diagnosing abnormality
- Created by: Fennstorey
- Created on: 15-11-18 12:42
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- DIAGNOSING ABNORMAL BEHAVIOUR
- AO1
- BASICS
- Diagnosis is proposing a cause for a medical problem
- Is followed by prognosis - prediction about how the problem will develop with or without treatment
- Mental disorders diagnosed in clinical interview
- Therapist
- Open ended qs
- Observations
- Bio-metric tools
- Complicated
- Poor description form client
- Difficult observations
- No bio-metric tools
- Therapist
- Diagnosis is proposing a cause for a medical problem
- 4 D's
- Basics
- assessment tool - decide if behavior is abnormal
- Situation/cont-ext must be considered
- No clear diff. between normal/abnor-mal
- Therapist judgement needed
- Just because 4 D's present doesn't mean psychiatric diagnosis is correct
- assessment tool - decide if behavior is abnormal
- Deviance
- behaviours and emotions that are viewed as unacceptable
- Statistical deviance
- how unusual is a behaviour
- Extremely rare = deviant
- Some behavior can be measured on quantitative scale
- e.g. extroversion via psychometric tests
- Distribution curve
- scores cluster round mean
- Normal = 68% in middle (1 SD = 34.1 either side of mean)
- Odd = 2SD from mean (13.6% either side of normal)
- Truly abnormal = 2.1% at top or bottom of scale
- Odd = 2SD from mean (13.6% either side of normal)
- Advantage -mathematicall-y objective
- However ignores feelings about behaviours
- Mental disorders becoming more common
- Wittchen et al. (2011)
- Mental disorders becoming more common
- However ignores feelings about behaviours
- how unusual is a behaviour
- Social deviance
- social norm is an unwritten rule about acceptable behaviour
- people stick to them
- can differ based on culture, gender, time period, situation, age
- violating social norm seen as abnormal
- those people seen as eccentric/rebel-lious
- extremely abnormal behavior - conflict with whole society
- people stick to them
- Advantage : define abnormality in terms of how we feel and our values
- however its subjective
- therapist may be influenced by own feelings rather than society's
- can be difficult to find out social norms
- however its subjective
- social norm is an unwritten rule about acceptable behaviour
- Dysfunction
- when the abnormal behaviour is significantly interfering with everyday tasks and living your life
- unable to cope with the demands of everyday life
- Rosenhan & Seligman (1989) suggest the characteristics that define failure to function adequately
- Unpredictabilit-y, irrationality, cause discomfort to others, suffering, maladaptivene-s, vividness, violate moral standards
- when the abnormal behaviour is significantly interfering with everyday tasks and living your life
- Distress
- simple view that abnormality involves being unhappy: experiencing negative feelings like anxiety, isolation, confusion and fear
- when these feelings become too common or persist too long
- e.g.When Prince Albert died in 1861, Queen Victoria went into mourning for the remaining 40 years of her life
- when these feelings become too common or persist too long
- Problem - judging it is subjective
- simple view that abnormality involves being unhappy: experiencing negative feelings like anxiety, isolation, confusion and fear
- Danger
- when the behaviour harms, or put at risk, the individual or others around them.
- based on the harm principle
- states that you have a right to behave in any way you like so long as you don't cause harm
- abnormal behaviour puts yourself or other people at excessive risk
- states that you have a right to behave in any way you like so long as you don't cause harm
- Basics
- BASICS
- AO2
- Basics
- Mental disorders are classified into groups of symptoms
- to provide effective treatment of a disorder, the condition needs to be accurately diagnosed
- Diagnosis depends on a comprehensive classification system
- DSM
- ICD
- Diagnosis depends on a comprehensive classification system
- to provide effective treatment of a disorder, the condition needs to be accurately diagnosed
- Mental disorders are classified into groups of symptoms
- Types of error
- Type 1/False positive
- diagnosing someone with a mental disorder when they are healthy
- come from "reading too much" into the client's behaviour
- also come from the fear of the consequences of a False Negative
- Type 2/False Negative
- diagnosing someone as healthy when in reality they are ill
- can come from the suspicion that the client is faking their illness
- diagnosing someone as healthy when in reality they are ill
- DSM-5
- diagnosing sc-hizophrenia
- Two symptoms needed for diagnosis
- has made False Positives less likely but may have caused False Negatives
- Two symptoms needed for diagnosis
- diagnosing sc-hizophrenia
- Type 1/False positive
- Cultural Problems in Diagnosis
- Psychology and psychiatry is very Western
- psychiatrists have to diagnose mental disorders in patients from non-Western background
- People from other cultures presenting their symptoms to a Western doctor may express themselves in unfamiliar ways
- African-Caribbeans it is not abnormal to talk to dead relatives while grieving
- false positive diagnosis of schizo
- African-Caribbeans it is not abnormal to talk to dead relatives while grieving
- People from other cultures presenting their symptoms to a Western doctor may express themselves in unfamiliar ways
- Disorders, classifications and symptoms that are recognised by Western psychiatry become "official"
- "unofficial" mental disorders are considered to be folk illnesses and are not taken seriously. This can lead to false negative diagnosis
- psychiatrists have to diagnose mental disorders in patients from non-Western background
- Psychology and psychiatry is very Western
- Medicalising Normal Experiences
- concern that clinical psychologists are 'medicalising' normal experiences like sadness, anger, laziness and bad habits
- False positives
- Lisa Appignanesi (2008) argues there are a number of reasons for this
- We trust doctors - accept diagnosis
- Doctors want to help
- We are lazy and believe that medical problems are for Doctor to fix - not for us to change
- Companies want to sell cures
- latest edition of DSM has been criticised for this, because it contains a lot of "new" mental disorders that include shyness and loneliness
- Advantage - makes mental disorders more normal = people more likely to open up
- concern that clinical psychologists are 'medicalising' normal experiences like sadness, anger, laziness and bad habits
- Basics
- AO3
- Credibility
- use of diagnostic systems means more communication between clinicians
- increased reliability
- Spitzer & Fleiss, 1974
- inter-rater reliability
- increased reliability
- DSM and ICD always being updated
- ensure that it is possible to make more valid diagnoses based on up-to-date evidenc
- The DSM focuses on the Four Ds, showing each has validit
- use of diagnostic systems means more communication between clinicians
- Objections
- diagnosis depends on which system is used, the validity of diagnosis is in doubt of diagnosis
- There has been found to be only a 68% agreement (Andrews et al, 1999) between the ICD and DSM
- Rosenhan (1973) provides evidence that diagnoses are flawed
- Since there are no objective measures of each of the four Ds, the therapist has to use their professional judgement
- subjective
- Credibility
- AO1
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