5.1.1 - Diagnosis of mental disorders, including deviance, dysfunction, distress and danger

Question 1

Define Clinical Psychology (4 AO1)

Answer 1

• Clinical psychology is concerned with abnormal behaviour seeking to define what makes a behaviour abnormal by looking at the statistical norm and deviation from the norm
• Then looking at diagnosing what the problem is so that it can be treated
• Psychiatrists take note of symptoms a patient has, the duration plus info about their general health and social or psychological problems they may have.
• From this they can decide what the disorder is eg lots of panic attacks may be a symptom of anxiety, and then they can give an appropriate treatment eg CBT

Question 2

The 4D’s

List them then give x2 AO1 on 4Ds as a whole

Answer 2

1. Deviance
2. Dysfunction
3. Distress
4. Danger

• The 4 Ds are used alongside the DSM in clinical interviews to help diagnosis
• the 4 Ds are referred to by clinicians to determine the point at which a behaviour displayed by an individual becomes abnormal and requires diagnosis and possibly treatment

Question 3

Detailed AO1 for Deviance and Dysfunction

Answer 3

Deviance - where clinicians look at the extent to which the behaviour is ‘rare’ and so not the ‘norm’ in society. If considered rare, unacceptable and deviant from the norm, a clinical disorder may be present

Dysfunction - if the behaviour is significantly interfering with the persons life then a mental illness may be present. The clinician should discuss with the patient all aspects of their everyday life to assess the extent to which the problematic behaviour is disturbing this (this behaviour can be deliberate and does not on its own, signal a disorder

Question 4

Detailed AO1 for Distress and Danger

Answer 4

Distress - extent to which behaviour is causing upset and negative feelings for the individual. It is considered in isolation from other D’s as patient may be distressed in current situation but function normally in other areas of life

Danger - assessed on scale of severity under 2 elements, danger to themselves or others - if either present indicates intervention needed

Question 5

Strengths of the 4D’s (x3 AO3)

Answer 5

• the 4Ds have practical application as they are useful for professionals when considering when a patients symptoms or issues become a clinical diagnosis. Therefore allowing clinicians to more accurately determine the point where an individuals behaviour becomes ‘abnormal’, increasing accurate diagnosis and successful treatment.
• Davis (2009) showed how the 4Ds can be used with the DSM IV and introduced a 5D named duration. Therefore this meant that the criteria for diagnosis became more detailed which helps clinicians to establish accurate symptoms and features, aiding better diagnosis of metal illness
• There are standardized tests to assess symptoms of many disorders and these should be used where possible rather than making a personal judgement about a patients symptoms. This means that the 4Ds help clinicians to make a more objective diagnosis by thoroughly assessing all criteria.

Question 6

Weaknesses of the 4D’s (x3 AO3)

Answer 6

• the clinician must take into account how the person is coping with the behaviour being discussed because what is considered to be dysfunctional by one person will be seen differently by another. Therefore there is a potential for subjectivity in the interpretations of the individual patients experiences which may cause diagnosis to be inaccurate if clinicians judgement of abnormal vary
• What patients choose to discuss can vary between clinicians and different disorders may be more evident through one D than another. Therefore it can be very difficult to make sure that a clinician can explore all 4 Ds in a standardized way if they don’t have access to perfect knowledge which can mean that there are issues of reliability diagnosis of disorders using the 4D’s
• Issues with the concept of each D and how they are defined: eg deviance = not all disorders are rare (depression 20% of pop), Distress = people with autism can feel v distressed at school/work but others may be completely fine eg if they work alone (lvl of distress may be diff for same clinical diagnosis)