Edexcel Psychology for A Level Yr 2 Revision Guide

A strength of the 4Ds is that using all four helps avoid erroneous diagnosis. For example, more factors than just deviance from statistical or social norms are considered when making a diagnosis. This avoids situations in which eccentric but harmless people are seen as abnormal, and those with common but debilitating symptoms of depression are missed. The importance of this is that a valid system should be neither over- nor under- inclusive (like this one). CA However, there are no hard and fast rules about how to combine the Ds, e.g. someone struggling to cope (signs of distress and dysfunction), but with no signs of danger or deviance, may not require a diagnosis. It could be the situation causing the problem (so could not be resolved by treatment, which is the purpose of a diagnosis). A weakness is that the 4Ds lack objectivity. Various methods try to increase objectivity, but this is unlikely (for example because ratings are being made of feelings). 4Ds compare individual with others, so decisions would be better if made in comparison to a reference group (more objective), not using the clinician’s view (more subjective). This shows that if the 4Ds are to be applied meaningfully, a clinician needs information not only about the person, but also their community. Another weakness is that the 4Ds create labels. For example, ‘danger’ as a criterion for mental disorder leads people to equate mental illness with being dangerous. This becomes distorted in the media, but most people with schizophrenia are no more dangerous than people without it (Fazel et al . 2009). This matters because such attitudes may become ‘self-fulfilling prophecies’ – stereotypes lead people to act as predicted by the stereotype. Application: 4Ds are effectively applied to diagnosis of mental disorders. The 4Ds are used by clinicians in conjunction with classification manuals (e.g. DSM-5 and ICD-10, see following spreads). There are different mixes of Ds in different disorders. For example, deviance from statistical norms helps define intellectual disability, while deviance from social norms, dysfunction and danger help define anti-social personality disorder. This shows that each of the 4Ds is used in diagnosis. I&D extra: There is potential for social control and abuse of power. Those who breach social norms or challenge government policies can be quieted by being labelled as mentally disturbed. For example, Russian psychiatrist Koryagin (1981) described how the KGB pressured psychiatrists in the 1960s to diagnose and imprison dissidents. This shows how misusing psychiatric diagnosis can ‘legitimise’ punitive treatments and social exclusion (Moncrieff 2010). Diagnosis of mental disorders Check it 1. Explain how the concept of ‘dysfunction’ could be used to make a diagnosis. (2) 2. Explain one weakness of using the concept of ‘deviance’ when diagnosing mental disorders. (2) 3. Standard essay: Evaluate the concepts of ‘deviance’ and ‘distress’ as ways of deciding whether or not to make a diagnosis. (8) or (20) 4. I&D/Synoptic essay: Assess the issue of social control. Refer to the diagnosis of mental disorders and examples from one other application of psychology (e.g. criminological, child or health). (20) Revision booster If you can’t think of an evaluation point, remember the fifth D, ‘duration’, which you can use as a strength or a weakness. It is a strength because in many disorders the symptoms have to be present for a certain time. It is a weakness because the symptoms of some disorders may make it difficult for the patient to decide how long they have been experiencing the symptoms. Unexpected item in the bagging area… ‘CA’ stands for ‘competing argument’. 35 AO3 Evaluation