reliability/validity/cultural issues of the DSM/diagnosis

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how to achieve reliability in diagnosis?
1) same psychiatrist gives the same diagnosis to same patient with same symptoms at a different time 2) different psychiatrists give the same diagnosis to the same patient
1 of 10
give three pieces of evidence about reliability in diagnosis
1) Beck et al: asked 2 psychiatrists to diagnose a set of patients and they only agreed 54% of the time 2) Nicholls: found low inter-rater reliability for eating disorders in children 3) Di Nardo: found good inter-rater for OCD but low for GAD
2 of 10
how to achieve validity in diagnosis?
1) the diagnosis accurately reflects the disorder and the symptoms 2) the patient improves with treatment (only would improve with correct diagnosis)
3 of 10
give two pieces of evidence about validity in diagnosis
1) Temerline: found that diagnoses can be swayed when opinion from a respected authority is given 2)Sanchez-Villegas: found that only 68% of people diagnosed with depression actually had it
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outline the cultural issue in diagnosis: cultural norms
different cultural norms: in Rastafarian tribes hearing voices is a sign of being with God. Psychiatrist may be of a different culture than the patient e.g. english so use the DSM which would say this is a symptom of schizo
5 of 10
outline the cultural issues in diagnosis: differences about how mental disorders develop
e.g. in morroco, think you can catch a mental disorder by 'stepping on it'. this would affect the treatment that they are given.
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outline cultural issue: DSM
the DSM is still said to be biased towards western cultures
7 of 10
outline the cultural issue in diagnosis: openness
different cultures would discuss their symptoms more openly than others so may affect diagnosis e.g. asian americans talk about their emotions with psychiatrists less than other groups
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give two pieces of evidence about cultural issues in diagnosis
1)Cooper et al: same symptoms more likely to have a diagnosis of schizo in USA and depression in the UK 2) Levav et al: found that black and irish people more likely to get a diagnosis of schizophrenia than other groups in the UK
9 of 10
state the 5 axis of the DSM
1)clinical disorder 2)personality disorder 3)general medical conditions 4)environmental stresses 5)global assessment of functioning
10 of 10

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give three pieces of evidence about reliability in diagnosis

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1) Beck et al: asked 2 psychiatrists to diagnose a set of patients and they only agreed 54% of the time 2) Nicholls: found low inter-rater reliability for eating disorders in children 3) Di Nardo: found good inter-rater for OCD but low for GAD

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how to achieve validity in diagnosis?

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Card 4

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give two pieces of evidence about validity in diagnosis

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Card 5

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outline the cultural issue in diagnosis: cultural norms

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