Clinical Psychology Flashcards
What are the 4 D’s?
Deviance, dysfunction, danger and distress.
Define ‘deviance’ and give an example.
Behaviour and emotions that are not normal in society.
The behaviour/emotions have to deviate from societal norms and are seen as unacceptable in society.
An example would be pedophila, characterized by recurrent fantasies, which symptoms must present significant distress and the individual must be over the age of 16 and 5 years older than their subject of desire.
Define ‘dysfunction’ and give an example.
Abnormal behaviour that leads to an inability to complete daily tasks.
An example would be Major Depressive Disorder; if an individual quits his job and runs from his family, that would be a sign of dysfunction.
Define ‘distress’ and give an example.
The individual’s subjective feelings of pain, anxiety, depression, agitation, disturbance of sleep, etc that accounts for negative feelings of individuals with psychological disorders.
An example would be social anxiety. The individual with this disorder may feel anxious about social gatherings, to the point of having a panic attack which cause distress.
Define ‘danger’ and give an example.
When an individual displays behaviour that means they are a danger to themself or to others.
An example would be smoking. It can be dangerous to the individual (lung cancer) but can also be dangerous to others (second hand smoking.)
Strengths of the 4 D’s?
Can be a useful tool for professionals when considering a patient’s symptoms.
Supports the validity of the DSM system in that various diagnosis are shown to focus on specific D’s; each has value.
Clinicians communicating with other clinicians when making diagnoses; increases inter-rater reliability.
Weaknesses of the 4 D’s?
There may be a lack of objectivity
If the 4 D’s were used by 2 different therapists, there may not come to the same conclusions.
What does the DSM describe?
It describes the symptoms, features and associated risk factors of over 300 mental and behavioural disorders.
When was the DSM-V1 published?
1952.
When was the most recent edition of the DSM published?
2013.
How many sections is the DSM made up of?
4.
What is the first section of the DSM?
It offers guidance about using the new system.
What is the second section of the DSM?
It details the disorders and is categorised according to our understanding of underlying causes and similarities between the symptoms.
What is the third section of the DSM?
It includes suggestions for new disorders which require further investigations. It includes information about the impact of culture on the presentations of symptoms.
What is the fourth section of the DSM?
It includes the impact of culture.
How is information gathered using the DSM?
Clinicians may gather info through observations but majority of the info was gathered through unsturcutured interviews.
The process involves ruling out disorders which do not match the person’s symptoms.
What is test-retest reliablity?
A measure of reliablity obtained by administering the same test twice over a period of time to a group of individuals.
What is inter-rater reliablity?
The extent to which two or more observers/raters/examiners agree.
Strength of the reliablity of the DSM?
Good level of agreement for some disorders - the field trials demonstrated impressive levels of agreement between clinicians for a variety of disorders.
Reiger and colleagues (2013) found that for 3 disorders had kappa values ranging from 0.60 - 0.79 (very good) but diagnoses of schizophrenia had kappa values of 0.40 - 0.59 (good).
It is clear that clinicians have adopted well to these changes.
Weakness of the reliablity of the DSM?
Falling standards - what counts as an acceptable level of agreement has fallen over the years.
Cooper (2014) explains that the DSM-5 task force classified 0.2 - 0.4 as acceptable. One of the least reliable diagnoses (0.28) was major depressive disorder.
This suggests that the DSM may be less reliable than previous versions and that diagnoses of MDD may have been in error.
Strength of the validity of the DSM?
Support for validity of conduct disorder - evidence supports the validity of certain disorders.
Kim-Cohen et al. (2005) demonstrates the concurrent validity of conduct disorder through interviewing kids. Specific risk factors i.e low income was common in most cases.
This suggests that accurate diagnoses could reduce adult mental health problems which are frequently preceeded by conduct disorder.
Weakness of the validity of the DSM?
Labels tell us nothing - lacking in validity; critisim from psychiatrists and psychologists believe it tells us nothing about the causes of a disorder.
What is the ICD?
The ICD is the international classification of disorders. It includes both physical and mental disorders.
Like the DSM, The ICD has seen many revisions across the years. The most recent revision was the ICD-10, in 1992.
How is the ICD structured?
Chapter 5 is titled ‘Mental and Behavioural Disorders’.
Each disorder has a code, starting with F. They are listed consecutively and there are 11 sections.
For example, schizophrenia, schizotypal and delusional disordes is one section grouped as F20 - F29.
F20 is the subcategory of schizophrenia and is further differentiated; F20.0 - paranoid schizophrenia.