Classification systems: The DSM

Question 1

What is the DSM?

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Answer 1

• Class system of symptoms, features, associated risk factors of 300+ mental/behavioural disorders

Question 2

What does section 1 involve (DSM-5)?

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Answer 2

• Guidance about using new system

Question 3

What does section 2 involve and what was added (DSM-5)?

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Answer 3

• Disorders, categorised based on knowledge of underlying causes/similarities in symp
• Dimensional assessment (independent measure of lvl, nb, duration of symp)

Question 4

What does section 3 involve (DSM-5)?

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Answer 4

• Suggestions for new disorders, needs ^investigation

- Impact of culture on presentation of symptoms, particularly if clinician from diff cultural background

Question 5

How do you diagnose using the DSM?

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Answer 5

• Gather info from observation, unstructured interviews
• Structured interview schedules based on symp lists (Beck Depression Inventory)
• Diagnostic part = Rule out non-matching disorders

Question 6

What is Cohen’s kappa and how is it reliable? (Spitzer)

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Answer 6

• Statistic (decimal)
• Proportion of people who receive same diagnosis when assessed then re-assessed
• At later time (test-retest) or diff practitioner (inter rater)

Question 7

What did Spitzer et al. say was a good agreement?

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Answer 7

0.7

Question 8

What is descriptive validity?

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Answer 8

• 2 people w same diagnosis exhibit similar symptoms

Question 9

What is aetiological validity?

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Answer 9

• When they share similar causal factors

Question 10

What is concurrent validity?

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Answer 10

• Clinician uses 1+ method to reach diagnosis

- Both methods lead to same diagnosis

Question 11

What is predictive validity?

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Answer 11

• Accurately predict outcome for individual from diagnosis e.g. prognosis

Question 12

Evaluate reliability of DSM

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Answer 12

Field trials = ^Lvls of agreement between modern clinicians, ^int reliability. Regier et al. found 3 disorders inc PTSD = 0.60 - 0.79 (kappa score) - very good, 7 more inc schizo = 0.40-0.59 (good)

Question 13

Evaluate validity of DSM

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Answer 13

Cohen et al. found concurrent validity of conduct disorder via interviewing children/their mothers, observing child’s Anti-SB, questionnaire done by child’s teacher. Risk factors (male, >income) ^common in cases (aetiolog validity). 5yr old w CD = ^likely to show educational problems at 7yrs old (predictive validity)

Criticism from psychiatrists/psycho’s, tells nothing of root causes, only classifies it, >aetiolog validity. Circular arguments: Why is a person hearing voices? As they have schizo. How do we know they have schizo, as they’re hearing voices. Label not cause