Chapter 1: Personality, Psychopathology, Diagnosis PDF
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Adelphi University
Jairo N. Fuertes PhD, ABPP
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This chapter provides an overview of psychopathology, mental disorders, and diagnosis. It discusses the definitions and classifications of mental disorders, as well as the purposes of a psychiatric diagnosis. The text emphasizes the importance of understanding symptoms and signs, as well as the role of biological and psychosocial factors in mental health.
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ADELPHI UNIVERSITY THE GORDON F. DERNER INSTITUTE of ADVANCED PSYCHOLOGICAL STUDIES PERSONALITY, PSYCHOPATHOLOGY, DIAGNOSIS: 0502-603 Chapter 1 Instructor: Jairo N. Fuertes PhD, ABPP Email: [email protected] ...
ADELPHI UNIVERSITY THE GORDON F. DERNER INSTITUTE of ADVANCED PSYCHOLOGICAL STUDIES PERSONALITY, PSYCHOPATHOLOGY, DIAGNOSIS: 0502-603 Chapter 1 Instructor: Jairo N. Fuertes PhD, ABPP Email: [email protected] Psychopathology that “Who in the rainbow can draw a line where the violent tint ends and the orange begins... so with sanity and insanity.” a goodcliniciangetstoknow the person seeshow the - Herman Melville, Billy Budd problemmanifests them in Psychopathology is defined as the study of mental disorders – their problems, causes and process. According to the DSM, mental disorders must produce clinically significant impairment or distress in one's personal, social, or occupational life. Biological changes may or may not be involved. The DSM-V classifies mental disorders; it does not classify individuals with mental disorders If there's nodistress no dysfunctionthere's no problem Psychopathology like the extreme of a daily temperature The Purpose of a Psychiatric Diagnosis Psychiatric Diagnosis serves two main purpose (Spitzer, 1976). Apsychiatricdiagnosis serves 2 main 1. Define Clinical entities purposes entities Defines clinical 2. Determine Treatment Determinestreatment Patients with a particular diagnosis should present with certain cardinal symptoms (e.g. diminished interest in pleasurable activities, insomnia, diminished concentration, etc.), and have a similar natural history (i.e. a typical age of onset, life course, prognosis, and complications. origin and pathogenesis of the condition. A diagnosis should reflect etiology progression How well a diagnosis defines a disorder guides treatment depends on it's validity and reliability lessened the amount of time aperson can yougetlovedones to DSM address theproblem help has symptomsbeforethey intervention take theTHEORY out do diagnose DSMtypicallyfavorsearly now the symptomsignsalign w despite debates regarding a diagnosis cardinal DSM is forever Symptoms, Signs, and Issues Psychopathology manifest as symptoms and signs. Symptoms are experienced subjectively, cannot be observed, and must be reported by the client. Symptoms include pain, hallucinations, appetite loss, paranoid thinking, and anxiety. Signs can be observed and documented objectively. Signs include phobic behavior, restlessness, weight loss, and paranoid speech. Patients with mental disorders have both symptoms and issues, whereas clients with problems in living only have issues. Issues contain ideas; symptoms do not. Biological factors primarily cause symptoms, whereas psychosocial factors primarily determine issues. day life or in personality issues where problems manifest in day to disorders ex trust authority Two diagnostic approaches: Descriptive and Psychological Descriptive approach: diagnoses are based on relatively objective phenomena that require nominal clinical inference. These phenomena include signs, symptoms, and natural history. The descriptive approach focuses on the what of behavior. The psychological approach is based primarily on inferred causes and inner mechanisms. This approach focuses on the why behind behavior. Both descriptive and psychological approaches are valuable, since each address a different aspect of psychopathology. adiagnosis guidespsychotherapy be descriptiveapproachhas proven to mostbeneficial The Descriptive Revival The main reason for writing DSM-II was to conform to the World Health Organization's International Classification of Diseases. However, DSM-II suffered from low inter-rater reliability and validity. The categories did not define disorders having predictable symptoms, natural histories, or response to treatment. The Descriptive revival emerged from the different classes of medications that were discovered that alleviated or eliminated symptoms of one disorder and not another. Correct diagnosis became essential for choosing the correct medication. Psychiatric Epidemiology Psychiatric epidemiology is the science that studies the frequency and distribution of mental disorders within various populations. Incidence refers to number of new cases, whereas prevalence refers to the number of existing cases. Incidence and prevalence can convey very different pictures of a disorder's frequency. Treatment does not affect incidence (new cases), but it does affect prevalence (existing) cases. Prevention can affect incidence. The Epid Catchment Area and Nat Comorbidity Survey reported that mental disorders has affected 20-30% of adult Americans during the preceding year and 32 – 50% of them throughout life. Table 1-3. Most common disorders include anxiety disorders, impulse control disorders, and mood disorders.