MENTAL HEALTH: TOPIC 1- Categorising mental disorders Flashcards
(7 cards)
Diagnostic Statistical Manual of mental disorders (DSM-5) & International classification of disorders (ICD-11)
Patient will display certain symptoms and/or report how they feel, diagnosis made using either DSM 5 (used in USA) or International classification of disorders (ICD-11) (used in majority of other countries).
Classification manuals provide list of psychological disorders & additional info such as symptoms required for diagnosis, subtypes, prevalence, how disorder develops, risk factors and prognosis & diagnosis issues relating to gender & culture.
Designed to work together and most clinicians nowadays combine both manuals (dsm5 and icd11)
Main purpose of making diagnosis is that it leads to a treatment…
DSM 5 contains info regarding every official psychiatric disorder (approx 300) each diagnostic listing contains detailed info regarding specific criteria required for diagnosis, as well as thorough overview of that disorder.
Latest edition involved 160 international researchers & clinicians in completing it.
Disorders change time to time- e.g homosexuality perceived as mental disorder until 1973- removed & replaced with ‘sexual orientation disturbance’ for ppl ‘in conflict with’ their sexual orientation.
1987- homosexuality completely removed from DSM.
DSM and ICD constantly revised, new disorders added, some removed.
How does process of using DSM/ICD work?
Clinicians go through diagnostic features, decide which symptoms best reflect behaviour displayed.
Classification of mental disorders involves identifying groups or patterns of behaviour/ mental symptoms that reliably occur together to form type of disorder.
Manual describes diagnostic categories for mental disorder & lists specific diagnostic criteria needs to be met for diagnosis to be made- each diagnostic category is based on prototypes, sets of features believed to be characteristic of that category.
Some symptoms essential for diagnosis, some may occur but not always be present.
Techniques of assessment:
Use of behavioural observations, clinical interviews, psychological tests, physiological tests.
Reliability & Validity of DSM
Classification system or diagnosis cannot be valid if not reliable- reliability refers to extent to which different psychiatrists agree on patients diagnoses (inter-rater reliability).
Rosenhan highlighted problems with categorising mental disorders-lack of reliability and validity.
For these systems to be reliable- 2 diff people should give same diagnosis for same symptoms for inter- rater reliability. Research evidence shows this not the case.
Classification systems should ensure valid (correct) diagnosis.
Criticism of psychiatry is that it actually increases suffering of those who receive MH diagnosis- removed control from patient, can be manipulated for political/social purposes.
Strengths of defining & categorising mental health issues
+ Helps establish as reliable standardised way to categorise & diagnose behaviours- improves reliability of diagnosis between physicians.
+ Helps direct most appropriate treatment for individual.
+ Helps individual come to terms with & understand why they are different, relief- fear of unknown reduced, now they can seek help.
+ Regularly monitored, reviewed & updated giving forum for psychiatrists to come together to discuss & share new issues/ problems as they arise.
Weaknesses of defining & categorising mental health issues
- Highly subjective- can change from one health professional to next.
- Requires self report from individuals- may not perceive their behaviour as abnormal or dysfunctional, may be prone to lying/disordered thoughts & social desirability.
- Significant overlap between disorders e.g loss of pleasure both depression and schizophrenia symptom.
- Ethnocentrism- depends on culture to how behaviour perceived, some seen as the ‘norm’ some not.
- Hard to diagnose reliably- individual differences and bias, research shows diff doctors use diff categories & drugs to treat the SAME patients.
