Evaluation: The 4D System of Determining if Diagnosis is Necessary
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A level (Clinical Psychology) Psychology Mapa Mental sobre Evaluation: The 4D System of Determining if Diagnosis is Necessary, creado por Katie Greensted el 31/05/2019.
Evaluation: The 4D System of
Determining if Diagnosis is Necessary
Deviance
Deviance is any
departure from how
society expects us to
behave, which is seen as
abnormal behaviour.
The do this by looking at the statistical frequency of
behaviours, however this is not a consistent or reliable
method of determining whether a behaviour is normal or
abnormal. For example, as mental health awareness increases
and becomes less stigmatised, issues are reported more so
become more common - does this keep them abnormal?
For example, talking
to yourself in public
would be considered
deviance from normal
behaviour.
People's perception of abnormal behaviour is subjective
and may also depend on factors such as culture (e.g. some
cultures see hearing voices as a religious experience, rather
than abnormal behaviour). Therefore, the 4D system may
lack reliability as different clinicians may consider different
behaviours as abnormal.
Dysfunction
Dysfunction refers to whether
the individual's psychological
state is preventing them from
effectively satisfying their
social and occupational roles.
To some extent, dysfunction is a spectrum
an many people have days where they are
more dysfunctional than others - it is not
necessarily a sign of abnormality and
underlying mental health disorders.
For example, if someone is
suffering badly from
depression or anxiety, they
may feel unable to leave the
house to work or socialise.
Our psychological state may not be the only cause
of dysfunctional behaviour. Therefore, it does not
necessarily mean someone needs diagnosis if they
are struggling from dysfunctional behaviour, and
the system therefore may lack validity.
Danger
Danger refers to if the
individual's behaviour is
a threat to themselves or
others around them.
Some individuals may suffer more from
emotional harm than physical harm, and
this may mean there is a lack of physical
evidence that their behaviour is putting
themselves or others in danger.
For example, if the individual's
condition is making them aggressive
and impulsive, it may be considered
as a threat to both themselves and
others around them.
There are many behaviours that people take part
in that are dangerous, but that isn't necessarily an
abnormal behaviour - for example, smoking. This
suggests that the 4D system may not be the most
valid in determining if diagnosis is necessary.
Distress
Distress refers to the extent to
which the individual perceives their
own behaviour and/or emotions as
upsetting and accounts for
negative feelings of individuals with
psychological disorders.
Other factors need to be taken into account
to determine if the individual's distress could
be a result of an undiagnosed mental illness,
such as causes and frequency.
Some individuals may struggle to
express their emotions, particularly
when it comes to sensitive issues.
Therefore, they may lie and may not be
sent for diagnosis when necessary -
less validity.
For example, the
individual may feel
anxious or upset whilst
dealing with a potential
mental health disorder.
Levels of distress are subjective, and as information is collected
by self-report data, this measurement could be exaggerated or
played down (social desirability bias). This could result in incorrect
decisions to send an individual for diagnosis, and therefore
reduces the validity of the system. A standardised measure is
needed to make this measure objective.
Duration was a 5th D added later on, which
suggests that the original 4D system was not
satisfactory enough. However, it also means that
the 4D system has now been improved, which
increases the reliability and validity of the
decisions made based off of the systems.