T3: Classification and Assessment of AB

• Syndrome is a disease or disorder that involves a particular group of signs and symptoms.
• Signs are objective observation of the syndrome by a physician or clinician; these are visible externally. (e.g. weight loss, skin rash)
• Symptoms are subjective. It is the patient’s observation of the syndrome. It can only be described by the person feeling them.
• Disease results from a pathophysiological response to external or internal factors.
• Disorder is a disruption to the normal or regular functions in the body or a part of the body.
• Cornerstones of diagnosis and assessment are reliability, validity, and standardization.
• Reliability is one of the cornerstones of diagnosis and assessment which is the degree to which a measurement is consistent; producing same results.
• Interrater reliability is a degree which two independent observers agree on what they have observed.
• Test-retest reliability is an extent to which the same test is administered to the same participants on two or more occasions.
• Alternate-form reliability is an extent in which scores on the two forms of the test are consistent.
• Internal consistency reliability assesses whether the items on a test are related to one another.
• Validity is one of the cornerstones of diagnosis and assessment which is related to whether a measure measures what it is supposed to measure.
• Content Validity refers to whether a measure adequately samples the domain of interest.
• Criterion validity is evaluated by determining whether a measure is associated in an expected way with some other measure.
• Concurrent validity is a type of criterion validity that if both variables are measured at the same point in time.
• Predictive validity is a type of criterion validity that assesses by evaluating the ability of the measure to predict some other variable that is measured at some point in time in the future.
• Construct validity is viewed as an overarching concept that encompasses all other forms of validity.
• Standardization is one of the cornerstones of diagnosis and assessment which is a process by which a certain set of standards or norms is determined for a technique to make its use consistent across different measurements.
• Classification System aka Nomenclature is a set of definitions of syndromes and rules for determining when a patient’s symptoms are part of each syndrome.
• Classification systems presently used by clinicians are DSM-5 by APA and ICD-10 by WHO.
• ICD-10 is International Statistical Classification of Diseases and Related Health Problems.
• The 2 essential strategies in the study and treatment of psychopathology are idiographic strategy and nomothetic strategy.
• Categorical approach is one of the ways of classifying human behavior in which we assume that every diagnosis has a clear underlying pathophysiological cause, such as bacterial infection or malfunctioning endocrine system, and that each disorder is unique.
• Dimensional approach is one of the ways of classifying human behavior that describes the degree of an entity that is present (e.g. a 1-to-10 scale of anxiety, where 1 represents minimal and 10, extreme).
• Prototypical approach is one of the ways of classifying human behavior that identifies certain essential characteristics of an entity so that clinicians can classify it, but it also allows certain nonessential variations that do not necessarily change the classification.
• Requirements for diagnosis:

  1. Minimum number of symptoms
  2. Minimum duration
  3. Clinical significance of the symptom
• Level of Disorders

  • Sub-threshold, 1 or 2 requirements are not met.
  • Subsyndromal, number or duration of symptoms are lacking.
  • Subclinical, symptoms do not cause clinically significant distress or impairment.
• How to write a correct DSM-5 diagnosis?

  1. Determine the disorder that meets the criteria.
  2. Write the name of disorder.
  3. Add any subtype or specifiers of disorder.
  4. Add the ICD-10 code.
• Culture Bound Syndromes are ways that cultural groups experience, understand, and communicate suffering, behavioral problems, or troubling thoughts and emotions.
• Cultural Syndromes are type of cultural concepts that are clusters of symptoms and attributions that tend to co-occur among individuals in specific cultural groups, communities, or contexts.
• Cultural Idioms of Distress is a type of cultural concepts which are ways of expressing distress that may not involve specific symptoms or syndromes, but that provide collective, shared ways of experiencing and talking about personal or social concerns. (e.g. “nausog”)
• Cultural Explanations or Perceived Causes are type of cultural concept which is the labels, attributions, or features of an explanatory model that indicate culturally recognized meaning or etiology for symptoms, illness, or distress.
• Amok is an example of culture bound syndrome which mean “murderous frenzy”, is a dissociative episode that is characterized by a period of depression followed by an outburst of violent, aggressive, or homicidal behavior.
• Ataque de Nervios is an example of culture bound syndrome which is an idiom of distress principally reported among Latinos from the Caribbean but recognized among many Latin American and Latin Mediterranean groups. Commonly reported symptoms include uncontrollable shouting, attacks of crying, trembling, heat in the chest rising into the head, and verbal or physical aggression.
• Possession Syndrome is an example of culture bound syndrome which is an involuntary possession trance states that are very common presentations of emotional distress around the world.
• Shenjing Shuairuo is an example of culture bound syndrome which means “weakness of the nervous system”, that is a translation and cultural adaptation of the term “neurasthenia”, lack of nerve strength. It is a syndrome of lassitude, pain, poor concentration, headache, irritability, dizziness, insomnia, and over 50 symptoms.
• Koru is an example of culture bound syndrome which is an episode of intense anxiety about the possibility that the penis or nipples will recede into the body, possibly leading to death.
• Hikikomori (withdrawal) is an example of culture bound syndrome which refers to a syndrome observed in Japan, Taiwan, and South Korea in which an individual, most often an adolescent boy or young adult man, shuts himself into a room (e.g. bedroom) for a period of 6 months or more and does not socialize with anyone outside the room.
• Taijin Kyofusho is an example of culture bound syndrome which is a Japanese culture-specific syndrome. This is the fear of interpersonal relations.
• Distal/Predisposing Cause is a causal factor which is anything that produces a susceptibility or disposition to a condition without actually eliciting it.