Issues in diagnosis

Question 1

Validity: evidence

Answer 1

-Kim-Cohen et al (2005):conduct disorder in 5 year olds:mothers interviewed and teachers completed questionaires-high agreements on childs behaviour+ childs self-report- validity as there is an agreement on symptoms
-Hoffman: alch dependence, abuse + coke dependence in inmates- structured interview- DSM diagnosis valid/ symptoms matched the criteria.
-Lee(2006): 48 primary school teachers given questionaires to rate children´s behaviour with ADHD- high validity
-Criticism: gender diff: girls criteria was not as complete
may produce findings they are searching for- e.g teacher knowing child with ADHD will be hyperactive- lowers validity+labelling:self-fufilling diagnosis.

Question 2

Reliability: evidence

Answer 2

-Goldstein(1998):comparing DSM 2 and 3-re-diagnosing 199 patients. Physicians re-diagnosed 8 random cases: high agreement + inter-rate reliability
-Brown (2001):362 anxiety/mood disorder patients in Boston two separate interviews using DSM schedules:good-excellent reliability for most categories+ high inter-rate reliability
-Criticism:some disagreements with symptoms- severe enough/lasted long enough? difficult to diagnose as they were close to boundaries

Question 3

Cultural issues in diagnosis:

Answer 3

-DSM is used in western cultures:´ cultural blindness´
-minority groups receiving more diagnoses:prejudice from the diagnostician
Banyard (1996): 25% patients on UK psych wards were black+ they only make up 5% of the population+ more likely to be seen by a junior doctor.
-Ethnocentricism: judging another culture based on your own cultural standards.

Question 4

Cultural bound syndromes

Answer 4

pattern of mental illness/abnormal behaviour unique to a specific culture+ is outside of standard classifications of psychiatric disorders
e.g Japenese women:extreme fear of offending others e.g body odour
-Luhrammn et al (2015): interviewed people with schizophrenia. 70% of American people:voices told them to hurt others. 50% Ghanian people:mainly positive voices. Indian people tended to hear voices of family members offering guidance/scolding them.
-Gurland et al (1970): psychiatrists in New York more likely to diagnose with schizophrenia than affective disorders than those in London- clinicians individual differences may affect interpretation of symptoms:differential diagnosis.
- Rastafarians use neologisms -unaware clinicians may see this as disorganised thinking- a symptom of schizophrenia.