Reliability and Validity of Diagnosis

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  • Reliability and Validity of Diagnosis
    • Reliability
      • Inter-rater
        • Consistency in diagnosis between two clinicians looking at the same patient
      • Test re-test
        • Repetition of a diagnosis assessed by testing the same person twice with a gap of weeks or months and diagnosis should be the same
      • Beck et al (1962)
        • The agreement on diagnosis for 153 patients between two psychiatrists was only 54%
      • Cooper et al (1972)
        • NY psychiatrists 2x as likely to diagnose schiz - London psychiatrists 2x as likely to diagnose mania or depression
      • Brown
        • 67% agreement rate for major depression
      • Davison and Neale (1994)
        • 92% agreement rate for psychosexual disorders, but only 54% for somatoform disorders
      • Zigler and Phillips (1961)
        • 54-84% agreement rate when looking at various mental illnesses
      • Nicholls et al
        • Compared reliability of DSM IV, ICD 10 & The Great Ormond Street's classification system for children with eating disorders
          • ICD - 36% agreement       DSM - 64% GOS - 88%
    • Validity
      • Criterion
        • When two or more diagnostic systems agree with each other e.g. DSM and ICD-10
      • Concurrent
        • Symptoms that form part of the disorder but are not part of the actual diagnosis, should be found in the diagnosed e.g. people with schizophrenia having poor personal hygiene
      • Etiological
        • A group of people who have been diagnosed with the same disorder will have the same factors causing it e.g. schiz - excess dopamine
      • Predictive
        • If diagnosis can lead to a prediction of future behaviours caused by the disorder
          • E.g. the drug lithium carbonate is effective for bipolar disorder but not other mental disorders. If a classification system has good predictive validity and diagnoses someone with bipolar, they should respond to lithium carbonate
      • Nicholls et al
        • Lacked criterion validity when diagnosing as DSM, ICD and GOS didn't agree- 50% couldn't be diagnosed using DSM
      • Kim Cohen et al (2005)
        • Predictive validity - predicted the children who were diagnosed would show behavioural and educational difficulties at 7
      • Lee (2006)
        • High criterion validity - the DSM, ADHD test and teacher assessments matched in their diagnosis



Good resource, much better than others


this is amazing chloe, really going to help me with my revision, thank you 


5 stars given to you


great resoucre chlo, really helpful! x

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