DSM Classification and Clinical Interview Quiz

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Questions and Answers

Which approach to the classification of psychological disorders assumes that they are real, discrete entities?

Both approaches

Categorical Approach (correct)

Neither approach

Dimensional Approach

Which approach to the classification of psychological disorders assumes that they differ from normality in degree?

Neither approach

Dimensional Approach (correct)

Both approaches

Categorical Approach

Which approach does the DSM traditionally adopt for classification of psychological disorders?

Biological approach

Categorical approach (correct)

Psychodynamic approach

Dimensional approach

What are two problems with the categorical approach to classification?

Diagnostic co-morbidity and boundary disputes Signup and view all the answers

Which of the following best defines comorbidity?

The occurrence of more than one mental disorder or physical condition at the same time Signup and view all the answers

What is the meaning of boundary disputes in the context of comorbidity?

Disputes concerning the false positives problem of setting a valid boundary between disorder and normal variation Signup and view all the answers

Which approach does the DSM-V maintain for classification of psychological disorders?

A categorical approach with a more dimensional approach within the diagnostic criteria Signup and view all the answers

What does aetiology refer to in the context of classification of disorders?

The scientific investigation into the origins of a disorder that cannot be explained biologically Signup and view all the answers

What does pathophysiology refer to in the context of classification of disorders?

The disordered physiological processes associated with disease or injury Signup and view all the answers

Which of the following is considered the gold-standard for classification of disorders?

Aetiology or Pathophysiology. Signup and view all the answers

What does the DSM-V classification of psychological disorders rely on?

Phenomenology Signup and view all the answers

Which of the following is a potential benefit of diagnosing a psychological disorder?

It helps to guide treatment Signup and view all the answers

What is a potential drawback of diagnosing a psychological disorder?

It can lead to stigma and labelling Signup and view all the answers

Which of the following is NOT a potential benefit of diagnosing a psychological disorder?

It can cure the disorder Signup and view all the answers

What was the driving factor in determining the diagnoses of the participants in the Rosenhahn Study?

Label assigned by the admitting psychiatrist Signup and view all the answers

Which of the following is a key reason why diagnostic reliability is important in a classification system?

To identify the causal mechanisms of psychological disorders Signup and view all the answers

Which diagnostic criteria approach was adopted in the DSM-III and all subsequent DSMs?

Polythetic Signup and view all the answers

What is the main reason for using polythetic diagnostic criteria in the DSM?

To handle clinical heterogeneity Signup and view all the answers

Which of the following best describes the polythetic approach to diagnosis?

A diagnosis can be arrived at in multiple ways, reflecting different combinations of the diagnostic criteria Signup and view all the answers

What is a potential problem with the polythetic approach to diagnosis?

Can cause misdiagnosis Signup and view all the answers

What can be a result of using the polythetic approach to diagnosis?

Can lead to multiple diagnosis Signup and view all the answers

Which method was used to assess diagnostic reliability in the development of the DSM-5?

Field trials with independent interviews Signup and view all the answers

How is diagnostic reliability operationalized in the DSM-5?

Using kappa as a measure of agreement Signup and view all the answers

What does kappa reflect in the assessment of diagnostic reliability?

The degree of agreement between assessors Signup and view all the answers

According to the 'rules of thumb' for evaluating diagnostic reliability, what level of agreement is considered poor?

<blockquote> .40 </blockquote> Signup and view all the answers

What level of agreement is considered excellent according to the 'rules of thumb' for evaluating diagnostic reliability?

<blockquote> .74 </blockquote> Signup and view all the answers

Which of the following is a common source of disagreement among interviewers when diagnosing a disorder?

The severity of associated distress or disability Signup and view all the answers

Which of the following is NOT a purpose of assessment in clinical psychology?

Personnel selection applications Signup and view all the answers

What does the DSM recommend regarding the diagnostic criteria for psychological disorders?

They should be used as guidelines Signup and view all the answers

What is one of the approaches that clinicians rely upon to inform the diagnosis of a psychological disorder?

Interviews with family members or other care-givers Signup and view all the answers

Which of the following is NOT a method used by clinicians to inform the diagnosis of a psychological disorder?

Object diagnostic tests Signup and view all the answers

Which type of clinical interview combines the strengths of both unstructured and structured interviews?

Semi-structured interviews Signup and view all the answers

What is the key characteristic of semi-structured interviews?

Flexibility to include additional probes Signup and view all the answers

What is the main focus of the body of a clinical interview?

To gather information and form hypotheses Signup and view all the answers

Which of the following is NOT a purpose of the opening of a clinical interview?

To summarise the main themes of the interview Signup and view all the answers

What should the clinician do at the close of a clinical interview?

Summarize the main themes of the interview, address questions or concerns, and discuss next steps Signup and view all the answers

Which type of questions should clinical interviewers balance during an interview?

Open and closed questions Signup and view all the answers

What is one thinking error that clinical interviewers must be aware of?

Confirmation bias Signup and view all the answers

Why should clinical interviewers avoid using too many 'why' questions?

They can come across as judgmental Signup and view all the answers

Study Notes

Classification of Psychological Disorders

The categorical approach assumes that psychological disorders are real, discrete entities that differ from normality in kind.
The dimensional approach assumes that psychological disorders differ from normality in degree.
The DSM traditionally adopts a categorical approach to classification.

Problems with Categorical Approach

Two problems with the categorical approach are:
- It assumes that disorders are discrete entities, which may not be the case.
- It does not account for comorbidity (the presence of multiple disorders).

Comorbidity

Comorbidity refers to the presence of multiple disorders in an individual.
Boundary disputes in the context of comorbidity refer to the difficulty of distinguishing between disorders.

DSM-V Approach

The DSM-V maintains a categorical approach to classification, but with a dimensional assessment component.

Aetiology and Pathophysiology

Aetiology refers to the causes of a disorder.
Pathophysiology refers to the underlying biological processes that contribute to a disorder.

Gold Standard for Classification

Clinical interviews are considered the gold-standard for classification of disorders.

DSM-V Classification

The DSM-V classification of psychological disorders relies on a combination of clinical interviews, behavioral observations, and self-report measures.

Benefits and Drawbacks of Diagnosis

A potential benefit of diagnosing a psychological disorder is that it can guide treatment and improve outcomes.
A potential drawback of diagnosing a psychological disorder is that it can lead to stigmatization and labeling.
A potential benefit of diagnosing a psychological disorder is NOT that it can provide a clear understanding of the causes of the disorder.

Rosenhahn Study

The driving factor in determining the diagnoses of the participants in the Rosenhahn Study was the clinically significant distress or impairment they experienced.

Diagnostic Reliability

Diagnostic reliability is important in a classification system because it ensures that different clinicians arrive at the same diagnosis for a given individual.
The diagnostic criteria approach adopted in the DSM-III and all subsequent DSMs is the polythetic approach.

Polythetic Approach

The polythetic approach to diagnosis involves meeting a certain number of criteria from a larger list of potential symptoms.
The main reason for using polythetic diagnostic criteria in the DSM is to increase sensitivity and flexibility in diagnosis.
A potential problem with the polythetic approach to diagnosis is that it can lead to heterogeneity within a diagnostic category.
A result of using the polythetic approach to diagnosis can be that individuals with different symptom profiles are given the same diagnosis.

Diagnostic Reliability Assessment

The method used to assess diagnostic reliability in the development of the DSM-5 was the kappa statistic.
Diagnostic reliability is operationalized in the DSM-5 as the extent to which different clinicians arrive at the same diagnosis for a given individual.
Kappa reflects the degree of agreement between clinicians above and beyond chance.

Evaluating Diagnostic Reliability

According to the 'rules of thumb' for evaluating diagnostic reliability, a level of agreement < 0.40 is considered poor, and a level of agreement > 0.80 is considered excellent.

Sources of Disagreement

A common source of disagreement among interviewers when diagnosing a disorder is the interpretation of symptoms and criteria.

Purpose of Assessment

The purpose of assessment in clinical psychology is NOT to determine the causes of a disorder.

Diagnostic Criteria

The DSM recommends using a combination of clinical interviews, behavioral observations, and self-report measures to inform the diagnosis of a psychological disorder.

Clinician's Approach

One approach that clinicians rely upon to inform the diagnosis of a psychological disorder is the use of clinical interviews.
The approach that clinicians do NOT rely upon to inform the diagnosis of a psychological disorder is the use of a single laboratory test.

Semi-Structured Interviews

The semi-structured interview combines the strengths of both unstructured and structured interviews.
The key characteristic of semi-structured interviews is that they use a predetermined set of questions and topics, but allow for flexibility and exploration.

Clinical Interview

The main focus of the body of a clinical interview is on the symptoms and experiences of the individual.
The purpose of the opening of a clinical interview is NOT to establish a diagnosis.
At the close of a clinical interview, the clinician should summarize the main points and provide feedback to the individual.
Clinical interviewers should balance open-ended and closed-ended questions during an interview.
One thinking error that clinical interviewers must be aware of is the confirmation bias.
Clinical interviewers should avoid using too many 'why' questions because they can lead to defensiveness and decreased rapport.

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Description

Test your knowledge on the DSM approach to classifying psychological disorders. Learn about the categorical and dimensional approaches and how they differ in understanding mental health conditions.