Clinical Flashcards
Deviance
Behaviours that are unusual, undesirable, or bizarre compared to social norms
This leads to negative attention from others + exclusion
Dysfunction
Inability to conduct everyday activities which can interfere with a persons ability to carry out normal roles + responsibilities
Includes self care, communication + socialising
Distress
When emotional symptoms such as anxiety cause distresss to be manifested as physical symptoms such as tiredness + pains
Danger
They are at risk of causing physical or psychological harm to the self or others
Such as hostile + hazardous behaviour
Diagnosis of mental health disorders - what are the 4 D’s
Deviance
Dysfunction
Distress
Danger
Diagnosis
The process of matching a persons behaviours, cognitions, feelings + desires
to the signs + symptoms of a recognised mental health disorder
in order to provide information about prognosis and treatment
David (2009)
Claims that there needs to be a sixth D as clinicians need to consider how long these symptoms have been occurring
Duration helps, understand whether a disorder is only over a small period or needs to be observed to make a diagnosis
Advantages of the 4 D’s
Help to avoid errors in diagnosis, like not seeing a disorder or misdiagnosing
Different disorders display a different combination of D’s + all feature in the diagnostic criteria to determine mental health disorders
Application
Disadvantages of the 4 D’s
There’s no rules on how the 4 D’s should be combined so may not be diagnosed properly
5 D’s can’t be objectively measured so can be confused and aren’t reliable
Putting on a label can lead to stereotypes and be more damaging
DSM (diagnostic + statistics manual)
A classification system that describes the symptoms, features + risk factors of 300+ mental + behavioural disorders in 22 categories (1952)
DSM-5 (2013)
Section 1: Offers guidance about using the new system
Section 2: Details disorders + is categorised to causes, symptoms + differences in disorders
Section 3: Suggestions for new disorders
How do clinicians diagnose a disorder
Gathering information about the individual through
observation
an unstructured clinical interview
ruling out disorders + picking the right one
Free pass
Advantages of DSM
field Rp trials showed levels of agreement between clinicians - Reliability
Evidence supports the validity of some disorders
Disadvantages of DSM
What counts as an accepted level of agreement has dropped over the years - Reliability
Psychologists feel that is lacks validity as it doesn’t specify what causes a disorder - Validity
DSM-1 (1952)
Included homosexuality as a psychopathic tendency
Was a money scheme for pharmacists
For shell-shock + PTSD
102 diagnoses in 2 categories
DSM-2 (1968)
More emphasis put onto ordinary disorders + homosexuality was no longer a sociopathic tendency
Included 182 disorders
Based off Freud, Rosenhan + Bandura
DSM-3 (1980)
Developed psychometric testing + mood altering drugs
Based of observation + biological evidence
Developed a standardised language for diagnosis
DSM-4
Less reductionist + more holistic + includes culture-bound syndromes
Psychiatric, personality, environment, stress, global functioning, general medical conditions
International statistical classification of diseases + related medical problems (ICD)
Classification system that includes mental + physical disorders
Disadvantage of ICD
The presentation, communication + interpretation of symptoms is shaped by language + culture so clients in different cultures may be misdiagnosed - also bad for research
Reliability of ICD
+Research comparing reliability of ICD9 + 10 of about 3000 patients accuracy improved from 68%-94% shows that the new disorders added didn’t affect diagnosis (inter-rater)
-reliability is meaningless without validity + the validity of diagnoses were often conflicted, reliability doesn’t test that the system is valid
Validity of ICD
Has predictive + concurrent validity as it shows that initial diagnosis were useful in their ability to accurately predict future outcomes
-need to make it easier to use + diagnose by not adding only disorders
How does ICD work
Each disorder has a code which allows for indexing medical records + makes it easier when conducting research
Schizophrenia
A psychotic disorder, characterised by positive symptoms such as delusions, hallucinations + negative symptoms may also be present such as lack of emotion or speech
Symptoms
Subjective experiences reported by the individual that can’t be observed
Features
Information about prevalence eg gender or age
Thought insertion
Believing one’s thoughts have been implanted by an external source
Hallucinations
Reception experiences, which don’t correspond with reality
Delusions
Fixed beliefs that are resistant to change + implausible to people of the same cultural background
Disordered thinking
Jumbled + unrelated thoughts leading to incoherent speech
When can schizophrenia be diagnosed
Until the individual has experienced at least 1 month of active symptoms and experienced disturbance every day functioning for at least 6 months
Advantages of reliability of schizophrenia
Diagnosis of schizophrenia can be made with a high degree of consistency with both DSM-5 + ICD 10. This suggests that descriptions for schizophrenia are sufficiently detailed to allow clinicians to distinguish it from other conditions.
Disadvantages of reliability of schizophrenia
Prognosis is variable + hard to predict as it shares as many symptoms with other disorders.
It can be difficult if the client is from a different cultural background from the psychologist as it requires an awareness + sensitivity to cultural + linguistic differences.
Unipolar depression
An effective disorder, characterised by low mood, loss of interest or enjoyment, marked tiredness +fatigue has to have been experienced for over two weeks
Affective symptoms of depression
People with depression may feel sad, empty, hopeless + lack pleasure or interest. Children + adolescents may be irritable, lack pleasure + be fearful
Bodily symptoms of depression
May have reduced energy levels which has a knock on effect to behaviour
significant weight loss or gain due to changes an appetite
Sleep patterns are disturbed with people getting insomnia
Cognitive symptoms of depression
Often experience negative thoughts + blame themselves for things out of their control
Feel guilty + unworthy of others
Have a lack of self-confidence + feel incompetent
Have a pessimistic outlook
Have thoughts of death or suicide
Behavioural symptoms of depression
Fatigue and loss of pleasure leads to social withdrawal + diminished activity
Show signs of agitation + slowed movements
Must be observable to be a symptom
What is depression linked to
Depression is linked to many chronic physical illnesses such as cancer + cardiovascular disease
How can cultural differences make diagnosis difficult? (DSM-5)
Many cultures don’t accept or recognise depression as a disorder + don’t have a word in their language for it.
Symptoms for it may have a specific cultural form so clinicians can’t diagnose.
DSM5 includes a section on how to conduct a ‘cultural formulation interview’
