diagnosis of mental disorders Flashcards
how are mental health disorders diagnosed?
- deviance
- dysfunction
- distress
- danger
what is deviance?
clinicians look at the extent to which the behvaviour is RARE
- if it is rare enough and deviant from the norm
what is dysfunction?
it the behaviour is significantly interfering with the person’s life than a mental illness may be present
- although there may be no obvious day-to-day impact of the behaviour, the clinician should look carefully into all aspects of the patient’s life as they may not be immediately obvious
what is distress?
the extent to which the behaviour is causing upset to the individual
- a patient may be extremely distressed by their current situation but still able to function completely normally in other areas of life
what is danger?
if the person is a danger to themselves, or to others
what is the unconventional 5th D?
if the other Ds persist then they may be a symptom of an illness
what is the subjectivity weakness?
the interpretation of the individual patient’s experience
- the clinician must take into account how the person is coping
- someone’s culture can impact on their diagnosis = African americans are 7X more likely to be diagnosed with SZ
what are reliability issues?
it must be sure that the person can be re-diagnosed by other clinicians (inter-rater reliability) or diagnosed again (test-retest reliability)
do the diagnostics have high validity?
construct - does it measure what is meant to measure
predictive - can it predict the future of someone’s disorder
what is the DSM?
the diagnostic and statistical manual for diagnosing mental health disorders is used in america and has 3 sections:
1 - looks at changes from the previous version and how to use
2 - all main mental health disorders and diagnostic criteria
3 - work in progress disorders that need more investigation
it focuses on mentla health classification
what is the ICD?
international classification of diseases has a wider scope than the DSM
- each disorder has the main symptoms and associative symptoms
what is a strength of the diagnosis for reliability?
if clinicians use the same classification systems there is some comparibility
- using the DSM is free from biases because they use objective behaviours and sets of symptoms agreed among clinicians
- clinicians diagnosis must be consistent with one another
what is the competing argument from the strength of reliability?
BECK et al found that agreement was a level of chance
- gave two clinicians 153 patients and they only agreed upon 54% of them
- this suggests diagnosis is unreliable
ZEIGLER found that there were 54-84% agreements between diagnosticians
what is the cultural weakness of reliability?
US-UK diagnostic project showed american and british psychiatrists the same video interview
- new york psychologist diagnosed with SZ twice as often whereas London psychiatrists with depression twice as often
Lipton and Simon randomly selected 131 patients from a psychiatric hosptial and attempted to rediagnose them.
- out of the original 89 only 16 were rediagnosed
is diagnosis predictively valid?
predictive validity means the diagnosis must be able to predict a patient’s prognosis and treatment
- banister et al found that in 1000 cases there was no clear cut relationship between diagnosis and treatment
what is the discrimination weakness?
giving a diagnosis can be stigmatising to an individual - if we label someone we may lose sight of the fact that they are an individual and lead to discrimination
- once a person has a diagnosis they may be expected to act like someone else with that disorder which may lead to a self fufilling prophecy
how can diagnosis be applied?
diagnosis communicates a lot of information which can be used to identify appropriate treatments.
