Abnormal_diagnosis_revision

What are classification systems for?

Answer explanation

Classification systems identify patterns of behavioral or mental symptoms that consistently occur together to form a disorder.

Contain description of disorders and their symptoms, so that diagnosis can be made.

What is the role of classification systems? Come up with 2-3 reasons

Though classification systems give us a more objective and unified way to diagnose disorders. However, it's still not perfect and has a lot of issues. What are some of them?

Answer explanation

1.     looking for evidence of abnormal behavior – sick role bias

2.     Reactivity occurs when individuals change behavior due to the awareness that they are being observed. The change may be positive or negative.

3.    A clinician’s unique style, degree of experience, and theoretical orientation will definitely affect the interview and thus further diagnosis.

5. 4. Cultural relativism in symptoms

What is the name of a classification system used in the USA?

Which organization developed ICD 11?

What are some differences between DSM and ICD systems?

Answer explanation

·       The ICD is produced by the World Health Organization, while the DSM is produced by the American Psychiatric Association.

·       The ICD's approach is multilingual with the intent that it will be used globally to increase mental health; the primary users of the DSM are American psychiatrists.

·       The ICD is distributed at a very low cost, with discounts to low-income countries, and available free on the Internet; the DSM generates a very substantial portion of the American Psychiatric Association's revenue.

·       Mostly similar, but have some differences in the descriptions and classifications. Ex. For personality disorders there are some different way to name same disorders, and also there are some disorders that don’t have a correlate in the other classification system

·       Different requirements to make a diagnosis. In DSM there are operationalized definitions of disorders – you have to meet certain criteria to be diagnosed with a disorder. Ex. Borderline personality in DSM has to meet 5 out 9 characteristics for diagnosis. In the ICD it more heavily depends on clinical discretion (there are more like guidelines to be followed rather than criteria to be met).

• ·    For ICD it may lead to low interrater reliability, while DSM has higher reliability. ICD is more prone to clinician subjectivity, however, it also allows for a more individualized diagnosis. DSM is more objective, less clinician freedom, but is more static and may not reflect all the individual differences in the expression of the disorder. However, need to remember that DSM is just a manual, clinicians are still free to give or not to give a diagnosis.

Evaluation of DSM system.

1. 1. Helen, Eason, Jenny, Curry - strengths of the system

2. 2. Andrew, Lisa, Janna, Ray - limitations of the system

Answer explanation

STRENGTHS:
1)     Widely used -  a common set of diagnostic criteria + common language

2)     Well operationalized disorders and criteria which gives relatively high inter-rater reliability, so it's more objective

LIMITATIONS:

1) The cutoffs are questionable. Why must someone have at least 5 of the 9 symptoms of Major Depressive Disorder to be diagnosed? Why 2 weeks instead of 1 week?

2)     Some things are vague - ‘the symptoms must cause significant distress or impairment in various areas of a client's life’ what is significant? - leaves space for subjectivity - so still possibility for clinician’s unique style, degree of experience etc, to affect the diagnosis.

3)     It’s quite rigid, so may not address all the individual differences in the disorder expression
GENERAL LIMITATIONS OF CLASS. SYSTEMS:
4) Sick role bias

5) Reactivity occurs when individuals change behavior due to the awareness that they are being observed. The change may be positive or negative.

Diagnosis --> ensure validity to ensure effective treatment --> problematic.

One of the reasons is clinical biases.

What is clinical bias?

Answer explanation

Clinical biases are cognitive biases that take place when a clinician is trying to make a diagnosis.

Which theory can explain occurrence of cognitive biases?

How is the following bias called?

The assumption that if a person is seeking assistance, s/he must have a mental disorder.