Classification systems: The DSM Flashcards
What is the DSM?
1
- Class system of symptoms, features, associated risk factors of 300+ mental/behavioural disorders
What does section 1 involve (DSM-5)?
1
- Guidance about using new system
What does section 2 involve and what was added (DSM-5)?
2
- Disorders, categorised based on knowledge of underlying causes/similarities in symp
- Dimensional assessment (independent measure of lvl, nb, duration of symp)
What does section 3 involve (DSM-5)?
2
- Suggestions for new disorders, needs ^investigation
- Impact of culture on presentation of symptoms, particularly if clinician from diff cultural background
How do you diagnose using the DSM?
3
- Gather info from observation, unstructured interviews
- Structured interview schedules based on symp lists (Beck Depression Inventory)
- Diagnostic part = Rule out non-matching disorders
What is Cohen’s kappa and how is it reliable? (Spitzer)
3
- Statistic (decimal)
- Proportion of people who receive same diagnosis when assessed then re-assessed
- At later time (test-retest) or diff practitioner (inter rater)
What did Spitzer et al. say was a good agreement?
1
0.7
What is descriptive validity?
1
- 2 people w same diagnosis exhibit similar symptoms
What is aetiological validity?
1
- When they share similar causal factors
What is concurrent validity?
2
- Clinician uses 1+ method to reach diagnosis
- Both methods lead to same diagnosis
What is predictive validity?
1
- Accurately predict outcome for individual from diagnosis e.g. prognosis
Evaluate reliability of DSM
1
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)
Evaluate validity of DSM
2
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