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Aims and Outcomes

Aims and Outcomes. Introduce the issues of reliability and validity in forming a diagnosis Discuss cultural and gender differences in diagnosing disorders Investigate the ICD and DSM diagnostic manuals. List 10 behaviours that you think are abnormal.

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Aims and Outcomes

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  1. Aims and Outcomes Introduce the issues of reliability and validity in forming a diagnosis Discuss cultural and gender differences in diagnosing disorders Investigate the ICD and DSM diagnostic manuals

  2. List 10 behaviours that you think are abnormal. http://www.youtube.com/watch?v=XwFLgBKK6ug&feature=related • Now think of your behaviour in a new context. Is it still normal?

  3. Littlewood and Lipsedge (1997) • Littlewood & Lipsedge (1997) have suggested there is bias in the system, not a greater vulnerability in certain groups in society. • They describe the case of Calvin, a Jamaican man arrested for arguing with the police when a post-office clerk wrongly believed he was cashing a stolen postal order. After he was arrested the psychiatric report noted: “This man belongs to Rastafarian - a mystical Jamaican cult, the members of which think they are God-like. The man has ringlet hair, a straggly goatee beard and a type of turban. He appears eccentric in his appearance and very vague in answering questions. He is an irritable character and has got arrogant behaviour." As written by a British prison psychiatrist. • A psychiatrist must have knowledge of cultural factors before making a diagnosis e.g. in Puerto Rican culture believing that evil spirits can possess a person is a general belief, not schizophrenia! • When testing a non-English speaker in English, the differences in language cause assumptions to be made.

  4. Ford and WidigerCheck out the origional study as a PDF on ilearn Aim To find out if clinicians were stereotyping genders when diagnosing disorders. Procedure A self report, where health practitioners were given scenarios and asked to make diagnoses based on the information. The independent variable was the gender of the patient in the case study and the dependent variable the diagnosis made by the clinician. An independent design as each participant was given either a male, female or sex-unspecified case study. A final sample of 354 clinical psychologists from 1127 randomly selected from the National Register in 1983, with a mean 15.6 years clinical experience. 266 psychologists responded to the case histories. Participants were randomly provided with one of nine case histories. Case studies of patients with anti-social personality disorder (ASPD) or histrionic personality disorder (HPD) or an equal balance of symptoms from both disorders were given to each therapist. Each case study was either male, female or sex unspecified. Therapists were asked to diagnose the illness. Results Sex-unspecified case histories were diagnosed most often with borderline personality disorder. Antisocial personality disorder was correctly diagnosed 42% of the time in males and 15% of the time in females. Females with ASPD were misdiagnosed with histrionic personality disorder 46% of the time, whereas males were only misdiagnosed with HPD 15% of the time. HPD was correctly diagnosed in 76% of females and 44% of males. Conclusions Practitioners are biased by stereotypical views of genders as there was a clear tendency to diagnose females with HPD (histrionic personality disorder) even when their case histories were of ASPD (antisocial personality disorder). There was also a tendency not to diagnose males with HPD although this was not as great as the misdiagnosis of women.

  5. Case study: Mike is a 43 year old divorced white male with two children he rarely ever sees,  ages 8 and 10. He has never been seen by a psychiatrist.  His family physician has tried to get him to see a local psychiatrist but Mike refuses to go. Mike says he knows someone has removed his brain and replaced it with someone else's.  He believes that this brain is controlling him and that he is not responsible for his actions.  He works everyday and has been on his current job for 15 years.  He says he has lots of friends but sometimes he thinks its one of them who did this to him.  He has a college education and has a degree in computer science.  His family physician ordered an MRI which came back negative and he also had an EEG. The EEG came back normal. • Now in your groups, use the DSM and ICD to make a diagnosis

  6. How does all this relate to reliability and validity of the diagnostic tools?

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