Abnormal Flashcards

1
Q

Reliability & Validity of diagnoses

A

Rosenhan 1973

Lipton & Simon 1985

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2
Q

Rosenhan (1973) Aim

A

To determine psychiatry hospital’s ability to detect sanity

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3
Q

Rosenhan (1973) Experiment

A

Naturalistic Observational Study

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4
Q

Rosenhan (1973) Participants

A
  • 8 sane people
  • 3 psychologists, 2 doctors
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5
Q

Rosenhan (1937) Method

A
  • each participant called various psychiatric hospitals
  • they claimed they were hearing voice with negative commands
  • they answered every question honestly except name and address
  • once admitted to hospital they stopped their ‘symptoms’ acting normal/sane
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6
Q

Rosenhan (1973) Results

A
  • all admitted to hospital
  • 7 diagnosed SZ, 1 bipolar
  • never discovered
  • all classified as “in remission” not sane
  • oral acquisitive syndrome
  • average 19 days stay 7-52 range
  • over 70% of psychiatrists & nurses ignored the participants when asked for request
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7
Q

Lipton & Simon (1985) Aim

A
  • investigate reliability of diagnoses
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8
Q

Lipton & Simon (1985) Participants & Experiment

A
  • 131 PATIENTS
  • 7 external clinicians to reevaluate their diagnoses
  • field experiment
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9
Q

Lipton & Simon (1985) Method

A
  • 7 clinicians re-evaluated and diagnosed the patients from a different psychiatric hospital to determine the reliability
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10
Q

Lipton & Simon (1985) Results

A
  • only 18% of patients originally had SZ had been re-diagnosed
  • 50 patients diagnosed w/ mood disorder after reevaluation
  • only 15 had originally received a mood disorder prior
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11
Q

DSM-I year & characteristics

A
  • 1952
  • based on psychoanalytic traditions
  • finding causes to abnormal behaviour (reliant on interpretation)
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12
Q

DSM-II year & characteristics

A
  • 1968
  • still heavily psychoanalytical
  • but moving towards objectivity
  • pre Rosenhan (1973)
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13
Q

DSM-III year & characteristics

A
  • 1980
  • post Rosenhan
  • shift towards objectivity
  • describing psychological disorders through observable symptoms
  • hardcore medical and biological approach to classifying mental illness through ‘medical checklist’
  • 265 disorders
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14
Q

DSM-IV year & characteristics

A

-1994
- post Lipton&Simon
- reduce overdiagnosis from prior DSM
- included clinical significance criteria

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15
Q

DSM & Homosexuality

A
  • disorder from 1952-1973
  • quietly removed
  • psychological disorders are cultural deviations
  • DSM is ethnocentric social norms
  • pathologising deviant behaviour as mental illnesses
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16
Q

DSM Expansion

A
  • ADD in 1980
  • ADHD in 1987
  • to include women
  • expansion NOT born from observed and unaccounted abnormality
  • further diagnoses otherwise ‘normal’
    people
  • invalid diagnoses of mental abnormality
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17
Q

ICD , countries , publisher , full name

A
  • international classifications of diseases
  • world health organisation
  • europe
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18
Q

DSM , countries , publisher , full name

A
  • diagnostic and statistical manual
  • American Psychiatric Association
  • USA, UK, Australia
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19
Q

CCMD , countries , publisher , full name

A
  • chinese classification of mental disorders
  • china
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20
Q

Purpose of classification systems

A
  • reliable & valid method of diagnosing psychological disorders
  • range of psychiatrists arrive at the same diagnosis with same symptoms
  • minimising cultural, clinical, biases & subjectivity
  • psychological experience of patient corresponds to diagnosis received
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21
Q

Challenges for classification systems

A
  • cross-cultural reliability
  • validity & reliability
  • minimising clinical biases & subjectivity
  • lack of biological evidence (still marketed as such for treatments)
  • expansion of DSM (more abnormality according to DSM)
  • comorbidity (polypharmacy, difficult treatments & reduced efficacy)
  • ethnocentrism (conforming to white Christian cultural norms vs deviation)
22
Q

Swami (2012) Participants & Experiment

A
  • 1218 british adults
23
Q

Swami (2012) Aim

A

To investigate the role of gender bias in diagnosis

24
Q

What is Gender Bias

A
  • males and females are associated more with different disorders due to gendered expectations
  • and so more likely to be diagnosed w mental illness which matches gender stereotype
  • than other gender w same symptoms
25
Q

Swami (2012) Method

A
  • participants given a description of a persons symptoms which corresponded to depression of DSM IV
  • the only difference was that half got the name of a female & other name of male
  • asked to determine whether description had mental health disorder
26
Q

Swami (2012) Results

A
  • participants were more likely to indicate the male did NOT suffer a disorder
  • whereas women were more likely to be indicated as suffering
27
Q

Clinical Biases Stuides

A
  • gender bias Swami (2012)
  • labelling bias Rosenhan (1973)
  • confirmation bias Lipton & Simon (1985)
28
Q

Reliability & Validity Studies

A
  • Rosenhan (1973)
  • Lipton & Simon (1985)
29
Q

Classification of Disorders

A
  • DSM
  • Rosenhan (1973) DSM-II
  • Lipton & Simin (1985) DSM-III
  • Swami (2012) DSM-IV
30
Q

Abnormality Vs. Normality

A

Models
- Jahoda (1958)
- Rosenhan & Seligman (1989)

Analysis Difference
- Rosenhan (1973)
- Lipton & Simon (1985)

31
Q

diagnosis of mental illnesses definition

A
  • When psychiatrists classify abnormalities in the mind via, thinking patterns, behaviours, deviations (statistically & culturally), originating in the mind

(Not very good to be changed)

32
Q

validity definition

A
  • accurately measuring (objectivity)
  • classifying symptoms that lead to an effective treatment as this would mean the diagnosis is true
33
Q

reliability definition

A
  • multiple people agree & come to same conclusion
  • multiple psychiatrists agree to diagnosis in accordance to same symptoms
34
Q

Rosenhan (1973) Implications

A
  • psychiatrists unable to detect sanity
  • behaviour was distorted to fit into label of abnormality
  • DSM-II is not effective in identifying sanity
  • depersonalisation/dehumanisation of misdiagnosis
35
Q

Lipton & Simon (1985) Implications

A
  • same symptoms do not correspond with same diagnosis from another psychiatrist
  • questioning reliability of DSM & of defining abnormalities
36
Q

Swami (2012) Implications

A
  • although done on members of the public (not psychiatrists) that cultural norms impact how we interpret the same symptoms to be abnormal vs normal
37
Q

Rosenhan Follow-Up Study

A
  • psuedo patients would be sent to psychiatric hosptial
  • staff were told to detect them
  • Rosenhan gave none
  • hospital detected 41 pseudo patients
38
Q

Rosenhan Stanford University Comparison (Aim)

A
  • ignoring of pseudo patients due to general superiority complex, or lack-of-care in hospitals
39
Q

Rosenhan Standford University Comparison (Method)

A
  • pseudo students approached faculty members at standford who appeared busy
  • asking for directions to parts on the campus
40
Q

Rosenhan Standford University Comparison (Results & implications)

A
  • all questions were answered & never ignored
  • psychiatric hospital’s dehumanising culture which devalues patients resulting in lack of care
41
Q

Abnormality Definitions

A

Jahoda (1958)
Abnormality is a deviation from ideal mental health

Rosenhan & Seligman (1989)
Failure to function adequatley
Cannot meet demands of ones own life regularly

42
Q

Jahoda (1958) Aim & Experiment & Method

A
  • determine criteria for ideal mental health
  • field survey
  • 740 adults responded to survey
  • Jahoda synthesised answers to model ideal mental health
43
Q

Jahoda (1958) Results

A

CHEAAP

  • capacity for growth
  • health relationships
  • environmental mastery (good daily functioning)
  • autonomy/independence
  • accurate perception if reality
  • positive self perception

abnormality is deviation from this

44
Q

Jahoda (1958) Limitations

A
  • infeasible to achieve all six parameters
  • most people would be classified as abnormal from this
  • cannot measure degrees of abnormality as these are HARD TO QUANTIFY
  • ‘realistic’, ‘accurate’ etc need further operationalisation
    (turning abstract ideas into measurable)
45
Q

Rosenhan & Seligman (1989) criteria

A

MISO-UUV

  • maladaptiveness (self destructive)
  • irrationality (behaviours don’t make sense to others)
  • suffering (subjective experience of ones state)
  • observer discomfort
  • unconventional (standing out, deviations from social norms)
  • unpredictability (inconsistent actions)
  • violation of morality (against common moral norms)
46
Q

Rosenhan & Seligman (1989) Limitations

A
  • abnormal behaviour may become adaptive
  • a lot of this measure is subjective to observer (discomfort)
  • unconventional behaviour (extreme sports)
47
Q

Abnormality - Statistical Infrequency (general definition)

A
  • a behaviour is classified as abnormal if it is statistically unusual
  • 1st threshold usually outside of the 95% most common in the range
  • 2nd threshold 99%
  • 3rd threshold 99.9% (severely abnormal)
48
Q

Abnormality - Statistical Infrequency (limitations)

A
  • statistical norms change
  • IQ increases 3 per 10 years
  • statistically infrequent behaviour could be advantageous
  • most people are statistically infrequent in ATleast one area
49
Q

Abnormality - Deviation from Social Norms (general definition)

A
  • abnormality when falls outside boundaries of social accepted behaviour
50
Q

Abnormality - Deviation from Social Norms (limitations)

A
  • societies different globally and change over time
  • this sets precedent to use abnormality as means of social control
  • socially acceptable behaviour may still be maladaptive
  • acceptability changes on social setting too
51
Q

Clinical Biases Definition

A
  • any cognitive bias that affects the validity of a diagnosis