DSM and ICD

Question	Answer
What are the '4 D's' of Mental Health Diagnosis?	Deviance, Dysfunction, Distress, Danger,
Explain 'Deviance' in context of the 4 D's	Deviance refers to deviating from the norms of society. If a behaviour is rare and deviates from the social norm, it suggests a clinical disorder is present.
Explain 'Dysfunction' in context of the 4 D's	The behaviour must be significantly effecting the patient's life. Most often, the behaviour makes it difficult to live a day-to-day life but sometimes it's not entirely obvious of where it impacts the patient's life but it will have an effect somewhere
Explain 'Distress' in context of the 4 D's	When diagnosing a mental disorder, it needs to be taken into consideration how much upset the behaviour is causing the individual and the people around them. This needs to be considered individually as a patient could be experiencing stressful life situations that are causing what is believed to be the symptom of mental disorder.
Explain 'Danger' in context of the 4 D's	If the patient's behaviour is becoming a danger to others and themselves then it is very likely this is a symptom of a mental disorder. If they are causing danger, it's likely that intervention will be needed immediately.
What can be considered the fifth D?	Duration- If he symptoms only last a few days and then end, it's unlikely to be a mental disorder.
What does DSM stand for?	Diagnostic and Statistical Manual of Mental Disorders
How many versions of the DSM have been released?	Five
How does the DSM work?	The DSM groups symptoms together into syndromes which relate to specific mental health conditions
What has happened to the DSM over time?	It has evolved in response to research and the changing of social norms. For example, homosexuality used to be in the DSM as a mental disorder but was eventually written out entirely.
What is meant by the DSM being 'multi-axial' and when was it introduced	Multi-axial refers to classification of patients where an individual is rated on 5 axes (or dimensions) to help with diagnosis.
What is Inter-rater reliability?	Having more than one opinion on a subject- for example, in mental health diagnosis, more than one person will be asked to diagnose a person to find an agreement between them.
What is test-retest reliability?	The repeating of a test. In mental health diagnosis, a patient will be diagnosed one way then diagnosed in another to see if diagnoses match.
Explain Beck et al (1962)	He found than the agreement on diagnoses for 153 patients was only 54%. This was due to vague criteria for diagnosis in the DSM and inconsistencies in the ways data was gathered about the patients.
Explain Cooper et al (1972)	He found New York psychiatrists were twice as likely to diagnose schizophrenia whereas London psychiatrists were twice as likely to diagnose manic depression after being shown the same video clip. He used the DSM for diagnosis.
What did Rosenhan show about the DSM?	He showed it was reliable as it consistently diagnosed schizophrenia in the same way but it was not valid as the patients didn't actually have schizophrenia.
Explain Goldstein (1988)	She re-diagnosed 199 patients using the DSM III as they'd previously been diagnosed using the DSM II. She found a few differences but it was 85% consistent. She then asked two other experts to re-diagnose a random sample of 8 and they both agreed on their diagnosis.
Explain Di Nardo's et al (1993)	Showed some improvements of the DSM after its third version. They tested the diagnosis agreement on GAD (generalised anxiety disorder) and OCD. OCD had a 80% consistency whereas GAD had a 57% agreement.
Explain Nicholls et al (2000)	Showed both the ICD-10 and the DSM IV have weaknesses in diagnostics. They used 81 patients with eating disorders to see if each of the books could diagnose them accurately. Reliability rate for DSM 0.64 and 0.36 for the ICD.
What is predictive validity?	Being able to predict what will happen from the findings. For example, diagnoses can lead to predicting the behaviour in the future of the individual.
What is etiological validity?	We have etiological validity if all of the people diagnosed with a disorder have the same factors causing it. Eg, schizophrenia should always be caused be a deficiency with dopamine.
What is construct validity?	Something has construct validity if it is operationalised into a construct (list of something) such as mental illnesses having a list of symptoms for each disorder. There is a lack of validity if the construct doesn't accurately represent the disorder.
Which of the new validities did Rosenhan have a lack of?	Construct validity. The psychiatrists diagnosed schizophrenia incorrectly 11 times. Their construct didn't accurately represent the people it was supposed to.
Explain Kim-Cohen et al (2005)	Conducted a longitudinal study to observe conduct disorder in 2000 five year olds. Parents and teachers were questioned on conduct disorder symptoms. The children who were diagnosed with conduct disorder were more likely to display behavioural and educational difficulties at age 7. PREDICTIVE VALIDITY.
Explain Hoffman (2002)	Studied different diagnoses for alcohol abuse and cocaine dependency using a computerised interview and the DSM. All participants were prison inmates. The symptoms from the interview and the DSM matched. High construct validity and reliability.
Explain Lee (2006)	Wanted to know whether the DSM would work for diagnosing Korean children with ADHD. Used 1663 children. There was a match between the DSM outlines and the answers on the questionnaires regarding the symptoms of the Korean children with ADHD. Match was only good for boys, however. May be issue with construct validity.
What does the ICD stand for?	International Statistical Classification of Diseases and Related Health Problems
What different categories are in the ICD?	1. Infectious and parasitic diseases 2. Neoplasms (growths) 3. Blood related disease 4. Endocrine, nutritional and metabolic diseases 5. Mental and behavioural disorders 6. Nervous system diseases
Which is more commonly used, the DSM or the ICD?	Reed et all (2011) asked 4887 psychiatrists worldwide whether they used the ICD or the DSM. 70% were using the ICD-10 but only 23% were using the DSM-5.
Explain Hiller et al (1992)	Compared the ICD-10 to the DSM 5 in terms of reliability and validity. They diagnosed patients who were actually mentally ill. ICD was more reliable (0.59) besides for bipolar disorder. DSM had a 0.54 reliability.
Explain Jakobsen et al (2005)	Used Danish in and out patients with SZ and/or psychosis. Found 87% predictive validity when diagnosed with SZ. He also found similar results with the DSM which improves reliability as findings were consistent.
Explain Cheniaux et al (2009)	Looked at various diagnoses of SZ, bipolar disorder and unipolar depression using DSM and ICD. Two psychologists (inter-rater reliability) interviewed 100 patients. They found schizophrenia was more commonly diagnosed with the ICD and bipolar disorder was most reliably diagnosed.
What else did Hiller et al (1992) discover about duration?	There was an issue between the ICD and DSM as they couldn't agree on how long a patient had to have symptoms of an illness before being diagnosed. DSM said 6 months whereas ICD said 1 month only.
Explain Jansson et al (2002)	He looked at the ICD-10, focusing on the diagnosis of SZ. Diagnosed 155 patients using the ICD-9 and ICD-10 to see if there were differences. Only some differences were found. Concluded the boundaries for diagnosis were blurred as they changed between the 9th and 10th book.
Explain Pihlajamaa et al (2008)	Validity of SZ diagnosis tested using DSM-III-R and the ICD-10. 807 SZ patients from Finland diagnosed with both books. Validity for DSM was 75% and ICD was 78%. The high level of agreement makes the diagnosis more reliable.
Which is open to everyone- the ICD or the DSM?	The ICD is open to everyone whereas the DSM is under revenue by the APA
Which is multilingual, the DSM or the ICD?	The ICD has copies in many different languages whereas the DSM is heavily dominated by English speaking countries so not many translated copies exist.
Which covers all types of disorders, not just mental disorders?	The ICD has 6 different levels of disorders in it. Only the 5th of these is regarding mental health- the others are related to physical disorders. The DSM only relates to mental health.

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	Created by Emma Lloyd about 8 years ago