VALIDITY:
Validity is the concept of how "true" a result is from any instrument or test. For example, there are a number of personality tests now on facebook that claim to be able to discern, from a few random questions (e.g., what picture looks best to you), what your personality might be like. I would argue that the validity of such measures is questionable. In another example, is the SAT a valid measure of academic ability? A test is valid when it measures what it claims to measure.RELIABILITY:
Reliability is the concept of consistency. Does the test, when given over and over, produce the same result? A regular bathroom scale should be consistent, for example, and each time you get on the scale, within say an hour or 2, should give you the same result. SATs are very reliable, as are the Praxis tests, and the Myers-Briggs personality indicator.
Given the readings, do you think the current diagnostic system (DSM IV-TR) is Valid? Reliable? Why are validity and reliability important? Is this the best nosology for mental illness? why is it important to have a diagnostic system and labels?
Reply to these questions, and to at least 2 of your classmates' replies.
Based on the readings, I do not think that the DSM is very valid or reliable. I do not think that it is reliable, because if two different doctors used the DSM to try to diagnose someone, they could each come up with different diagnoses. I also do not think the DSM appears to be very valid, because people have differing definitions of mental illness like it being caused by a chemical imbalance or it being a social construct etc. Reliability and validity are important because they determine how "good" a test is. They judge a tests accuracy and consistency. I think the best treatment for mental illness would be more individualized to the person rather than labeling their symptoms as a disorder. However, there are advantages to labeling and having diagnostic symptoms like leading to better treatments for common symptoms and giving the person a name to what they are experiencing. Also, while it is a response to our healthcare system, giving a diagnosis is often required in order to get insurance coverage for treatment.
ReplyDeleteThat's a great point with validity Brittney, how can we even test how accurately it identifies any mental illness when there isn't even a consensus on the definition. Though I also agree that it is nice to have a name to put to what is happening to you, which is where the labels are helpful.
DeleteBrittney, I like the idea of focusing on individualized treatment without a broad label of symptoms, however I think it would also be very difficult to determine which evidenced based treatments would be effective for varied symptoms without the broader diagnostic categories, as well as very time consuming for practitioners who may already be stretched thin with large caseloads.
DeleteI totally agree with you when you said that two doctors could come up with two different diagnoses. It seems like there is no in between when it comes to DSM, which makes it hard for practitioners. The DSM should be used in that place where two doctors come up with two different diagnoses, but it doesn't seem like it helps when it comes to that point.
DeleteYes, I agree with what you're saying and question whether or not labels would be given if not needed for insurance purposes.
DeleteGoing from the readings it seems that the none of the DSMs were valid or reliable. While it was obvious that the article were written to criticize the DSM, they bring up very valid points. How did we as a society so easily accept something that has never been proven to do what it says it can. I mean reading the criteria for some diagnosis’s it is clear that it is very much up to the clinician about deciding if the individual fulfills the ‘requirements’ to classified with a metal illness. With the decision to diagnose someone very much in the clinicians hands, and way of thinking it is obvious then that it cannot be very reliable. For every individual has a different way of thinking due to how they were raised, where they grew up, what they feel is ‘typical’ behavior or what isn’t. Though society does help ensure that some behaviors are considered ‘bad’ and not allowed, so something can be agreed on but overall there is no way to say everyone will think the same way thus there cannot be high reliability on being able to diagnose individuals correctly. I mean in The Myth of Psychiatric Diagnosis it is stated that acceptable reliability has been lowered from 0.6 kappas to 0.2-0.4. So that shows the reliability is low and for them to even allow certain diagnosis’s in the DSM V they needed to lower the requirements. So that doesn’t really instill a lot of trust in the DSM V and correctly diagnosing people.
ReplyDeleteValidity and reliability are extremely important, it essentially is saying that it is ‘right’ and proves so by how consistent it is. But the DSM doesn’t prove either and that is not the best nosology for mental illness at all, it leaves it purely up to clinical judgement and who are we to say anything about what an individuals mental state is. How do we know that we are sane enough to making this decision about someone else’s sanity.
Unfortunately in todays society we need labels to ensure that individuals can receive services that they need, that any financial assistance such as insurance can be approved for the individual. Also with a diagnosis it does give clinicians a place to start with treatment and helping the person be able to live their life as they want to. Though society has made it that a lot of labels are viewed in a very negative way. Instead of having a label(like a name tag) just for doctors and the insurance company that can be removed when entering the rest of the world, psychiatric diagnosis really have become stigmatized so people are more like branded with a branding iron right on their forehead, making them forever different and a concern to some.
Samantha I agree with you that there are so many problems with the validity and reliability of diagnoses within the DSM V. They appear not only to be very subjective but also perhaps too liberal with their determinations of what classifies as disease. It's almost as though they want everyone to qualify. When you step back and ask yourself, who benefits from this reclassification of mental illness?, the DSM V appears to be little more than a generous gift to the pharmaceutical and insurance companies and further begs the question, should an evidence based field of science really be taking it all that seriously?
DeleteI think it is interesting that you questions what sanity or insanity even means. I think their definition varies in different societies. For example in my abnormal psych class this past spring we learned about the difference of having schizophrenia in developing or developed countries. In some developing countries when a person experiences hallucinations it is seen as a religious blessing rather than a mark of insanity.
DeleteAlthough I think it can be beneficial to have a diagnostic system with labels because it helps practitioners determine the treatment methods and most current evidence based practices that may benefit clients and often necessary to help them bill insurance companies for services, the concept of mental health and mental illness has always been a very subjective field that relies on very subjective definitions of what is normal for the current time period. Because we all lead such diverse lives and come from diverse backgrounds, it is very difficult to have a universal concept of normal and which makes it equally difficult to have a universal diagnostic system that measures the deviations from normal with validity and reliability. Although the DSM IV makes a thorough attempt at doing exactly that, it also serves as evidence why there can not be a single comprehensive diagnostic tool. We are always learning new information about mental illness and how to treat it. As we gain a more comprehensive understanding of mental health disabilities, it often changes the way we classify and treat them, as we have seen with the changes to how Schizophrenia and Autism Spectrum Disorder have been classified. We are also constantly changing our perceptions of mental illness culturally. Where homosexuality was once classified as a disorder, we have moved away from that cultural mindset. Now there are questions as to whether or not Gender Dysphoric Disorder should be re-classified or disposed of as well. Although I think it is important to have a diagnostic system with reliability and validity to the greatest extent possible because it can be very helpful to people who are suffering to be able to identify the source of their distress and help them figure out how to get treatment, I also understand that people with mental health disabilities are diverse and are much more than a mold of the most commonly experienced DSM IV symptoms and I feel there is a danger in putting too much stock in these subjective labels which have the potential to strip people of their humanity, stick with them indefinitely and cause harm to them even after recovery.
ReplyDeleteI do like how you stated the importance of trying not to strip people of their humanity because I am a big fan of person centered therapy where you try to understand the individual experience and realize that a person is the master of his or her own life and no one knows better what they're going through or what to do than themselves. So on one hand when we label someone with a diagnosis it may make them feel less like an individual but it may also help them to understand what they are going through better and not feel so alone in their experience.
DeleteI do like how you stated the importance of trying not to strip people of their humanity because I am a big fan of person centered therapy where you try to understand the individual experience and realize that a person is the master of his or her own life and no one knows better what they're going through or what to do than themselves. So on one hand when we label someone with a diagnosis it may make them feel less like an individual but it may also help them to understand what they are going through better and not feel so alone in their experience.
DeleteI like how you talked about mental illness changing all the time and diagnosis' not changing with them. I think that the DSM needs to be updated annually to make sure that it is doing it's job as a manual for practitioners. It's not going to be helpful if it's three years old and all kinds of things have changed in the mental illness world.
DeletePersonally, I don't think the DSM is valid or reliable. It's very black and white and makes it hard to give someone a diagnosis off of a few behaviors. Although the DSM does help a lot of practitioners diagnose their patients, I don't think it should be used. There is such a large spectrum of mental illness, which makes it hard to pin point the exact diagnosis. It's important to have reliability and validity when it comes to a piece of material that is supposed to help diagnose patients. I don't think it's easy to diagnose patients, which it why the DSM is point in place to make it easier. I just don't think it works for everyone and there should be another resource that is more reliable and valid for all patients no matter their diagnosis.
ReplyDeleteWhile the DSM is not valid or reliable do we really have any other option for how we diagnose mental illnesses? While another resources would be great how realistic is that?
DeleteThough I totally agree that just because an individual has a few certain attributes doesn't mean they are mentally ill
It would be great if there were another source of information that could be used instead of the DSM for more valid and reliable results. I agree that this doesn't work for everyone because of how large the spectrum of mental illness is.
DeleteI think the DSM is very helpful and insightful when it comes to determining a diagnosis, but whether or not it is entirely reliable or valid… that is questionable. I think that mental illnesses can be very similar in symptoms and its effect on the brain, however, how mental illness develops varies in every individual. Just as no two humans – not even twins - are 100% alike, neither are mental illnesses. When an individual submits to a diagnosis that “sets the stage” for their treatment. Because research shows that that diagnosis is most beneficial with such and such type of treatment, how can that be accurate when no two mental illnesses nor individuals are identical?
ReplyDeleteThe DSM is essential in treatment for the purpose of a diagnosis, which is needed to receive treatment. Without a diagnosis insurance will not provide coverage. It is also good to have somewhat of an idea of what type of mental illness an individual is exhibiting and in what direction to head with treatment.