Conceptual Issues: Classification and Diagnosis. Flashcards
Understanding conceptual issues within the classification and diagnosis of mental illness.
What are the two current classification systems?
What were they initially influenced by and what do they reflect now?
The International Classification of Diseases and Health Related Problems (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM).
They were initially influenced by psychoanalysis but now reflect the ‘medical model’.
What are the two main components of mental illness that the handbooks focus on?
- Mental illness is comprised of unacceptable behaviour.
2. Mental illness is caused by internal dysfunction.
In what way do the handbooks fail to understand mental illness (2 things)? And what problem might it cause?
They fail to understand mental illness by only looking at external symptoms and seeing the person as the problem (society as the norm).
Could indicate that we overestimate mental illness.
What are some assumptions that the medical model makes about illness and health?
Illness is qualitatively different from health (either one or the other).
What are some assumptions the medical model makes about different illnesses (5 things)?
Different illnesses are distinguishable from one another; do not cause one another; occur independently; have specific causes and respond to specific treatments.
When diagnosing what is the ultimate goal (based on the medical model)?
To diagnose based on finding the cause of an illness.
What were the early ideas about how mental illness should be identified and thus categorised?
Give some examples.
That mental illness should be identified according to underlying BIOLOGICAL CAUSES (bacterial/viral infections; localised brain damage; toxins; genetics).
What did early understandings of mental illness cause?
Harmful treatments that had no empirical basis (lobotomy, etc.).
What model came after the early biological model?
The psychoanalytic model.
In what ways did Freud revolutionise the concept of mental illness (3 things)?
- Put mental illness on a continuum (pathology being an extreme manifestation of ‘normal’).
- Introduced different mental illnesses (neuroses, depression, etc.).
- No dividing line between different illnesses (similar symptoms for different illnesses)
A quick overview of the development of the DSM:
DSM-1 (1952) & DSM-2 (1968): psychoanalytic.
DSM-3 (1980) & beyond:
reflect the medical model but still contain disorders introduced by psychoanalysis.
DSM-3 and beyond reflect the medical model. What were some changes made to classification in these editions, after the influence of psychoanalysis? (2 things)
- No theoretical assumptions about causation.
2. If causation is not known, provide a description of symptoms.
When the causation of a mental illness is NOT known, what must a clinician do?
Look for symptoms that might be individually treatable, OR that cluster to form a syndrome that is treatable.
How does a clinician/researcher understand symptoms? And how might they then understand the underlying disease/cause of symptoms?
Understanding symptoms by: measurement, direct observation, patient report.
Understanding the disease by: observing how symptoms cluster together, observing the course of an illness.
What are some improvements on reliability in the later DSM’s?
Experts can agree on diagnosis for effectively/efficiently.
