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clinical biases
diagnoses may be invalid as clinical biases can negatively influence judgement. dual process model - heuristics (systems 1 and 2), prestige effect, stereotype etc. confirmation bias (temerlin) = the tendency to interpret information to confirm previous assumptions. anchoring bias (friedlander and stockman) = relying too much on the initial piece of information to make decisions.
ethical considerations in diagnosis (labelling theory)
ethical consideration are vital because they impact treatments and societal perceptions around mental health. one ethical concern is labelling theory = the profound effects on behavior, self and societal perceptions around mental. pros of labelling theory : access to treatment, validation and understanding of behavior. cons of labelling theory : stigma, reduce the human experience, identity issues and over/mis diagnosis. langer and abelson = -ve, gove and fain = both +ve and -ve.
classification systems
DSM, ICD, CCMD are classification systems, used to diagnose patients. they provide checklist of affective, behavioral, cognitive and somatic symptoms (ABCS). it is a ‘best fit’ design to guide diagnosis. intensity and duration of symptoms are also taken into account. DSM : american, continual progressions but issues with reliability and validity. parker = DSM 4 and lipton = DSM 3
ethics in a study
diagnosis leads to treatment, but sensitive topics require appropriate ethical standards to result in the least distress. ethical guidelines are implemented (consent, anonymity, right to withdraw, deception, undue stress/ harm, (de)brief). deception (rosenhan) = intentional mislead/ withhold info (preventing demand characteristics an creating a natural environment). undue stress/ harm (lipton and simon) = physical or psychological distress beyond everyday encounters, any distress should be temporary, not extreme and come along a debrief.
validity and reliability
validity (rosenhan) = extent a diagnosis is accurate and leads to a successful treatment. reliability (lipton and simon) = when different doctors agree on a diagnosis using the same diagnostics system. to improve this, classification systems were implemented (e.g DSM) through mating results to the system, there are issues with this ‘best fit’ design. issues with DSM regarding outdated usage.
abnormality
diagnosis of mental illness is linked to the identification of behavior that is considered ‘abnormal’, however this definition changes over time and cross cultures as they have different beliefs as to what ‘abnormal’ looks like. abnormality can be identified through symptoms, deviation from social norms and deviation from optimal health. symptoms : using classification systems (rosenhan), DFSN : luhrmann, america believes that the experience hearing voices is abnormal but it is a spiritual experience, DFOH (jarod’s) : luhrmann, self acceptance, room for future development and growth, positive relationships, people can still leave a perfectly normal life whilst experiencing hearing voices.
research methods
research methods allow investigation into human behavior. 2 commonly used qualitative methods are observations and interviews, both providing in depth, rich, detailed information. observations (rosenhan) = systematic watch and recording of behaviors, can covert or overt (natural and no demand characteristics but ethical concerns). interviews (luhrmann) = direct verbal interactions to explore experiences (they avoid ethnocentric bias - they can explain themselves, give a voice to a patient but can be subjective analysis and potential for demand characteristics).
sociocultural factors
sociocultural factors = norms, value, beliefs and practices of a specific cultural/ social group that effects how mental health is perceived, expressed and diagnoses (affecting the diagnostic process). culture = luhrmann, norms vary across cultures. social factors = felitti, socio economic status may be more stressful and may result in barriers to access support (ACEs).
