The Validity of Prototype Diagnosis in Everyday Practice Público

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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School	Laney Graduate School
Department	Psychology
Degree	PhD
Submission	Dissertation
Language	English
Research Field	Psychology, Clinical Psychology, General
Palabra Clave	prototype diagnosis prototype matching dimensional diagnosis limitation of dsm-iv
Committee Chair / Thesis Advisor	Westen, Drew, Emory University
Committee Members	Barsalou, Lawrence, Emory University Craighead, W Edward, Emory University Lilienfeld, Scott O, Emory University Wolff, Phillip, Emory University

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