PSYB32H3 Chapter 3: (b) History and Issues in the Classification of Abnormal Behaviour (DSM-5)
3 Jun 2018
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CHAPTER 3
3.4 - Diagnosis: Why It Matters
• arriving at the correct diagnosis is fundamentally important and a key first step in
deciding the appropriate course of treatment.
• Diagnostic and Statistical Manual of Mental Disorders (DSM) = A publication of the
American Psychiatric Association that is an attempt to delineate specific and discrete
syndromes or mental disorders - current one is the fifth edition (DSM-5).
3.5 - A Brief History of Classification
• Multiaxial classification = Classification having several dimensions, each of which is
employed in categorizing. In the DSM-IV, five axes were used in the communication of a
diagnosis. The multiaxial system was removed in the DSM-5.
• Mental disorder = A behavioural or psychological syndrome associated with current
distress and/or disability.
• DSM-5 provides the following definition:
o “A syndrome characterized by clinically significant disturbance in individual’s
cognition, emotion regulation, or behavior that reflects a dysfunction in the
psychological, biological, or developmental processes underlying mental
functioning. Mental disorders are usually associated with significant distress or
disability in social, occupational, or other important activities.”
3.6 - Issues in the Classification of Abnormal Behaviour
• Some critics of classification argue that to classify someone as depressed or anxious
results in a loss of information about that person, thereby reducing some of the
uniqueness of the individual being studied
• The DSM represents a categorical classification, a yes-no approach to classification
o Categorical classification = An approach to assessment in which the basic
decision is whether a person is or is not a member of a discrete grouping.
• Dimensional classification = An approach to assessment according to which a person is
placed on a continuum.
o entities or objects being classified must be ranked on a quantitative dimension
(e.g., a 1-to-10 scale of anxiety, where 1 represents minimal and 10 extreme)
o allows for the possibility that certain individuals may experience a number of
troubling symptoms of a disorder but not meet the number of symptoms required
for an actual diagnosis
• The 2 components of reliability—agreeing on who is a member of a class and who is not:
o Sensitivity = An element of diagnostic reliability that reflects the agreement
between assessors regarding the presence of a specific diagnosis.
o Specificity = An element of diagnostic reliability that reflects the agreement
between assessors concerning the absence of a specific diagnosis.
• Kappa = A statistic that reflects the extent to which two or more raters select the same
category when evaluating a person. In psychology, it is the extent to which two clinicians
agree about diagnoses when evaluating the same people.
• How valid are diagnostic categories? → construct validity
o diagnoses of the DSM are referred to as hypothetical constructs because they
are inferred, not proven, entities
o In the case of diabetes, we know the symptoms, the biological malfunction that
produces them, and some of the causes. For schizophrenia, we have a proposed
Document Summary
American psychiatric association that is an attempt to delineate specific and discrete syndromes or mental disorders - current one is the fifth edition (dsm-5). 3. 5 - a brief history of classification: multiaxial classification = classification having several dimensions, each of which is employed in categorizing. In the dsm-iv, five axes were used in the communication of a diagnosis. The multiaxial system was removed in the dsm-5: mental disorder = a behavioural or psychological syndrome associated with current distress and/or disability, dsm-5 provides the following definition: A syndrome characterized by clinically significant disturbance in individual"s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. Construct validity: diagnoses of the dsm are referred to as hypothetical constructs because they are inferred, not proven, entities.
