biomedical model pt. 2: diagnosis of mental disorders

Question 1

diagnosis of mental disorders

what is diagnosis based on?

Answer 1

a classification system - specifies symptoms required for a given diagnosis

Question 2

diagnosis of mental disorders

meeting diagnostic criteria:

Answer 2

• meeting diagnostic criteria (e.g. panic attacks) is not sufficient
• the symptoms must cause: clinically significant distress or impairment in social, occupational, or other important areas of function

Question 3

historical context

who developed the classification system for mental disorders?

Answer 3

Emil Kraepelin
He emphasised the importance of brain pathology in mental disorders

Question 4

DSM

How many disorders does the most recent version of the DSM include?

Answer 4

297 disorders
some have been removed and are no longer considered mental disorders (e.g. homosexuality)

Question 5

DSM major revisions

DSM I (1952)

3 points

Answer 5

• established mainly by psychoanalysts
• disorders were described using ‘prototypes’
• no diagnostic criteria

Question 6

DSM II (1958)

3 points

Answer 6

• psychoanalysis still dominated
• homosexuality replaced by ‘sexual orientation disturbance’
• no clear descriptions of ‘disorders’

Question 7

DSM III (1980)

3 points

Answer 7

• relied to a much greater extent on empirical data
• included specific diagnostic criteria
• translated into 20 languages

Question 8

DSM III-R (1987)

3 points

Answer 8

• renamed, added and deleted categories
• pressure groups had an influence e.g. ego-dystonic homosexuality removed
• increased reliability

Question 9

DSM IV (1994)

3 points

Answer 9

• term neurosis was dropped
• conservative approach
• inclusion of a clinical significance criterion to almost half of all the categories, which required that symptoms cause: “clinically significant distress or impairement in social, occupational or other important areas functioning”

Question 10

DSM IV-TR (2000)

Answer 10

• minor changes related to prevalence rates, course and aetiology

Question 11

DSM 5 (2013)

2 points

Answer 11

• most substantial revision in the last 20 years
• clearly influenced by the biomedical model of mental disorders

Question 12

what does the DSM 5 state?

Answer 12

• does not include all possible mental disorders
• cultural and social context must be considered
• making diagnoses requires clinical judjement, not just checking sypmtoms

Question 13

what are diagnoses made on the basis of?

3 factors

Answer 13

• clinical interview
• DSM-5 text descriptions and criteria
• clinical judgement

Question 14

new disorders included in DSM 5

3 disorders

Answer 14

• binge eating disorder
• hoarding disorder
• mild neurocognitive disorder

Question 15

Advantages of classification

advantages of classification:

Answer 15

• facilitates communication between researchers and clinicians by providing a common professional language
• enables consistency in empirical research
• provides a framework for discussing difficult topics and offering help
• labels help to define groups

Question 16

limitations of classification

Limitations of classification

3 points

Answer 16

• some patients feel disempowered by diagnosis or exclueded from society
• been seen as ‘mentally ill’ can cause more distress
• people seen as mentally ill are often mistreated