools 1. What are the five main sources of assessment data? 2. What are the unique strengths of each of these sources?

17 Diagnostic Classification: How Do Health Professionals Categorize Mental Disorders? History of the DSM DSM-I: 1952 DSM-II: 1968 DSM-III: 1980; DSM-III-R: 1987 DSM-IV: 1994; DSM-IV-TR: 2000 DSM-5: 2013

18 Diagnostic Classification: How Do Health Professionals Categorize Mental Disorders? Diagnosis involves: Specific operational criteria for each disorder A polythetic approach Assessment of Medical conditions Exposure to stressors Overall functioning Comorbidity with other mental disorders

19 Diagnostic Classification: How Do Health Professionals Categorize Mental Disorders? DSM-5 Diagnostic Categories Neurodevelopmental disorders Elimination disorders Disruptive, impulse-control, and conduct disorders Schizophrenia spectrum and other psychotic disorders Bipolar and related disorders Depressive disorders Anxiety disorders Obsessive-compulsive and related disorders Trauma- and stressor-related disorders Dissociative disorders Somatic symptom and related disorders Feeding and eating disorders Sleep-wake disorders Sexual dysfunctions Gender dysphoria Substance-related and addictive disorders Neurocognitive disorders Personality disorders Paraphilic disorders Other mental disorders

20 Diagnostic Classification: How Do Health Professionals Categorize Mental Disorders? Other Factors that Influence Diagnosis Money and privacy Diversity and assessment bias Diversity and the expression of mental disorders Diversity and interactions between clients and clinicians

21 Section Review: Diagnostic Classification 1. What does it mean to say that the DSM has a polythetic approach to diagnosis? 2. What DSM-5 diagnostic categories are you most interested in learning about? 3. What other factors, especially those related to diversity, affect the diagnosis of mental disorders?

22 The Frequency of Mental Disorders: How Common Are They? Key Terms Prevalence vs. incidence

23 The Frequency of Mental Disorders: How Common Are They? Notable Facts About one in four adults in the United States experience a diagnosable mental disorder in a given year. Lifetime prevalence of mental disorders is often related to demographic or social variables. Many people with a history of mental disorders are considered in remission. Many people do not receive treatment for mental disorders.

24 The Frequency of Mental Disorders: How Common Are They? Notable Facts (continued) Comorbidity is common. The average age of noticing the first symptoms of a mental disorder is 16. The prevalence of mental disorders varies considerably worldwide. Personality disorders and alcohol use disorders are the most common disorders worldwide. Having a mental disorder in the developing world can be especially difficult.

25 Our Textbook s Four Guiding Principles: M.A.P.S. M = Medical Myths A = Attempted Answers P = Prejudicial Pigeonholing S = Superficial Syndromes

26 Our Textbook s Four Guiding Principles: M.A.P.S. M = Medical Myths Medications are not always the best treatment for most of the disorders in the DSM The biological/medical model is only one narrow lens through which we view disorders The medical model stresses the individual above the sociocultural context A = Attempted Answers Symptoms of disorders often arise as the person s attempted solution to a problem E.g., delusions may create meaning, compulsive behaviors may reduce anxiety, rituals may manage discomfort

27 Our Textbook s Four Guiding Principles: M.A.P.S. P = Prejudicial Pigeonholing Labeling produces stereotypes, prejudice, and harm Gender bias in the DSM S = Superficial Syndromes We should aim to understand what causes disorders and how best to treat them, and not just focus on how to spot disorders based on surface characteristics Mental disorders occur on a continuum, not in discrete categories A focus on symptoms facilitates reliable diagnoses, but not necessary valid diagnoses.

Key Questions 1. What are mental disorders? 2. How do health professionals detect mental disorders? 3. How do health professionals categorize mental disorders?

28 Key Questions 1. What are mental disorders? 2. How do health professionals detect mental disorders? 3. How do health professionals categorize mental disorders? 4. How common are mental disorders in the United States and worldwide? 5. What are four guiding principles to keep in mind when studying abnormal psychology?

29 Ch. 1 Tables and Figures

30 Table 1.1 Structured Interviews Frequently Used to Assess Clinical Conditions

31 Table 1.2

32 Table 1.3 MMPI-2-RF Scales and Simulated Norms Source: Ben-Porath & Tellegen, 2008/2011.

33 Table 1.3 (cont.)

34 Table 1.4 Some Neurodiagnostic Procedures

35 Table 1.5

36 Table 1.6 Prevalence of Specific Mental Disorders in Adults Worldwide

37 Figure 1.1 Correlations Showing Different Relationships Between Two Variables

38 Figure 1.2 A Sample Figure Completion Task From a Test of Cognitive Ability

39 Figure 1.3 Inkblot Such As Those Used in the Rorschach Source: Dimec/Shutterstock.com.

40 Figure 1.4 MMPI-2-RF Profile Source: Based on data from Nichols, 2006.

41 Figure 1.5 Mapping the Geography of the Brain (a) CT scan (b) MRI Sources: (a) Santibhavanak P/Shutterstock.com. (b) Triff/Shutterstock.com.

Figure 1.5 Mapping the Geography of the Brain (c) PET scan (d) fmri Sources: (c) Jens Maus (Langner) (http://www.jens-langner.

42 Figure 1.5 Mapping the Geography of the Brain (c) PET scan (d) fmri Sources: (c) Jens Maus (Langner) ( (d) John Graner, Neuroimaging Department, National Intrepid Center of Excellence, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889, USA.

43 Figure 1.6 A DSM-5 Diagnosis of Gollum from The Hobbit and Lord of the Rings Source: Mawardi Bahar/Shutterstock.com.

Introduction to the DSM-5 for APRNs. Presenters. Disclosures. Continuing Education Subcommittee APNA Education Council. Co-Chairs of CE subcommittee:

Introduction to the DSM-5 for APRNs Continuing Education Subcommittee APNA Education Council Presenters Co-Chairs of CE subcommittee: Barbara J. Limandri, PhD, PMHCNS-BC Joyce M. Shea, DNSc, APRN, BC Presenters: