Issues of bias in the diagnostic system

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What is one issue of the DSM and ICD?
Cultural bias
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What do critics suggest about both systems?
They treat mental patients differently according to the background from which they come
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What can they relate to?
Ethnic background, Social class background
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What about in terms of ethnic background?
Diagnosis of mental disorder tends to be based on a white, western view of normality
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What does this discriminate against?
people from different backgrounds
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Seeing them as what?
inferior
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What is the term for some psychiatrists?
Colour blind psychiatrists
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What may these diagnose as a client as?
abnormal and mentally ill when they describe experiences which are normal within their ethnic group.
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What is an example?
the DSM assumes that hearing voices is abnormal and a symptom of a disorder
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What do some ethnic groups view?
hearing voices as normal and even desirable e.g. Shamanim
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Where does the support for the idea that the DSM and ICD systems?
they are culturally biased comes from Cochrane et al
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What did they find out about Afro-Caribbean immigrants?
in the UK are at least 7 times more likely to be diagnosed with Schizophrenia than white people
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Where is the black rate of Schizophrenia is highest?
UK
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What were psychiatrists more likely to diagnose schizophrenia?
if the individual was black as opposed to white
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What does this suggest about the decisions in the diagnostic system?
effected by ethnic background
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what about in terms of social class?
both the DSM and the ICD treat patients differently depending upon their class poition
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Who does diagnosis tends to be biased against?
people in lower classes
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People who come from a very different social background from the?
middle class psychiatrist
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For example, lower class patients are likely to be what?
for longer, are more likely to be prescribed drugs than talking treatments such as CBT, and to have a poorer prognosis
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Where does support come from?
Johnstone
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What did she find?
working class people were more likely than middle class people to be diagnosed with schizophrenia
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When the symptoms they described as what?
the same
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What does this suggest?
the diagnostic process is onesided and inaccurate in terms of social class
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What is another of bias in diagnostic system?
gender bias
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What did critics suggest?
DSM and ICD treat patients differently according to whether they are male or female
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What does Diagnosis tend to be based on?
sex role stereotyping
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Diagnosis often sees what as superior?
male attributes
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psychiatrists (usually male) often hold strong views on what?
normal behaviour for men and women, which leads to many more female being diagnosed with an eating disorder than males
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The bias is reflected in the fact that one of the criteria for anorexia?
have the client's periods have stopped
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On the other hand what are males more likely to be diagnosed with?
antisocial personality disorder than females
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Where does support come from?
Broverman
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What did he ask psychiatrists to identify?
the characteristics of a healthy man, a healthy woman or a normal adult
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What did the characteristics of the man do more?
Overlap more with the person 'gender unspecified'
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What does this suggest?
male characteristics are more 'normal' and desirable than female ones
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What does research also show?
women are much more likely to be diagnosed with depression or phobias than men
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What does this research suggest?
the diagnostic process is distorted
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In methodology terms supporters of the DSM and ICD such as Spitzer point to what?
improvements in reliability and validity since the systems were first introduced
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For example, what is the number of seperate disorders in DSM-IV has increased to?
400
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What is diagnosis now based on?
5 seperate axes rather than just one
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Including the what?
GAF score
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The release of the DSM V in April 2013 will have made the system?
even more reliable and valid, and thus less biased
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However, What did Rosenhan's research involve?
8 sane pseudopatients being admitted to an insane places
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What does this suggest about diagnosis?
it is inevitably biased and subjectine
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What did he find about psychiatrists?
They could not distinguish between normality and abnormality, sanity and insanity whatever system they used
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What do people argue about these systems?
They are not biased
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What are there?
real differences in the rates of mental disorder between groups of people
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For example, perhaps UK black people are really what?
more likely to suffer from schizophrenia than white people due to the 'racism-induced stress'
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That cause what?
prejudice and discrimination
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Also perhaps women really are more likely to suffer from?
depression than men due to hormonal differences leading to PMT and PND
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What does this suggests?
accusations of onesidedness in the DSM and ICD could be false
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What is the final issue of bias in the DSM and ICD?
serious ethical implications of this bias
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What did Laing suggest?
Once a person is diagnosed with a mental disorder, they become labelled and stigmatised
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The label often acts as what?
A self-fulfilling prophecy
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This is particularly unjust if bias has what?
led to a misdiagnosis, even to someone being institutionalised
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In a recent study, How many diagnosises of schizophrenia were reduced to?
89 to 16
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Therefore, how many black people have been admitted to mental hospitals as?
Schizophrenic when in fact they are perfectly sane
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What does this suggest?
it is essential to reduce bias in the diagnostic systems
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In order to remove what?
the potentially damaging effects on people's lives
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Therefore what would Laing suggest?
we should get rid of the DSM and ICD altogether
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as what?
mental illness is a myth
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Why can the DSM and ICD be useful?
They give us an idea of the number of people with a disorder
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What can they help with?
treatment suggestions
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However due to their bias, perhaps the way forward is what?
try and avoid using labels and classification when diagnosing mental disorder
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and use more what?
idiographic approach that analyses each patients problems individually
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Card 2

Front

What do critics suggest about both systems?

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They treat mental patients differently according to the background from which they come

Card 3

Front

What can they relate to?

Back

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Card 4

Front

What about in terms of ethnic background?

Back

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Card 5

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What does this discriminate against?

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