1. Child Psychopathology Family factors Assessment and Diagnosis Reading for today: Chapter 4

2. Family and society What is the family context of a child? The broader social context is also important Bronfenbrenner’s model Figure 2.7 of text Group activity: Using this model, describe exactly how poverty may have a negative impact on child development and psychopathology

3. You are conducting an assessment of this girl. What do you want to know about her?

4. Why do we conduct an assessment? To provide a diagnosis. –What is a diagnoosis? –What is implicit in diagnostic categories? To make a prognosis. –What is a prognosi.s? –Why is this important? To provide treatment planning and evaluation –How is treatment linked to an assessment?

5. Clinical Interviews The most universally used assessment procedure Information includes developmental and family history Mental status exam assesses a child’s general mental functioning –Orientation to person, time, and place Interviews can be unstructured or semi- structured

6. Categories of information Family (Immediate and extended) Medical School & work Developmental history Interests and hobbies Traumas and critical incidents Did we cover all of these when asking about the teenage girl?

7. Behavioral assessment Objective description of the ABC’s of behavior Sometimes different people have different views of a behavior Checklists, frequency counts, rating scales completed by self or other: unreliable but cheap Observations can be structured or iunstructured; in vivo or in clinic Figure 4.2, 4.3, & 4.9: Three examples

8. Psychological testing Developmental tests screen for risk and delay Intelligence and educational tests –WISC-III assesses verbal and non-verbal intelligence, predicts academic achievement –Achievement tests assess knowledge in an area Projective tests: How to children respond to ambiguous stimuli? Rorschach, drawings Neuropsychological assessment: CNS

9. Classification and diagnosis

10. What is classification and diagnosis What are “taxa” in biology? Taxonomy? Categorical approach appropriate for clinical purposes Dimensional approach empirically based and more appropriate for research purposes Cutoff scores can be used to convert a quantitative measure into a qualitative distinction, e.g., CDI score of 19 or greater becomes “depressed”

11. History of childhood classification 1840: U.S. Census data of “idiocy/insanity” 1880: Dementia, dipsomania, mania, melancholia, monomania, paresis 1948: WHO includes categories in ICD DSMI in 1952, DSMII in 1968, DSMIII in 1980, DSMIII-R in 1987, DSMIV in 1994 Why will there be a DSM-V?

12. DSM-IV Axes Axis I: Major Disorders Any mental disorder listed in the manual is indicated here, except for those on Axis II. In the case of more than one disorder, the primary disorder is listed first. Axis II: Personality Disorders and Mental Retardation Axis III: General Medical Conditions Any medical problems relevant to treatment of the patient. Axis IV: Psychosocial or Environmental Problems Any type of stressful events or problems with relationships, chronic or acute. Axis V: Global Assessment of Functioning A rating from 1 to 100, 1 indicating severe impairment in everyday functioning, and 100 being perfectly functional.

13. DSM-I Listed as "Homosexuality",Characterized as "ill primarily in terms of society and of conformity with the prevailing cultural milieu.” DSM-II Listed as "Homosexuality", Characterized as an "other non-psychotic mental disorder". DSM-III Listed as "Ego-Dystonic Homosexuality", for individuals experiencing distress over conflict between wishing to be heterosexual, but having homosexual tendencies. DSM-III-R & DSM-IV Not Included