classification of disorders

Question 1

when was DSM 5 introduced

Answer 1

2000 published in 2013

Question 2

DSM 5 is no longer multi-axial. what does this mean

Answer 2

looks at the individual as a whole in order to diagnose the disorder instead of considering many different aspects as this became too heavily focused on the ideas. therefore the method now used in non-axial

Question 3

what disorder is no longer controversially classified as a separate disorders and has now been placed on a spectrum

Answer 3

Asperger’s disorder. on a spectrum with ASD

Question 4

how has the diagnosis of schizophrenia changed

Answer 4

must now be present for 6 months and must include at least one month of active symptoms before a full diagnosis takes place. categorised by delusions, hallucinations, disorganised speech and behaviour and other symptoms that cause social or occupational dysfunction

Question 5

how has the DSM-V taken culture into account

Answer 5

incorporates a greater cultural sensitivity throughout the manual. gives more detailed and structured information about cultural concepts of distress. different cultures explain symptoms in different ways.

Question 6

organisation of DSM - V

Answer 6

section 1 - will give an introduction to DSM -V with info on how to use the updated manual
section 2 - will outline the categorical diagnoses according to a revised chapter organisation
section 3 - include conditions that require further research before their consideration as formal disorders, as well as cultural formulations

Question 7

changes of DSM V

Answer 7

• chapter order restructured based on disorders apparent relatedness to one another as reflected by similarities in disorders underlying vulnerabilities and symptom characteristics. the changes with align DSM-V with the world health organisations ICD
• removal of multiaxial systems

Question 8

is DSM free

Answer 8

no. provides a large proportion of APA revenue

Question 9

is ICD free

Answer 9

yes

Question 10

what does DSM include

Answer 10

covers only mental disorders

Question 11

what does ICD include

Answer 11

addresses all health issues ->

all diseases

Question 12

who published DSM

Answer 12

american psychiatric association

Question 13

who published ICD

Answer 13

world health organisation

Question 14

who uses DSM

Answer 14

psychiatrists

Question 15

who uses ICD

Answer 15

countries and front line service providers

Question 16

what language is DSM in

Answer 16

english

Question 17

what language is ICD in

Answer 17

all languages

Question 18

define comorbidity

Answer 18

more than 1 disorder. the presence of one or more disorder co-associated with the primary disorder of the patient

Question 19

reliability of DSM

GOOD

Answer 19

good –>
GOLD STEIN looked at the effect of gender of diagnosis of schizophrenia. she re-diagnosed 199 patients, originally diagnosed using DSM II some differences - she asked two other experts to re-diagnose a random sample of 8 of the patients using the case histories with all indication of previous diagnoses removed. high level of agreement

Question 20

reliability of DSM

POOR

Answer 20

poor –> BECK ET AL looked at the inter-rater reliability between 2 psychiatrists when considering the cases of 154 patients. the reliability was only 54% meaning they only agreed on a diagnosis for 54% of 154 patients
ROSENHAN –> of 193 patients that entered into a hospital - 41 were judged as being a pseudo-patient (they were all real patients)
KIRK AND KITCHENS argued that there are methodological problems with the studies used to test the reliability of the DSM up until 92. these limit the generalisability off the findings. they argued that training and supervision of interviews was insufficient and that they lacked the commitment and skills to be accurate. findings might not relate to clinicians in normal clinical settings

Question 21

validity of DSM

GOOD

Answer 21

HOFFMAN –> alcohol and cocaine dependence and abuse in prison inmates. computerised structured interview. found a high concordance with their interview findings and DSM diagnosis. that dependance was a more severe syndrome than abuse in alcohol and cocaine
has converged validity as there was a correlation found between the drug use and the interview results.
KIM-COHEN had CONCURRENT, CONVERGENT and PREDICTIVE VALIDITY.
interviewed mothers, gave questionnaires to teacher regarding symptoms over last 6 months
predictive validity - 5 yr olds diagnosed with conduct disorder were more likely to have behavioural and educational difficulties
concurrent and convergent validity - mothers responses, questionnaires and child self report all led to diagnosis of conduct disorder

Question 22

validity of DSM

POOR

Answer 22

NICHOLLS over 50% could not be diagnosed using DSM, but this figure inflated so many raters giving the same rate that the children were not rateable using these criteria
KIRK AND KUTCHINS as an unreliable diagnostic tool also lacks validity, suggested that DSM could also lack validity
ROSENHAN shows that DSM has a low validity as 7/8 pseudo-patients were diagnosed with sz. comorbidity issues