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Diagnosis and Classification of Psychological Problems. Definitions of Abnormal Behavior. Conformity to norms: Statistical Infrequency or Violation of Social Norms Subjective distress Disability or dysfunction. Conformity to norms: Statistical Infrequency or Violation of Social Norms.
Cutoff points are quantitative
Social norms seem obvious and have intuitive appeal
There are few guidelines for establishing cutoff scores
Number of deviations
Cultural relativityConformity to norms: Statistical Infrequency or Violation of Social Norms
A behavior or symptoms are abnormal if they causes the person distress?
Individuals who may be distressed “inside” but not outwardly suffering, can be identified (can’t tell by looking)
Not all pathology causes distress (e.g. conduct disorder or psychoses)
Difficult to determine the amount of subjective distress is needed to be labeled abnormal?Subjective distress
…The most widely accepted definition used in DSM-IV-TR describes behavioral, emotional or cognitive dysfunctions that are unexpected in their cultural context and associated with personal distress or substantial impairment in functioning.
ICD-10: current system developed in 1990
In 1952 the American Psychiatric Association developed and published its own Diagnostic and Statistical Manual
DSM-IV-TR was published in 2000Current Diagnostic Systems
DSM-II (1968). Expanded list to 145 diagnostic categories but very similar to first manual in form
DSM-III (1980) Introduced many important changes (see next slide)
DSM-IV-TR (2000)Diagnostic and Statistical Manual: A Brief History
Not based on a specific theory
Presented explicit diagnostic criteria
The specificity of diagnostic criteria made it possible to examine the reliability and validity of diagnostic categories
Personality disorders and developmental disorders
Physical conditions (e.g. diabetes)
Severity of psychosocial stressors
Highest level of adaptive functioning in the past yearDSM-III and DSM-III-R
Revisions were based on empirical data generated by DSM-III and DSM-III-R
Axis IV: Rating of severity of stressors changed to a checklist
Axis V ratings changed to GAF (Global Assessment of Functioning)
1=Markedly poor functioning
90= Superior functioning
Only changes in the descriptions of some of the disordersDSM-IV and DSM-IV-TR
Axis I: Clinical Disorders
Axis II: Personality Disorders
Axis III: General Medical
Axis IV: Contributing Problems
Axis V: Rating of Functioning
Sex Bias in the Diagnosis of Borderline Personality Disorder and Posttraumatic Stress Disorder (Becker and Lam, 1994)
Clinicians rated female clients higher for applicability of BPD diagnosis than male clients
Rosenhan’s On Being Sane in Insane Places