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CLP 6169, Week 3 Notes

by: Jadenole

CLP 6169, Week 3 Notes CLP 6169

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Lecture notes for week 3.
Adult Development and Psychopathology
Dr. E
Class Notes
Psychopathology; Adult Development; psychology
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This 3 page Class Notes was uploaded by Jadenole on Wednesday January 6, 2016. The Class Notes belongs to CLP 6169 at Florida State University taught by Dr. E in Spring 2016. Since its upload, it has received 20 views. For similar materials see Adult Development and Psychopathology in Language at Florida State University.


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Date Created: 01/06/16
Lecture 3: Diagnosis and the DSM-5 Using the DSM-5:  Symptoms are what the client reports or complains about  Signs are what the therapist observes Diagnosis - Is it Necessary?  Insurance often requires diagnosis o However, if diagnosis does not impact treatment, it may not be necessary  Clinical significance: symptoms or dysfunction that warrant diagnosis What is Abnormal?  Pay attention to the client’s affect: emotions, moods, facial expressions, and nonverbals  Ask yourself, what is the client getting with these thoughts, feelings, or behaviors? o Maladaptive: Not doing what you should to get what you want or need  Social expectations: may not be a good measure of normal vs. abnormal. Social expectation are culturally exclusive o It was not until the late 1960’s that homosexuality was removed from the DSM  Be aware of distress or discomfort towards self or others in the environment Additions and Revisions to the DSM-5:  The DSM-IVTR did not include the advanced research we have now – more empirical evidence, assessments, and genetic test information was added  ICD-10-CM: coding used for medical and mental diagnoses across various fields o The DSM-5 aligns with these because we don’t want competing diagnostic tools o Facilitates communication between different professions and is necessary for research  The DSM-5 was almost not released because the American Psychiatric Association couldn’t come to a vote  Consider the impact of pressure from major pharmaceutical companies (big $) o Example: wanting certain symptoms to be added to fit their medication  Two codes listed for each disorder: one in bold font and one in parentheses o Parentheses code is the ICD-10-CM code  Categorical: you either have a diagnosis or not (presence or absence) o Better for research purposes – easier to analyze data  Dimensional: classify on quantitative continuum; diagnosing on a spectrum or range o Example: mild, moderate, or severe o Example 2: Pain scale 1-10  It was discovered that about 30% of diagnoses were NOS (not otherwise specified) – from the DSM-IV o Meeting some, but not all of criteria – enough to give a diagnosis  Neurodevelopmental disorders used to be known as childhood disorders because they manifest early in life o The organization of the DSM-5 starts with disorders that develop early Definition of a Mental Disorder:  “Usually associated with significant distress or disability in social, occupational, or other important activities.” (PowerPoint) o This is not always the case - some clients flourish with diagnosis  Social deviance: engaging in criminal activity does not mean you have a mental disorder  If the deviance or conflict results from the dysfunction caused by a disorder, the diagnosis is necessary (Ex: A client with a substance abuse disorder constantly gets into fights) Recording a Diagnosis:  Example: F33.2 (pg 162) Major Depressive Disorder, recurrent episode (PowerPoint)  Subtypes: you can’t be in more than one – must be in a type. Mutually exclusive and jointly exhaustive subgroupings within a diagnosis  Specifiers – including features, giving more specific information about the diagnosis  Provisional diagnoses: used in place of “rule out” system. Use when you are pretty sure that a client will meet the criteria for a certain disorder  Other specified and unspecified disorders used in place of “Not Otherwise Specified” o Other Specified: Insufficient symptoms to meet full criteria, but mostly fit within that category o Unspecified: more vague, not explaining symptoms as much Cultural Factors:  Example of cultural phenomenon: “roots” or being “rooted”: form of southern voodoo bringing on mental illness o Treatment was not effective when “roots” were not incorporated or acknowledged  Certain behaviors may be seen as acceptable in the individual’s culture, but the practitioner may see it as requiring diagnosis o Ex: Having visions, enduring a certain amount of suffering, etc.  Culture impacts what is extreme and what is not, and could be the reason behind what we cannot seem to understand (why someone did what they did, or behaves a certain way) DSM-V Disorders:  Not empirically proven: DMDD, PDD, Asperger’s Disorder, and Substance Abuse o Not enough evidence to add the disorders o Asperger’s Disorder and Substance Abuse were retired after the DSM- IV o Substance Abuse is now broken into several “substance use” categories  The number of diagnostic categories and the number of disorders have increased over the different versions of the DSM o There are now 20 categories and 365 disorders in the DSM-V (PowerPoint)  The NIMH voted not to include the DSM-V in their research – may be a sign that we could be moving away from the DSM in the future Differential Diagnosis:  Eliminate alternative disorders, do a complete case history and medical history o Rule out substance use, which could be causing the symptoms  Malingering: client is trying to manipulate practitioner into giving them a certain diagnosis to get something from it (Example: obtaining medication, or getting out of criminal charges) o Using language that is overly clinical, saying they have all symptoms  There are cases where drug use (even one time) can trigger mental illness – these individuals may have a genetic predisposition for mental illness and substance use brings it out o The drug wears off (out of the person’s system), but the abnormal behavior and/or cognitions are still present and stick with the individual  Substance use and other forms of mental illness can be comorbid – dual diagnoses. These clients are often the hardest to treat Before Diagnostic Interview:  Read the case files – any background information that you already have  Brush up on the DSM criteria, so you know what to look for  However, you want to avoid asking questions that will confirm diagnosis (Confirmatory Bias Effect) and using your first impressions of the client (Halo Effect) Preparing for an Interview:  Maintain professional distance when conducting interview – not appearing to be a friend or like you are on a “first date.” Know your needs, problems, biases, and blind spots as a counselor. Also be sure not to work with family or loved ones (cannot be objective)  Be aware of environmental factors that could be dangerous or distracting when working with inpatient clients  People with psychiatric issues can be hypersensitive to nonverbal behavior  Be aware of abrupt changes in a person’s demeanor


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