diagnosis and classification Flashcards
(34 cards)
what is meant by the term ‘abnormal’?
behaviours that reside out with the parameters of that which is considered acceptable
how does society shape what is known to be abnormal behaviour?
it is a unifying concept that defines what is atypical or typical. these concepts change over time to fit societal norms. societies are fluid constructs
what are the 3 important aspects of defining ‘abnormal’?
- subjective discomfort
- social non-conformity
- statistical abnormality
how can subjective discomfort be used when defining abnormal?
- feelings of anxiety, depression and emotional distress.
- this comes form engaging in a behaviour that is atypical that results in negative psychological consequences
- BUT not everyone that engages in these behaviours will subsequently experience negative symptoms.
- abnormality cannot solely be based on this
how can social non-conformity be used to describe abnormal?
disobeying societal standards for normal conduct, leading to destructive behaviour
BUT is nonconformity always destructive?
how can statistical abnormality be used to define abnormality?
extreme scores on some dimension
- a rare characteristic can mean signs of a disorder, but not always
it is precise data but doesnt really correspond with what people consider abnormal
what factors should be considered when thinking about abnormal behaviours?
- cultural and social context = have different ideas of normal
- presence of distress = if the behaviour is not causing the person upset or harm, does it really matter?
- prevalence = how common is the behaviour?
- impact on functioning = how much is the behaviour impacting the persons ability to function?
- developmental stage = consider if the behaviour is normal for that stage of development
talk about the example of homosexuality as an abnormal behaiovur
it was considered to be a mental illness for many years.
- 1986 - all references to homosexuality being a mental illness were removed from the DSM
- WHO removed theirs in 1990
all contemporary models of diagnosis are..
biopsychosocial
forces you to consider biological, psychological and social factors
when was the first time that psychology and sociology were factored into a discussion about health?
1977
what is the life stress model?
a model which highlights the important impact that the number of life stressors have on the development of disorders.
- attempts to explain behaviour as a predisposition to vulnerability together with stress and life experience.
- your response to psychological experience will determine whether or not you go on to develop abnormal behaviour
what is diagnosis?
the classification of disorders by symptoms and signs
what advantages are there of diagnosis?
- facilitates communication between professionals
- advances the search for causes and treatments
- cornerstone of clinical care - diagnosis means that we can intervene. how can we help without an accurate diagnosis?
what is classification?
the subset (examples) of a particular disorder
what advantages are there of classification?
- permits tailored treatments for the example of a disorder
- facilitates between-group comparisons within conditions
- prevents the over-generalisation of disorders
what do DSM and ICD stand for?
Diagnostic and Statistical Manual
International Classification of Disorders
describe the perfect system for diagnosis
it would classify disorders by the presenting signs and symptoms, etiology/history, prognosis and response to treatment
- there would be no chance of misdiagnosis
- it would identify different symptom clusters that signal different disorders with no overlap between symptoms or signs between disorders
- it would identify, precise, effective treatments
describe the focus of the 5 versions of DSM
- 1952 = vague terminology and freudian focused
- 1968 = less freudian, pharmacologically focused.
- 1980 = robert spitzer - the notion of classifying disorders into discrete categories within diagnosis
- 1994 = more focus on reliability and evidence base
- 2013 = current model
what did robert spitzer propose?
that classification of disorders should be integrated into the DSM
what is the DSM definition of a mental disorder?
clinically significant disturbance in an individuals cognition, emotion regulation or behaviour
- it must be associated with distress or disability
what does DSM5 include regarding culture?
- culture bound syndromes - some conditions arise only in some countries
- importance of cultural sensitivity - encourages clinicians to consider cultural explanations for the disorder
what advantages are there of the DSM?
- there is emphasis on empirical research - an evidence base for everything
- use of explicit diagnostic criteria- easy to map the symptoms onto a diagnosis
- inter-clinician reliability
- atheoretical language
what disadvantages are there of the DSM?
- comorbidity - receiving 2 diagnosis’ at once (rates are around 40%)
- diagnosis does not account for normal reactions to life stressors
- the criteria involves too much of the population
- questionable reliability
- heterogeneity of symptom profiles - large differences within groups
- polythetic nature of disorders - the same diagnosis can be applied to similar AND different symptoms
- resilience is not included in the understanding of disorders
- controversial cut offs
what is meant by heterogeneity of symptom profiles?
that there are large differences within a group profile
