Abnormal Psychology: Session 3: Diagnosis of Mental Disorders
Abnormal Psychology: Session 3: Diagnosis of Mental Disorders
Abnormal Psychology: Session 3: Diagnosis of Mental Disorders
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What is diagnosis?
These include:
direct observation of the individual’s behaviour
DSM ICD
Diagnostic and Statistical Manual of Mental Disorders International Classification of Diseases
Based
largely on abnormal experiences and beliefs reported by patients, as well as
agreement among a number of professionals as to what criteria should be used.
This
can explain why the criteria change in revisions of the diagnostic manuals, for
example homosexuality was included in earlier versions of the DSM.
finished
Task
Watch the video critique of the DSM
What are the issues with validity and
reliability?
Remember you also need to think critically
patients may act the label that has been given to them (self fulfilling
insanity defense)
Temerline (1970)
Clinically trained psychiatrists were influenced in
healthy individual.
The authority claimed, even though the person only
Comer (2004)
•Over inclusion and ‘patholologizing’ problems
•The DSM keeps expanding
•According to Comer 48% of Americans might qualify for
a diagnosis on the DSM.
•E.g. mood changes with the menstrual cycle should that
really be seen as ‘Pre Menstrual Dysphoric Disorder’?
This could be seen as ‘pathologizing’ what is normal
behavior for women (gender bias).
Key Study: Rosenhan (1973) Covert Observation: On being Sane
in Insane Places (pg 142)
The impact of Rosenhan’s (1973) classic study: on being
sane in insane places
In the 1960s and 70s there was some concern among
psychiatrists that they gave diagnosis of schizophrenia too
readily.
However – the diagnosis was high in inter rater reliability – since nearly
all the ‘pseudo patients’ where given the diagnosis of schizophrenia –
but this was not a valid diagnosis.
This shows that a diagnosis may be high in reliability and low in validity
at the same time.
Each edition of the DSM attempts to improve both the reliability and
validity of diagnostic criteria.
Task
Look at page 142 in your textbook
Answer the questions about Rosenhan’s
questions on a computer
It gave them the opportunity to reveal symptoms
and reliability
Evaluation: limitations
There is a large amount of research supporting
the view that the reliability and validity of
diagnosis are poor. This is due to many reasons,
e.g. a possible social construction of mental
illness, poor diagnostic tools, the possibility of
faking, social influence, errors in attribution by
practitioners and labeling
There are significant individual and cultural
differences for the symptoms of mental
disorders.
An individual may have multiple mental disorders
A wrong diagnosis may lead to a social stigma
(an ethical issue)
Counter argument
There are methodological problems with the studies on
validity and reliability (researcher bias, generalisability,
ecological validity)
Revised diagnostic tools are higher in reliability than
earlier versions, e.g. DSM-IV-TR
Many people do seek help voluntarily for disorders (which
may mean that the disorder is valid)
The reliability of diagnosis is high for some disorders,
e.g. obsessive compulsive disorder
There are many similarities of disorders across cultures
Diagnostic systems do not classify people, but the
disorders that they have
Alternative methods for diagnosis are being developed all
the time
Key Terms Test
Reliability
ICD
DSM
Diagnosis
Classification
Key Terms Reminder
Reliability:
this is how effective the use of a particular method of diagnosis (for example the DSM) is at
identifying a disorder.
ICD:(International Classification of Diseases and Related Health Problems): The classification system
for medical and mental health problems used by the World Health Organization (WHO).
DSM: (The Diagnostic and Statistical Manual of Mental Disorders): The classification and diagnosis
system developed by the American Psychiatric Association (APA).
Diagnosis: is the process of identifying a medical condition or disease by its signs (what the physician
sees), symptoms (what the patient says), and from the results of various diagnostic procedures.The
conclusion reached through this process is called a diagnosis. Diagnosis is a clinical judgment on the
part of the psychiatrist.
Classification:
A list of disorders along with descriptions of symptoms and guidelines for making
appropriate diagnosis (Comer, 2004). For example, deciding what schizophrenia is as apposed to
depression.
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