Individual Differences in Mental Health Disorders and Diagnoses

I'm Doctor Cody Porter. I'm a senior lecturer from U A Bristol.

And in today's topic,

we're going to cover individual differences

of mental health disorders and diagnosis.

So a diagnosis is reliable or, in other words, consistent

if it's applied to the same person based upon the same symptoms by other clinicians.

In other words, if a clinician identifies someone as having depression

and that person goes to another clinician

and is also identified as having depression,

that diagnosis is considered to be reliable.

Now a reliable diagnosis is helped

by the diagnostic statistical classification systems,

such as the DS M or the I CD.

So we're on the DS M five or the I CD 10,

and another tool that's really useful for making reliable diagnosis

is the four DS.

Now the four DS refer to deviance, distress,

dysfunction and danger,

and the four DS are an assessment tool used

to decide whether or not a behaviour is abnormal.

Now abnormality may require an investigation

in order to really achieve that diagnosis,

so let's break those four

days apart a little bit more

so.

Deviance refers to behaviours and emotions that are viewed as being unacceptable.

Dysfunction refers to when an abnormal behaviour

is significantly interfering with everyday tasks.

So specifically when that dysfunction is affecting

that person's day to day living,

distress happens when an abnormality is there.

Um, in other words,

when negative feelings occur inappropriately or

persistently over a long period of time

and finally, danger.

Danger is when the behaviour harms or puts at

risk either the individual themselves or other people.

So they are the four days

and they're really important for helping us to decide

whether or not behaviour is or isn't abnormal.

But individual differences can also have an impact on diagnosis,

and it's really important to bear that in

mind when you're thinking about mental disorders.

So social norms and deviance is a point that we're now going to focus upon.

So social norms are the unwritten rules about what is acceptable,

but what is acceptable in terms of behaviour.

The norms are therefore the behaviours and the attitudes

that most people stick to within a specific society.

Now, when people violate these social norms, this is seen as being quite abnormal.

Most abnormal behaviour is harmless and abnormal.

People are treated as being quite ecocentric,

um, rebellious

rather than being perceived as deviant.

However, extremely abnormal behaviour conflicts with these values,

Um, these values that are shared by society as a whole, and whenever this happens,

people tend to feel anxious or threatened by that

person who is perceived as being quite deviant.

Now,

one of the criticisms of social norms and using

social norms to identify abnormal behaviour or mental disorders

is the fact that they can differ from culture to culture.

It can also differ from time to time.

So when we think about culture, for example,

hearing voices, um in British culture would be viewed as being quite abnormal.

However, in other cultures, for example, in cultures where they believe that, um,

talking to spirits is normal, then of course,

hearing voices would be perceived as a normal behaviour.

That's a good example of cultural variation.

And of course, age plays a role, too.

So take the thumb sucking behaviour. For example,

thumb sucking is viewed as an appropriate behaviour for young Children.

And yet when we see thumb sucking in adults

the same behaviour this is viewed as being quite abnormal

and finding another example and a really important one is the time or the era,

So let's think about the diagnostic criteria.

So homosexuality was viewed as a mental illness in the DS m one,

and it's now viewed as being acceptable in Western society.

So it's really important we consider the era in which diagnosis have taken place.

And when we think about mental health and clinical research,

we also need to think about the time in which the research was conducted.

Because mental illness that was conducted or research into mental illness it

was conducted in a time when homosexuality was viewed as a mental disorder

will be very different from the type of mental illness.

Research is conducted in today's society,

so some of the limitations of this

now focusing too much on individual differences can

sometimes obscure things that people share in common.

So it is a fine line to people to balance.

So just as a little bit of a summary,

an alternative to the DS M five or the I CD

10 when it comes to diagnosing mental illness is to focus on

identifying abnormal behaviour.

Using the four DS

again, they are deviant dysfunction, distress and danger.

It's also useful to think about social norms and to really pick that apart

because when people break from social norms,

they're usually being viewed as quite abnormal,

which usually leads people to believe that actually,

that person might be suffering from a mental illness or a mental disorder.

So when we consider individual differences,

we also need to think about what could go wrong with this.

So, for example,

even though depression is really rare in Children, it does occur,

and it's actually something that might be increasing

now.

This is really important,

because if we start to think of individual differences and we start to think, OK,

we're gonna put depression in a category it's usually only an adult,

so we're not going to consider any Children to have this.

Then we find that actually, we get some false negative diagnosis

where actually somebody under the age of 18 has depression,

but they're not getting picked up on it because

of the way that we're identifying our diagnostic criteria.

When we think of men and women,

they have more in common than what they don't have in common,

and women can develop schizophrenia earlier in life,

and men can also develop schizophrenia later in life,

which goes against what we know about the diagnostic criteria identified.

Schizophrenia.

So a really good example of this is Bradshaw's study of, um, Carol.

Carol was a patient who had schizophrenia.

She was a young woman who developed schizophrenia

in her late teens to early twenties.

Um, and Bradshaw actually worked with her to use C BT and found C BT to be effective.

And this is a really good example of where

you shouldn't just be using the diagnostic criteria.

You should be looking at the symptoms and whether

or not the person could have the symptoms,

despite the fact that they're not neatly fitting into that box.

So this leads to a really big debate.

And this big debate is over whether individual differences really do influence

mental health or whether they're just a artefact or a human creation.

For example, are women really more depressed than men?

Or are they just more likely to go to

the doctors and therefore get diagnosed compared to men?

And this touches on lots of key debates in psychology.

So positivists who believe that the

scientific status of psychology would argue that

actually the differences are real and they point to a number of,

um, serotonin receptors in the female brain, for example.

To justify this,

they might also argue that some ethnic groups suffer from mental disorders, um,

based upon scientific evidence or biological reasons.

Now, this viewpoint can easily lead to stereotype and sexism and racism,

and the anti positivist view is that people are all the same,

and actually it's just society that treats them differently

now because of this, because of this view point that society is sexist.

Many of the abnormal and dysfunctional things that men do, such as fighting um,

getting involved in criminal activity getting drunk

are not viewed as being mentally ill.

But when women

or men from ethnic minority groups behave strangely,

these are diagnosed as being mental illnesses or mental disorders.