ICD + DSM + the 4D's

Question 1

definition of statistical infrequency

Answer 1

a behaviour is seen as abnormal if it’s statistically uncommon, or not often seen in society.

Question 2

what is a deviation from social norm

Answer 2

a behaviour is seen as abnormal if it violates social norms and what is acceptable

Question 3

name the 4 D’s

Answer 3

deviance, dysfunction, danger, and distress

Question 4

deviance

Answer 4

the extent to which the behaviour is rare within society

Question 5

dysfunction

Answer 5

if behaviour is interfering with the person’s life then a mental illness may be present.

Question 6

distress

Answer 6

how much is the behaviour causing upset to the person.

Question 7

danger

Answer 7

danger to themselves and a danger to others.

Question 8

name the simplified strengths of the 4D’s of diagnosis

Answer 8

1. using all 4 may help to avoid errors in diagnosis
2. used by mental clinicians in conjunction with DSM-5 and ICD-10 to help decide diagnosis

Question 9

name the weaknesses of the 4D’s of diagnosis

Answer 9

1. there are no rules about how the 4D’s should be combined
2. they do not lend themselves to objective measurement
3. we end up with labels for people with mental health issues

Question 10

what is the DSM? (A01)

Answer 10

• describes symptoms, and features associated with risk factors
• 300 mental/behavioural disorders
• 22 categories
• produced in 2013 by American Psychiatric association
• lead to labelling, stigmatisation, and ineffective treatment

Question 11

what is the ICD-10? (AO1)

Answer 11

• includes physical and mental disorders
• alphabetical index
• available in many languages
• shaped by language may have cultural bias towards one culture
• originate 1893 international list of causes of death

Question 12

argument for diagnosis of DSM

Answer 12

• good inter rater reliability (kappa values), diagnosis may be reliable if different clinicians agree on it.
• concurrent validity: more than one diagnosis tool getting the same result

Question 13

argument for the diagnosis being unreliable/invalid of DSM

Answer 13

Clinician factors - different info may be gathered leading to diff diagnosis (subjective)

cultural differences - Daris (2009) suggested differences in what brings people distress affected by surroundings.

Question 14

arguments for diagnosis being reliable/valid for ICD-10

Answer 14

• etiological: casual factors of two people with the same disorder
• predictive validity: results can predict future behaviour from their diagnosis.

Question 15

argument for the diagnosis being unreliable/invalid of ICD-10

Answer 15

co-morbidity: presence of more than one disorder or symptoms.

Question 16

strengths of ICD

Answer 16

1. improvements in reliability
2. good consistency with two clinicians assess the same clients using ICD-10
3. mason (1997) have shown that the diagnosis of SZ using ICD-10 has good predictive validity
4. WHO’s approach to the development of ICD-11 is that they aim to improve clinical utility of the system

Question 17

weakness of ICD-10

Answer 17

1. however study did reveal some less satisfactory results for childhood and personality disorders

Question 18

explain a strength of diagnosing disorders using the 4 D’s (hint=inclusiveness)

Answer 18

using all 4 can help avoid errors in diagnosis. If deviance from social norms were the only consideration when making diagnosis, then those who are eccentric and harmless may be seen as abnormal while those with common but debilitating symptoms of depression may be missed. Therefore, this is important because valid system should be neither over or under inclusive.

Question 19

explain a strength of diagnosing disorders using the 4 D’s (hint = Clinicians)

Answer 19

used by clinicians to help decide diagnosis for patient. Different disorders tend to display different combinations of D’s. Deviance from statistical norms is used to help determine intellectual-disability. Therefore, this shows that each of the 4D’s is used in diagnosis.

Question 20

explain a weakness of the 4D’s hint - reliability

Answer 20

lack of objectivity affects reliability. As the 4D’s involve making comparisons between the individual and others in society, decisions would be better if they were made in comparison to a reference group. Therefore, this shows that if the 4D’s are to be applied meaningfully, a clinicians requires detailed info about not only the person, but their community.

Question 21

explain a weakness of the 4 D’s hint = predisposition

Answer 21

labels for people with mental health issues = using danger as a criterion for mental disorders with being dangerous becomes distorted into the media. Most people with SZ are not acctually more dangerous than people without SZ. Therefore, this matters because such attitudes may become self fulfilling prophecies - stereotypes lead to people to act in the way predicted by the stereotype.