Clinical Psychology - Diagnosis

Diagnosis of Mental Disorders - Pack 1

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Last updated: February 17, 2023

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First submitted	February 8, 2023
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Hint	Answer
What are the 4 D's	Deviance, Distress, Dysfunction, Danger
What is Diagnosis?	Clinician assessing patient and deciding whether they have a mental disorder
What is Deviance?	Behaviour or emotions that are unusual in society
What is Distress?	The extent to which the individual finds their behaviour upsetting
What is Dysfunction?	When behaviour interferes with the person's day-to-day life
What is Danger?	Behaviour that could harm others or the individual
Strength of 4 D's	Practical applications, holistic view
Who suggests Duration should be added?	Davis (2009) - Increases Validity
Weaknesses of 4 D's	Subjective - May lack Validity, lacks reliability as different professionals may have different diagnosis
Why might Davis' suggestion be a weakness?	Can be criticised for being incomplete
Issues and Debates	Social control, practical issues (interviews), Psychology as a Science(relies on interviews)
What are the 2 classification systems?	DSM 5 and ICD 11
Who publishes the ICD?	World Health Organisation
Who publishes the DSM?	American Psychiatry Association
Where is the DSM mainly used?	North America
What does the DSM assess?	Type of disorder, factors along side it, psychosocial and contextual factors, disability
Why is the DSM less reductionist than the ICD?	It takes into account psychosocial factors and disability
What does the DSM only assess?	Mental conditions
How many categories does the ICD assess?	100 categories

Hint	Answer
What categories does this include?	Dementia, Schizophrenia, Affective disorders and Personality disorders
What approach does the ICD have?	A criterion-based approach
Strengths of Diagnosis	DSM is high in reliability (Brown, 2002), high inter-rater reliability (Pederson,2001), ICD is objective (criterion approach), Good predictive validity (Mason et al, 1997)
What did Brown (2002) do?	Tested the reliability and validity of the DSM IV for anxiety and mood disorders and found it good to excellent
What did Pederson (2001) find?	Found that 71% of psychiatrists agreed with the ICD 10 definition of depression when assessing 116 patients.
What did Mason et al (1997) find?	The ICD was reasonably good at predicting disability 13 years later. Therefore good predictive validity
Factors that impact reliability of Diagnosis	Patient Factors and Clinician Factors
What are patient factors?	When patients give psychiatrists slightly different information. Could lead to differing diagnosis
What are clinician factors?	When the clinicians using the classification systems aren't completely objective
Weaknesses of Diagnosis	Early versions had poor diagnostic reliability (Spitzer and Williams, 1985) (Hiller et al (1992), subject to clinician factors and patient factors
What did Spitzer and Williams (1985) do?	Reviewed the process of Diagnosis and found that experienced psychiatrists agree 50% of the time
What did Hiller et al (1992) find?	Reliability is in doubt for some disorders related to Schizophrenia
Issues with the classification system	Could be bias (Cochrane et al, 1995), Can't apply cross-culturally (Littlewood, 1992)
What did Cochrane et al (1995) argue?	Classification systems themselves lead practitioners to take a Eurocentric bias (based on European ideas)
What did Littlewood (1992) find?	The DSM IV makes assumptions about nuclear family life that aren't applicable cross-culturally
What is the Clinical Psychology Classic Study?	Rosenhan (1973)
What is concurrent validity?	If two pieces of evidence agree
What is aetiological validity?	When the cause is understood
What is predictive validity?	When the future course of the disorder is known

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