o To identify key aspects of the construct validity of PD
o To identify and distinguish between different alternative models of PD, incl.:
o FFM (NEOCA)
o AMPD
o And to link and apply this to the PD framework
o To reflect on PD assessment and the why, what and hows
o To identify and distinguish the different domains of psychodiagnostics, incl.:
o Domain aims
o Instruments to use
o Pro/cons of the instruments
o To apply knowledge of PD assessment to clinical examples
EMMELKAMP CHAPTER 2 DIAGNOSIS AND ASSESSMENT
Validity of the concept of PD
- two main approaches: standardized medical approach known from the PD model
from DSM-4 and an alternative model using a more dimensional approach instead of
a categorical approach
- DSM-5: includes the old categorical version but has the alternative model in the
research section
- what distinguishes normal and abnormal personality variation?
- how can different levels of functioning personality be standardized to make a model
which can be generalized in clinical practice?
- does the used model need to be clinically relevant or more research driven?
- construct validity of PDs?
Different approaches to abnormality
- DSM5 lost the axis approach
- all-or-none categorical formulation implies there should be an identifiable cut-off
point of where normal ends and abnormal begins
- taxometrics investigates whether latent structures of PDs are categorical (taxonic) or
dimensional
o direct empirical tests of underlying structure for most PDs is missing
o some taxometric evidence for cluster C, paranoid PD and borderline PD
o review suggests little evidence for the categorical approach for PDs other than
schizotypal PD
- cluster and factor analytic techniques have also been used
o mixed results
- define pathology by nature and associated domains of impaired functioning:
o 3 step criteria: functional inflexibility, self-defeating circles, and tenuous
stability under stress
- tripartite criterion for pathology:
, o a) failure of the self-system to establish stable and integrated representation
of the self
o b) maladaptive functioning in interpersonal relationships
o c) failure to develop and maintain prosocial and cooperative relationships
o this resembles more a dimensional approach
DSM-5 PDs
- categorical representation is easier to define, are convenient, and guide clinical
decision making easily
- to diagnose PD:
o 1. does the person meet the general criteria for a PD
o 2. look at more specific criteria with dynamics of PDs, symptoms and cut-off
numbers
The DSM criteria
- personality pathology is dichotomous (either there or not)
- each criterion is weighed equally for diagnosis and no criterion is necessary for
diagnosis
- it’s not possible to capture the full range thus, other specified/unspecified categories
for when presentation is less homogenous
- polythetic criteria of equal weight: there is no single criterion required/essential to
the disorder, but there are alternative definers, with a certain critical min. number to
be present
o possibility to capture a wide range of psychopathology, heterogeneity
o meeting 5 or more out of nine criteria in borderline PD gives 246 variations
o some criticism for not weighing importance on some criterion
o there is evidence that some criteria are more essential as they differ in their
sensitivity and specificity (if a criterion has high specificity and high sensitivity
then it’s prototypical of that disorder)
- symptoms vs traits: disorders are a mixture of symptoms, behavioral expression of
traits and traits themselves
o some disorders have emphasis on symptoms and behavioral expressions (e.g.
borderline PD) and some disorders have emphasis on traits (e.g. paranoid PD)
o advantage to behavioral criteria is minimal inference from rater
o but we favor behavioral expressions at the expense of characteristic patterns
of inner experiences (motivation, cognitive style, affect etc.)
- comorbidity: people with PDs usually have multiple PDs and can also have syndrome
disorders
o often people come in for complaints other than their PD
- most objections are not specific to PDs but other clinical syndromes too
Differential diagnostics
- motivation for behavior is very important in current classification e.g. schizoid vs
avoidant social isolation motivation
- structure to diagnostic process:
o 1. self-report instruments to narrow down range of potential PDs
o 2. info used to select relevant parts of a structured interview
Voordelen van het kopen van samenvattingen bij Stuvia op een rij:
Verzekerd van kwaliteit door reviews
Stuvia-klanten hebben meer dan 700.000 samenvattingen beoordeeld. Zo weet je zeker dat je de beste documenten koopt!
Snel en makkelijk kopen
Je betaalt supersnel en eenmalig met iDeal, creditcard of Stuvia-tegoed voor de samenvatting. Zonder lidmaatschap.
Focus op de essentie
Samenvattingen worden geschreven voor en door anderen. Daarom zijn de samenvattingen altijd betrouwbaar en actueel. Zo kom je snel tot de kern!
Veelgestelde vragen
Wat krijg ik als ik dit document koop?
Je krijgt een PDF, die direct beschikbaar is na je aankoop. Het gekochte document is altijd, overal en oneindig toegankelijk via je profiel.
Tevredenheidsgarantie: hoe werkt dat?
Onze tevredenheidsgarantie zorgt ervoor dat je altijd een studiedocument vindt dat goed bij je past. Je vult een formulier in en onze klantenservice regelt de rest.
Van wie koop ik deze samenvatting?
Stuvia is een marktplaats, je koop dit document dus niet van ons, maar van verkoper ebru1365. Stuvia faciliteert de betaling aan de verkoper.
Zit ik meteen vast aan een abonnement?
Nee, je koopt alleen deze samenvatting voor €6,49. Je zit daarna nergens aan vast.