Controversial Issues Exam 2 Part 5

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Controversial Issues Exam 2 Part 5
2012-03-26 02:42:11
Controversial Issues Exam Part

Controversial Issues Exam 2 Part 5
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  1. Is the DSM-IV a useful classification system
    Frances, First, and Pinus vs. Kutchins and Kirk
  2. Carefully done
    Frances et al. defned the reliability of DSM-IV by citing that 6,000 patients were evaluated at 70 sites by several hundred raters.
  3. DSM and the OCD
    DSM is used primarily is the US. Other countries rely on the pstchiatric section of the ICD ( International calssification of General Medical Disorders). Frances et al. claim that DSM is compatible with both ICD 9 and the newer ICD 10
  4. Syndrome
    a group of symptoms that ten to co-occur. Most of the DSM diagnoses are syndromes and, therefore, constitute diagnostic "catergories"
  5. Dimensional System vs. Categorical System
    • Many professionals, including Dr. R, would perfer dimensional system over DSM catergorical systems. Dimensional systems:
    • 1. improve reliability over catergorical systems
    • 2. retain precise information that is lost when categories are used
  6. Dimensional Acceptance
    Frances et al. acknowledge that dimensional approaches may be more widely accepted as we learn more about them
  7. Kutchins and kirk
    • Say political issues help shape changes in DSM, they say
    • 1. Gay activites ojecting homosexuality as a diagnosis
    • 2. Vietnam veterans wanting the PTSD diagnosis
    • 3. Feminist objecting to proposed categories such as paraphiliac rapism, sadisitc personalitiy disorder, and what is now PMDD or premenstral dysphoric disorder
  8. Too big
    According to Kutchins and kirk
    DSM is over 50% longer tgan DAM-III- at the 900+ pages
  9. Confusing the issue? Kuthcins and Kirk see the DSM-IV as
    • 1. Complicated to use
    • 2. time consuming
  10. Relaxed Rules
    Accd to Kutchins and Kirk, full criteria are not needed for a diagnosis, leading to sloppier practice
  11. Cahanging the face of DSM
    DSm I (1952) was heavily influenced by Freudian theory, making frequent use of workds like reaction and neurosis. Over the years, it has moved away from psychoanalytic thinking terminologies. One would be hard pressed to find the word neursis in DSM-IV. Not bad , just a fact
  12. American Automobile Industry
    Kutchins and kirk compared DSM to the auto industry , suggesting that is has become so big and cumbersome that it is doomed to eventual failure. It even has an extensive set of assesories
  13. Dr. R thoughts 1
    For such a big text, it is just a guide with criteria not being required for diagnosis
  14. Dr. R thoughts 2
    Many professionals dont fully know or use the criteria for even the most frequently diagnosised conditions, instead basing on their experience and impressions
  15. Dr. R thoughts 3
    personality disorders are known for having particulary poor relaibiity and vailidty
  16. Dr. R thoughts 4
    Comorbidty Problem - individuals having many multiple diagosis adds complexcity and makes the prevalence of various conditions appear to be higher than they actually are