Diagnosis of mental disorders

Thinking about abnormality:

The 4Ds of diagnosis (Davis)

The 4 Ds of diagnosis are explained in this paper: the-4ds-of-diagnosis

There is a reasonable amount of information on each of the Ds in order for you to describe how each is related to diagnosis, however we need to learn a little more about how other psychologists have conceptualized each idea in order to elaborate your descriptions, explain how they help us to differentiate between people requiring a diagnosis or not and to give us a head start in evaluating each idea with regard to its usefulness in making diagnoses. Follow the links below for more on each area.




Can you identify the 4Ds in the case of Steven? the-case-of-steven-v
An activity created by the brilliant John Crane from the International School of Prague:

Practice Questions:

  1. Tallulah carries seven crystals in her handbag and touches them in a specific order before she leaves for work. Explain the usefulness of any two of the 4Ds of diagnosis with reference to Tallulah. (4)
  2. Explain one strength and one weakness of the concept “deviation” when deciding whether a person requires a diagnosis of a mental disorder (4)

Possible model answer

  1. Compare the concepts of dysfunction and distress as applied to the diagnosis of mental disorders (4)
  2. Assess the usefulness of at least two of the 4DS of diagnosis (8 or 20)
  3. One winter’s night, university student, Elise was found wandering the campus in her nightie. Freezing cold, she was apparently whispering some sort of mantra, possibly a prayer, she seemed terrified and distraught. Elise was taken by some other students and to the University Welfare Office. They recognised some of her symptoms and when Elise eventually spoke to a psychiatrist, she revealed that the she felt that her thoughts were being controlled by a terrorist organisation who were telling her to harm her university friends.
    To what extent might the 4 Ds of diagnosis be useful in assessing Elise and her needs (20) (8+4+8)

    Thoughts on this question 

  4. Issues  & Debates: Evaluate the use of psychology in social control (20) (can you see how this topic could fit into this issues and deabtes essay?)
Use the cases below to discuss problems of defining abnormality.
  • Phineas’ wife had died recently and he found himself weeping very frequently, feeling very sad, vulnerable and emotional.
  • Jemima is a ten year old who has a fascination with shiny leather belts – she carries one around with her and at times whirls it furiously, becoming more and more excited in the process. At the height of her excitement she lets out high-pitched bird-like noises, jumps up and down on the spot and flaps her hands at eye level.
  • Carrie is very different from her peers, who often make fun of her because she does not wear trendy clothes or make-up, does not go to the pub and, though she is 19 years old.has never had a date. Her mother will not allow her to do any of those things.

Wider reading

Psychiatric diagnosis as a political device: stars




Activity: Divide into teams of 4-5. Each person become an expert on one area of the Timothy Davis’s paper (one person per D: danger, distress, dysfunction, deviance and one extra person to cover the last section of the article on duration). You could make Cornell notes to help read for meaning and recall. Share what you have learnt with each other as a group and then play this Kahoot game in teams.

Click here for Cornell note taking template: cornell template