The Validity of Prototype Diagnosis in Everyday Practice Open Access

Peart, Joanne (2009)

Permanent URL: https://etd.library.emory.edu/concern/etds/2n49t179j?locale=en
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Abstract

The Validity of Prototype Diagnosis in Everyday Practice
By Joanne Lisa Peart

The goal of the current study was to test the validity of a prototype-matching approach to
clinical diagnosis in a naturalistic outpatient sample of 84 patients taken from 6 sites.
Validity was determined by 1) correlating prototype ratings made by the treating clinician
based on all available clinical data with patient self-reports of the same or similar
constructs, and 2) assessing whether prototypes showed incremental validity above and
beyond categorical DSM-IV diagnoses on a subset of disorders studied (two common
mood disorders: major depressive disorder and dysthymic disorder). Significant
correlations between prototypes and self-reports fell in the range of .22 to .48 for similar
constructs. In a number of cases, associations between relevant self-report measures and
diagnostic prototypes outperformed those associations between the same self-report
measures and categorical diagnosis. Furthermore, a series of hierarchical linear
regressions showed incremental validity of prototype diagnosis in a subset of mood
disorders in predicting many clinically-relevant variables. Strong associations between
prototypes and related self-report constructs coupled with generally equal or stronger
associations when compared to DSM-IV categorical diagnosis and incremental validity in
predicting criterion variables suggest that prototype diagnosis is a valid alternative to the
categorical diagnostic approach that has been in place since DSM-III.



Table of Contents

Table of Contents

Introduction……………………………………………………………………………….……..1

The Current Diagnostic System……………………………………………………………...3

Classification and Categorization …………………………………………………………..9

Prototype Literature to Date……………………………………………………………….15

The Present Study……………………………………………………………………………...19

Hypotheses………………………………………………………………………………….20

Method…………………………………………………………………………………..….22

Procedure…………………………………………………………………………………..27

Data Analysis……………………………………………………………………………….28

Results………………………………………………………………………………...………..30

Discussion…………………………………………………………………………...…………36

Limitations……………………………………………………………………………………...41

Implications……………………………………………………………………………………..44

References…………………………………………………………………………………..…..50

Tables……………………………………………………………………………………….......65

Appendices ……………………………………………………………………………………..71

Appendix A: Hierarchical Linear Regressions…………..........……………………………71

Appendix B: Prototype Matching Approach to Diagnosis………………….……………..85


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