DSM-IV and ICD-10 Rel and Val

Question 1

Define ‘reliability’ in terms of diagnosing a mental disorder.

Answer 1

How consistent the ability to diagnose correctly is when using the DSM and ICD.

Question 2

List the 2 different types of reliability.

Answer 2

1) Inter-rater

2) Test-retest

Question 3

Define ‘inter-rater reliability’ in terms of diagnosing a mental disorder.

Answer 3

The consistency of multiple clinicians agreeing on the diagnosis of a patient using the same diagnostic tool.

Question 4

Define ‘test-retest reliability’ in terms of diagnosing a mental disorder.

Answer 4

Whether the diagnosis of a patient is consistent when being re-diagnosed at a later date.

Question 5

Give 3 examples of studies testing the reliability of the DSM and/or the ICD.

Answer 5

1) Beck et al (1961)
2) Goldstein (1988)
3) Cheniaux (2009)

Question 6

What did Beck et al (1961) find in terms of the reliability of the DSM and ICD?

Answer 6

He found 54% inter-rater reliability between 2 psychiatrists for 154 patients.

Question 7

What did Goldstein (1988) find in terms of the reliability of the DSM-II and DSM-III?

Answer 7

He tested the reliability of the DSM-III against the DSM-II when re-diagnosing patients with Sz (169/199 were successfully re-diagnosed).

Question 8

What did Cheniaux (2009) find in terms of the reliability of the DSM-III and ICD-10?

Answer 8

Compared the diagnosis between DSM-IV and the ICD-10 of Sz, depression, etc. Found that Sz was more frequently diagnosed using the ICD-10.

Question 9

Define ‘validity’ in terms of diagnosing a mental disorder.

Answer 9

How accurate and correct the DSM and ICD are at diagnosing a mental disorder.

Question 10

List the 5 different types of validity.

Answer 10

1) Predictive
2) Construct
3) Concurrent
4) Etiological
5) Convergent

Question 11

Define ‘predictive validity’ in terms of diagnosing a mental disorder.

Answer 11

The accuracy of a prediction made when diagnosing a mental disorder which is tested at a later date.

Question 12

Define ‘construct validity’ in terms of diagnosing a mental disorder.

Answer 12

How accurate the criteria for diagnosis of a mental disorder is.

Question 13

Define ‘concurrent validity’ in terms of diagnosing a mental disorder.

Answer 13

When results of a study testing the DSM against the ICD matches another done at the same time.

Question 14

Define ‘etiological validity’ in terms of diagnosing a mental disorder.

Answer 14

This is established by examining what is known about the causes of the disorder and matching them to the person’s history.

Question 15

Define ‘convergent validity’ in terms of diagnosing a mental disorder.

Answer 15

When two measures of the same diagnosis agree with each other using a test of correlation.

Question 16

Give 3 examples of studies testing the validity of the DSM and/or the ICD.

Answer 16

1) Sanchez-Villages et al (2008)
2) Allardyce et al (2007)
3) Jakobsen et al (2005)

Question 17

What did Sanchez-Villages et al (2008) find in terms of the validity of the DSM?

Answer 17

62 ‘depressed’ patients and 42 ‘non-depressed’ patients were re-diagnosed and found that 68% of the 62 were diagnosed again and 81% of the 42 were confirmed of not having depression - this has high predictive validity.

Question 18

What did Allardyce et al (2007) suggest in terms of the validity of the DSM and ICD?

Answer 18

Some symptoms of Sz are common amongst amongst general population and so he questioned the construct of the criteria used to diagnose a mental disorder.

Question 19

What did Jakobsen et al (2005) find in terms of the validity of the ICD-10?

Answer 19

Found that in a sample of Danish (in)patients with Sz and a sample of (out)patients with a history of psychosis, there was 87% predictive value when making the correct diagnosis using the ICD-10.

Question 20

Give 2 examples of studies testing the reliability AND validity of the DSM and/or the ICD.

Answer 20

1) Rosenhan

2) Cooper (1972)

Question 21

What did Rosenhan find in terms of the reliability AND validity of the DSM-III?

Answer 21

Reliability
- Pseudopatients were consistently diagnosed with Sz
Validity
- DSM-III can’t recognise fake patients against real patients and so there is no accuracy in correct diagnosis

Question 22

What did Cooper (1972) find in terms of reliability AND validity of the DSM?

Answer 22

Reliability
- USA diagnosed mainly Sz and UK diagnosed mainly depression for 154 patients, highlighting issues of consistency between cultures
Validity
- A different culture diagnosing someone differently questions accuracy of diagnostic tools

Question 23

List 3 examples of general evaluation points.

Answer 23

1) Clinician’s training
2) Differing cultures
3) Patient disclosure

Question 24

Evaluate the reliability of a ‘clinician’s training’ on diagnosis.

Answer 24

P - Low
E - Training can be insufficient or outdated
E - The lack of skills will decrease the consistency of whether or not the diagnosis is accurate

Question 25

Evaluate the validity of ‘differing cultures’ on diagnosis.

Answer 25

P - Low
E - Culture can impact on diagnosis due to the clinician not understanding the impact of something in the patients culture
E - Therefore diagnosis and treatment may be inaccurate

Question 26

Evaluate the reliability AND validity of a ‘patient’s disclosure of symptoms’ on diagnosis.

Answer 26

Reliability
- Different symptoms given by the patient can affect reliability of diagnosis as they will be inconsistent
Validity
- In order to make a correct diagnosis the patients needs to describe ALL symptoms accurately