Psychology Psychological Disorders Introduction & Classification
To view other notes of Psychology Click Here.
Introduction
When people think of mental illness, they often think of imaginary voices or terrifying killers like Charles Manson. However, psycho-logical disorders are not always that dramatic—or that clear-cut. Suppose a person drinks heavily on weekends and doesn’t spend any time with his family. Another person keeps to a strict diet in order to stay thin and still isn’t satisfied with her body weight. Do these people have mental disorders?
The question of what classifies as a mental disorder is often difficult to answer. Psychologists use many criteria to evaluate and diagnose these disorders, and they use a detailed system to classify them into categories. The origins of psychological disorders are varied and often unclear, and understanding these disorders involves an understanding of biology, culture, and personality. Many factors help make us who we are, and those same factors may, in certain people, prove precarious.
What Is a Psychological Disorder?
Several criteria exist for defining a psychological disorder. Sometimes a person needs to meet only one criterion to be diagnosed as having a psychological disorder. In other cases, more than one of the following criteria may be met:
- Violation of cultural standards behavior
Example: Ted’s delusion that he is a prophet causes him to stand at street corners lecturing people about the morality of their behavior.
- Exhibition of behavior harmful to self or others
Example: Bethanne’s excessive use of alcohol makes her unable to hold down a job.
- Experiencing distress
Example: David suffers from chronic and painful anxiety.
Model of Psychological Disorders
Psychologists use different conceptual models for understanding, describing, and treating psychological disorders.
The Medical Model
The medical model is a way of describing and explaining psychological disorders as if they are diseases. Many terms used to discuss psychological disorders come from the medical model. Diagnosis refers to the process of distinguishing among disorders. Etiology refers to the cause or origin of a disorder. Prognosis refers to a prediction about the probable course and outcome of a disorder.
Critics argue that this model is not suitable for describing psychological problems. They say that psychological problems are not illnesses but rather behaviors and experiences that are morally or socially deviant.
The Vulnerability-Stress Model
The vulnerability-stress model states that psychological disorders result from an interaction between biological and environmental factors. According to this model, individuals who have a biological vulnerability to a particular disorder will have the disorder only if certain environmental stressors are present.
The Learning Model
The learning model theorizes that psychological disorders result from the reinforcement of abnormal behavior.
The Psychodynamic Model
The psychodynamic model states that psychological disorders result from maladaptive defenses against unconscious conflicts.
Disorder Assessment
Psychologists use two methods to assess a psychological disorder: objective testing and projective testing. Objective tests are usually pencil-and-paper standardized tests such as the Minnesota Multiphasic Personality Inventory(MMPI). Projective tests require psychologists to make judgments based on a subject’s responses to ambiguous stimuli. Word association tests or the Rorschach test, in which subjects interpret a series of inkblots, are examples of projective tests. (See pages 285–287 for more information on these tests.)
Classification
Psychologists and psychiatrists have classified psychological disorders into categories. Classification allows clinicians and researchers to describe disorders, predict outcomes, consider treatments, and encourage research into their etiology.
Insanity
Insanity is not a diagnostic label that psychologists use. Rather, it is a legal term that refers to the inability to take responsibility for one’s actions. The law does not consider most people with psychological disorders to be insane. People can use an insanity defense only if they were unable to distinguish right from wrong at the time they committed a crime.
The DSM
Psychologists and psychiatrists use a reference book called the Diagnostic and Statistical Manual of Mental Disorders(DSM) to diagnose psychological disorders. The American Psychiatric Association published the first version of the DSM in 1952. It has been revised several times, and the newest version is commonly referred to as the DSM-IV.
The DSM-IV uses a multi-axial system of classification, which means that diagnoses are made on several different axes or dimensions. The DSM has five axes:
- Axis I records the patient’s primary diagnosis.
- Axis II records long-standing personality problems or mental retardation.
- Axis III records any medical conditions that might affect the patient psychologically.
- Axis IV records any significant psychosocial or environmental problems experienced by the patient.
- Axis V records an assessment of the patient’s level of functioning.
Psychologists and Psychiatrists
People sometimes use the words psychologist and psychiatrist interchangeably, but they are not the same. Psychologist is a broad term that refers to anyone with advanced training in psychology who conducts psychological testing, research, or therapy. A psychiatrist has a medical degree and treats patients with mental and emotional disorders. A psychiatrist can also prescribe medication.
Criticisms of the DSM
Although the DSM is used worldwide and considered a very valuable tool for diagnosing psychological disorders, it has been criticized for several reasons:
- Some critics believe it can lead to normal problems of living being turned into “diseases.” For example, a child who displays the inattentive and hyperactive behavior normally seen in young children could be diagnosed with attention-deficit/hyperactivity disorder by an overzealous clinician. In earlier versions of the DSM, homosexuality was listed as a disorder.
- Some critics argue that including relatively minor problems such as caffeine-induced sleep disorder in the DSM will cause people to liken these problems to serious disorders such as schizophrenia or bipolar disorder.
- Other critics argue that giving a person a diagnostic label can be harmful because a label can become a self-fulfilling prophecy. A child diagnosed with attention-deficit/hyperactivity disorder may have difficulty overcoming his problems if he or other people accept the diagnosis as the sole aspect of his personality.
- Some critics point out that the DSM makes the process of diagnosing psychological disorders seem scientific when, in fact, diagnosis is highly subjective.
In general, psychologists view the DSM as a valuable tool that, like all tools, has the potential for misuse. The DSM contains many categories of disorders, and the following sections will cover a few of these categories.
Culture and Psychological Disorders
Most of the major disorders listed in the DSM are found worldwide, although cultural factors often influence the symptoms and course of disorders. Culture-bound disorders, on the other hand, are limited to specific cultural contexts. They may or may not be linked to DSM diagnostic categories. One example of a culture-bound syndrome described in the DSM is dhat, a condition that occurs in India and is characterized by anxiety, hypochondria, discharge of semen, whitish urine color, weakness, and exhaustion. Similar conditions exist in Sri Lanka and China.
