Psychology AO1 AO3 Essay Plan (eval)
4Ds of diagnosis 1. Brief description of the 4Ds and their function in
1. Deviance diagnosis. The 4Ds are a method of diagnosis that
Deviance means that the individual is unusual, undesirable or even can assess the extent to which the mental health
bizarre. This is because norm breaking can lead to social isolation and issue becomes an illness
negative attention, which is why mental illness is likely to occur in It can be very useful in diagnosis to avoid misdiagnosis due
those that are not socially conforming. Psychologists should also take to statistical deviance. The 4Ds take into account cultural
into account the influence of cultural norms in the individual’s and social norms that can help differentiate eccentric
environment. people from those mentally ill.
2. Dysfunction
Dysfunction refers to an inability to perform daily activities and 2. Lacks objectivity
routine such as waking up, going to school or work and even The 4Ds is a method of assessment with only
scheduled mealtimes. This can determine the person’s cognitive interpretation from the clinician. The 4Ds utilise
function or communication which is important in diagnosis comparison with social norms and others in society,
3. Distress meaning it lacks reliability because it is up to the
The amount of emotional or psychological harm the person is in. interpretation of the researcher and what their definition
clinicians should consider physical manifestations of pain as well. of social normative is.
Physical symptoms can include headaches, fatigue, palpitations etc.
Clinicians should consider the duration of their distress. For 3. Labelling
example, if they are feeling grief due to the recent passing of a family The 4Ds can label people with diagnoses. For example,
member, there may not be grounds for diagnosis. The K10 people that are rated high for danger could be labelled as
questionnaire, Kessler psychological distress scale can be used to dangerous and as criminals because of their diagnoses. This
assess the intensity of their psychological symptoms. makes the individual socially doubt themselves and
4. Danger internalise them, it can also make daily life like finding a
Danger refers to hostile, impulsive and harming behaviour to job a lot harder.
themselves and other people. Mental illness can increase the risk of
psychotic behaviour that in most cases, do lead to criminal violence. 4. Application
Therefore danger can also be grounds for diagnosis The 4Ds can be combined with diagnostic manuals like
the DSM-5 to triangulate the results to gain a more reliable
diagnosis.
, Classification systems: The DSM 1. Explaining the manual and how its reliability is
The Diagnostic and Statistical manual is a diagnostic manual that assessed
was first established in 1952 for American soldiers after WWII, it Regier 2013 reassessed the kappa values of multiple mental
comprises information of over 300 mental disorders in 22 categories. disorders using the DSM-5. For example, PTSD had kappa
Section 1: this includes in depth description of how to use the new values of 0.6-0.79, which is a very good score.
manual Schizophrenia and 7 other disorders, had kappa values 0f
Section 2: this section includes detailed current knowledge about the 0.4-0.59, which is good. This shows that the DSM is a
mental disorders, including similarities and differences between them reliability mode of diagnoses for these.
Section 3: this section includes discussion of new disorders that need
further clarification and also how cultural factors can affect the Competing: Cooper 2014 explains that the expectations
diagnosis of mental illnesses. for acceptable level of agreement has plummeted over the
last 35 years. Kappa values ranging from 0.2-0.4 was now
Using the manual acceptable. She made the example of major depressive
The DSM-5 is the newest version of this manual, published in 2013. disorder, with a low score of 0.28 that was deemed
Clinicians usually use unstructured interviews in their appointments acceptable by the committee.
to diagnose the mental disorder, by observing their communication,
emotional stability and past experiences. The diagnosis includes 2. Validity of the DSM
asking questions that rule out possibilities of the disorder and narrow Cohen et al and children diagnosed with conduct disorder
it down. They may use structured interviews to evaluate their using the DSM. She showed concurrent validity by
symptoms like the Beck Depression Inventory. interviewing their mothers, observing their behaviour and
paired with teacher questionnaire results as well. Most of
Evaluating the validity and reliability of the disorder them showed similar factors like male, parental mental
Spitzer, the chairman of the DSM committee, decided to use illness and low income, which shows aetiological validity.
Cohen's kappa values to evaluate the accuracy of the diagnosis, this Children diagnosed with CD at 5 were more likely to
is a decimal statistic of the proportion of people that have the same display learning difficulties and behavioural issues at 7, this
diagnosis when they are re-evaluated by an alternate practitioner later shows good predictive validity.
on. They agreed that 0.7 would be high enough to be reliable. This
increases test retest reliability and inter rater reliability because there 3. Application
is re assessment with multiple clinicians. This can be applied to diagnoses, it tells us like the
Validity can be measured in 4 ways with the DSM. Descriptive diagnoses made by the DSM are reliable and valid and
validity is when two people with the same diagnoses have the same therefore it can be used in GPs. However, the labels given
symptoms. Concurrent validity is when two methods of diagnoses by the DSM does not tell us anything about the causes of
reach the same conclusion regarding the mental disorder. Aetiological the disorder.
validity is when people with the same diagnoses have the same causal
factors. Lastly, predictive validity refers to if the GP is able to predict
the future outcomes for the patient, this includes their reaction to
treatment or their prognosis.
4Ds of diagnosis 1. Brief description of the 4Ds and their function in
1. Deviance diagnosis. The 4Ds are a method of diagnosis that
Deviance means that the individual is unusual, undesirable or even can assess the extent to which the mental health
bizarre. This is because norm breaking can lead to social isolation and issue becomes an illness
negative attention, which is why mental illness is likely to occur in It can be very useful in diagnosis to avoid misdiagnosis due
those that are not socially conforming. Psychologists should also take to statistical deviance. The 4Ds take into account cultural
into account the influence of cultural norms in the individual’s and social norms that can help differentiate eccentric
environment. people from those mentally ill.
2. Dysfunction
Dysfunction refers to an inability to perform daily activities and 2. Lacks objectivity
routine such as waking up, going to school or work and even The 4Ds is a method of assessment with only
scheduled mealtimes. This can determine the person’s cognitive interpretation from the clinician. The 4Ds utilise
function or communication which is important in diagnosis comparison with social norms and others in society,
3. Distress meaning it lacks reliability because it is up to the
The amount of emotional or psychological harm the person is in. interpretation of the researcher and what their definition
clinicians should consider physical manifestations of pain as well. of social normative is.
Physical symptoms can include headaches, fatigue, palpitations etc.
Clinicians should consider the duration of their distress. For 3. Labelling
example, if they are feeling grief due to the recent passing of a family The 4Ds can label people with diagnoses. For example,
member, there may not be grounds for diagnosis. The K10 people that are rated high for danger could be labelled as
questionnaire, Kessler psychological distress scale can be used to dangerous and as criminals because of their diagnoses. This
assess the intensity of their psychological symptoms. makes the individual socially doubt themselves and
4. Danger internalise them, it can also make daily life like finding a
Danger refers to hostile, impulsive and harming behaviour to job a lot harder.
themselves and other people. Mental illness can increase the risk of
psychotic behaviour that in most cases, do lead to criminal violence. 4. Application
Therefore danger can also be grounds for diagnosis The 4Ds can be combined with diagnostic manuals like
the DSM-5 to triangulate the results to gain a more reliable
diagnosis.
, Classification systems: The DSM 1. Explaining the manual and how its reliability is
The Diagnostic and Statistical manual is a diagnostic manual that assessed
was first established in 1952 for American soldiers after WWII, it Regier 2013 reassessed the kappa values of multiple mental
comprises information of over 300 mental disorders in 22 categories. disorders using the DSM-5. For example, PTSD had kappa
Section 1: this includes in depth description of how to use the new values of 0.6-0.79, which is a very good score.
manual Schizophrenia and 7 other disorders, had kappa values 0f
Section 2: this section includes detailed current knowledge about the 0.4-0.59, which is good. This shows that the DSM is a
mental disorders, including similarities and differences between them reliability mode of diagnoses for these.
Section 3: this section includes discussion of new disorders that need
further clarification and also how cultural factors can affect the Competing: Cooper 2014 explains that the expectations
diagnosis of mental illnesses. for acceptable level of agreement has plummeted over the
last 35 years. Kappa values ranging from 0.2-0.4 was now
Using the manual acceptable. She made the example of major depressive
The DSM-5 is the newest version of this manual, published in 2013. disorder, with a low score of 0.28 that was deemed
Clinicians usually use unstructured interviews in their appointments acceptable by the committee.
to diagnose the mental disorder, by observing their communication,
emotional stability and past experiences. The diagnosis includes 2. Validity of the DSM
asking questions that rule out possibilities of the disorder and narrow Cohen et al and children diagnosed with conduct disorder
it down. They may use structured interviews to evaluate their using the DSM. She showed concurrent validity by
symptoms like the Beck Depression Inventory. interviewing their mothers, observing their behaviour and
paired with teacher questionnaire results as well. Most of
Evaluating the validity and reliability of the disorder them showed similar factors like male, parental mental
Spitzer, the chairman of the DSM committee, decided to use illness and low income, which shows aetiological validity.
Cohen's kappa values to evaluate the accuracy of the diagnosis, this Children diagnosed with CD at 5 were more likely to
is a decimal statistic of the proportion of people that have the same display learning difficulties and behavioural issues at 7, this
diagnosis when they are re-evaluated by an alternate practitioner later shows good predictive validity.
on. They agreed that 0.7 would be high enough to be reliable. This
increases test retest reliability and inter rater reliability because there 3. Application
is re assessment with multiple clinicians. This can be applied to diagnoses, it tells us like the
Validity can be measured in 4 ways with the DSM. Descriptive diagnoses made by the DSM are reliable and valid and
validity is when two people with the same diagnoses have the same therefore it can be used in GPs. However, the labels given
symptoms. Concurrent validity is when two methods of diagnoses by the DSM does not tell us anything about the causes of
reach the same conclusion regarding the mental disorder. Aetiological the disorder.
validity is when people with the same diagnoses have the same causal
factors. Lastly, predictive validity refers to if the GP is able to predict
the future outcomes for the patient, this includes their reaction to
treatment or their prognosis.
