Classification and Assessment of Abnormal Behavior

• The text provides an overview of the classification and assessment of abnormal behavior.
• It covers diagnostic systems like the DSM and ICD, as well as various assessment methods, including interviews, psychological tests, and physiological measurements.

How Abnormal Behavior Patterns are Classified

• The Diagnostic and Statistical Manual of Mental Disorders (DSM) was first introduced in 1952.
• The DSM-5 was published in 2013.
• The International Statistical Classification of Diseases and Related Health Problems (ICD) is published by the World Health Organization.
• The ICD is used for compiling worldwide statistics on disorders.
• The DSM-5 is compatible with the ICD.

The DSM and Models of Abnormal Behavior

• The DSM system considers abnormal behaviors as indicators of underlying disorders or pathologies.
• The DSM is descriptive rather than explanatory.
• The DSM uses the term "mental disorder".

Categorical and Dimensional Components of the DSM-5

• The DSM-5 is primarily based on a categorical model of classification, using a yes/no type of judgment.
• The DSM-5 includes a dimensional component for many disorders.
• The dimensional component determines if a disorder is present and rates the severity of symptoms.

Culture-Bound Syndromes

• Culture-bound syndromes may reflect exaggerated forms of superstitions and belief patterns specific to a culture.
• Anorexia nervosa and dissociative identity disorder are culture-bound syndromes prevalent in the United States

Disadvantages of the DSM System

• Controversies arise from disagreements about symptoms associated with some syndromes.
• There is a criticism of reliance on the medical model within the DSM.
• The categorical structure of the DSM is a point of contention.
• There is concern about differentiating between behaviors and disorders.
• Stigma of labels, including sanism which involves the negative stereotyping of people identified as mentally ill.

Changes in the DSM-5

• The DSM system is periodically revised to reflect new research and understanding of mental disorders.
• Existing disorders have been reclassified or consolidated in the DSM-5.
• Asperger's disorder and autistic disorder are now under autism spectrum disorder. -Trichotillomania is now moved to Obsessive-Compulsive and Related Disorders.
• Pathological gambling is now moved to Substance Use and addictive Behaviors.
• Posttraumatic stress disorder (PTSD) is now moved to Trauma- and Stressor-Related Disorders.

Standards of Assessment

• Reliability refers to the consistency of an assessment method.
• Internal consistency measures whether different parts of the same assessment yield similar results.
• Test-retest reliability assesses the consistency of results when the same test is administered to the same person at different times.
• Interrater reliability measures the degree of agreement between different raters or observers using the same assessment.

Methods of Assessment

• Clinical interviews are the most widely used assessment method.
• Most interviews cover identifying data, the presenting problem(s), psychosocial history, medical/psychiatric history, and medical problems/medication.

Interview Formats

• Different interview formats exist, including unstructured, semistructured, and structured interviews, as well as mental status examinations.

Computerized Interviews

• Computerized interviews involve clients responding to questions on a computer screen.
• Evidence suggests that people tend to reveal as much or more to a computer than to a human interviewer.
• Computer interviews may be helpful in identifying problems that clients are unwilling to report to a live interviewer.

Psychological Tests

• Psychological tests are a structured assessment method to evaluate reasonably stable traits.
• Tests are standardized to provide norms for comparing clients' scores to the average.
• Tests can predict criterion variables, such as underlying conditions or future outcomes.

Intelligence Tests

• Assessment of abnormal behavior often includes evaluating intelligence
• Alfred Binet (1857–1911) developed the first formal intelligence test.
• The definition of intelligence continues to spark debate.
• Scores on intelligence tests expressed as an intelligence quotient, or IQ.
• An average IQ score is defined as 100.
• Wechsler scales are the most widely used intelligence tests today.

Objective Tests

• Objective tests involve subjects responding to specific questions or statements about items that reflect personality.
• The Minnesota Multiphasic Personality Inventory (MMPI) and the Million Clinical Multiaxial Inventory (MCMI) are the most widely used objective tests.

Minnesota Multiphasic Personality Inventory (MMPI-2)

• The MMPI is a test of personality used in diagnosing abnormal behavior patterns.
• It contains more than 500 true-false statements.
• The MMPI consists of multiple individual scales.

The Million Clinical Multiaxial Inventory (MCMI)

• The MCMI helps clinicians form diagnoses for personality disorders.
• It is now in its 3rd edition (MCMI-III).
• The MCMI is the only objective test that focuses specifically on personality disorders.
• It is useful in helping clinicians discriminate between various personality disorders and non-personality disorders.

Evaluation of Objective Tests

• Objective tests are relatively easy to administer.
• They often reveal information that may not be revealed during a clinical interview or by observing the person's behavior.
• The validity of objective tests depends on the criteria used to validate them.

Projective Tests

• Projective tests may offer clues to unconscious processes.
• Critics suggests that results are based on clinicians' subjective interpretation.

The Rorschach Inkblot Test

• Hermann Rorschach (1884–1922), a Swiss psychiatrist, developed the Rorschach Inkblot Test.
• Clinicians interpret the responses, based on their content and form.
• A response consistent with the form of the blot suggests adequate reality testing.

The Thematic Apperception Test (TAT)

• The Thematic Apperception Test (TAT) was developed by Harvard University psychologist Henry Murray in the 1930s.
• Respondents are asked to describe what is happening in each scene depicted in a series of pictures.
• Psychodynamic theorists believe that people project underlying psychological needs and conflicts into their responses.

Neuropsychological Assessment

• Neurological impairment can be assessed through a neurological evaluation by a neurologist.
• A clinical neuropsychologist may administer neuropsychological assessment techniques.

The Bender Visual Motor Gestalt Test

• The Bender Visual Motor Gestalt Test was one of the first neuropsychological tests to assess brain damage.
• It remains one of the most widely used neuropsychological tests.
• It consists of copying geometric figures that illustrate Gestalt principles of perception.

Behavioral Assessment

• Behavioral assessment focuses on the objective recording and description of problem behavior.
• It samples behavior in real-life situations to maximize the relationship between the testing situation and the criterion.
• Behavioral assessment may include a functional analysis.

Self-Monitoring

• Self-monitoring involves observing or recording one's own behaviors, thoughts, or emotions.
• Behaviors that are easily counted are well suited for self-monitoring.
• Self-monitoring can produce highly accurate measurement because behavior is recorded as it occurs.
• A disadvantage of self-monitoring is that some clients are unreliable and do not keep accurate reports.

Analogue Measures

• Analogue measures simulate settings where target behaviors occur naturally, but are carried out in laboratory or controlled settings.
• Role-playing exercises are common analogue measures.
• The Behavioral Approach Task (BAT) is an analogue measure of a phobic person's approach to a feared object.

Behavioral Rating Scales

• Behavioral rating scales are checklists that provide information about the frequency, intensity, and range of problem behaviors.
• Parents often use checklists to assess children's problem behaviors.
• The Child Behavior Checklist (CBCL; Achenbach & Dumenci, 2001) asks parents to rate their children on over 100 specific problem behaviors.

Cognitive Assessment

• Cognitive assessment measures thoughts, beliefs, and attitudes associated with emotional problems.
• Clients may keep a thought diary to record dysfunctional thoughts daily.
• The Automatic Thoughts Questionnaire (ATQ-30-Revised) rates the frequency and strength of belief of 30 automatic negative thoughts.
• The Dysfunctional Attitudes Scale (DAS) is an inventory of underlying attitudes associated with depression.

Physiological Measurement

• Physiological measurement assesses physiological responses potentially linked to abnormal behavior.
• Galvanic skin response (GSR), electromyograph (EMG), electroencephalograph (EEG), computed tomography (CT), and positron emission tomography (PET) are examples of physiological measurements.

Brain-imaging and Recording Techniques

• The electroencephalograph (EEG) records electrical activity in the brain to study brain wave patterns in different mental states.
• Computed Tomography (CT) measures radiation from multiple angles and enables scientists to integrate measurements into a three-dimensional picture of the brain for potential structural abnormalities
• Positron Emission Tomography (PET) can be used to study functioning of parts of brains for abnormalities in brain activity for those with abnormalities in cognitive activity or disease.