clinical key question

Question 1

what is the clinical key questions

Answer 1

is it a problem for society if different cultures define different mental health disorders differently

Question 2

AO1- DSM (5)

Answer 2

• Requires at least 2 of the 4 positive symptoms and 1 must be either hallucinations, delusions, or disordered thinking
• A diagnosis must be provided when the person has experienced these symptoms for 6 months
• clinicians gather information about an individual through observations
• structured interviews using questionnaires such as Becks Depression Inventory, which is based on symptoms list and has 21 questions each with 4 possible responses
• written for the use of diagnosing WW2 soldiers so orientated around western culture

Question 3

AO1- ICD (4)

Answer 3

• ICD considers subtypes e.g. catatonic behaviour and paranoia
• The ICD contain both physical and psychological disorders and is used when diagnosing mental illnesses
• The ICD is multilingual and freely available and therefore is used cross-culturally by researchers and clinicians across the world
• The clinician selects key words from the interviews held with the patient and then selects key words such as hallucinations to look up in the alphabetical index to locate their specific category

Question 4

AO1- CCMD (4)

Answer 4

• Collectivists cultures e.g. China have their own classification manuals for mental health disorders. Different classification manuals reflect the beliefs of each culture
• The CCMD is similar in structure to the ICD and DSM but contains around 40 culturally relevant diagnoses
• Koro (Genital Retraction Syndrome) is an excessive fear of the genitals shrinking back into the body, which is a specific disorder relevant to the Chinese and East Asian culture
• Different cultures have different priorities in terms of mental health.

Question 5

A01- 4D’S (1)

Answer 5

• acknowledges how behaviour is culturally relative within the category of Deviance

Question 6

A03- DSM (2)

Answer 6

• Rastafarians use neologism, which are a play on English words, (‘overstand’ instead of ‘understand’). For a clinician, who is unaware of these cultural norms, they may see this as a sign of disordered thinking
• Luhrmann- interviewed American, Indian and Ghanian people. 70% American’s- voices they heard told them to hurt people, 50% Ghanian’s- voices were mainly positive. Indian people tended to hear more family members, only 10% of Americans only heard family members

Question 7

A03- ICD (1)

Answer 7

• Gurland- psychiatrists in New York were more likely to diagnose clients with Schizophrenia than Depression compared to psychiatrists in London, due to differences in the clinician and not the patient themselves. Individual differences in cultural backgrounds, experience and training can affect their interpretation of symptoms, leading to differential diagnoses.

Question 8

A03- CCMD (1)

Answer 8

• A report on the priorities for EMRO (Eastern Mediterranean Regional Office) found that they had evidence to justify the 3 priorities in action; ‘the respect of human rights in people admitted to hospitals’, ‘their gradual transfer of their care to the community level’, and ‘the reconstruction of the health care systems of Afghanistan in which no mental health care is provided’

Question 9

AO3- 4D’S (2)

Answer 9

• Lakeman - hallucinations in the Māori tribe who hear voices. This would be seen as a symptom of Schizophrenia in many cultures but in Māori culture it is seen as a spiritual experience
• Becker- reports of self inflicted vomitting increased from 0-11.3%, score of 20+ on EAT-26 questionaire over doubles. This was all based on the exposure of TV as well as supermodels which encouraged the Fijian social norms to deteriorate.