Evaluation: The 4D System of Determining if Diagnosis is Necessary

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A level Psychology (Clinical Psychology) Mind Map on Evaluation: The 4D System of Determining if Diagnosis is Necessary, created by Katie Greensted on 31/05/2019.
Katie Greensted
Mind Map by Katie Greensted, updated more than 1 year ago
Katie Greensted
Created by Katie Greensted over 5 years ago
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Evaluation: The 4D System of Determining if Diagnosis is Necessary
  1. Deviance
    1. Deviance is any departure from how society expects us to behave, which is seen as abnormal behaviour.
      1. 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?
      2. For example, talking to yourself in public would be considered deviance from normal behaviour.
        1. 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.
      3. Dysfunction
        1. Dysfunction refers to whether the individual's psychological state is preventing them from effectively satisfying their social and occupational roles.
          1. 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.
          2. For example, if someone is suffering badly from depression or anxiety, they may feel unable to leave the house to work or socialise.
            1. 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.
          3. Danger
            1. Danger refers to if the individual's behaviour is a threat to themselves or others around them.
              1. 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.
              2. 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.
                1. 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.
              3. Distress
                1. 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.
                  1. 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.
                    1. 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.
                    2. For example, the individual may feel anxious or upset whilst dealing with a potential mental health disorder.
                      1. 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.
                    3. 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.
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