Clinical Psychology Flashcards
AO1: Diagnosis of mental disorders
Deviance- Unusual, undesirable or bizarre behaviour that breaks social or statistical norms.
Dysfunction- Inability to complete everyday activities e.g. getting up in the morning. Measured using WHODAS II which is a questionnaire that looks at a persons understanding of what’s going on around them, communication and deterioration in selfcare.
Distress- The subjective experience of feeling upset and/or anxious could be manifested as physical symptoms such as aches and pains. Measured using the Kessler Psychological Distress Scale.
Danger- At risk of causing physical or psychological harm to the self or others. Requires the agreement of 3 professionals in order to detain a person.
Strengths: Diagnosis of mental disorders
Help avoid erroneous diagnosis- Without all 4 some could be missed as they are not ‘dangerous’ such as depression as it may not also cause deviant behaviour.
Application to diagnosis- Can help decide whether making a diagnosis is appropriate. As different disorders tend to display a different combination of Ds
Weaknesses: Diagnosis of mental disorders
Lack of objectivity- As the subjectivity is based on the individual patients experience. Which affects the reliability of the diagnosis.
Labelling-FAZEL as schizo not more dangerous It creates labels for people with mental health disorders and using ‘danger’ may create a self fulfilling prophecy.
Cultural differences- Some behaviour that might be abnormal for one person might be normal for another. Neologisms in Rastafarianism culture.
AO1: DSM
Describes the symptoms, features and associated risk factors of over 300 mental and behavioural disorders and arranged into 22 categories.
Generates revenue for the American psychiatric Association. First published in 1952 but has been revised a number of times.
Section 1: Offers guidance about using the new system.
Section 2: Details the disorder and is categorised according to our current understanding of underlying causes and similarities between symptoms.
Section 3: Includes suggestions for new disorders which currently require further investigation.
Clinicians gather information through observation but much of the diagnosis will be based on unstructured (clinical) interviews. Or through structured interviews such as Becks depression inventory.
Strengths: DSM-5
Reliability- Good levels of agreement for some disorders- Regier reported that 3 disorders inc. PTSD, had Kappa values of 0.6 to 0.79 (very good)
Validity- Kim-Cohen demonstrated concurrent validity of conduct disorder through interviewing children and their mothers. Also finding aetiological validity as many causal factors would be similar. Predictive validity was demonstrated as they were more likely to display difficulties ages 7.
Weaknesses: DSM-5
Reliability- Falling standards as Cooper says the DSM-5 task force classify levels as low as 0.2-0.4 as ‘acceptable’
Validity- Psychiatric diagnosis tells us nothing about what is causing a disorder. Diagnosis is simply a label that tells us nothing useful.
AO1: ICD-10
Both physical and metal disorders
It is multilingual and freely available.
It provides a ‘common language’ so that data collected in different countries can be usefully compared.
Chapter 5 is entitled mental and behavioural disorders. Each disorder has a code starting with F and there are 11 sections.
Using it- A clinician selects key words from an interview with a client that relate to their symptoms and looks these symptoms up in an alphabetic index. They then use the other symptoms to locate a subcategory.
Strengths: ICD-10
Improvements- Due to feedback from other psychologists and through converting it into multiple languages the inconsistencies have been revealed which allowed them to be changed and improved to make it clearer.
Ponizovsky- Compared reliability of the ICD-9 to ICD-10, 3000 assessed, they found with test-retest the proportion of people who received the same diagnosis rose from 68% to 94.2%.
Mason- Found that diagnosis of schizophrenia using ICD-10 has good predictive validity. That the ICD-9 and ICD-10 were ‘reasonably good at predicting disability’ 99 people 13 years later.
Weaknesses: ICD-10
Meaningless- High reliability is meaningless without validity. Tells nothing of true meaning of diagnosis. Unless the system is valid then reliability means nothing.
Gurland- Psychologists in New York were more likely to diagnose clients as having schizophrenia than affective disorders. Compared to psychiatrists from London.
AO1: Rosenhan
Aim- Aimed to see if diagnosis of mental disorders was valid/reliable
Procedure-
- -All pseudo patients were admitted with either a diagnosis of schizophrenia or manic depression (now bipolar)
- -Rosenhan said the pseudo patients acted normally once admitted e.g. making conversations with fellow patients.
- -Once admitted the pseudo patients did not claim to hear voices anymore
Findings- 7 diagnosed with schizophrenia and 1 with bipolar. Length of Hospitalisation varied from 7 to 52 days. 30% of patients on the ward voiced suspicions.
Conclusions- ‘we cannot distinguish between the sane and insane in hospitals.’
Strengths: Rosenhan
Ecological validity- The validity of the results is higher as a variety of real hospitals were selected for the observations and staff had no idea.
Reforms- Highlighted the issues with diagnosis so the DSM was reformed.
Generalisable- Used a range of hospitals, private and shabby ones and teaching and research hospitals.
Mistreatment- Provided an account of lack of respect and occasional mistreatment. Average of 6.8 mins of attention.
Weaknesses: Rosenhan
Consent- As they did not know they were part of a study the staff did not give consent to take part in the study.
Unrealistic- As the pseudo patients were admitted, the staff had no reason to think they were faking it, as healthy people do not say they hear voices that are not there.
Impact- Staff could be distressed, and may question their work which would negatively impact on real patients.
