Bias in diagnostic systems

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  • Bias in diagnostic systems
    • 2 classification systems
      • Diagnostic and Statistical Manual of Mental Disorders (DSM IV)
        • America
      • International Classification of Diseases (ICD 10)
    • Social Class
  • America
  • Europe
    • International Classification of Diseases (ICD 10)
  • There are no physical tests e.g. urine samples
    • 2 classification systems
      • Diagnostic and Statistical Manual of Mental Disorders (DSM IV)
    • Rely on self report => bias
      • There are no physical tests e.g. urine samples
      • bias = more likely to be diagnosed with a particular disorder than others
        • Rely on self report => bias
        • African Culture BIas- particularly schizophrenia
          • Bias in diagnostic systems
            • Social Class
          • COCHRANE AND SASHIDHARN
        • COCHRANE AND SASHIDHARN
        • Culturally biased diagnostic tools
          • Developed in USA and Europe => over emphasising westernised ideas of health=> ignoring cultural role
            • Culturally biased diagnostic tools
              • The same illness may appear differently in different cultures
                • EBIGNO
              • LITTLEWOOD AND LIPSEDGE
              • EXP
                • Genuine differences in rates of mental illness
                  • Ethnic minority=> stress => mental illness
                    • Lower class, living in foreign culture, laguage barrier => lack of communication
            • Hearing voices in one culture is normal but not in another => psychologist misinterpretations
              • Developed in USA and Europe => over emphasising westernised ideas of health=> ignoring cultural role
                • The same illness may appear differently in different cultures
                  • EBIGNO
                • LITTLEWOOD AND LIPSEDGE
                • EXP
                  • Genuine differences in rates of mental illness
                    • Ethnic minority=> stress => mental illness
                      • Lower class, living in foreign culture, laguage barrier => lack of communication
            • Koro is found in south east Asia => would be misdiagnosed in westernised countries as unfamiliar with symptoms
              • LEWIS
                • Issue: enforcing steretypes & only 1 study => ungeneralisable
                  • LEWIS
                  • Genetic factors
                    • People of African descent have a genetic vulnerability to developing certain mental illnesses
                      • NOT culture, social status or stress. Increase in prevalence of genes for a particular illness
                        • W.H.O.
                        • NAZROO
                        • LITTLEWOOD
                  • People of African descent have a genetic vulnerability to developing certain mental illnesses
                    • NOT culture, social status or stress. Increase in prevalence of genes for a particular illness
                      • W.H.O.
                      • NAZROO
                      • LITTLEWOOD
                  • Gender differences e.g. 90% anorexia nervosa sufferers = women
                    • LEO AND CARTAGENO
                    • EXP
                      • Real differences rather than bias e.g. social roles and life experiences
                    • normal female behaviours are seen as a sign of illness e.g. anorexia nervosa, a symptom is ceasing menstrual cycles
                      • suggests all sufferers are female
                  • Until recently, psychiatry = male dominated => male behaviours = way standards of all behaviour
                    • Gender differences e.g. 90% anorexia nervosa sufferers = women
                      • LEO AND CARTAGENO
                      • EXP
                        • Real differences rather than bias e.g. social roles and life experiences
                      • normal female behaviours are seen as a sign of illness e.g. anorexia nervosa, a symptom is ceasing menstrual cycles
                        • suggests all sufferers are female
                  • women are more likely to be diagnosed with depression and significant phobias, men more likely to suffer from alcohol abuse
                    • no significant differences for schizophrenia and bipolar
                  • no significant differences for schizophrenia and bipolar
                  • pregnancy might explain why women are more predisposed to depression
                    • NOLEN-HOEKSEMA
                      • pregnancy might explain why women are more predisposed to depression
                      • Low social classes are more likely to be diagnosed with mental disorders
                        • most prevalent disorder among middle-class = eating disorders
                          • maybe due to job roles=> stressful lives = disturbed food habits. Middle class more concerned with media and body image
                        • BRUCE
                        • EXP
                          • clinicians may be more likely to diagnose mental illnesses for the lower class
                            • JOHNSTONE
                            • Social Causation Hypothesis
                              • stressful life due to poverty, unemployment
                            • Social Drift Hypothesis
                              • schizophrenia=> lose job => low social status
                      • most prevalent disorder among middle-class = eating disorders
                        • maybe due to job roles=> stressful lives = disturbed food habits. Middle class more concerned with media and body image
                      • clinicians may be more likely to diagnose mental illnesses for the lower class
                        • JOHNSTONE
                        • Social Causation Hypothesis
                          • stressful life due to poverty, unemployment
                        • Social Drift Hypothesis
                          • schizophrenia=> lose job => low social status
                      • EXP

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