Announcements
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Clinical treatment writing assignment
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2.
Choose a topic—some child problem (e.g. sleep problem, ADHD,
autism, etc.)
Research the treatments for that problem. Can use a variety of
sources but need to document and cite.
From the perspective of a parent, choose the treatment that you
would prefer if your child had this problem. Justify and explain your
choice.
Proofread carefully! Look for typos, grammar errors, consider
organization of paper, need intro. paragraph and conclusion.
Cite references using APA style.
Parent interview – bring your results to next class
Classification
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We have Diagnostic & Statistical Manual
(DSM-IV-TR)
Why have such a system?
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Communication
Summarize
Identify treatment strategies
Facilitate research
Etiology/prognosis
Potential problems with
classification
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Stigma
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Self-fulfilling prophecy
Overlook important factors
Labeling effects
Focus on weaknesses
Lose information
**importance of person-first language
Approaches to classification
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Empirical Approach
Clinical Approach
Empirical Approach
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relies on factor analysis
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No initial assumptions about which symptoms go
together
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No initial assumptions about what diagnostic
categories exist
Empirical Approach
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Example: our very own Milich et al. (1982)
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90 boys
Trained judges to rate boys on behavioral symptoms (see
overhead)
Factor analysis revealed 3 factors
Example: Achenbach’s Child Behavior Checklist
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Rating scale of 100 most commonly reported problems
8 factors (see overhead) with some variability
General Information on
Categorization
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Based on Achenbach
Two broad categories
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Externalizing – undercontrolled
Internalizing – overcontrolled
Good reliability and validity evidence
Narrow band factors
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Often specific to age, gender, and setting
Some debate: e.g. anxiety vs. depression
Strengths of empirical classification
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Avoids bias to which clinicians are
susceptible
Quantitative approach to decision making
Allows for evaluation of differing
perspectives
Limitations of empirical approach
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Implementation
Limitations of data going into factor analysis
Does not identify rare disorders
Clinically Derived systems
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Relies on experts in the field
Experts use their clinical observations
Some compromise involved
Example: DSM systems
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Symptom based
DSM systems
Strengths:
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Breadth of coverage
Operational criteria
Includes exclusionary criteria
No attempt to identify etiology
Weaknesses
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Fails to recognize interactions with environment
Some poor operational definitions e.g. “often”
Lacks developmental framework
All or nothing approach
DSM-IV
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Attempted to integrate empirical and clinical
approaches
Used experts but also
Used literature reviews
Field trials
Writing Assignment
Briefly describe the next study to be done
following Milich et al. (1992). Why would you
do this study? Describe the design of the study.
What would this study tell us and why is this
important?