Diagnosing mental disorders 4D's Flashcards
Statistical infrequency
if something is rare it is abnormal
Social deviation
if something goes against social norms it is abnormal
Failure to function adequately
if behaviour stops you from functioning (e.g. physically, mentally) then t is abnormal)
The 4Ds
used by clinicians to determine whether behaviour is abnormal
Deviance
Refers to the extent to which the behaviour is rare; if it is rare and deviant from the norm then it might signify a disorders present.
Dysfunction
If behaviour is significantly interfering with the person’s life then a disorder may be present e.g. cannot go to work, care for themselves. The clinician should look carefully into all aspects of the person’s life, as impairment may not be obvious.
Distress
The extent to which the behaviour is causing upset to the individual. This should be treated in isolation from the other Ds as the patient may be very distressed by their current situation but still able to function in other areas of their life. The subjective experience of the patient is important
Danger
the patient’s behaviour in relation to danger to themselves and danger to others must be considered; if possible danger is identified, then intervention might be needed. This might be considered on a scale of severity.
The 4Ds - strengths
They are useful for professionals when diagnosing disorders and many disorders in the DSM focus on the Ds.
The 4Ds - weaknesses in terms of subjectivity
Applying the Ds is subjective as patients and clinicians may have different ideas as to what counts as dysfunctional.
The 4Ds - weaknesses in terms danger
Many of us put ourselves in danger from time to time (e.g. take drugs, complete a skydive) but this would not necessarily be considered abnormal.
The 4Ds - weaknesses in terms deviance
With regard to deviance, many problematic disorders, such as depression, are not very rare in some societies, so clinicians must ensure they weigh this up against other measures.
The 4Ds - weaknesses in terms culture
The clinician must take account of the patient’s culture when using the 4Ds as what is rare in one culture or what seems distressing in one culture might not be in another; for example social norms vary between cultures so can affecting abnormality.
