4D's/Introduction to Clinical Psychology Flashcards
What is clinical psychology? (what is it about, and why)
Clinical psychology is concerned with abnormal behaviour.
It seeks to define what makes behaviour abnormal (compared to just being eccentric), and then to diagnose what the problem is so it can be treated.
What are the four D’s and what are they used for?
- Deviance
- Dysfunction
- Distress
- Danger
With physical illness, a clinician might take your temperature or do a blood test/scan to see if outcomes are ‘abnormal’.
Diagnosing mental disorders is harder - the 4Ds can help determine when a mental health issue’ could be considered a mental health ‘disorder’.
The 4D’s are like a blood test for mental health.
What is Deviance and what classifies as Deviance?
Deviant behaviours are unusual, undesirable, and even bizarre.
Deviance is classified as failure to conform to statistical and/or social norms (so norm-breaking is a useful indicator of psychological abnormality).
- Statistical norms : these are used to measure the unusualness of any behaviour.
- Social norms : desirability of the behaviour depends on historical context, and the culture, age and/or gender of the individual.
What is Dysfunction what classifies as Dysfunction?
Dysfunction is symptoms that distract, confuse or interfere with ability to carry out role and responsibilities.
Dysfunction can also include trouble getting up in the morning, failure to complete tasks at work or college and problems participating in routine activities (e.g. socialising).
What is Distress what classifies as Distress?
When symptoms cause emotional anxiety or pain.
Sometimes psychological distress shows as physical symptoms (e.g. aches and pains, palpitations, feeling tired all the time), so these are important for diagnosis.
- However, Distress could be seen as normal depending on the situation (e.g. it would be normal in relation to a job loss or bereavement).
What is Danger what classifies as Danger?
Careless, hostile or hazardous behaviour that jeopardises safety of the person/others.
Behaviours like a history of violence can indicate that someone is dangerous to themselves or other people.
In the UK, a person may be detained under the Mental Health Act (‘sectioned’) if three professionals agree they are a danger to themselves or others.
What is the strength of the four D’s? (hint: avoid erroneous diagnosis)
A strength of using using all 4D’s is that it helps avoid erroneous diagnosis (The doctor misinterpreted test results, leading to an improper treatment).
For example, more factors than just deviance from the norms are considered when making a diagnosis.
This avoids situation in which eccentric people are seen as ‘mental’ as they simply don’t conform to social or statistical norms.
This is important as a diagnosis system should not be under or over inclusive, which is why using all of the 4D’s is good.
I DONT UNDERSTAND THIS..
CA However, there are no rules about how to combine the Ds for a diagnoses. For example, someone struggling to cope (signs of distress and dysfunction) may seem to have a mental health issue according to the 4D’s, but with no signs of danger or deviance, may not require a diagnosis. It could be the situation causing the problem (so could not be resolved by treatment, which is the purpose of a diagnosis).
What are the weaknesses of the four D’s? (hint: lacks objectivity & creates labels)
A weakness of the 4Ds is that they lack objectivity.
The 4Ds compare individuals with others, so diagnosis would be better if compared to a reference group, not the clinicians views.
Another weakness of the 4Ds is that it creates labels.
For example, ‘danger’ as a mental health criteria leads people to assume those who are mental are also dangerous.
This assumption is wrong as most people with schizophrenia are no more dangerous than people without it (Fazel et al. 2009).
This matters because labels can become ‘self-fulfilling prophecies’ - i.e. stereotypes lead to people acting like the steryotype.
What is an application of the four D’s? (hint:
An application of the 4D’s is that they are used inline with classification systems like the ICD-10.
For example, deviance from statistical noms helps define intellectual disability, whilst deviance from social norms (along with dysfunction and danger) can help define anti-social personality disorder.
This shows that each of the 4D’s can, and are, used in diagnosis.
