Diagnostic manuals: IDC and DSM

Question 1

What is the ICD?

Answer 1

• The IDC contains physical and mental diagnosises
• And like the DSM, it undergoes frequent reviewing e.g. IDC-9 to IDC-10
• It it available** for everyone** as it’s online therefore it can be used by clinicians, researchers etc
• It contains a ‘common language’ so countries around the world can use it
• it contains ICD codes

Question 1

What are the ICD CODES?

Answer 1

• the ICD uses codes for** each disorder**
• it starts with the code F an example of this is the subcategory F20 within this there are different types of SZ such as F20.0 for paranoid SZ or F20.1 for hebeprenic SZ
• It contains ‘leftover’ codes for new disorders to be added

Question 2

How Clinical Psychologist use Classification System?

Answer 2

• Classification system is esentially a checklist where for clinincians to reach a diagnosis
• It is mainly by process of elimination by going in a specific order

Question 3

What is the DSM?

Answer 3

• a manusal for mental diagnosis which includes the symptoms, features and risk factors
• it was produced by the APA and undergoes frequent revision

Question 4

How Clinical Psychology Diagnose MHD?

Answer 4

in the DSM
- they gather information through observations which are mainly unstructured interviews
- it involves ruling out disorders that don’t match the person = eliminating
- and decide which ‘fit the best’ for that individual
- this can take between 10 mins to weeks or months

Question 5

What are the reliabilty and validity of Diagnostic Manuals?

Answer 5

• It has reliablity if the patient went to two different clinicians and both got the same diagnosis using the same tool DSM or ICD or 4D’s
• has inter-rater reliability
  The validity of the diagnosis can be reduced if there is
  
  • type 1 error - effect not real - null hyposthesis rejected - dont have MHD but was diagnosed
  • type 2 error - effect was real - null hypothesis accepted - does have MHD but wasn’t diagnosed
  • concurrent validity = clinicians use** more than one method** or technique to reach a diagnosis and both methods lead to the same diagnosis

Question 6

What are the evidence showing strength of reliability in Diagnostic Manuals?

Answer 6

Rosenhan found out there was consistent reliablity
- the DSM used had consistent diagnostic of pseudpatients with 11/12 SZ and 1 bipolar when they showed the** same symptoms** which were empty, hollow, thud

Goldstien found diagnostic manuals are reliable
- found out with the use of 2 clinicatiosn diagnosing nearly 200 patients
- there were high-levels of interater reliability when of diagnosing SZ using the DSM

Andrews et al
- found high interater reliability on diagnosis for depression, substance dependence and anxiety disorders

Brown
- tested reliabilty and validity of DSM IV for anxiety and depression
- found out they were‘good’ and ‘excellent’

Question 7

What are the evidence showing weakness of reliabilty using classification systems of diagnostic manuals?

Answer 7

Beck found there was poor levels of inter-rater reliability
- poor levels of inter-rater reliablity when using early editions of diagnostic manuals
- found out only 54% agreegrement of diagnosing the same disorder

Andrew
found there was only 68% agreement between using ICD and DSM on assessing 1500 patients

Brown
- brwn suggested that there were only reliability for certain disorders e.g. depression/anxiety
- it has worse reliabitliy on PSTD as there are overlaps in symptoms with other disorders such as depression
- this shows that symptoms are comorbid (more than one disorder present)
- majority of patients suffering depression also have anxiety disorder

Question 8

Evidence that support classifications systems using diagnostic manuals are valid

Answer 8

Jansson
- checked on how much agreement there was between ICD and DSM
- there was high rate of agreement for the same disorder
- more than on method used showed concurrent validity

Hoffman et al
- compared the accuracy of classifying diagnosis of the DSM and the ICD
- it showed that the two classification systems of DSM AND ICD showed agreement of severe alcoholism among 7000 prisoners
- increase concurrent validity OF SEVERE ALCHOL DISORDERS

PREDICTIVE VALIDITY
- predictive validity is when you can predict the future behaviour
- for example if patient was accureatly diagnosed from depressio and given the effective treated the clinicians expect the behaviour of less low mood when prescribed antidepressants

Question 9

Evidence showing low validity of classification systems using diagnostic manuals

Answer 9

ROSENHAN found that staff made type 1 and type 2 errors in both experiments
- experiment 1 showed 12 sane paitients diagnosed - type 1 error (there was no effect)
- **experiment 2 **showed 41 real patients thought to be fake by at least one member of staff
- experiment 2 showed 19 real patients thought to be fake by two members of staff

Hoffman et al
- found that the ICD and DSM differed when it came to mild or moderate alcohol disorders
- **1/3 with mild **alcohol disorders using the DSM
- no diagnosis using ICD
- shows low concurrent validity for mild disorders

• patients may have inaccuracy infor of their problems due to memory, denail, shame, disorganised thoughts etc
• clinicians can be biased when they gather information e.g. asking questions/diagnosing
• culture may have differnt behaviours that may not be common in another