The 4 D's

Question 1

what are judgements of abnormality based on

Answer 1

• the 4 d’s

Question 2

4 d’s

Answer 2

• dysfunction
• deviance
• distress
• dangerousness

Question 3

what are the 4 d’s used for

Answer 3

• assessment tool to decide whether behaviour is abnormal
• abnormality may require investigation and diagnosis

Question 4

what is identifying a mental disorder using the 4 d’s based on

Answer 4

therapists judgement

Question 5

what do we need to consider when using the 4 d’s

Answer 5

• context and situation
• just because the 4 d’s are present does not mean a person must be given a psychiatric diagnosis

Question 6

deviance

Answer 6

• behaviours emotions and thought which deviate from social or cultural norms
• they are seen as unacceptable by society
• may change across time or place as social norms change

Question 7

examples of highly deviant behaviours

Answer 7

• chronic lying
• stealing

Question 8

why can’t a genius be classed as deviant

Answer 8

• they do not have a negative effect on society
• it is seen as a positive thing

Question 9

name behaviours which are a major symptom of deviance

Answer 9

• paedophilia = symptoms shown in DSM clearly indicate non-conformity with norms
• cannibalism
• delusions of persecution

Question 10

details about deviance

Answer 10

• unacceptable behaviour which has a negative impact on society
• behaviour which deviates from statistical norm
• deviation from social norms or non conformity

Question 11

why is deviant behaviour difficult to diagnose

Answer 11

• different mental behaviours show similar deviance

Question 12

distress

Answer 12

• negative behaviours and feelings that cause distress to individual or to others around them
• considered abnormal

Question 13

distress details

Answer 13

• displayed as low mood, anxiety, anger
• it is the extent to which behaviour is causing upset in an individual
• difficult to measure

Question 14

why is distress difficult to measure

Answer 14

• a person may be unable to function but not experience feelings of distress
• whilst others can experience distress yet still function

Question 15

major symptom for distress

Answer 15

hypochondriasis

Question 16

hypochondriasis

Answer 16

• individuals fear having a serious disease
• based on misinterpreting body symptoms

Question 17

dysfunctional

Answer 17

• behaviours and feelings are dysfunctional when they interfere with the persons ability to function in daily life, to hold a job, or form relationships
• cannot be used as criteria on its own
• dysfunction can be deliberate

Question 18

behaviours which are symptoms for dysfunction

Answer 18

• insomnia
• unable to go to work / keep a job
• relationship breakdown
• decrease in pleasure in social activities

Question 19

details around dysfunction

Answer 19

• major depressive disorder = affects normal everyday life
• difficult to use in diagnosis as many life events and issues can be major depressive disorder symptoms

Question 20

dangerous

Answer 20

• behaviours and feelings that are potentially harmful to an individual or the individuals around them are seen as abnormal

Question 21

major symptoms for dangerousness

Answer 21

• suicidal thoughts
• self harm
• violence
• nicotine dependence
• eating disorders

Question 22

details with dangerousness

Answer 22

• if peoples lives are in danger it may indicate intervention is needed

Question 23

Strengths - 4 d’s

Answer 23

• deviance uses statistical measures to help inform decisions
• Davis 2009
• provide a holistic approach
• practical applications
• supports validity of DSM

Question 24

Davis 2009

Answer 24

• it can help in making a decision by matching behaviour and beliefs to the DSM
• helps the therapist to know when a condition may need a formal diagnosis

Question 25

4 d's provide a holistic approach to abnormality -

Answer 25

- can be seen as an adequate gage of psychological abnormality

Question 26

practical applications -

Answer 26

- useful for professionals in real life scenarios

Question 27

supports validity of DSM

Answer 27

- as a diagnostic classification system in that various diagnosis are shown to focus on specific d's - showing each 'D' has a value - using DSM and ICD -10 to help decide to make a diagnosis - useful when considering patients symptoms for diagnosis

Question 28

4 d's weaknesses

Answer 28

- subjective - clinician must interpret what the patients disclose and form a judgement - deviance doesn't always consider behaviours that aren't rare - diagnosis can lead to labelling - potential for social control - clinicians need to consider how long the behaviour has been displayed before diagnosing

Question 29

subjective

Answer 29

- 4 D's dependent on the discussions between patient and clinician - as there is not a formal standardised approach to this for all 4 d's it is subjective - 2 professionals may not reach the same conclusion - not reliable ?

Question 30

deviance doesn't always consider behaviours that aren't rare or unacceptable but are still abnormal

Answer 30

- e.g alcohol addiction

Question 31

diagnosis can lead to labels for people with mental disorders

Answer 31

- e.g 'danger' - as criteria leads people to equate mental illness as being dangerous - diagnosis distorted in media leading to self fulfilling prophecies - people act in the way predicted by a stereotype

Question 32

potential for social control

Answer 32

- abuse of power - those who breach social norms can be quieted by labelling as mentally disturbed - e.g Russian psychiatrist

Question 33

Russian psychiatrist

Answer 33

- described how KGB in Russia pressurise psychiatrists in the 60s to diagnose and incarcerate political dissidents - demonstrates how misuse of psychiatric diagnosis can be used to legitimise punitive treatments and social exclusion

Question 34

Timothy Davis

Answer 34

- added 5th D - duration - as clinicians need to take into account how long behaviour has been displayed before considering diagnosis