4Ds

Question 1

When the 4ds are useful

Answer 1

Helps to determine the point at which a mental health issue might be more helpfully considered a disorder (crucial decisions given the implications for treatment)

Question 2

Deviance

Answer 2

Behaviours that are unusual, undesirable or even bizarre. Understanding of statistical and social norms necessary to determine how unusual the behaviour is- failure to conform to social norms= negative attention and exclusion, indicator of psychological abnormality

Question 3

Dysfunction

Answer 3

Symptoms which distract, confuse of interfere with a person’s ability to carry out their usual roles and responsibilities. Assessed using the WHODAS II. E.g. trouble getting up, brushing teeth

Question 4

Distress

Answer 4

Symptoms that causes emotional pain or anxiety- can manifest in physical symptoms too. Quantitative data can be collected through K10 (questionnaire about experience over last 2 weeks)

Question 5

Danger

Answer 5

Behaviour that jeopardises the safety of themselves or others. Can be sectioned under the mental health act if 3 professionals agree they are a danger.

Question 6

5th D- Duration

Answer 6

Davis (2009) How long a patient has been experiencing symptoms before taking the next step in diagnosis

Question 7

Strengths of 4ds

Answer 7

Helps avoid erroneous diagnosis-
-Using more than one improves validity, neither under or over inclusive.

Application to diagnosis
- 4Ds used in conjunction with classification manuals (DSMV and ICD10) to help decide whether making a diagnosis is appropriate. E.g Anti-social personality disorder combines deviance, dysfunction and danger.

Question 8

Weaknesses of 4Ds

Answer 8

Cultural differences
- Some behaviours or symptoms may be seen as deviant or dysfunctional in one culture, whilst being the norm in another, leading to potential misdiagnosis.

Lack of objectivity
- No objective measurements in the 4Ds, meaning that interpretations of symptoms are subjective, decreasing the reliability because different clinicians may classify the same symptoms differently

Labelling
-Using ‘danger’ equates mental illness with danger. Fazel et al (2009) says that most people with SZ are actually not more dangerous than people without this diagnosis