Abnormal Psychology
Dr. David M. McCord
Assessment and Diagnosis
• Assessment
– What are the problems, what caused them,
what are we going to do about them
• Diagnosis
– The art and science of determining the nature
of a disorder and differentiating it from other
disorders
• Purposes
– To gather info that will help explain etiology
– To predict progress and outcome (prognosis)
– To plan the most appropriate methods of
treatment
Symptoms, Syndromes (patterns of symptoms)
Brief History of Diagnostic Systems
• Hippocrates – mania, melancholia,
phrenitis, hysteria
• Paracelsus – “insanity” – 1500’s
• Morel (1809-1873) – Dementia Praecox
• Kraepelin (1855-1925) 1st major diagnostic
system
• Meyer (1866-1950) introduced Kraepelin’s
system to America
• Eugen Bleuler (1857-1939) schizophrenia
• DSM – 1952
• DSM II – 1968
------------------------• DSM III – 1980
• DSM III R – 1987
• DSM IV – 1994
• Axis I – Clinical disorders
• Axis II – Personality Disorders and Mental
Retardation
• Axis III – General medical conditions
• Axis IV – Psychosocial and Environmental
Problems
• Axis V - Global Assessment of Functioning
• Axis I – Clinical disorders
– Disorders Usually First Diagnosed in Infancy,
Childhood, or Adolescence
– Substance-Related Disorders
– Schizophrenias and other Psychoses
– Mood Disorders
– Somatoform, Factitious, & Dissociative
– Sexual and Gender Identity
– Eating, Sleep, Impulse Control Disorders
– Adjustment Disorders
• Axis II
– Personality Disorders
• Paranoid, Schizoid, Schizotypal
• Antisocial, Borderline, Histrionic, Narcissistic
• Avoidant, Dependent, Obsessive-Compulsive
– Mental Retardation
• Mild, Moderate, Severe, Profound
• Axis III – General Medical Conditions
– Examples: infectious and parasitic diseases,
– Tumors and cancers
– Blood, circulatory, respiratory diseases
– Digestive system disorders
– Genitourinary system disorders
– Skin, musculoskeletal, joint problems
– Congenital anomalies
• Axis IV – Psychosocial and environmental
problems
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With primary support group
Related to social environment
Educational problems
Occupational problems
Housing problems
Economic problems
Access to health care services
Related to interaction with legal system
• Axis V – Global Assessment of
Functioning
Consider psychological, social, and
occupational functioning on a hypothetical
continuum of mental health – illness: 0 to 100.
Don’t include problems due to physical or
environmental limitations.
Axis I 296.23
305.00
Axis II 301.6
Axis III
Axis IV
Axis V
Major Depressive Disorder, Single
Episode, Severe Without Psychotic
Features
Alcohol Abuse
Dependent Personality Disorder
None
Threat of job loss
GAF = 35 (current)
Axis I 300.40
315.00
Axis II V71.09
Axis III
Axis IV
Axis V
Dysthymic Disorder
Reading Disorder
No diagnosis
Otitis media, recurrent
Victim of child neglect
GAF = 53 (current)
• Problems with labeling
• Advantages
• The Rosenhan study 1973
– “On being sane in insane places”
• Introduction and Reason for Referral
• Background history
– Intelligence testing (cognitive abilities)
– Achievement testing
– Neuropsychological screening
– Personality traits
– Emotional characteristics
– Behavioral tendencies
• Summary and Conclusions
• Recommendations
• Projective tests
– Projective hypothesis
– TAT, Rorschach, DAP
• Personality Inventories
– MMPI-2
• (Research chapter from website)