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Study guide: Diagnosis

In order to prepare for exams, it is important to prepare a "tailor-made" study guide.  A study guide should reflect your own learning and not just what someone tells you is the "best" research to use on an exam.

For the topic "factors in diagnosis", you will find an attached study guide.  I recommend that you attempt to fill it in before looking at the responses below.  There is both a paper and a digital copy available.

Factors in diagnosis study guide

Digital factors in diagnosis study guide

Question 1: Discuss the concepts of normality and abnormality.

Terms/theories: data triangulation, conceptual vs. practical definitions of abnormality, Jahoda's(1958) optimal health model; Rosenhan and Seligman's criteria for abnormal behaviour.

Research: Cultural differences in definitions: Luhrmann (2015), Bolton (2002), Li-Repac (1980); using symptoms to define abnormality: Rosenhan (1973); Parker et al (2001)  

Critical thinking: the difficulties of measuring dysfunction and distress; the cultural differences in determining abnormality, ethical considerations in labelling, change over time (e.g. homosexuality), problems with using symptom-based classification systems; the importance of data triangulation, the etic and ethnocentric nature of Jahoda's model.

Different command terms: No other command term can be used other than discuss.

Question 2: Discuss one or more classification systems used in abnormal psychology.

Terms/theories: Etic/emic, DSM vs ICD (or CCMD), reliability, sick role bias, clinical interview, the reliability of diagnosis

Research: Using an etic vs emic approach: Parker et al (2001),  Bolton (2002) Problems with reliability: Cooper (1972); Lipton and Simon (1985); Lobbestael (2011)

Critical thinking: advantages and disadvantages of using a classification system; problems with an etic approach to diagnosis; lack of reliability of diagnosis in spite of the use of classification systems; may be considered an oversimplification, reducing the continuum of human behaviour to labels; the concept of mental illness is "medicalized"; a potential for over-diagnosis, in which people are labelled as having a disorder based on a new addition to the guide;  decisions are made in the creation of the guide that reflect current political and health care realities.

Different command terms: Evaluate, contrast

Question 3: Discuss the role of one or more clinical biases in diagnosis.

Terms/theories: You should know one or more of the following clinical biases: Anchoring bias, confirmation bias, illusory correlation; cultural bias

Research: Anchoring bias: Friedlander & Stockman (1983), Temerlin (1970); confirmation bias: Mendel (2011), Temerlin (1970), Illusory correlation: Swami (2012), Johnstone (1989); cultural bias: Li-Repac (1980), Luhrmann (2015)  

Critical thinking: The role of system 1 thinking, implications of bias on the validity of diagnosis, is there a "grain of truth" to class and gender differences, low ecological validity of experiments done to test biases.

Different command terms: Evaluate research.

Question 4: Discuss the validity and/or reliability of diagnosis.

Terms/theories: Reliability, validity, reactivity, sick-role bias, comorbidity

Research: Reliability: Cooper (1972); Lipton and Simon (1985); Lobbestael (2011) Validity: Li-Repac (1980), Rosenhan (1973), Mitchell et al (2009); Luhrmann (2015) 

Critical thinking: Implications of low reliability; obstacles to effective diagnosis: Blood and urine testing cannot currently be used to diagnosis psychological disorders; disorders are “clusters of symptoms.” These symptoms are assumed to be related to one another, even though this may not be the case; many symptoms are difficult to measure. For example, a decrease in concentration, feelings of helplessness or hearing voices; Psychiatrists are heavily dependent on self-reported data and this is known to result in some bias; individuals may suffer from two or more psychological disorders simultaneously.

Different command terms: Evaluate research. Please note, the IB has indicated that the terms "validity and reliability" may not be separated.  You may be asked a question that asks for both - or you will get an "and/or" question, in which you may choose. 

 Question 5: Discuss ethical considerations in the study of factors influencing diagnosis.

Terms/theories: Ethical considerations include: informed consent, anonymity, right to withdraw, deception, undue stress or harm, and debriefing.

Research: Any research could be used to discuss ethical considerations. Deception: Rosenhan (1973), Swami (2012); the importance of anonymity: Swami (2012), Loebbestael, Leurgans and Arntz (2011); informed consent: Rosenhan (1973); undue stress or harm: Lipton and Simon (1985)

Critical thinking: Why is deception used; the concerns about using real patients vs. only scenarios, asking professionals to take part in tests of reliability, cost-benefit analysis when making ethical considerations.

Different command terms: This question may only be asked as a "discuss" question.

Question 6: Discuss one or more research methods used in the study of factors that influence diagnosis.

Terms/theories: research methods = interviews, observations, experiments, correlational studies, and case studies.

Research: Any research could be used. Experiments: Swami (2012), Li-Repac (1980)  ; naturalistic observation: Rosenhan (1973); questionnaires:  Parker et al (2001); interviews: Johnstone (1989);  Luhrmann (2015)  Case study:  Bolton (2002) 

Critical thinking: Strengths and limitations of research methods.  Problems of operationalization.  The ability to draw conclusions about cause and effect.

Different command terms: Evaluate, contrast

Question 7:  Discuss ethical considerations in diagnosis.

Terms/theories: Stigmatization, labeling, empowerment

Research: Labelling theory: Langer & Abelson (1974); Gove and Fain (1973); Doherty (1975); Warner et al (1989); Crisp et al (2000)

Critical thinking: There are both potential positive and negative consequences to diagnosis. A strong essay would look at both sides of the issue. It is also difficult to measure the effect of diagnosis as there are both short-term and long-term effects. An initial diagnosis may lead to feelings of marginalization and shame, but in the long-term leads to recovery, reintegration into the community, and empowerment.

Different command terms: This question may only be asked as a "discuss" question

Question 8: Discuss sociocultural factors in diagnosis.

Terms/theories: diagnosis, culture-bound syndromes, adverse childhood experiences

Research: The role of culture (Al-Solaim and Loewenthal (2011), Bolton (2002), Li-Repac (1980), Luhrmann (2015), Parker et al (2001)); the role of social factors ( Amenson and Lewinsohn (1981), Brown & Harris (1978), Felitti et al (1998))

Critical thinking: When discussing sociocultural factors, it is important to link the factors to how they play a role in diagnosis.  For example, Nadine Burke Harris makes the argument that we should not be asking "what's wrong with you?" but instead, "what's happened to you?" As with all research, it is difficult to recreate a real diagnosis under lab conditions.  This is why studies like Bolton's that were done in the field are so important for our understanding of the role of culture in diagnosis.  Finally, when considering the role of social factors - e.g. the role of social class - remember that this can lead to clinic biases.

Different command terms: This question may only be asked as a "discuss" question

 Teacher only box

Question 8 combines the approach to the topic - that is "the sociocultural approach" with "factors in diagnosis."

It is unlikely that they would do the same with the cognitive approach as there is already a question on clinical biases.

It is really unclear how they would ask a question about a biological approach to diagnosis.  Currently, there are no biological tests for clinical diagnosis of the psychological disorders, only neurological disorders.  And that is beyond the scope of this course.