Diagnosis ABpsych - Psychology PDF

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Evaluate the use of classification systems in the diagnosis of abnormal behaviour Contrast two diagnostic systems for the classification of mental illness Discuss the role of clinical bias in diagnosis Discuss the validity and reliability of diagnosis KEY TERMS ICD: (International Classification of Diseases and Related Health Problems) the classification for medical and mental health problems used by the WHO. Current one being used is ICD-11 DSM: (The Diagnostic and Statistical Manual of Mental Disorders) The classification and diagnosis systems developed by the American Psychiatric Association (APA). Current one being used is DSM-5 Diagnosis: is the process of identifying a medical condition or disease by its signs (what the psychiatrist sees), symptoms (what the patient says) and from the results of various diagnostic procedures. The conclusion reached by this process of called a diagnosis. Diagnosis is a clinical judgement on the part of the psychiatrist. DIAGNOSIS ON THE BASIS OF:  Symptoms  The patients’ self-reports  Observation  Clinical tests  Other factors, such as information from relatives  Brain scans

Beck et al (1961) - Looked at the inter-rater reliability between 2 psychiatrists when considering the cases of 154 patients. Cooper et al (1972)- Reliability Lipton and Simon (1985) – Reliability Rosenhan (1973) – Both Li-Repac (1980)- Validity Lobbestael et al (2011)- Reliability Mitchell et al (2009) – Validity

WHY IS DIAGNOSIS OFTEN UNRELIABLE?  The actual understanding is not in such depth  Lots of overlap between two distinct mental illnesses  Rarely can blood or urine testing be used to determine mental illness  Most disorders are clusters of symptoms: How many symptoms and for how long until diagnosis

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Many of these symptoms cannot be easily measures: no quantitative system. Often psychologists are dependent on self-reported data Cultural and gender biases of the psychologist may lead to over or under pathologization It isn’t unusual for a patient to be suffering from two or more psychological conditions simultaneously. This is known as comorbidity Reactivity: people who are aware of being assessed may change the way they usually behave

THE SOLUTION? Robins and Guze (1970) argue that triangulation is essential for valid diagnosis. This includes source triangulation as well as researcher (clinician) triangulation. Sources of data include:    

Distinct clinical description from observations and interviews Laboratory studies (including psychological tests and blood testing) Family studies and medical history Nadine Burke argues that ACEs- adverse childhood experiences- should also be part of the medical history...