DSM &ICD Classification Systems and Reliability of Diagnosis Flashcards
Describe the DSM
The Diagnostic and Statistical Manual of mental disorders. First published in 1952 by the APA, it classifies and diagnoses mental disorders.
What are the 5 axis of the DSM?
1) Clinical Disorders. 2) Underlying personality disorders. 3) Medical and physical conditions. 4) Psychosocial and Environmental disorders. 5) Assessment of functioning on a global scale (1-100).
What has changed in the DSM?
After many developments and revised versions of the DSM, particular things have changed:
Homosexuality was removed.
Describe the ICD
International classification of disease. It was created by WHO, and measures all disease, mental and physical. The newest version is the ICD-10. It has 22 chapters, and one on mental health.
Compare the ICD and DSM
The ICD is produced by WHO and is worldwide, and the DSM was produced by APA and is Americanised.
The ICD is free but the DSM is for profit.
The ICD is available to all countries and service providers where the DSM is just available to psychiatrists.
The ICD is multilingual and multidisciplinary but the DSM, is just in English.
The ICD covers all conditions but the DSM is just mental health.
Why could diagnosis be unreliable?
Symptoms are subjective
People may be more/less open to different therapists.
Certain institutions may be better/worse at diagnosis.
Insufficient evidence is gathered.
Categories of illness are not used properly.
Unstrucutred/informal procedures are less accurate.
Some illnesses are harder to diagnose.
Studies for reliability
Beck et al (1961)- unreliable diagnosis, Goldstein (1988) reliable DSM, Stinchfield (2003) Reliable DSM, Kirk and Kutchins (1992) Unreliable studies that show reliability.
Four factors for good validity (Robins and Guze)
1) The illness fits in other ways, not just symptoms (age, gender).
2) The symptoms usually go together and do in this case.
3) The symptoms don’t fit another illness better.
4) If the disorder runs in families, it does in this case.
Why might validity be difficult to achieve?
Many illnesses are difficult to diagnose and are misdiagnosed.
Many symptoms apply to other illnesses.
Illnesses can manifest themselves in other ways.
Studies for validity
Rosenhan (1973) Low validity, Lee (2006) high validity, Hoffman (2002) DSM is valid, Jarsson et al (2002) valid.
Studies for culture on mental health
Lurhmann et al (2015) found hearing voices was better received in India and Ghana than in the USA.
Kulhara et al (2009), in developing countries a larger proportion of Schizophrenia cases end better than in developed.
Name and explain a culture-bound syndrome
Penis Panics. In some cultures, males think their penis will retract into themselves, and women think similarly about their breasts. This is seen all over the world, but mostly in Africa and Asia.
How to overcome cultural bias
Focus on universal symptoms and take all axis into account.
