Week Seven - Formulation, Diagnosis And The PTM

Question 1

Define diagnosis

Answer 1

The identification of nature of an illness / problem by examination of symptoms
(- only 54% reliability)

Question 2

What year were the DSM and ICD-6 created

Answer 2

1948
APA developed DSM-1
WHO developed ICD-6

Question 3

What are the two key studies questioning reliability and validity in diagnosis?

Answer 3

1 - Rosenhan
2- Kendall

Question 4

Explain how Rosenhan’s studies questioned reliability and validity of diagnosis

Answer 4

Being sane in insane places study - diagnosed when no illness
Further pseudo patient study - 41 diagnosed as pseudo patients where 0 existed

Question 5

Explain how Kendall’s study questioned reliability and validity of diagnosis

Answer 5

Looked at cultural diagnosis
US vs UK diagnosed differently

Question 6

Define and explain formulation

Answer 6

Co-construction of hypothesis - relationships, social circumstances, life events
Allows for establishment of how clients problems and symptoms are related

Question 7

What are the 5 steps of formulation?

Answer 7

1. Clarifying hypothesis and question
2. Understanding
3. Prioritising issues and problems
4. Lack of progress
5. Overcoming bias

Question 8

What is the purpose of formulation?

Answer 8

To establish the 5 P’s
(Presenting, predisposing, precipitating, perpetuating, protective)

Question 9

What is the PTM model?

Answer 9

Power, Threat, Meaning
New framework including formulation, aiming to move away from DSM and medicalisation

Question 10

What are the four questions summarised from the PTM model?

Answer 10

1. What has happened to you?
2. How did it affect you?
3. What sense did you make of it?
4. What did you have to do to survive?

Question 11

How is formulation individualised?

Answer 11

Patient centred
Helps user understand illness
Helps establish relationship between service user and client