Diagnosis

• reasons why it's hard to define abnormal behaviour in an objective and scientific way?

  • no clear dividing line separating normal and abnormal behaviour.
  • concept of abnormality can change over time (1987 homosexuality)
  • concept of abnormality can change between cultures
  • many different types of behaviour can be considered abnormal (eg waiting by door 20minutes before class)
• what are the 4 D's of diagnosis? (in an attempt to deal with issue of defining abnormal behaviour)

  • deviance: behaviours or emotions that are unusual in society, statistically rare and disapproved by society.
  • distress: extent individual finds behaviour/emotions upsetting.
  • dysfunction: behaviour interferes with persons day-to-day life.
  • danger: behaviour that can harm others or individual
• strengths of 4 D's?

  • practical applications in helping decide whether a patients symptoms warrant a clinical diagnosis
  • provide holistic way to assess mental health, cover a wide range of symptoms.
  • Davis (2009), found a 5th D needs to be added- duration (increases validity)
• weaknesses of 4 D's?

  • subjective, eg how much does something impact someones life? may check doors out of safety
  • lack validity, diagnosis may not be accurate due to subjectivity.
  • if being used by 2 professionals, reliability is low since they may not arrive at the same diagnosis and reduce scientific status.
  • incomplete, Davis (2009) adds 5th D- duration.
  • social control, discriminate against those who majority of society disapprove of (Joyce Brown, homeless)
• what are the 2 major classification systems?

  • ICD 10, published by WHO and is used commonly in Britain/ other parts of the world.
  • DSM 5, published by American Psychiatric Association and is used in North America.

  both are diagnostic tools used to identify and treat particular disorders
• strength of classification systems?

  reliability, constantly changing to fit cultures
• weaknesses of classification system?

  • subjectivity when deciding on a diagnosis.
  • reductionist, both rely on checklists of behaviours.
  • use medical model, which assumed mental health issues are illnesses and should be treated the same as physical illnesses
• the DSM-5

  published in May 2013. assesses individuals in terms of: type of disorder they suffer in categories, factors that can exist alongside a clinical disorder (general medical conditions), psychosocial and contextual factors that can influence wellbeing of an individual (homelessness), disability.

  • assessment= several procedures: clinical observation of client/medical records.
• ICD 10

  diagnoses both mental and physical conditions. It is a free open resource, has 100 categories with similar disorders linked together. assessment of patient involves several procedures: clinical observation, observation of client and medical records.
• comparison of ICD and DSM?

  • both use categories and symptoms are present over a 2-week period.
  • ! ICD criterion-based approach to diagnosis is more reductionist (doesn't look at disability and psychosocial factors in DSM) than DSM holistic approach.
  • ICD is free, DSM isn't.
  • ICD= both mental and physical conditions. DSM= only mental.
  • ICD= published by WHO, DSM= published by American Psychiatric Association.