Diagnosis Of Mental Disorders Flashcards
(62 cards)
What are the 4 reasons that’s make it difficult to define abnormal behaviour?
1) There is no clear dividing line separating normal and abnormal behaviour.
2) The concept of abnormality can change over time
3) The concept of abnormality can change between societies and cultures
4) many different types of behaviour can be considered abnormal.
What are the four D’s of diagnosis?
1) deviance
2) dysfunction
3) Distress
4) Danger
What does Deviance (one of the 4D’s) refer to?
Deviance refers to behaviour that is both statistically rare and disapproved by society. E.g walking around the streets of London nude
What does Distress ( one of the 4D’s) refer to?
Distress is the extent to which an individuals behaviours or emotions upsets them. E.g Roger finds his emotions very upsetting visits a counsellor to try and reduce his anxiety.
What does Dysfunction ( one of the 4D’s ) refer to?
Dysfunction is the extent to which an individuals behaviour / emotions interferes with their day to day life. E.g Susan not wanting to get out of bed and help her kids get ready for school
What does Danger ( one of the 4D’s) refer to?
Danger refers to the harm someone’s behaviour could cause to both others or themselves. E.g Burt refusing to eat can cause many health implications.
What is a strength of the four D’s of diagnosis ?
They are useful because they have a practical application in helping professionals decided whether a patients symptoms warrant a clinical diagnosis.
OR
they provide a holistic way to assess someone’s mental health as they consider a wide range of symptoms
What is a weakness of the four D’s of diagnosis ?
they are open to subjectivity in the application as the clinician must assess to what extent someone’s behaviour is Distressing/dysfunctional/deviant/dangerous. This reduces the validity because diagnosis may not be accurate. It also reduces reliability as if used by two different professionals they may not arrive at the same diagnosis.
The issue of social control as they are used as a way to discriminate against people whom the majority disapprove of and want removed from society.
Why did Davis (2009) suggest the four D’s of diagnosis is incomplete ?
Davis (2009) critised the model for being incomplete and suggested that a fifth “D” needs to be added; Duration. Referring to how long symptoms last for.
What is the Medical model of abnormality ?
This model is s biological approach which assumed the major source of abnormal behaviour is a form of medical ‘illness’. Considering psychological symptoms to be outward signs of inner physical disorders. The medical model suggests if symptoms are grouped together and classified as a ‘syndrome’ the true cause can be discovered and allow appropriate physical treatment to be administered.
What does ICD stand for? Who published this classification system and who is it commonly used by?
The international standard classification of diseases (ICD 10).
Was published by the world health organisation (WHO).
Most commonly used in Britain and most parts of the world.
What does DSM stand for ?
Who published this classification system ?
Who most commonly used the DSM ?
The Diagnostic and Statistical Manual of Mental Disorders ( DSM 5).
Published by the American Psychiatric Association.
The DSM is generally used in North America
What is a strength of the classification systems ( ICD and DSM) ?
They are both regularly updated to take into account new research. Both attempt to improve psychiatric diagnosis across cultures and to take into account of people’s changing cultural views. Regular revision of both manuals allows inconsistencies and a ambiguities to be removed to create a clear set of criteria; increasing reliability.
What is a weakness of the classification systems ( ICD and DSM) ?
Even though believed to be reliable there is always and element of subjectivity as clinicians must use their own judgement to decided if the list criteria is within normal limits.
OR
Both classification systems rely on checklists of behaviour to diagnose complex mental heath issues and can therefore be criticised for being reductionist.
OR
They have also been criticised for using the medical model which assumes mental health issues are medical illnesses with physical causes
What are problems with using the medical model of diagnosis for mental disorders ?
Unlike physical illness the symptoms mental illness are much more subjective to observe and measure e.g feelings of despair or hearing voices. Therefore these can’t easily be measured, so clinicians must make judgements based on experience.
Diagnosis of physical illness can often relate to causes of the problem e.g measuring blood sugar level to check a diagnosis of diabetes. However causes of mental illness are unknown which in turn effects the treatments based on the medical model as they can be focusing on only the symptoms of mental disorders and not the causes.
What 4 things does the DSM assess individuals on ?
1) Type of disorder e.g psychotic disorder, eating disorder, anxiety disorder.
2) co-existing factors like mental retardation and general medical conditions such as diabetes
3) psychosocial and contextual factors such as homelessness and unemployment
4) disability - the overall functioning of the individual
How does the ICD work?
The ICD is used to diagnose both physical and mental conditions. The ICD has 100 categories including dementia, schizophrenia and personality disorders , with similar disorders linked together. Each of the categories notes the relevant disorders, each disorder then has a description of characteristics.
What are similarities between the DSM and the ICD ?
Both are regularly updated to take into account for new research and changing views in society.
Both try to account for different cultural views.
Both include categories of mental disorder based on patterns of symptoms.
Both use the medical model.
Both can be seen as reductionist as they rely on a checklist of symptoms.
What are the differences between the DSM and ICD ?
The DSM is published by the American Psychiatric Association and must be payed for. Whereas the ICD is published the world health organisation and is free to use.
The DSM can only be used to diagnose mental conditions whereas the ICD can be used to diagnose both mental and physical illnesses.
The DSM is considered to be more holistic than the ICD as it uses 4 ways to assess people: (1) type of disorder (2) co-excisiting factors (3) psychological and contextual factors and (4) other disabilities. However the ICD doesn’t look at other aspects which may effect a diagnosis it is pure criterion based.
What is inter-rater reliability in clinical psychology ?
The extent to which clinicians agree of diagnosis.
Who conducted research on the early version DSM and what did they find that suggested that this version had low reliability ?
Spitzer and Williams (1985) reviewed the process of diagnosis and found experienced psychiatrists only agree on diagnosis about 50% of the time.
What lead to the improvement in reliability of diagnosis and who’s research supports this ?
The move to more criterion based system where each disorder has a checklist of symptoms has increased reliability of diagnosis and so more recent version of the DSM can be seen as more reliable as shown in Brown (2002) research who tested the reliability and validity of DSM IV diagnosis for anxiety and mood disorders and found them to be good to excellent.
What possible patient factors impact on reliability of diagnosis ?
Patient factors - Patients may give different psychiatrists slightly different information for various reasons which could lead to different practitioners into giving different diagnosis to the same person.
What clinician factors could impact on reliability of diagnosis ?
Clinician factors - the practitioners using the classification systems are not completely objective
And
Clinician factors - the practitioner may gather insufficient information or the practitioner may not use the categories of the classification system correctly.
