Clinical Psychology Lesson one: Diagnosing mental health disorders the four Ds’ of diagnosis

Does Eeyore have a mental disorder? Why do you think this? Does it have a negative impact on his life? Does it impact anyone else?

What is clinical psychology (A01) BPS: Clinical psychology aims to reduce psychological distress and to enhance the promotion of psychological well-being. Assessment of mental disorder and behavioural problems. What is clinical psychology (A01) Clinical psychology is concerned with abnormal behaviour There are a variety of assessment methods available including psychometric tests, interviews and direct observation of behaviour. What makes behaviour abnormal? Provide appropriate treatment

What is Clinical Psychology? Concerned with abnormal behaviour. Define what makes abnormal behaviour. The study of mental health and mental disorders. Diagnosing, explaining and treating mental illness. It is a process that involves: taking note of symptoms, general health and any psychological or social problems. Using this information they come up with a treatment for that behaviour.

What is abnormal behaviour? 2 minute discussion In pairs discuss the characters and decide whether or not you think they show any abnormal behaviours Why?

At what point does normal behavior become abnormal?? Problem?

Statistical Definition of Abnormality Statistical infrequency Behaviour that is statistically rare is said to be abnormal

The Social Norms Definition of Abnormality Behaviour which conforms to social norms. Norms are social rules that are not laws but customs If someone goes against these social norms their behaviour is said to be abnormal. What needs to be taken into account is: culture, the situation, age, gender and historical context

DSM 5 definition of mental disorder – Draw a diagram to illustrate the definition “A mental disorder is a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation,  or behaviour that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behaviour (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above."

Much of clinical psychology’s vocabulary comes from medicine. Abnormal behaviour is referred to as psychopathology and is classified in terms of symptoms. The classification being called the diagnosis. Treatment/therapy refers to methods to change behaviour. The individual is usually referred to as the patient (or client in therapy) and is considered to be treated when the abnormal behaviour is no longer displayed.

How is the decision made? Clinical interviews Standardised tests

Diagnosing mental health disorders - Four dimensions (4 Ds) of diagnosis Four Ds are used as a tool to decide whether behaviour is ‘abnormal’ and worth of investigation and diagnosis It is a an initial diagnostic process It is not a classification system (these systems are used to decide what disorder is present based on symptoms)

5 minutes – in pairs provide a definition for each word 5 minutes – in pairs provide a definition for each word. Without using help! 2. Dysfunction? 1. Deviance? 3. Distress? 4. Danger?

Dimension Definition Key words Example 1. Deviance 2. Dysfunction 3. Distress 4. Danger Duration If the behaviour is significantly interfering with the person’s life a disorder may be present. All aspects of a patient’s life is discussed to assess the problematic behaviour If the person is putting their own life or other’s people’s lives at risk. Refers to danger to themselves or others. Length of time the symptoms have been present Behaviour which is ‘rare’ within society. If the behaviour is considered deviant from the norm then it could suggest a clinical disorder is present When the behaviour is causing upset to the individual. This involves negative feelings.

Back to Eeyore – use the four Ds Deviance? Distress? Is intervention needed? Is a diagnosis necessary? Do we all agree? Problem with this? Danger? Dysfunction?

H/W - Reading Read the article on the learning space Make notes on the four ds and identify any evaluation points What is the fifth dimension? Conceptualizing Psychiatric Disorders Using “Four D’s” of Diagnoses (Davis, 2009)