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1.3 Current Diagnosing and Recording of Mental Illness

Sanjula Costa

LEARNING OBJECTIVES

To understand different study types and resources used for recording and diagnosing mental health outcomes for research. By the end of this chapter, you should be able to:

  • Compare and Contrast the various diagnosing and recording tools
  • State advantages and disadvantages to each study type and how it impacts the research process

Diagnosing and maintaining records of mental health can be challenging as the diagnosis is based on clinical interviews where recall bias and affective state can hinder accuracy. Nonetheless, data collection and how we maintain this data are important for research. Additionally, with the emergence of technology and digital platforms, diagnosing and recording mental illness has evolved.

Cross-Sectional Self Report Studies

Cross-sectional studies are widely used in developmental psychology as it looks at data from a population at a specific point in time. Participants are recruited based on a variable of interest (Kesmodel, 2018; Spector, 2019). This means that data from the population is collected but no variables are manipulated. Therefore, cross-sectional studies are observational where characteristics of a community can be described but cannot conclude on any cause and effects. This type of study can be used to establish if exposure to specific risk factors might associate with particular outcomes.

For Example: In the study conducted by Kisely et al. 2020, the researchers studied the effects of childhood maltreatment on the mental health of adults. The population of interest in this study is those who experienced childhood trauma. Any changes found in mental health outcomes will be attributed to the type of maltreatment.

Advantages

Self-Reporting Surveys and Interviews

Self-Reporting surveys and interviews are questionnaires where participants evaluate themselves (Frey, 2018). The questionnaires usually do not involve open-ended questions but follow Yes/No, True/False or Rating Scale format.

Advantages:

Allows participant experiences to be quantified and standardized so that comparisons between participants is easier

Participants may be more honest and disclose information they might not have if the interview was done face-to-face

Provides information through the participant’s point of view instead of a researcher’s

Disadvantages:

Participants may lack self-knowledge hindering the accuracy of the questionnaire

Impression management: Participants may intentionally misrepresent themselves thereby skewing data

Comprehension skills may contribute to incomplete or inaccuracy

  • Inexpensive and Quick: Cross-sectional studies provide researchers with a large amount of information quickly. The use of self-reporting, allows researchers to collect data from a large number of participants. Since the data is collected at once, incomplete or missing data from participants is limited.
  • Can examine multiple variables: Researchers can look at numerous factors at once. For example in the Kisley study, the authors were able to look at age, gender, income, and other social determinants that may contribute to a child being vulnerable to maltreatment and mental illness.

Disadvantages

  • Cohort Differences: Differences may arise in cross-sectional cohorts as people of the same age may have different experiences. This is where social determinants might have the greatest impact
  • Report Bias: how a participant recalls their experience may not be accurate and researchers cannot fact check a participants’ memory. For example, the description of a participant’s maltreatment or how many times abuse occurred may not be accurate.

Longitudinal Studies

Similar to cross-sectional studies, longitudinal studies are also correlational and observational research. They look at variables over an extended period of time (Weeks, Months, Years, Decades) for the same group of participants (Frey, 2018). Once data is initially collected, the study methods may be repeated over time to examine how the variables of interest change with time.

For example: In the Kisely study, data were collected from participants at Birth, 6 months and at multiple years up to 30 years after birth.

Advantages

Example from Kisely et al. 2020 Longitudinal Birth Cohort

The study used longitudinal follow-up of prospective agency notified maltreatment.

An advantage of using agency reporting is accuracy in timelines such as the age in which maltreatment occurred and frequency. However, not all abuse is reported and the assessment of maltreatment may be inconsistent with what the agency is reporting and participant statements.

  • Allows for the observation of variables as they change over time. Researchers can look at how variables change at different points in life. For example, phenotypes of mental illness may be displayed differently when participants are juveniles, a teen, or an adult. Additionally, as participant ages, social determinants might change impacting recovery or worsening of mental health outcomes.

Disadvantages

  • Longitudinal studies can be expensive and require dedication to slow collection of data
  • Longitudinal studies can often have a small sample size as participants may not want to commit to a long timeframe
  • Participants may also withdraw from the study influencing the results of the study.

 

 

DSM-5

Measuring DSM-5

DSM- 5 diagnoses can be measured using World Health Organization Composite International Diagnostic Interview (CIDI)

CIDI is a structured interview to diagnose mental health. CIDI- Auto is a computerized version.

CIDI – Auto is beneficial as it maintains animosity of the participants during the interview process and they are more likely to answer more honestly.

Diagnostic and Statistical Manual of Mental Disorders (DSM) 5th Edition is the current manual in diagnosing Mental disorders. It provides information for clinicians and researchers to understand common health issues with guidelines for diagnoses (Frey, 2018).

Advantages

  • Provides codes that summarize mental health disorders
  • Standardizes mental health conditions. This can be advantageous and disadvantageous. It is beneficial to research as it eases data organization and statistical analysis.

Disadvantages

  • Mental health is complicated with an array of symptoms with varying degrees unique to each individual. Therefore, an absolute diagnosis may not be valid
  • This also increases the risk of over-diagnosis and misdiagnosis.

 

Summarize your Learning – Use the chart below to organize and summarize what you have learned about the current diagnostic and recording tools used for Mental Health.

Cross-Sectional Study Longitudinal  Study Self-Reporting Survey DSM-5 CIDI
Characteristics
Advantage
Disadvantage

 

 

KEY TERMS

  • Developmental Psychology: a subgroup in psychology that examines how one changes overtimes. Focus is usually given to cognitive development and learning abilities.
  • Observational Studies: a study where data is collected from populations without a variable being manipulated. For example, observational studies do not have a treatment group
  • Correlational Studies: non-experimental research where two variables are studied to examine their relationship usually through statistical analysis.
  • Cohorts: a group of participants that share a common demographic factor. For example, born in the same generation or part of the freshman class in high school.
  • Phenotypes: Observed characteristics of a condition.

 

Testing your knowledge, please complete the following activity after the reading.