The 4D's, Classification Systems & Diagnosis (Clinical Psychology) Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

What are the 4 D’s of Diagnosis?

A

Deviance Dysfunction Distress Danger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is meant by Deviance (when discussing diagnosis)?

A

How rare/ infrequent the behaviour is within society Does it break social norms?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is meant by Dysfunction (when discussing diagnosis)?

A

If their behaviour interferes with their life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is meant by Distress (when discussing diagnosis)?

A

Does it cause the individual to become upset?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is meant by Danger (when discussing diagnosis)?

A

Does it cause danger to themselves/others?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Is Diagnosis reliable?

A

Everything is self-reported by the patient: The patient’s recall may be biased Everything is interpreted by the clinician, which may have a biased perspective on the patient’s symptoms.problems The subjectivity weakens reliability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the Strengths + Weaknesses of the 4Ds of Diagnosis?

A

The 4D’s of diagnosis is a standardised procedure Therapists will have to cover all 4D’s, which is a long + difficult process that leads to different views

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the Issues + Debates surrounding Diagnosis?

A

Social Control: Some argue that clinicians have a lot/too much power in making diagnoses. Once a person is labelled as ‘mentally ill’ there are serious implications + it can be difficult for them to lose that label. Many individuals who have been sectioned under the mental health act find it to be a distressing + dehumanising process, as their power to make decisions is removed, and some are treated badly in care

Practical Issues: Research into mental health often involves data form the diagnosis of real patients. The diagnosis method of clinical interviews is subjective; due to relying on self report, ad clinician bias. This leads to inaccurate/inconsistent diagnosis between clinicians

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are Classification Systems?

A

Comprehensive and standardised lists of known mental disorders and their symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What 2 Classification Systems are looked at in Clinical Psychology?

A

DSM ICD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When was the ICD first written?

A

1948

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When was the DSM first written?

A

1952

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does the DSM stand for?

A

Diagnostic and Statistical Manual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the DSM?

A

The DSM is a multiaxial tool as it examines 5 different aspects of the patient’s behaviour and health. It is an American system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How many Axes does the DSM have?

A

The DSM is multiaxial - 5

Axis I: The main clinical syndrome/mental disorder

Axis II: Personality disorder and retardation- anything wrong with the personality that may influence the main disorder

Axis III: Medical conditions that may affect the main disorder

Axis IV: Psychosocial stressors - any events in a person’s life that may affect mental disorders + stress

Axis V: Global assessment of functioning- a test assessing social + occupational functioning, seeing how well they can carry out everyday activities (e.g. washing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does the ICD stand for?

A

International Classification of Diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the ICD?

A

The ICD-10 lists and categorises all diseases including mental and physical ones. This is a European system.

18
Q

How does the ICD work?

A

Section F deals with mental health disorders. Each mental health diagnosis is given a code the describes: the family of the disease, the particular disorder, the severity of the disorder, the severity of the disorder and any specific symptoms seen. (This doesn’t have to be learnt)

19
Q

What did Ward et al (1962) find about the diagnostic systems?

A

Disagreement between psychiatrists is due to inconsistent interpretation and inadequacy of the DSM / ICD-10

20
Q

What is meant by (inter-rater) Reliability of Diagnosis?

A

The extent to which clinicians agree on the same diagnosis for each patient

21
Q

What is Test-Retest Reliability?

A

When the same clinician makes the same diagnosis on different occasions.

22
Q

What evidence Supports that Diagnosis is Reliable?

A

Brown (2001) Hoffmaan (2002) Rosenhan (1973)

23
Q

How does Rosenhan’s (1972) study support the Reliability of Diagnosis?

A

Although inaccurate, 7 out of 8 pseudopatients were given a diagnosis of schizophrenia

24
Q

How does Brown’s (2001) study support the Reliability of Diagnosis?

A

He tested the reliability and validity of DSM IV diagnosis for anxiety and mood disorders and found them to be ‘good’ to ‘excellent’.

25
Q

How does Hoffmaan’s study support the Reliability of Diagnosis?

A

Hoffmaan used a computer to give structured interviews to prison inmate patient who had been diagnosed with either alcohol abuse, alcohol dependence or cocaine dependence, using the DSM-IV. The computer diagnosis were consistent with the DSM- IV Using a computerised diagnostic system eliminates any subjectivity that might take place in a diagnostic interview, making it objective.

26
Q

What evidence Challenges the Reliability of Diagnosis?

A

Beck (1954) Stetka + Ghaemi Cooper et al Ward et al

27
Q

How does Beck’s study challenge the Reliability of Diagnosis?

A

Beck found that the same set of symptoms were only diagnosed as the same disorder 50% of times.

28
Q

How does Stetka + Ghaemi study challenge the Reliability of Diagnosis?

A

S+G suggest that under half of clinicians had started using the DSM-5 one year after its release, due to concerns that led to unreliable diagnosis.

29
Q

How does Cooper et al study challenge the Reliability of Diagnosis?

A

He reported that trials of the DSM-III showed schizophrenia had a reliability estimate of 0.81 (there’s an 81% chance another will give the same diagnosis), but for the DSM V it was 0.46

30
Q

How does Ward et al study challenge the Reliability of Diagnosis?

A

He said that disagreement between psychiatrists is due to inconsistent interpretation and inadequacy of the DSM / ICD-10

31
Q

What Patient Factors affect the Reliability of Diagnosis?

A

Issues with memory, denial and shame Symptoms- e.g. disorganised thoughts Personality disorders - e.g. psychopathy, manipulation

32
Q

What Clinician Factors affect the Reliability of Diagnosis?

A

Unstructured interview- can lead to clinicians focusing on different specific things (e.g. nightmares, past events, love life, etc); leading to different info being gathered Subjectivity due to background and training; leading to different interpretations A diagnosis may have I-R validity, bu that doesn’t mean its valid (e.g. Rosenhan)

33
Q

What is meant by the Validity of Diagnosis?

A

Whether the diagnosis given to a patient is accurate or not

34
Q

Why is the Validity of Diagnosis Important?

A

An inaccurate diagnosis leads to the wrong treatment, delayed recovery, and (in some cases) make things even worse.

35
Q

What is Concurrent Validity?

A

This could be checked by looking at another diagnostic tool (e.g. DSM with the ICD). If there is broad agreement about which symptoms constitute which disorder, there is broad concurrent validity.

36
Q

What is Aetiological Validity?

A

When the patients history matches what’s known about the causes of the disorder

37
Q

What is Predictive Validity?

A

Where the future of the course of the disorder is known, and can be applied to the person; so the diagnosis can be checked against the outcome in order to see if it’s valid. i.e. when the treatment is successful

38
Q

What is Implicit Bias?

A

A positive or negative mental attitude towards a person, thing or group that a person holds at an unconscious level. Clinicians have this, affecting the interpretation of the info given to them

39
Q

How does Hoffman’s research support the Validity of Diagnosis?

A

Hoffmaan: Hoffmaan used a computer to give structured interviews to prison inmate patient who had been diagnosed with either alcohol abuse, alcohol dependence or cocaine dependence, using the DSM-IV. The computer diagnosis were consistent with the DSM- IV; showing it has concurrent validity

40
Q

How does Aboraya’s research challenge the Validity of Diagnosis?

A

Aboraya: Clinicians focus on acute symptoms and overlook others. Also, patients’ mood, memory and shame lead to inaccuracy

41
Q

What is Comorbidity?

A

When there is a presence of more than one disorder in the same person at one time. Many disorders overlap with each other (e.g. depression and anxiety), making a valid + reliable diagnosis difficult.