Introduction to Clinical and Counselling Psychology 04
-
Upload
ram-lifschitz -
Category
Documents
-
view
229 -
download
0
Transcript of Introduction to Clinical and Counselling Psychology 04
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
1/33
Diagnosis & Classification
Zoltan Kovary PhD
ELTE PPK
Department of Clinical Psychology and Addictology
20!"# A$t$mn %emester
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
2/33
%etch for today's lect$re
(ormality & pathology
The theoretical)$estions of ta*onomy
(osologic systems +istrorical ,acgro$nd
Contemporary systems Diagnostic -or & tools
in clinical psychology
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
3/33
The )$estions of normality& pathology
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
4/33
(ormality and pathology./
. has different interpretations edical
1$ristic %tatistical oral
./are relative n time n space
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
5/33
The criteria forpsychological normality
A,illity to adapt A,ility to en3oy
nterpersonalcompetence
ntellect Emotional and
motivational controland stress tolerance
%ocial attit$des4empathy5 intimity
Prod$ctivity A$tonomy and self
confidence Positive self image
ntegrity
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
6/33
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
7/33
Criteria for a,normal mentalf$nctioning & ,ehavior4 the 6 Ds
ental f$nctioning and
,ehavior are a,normalif it's.Deviant
Ca$sing DistressDisfunctional
Dangerous
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
8/33
What is dysfunctional in the cases ofdisorders?
Etiological models of mental disorders
7rganic",iological"medicalmodel 8rain f$nctioning
Dynamic model Personality"character
8ehaviorist model 8ehavior
Cognitive model
nformation processing Phenomenological model
%ym,oli9ation of e*periences
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
9/33
What kind of illneses are mentaldisorders?
Classic /big diseasecategories
%pecific etiology :ell o$tlined
symptomatology Typical clinical co$rse 7$tlined prognosis
;eporta,le changesSomatic illnesses
Small diseasecategories
Diverse etiology %imilar symptomatology %imilar clinical co$rse ore or less predicta,le
prognosis
Detecta,le changes arenot al-ays
Mental illneses/disorders
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
10/33
Ta*onomy4
the )$estions ofclassification
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
11/33
Classication of mentaldisorders
Paradigms
Clinical testa,ility
E*plicit criteria for disorders Concentration of informations
Ed$cation5 research5 statistics
Principles Classifia,le
$t$ally e*cl$sive categories %eparated
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
12/33
Historical development ofdiagnostic categories
+ippocrat
Mania, hysteria
(e$rosis
:illiam C$llen @/th cent/B
?re$d @20th cent$ryB
Actual neuroses Psychoneuroses
Psychosis
Emil Kraepelin @th cent/B Dementia praecox, PMD
E$gene 8le$ler @20th cent/B
Schizophrenia Personality disorder
K$rt %chneider Characteropathia
?ran9 Ale*ander Characterneuroses
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
13/33
?re$d's contri,$tion
Actual neuroses
(e$rasthenia
An*iety ne$roses
+ipochondria
Psychoneuroses +ysteria 7,sessional ne$roses
An*iety hysteria @pho,iaB
Narcissistic neuroses @paraphreniaB
Paranoia
Dementia praeco* @sch/B
Traumatic neuroses
Characterne$roses @?/ Ale*anderB
Pathone$roses @?erenc9iB
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
14/33
Contemporary nosologic
systems
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
15/33
International Classication of
Diseases
CD 4 # A ,rief description of mental
dist$r,ances CD 04 2
($m,er of categories increased Tighter criteria Coding system ,ased on
n$m,ers ore precise differentiation of
s$,gro$ps Class9ic categories
(e$rosis (e$rasthenia
(o itemi9ed diagnosticcriteria
CD is coming in 20
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
16/33
Categories of mental and,ehavior disorders in CD 0
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
17/33
D! " I# D% 4 !2 D% 4 0
Descriptive clinical categories temi9ed5 e*plicit5 operational
criteria (e$rosis re3ected
D% 4 6 $ltia*ial diagnostics4
/ Clinical disorder
/ Personality disorders"mental
retardation / %omatic state
/ Psychosocial and environmentalpro,lems
/ =lo,al Assessment of ?$nctioning@=A? FB
D% 4 20G $pdate
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
18/33
Categories of D%
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
19/33
$e% diagnostic categoriesin D! #
Comple* posttra$matic stressdisorder
Depressive personalitydisorder
(egativistic @passiveHagressiveB personalitydisorder
7lfactory ;eference %yndrome ;elational Disorder
%in Picing Disorder 8inge Eating Disorder
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
20/33
=ro$ps of disorders in D%
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
21/33
Contradictions in psychiatricdiagnosing and their handling
$ltiple diagnosesI $ltia*ial diagnosis
D% J
Comor,idity theory %pectr$m & contin$$m
approaches
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
22/33
The mood spectr$m & disorders
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
23/33
The contin$$m hypothesis of eatingdisorders according to andereycen
Anorexia
Hiperoxi
a
&ulimianervosa
Dieting"starving
elf"inducedvomiting
'sing prgative
(lean"fat)persons
ta*lee+tremeo*esity
Extreme leanness Normal weight Extremeobesity
BulimarexiaAnorexiaNervosa
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
24/33
Psychodynamic approach to clinical diagnosis.
Kernbergs personality organization model
Temperament Introversion vs extraversion
Personality organization
Psychotic psychotic disorders Borderline severe personality disorders!
perversions! addictions
(Intermediate" mild personality disorders
Neurotic symptomatic neuroses
#riteria o$ personality organization
%atureness o$ ob&ect relations 'tability o$ sel$(identity
Personality structure ) $unctions 'uperego*$unctions
+go*$unctions
Id sympotoms
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
25/33
organi-ations and personalitydisorders
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
26/33
The diagnostic -or in
clinical psychology
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
27/33
Diagnosis and diagnostics
Diagnosis The identification of the nat$re
and ca$se of a certain
phenomenon Diagnostics
%cientific discipline
The process of diagnosing Diagnosis and
differentialdiagnosis Prognosis ndication and contraindication
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
28/33
The differences ,et-een psychaitric andpsychological"psychotherape$tic diagnosis
Psychiatric diagnosis
Diagnostic classification
Treatment plan
Process of treatment
Psychological/psycho-therapeutic diagnosis
st level Psychiatric diagnosis
ndication
2nd level Personality str$ct$re & dynamics
Prognosis H ndication
Grd level ;ating s$ita,ility for
psychotherapy otivational5 relationship5
s$ita,ilty5 matching5 environmentaletc/ diagnoses
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
29/33
The process of diagnosing inclinical"psychoterape$tic -or
s$ally the first phase of the therape$ticprocess @H! occ/B
The $nity of diagnosis5 prognosis andindication
The role of the psychologist"therapist
The role of the relationship
The role of time
The )$estion of depth
The therape$tic effects of the diagnosticphase
Psychoed$cation 8$ilding relationship %pecific"nonspecific effects
Th t l f li i l
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
30/33
The tools of clinicalpsychodiagnostics
:hat can -e $seI Depends on the.
nstit$tional ,acgro$nd
Diagnostic targets
Clinical question(sB
Tools of diagnostics ntervie-"e*ploration
8ehavioral diagnostics
Psychological tests
Plan of diagnostic process ntervie-"e*ploration
Test ,attery Performance tests T+E( personality tests
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
31/33
E*ploration"intervie-
8asic tool of assessment Contains the story of.
the disease @cross sectionB The -hole life @longit$dinal
sectionB 8asic forms
nstr$ct$red %emiHstr$ct$red
%tr$ct$red ersions
?irst intervie- @psychotherapyB
%$rvey intervie- Psychodynamic Cognitive etc/
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
32/33
8ehavioral diagnostics
7,3ectively o,servea,le ,ehavior 7,servations dentifing -ellHdefined $nits
pro,lem ,ehaviors :hat does he"she doI
:hat doesn't he"she doI
Doesn't identify personality traitsor inner str$ct$re & dynamics
mportance of relationship -ith
the environment Time dynamics of formation
! " (S# $# C# C%
-
7/24/2019 Introduction to Clinical and Counselling Psychology 04
33/33
Tes9tvi9sglato
Performance tests
?oc$sing on partic$lar
f$nctions emory
Attention
ntelligence tests M
;aven Progressive atri* ntelligence str$ct$re
:echsler test
Personality tests
7,3ective tests %cales5 simple inventories
8D
Comple* tests P
Pro3ective tests
Associative @;orschachB Choice @%9ondiB Completion @P?TB Constr$ctive @TATB E*pressive @Dra-ing testsB