SYLLABUS:
Psychology 5309
Graduate Seminar in Psychopathology
Meetings:
Tuesdays and Thursdays 3:00-4:20
Instructor: Dr. James Wood
Psychology 203
Phone: 747-6570
E-mail: jawood@utep.edu
Website: http://utminers.utep.edu/jawood
Office Hours:
Thursdays 8:00-10:00 a.m. or by appointment
Texts:
American Psychiatric Association (2000). Desk reference to the diagnostic
criteria from DSM-IV-TR. Fourth Edition, Text Revision. Washington,
DC: Author.
Davison, G. C., & Neale, J. M. (2001).
York: John Wiley & Sons.
Abnormal Psychology
(8th ed.).
New
Othmer, E., & Othmer, S. C. (2002). The Clinical Interview Using DSM-IV-TR.
Volume 1: Fundamentals. Washington, DC: American Psychiatric Press.
Meehl, P. E. (1973). Why I do not attend case conferences. In
Psychodiagnosis: Selected Papers. Minneapolis: University of Minnesota
Press. (The article by Meehl (1973) will be available later in the
semester in the UTEP library copy center).
Structured Clinical Interview for the DSM-IV. (The instructor will hand out
copies of the SCID-IV later in the semester).
READINGS (must be completed by the dates given)
January 20
Davison & Neale:
Chapter 1. Introduction: Historical and Scientific
Considerations.
Chapter 2. Current Paradigms in Psychopathology and
Therapy.
Chapter 3. Classification and Diagnosis.
Chapter 4. Clinical Assessment Procedures.
DSM-IV-TR Desk Reference:
Read all materials prior to the sections on “Diagnostic
Categories”, including Introduction, Cautionary Statement,
DSM-IV-TR Classification, Use of This Manual
January 27
Davison & Neale:
Chapter 5: Research Methods in the Study of Abnormal
Behavior.
Chapter 11: Schizophrenia
Here and for all further assignments, read relevant sections of
DSM-IV-TR Desk Reference
February 3
February 10
February 17
February 24
March 2
March 10
March 13-21
Davison & Neale:
Chapter 10: Mood Disorders
Davison & Neale:
Chapter 6: Anxiety Disorders
Davison & Neale:
Chapter 7: Somatoform and Dissociative Disorders
Chapter 8: Psychophysiological Disorders and Health
Psychology
Chapter 9: Eating Disorders
Davison & Neale:
Chapter 13: Personality Disorders
Chapter 12: Substance-Related Disorders
Davison & Neale:
Chapter 14: Sexual and Gender Identity Disorders
Davison & Neale:
Chapter 15: Disorders of Childhood
Chapter 16: Aging and Psychological Disorders
Chapter 18: Legal and Ethical Issues
SPRING BREAK
March 23
Davison & Neale:
Chapter 18: Legal and Ethical Issues
March 25
MIDTERM
March 30
Othmer & Othmer, pp. 1-167
SCID handout
April 6
Othmer & Othmer, pp. 169-332.
SCID handout
April 13
Othmer & Othmer, pp. 333-473.
SCID handout
April 20
SCID handout
TAKE-HOME ASSIGNMENT IS DUE.
April 27
Meehl (1973).
May 6 (Thursday).
"Why I do not attend case conferences."
1:00-2:30 p.m.
FINAL
OBJECTIVES OF COURSE.
By completion of course, students will be able to
(1) demonstrate basic knowledge of psychopathology, including the
etiology, symptomatology, and course of psychological disorders;
(2) demonstrate thorough knowledge of the organization and logic of the
DSM-IV-TR, and of the criteria it provides for diagnosis of
psychological disorders;
(3) conduct diagnostic interviews and form appropriate diagnostic
opinions based on them.
Objective 1, psychopathology, will be emphasized up to the midterm.
Objective 3, diagnostic interviewing, will be emphasized after the midterm.
Objective 2, DSM-IV-TR, will be emphasized throughout the course.
PREREQUISITES
Students are presumed to have the background equivalent to an undergraduate
course in Abnormal Psychology.
APPROACH
This course will require a great deal of reading. The grading system is
designed to reward students for doing the readings promptly, carefully, and
thoughtfully.
The emphasis in the course is on preparing students to be knowledgeable and
competent diagnosticians.
SUGGESTIONS REGARDING THE READINGS
I advise you to read each assigned chapter in Davison and Neale (2001) at
least once, then make sure you understand the material covered in the
"Summary" and "Key Terms" at the end of the chapter. Quiz questions may cover
the following in Davison and Neale (2001):
(a) Questions on big, dramatic, memorable, or highly stressed points in
the text. For example, such questions might ask about certain anecdotes in
the text, or certain interesting points discussed in a graph or picture
caption. These questions are to check that you really did read the text, and
didn't simply read the Summary and Key Terms at the end of the chapter.
(b) Questions on important terms, concepts, or pieces of information in
the chapter. These questions are to check that you have grasped the most
important points in the book.
After reading about a particular set of disorders in Davison and Neale (2001),
you should then read the relevant sections of Desk Reference of the DSM-IV-TR.
The main purpose of reading the Desk Reference is to become knowlegable
regarding the precise diagnostic criteria for the disorders we are studying.
There is no way that you can remember all the diagnostic criteria for all the
disorders in the DSM-IV-TR. For a particular chapter, concentrate on the
following:
(a) Learn the names of the various disorders and their simple
definitions. For every disorder, you should be able to give a two or
three-sentence description of the disorder and its most important
features.
(b) Read the diagnostic criteria for each disorder. You aren't expected
to memorize them, but you should recognize and remember "big points"
about them. For example, you would be expected to know that the
criteria for a Major Depressive Episode exclude cases in which the
patient has been recently bereaved, or in which the symptoms are due to
the direct physiological effects of a drug of abuse or medication.
(c) You are expected to know more about major clinical syndromes than
about other disorders. For example, you are expected to know more
details about Schizophrenia, Major Depression or Panic Disorder than
about Stuttering. On a quiz, you might be asked more detailed questions
about Schizophrenia, but only a general question about Stuttering.
(d) For some disorders, the DSM-IV-TR explains how to designate certain
"specifiers." For example, there are several "specifiers" for
schizophrenia. You don't have to memorize these specifiers, but you
should definitely read about them and know approximately what they are
and when they are assigned. Some quiz questions may ask about these
specifiers.
(e) Some major clinical disorders are divided from each other by fine
definitional lines. You should take some time to understand what the
distinctions are. For example, what are the differences among
Schizophrenia, Schizoaffective Disorder, Brief Psychotic Disorder and
Schizophreniform Disorder? As another example, what are the differences
between Bipolar I Disorder and Bipolar II Disorder?
The readings from Othmer and Othmer (2002) that are assigned for the second
half of the course are fairly heavy. The instructor has provided you with a
separate handout that will help orient you to the readings by Othmer and
Othmer. You are also expected to read a chapter by Paul Meehl, "Why I Do Not
Attend Case Conferences," during the last week of the class. Questions from
this chapter may appear on a pop quiz or the final exam.
During the second half of the course, the instructor will hand out copies of
the Structured Clinical Interview for the DSM-IV (SCID). You are expected to
read this interview, familiarize yourself with the instructions, and do some
practice with it at home. Questions about the SCID may be included on the
weekly quizzes and on the final examination. There will probably be
opportunities to practice using the SCID in class.
GRADING:
Pop quizzes: There will be seven pop quizzes during the semester. There are
no make-ups for pop quizzes, so if you miss a pop quiz your grade will be 0.
At the end of the semester, the grades from your two lowest pop quizzes will
be dropped (if you have missed a pop quiz, it will probably be one of the
grades that is dropped), and the remaining five pop quizzes will be averaged
to compute your "pop quiz grade". This grade will count toward 70% of your
course grade.
The purpose of pop quizzes is to ensure that you do the readings on
time. So it is possible there will be a pop quiz on Schizophrenia on January
27, even if this topic has not been covered yet in class. A pop quiz will
normally cover only the readings due on the date in question, unless I’ve
announced otherwise beforehand. A typical pop quiz will be fill-in-the-blank,
with some multiple choice questions, to see if you understood and remembered
the major points in the readings.
Mid-term and final: The mid-term examination will count toward 10% of your
grade. The mid-term examination will cover all readings and the lecture
material up to the time of the examination.
The final examination will count toward 10% of your grade. It will
focus on the readings and lecture material assigned after the mid-term.
However, some questions regarding diagnostic issues may require knowledge of
topics covered before the mid-term. To clarify: on the final, you may be
asked about topics covered before the midterm, but only so far as those topics
bear on diagnosis.
Paper: There will one brief paper assigned -- a case report that will not
require any research. This paper will count toward 10% of your grade.
OUTLINE OF SOME OF THE IDEAS IN
The Clinical Interview Using DSM-IV-TR. Vol. 1 Fundamentals
by Othmer & Othmer
FOUR COMPONENTS OF THE INTERVIEW
1.Rapport
(Building and Maintaining Rapport)
2.Techniques
(Techniques for Gathering Information)
3.Mental Status
(Assessing cognitive function)
4.Diagnosing
(The process of arriving at a diagnosis, or group of diagnoses)
FIVE PHASES OF THE INTERVIEW
1.Warm-up and screening of the problem
(Establishing rapport; observation; identification of presenting problems, symptoms)
2.Follow-up of preliminary impressions
(Detailed testing of hypotheses formed during step 1; arrival at provisional diagnoses)
3.History and database
(Gathering history relevant to provisional diagnoses; ruling out organic factors)
4.Diagnosis and feedback
(Screening for problems that have not yet been identified; Trying not to miss something
important)
5.Prognosis and treatment contract
(Conveying diagnostic impressions to patient in an appropriate way; Reaching agreement with
patient regarding short- or long-term plans)
The interaction of the four "components" with the five "steps" is portrayed in the diagram on
page 11, and in the table on page 291.
HINTS FOR STUDY OTHMER AND OTHMER
This is a wonderful book. It is simply crammed with good advice about interviewing and making
diagnoses. After you get out "in practice," you will probably want to look through it from time to
time for advice on the problems you encounter.
There are two drawbacks to the book, however. First, the authors describe interviewing from
two perspectives: the "descriptive" and the "psychodynamic." Their treatment of the
"descriptive" issues makes up 95% of the book and is quite good. Their treatment of the
"psychodynamic" issues is mercifully brief. For purposes of this class, you should read the whole
book, but just skim the parts that are "psychodynamic" (e.g. the discussion of "defenses").
The second drawback of the book is its organizational complexity. Interviewing and diagnosis
are complex topics, and I think that Othmer and Othmer do about as well as anyone could in
organizing the discussion. Nevertheless, you may get "lost" from time to time. Here is my
advice:
1. The "skeleton" of Othmer and Othmer's approach consists of the four components and the
five stages. If you ever get confused and start asking "Where am I? Why are the authors
discussing this topic now? Where does this section of the book fit in?", refer back to the four
components and the five stages. On the first page of this handout, I've listed the components and
stages. Also, I've given the page numbers for a diagram and table that will help you understand
how everything fits together.
2. It might be helpful to spend a few hours skimming the book from beginning to end before you
start tackling individual chapters. By skimming the book beforehand, you can get a picture of its
basic ideas and its organization. Once you get the "big picture," you will find the individual
chapters much more interesting.
3. Pay special attention to the Outlines that appear at the beginning of each chapter. After
reading each chapter, go back to the outline at the beginning of the chapter and make sure you
can explain everything in the outline. The quizzes are likely to ask you to explain the headings in
these outlines. For example, on page 13 there is an outline of the chapter on rapport. Quiz
questions might be something like this:
Explain what it means to be an "empathic listener."
If a client expresses distress non-verbally during an interview, what rapport-building technique is
suggested by Othmer and Othmer? (Answer: Respond with Empathy)
What is patient "insight"? What are the three levels of insight, according to Othmer and Othmer?
4. Some of the chapters simply contain too much detail to be memorized. For example,
"Chapter 5, Testing" describes numerous tests. There is simply no way for you to remember
what all these tests are and how to give them.
In clinical practice, however, you will need to know (a) that these tests exist, and (b) what they
are good for. From time to time, as a practicing clinician you will find yourself turning to this
book and saying something like, "I think this patient has memory problems. What do Othmer
and Othmer suggest I do for assessment?"
For this class, you should have at least a "nodding acquaintance" with the detailed subjects
discussed by Othmer and Othmer. For example, you should know what an aphasia is, and you
should be able to describe in a sentence or two the sort of tests that would be used to test for
aphasia. A quiz question might ask: "Describe in a sentence or two one of the tests used to
assess the presence of aphasia."
5. There are "checklists" at the end of some of the chapters. You should look through these
checklists to make sure that you understand (a) their logic, (b) their relationship to what has been
described in the text, and (c) all the vocabulary terms used in the checklist. The vocabulary
terms are important because they describe clinically important symptoms or signs that you will
need to know about in clinical practice.
For example, on pp. 160-167, the checklist refers to "athetotic movements," "choreatic
movements" "dysprosody," "perseveration," "tangentiality" and other such things. Make sure
you know what these words mean, and where they "fit into" the diagnostic picture (i.e.
dysprosody is a symptom of disordered speech; tangentiality is a symptom of disordered
thought).
6. At various points, Othmer and Othmer give excerpts from real clinical interviews. You should
pay attention to these excerpts, and be able to state why Othmer and Othmer have included them.
For example, on page 118 there is an excerpt in which the patient keeps responding "cereals." A
quiz might present you with this excerpt and ask what it illustrates (Answer: Perseveration).
7. At various points the text uses headings to organize the discussion. Pay special attention to
these headings. You do not have to memorize them. But as an example, a quiz might ask:
"There are five qualities of mood. Name any two of them." (See pp. 130 ff. for the answer). It
might be helpful to outline the chapters, or arrange with your classmates to do so.