Reliability of the DSM

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Pontizovsky et al. (2006)

  • Looked at agreement in diagnosis on admission and on release
  • 998 patients
  • Israeli hospital

Findings:

  • Kappa for mood disorder = 0.68
  • Psychotic patients = 0.62

Reliability is high as a kappa of 1 would mean complete agreement in diagnosis

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Kirk and Kutchins (1992)

 

  • Looked at methodological problems with studies testing DSM
  • Use of interviews and questionnaires: interviewers training was poor- lacked commitment and skills
  • research setting- can't be generalised to setting of clinic- meaning diagnosis is NOT accurate

Not reliable 

 

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Cooper et al. (1997)

  • Affect of culture on diagnosis
  • Psychiatrists in NYC = 2x as likely to diagnose SCHIZOPHRENIA
  • Psychiatrists in London = 2x as likely to diagnose MANIA or DEPRESSION
  • Both were shown same video taped clinical interview!!

Cultural factors may affect reliability of diagnosis due to difference in beliefs and norms.

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Goldstein (1988)

 

  • Reliability of DSM III 
  • Researchers looked at histories of patients previously diagnosed with schizo
  • High level of agreement for diagnosis (re-hospitalisation)

Highlights the RELIABILITY of the DSM III

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Subjectivity of diagnosis

  • there have been different diagnosis' which show psychiatrists may be SUBJECTIVE when giving diagnosis- personal opinion
  • Misdiagnosis may also be deliberate- some institutions only admit people with certain problems, may misdiagnose to admit someone or to send them away?

DSM NOT RELIABLE

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Why is RELIABILITY important?

 

  • If there is unreliability in classification system- could result in unreliable diagnosis
  • Severe consequences- could affect selection of treatment and also communication with patient

E.g; could be given treatment for no reason...or not given treatment when need it 

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