Chapter 2 Notes (Abnormal Psych)-PDF

Assessment, Classification, and Treatment Readings: Chapter 2 Abnormal Psychology – PSY 223 Learning Outcomes By the end of this class, you should be: Identify, describe, and apply: Methods of Assessment Approaches to classification Approaches to treatment...

Assessment, Classification, and Treatment Readings: Chapter 2 Abnormal Psychology – PSY 223 Learning Outcomes By the end of this class, you should be: Identify, describe, and apply: Methods of Assessment Approaches to classification Approaches to treatment Abnormal behaviour and society Assessment Methods Assessment Methods The Clinical Interview: Most widely used method of assessment The format might vary, but it typically includes gathering information about present complaints, possible precipitating events, and how the problem affects the person’s daily functioning Three major types of clinical interviews Unstructured Semi-structured Structured Assessment Methods As part of a formal interview, an interviewer may include: Mental Status Examination appearance (appropriateness of attire and grooming) mood, attention, perceptual and thinking processes, memory orientation(knowing who they are, where they are, and the present date) level of awareness or insight into their problems judgment in making life decisions Assessment Methods Psychological Tests of Intelligence: What is intelligence? Global capacity to understand the world and cope with its challenges Trait or traits associated with successful performance on intelligence tests Assessment Methods Psychological Tests of Intelligence: The Stanford-Binet Intelligence Scale Mental Age Age equivalent that corresponds to the person’s level of intelligence, as measured by performance on the Stanford-Binet Intelligence Scale (SBIS) Chronological Age Intelligence quotient IQ = MA/CA × 100 Assessment Methods Psychological Tests of Intelligence: The Stanford-Binet Intelligence Scale In 1904 the French government had laws requiring that all children attend school and efforts were made to identify children who needed extra help. Part of this effort, the French government asked Alfred Binet to help decide which students were most likely to experience difficulty in school. Assessment Methods Psychological Tests of Intelligence: The Stanford-Binet Intelligence Scale Binet and his colleague, Theodore Simon, began developing questions that focused on areas not explicitly taught in the classroom, such as attention, memory, and problem-solving skills. They then worked to determine which questions best predicted academic success. This was the fist researched and standardized test of intelligence. It has obviously gone through many revisions and updates and is currently used by psychologists to help assess intellectual capabilities. Assessment Methods Psychological Tests of Intelligence: The Wechsler Scales Wechsler’s scales include both verbal and performance subtests Verbal subtests generally require knowledge of verbal concepts Performance subtests rely more on spatial-relations skills Assessment Methods Figure 2.2 An idealized distribution of IQ scores Assessment Methods Psychological Tests of Personality: Self-report tests Minnesota Multiphasic Personality Inventory (MMPI). This is one of the most common self-report tests. Others are, but not limited to: Beck Depression Inventory (BDI) Personality Assessment Inventory (PAI) Millon Clinical Multitaxical Inventory (MCMI) Projective tests Rorschach Inkblot Test Thematic Apperception Test (TAT) House Person Tree Assessment Methods Psychological Tests of Personality: Self report tests (administered questionnaires) do not rely on interaction and questions from the examiner. Responses are matched against a larger data-base where factor – analysis is used to divide responses into subscales. Some self-report tests are also criterion-related. For example, assessing a person's responses against what people with depression (or any other mental health issues) typically respond. Assessment Methods Psychological Tests of Personality: Minnesota Multiphasic Personality Inventory -2- Restructured form (MMPI-2-RF) contains 338 true–false statements that assess interest patterns, habits, family relationships, somatic complaints, attitudes, beliefs, and behaviours characteristic of psychological disorders used as a test of personality and assisting in the diagnosis of abnormal behaviour patterns Assessment Methods Psychological Tests of Personality: Projective Tests. These tests allegedly evoke responses that may reveal a person’s personality by that person ‘projecting’ core attitudes, beliefs and values on neutral or ambiguous stimuli. Assessment Methods Psychological Tests of Personality: The Rorschach Inkblot Test A person’s responses to inkblots are used to reveal aspects of their personality Evaluation of the Rorschach Inkblot Test lack of a standard scoring procedure interpretation of a person’s responses is not objective depends on the subjective judgment of the examiner Assessment Methods Psychological Tests of Personality: The Thematic Apperception Test (TAT) TAT consists of a series of cards depicting ambiguous scenes Respondents are asked to construct stories about the cards. “Make up a story around this picture. Like all good stories it should have a beginning, a middle, and an ending. Tell me how the people feel and what they are thinking.” Assumed that their tales reflect their experiences and outlooks on life, shed light on deep-seated needs and conflicts Assessment Methods Psychological Tests of Personality: Evaluation of the TAT Clients’ responses may represent reactions to stimulus cues rather than projections of their personalities Scoring and interpretation of responses largely depends on clinicians’ subjective impressions Assessment Methods Psychological Tests of Personality: House-Person-Tree test is typically used for children and does not require a lot verbal interaction with the examiner. Test takers are asked to draw a house, person and tree. Examiner may ask some questions about the drawing. Example of some questions would be; Who lives in the house? Do people visit the house? What kind of tree is it? Who is the person? How does the person feel? The drawing and responses are used to infer cognitive, emotional and social functioning.  Like all other projective tests, the results are highly subjective and idiosyncratic to the examiner. There is a comprehensive manual on scoring, and accompanying training. These are qualitative in nature, not validated by research very well. Assessment Methods Neuropsychological Assessment: Used to evaluate whether or not psychological problems reflect underlying neurological damage or brain defects The Bender Visual Motor Gestalt Test The Luria-Nebraska Neuropsychological Battery (LNNB) The Halstead-Reitan Neuropsychological Battery (HRNB) Assessment Methods Behavioural Assessment: Psychometric approach Rorschach, TAT, and MMPI used to identify and measure the reasonably stable traits in an individual’s personality that are believed to largely determine their behaviour Assessment Methods Behavioural Assessment: Behavioural Approach behaviour is primarily determined by environmental or situational factors, such as stimulus cues and reinforcements Behavioural Assessment clinical assessment that focuses on the objective recording or description of problem behaviour rather than on inferences about personality traits Assessment Methods Behavioural Assessment: Behavioural Interview Approach to clinical interviewing that focuses on relating problem behaviour to antecedent stimuli and reinforcement consequences Assessment Methods Behavioural Assessment: Direct Observation Evaluation of Direct Observation does not rely on self-reports, which may be distorted by efforts to make a favourable or unfavourable impression behavioural observation can suggest strategies for intervention lack of reliability or inconsistency of measurement across time or between observers Assessment Methods Behavioural Assessment: Self-monitoring Process of recording or observing one’s own behaviour, thoughts, or emotions Behaviours that can be easily counted, such as food intake, cigarette smoking, nail-biting, hair pulling, study periods, and social activities Assessment Methods Cognitive Assessment: Involves the assessment of cognitions (thoughts, beliefs, and attitudes) Methods of Cognitive Assessment Thought Diaries Automatic Thoughts Questionnaire Dysfunctional Attitudes Scale Assessment Methods Physiological Measurement: Examines people’s physiological responses Galvanic skin response (GSR) Electroencephalograph (EEG) Electromyograph (EMG) Assessment Methods Brain-Imaging and Recording Techniques: Computerized tomography (CT Scans) Positron emission tomography (PET Scans) Magnetic resonance imaging (MRI) Functional magnetic resonance imaging (fMRI) Brain electrical activity mapping (BEAM) Magnetoencephalography (MEG) Assessment Methods Sociocultural Factors: Reliability and validity of assessment tools may be culture-specific Disentangling psychopathology from sociocultural factors Issues of translation Classification Classification Current Systems of Classification: Diagnostic & Statistical Manual of Mental Disorders (DSM) International Statistical Classification of Diseases and Related Health Problems (ICD) Chinese Classification of Mental Disorders (CCMD) Classification The Diagnostic and Statistical Manual of Mental Disorders (DSM): Features of the DSM Abnormal behaviour patterns are classified as mental disorders The DSM classifies disorders people have, not the people themselves Specific diagnostic criteria are used Classification The Diagnostic and Statistical Manual of Mental Disorders (DSM): Features of the DSM Abnormal behaviour patterns that share features are grouped together A diagnosis is given only when the minimum number of symptoms or features are present to meet the diagnostic criteria Classification Evaluation of the DSM System: Reliability Validity Predictive validity Cultural factors Classification Details of the DSM: DSM-5 published in 2013 DSM-5 TR Published in 2022. TR = Text Revision DSM-5 classifies abnormal behaviour patterns, or psychological disorders according to developmental models New disorders have been added and some existing disorders were reclassified or consolidated with other disorders under new diagnostic labels Classification Focus on Diversity: Culture-Bound Syndromes Patterns of psychological distress that are limited to one or only a few cultures Example: taijin-kyofu-sho (TKS) is a common disorder seen in Japan, that involves excessive fear of offending or causing embarrassment to others Treatment Methods Treatment Methods Three major types of helping professionals: Clinical Psychologist Psychiatrist Social Worker Treatment Methods Three major types of helping professionals: Clinical Psychologist In most provinces requires a doctoral degree in psychology from an accredited college or university (Ph.D. or Psy.D.) Specialize in administering psychological tests, diagnosing psychological disorders, and practicing psychotherapy Treatment Methods Three major types of helping professionals: Psychiatrist Medical degree (M.D.) with residency program in psychiatry Specialize in the diagnosis and treatment of psychological disorders, conduct psychotherapy and diagnostic interviews Prescribe psychiatric drugs and use medical interventions such as (ECT) Treatment Methods Three major types of helping professionals: Social Worker Have earned a master’s degree in social work (M.S.W.) Knowledge of community agencies and organizations to help people with severe psychological disorders receive the services Conduct psychotherapy or specialize in couples or family therapy Treatment Methods Biological Therapies: Medication E CT Deep brain stimulation Treatment Methods Biological Therapies: Psychopharmacology Field of study that examines the effects of drugs on behaviour and psychological functioning Explores the use of psychoactive drugs in the treatment of emotional disorders Treatment Methods Biological Therapies: Medication Anti-Anxiety Drugs Anti-Psychotic Drugs Antidepressants Lithium Treatment Methods Biological Therapies: Electroconvulsive Therapy induction of a convulsive seizure by means of passing an electric current through the head; used primarily in the treatment of severe depression Deep Brain Stimulation involves implanting electrodes within the part of the brain that affects mood Treatment Methods Types of Psychotherapy: Psychodynamic Therapies Psychoanalysis the form of psychodynamic therapy originated by Sigmund Freud Psychoanalysts view psychological problems as rooted in early childhood experience Free Association Transference Modern Psychodynamic Approaches Treatment Methods Types of Psychotherapy: Behaviour Therapy Behaviour therapists apply the principles of learning to help clients make adaptive changes in their behaviour Focus is on changing behaviour not personality Therapy lasts from a few weeks to a few months Treatment Methods Types of Psychotherapy: Behaviour Therapy Systematic desensitization Gradual exposure Token economies Modelling Treatment Methods Types of Psychotherapy: Humanistic-Existential Therapies Person-centred therapy Emotion-focused therapy Treatment Methods Types of Psychotherapy: Cognitive-Behaviour Therapies Focus on helping clients identify and correct maladaptive beliefs, automatic types of thinking, and self-defeating attitudes Negative emotions such as anxiety and depression are caused by the interpretations placed on troubling events, not by the events themselves Treatment Methods Types of Psychotherapy: Cognitive-Behaviour Therapies Rational Emotive Therapy Beck’s Cognitive Therapy Meichenbaum’s Cognitive-behavioural Therapy Treatment Methods Types of Psychotherapy: Eclectic Therapy Group, Family, and Couple Therapy Computer-Assisted Therapy Treatment Methods Types of Psychotherapy: Indigenous Healing Perspective Mental wellness a balance of physical, mental, emotional and spiritual Mental wellness as a continuum from minimal to optimal Mental wellness as multileveled: individual, family, community Treatment Methods Does Psychotherapy Work? The combined results of hundreds of controlled studies comparing various types of therapies (psychodynamic, behavioural, humanistic, etc.) against control groups showed that the average psychotherapy client in these studies was better off than 75–80% of the clients who remained untreated Abnormal Psychology and Society Abnormal Psychology & Society Civil versus Legal Commitment: Civil commitment (Psychiatric commitment) Legal process involved in placing an individual in a psychiatric institution, even against their will Individuals deemed to be mentally disordered and a threat to themselves or others may be involuntarily confined to psychiatric institutions to provide them with treatment and help ensure their own safety and that of others Abnormal Psychology & Society Civil versus Legal Commitment: Legal commitment (Criminal commitment) Legal process involved in confining a person found “not criminally responsible” on account of a mental disorder in a psychiatric institution Abnormal Psychology & Society Predicting Dangerousness: Who is most dangerous? The drunk driver? The institutionalized psychiatric patient? The scheming corporate executive? Abnormal Psychology & Society Duty to Warn: Confidentiality principle of safeguarding information so that it remains secret and is not disclosed to other parties Duty to Warn obligation imposed on therapists to warn third parties of threats made against them by the therapists’ clients Abnormal Psychology & Society Tarasoff case (1976) “the protective privilege ends where public peril begins” 3 conditions sufficient to impose duty to warn (a) special relationship (b) a reasonable prediction of conduct that constitutes danger, and (c) a foreseeable victim (even when victim is not specifically named) Truscott & Crook, 2022 Abnormal Psychology & Society Patients’ Rights: Right to Treatment Right to Refuse Treatment Abnormal Psychology & Society Mental Illness and Criminal Responsibility: The Insanity Defence defendant in a criminal case pleads guilty but not criminally responsible on the basis of having a mental disorder Not criminally responsible on account of a mental disorder” (NCRMD) Not Criminally Responsible Reform Act (2014) Abnormal Psychology & Society Mental Illness and Criminal Responsibility: Competency to Stand Trial In Canada, a judge can order compulsory treatment if the defendant in a criminal trial is found unfit to stand trial due to a mental disorder Outcomes Revisited It is now the end of class, and you should be: Able to identify, describe, and apply: Methods of Assessment Approaches to classification Approaches to treatment Abnormal behaviour and society