diagnosis of mental disorders - 4 D's Flashcards
deviance
- behaviours, cognitions, feelings and desires which are extreme, unusual or bizarre and which differ from social or statistical norms
- an understanding of statistical and social norms is necessary to determine firstly how unusual the behaviour is (statistics) and secondly the desirability of the behaviour within a particular social / cultural group
- social norms depend upon the historical context and the culture, age and gender of the individual and this is important information when assessing deviance
- when an individual fails to conform to social norms, this may lead to negative attention from others and social exclusion and for this reason, norm-breaking is seen as a useful indicator of psychological abnormality
- an example of deviant behaviour is paedophilia
strength of deviance - objective
one strength of using deviant behaviour to diagnose mental health disorders is that it is an objective measurement
deviant behaviour is defined statistically as behaviour which lies 2 standard deviations away from the mean
this means that diagnosing someone with deviant behaviour is not down to opinion, it is a set scale where for an individual to be classed as behaving in a deviant way they have to be dsplaying a behaviour which lies 2 standard deviations away from the mean on a normal distribution curve
therefore, this means that when a patient is being diagnosed with deviant behvaiour it is not down to the professionals opinion, but down to a set measurement which clinicans use globally
COUNTER ARGUMENT TO strength of deviance - objective
However, the cut off point of 2 standard deviations is rather arbitary and may result in somone with uncommon behaviour that lies within 2 standard deviations of the mean not being defined as displaying abnormal behaviour
therefore, this means that people will not recieve the care which they require if the deviant behaviour which they are displaying is more frequent in the population because it lies within 2 standard deviations of the mean
weakness of deviance
one weakness of using the definition of ‘deviant behaviou is defined as any behvaiour which exists 2 standard deviations from the mean’, is that more frequent abnoirmalities are not classed as two standard deviations from the mean so may not recieve the psychiatric care which they require
this definition of deviance behaviour classify’s depression as statistically normal due to this type of behaviour being more frequent in the population - 1 in 3 people suffer from depresion, this does not make sense in terms of psychiatric care
therefore, this means that people with mental health disorders such as depression, may not recieve the medical care which they need because there behaviour is not classsed as being 2 standard deviations away from the mean
dysfunction
- behaviour that shows an inability to function in everday life and not being able to maintain a healthy life style or carry out their usual roles and responsibilities
- psychologists use a variety of objective measures to assess everyday functioing - such as the WHODAS scale, a questionairre which looks at factors sich as a person’s understanding of what is going on around them, communication and deterioration in self-care
- dysfunction can also affect an indiviudals ability to get up in the morning, completing tasks at work or college and participanting in routine activities such as going to the gym or socailising
strength of dysfunction - objective
one strength of using dysfunctional behaviour to diagnose mental health disorders is that it is an objective measurement
dysfunctional behaviour is defined objectively using scales such as the GAF and WHODAS scales in DSM and ICD
this means that daily functioning can be objectively measured by clincians using the GAF scale to rate the patients symptoms of dysfunction and given them a score for each section of the questionairre - the higher a patients score on the GAF scale the worse the patient is doing
therefore, this means that when a patient is being diagnosed with dysfunctional behvaiour it is not down to the professionals opinion, but down to a set measurement which clinicans use globally to define dysfunctional behaviour
COUNTER ARGUMENT TO strength of dysfunction - objective
However, when clinicians are using these objective scales, there interpretation of how dysfunctional a patient is within the scale of the questionairre can be subjetive
each clinicians interpretation of what is dysfunction can be different but cannot be objectively measured as it is down to opinion
therefore, this makes the objective measures used for diagnosis of dysfunctional behaviour an unreliable criteria to use as some clinicians may disagree on what is dysfunctional
weakness of dysfunction - does not consider the reasons for dysfunctional behaviour
one weakness of using dysfunctional behaviour to diagnose mental health disorders is that it does not take into account the reasons for this dysfunctional behaviour
some people may choose to engage in dysfunctional behaviour such as not going out as a personal lifestyle choice, this does jnot mean that they are abnormal or behaving in a dysfunctional way, it is a life choice an individual has made
therefore, this means that dysfunction as an indicator of abnormality is not useful in all cases because some people may display dysfunctional behaviour as a life choice
distress
- when symptoms of mental health disorders cause emotional pain or anxiety - this is a sign that a clinical diagnosis may be beneficial to that individual
- sometimes, psychological distress may be manifested as physical symptoms such as aches and pains, palpatations or feeling tired all of the time - these symptoms are important too
- sometimes distress can be considered normal depending on the situation, e.g., if a persona has just lost their job or been bereaved
- a clinician will consider the intensity or duration of the distress as well as functioning in ordernto make a decision about diagnosis
- quantitative data can be collected using scales such as the K-10 scale - a 10-item self-report questionairred which focuses on experiences in the past four weeks
weakness of distress
one weakness of using distress levels to diagnose mental health disorders is that it does not take into account the reasons whre distress is apparent
for example, after losing a loved one, distress is apparent and consdiered a normal feeling during this period. however, this may only be temporary and not mean that a person is anxious or depressed
therefore, this means that the duration of time should be taken into account when diagnosing someone as having high levels of distress because this could be due to events such as death which are expected to cause high levels of distress
strength of distress
one strength of using distress levels to diagnose mental health disorders is that it gives clinciains an indicator to identify the indidividuals who are most upset and showing signs of emotional pain or anxiety
this means that clincians are able to provide the correct levels of comdort and support to these people at the times which they are in need
therefore, this can help people who are in need of extra help and support at necessary times to ensure they are not left alone and someone is always around to help when it is needed
danger
- danger is when someone is a danger to themselves or others
- for example, when someone is feeling suicidal they are a danger to themselves
- this could be displayed through careless and hostile or hazardous behaviour which puts someones safety at risk
- predicting violent behaviour is difficult, but if someone has a history of aggression, this makes another incident more likely
- in the UK, if an individual is percieved to be a danger to themsleves or other, they must be detained under the Mental Health Act (‘sectioned’) - this requires the agreement of 3 professionals
- the patient does not have to consent, but they will be taken to a mental hospital where they will be provided with treatment
strength of danger
one strength of using danger to diagnose mental health disorders is that it is a useful criteria to protect indivudals
this criteria can prevent individuals from getting harmed and can save lives
if a patient is percieved to be a danger to themselves by 3 or more clinicians, they will be sectioned - admitted to a psychiatric hospital to provide them with protection
therefore, this will allow patients to be protected when they are a danger to themselves or others which will help to save lives
weakness of danger
one weakness of danger is that being defined as dangerous can lead to being labelled which can affect your career prospects and life choices
using ‘danger’ as a criteriion for mental disorders leads people to equate mental illnesses with being dangerous
this becomes distorted in the media and popular feature films
Fazel et al found in 2009 that most people with schizophrenia are no more dangerous than people who have not got schizophrenia
therefore, this can cause people’s attitudes to become self-fufilling prophecies and lead people to act in the way in which people are saying that they should act - in a dangerous way
