L2: Classification and Diagnosis 1 Flashcards
In what way does the DSM fail to apply its general criteria for mental illness to its specific diagnostic categories?
Its criteria for specific mental illnesses only list descriptive symptoms, rather than criteria relating to causative internal dysfunctions.
In terms of the DSM definitions, why might the prevalence of mental illness be overestimated in the community?
Because the DSM only lists symptoms of illnesses. Symptoms may be present without internal dysfunction. If clinicians only look at symptoms, rather than an internal dysfunction causing these symptoms, there may be other social or cultural causes that they are missing.
Outline the two current manuals that are used to classify mental illnesses.
ICD 10 - International Classification of Diseases and Related Health Problems. Written by WHO. 10th Ed. Mainly used outside the US and Australia.
DSM-5 (2013). Diagnostic and Statistical Manual of Mental Disorders. Published by American Psychiatric Association. Used in the US and Australia.
List 5 assumptions of the medical model.
- Illness is qualitatively different from health.
- Different illnesses are:
- clearly distinguishable from each other
- occur independently from each other
- due to different, identifiable causes
- respond to specific treatments
What were some of the biological phenomena doctors thought might be identified as the causes of mental illness in the 1900’s?
- Toxins
- Brain damage
- Heredity
- Bacterial or viral infections
Outline three reasons why the medical model initially fell out of favour.
- progress slowed down in the 20th century
- no specific treatment breakthrough was made
- some very harmful and invasive treatments, e.g. lobotomy, organ removal were trialled
During which period was psychoanalysis most influential?
1940s-1970s
In what three major ways did psychoanalysis impact the practice of psychiatry?
- Revolutionised the understanding of mental disorders.
- Led to a proliferation of mental health workers - shift from mental asylums to outpatient offices
- Extended client base to those with milder conditions
In what three major ways did psychoanalysis change the understanding of mental disorders, specifically?
- No clear dividing line between the normal and abnormal. Pathology is just an extreme manifestation of a continuum.
- Included conditions other than psychotic states. E.g. anxiety, depression, phobias.
- No clear dividing line between various disorders. E.g. anxiety, depression, phobia etc. all thought to arise from the same intra-psychic conflicts.
Which two versions of the DSM were grounded in psychoanalytic theory?
DSM-I and DSM-II
Why were the psychoanalytic criteria in the DSM flawed?
They didn’t have valid reliability or validity.
In what ways was the reliability of psychoanalytic diagnostic criteria flawed?
- There was low inter-rater reliability
- No specification of the frequency or intensity of required symptoms, specification of time periods, or of which symptoms had to be present.
In what ways was the validity of psychoanalytic diagnostic criteria flawed?
- disorders like depression were conceptualised as reactions to unconscious psychic conflict. These explanations for the causes of disorders were difficult to test empirically or disprove.
How did Kraeplin combine the medical and psychoanalytic models?
- Kraeplin retained the mental disorders described by psychoanalysts, but
- returned to the medical model in adopting a descriptive approach, clustering symptoms together in observable syndromes instead of speculating about their causes
What features of the DSM-III show Kraeplin’s approach to classifying mental disorders?
- uses the medical model
- retains all disorders described by psychoanalysis
- no theoretical assumptions about causation
- description of symptoms where causation unknown
- clear, explicit criteria and decision rules
- improved reliability
