Looking at the extent to which the behaviour is 'rare' within society.
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Define Dysfunction?
The extent to which a behaviour is interfering with a person's life and disturbing it.
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Define Distress?
The extent to which the behaviour is causing upset to the individual.
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Define Danger?
If they can cause danger to themselves or others, and putting lives at risk.
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Define Duration?
How long they persist for.
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Strengths of the 4 D's?
1) Can be matched to the DSM so support validity of it. 2) Provide a holistic way to assess someone's mental health.
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Weaknesses of the 4 D's?
1) Likely to be subjective in the application. 2) May lack validity, because diagnosis may not be accurate. 3) Can be criticised for being incomplete. 4) Issue with deviance - some problematic behaviours are not that rare
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What are Classification Systems?
ICD and the DSM - Diagnostic manuals.
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What is the ICD-10?
Made for mental disorders. Section F is specific for disorders - groups disorders as being part of families.
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Coding in the ICD-10?
Allows clinicians to go from the general to the specific and to convey their diagnosis to others in an easy way.
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Define Clinical Interview?
The process of evaluating a client by gaining important personal information about them regarding their health.
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What is the DSM-V?
Diagnostic and Statistical Manual of Mental Disorders - groups disorders into families.
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What is the Study on the Diagnostic Systems?
Rosenhan (1973)
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What are the Studies on Reliability of Diagnosis?
Ward et al, Beck and Brown.
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Reliability of Diagnosis - Ward et al?
He studies 2 psychiatrists diagnosing the same patient and found that disagreement occurred because of the diagnostic tool being used.
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Reliability of Diagnosis - Beck?
Found that the same set of symptoms were only diagnosed as the same disorder in about half the cases - suggesting low reliability.
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Reliability of Diagnosis - Brown?
Tested the reliability and validity of DSM-IV diagnosis for anxiety and mood disorders - found them to be good to excellent.
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What are Patient Factors?
Information provided by the patient may be inaccurate because of: memory, denial or shame - makes diagnosis difficult.
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What are Clinician Factors?
Unstructured nature of clinical interviews focus on different things - lead to different information being gathered differently. - Subjective judgement also causes issues.
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Race and Culture?
Behaviour that is common in 1 culture may be different in another. Difference in cultures of the clinician and patient may result in cultural shame.
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What are Culture-bound symptoms?
Disorders only found in 1 culture.
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Define Concurrent Validity?
Could be checked by looking at another diagnostic tool such as comparing the DSM with the ICD. Broad agreement of which symptoms constitute which disorder = broad concurrent validity.
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Define Aetiological Validity?
Can be established by examining what is known about the causes of the disorder and matching them to a person’s history.
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Define Predictive Validity?
Is where the future 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 is valid.
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Define Implicit Bias?
The clinician may be affected by these. E.g. They might be more ready to diagnose a female patient with depression because it is more prevalent in the female population.
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Define Comorbidity?
The presence of more than one disorder in the same person at the same time.
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