2. reliability and validity of diagnosis

Question 1

reliability in diagnosis and classification

Answer 1

consistency of a classification system e.g DSM V to assess symptoms of schizophrenia
must be repeatable so clinicians can’t reach the same diagnosis at different times (test-retest reliability)
different conclusions reach same conclusions (inter-rater reliability)- uses kappa score above 0.7=good

Question 2

validity in diagnosis and classification

Answer 2

extent the diagnosis represents something real and distinct from other disorders (criterion validity)
extent system measures what it intends
diagnosis can’t be valid if not reliable

Question 3

cultural differences in diagnosis
reliability
Copeland 1971

Answer 3

variations between countries influences diagnostic process
Copeland 1971: 134 US and 194 british psychiatrists a description of a patient. 69% US diagnosed schizophrenia vs 2% of british
BUT 1971= before DSM V, lacks temporal validity, current DSM V is more reliable

Question 4

cultural differences in diagnosis
reliability
Luhrman

Answer 4

hearing voices can be influenced by the cultural environment
60 adults with schizophrenia, 20 Ghana, India, US
African and Indian= positive experiences offering advise vs Americans= violent and indicating sickness
‘harsh, violent voices in the west not an inevitable feature= a lack of characteristics/ consistency

Question 5

cultural differences in diagnosis
reliability
subjectivity

Answer 5

hoped the DSM and ICD would give a standardised method of recognising mental disorders
interpreting behaviour= more subjective than hoped
eg Rosenhan

Question 6

reliability and validity
Rosenhan 1973

Answer 6

aim: how good diagnoses were using the DSM II if they were linked to symptoms or environment, should tell who has a real mental disorder vs not ‘pseudopatient’ who has 1 symptom then acts normally
procedure: him & 7 volunteers to range of hospitals pretending to have a single symptom: hearing voices saying ‘empty’, ‘hollow’, or ‘thud’
acted as patients
recorded responses from doctors
findings: all 8 to hospitals
all released with diagnosis
real patients said there was nothing wrong with them t doctors
doctors didn’t notice
doctors ignored there questions 71% of time
conclusion: environment= major impact on process of diagnosis, hospital not tell, after labelled a condition patients find it hard to escape label

Question 7

Rosenhan 1973
reliable? validity? DSM?

Answer 7

high reliability= all the same diagnosis
poor validity= weren’t diagnosed correctly
DSM II was in place, lacks temporal validity current DSM V more accurate diagnoses

Question 8

gender bias
validity

Answer 8

accuracy of diagnosis affected by gender
gender bias diagnostic criteria
basing beliefs on sterotypical beliefs

Question 9

gender bias
validity
abaroverman et al

Answer 9

diagnostic categories basied towards pathologising one gender
clinicns in the us based ‘healthy’ adult behaviour on healthy ‘male’ behaviour
= women seen as less mentally healthy