Assessing and Diagnosing Abnormality

 OBJECTIVE 1. Discuss the types of information that should be obtained during an assessment, and why each is important in ensuring that clinicians gather all the information that is needed for an accurate assessment. 2. Describe and give examples of each of the various tools used by clinicians to gather information during an assessment. Discuss the advantages and disadvantages of each assessment tool. 3. Define reliability and validity. 4. Discuss the problems in assessment, and how they might be overcome or diminished. 5. Evaluate the modern method for diagnosing mental disorders. THOUGHT QUESTION 1. Describe the tools used to diagnosis abnormality. 2. How can the problems of assessment be overcome? ASSESSING AND DIAGNOSING ABNORMALITY While there can be an ongoing debate about the issue of whether or not we can identify what is truly abnormal behavior, we must still have some means of identifying people with such behaviors who need help. Assessment is the process by which a clinician evaluates a client in terms of the factors – physiological, psychological, social – that affect that person’s functioning. because we do not want such assessment to be totally subjective (note that there will always be some degree of subjectivity) psychologists have devised some standards and some tools to help with this assessment. Most clinicians used the Diagnostic and Statistical Manual Diagnostic of Mental Disorders. The Fifth edition of the DSM was just published in May 2013. It includes criteria for the most common mental disorders including: description, diagnosis, treatment, and research findings. It is published by the American Psychiatric Association, Washington D.C. and is the main diagnostic reference of mental health professionals in the United States. There are significant changes in the new edition. The previous edition, DSM IV-TR worked on a multiaxial classification system. The 5th edition does not have this same system of organization. (Note that the current edition of our textbook still references the IVthe edition.). Read about the major changes in the 5th edition at http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf . Another tool is used by some clinicians, particularly those outside of the United States. The International Classification of Diseases (ICD) is endorsed by the United Nations’ World Health Organization. Read about the ICD at http://www.who.int/classifications/icd/en/. You can read about the comparison of these tools at: http://www.apa.org/monitor/2009/10/icd-dsm.aspx Some assessment tools commonly used are unstructured interviews, structured interviews, clinical tests, questionnaires, and inventories and behavioral observations. Outside input from family member may also be solicited. Thus the process of making a mental health diagnosis can be quite complicated. An example of what is called a decision tree for making such diagnoses can be seen at this site:http://highered.mcgraw-hill.com/sites/0072562463/student_view0/diagnostic_decision_trees.html A DSM diagnosis is required by most insurance companies for reimbursement for treatment. Assessment, however, can be a lengthy and complicated process, RELATED WEBSITES http://www.apa.org/science/programs/testing/index.aspx This is the Testing and Assessment site of the American Psychological Association’s Science Directorate. http://buros.org/ The Buros Institute of Mental Measurements has published critical reviews of tests and testing for over 6 decades. THIS IS THE ASSIGNMENT…….In this chapter we will explore changes in the DSM. You have been assigned a disorder (according to first letter of your last name). Go to http://www.psychiatry.org/psychiatrists/practice/dsm/dsm-5 and read about changes. You are not buying the book. Scroll down and on the. right click on Fact Sheets. Look at your specific disorder. Look at how the ICD classifies the disorder -http://www.who.int/classifications/icd/en/GRNBOOK.pdf . What differences do you see?