IB Psychology 3.1.17 Today’s Agenda: Turn in: Abnormal Intro Cont. Form Groups HW: CRA 5.1-5.2 (148-152) Turn in: Nothing Take out: Notes, notes, notes Today’s Learning Objectives: Discuss validity and reliability of diagnosis

How can one tell if another is sane or insane?

Classification Aims of diagnostic classification describe the disorder predict its future course imply appropriate treatment stimulate research DSM-IV (Diagnostic and Statistical Manual of Mental Disorders)…now 5 APA’s manual for classification of psychological disorders the manual brings consistency criticisms exist

Diagnosis Formal standardized critical interview Direct observation Clinician evaluates the patient’s responses Direct observation Brain-scanning Testing (personality tests, for example)

ABCS (used to describe symptoms) Affective symptoms: emotional elements Behavioral symptoms: observational behaviors Cognitive symptoms: ways of thinking Somatic symptoms: physical symptoms

Validity and Reliability of Diagnosis Classification system Can clinicians arrive at the same diagnosis? The system is descriptive David Rosenhan study (1973) Lipton and Simon (1985)

Rosenhan (1973) On being sane in insane places Aim: To test reliability and validity of diagnosis in a natural setting. Rosenhan wanted to see if psychiatrists could distinguish between “abnormal” and “normal” behavior. Discuss validity and reliability of diagnosis

Rosenhan (1973) Procedure: This was a covert participant observation with eight participants consisting of five men and three women (including Rosenhan himself). Their task was to follow the same instructions and present themselves in 12 psychiatric hospitals in the USA. Discuss validity and reliability of diagnosis

Rosenhan (1973) Results: All participants were admitted to various psychiatric wards and all but one were diagnosed with schizophrenia. The last one was diagnosed with manic depression. Discuss validity and reliability of diagnosis

Rosenhan (1973) All pseudo-patients behaved normally while they were hospitalized because they were told that they would only get out if the staff perceived them to be well enough. Discuss validity and reliability of diagnosis

Rosenhan (1973) The pseudo-patients took notes when they were hospitalized but this was interpreted as a symptom of their illness by the staff. It took between 7 to 52 days before the participants were released. Discuss validity and reliability of diagnosis

Rosenhan (1973) They came out with a diagnosis (schizophrenia in remission) so they were “labeled”. Discuss validity and reliability of diagnosis

Rosenhan (1973) Follow Up A follow-up study was done later where the staff at a specific psychiatric hospital were told that impostors would present themselves at the hospital and that they should try to rate each patient whether he or she was an impostor. Discuss validity and reliability of diagnosis

Rosenhan (1973) Follow Up Of the 193 patients: 41 were clearly identified as impostors by at least one member of the staff 23 were suspected to be impostors by one psychiatrist 19 were suspected by one psychiatrist and one staff member. Discuss validity and reliability of diagnosis

There were no impostors. Rosenhan (1973) Follow Up There were no impostors. Discuss validity and reliability of diagnosis

Influences on diagnosing Attitudes and prejudice of psychiatrist Expectations that certain groups/gender are prone to depression therefore you interpret as depression. Overpathologization – the excessive use of applying expectations/stereotyping to create a diagnosis.

Influences on diagnosing