Edexcel Psychology for A Level Yr 2 Revision Guide

Chapter 2 Clinical psychology Diagnosis of mental disorders When Shelley asked for a blue rinse, she got more than she bargained for. The 4Ds of diagnosis = deviance, dysfunction, distress, danger. Apply it Concepts Steve sometimes finds himself wandering at the side of the motorway and doesn’t know why. He is frightened by feelings he says make him do it. When he is really scared he spends whole days in his wardrobe to stop the feelings. Steve may be diagnosed by a clinician using four criteria: deviance, dysfunction, distress and danger. 1. Explain how ‘distress’ and ‘danger’ is used in diagnosing Steve. (4) 2. Explain one strength and two weaknesses of using the four features to diagnose Steve. (6) 3. Context essay: Discuss the use of deviance, dysfunction, distress and danger to decide if Steve has a mental disorder. (8) The term ‘clinician’ refers to a health care professional who works directly with people/ clients/patients.This may include psychiatrists, clinical psychologists, nurse practitioners, doctors. Note that a psychiatrist is medically trained whereas a psychologist is not. When a diagnosis is helpful With physical illness, a clinician might take your temperature or do a blood test/scan to see if outcomes are ‘abnormal’. Diagnosing mental disorders is harder – but the 4Ds can help determine when a mental health ‘issue’ could be considered a mental health ‘disorder’. This is a crucial decision, with implications for treatment and the potential for being stigmatised as ‘mentally ill’. Deviance Deviant behaviours are unusual, undesirable and even bizarre. • Statistical norms – these are used to measure the unusualness of any behaviour. • Social norms – desirability of the behaviour depends on historical context, and the culture, age and/or gender of the individual. Failure to conform to statistical and/or social norms may lead to negative attention from others and social exclusion (so norm-breaking is a useful indicator of psychological abnormality). Dysfunction Symptoms that distract, confuse or interfere with ability to carry out roles and responsibilities. Psychologists use a variety of objective measures to assess everyday functioning. e.g. the WHODAS II – questionnaire assessing a person’s understanding of what is going on around them, communication and deterioration in self-care, etc. Dysfunction can also include trouble getting up in the morning, failure to complete tasks at work or college and problems participating in routine activities (e.g. socialising). Distress When symptoms cause emotional pain or anxiety. Sometimes psychological distress shows as physical symptoms (e.g. aches and pains, palpitations, feeling tired all the time), so these are important for diagnosis. Distress could be seen as normal depending on the situation (e.g. it would be normal in relation to a job loss or bereavement). A clinician considers the intensity or duration of the distress, as well as a person’s level of functioning, when making a diagnosis. Quantitative data can be collected using scales such as the Kessler Psychological Distress Scale (K10), a 10-item self-report scale focusing on experiences in the past four weeks. Danger Careless, hostile or hazardous behaviour jeopardises safety of the person and/ or others. Predicting violent behaviour is difficult but a history of aggression makes another incident more likely. In the UK, a person may be detained under the Mental Health Act (‘sectioned’) if three professionals agree they are a danger to themselves or others. The person can be taken (without consent) to hospital for treatment. Spec spotlight 5.1.1 Diagnosis of mental disorders, including deviance, dysfunction, distress, and danger. 34 AO1 Description