diagnosis of mental disorders

Question 1

define diagnosis

Answer 1

matching a person’s behaviours, cognitions, feelings and desires to the signs and symptoms of a recognised mental disorder, in order to provide information about the prognosis and treatment

Question 2

define deviance

Answer 2

behaviours, cognitions, feelings and desires which are extreme, unusual or bizarre which differ from social and statistical norms

Question 3

define dysfunction

Answer 3

inability to conduct everyday activities

Question 4

define distress

Answer 4

the subjective experience of feeling upset/or anxious

Question 5

define danger

Answer 5

at risk of causing physical harm or psychological harm to the self or to others

Question 6

what are the four Ds of Diagnosis ?

Answer 6

1. danger
2. deviance
3. dysfunction
4. distress

Question 7

define duration in the diagnosis context

Answer 7

duration is important because short periods of distress or deviance are not necessarily an indication of a mental disorder - e.g., during exam periods you may be sad, stressed and perhaps not being as social as your might usually be.

Question 8

what is a strength and a competing argument of the four Ds ?

Answer 8

IT HELPS AVOID ERRONEOUS DIAGNOSIS
For, example if deviance from social or statistical norms was the only consideration when making a diagnosis, then those who are eccentric yet harmless may be seen as abnormal while those with common but debilitating symptoms of depression may be missed. (just because it is statistically normal, doesn’t mean that is good)

COMPETING ARGUMENT
There are no hard and fast rules about how the Ds should be combined. e.g., if a person is struggling to cope and showing signs of distress and dysfunction but there are no signs of deviance or danger, the person may not require a diagnosis. (problem caused by a situation - like the exam example)

Question 9

what is a problem with the four Ds ?

Answer 9

LACK OF OBJECTIVITY
A weakness is that the four Ds are not an objective measurement. ratings are being made of feelings - lack of objectivity in turn affects reliability. the 4Ds involve making comparisons between the individual and others in society - decisions would be more objective if decisions were made by making comparisons to a reference group (then it wouldn’t be on the basis of the subjective view of the clinician).

Question 10

what is the ultimate problem with diagnosis ?

Answer 10

LABELLING
A weakness is that we end up putting labels on people with mental disorders. for example, using ‘danger’ a criterion for a mental disorder leads people to equate mental illness with being dangerous - this becomes distorted in media and film. most people with schizophrenia are not more dangerous than people without the diagnosis (Fazel et al 2009) - this is serious because such attitudes may become ‘self-fulfilling prophecies’ - stereotypes lead people to act the way predicted by the stereotype.

Question 11

what is an application of diagnosis ?

Answer 11

HELPFUL IN CONJUNCTION WITH DSM-5 AND ICD-10
Different disorders tend to display different combinations of Ds. for example, deviance from statistical norms is used to help determine intellectual disability while deviance from social norms, dysfunction and danger all feature in the diagnostic criteria for anti-social personality disorder (APA 13). THIS SHOWS THAT ALL FOUR Ds ARE USED IN DIAGNOSIS.