The four Ds Flashcards
What are the 4 Ds of diagnosis?
Deviance
Dysfunction
Distress
Danger
Define ‘deviance’ and provide an example.
Behaviours and emotions that are statistically rare and are often disapproved of by most of society due to not being the norm
Examples: lying and theft, paedophilia
Define ‘dysfunction’ and provide an example.
Behaviour that interferes with a person’s everyday life, causing a person to not live a normal life
Examples: insomnia, unable to work, relationship breakdown
Define ‘distress’ and provide an example.
The extent to which a person perceives their own negative behaviours/emotions as upsetting, often experienced by someone with a disorder
Examples: angry, crying, stressed
Define ‘danger’ and provide an example.
Danger to others or the individual themselves
Examples: Violence towards others, self-harm
What is the strength of deviance?
Has practical application in helping professionals decide whether a patient’s symptoms warrant a clinical diagnosis
What are the 2 weaknesses of deviance?
Reductionist
+ Ignores how the person feels about their behaviour
+ E.g. a ‘neurodivergent’ person may enjoy being alone, doesn’t necessarily make their behaviour deviant from social norm of being sociable
May change across time and place as social norms change
+ E.g. homosexuality once considered a mental disorder
+ Now considered socially acceptable in the DSM
What is the strength of dysfunction?
Using it to diagnose a mental health condition provides a holistic way to assess someone’s mental health - the 4 D’s cover a wide range of symptoms
What are the 2 weaknesses of dysfunction? (2 points for each)
Low reliability:
Researcher bias can occur as psychiatrists will base diagnosis on their own professional opinion
One clinician may classify behaviour as dysfunctional but not another
Low internal validity:
Difficult to measure so subjectivity is likely in its application
No universal consensus about what constitutes dysfunctional behaviour - everyone is likely to experience some form of it in their life
What is the strength of distress? (3 points)
Using it with the other Ds allows a diagnosis to be measured objectively using quantitative scales
E.g. the Beck Depression Inventory indicates self-report scales of emotion and harm
Can be easily repeated to assess the reliability of clinical diagnosis
What are the 2 weaknesses of distress? (2 points for each)
Low reliability:
Subjectivity from psychiatrist’s perception of what constitutes distress - 2 different professionals may reach different conclusions about the diagnosis
Particularly important with cross-cultural perceptions since society may view it differently
Difficult to measure:
Not a universal experience felt by all as a person may be dysfunctional but not distressed about it
E.g. a person may enjoy restricting their diet
What is the strength of danger?
Increased practical applications - dangerous behaviours are likely to be overt, making them generally much easier to identify in comparison to other symptoms
What are the 2 weaknesses of danger?
Low reliability:
+ Subjectivity from psychiatrist’s perception of what constitutes dangerous behaviour
+ Could result in researcher bias - one clinician may classify a behaviour as ‘dangerous’ but not another
Reductionist
+ Ignores how person feels about their behaviour
+ E.g. an ‘adrenaline junkie’ may use skydiving as catharsis over risky activities like taking drugs
What is the strength and weakness of the 5th D, duration?
Strength: provides more clarity and consistency between clinicians when deciding how long the patient needs to have displayed symptoms
Weakness: Davis’s (2009) proposal of the 5th D puts the credibility of the original 4D model into question
