Lesson 1 Intro and Exploring Diagnosis - Coggle Diagram
Lesson 1 Intro and Exploring Diagnosis
What is Abnormal Behaviour?
o Behaviour that is atypical or statistically uncommon within a particular culture or that is maladaptive or detrimental to an individual or those around that individual.
Mental Health Diagnosis
• Health Professional for Diagnosis
o Clinical Psychologists
• Assessment and Diagnosis Process
o Mental health disorders are diagnosed by a healthcare provider who has knowledge and experience in mental and behavioural health.
o The diagnosis process is multi-step and may include:
o - A physical exam to rule out physical problems that could cause your symptoms.
o - Laboratory tests to screen for underlying or less obvious possible causes.
o - A psychological evaluation where a doctor or mental health professional talks to you about your symptoms, thoughts, feelings, and behaviour patterns.
• The 5 D's of Diagnosis
o Distress- The feature of the diagnostic decision is related to the extent to which behaviour is causing upset to the individual or behaviour is distressing to others i.e. person talking to themselves may not be distressed but others may be distressed
o Danger- Does behaviour present danger to themselves and/ or others.
o Duration- How long behaviour lasts. Behaviours may be reminiscent of 4 Ds in short-term but may not be present in long term.
o Dysfunction- If behaviour significantly interferes with person’s life so mental illness may be present. Behaviour interferes with day-to-day activities.
o Deviance- If Behaviour is rare within society and deviant from social norms. How far does behaviour move away from what is considered normal.
Evaluation of Diagnosis
o Results of diagnosis can be tested for inter-rater reliability as another clinician may observe behaviour and see whether it’s applicable to 4 Ds in same manner as first suggested. (Reliability)
o Reliability issues in terms of behaviour needing further diagnosis and relies on what is discussed between patient and clinician
• Subjectivity in interpretation of patient’s experience
o Interpretation of behaviour i.e. symptoms of depression like isolation may be seen as deviant by some clinicians or not all, low reliability of results
o Subjectivity in terms of what patient's may say, they may explain their experiences differently so reliability may be lowered
o Semi-Structured and Unstructured Interviews may decrease replicability and reliability of results as consistency of diagnosis cannot be approved in replications
o Application to diagnosis. The 4Ds are used by mental health clinicians in conjunction with classification manuals such as the DSM-5 and ICD-10 to help decide whether making a diagnosis is appropriate, and if so, which one.
o An accurate and valid diagnosis may be difficult to achieve if the clinician can’t determine truth, leading to potential misdiagnosis.
o Internal validity issues of diagnosis if patient isn’t honest about behaviour and life experiences (Social Desirability bias).
o Due to the nature of some disorders, patients may not be able to tell the truth either because they are compelled to lie or they may simply believe that what they are saying is true.
o Patient may be inaccurate about discussing their experiences so there may be low internal validity of diagnosis
Issues and Debates
• Social Control
o Clinicians have power in diagnoses as they can have serious implications for patient once they’re labelled as mentally ill.
o It is possible to treat patients against consent if they’ve been sanctioned under mental health act and deemed risk to self or others.
• Role of Culture
o It is important to consider the role of culture.
o Some behaviours may seem alien to a clinician from a different cultural background of the client.
o Therefore, certain behaviours may be abnormal for one person but entirely normal for another.
• Practical Issues in Design
o The diagnostic process is often conducted through clinical interviews with patients by clinicians.
o These interviews may be low in reliability and validity.
o The self-report method in general is limited as patients may withhold information or not tell the truth (Social Desirability Bias and Demand characteristics).
• Clinical Interviews
o A clinical interview is guided by clinician’s questions, if they focus on one set of symptoms, diagnosis may be different from clinician who focuses on numerous symptoms.
o These are semi-structured or unstructured interviews conducted between patient and clinician.
o Honesty is important to consider when interviewing patients for diagnosis.
Social desirability bias can affect validity
• Due to the nature of some disorders, patients may not be able to tell the truth either because they are compelled to lie or they may simply believe that what they are saying is true (Schizophrenia- delusions)
so low validity of diagnosis
• Nature of interviews means that they can’t be replicated to gain ‘set’ answers- lowers reliability.
• The chances of a misdiagnosis are high and therefore, this has implications for treatment.
Evaluating Further (Deviance of Behaviours)
o 1 in 5 people will experience a mental health problem in their lifetime.
o Currently 280,000 people are being treated for Schizophrenia under the NHS.
o The number of young people admitted to hospital over the last 10 years for self-harming had risen by 68%.
• This means that this criterion must be judged in combination with the others and not alone because deviancy alone may not be a result of a mental health disorder because, due to societal stereotypes and norms, very simple actions can be seen as deviating even If no mental health disorder is present.