Week 3 workshop - nosologies

Question 1

what is a nosology?

Answer 1

refers to the medical classification of diseases

Question 2

what do psychiatric nosologies do?

Answer 2

• Facilitate diagnosis and treatment (given these signs and symptoms, this is the likely cause)
  
  • Standardise diagnosis
  • Legitimise conditions

Question 3

problems with psychiatric classification

Answer 3

• No organic markers or definitive diagnostic tests. DSM disorders are classified on the basis of consensus about clusters of clinical symptoms.
  
  • Classification can seem arbitrary
  • Increasing numbers of diagnoses could mean widening stigmatisation

Question 4

what is ADHD

Answer 4

• Attention deficit hyperactivity disorder

Question 5

symptom clusters for ADHD

Answer 5

○ DSM-5 diagnostic criteria for ADHD: symptoms of inattention, hyperactivity and impulsivity

Question 6

what is the purpose of diagnosis?

Answer 6

provide an explanation
guide treatment

Question 7

are psychiatric diagnoses explanations?

Answer 7

• A diagnosis of ADHD doesn’t provide an organic explanation for a condition; it simply provides a description of behaviour
  Organic diagnoses are based on objective tests; psychiatric diagnoses are based on description and opinions. They are metaphors.

Question 8

psychological formulation

Answer 8

• A formulation is not an expert pronouncement, like a medical diagnosis, but a plausible account, and as such best assessed in terms of usefulness than truth (BPS 2011)
  
  • Butler 1998 - psychological formulation starts from the assumption that at some level it all makes sense

Question 9

principles of psychological formulation (BPS 2011)

Answer 9

• Grounded in psychological theory and evidence
  
  • Constructed collaboratively using accessible language
  • Constructed reflectively
  • Centrally concerned with personal meaning
  • Best understood in terms of usefulness than truth

Question 10

how can psychological formulation be useful?

Answer 10

• Clarifying hypotheses and questions
  
  • Providing an overall picture or map
  • Noticing what is missing
  • Prioritising issues and problems
  • Selecting and planning interventions
  • Predicting responses to interventions
  • Ensuring cultural perspective is incorporated
  • Helping the service user feel understood