Classification Systems: DSM A03 Flashcards
How is reliability of the DSM checked?
Cohen’s Kappa
What is a ‘good agreement’ of reliability according to Spitzer et al (2012)
0.7
What is test-retest reliability in relation to reliability of the DSM?
When the proportion of people who get the same diagnosis when assessed and re-assessed.
What is inter-rater reliability in relation to the reliability of diagnosis using the DSM?
When the proportion of people who get the same diagnosis by an alternative practitioner.
What are the 4 types of validity relevant to diagnosis?
- Descriptive Validity
- Aetiological Validity
- Concurrent Validity
- Predictive Validity
What is descriptive validity?
When two people with the same diagnosis exhibit similar symptoms.
What is Aetiological Validity?
When two people with the same diagnosis share similar causal factors.
What is Concurrent Validity?
When a clinician uses more than one method or technique to reach the same diagnosis.
What is Predictive Validity?
Accurately predicting outcomes for an individual from their diagnosis (prognosis).
What is a strength of the reliability of the DSM?
There is a good level of agreement (Kappa Values) for some disorders:
PTSD = 0.60 - 0.79 (very good)
Seven more disorders including Schizophrenia had values of 0.40 - 0.59 (good)
All according to Regier et al (2013)
What is a weakness of the reliability of the DSM?
There are falling standards, the ‘acceptable’ level of agreement has fallen over the last 35 years, which means the DSM may be less reliable than previous years.
What is a strength of the validity of the DSM?
Support by Kim-Cohen et al (2005) for conduct disorder.
They showed concurrent validity by interviewing children and mothers, did observations of anti-social behaviours and did questionnaires with teachers.
They showed Aetiological Validity because the risk factors were the same (eg male, low income).
They showed Predictive Validity when they found that 5 year olds with CD were more likely to have behavioural problems at 7 years old.
What is a weakness of the validity of the DSM?
Labels tell us nothing about the cause.
How can we link Issues and Debates to the classification system: DSM?
One issue is making comparisons between different explanation. The trauma-informed approach has been gaining interest amongst clinicians (Johnstone & Miners, 2018).
Symptoms are survival strategies, eg hostile voices can be identified as a person who abused or hurt them. Therefore it makes sense to treat the symptom in terms of its meaning rather than trying to diagnose a disorder.
