- Unit 5 Clinical psychology
- Summary notes 60 pages Includes all topics from Edexcel specification (content, methods, studies, key question and practical)
- Includes exam style answers as well as detailed A01 and A03
- 5.1.1 Diagnosis of mental disorders, including deviance, dysfunction,
distress, and danger.
- 5.1.2 Classification systems (DSM IVR or DSM V, and ICD) for mental
health, including reliability and validity of diagnoses.
- 5.1.3 Schizophrenia and one other disorder from anorexia nervosa,
Obsessive-compulsive disorder (OCD) and unipolar depression.
- 5.1.4 For schizophrenia and the other disorder, students should be
familiar with two treatments for each disorder: one from biological
and one from psychological. Two treatments for each disorder. The
two for schizophrenia must come from different topic areas.
- 5.1.5 Individual differences
5.2 Methods
- 5.2.1 Awareness of Health and Care Professions Council (HCPC)
- 5.2.2 Researching mental health The use of longitudinal, cross-
sectional, cross cultural methods, meta-analysis, and the use of
primary and secondary data.
- 5.2.3 The use of case studies, to include an example study: e.g.
Lavarenne et al. (2013) Containing psychotic patients with fragile
boundaries: a single group case study.
- 5.2.4 The use of interviews in clinical psychology, to include an
example study: e.g. Vallentine et al. (2010) Psycho-educational group
for detained offender patients: understanding mental illness.
- 5.2.5. Within the methods mentioned here: Analysis of quantitative
data using both descriptive and inferential statistics (chi-squared,
Spearman's, Wilcoxon and Mann-Whitney U as appropriate). Analysis
of qualitative data using thematic analysis and grounded theory.
5.3 Studies
Classic study
- 5.3.1 Rosenhan (1973) On being sane in insane places. One
contemporary study on schizophrenia
- 5.3.2 Carlsson et al. (2000) Network interactions in schizophrenia –
therapeutic implications.
One contemporary study on another disorder, from the following:
Depression
- 5.3.3 Kroenke et al. (2008) The PHQ-8 as a measure of current
depression in the general population.
5.4 Key questions
5.5 Practical investigation
,1.1 Diagnosis of mental disorders including deviance, dysfunction, distress, danger
A01: The four Ds are used as an A01: Distress relates to how far the
assessment tool to decide whether behaviour is causing the individual to
behaviour is abnormal, abnormality become upset. The actual experience of
may require investigation and the patient client must be accessed as
diagnosis. The four D are used together some people become distressed when
rather than in isolation when defining facing minor difficulties that others
abnormality and making a diagnosis. view as unimportant, and others might
Deviance examines how rare or face major difficulties but not that
infrequent behaviour is within society. much distress. Sometimes psychological
This could be because it is statistically distress shows as physical symptoms
rare- a small % of the population e.g., aches pains and feeling tired all
experiences it. Alternatively, it could the time. Quantitative data can be
be that it breaks social norms - Makes collected using scales such as the
people feel uncomfortable e.g. shouting Kessler psychological distress scale a 10
or talking to yourself in public. Failure item self report scale focusing on
to conform to statistical and or social experiences in the past four weeks
normal may lead to negative attention
from others and social exclusion
A03: The DSM focuses on the four Ds A03: Since there are no objective
showing each has validity. For example measures of the four ds the therapist
in the DSM it is not enough for has to use their professional judgement.
schizophrenia to include deviant What one views as dysfunctional (such
behaviour, distress must also be as not going to work) might not be
present as well as dysfunction. Davis considered as dysfunctional by the
2009 supports validity of DSM system client or by a different therapist. This
in that various diagnosis are shown to means there will be bias. Clinicians may
focus on specific Ds showing each has also have their own bias about what the
value. disorder is and focus on a particular set
of symptoms leading to an inaccurate
diagnosis. This can lead to people
``shopping around for psychiatrists” who
support their beliefs about the disorder.
The lack of objectivity of the four ds
raises issues about the reliability of
diagnosis. If the four ds are used by two
different therapists, they may not reach
the same diagnosis. E.g. dissociative
identity disorder is a recognised disorder
in the USA but not Britain
A01: Dysfunction is if this person's A01: The patients/clients behaviour
behaviour is interfering with their life must be accessed in 2 ways: danger to
then this could be an example of a themselves as danger to others. If an
mental disorder. For example if their individual is placing their own life and
personal relationships, personal or other lives in danger then
hygiene, household maintenance intervention may be needed. In the UK a
occupation or school work are person may be detained under the
suffering or made impossible this mental health act if 3 professionals
means they might be diagnosed with agree they are a danger to themselves
mental disorder or others.
,A03: The 4ds of diagnosis work for A03: Diagnoses are conducted through
professionals has practical application clinical interviews (unstructured or
as all features are recognisable and semi-structure) to gather info on the
measured with a lot of training used client's behaviour in order to make a
alongside the DSM classification. clinical assessment. These methods have
issues with subjectivity and bias.
Relying on self-report data from the
patients may mean that they are not
telling the truth, if they leave out key
information or exaggerate symptoms
then the diagnosis may be invalid.
Clinicians may have their own bias
about what the disorder is and focus on
a particular set of symptoms leading to
an inaccurate diagnosis. E.g., factitious
disorders (e.g. Munchausen syndrome)
where people fake an illness or
psychological disorder to get medical
attention indicates deviance from the
norm as well as distress felt by the
individual though faking illness. There
may be danger as they may harm
themselves to backup their claims;
dysfunction may incur as faking the
illness involves losing jobs.
Issues and debates: application Issues and debates: social control
In conclusion a range of factors are Some argue that clinicians have a lot
considered when making a diagnosis and, in some cases, too much power in
which avoids situations in which making mental health diagnosis. Once a
eccentric harmless people are seen as person is labelled mentally ill there are
abnormal and those with debilitating serious implications, and it can be
symptoms of depression are missed difficult for them to lose the label.
Timothy Davis (2009) argues that Many individuals who have been
diagnosing mental disorders involves sectioned under the mental health act
deciding when a characteristic is find it a distressing and dehumanising
problematic enough to become a process as their power to make
clinical diagnosis. The four Ds can decisions is removed and some are
assist in making a decision by treated badly in care. Timothy Davies
matching behaviour and beliefs to the proposes that a 5th d duration needs to
DSM. This helps therapists to know be included: for instance, grief is normal
when a condition might need a DSM after the death of a loved one but if the
diagnosis grief goes on for to long it becomes
abnormal. There are also other issues
such as depression (a form of deviance)
affects 20 percent of the population at
some point of their life which is
common however it is still an
abnormality that requires treatment
, Extra evaluation points - 4 ds
Since there are no objective Factitious disorders exist where
measures of each of the four ds the people fake illness or psychological
therapist has to use their disorder to get medical attention.
professional judgement. What one This indicates deviance from the
views as dysfunctional such as not norm as well as distress felt by the
going to work might not be individual through faking illness,
considered as dysfunctional by the there may be danger as they may
client or by going to a different harm themselves to back up their
therapist. This can lead to people claims dysfunction may incur faking
shopping around for a psychiatrist the illness involves losing jobs
who will support their beliefs about withdrawing from social life etc
their disorder. For example
dissociative identity disorder
(multiple personality) is a
recognised disorder in the USA but
not on Britain
Depression (a form of deviance) However the diagnosis by clinician
affects 20 percent of the population with the 4ds is subjective as
at some point of their life which is clinicians may disagree on the
common however it is still an particular diagnosis due to their
abnormality that requires own background of patient factors
treatment
African-Caribbean people in the UK If all the Ds are used together to
are 3-5 times more likely to be determine a diagnosis than the
diagnosed with schizophrenia and diagnosis becomes holistic
hospitalised than other groups. You
are also more likely to be diagnosed
with serious mental disorders if you
are poor. Women are more likely to
be diagnosed than men
Issues and debates. Labelling In the '60s and '70s, the Soviet
someone as abnormal using the Union was condemned for declaring
four Ds might be used to force political opponents to be "mad" and
people to conform to the society's putting them in mental asylums.
standards. If they do not, then Wanting to have democratic
psychiatric treatment will freedom was considered a symptom
'normalise' their behaviour. This is of paranoid schizophrenia. Vladimir
a form of social control that can Burosky is a famous Russian activist
become oppressive and unjust. who experienced this himself
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