Hint
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Answer
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What are the 4 D's
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Deviance, Distress, Dysfunction, Danger
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What is Diagnosis?
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Clinician assessing patient and deciding whether they have a mental disorder
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What is Deviance?
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Behaviour or emotions that are unusual in society
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What is Distress?
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The extent to which the individual finds their behaviour upsetting
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What is Dysfunction?
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When behaviour interferes with the person's day-to-day life
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What is Danger?
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Behaviour that could harm others or the individual
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Strength of 4 D's
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Practical applications, holistic view
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Who suggests Duration should be added?
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Davis (2009) - Increases Validity
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Weaknesses of 4 D's
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Subjective - May lack Validity, lacks reliability as different professionals may have different diagnosis
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Why might Davis' suggestion be a weakness?
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Can be criticised for being incomplete
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Issues and Debates
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Social control, practical issues (interviews), Psychology as a Science(relies on interviews)
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What are the 2 classification systems?
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DSM 5 and ICD 11
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Who publishes the ICD?
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World Health Organisation
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Who publishes the DSM?
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American Psychiatry Association
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Where is the DSM mainly used?
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North America
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What does the DSM assess?
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Type of disorder, factors along side it, psychosocial and contextual factors, disability
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Why is the DSM less reductionist than the ICD?
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It takes into account psychosocial factors and disability
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What does the DSM only assess?
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Mental conditions
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How many categories does the ICD assess?
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100 categories
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What categories does this include?
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Dementia, Schizophrenia, Affective disorders and Personality disorders
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What approach does the ICD have?
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A criterion-based approach
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Strengths of Diagnosis
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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)
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What did Brown (2002) do?
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Tested the reliability and validity of the DSM IV for anxiety and mood disorders and found it good to excellent
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What did Pederson (2001) find?
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Found that 71% of psychiatrists agreed with the ICD 10 definition of depression when assessing 116 patients.
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What did Mason et al (1997) find?
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The ICD was reasonably good at predicting disability 13 years later. Therefore good predictive validity
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Factors that impact reliability of Diagnosis
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Patient Factors and Clinician Factors
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What are patient factors?
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When patients give psychiatrists slightly different information. Could lead to differing diagnosis
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What are clinician factors?
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When the clinicians using the classification systems aren't completely objective
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Weaknesses of Diagnosis
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Early versions had poor diagnostic reliability (Spitzer and Williams, 1985) (Hiller et al (1992), subject to clinician factors and patient factors
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What did Spitzer and Williams (1985) do?
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Reviewed the process of Diagnosis and found that experienced psychiatrists agree 50% of the time
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What did Hiller et al (1992) find?
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Reliability is in doubt for some disorders related to Schizophrenia
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Issues with the classification system
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Could be bias (Cochrane et al, 1995), Can't apply cross-culturally (Littlewood, 1992)
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What did Cochrane et al (1995) argue?
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Classification systems themselves lead practitioners to take a Eurocentric bias (based on European ideas)
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What did Littlewood (1992) find?
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The DSM IV makes assumptions about nuclear family life that aren't applicable cross-culturally
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What is the Clinical Psychology Classic Study?
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Rosenhan (1973)
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What is concurrent validity?
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If two pieces of evidence agree
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What is aetiological validity?
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When the cause is understood
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What is predictive validity?
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When the future course of the disorder is known
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