Diagnosis of mental disorders (4Ds)

What are the 4Ds

• Deviance

• Dysfunction

• Distress

• Danger

What is the 5th newly added D?

Duration

What are the 4Ds used for?

To decide whether behaviour is abnormal and worth investigating to get a potential diagnosis

Deviance

Behaviour considered rare in society

• Not statistically/socially normal

• If behaviour not within two standard deviations of the population it can be considered abnormal

dysfunction

Behaviour significantly impacting person’s daily life

• like not being able to go to work or normal activities that they would usually do

• Psychiatrist must look at all aspects of a patient’s life as dysfunction may not always be so obvious

Distress

behaviour causing upset to the individual

• negative feelings

• If behaviour causes upset despite being no logical reason for person to be upset

• Distress can be used in isolation from other Ds (presence of other Ds not necessary to make diagnosis)

Danger

Putting own or others’ life at risk/ harm

Duration

length of time symptoms have been present

Deviance strength

Statistical deviance

• objective measure of whether behaviour is abnormal - more scientific + useful for diagnosis

• Useful as can lad to diagnosing + treatment

Deviance/4Ds cultural weakness

Cultural issues when applying 4Ds

• Not all cultures classify all things in 4Ds as abnormal

• Like Caribbeans see talking to dead relatives to be normal when grieving

• Lowers accuracy of using 4Ds + validity

• inaccurate assessment, diagnosis + treatment

Reliability strength of 4Ds

standardised definitions of 4Ds

• Can get same consistent conclusions regarding behaviour, using test re-test method to find consistent results

• reliable

Weakness of 4Ds

Subjectivity

• Different professionals may see symptom as abnormal, some might not

• Decreases accuracy + validity

• Wrong diagnosis/ treatments etc

Duration strength

Development over time

• makes it more valid as considers duration of time of symptoms , as if symptoms only experienced for a short period of time, may not be appropriate or necessary to diagnose

• Behaviour can be assessed more accurately

Duration weakness

means the 4Ds is an incomplete diagnostic tool as the 5th D needs to be added

• lowers accuracy + validity of diagnostic tool