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

2. How can one tell if another is sane or insane?

3. 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

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

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

6. 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)

7. 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

8. 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

9. 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

10. 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

11. 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

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

13. 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

14. 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

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

16. 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.

17. Influences on diagnosing