4Ds

Question 1

AO1 for deviation

Answer 1

• devient behaviour is unique rare or extreme
• there is 2 ways a person can be deviant either: devotion from the statistical norm or deviation from the social norm

DEVIATION FROM THE STATISTICAL NORM:
- if a persons traits are seen as statistically infrequent
- we can work out statistical norms through a standardised test which would be plotted which sit in the curve of normal distribution
- both ends of the cure of normal distribution is seen as abnormal - people who fall in the bottom or top 2.2% of the population
- e.g. the prevalence of sz is 1-2% so it is considered as abnormal by this definition

DEVIATION FROM THE SOCIAL NORM:
- behaviour that conforms to social norms is considered as ‘normal’ and anything that sits outside of this is ‘abnormal’
- behaviour which goes against social norms is often judged as bizarre and/or extreme e.g. talking to trees rather than people
- we tend to be wary of the people carrying out this behaviour
- it has to be clear to everyone what the social norms are so that abnormal behaviour is seen as such by everyone in that society
- what is seen as abnormal may be different for different societies

Question 2

what is Dysfunction

Answer 2

• if a behaviour significantly interferes with a persons ability to carry out everyday tasks and live their lives in general then this may indicate a mental disorder
• these symptoms can distract, confuse or interfere with their ability to carry out daily tasks
• objective measures cab be assessed using the GAF scale and the WHODAS-II scale
• sometimes day to day impact may not be as obvious, so clinicians may need to look carefully at all aspects of an individuals life. as some aren’t obvious
• e.g. some people with severe unipolar depression may be unable to work and their relationships may be affected

Question 3

what is distress

Answer 3

• related to the extent to which behaviour is causing upset or anxiety to and individuals life
• distress can manifest itself physically e.g. heart palpitations
• it can be assessed on the kessier psychological distress scale (K10)
• should be treated in isolation to all other 4 Ds as the individual may be experiencing lots of difficulty and aren’t distressed or the other way round. it can also depend on the situation e.g. bereavement
  -e.g. a common feature of bipolar disorder is extreme risk taking behaviours

Question 4

what is danger

Answer 4

• careless, hostile or hazardous
• danger to themselves- self harm
• danger to others
• scale of severity
• if behaviour is extremely risky or getting worse then a diagnosis may be a required
• e.g. a common feature of bipolar disorder is extreme risk taking behaviour

Question 5

1 strength 1 weakness of deviance

Answer 5

1. • Gives a quantitative measure that’s objective, so it’s more likely to be reliable, as it should be interpreted the same by all clinical professionals and they should come to the same conclusions.
2. • Some disorders are not statistically rare but are still considered to be abnormal by wider society (for example, depression isn’t statistically rare but many would still consider it abnormal because it’s a psychiatric disorder).

Question 6

1 strength 1 weakness of dysfunction

Answer 6

1. +Standardised tests such as the GAF (Global Assessment of Functioning) scale give a quantitative, objective measure, meaning there should be greater consistency among clinicians.
2. -There is subjectivity when deciding what is dysfunctional, so a psychiatrist may base it on their own professional opinion. This means that certain behaviours may be classified as dysfunctional by one clinician but not another, affecting reliability of diagnosis.

Question 7

1 strength 1 weakness of distress

Answer 7

1. +Standardised tests such as the Kessler Distress Scale give a quantitative, objective measure, meaning there should be greater consistency among clinicians.
2. -There are different ways of showing distress – someone might not get the help they need with their disorder if they don’t show the obvious signs (e.g. if they keep their distress internalised).

Question 8

1 strength 1 weakness of danger

Answer 8

1. • ‘Danger’ to self/others is often a criterion for sectioning, which means people can get the help they need when otherwise they may not seek help.
2. • Cultural differences can also have an influence. For example, some cultures engage in behaviours that might be considered dangerous in other cultures but they consider to be normal and not dangerous. This can also lead to incorrect diagnosis and/or lack of consistency between clinicians.