DSM and the issue of co-morbidity in childhood mental disorders - a functional perspective and proposed solution
This episode is primarily relevant to professionals and students.
In this episode, R. Trent Codd, III, Ed.S. interviews Ennio Cipani, PhD about the DSM system and it's problem with co-morbidity. They discuss a number of things including:
- The difference between a topographic and functional approach to diagnosis and treatment
- How the functional approach might be an approach that escapes the DSM problem of co-morbidity
- His functional diagnostic system
- How an analysis of negative symptoms can have utility for a diagnostic system to discern chronic conditions
References related to this podcast:
- Functional Behavioral Assessment, Diagnosis and Treatment (2nd Edition, 2011). Cipani and Schock.
- Cipani, E. (2012, May 7). The issue of co-morbidity in DSM-V Childhood Mental Disorders: A functional perspective and proposed alternative diagnostic system. (audio podcast). Retrieved from www.CBTRadio.org
Prior podcast on function-based diagnostics
- Cipani, E. (2011, September 4). Function-based diagnostics. (audio podcast). Retrieved from http://behaviortherapist.podbean.com/2011/09/04/function-based-diagnostics/
Ennio Cipani, Ph.D., a graduate of Florida State University, is a licensed psychologist and a full professor in the Department of Special Education at National University - Fresno. He has published numerous articles, chapters, books, and instructional material (including software), in the areas of child behavior management in homes and schools. Among his latest books are "Children and Autism (2001)" and "Functional behavioral assessment, diagnosis and treatment, 2nd edition (co-authored with Keven Schock, 2011)." He has given many workshops at state and national conventions, as well as continuing education courses for psychologists, social workers, marriage and family therapists and others, focusing on the effective management of problem child behavior. Dr. Cipani has been doing in-home and school based behavioral consultation for families and school personnel since 1982. He has dealt with many families and a variety of behavior problems, conducting assessment and intervention activities in homes and classrooms. A copy of his book, Punishment on Trial is available as a free download at www.ecipani.com/PoT.pdf (make sure to capitalize where indicated).
Discussion questions (for undergraduate and graduate students):
- Do you agree or disagree with Dr. Cipani's analysis of why children can often be diagnosed with several disorders, i.e., co-morbidity?
- What are the implications of using the proposed method of determining the presence/absence of a symptom, when contrasted with the static methods used currently (i.e., measures do not manipulate any environmental variable, merely observes/describes behavior under whatever contextual conditions are present).
- How would you explain a rapid change in a negative symptom, given a manipulation of a contingency when compared with data from a baseline measure (where it does not occur). Is there any argument that can be made as to the chronic nature of such a symptom when such a behavior reaches a reasonable level of occurrence quickly when powerful reinforcement contingencies are stated and applied?
- How practical would this system be in clinics? Facilities? Group homes? Private practice?
- Does this approach make sense? Why or why not? Do you see this being relevant for DSM-VI? DSMXXV?