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clinical lesson one the four ds - Coggle Diagram
clinical lesson one the four ds
definition of clinical psychology
Diagnosing, explaining and treating mental illness
Seeks to define what makes behaviour abnormal and diagnose problems
statistical definition of abnormality
The statistical definition of abnormality describes the ‘norm’ as something that is usual or typical. When behaviour is rare (statistically infrequent) it is regarded as abnormal. Some characteristics can be measured and the distribution of this characteristic can then be presented in a graph known as the ‘normal distribution curve’. Any normal characteristic occurs in the 95% of the population and any abnormal characteristic occurs in the 2.5% of the population on each side
social norm definition of abnormality
Every society sets standards according to which it expects its members to behave. These standards are called social norms. There are certain rules for appropriate conduct.
Explicit rules – Clearly written e.g. the law
Implicit rules – Being suggested but not actually expressed in a formal manner
Anyone who goes against these conventional rules of conduct is seen as abnormal. According to this view, behaviour cannot be considered abnormal as long as society accepts it.For example, we don’t expect to see people talking to themselves and may try to avoid them. However, if we see that they have a mobile phone then this behaviour becomes acceptable, as it is a social norm to talk on mobile phones in public.
the four ds
One of the biggest issues for clinical psychologists is determining at what point the behaviour that is displayed becomes classed as “abnormal”. This is important as clinical diagnosis will lead to the correct treatment. One method used by clinical psychologists is the four ds: deviance, dysfunction, distress and danger.
Dysfunction: If a behaviour is significantly interfering with a persons’ life then a mental illness may be present. This term involves maladaptive behaviour that impairs the individual's ability to perform normal daily functions, such as getting ready for work in the morning, or driving a car. Such maladaptive behaviours prevent the individual from living a normal, healthy lifestyle. A clinical psychologist should look carefully into all aspects of the patient’s life because disturbances could be present that are not immediately obvious and have no day to day
danger The patient’s behaviour here has to be assessed under two key elements.
Danger to themselves
Danger to others
If the person is putting their life or the lives of others in danger then this might indicate that intervention is needed. This has to be considered on a scale of severity because people engage in behaviours that could be considered dangerous, but when the behaviour becomes extremely risky then a diagnosis maybe necessary.
Deviance: This term refers to how far a behaviour “deviates” or is difference from the norm. Specific thoughts, behaviours and emotions are considered deviant when they are unacceptable or not common in society. Psychologists must, however, remember that minority groups are not always deemed deviant just because they may not have anything in common with other groups. Therefore, we define an individual's actions as deviant or abnormal when their behaviour is deemed unacceptable by the culture they belong to.
Distress: This feature of diagnosis it related to the extent to which the behaviour is causing upset to the individual. This should be treated in isolation from the other 4 Ds because the patient maybe extremely distressed by their situation but still be able to function normally in other areas of their life. The subjective experience of the patient is very important here because some maybe facing a great deal of difficulty but coping well but others may be very distressed by something that some may view as trivial.
evaluation of the 4 ds
weaknesses
he 4ds might not be enough to make a full diagnosis - some have suggested that a 5th D - Duration - is necessary
As the 4ds can be applied subjectively, that means that professionals might not come to the same conclusions about an individual. That reduces reliability
Rosenhan (1973) provides evidence that diagnoses are flawed, as staff were unable to tell mentally disordered patients apart from those who were healthy.
Since there are no objective measures of each of the four Ds, the therapist has to use their professional judgement. What one views as dysfunctional (such as not going to work) might not be considered dysfunctional by the client or by a different therapist.
strengths
Supports the validity of the DSM - the diagnoses have been shown to focus on specific Ds (so each has some value)
The 4ds have a practical application as professionals can use them to consider whether symptoms/issues are part of a clinical illness
The DSM focuses on the Four Ds, showing each has validity. For example, in the DSM, it's not enough for schizophrenia to include deviant behaviour; distress must also be present as well as dysfunction.