An urge for paradigm shift in psychometrics and psychiatric disease diagnosis

Authors

  • Rehana Khalil Department of Family & Community Medicine, Unaizah College of Medicine, Qassim University, Saudi Arabia

DOI:

https://doi.org/10.18203/2349-3933.ijam20161101

Keywords:

Paradigm shift, Psychometrics, Psychiatric disease diagnosis marker

Abstract

Background: With the advancement in all modalities of medicine, the psychometrics and diagnosis of psychiatric illnesses also advanced in twentieth century but not accurate enough to label them explicit. Despite of extensive research in the field of mental health, there is a paucity of data on critical analysis of measuring methods of mental capacities, processes and diagnostic modalities of mental illnesses. The aim of current study was to explore the perception of all concerned stakeholders about the effectiveness of assessment methods in psychology and psychiatry.

Methods: Semi-structured interviews with individual participants were conducted in Karachi, Pakistan during October 2015 to January 2016 for this qualitative study. Total 28 participants participated in the study, 7 participants per domain (doctors, psychologists, psychiatrists, and medical students/residents) were selected by homogeneous quota sampling. Interviews were transcribed, and identification of emerging and repeated themes was done. NVivo and concordance software were used to conduct content and discourse analysis, with simple counting methods. Microsoft excel was used for charts and tables. Each respondent gave written informed consent to participate in the study.

Results: More than one third (39%) of the sample contemplated the current methods of psychological and psychiatric assessment as deficient to a major extent in accuracy while one third (36%) of them said it is insufficient to some extent and one participant stated it is completely deficient which makes 4% of the sample. Near half (43%) of respondents identified weakness of DSM IV and psychometrics as arbitrary, one fifth (21%) as use of checklist for diagnosis, and one third (36%) as unavailability of confirmatory tests. Almost half of the respondents (46%) put forward the proposal of listening the mind talk or self-talk of the patient/person while one third (36%) of sample suggested for a device which can help in abridging the subjective bias in assessment and confirmation. One fifth (18%) proposed to see the thought process and content of patient/person in their minds on a screen.

Conclusions: A significant number of stakeholders of psychology and psychiatric fields affirmed the limitations of the current criteria for diagnosis for mental conditions and illnesses stated either by DSM or ICD and psychometrics. The stated constraints included inconsistency, use of checklist for diagnosis, and lack of confirmatory tests. There is a demand of more objective methods addressing the scientific impediments in advancement in the fields of psychology and psychiatry.

Metrics

Metrics Loading ...

References

Black DW, Andresen NC. Introductory Textbook of Psychiatry. DSM5 Edition. 6th edition. American Psychiatric Publishing. 2014; 3-15.

American Psychiatric Association: Diagnostic and Statistical Manual: Mental Disorders. Washington, DC, American Psychiatric Association, 1952.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 2nd Edition Washington, DC, American Psychiatric Association,1968.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Washington, DC, American Psychiatric Association,1994.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. Arlington, VA, American Psychiatric Association, 2013.

Black DW, Grant JE: DSM-5 Guidebook: The Essential Companion to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington DC, American Psychiatric Publishing, 2014.

Decker H: The Making of DSM-III: A Diagnostic Manual’s Conquest of American Psychiatry. New York, Oxford University Press, 2013.

Feighner JP, Robins E, Guze SB, Woodruff RA Jr, Winokur G, Munoz R. Diagnostic criteria for use in psychiatric research. Arch Gen Psychiatry. 1972;26:57-63.

Spitzer RL, Williams JBW, Skodol AE. DSM-III: the major achievements and an overview. Am J Psychiatry. 1980;137:151-64.

Wilson M. DSM-III and the transformation of American psychiatry: a history. Am J Psychiatry 1993;150:399-410.

Sadock BJ, Sadock VA. Kaplan & Sadock’s Pocket Handbook of Clinical Psychiatry. Fifth Edition. Lippin cott Williams&Wilkins. 2010.

The Free Dictionary. Retrieved from: http://www.thefreedictionary.com/ engineering. Accessed on 28th Feb 2016.

Framingham J. Psychological Testing. Accessed on Retrieved from: http://psychcentral.com/lib/how-is-psychological-assessment-used. Accessed on 28th Feb 2016.

Downloads

Published

2017-01-02

Issue

Section

Original Research Articles