January 12, 2023
Overlapping domains in study of abnormal behavior
- Nature
o Pure description
o Ex. Difference between mood and personality disorder
- Causes
o Explanation
o Why does someone develop depression, anxiety, etc.
- Factors involved in eliminating or reducing psychopathology… or
treatment
o Relies heavily on explanation and cause
Nature of psychopathology… or description
- How do we delineate mental disorder
o Carve them up
- Defining
- Organizing
o Categorization and classification
Challenge for defining: what’s the “gold standard”
- For physical illness the norm is the structural ad functional
integrity of the body
- For mental disorders... what “norm” of human functioning should
we use?
o More complicated
o “normal” behavior and mental functions are highly variable
o Variability in human behavior is what makes humans unique
and wonderful
o Makes diagnosing abnormal behavior tricky
Elements of definition
- Mental illness entails internal dysfunction
o Some psychological process (mood, emotion, memory,
cognition, language) is unable to function appropriately
o Psychological process: some process that is supposed to be
working properly
- Must have either distress (mental pain) or disability (loss of
functioning)
o Severity criteria (to distinguish from normal experiences)
o What makes it clinically significant
- Ultimate cause (etiology) irrelevant
o Need not be internal or psychological
o May be psychological, biological, social
o Example: adjustment disorders tied to current life stress
o Can develop disorder de to chemical in environment
- Mental disorder is not social deviance
o Deviance is personally chosen violation of social norms
o Only mental disorder when due to internal dysfunction
“Nomenclature”
- Standardized system if terms used within a particular science or
discipline
- Good description, using standardized terms, permits classification
o E.g. impulse > impulse-control disorders
- Standardized classification adds clarity, efficiency, and consistency
to communication
- A classification for diseases if called a nosology
o In America for mental disorders: DSM
- Specialised language
- Cynical word: jargon
Pros of DSM-5
- Operational criteria are given
o For each disorder
o Clear definition that can be measured and observed
- Relatedly, subjectivity is minimized
o Someone that meets symptoms for GAD, will meet
symptoms at all psychologists
- Descriptive and atheoretical
o Doesn’t claim cause of disorders
o Disorders grouped by symptoms, not causes
Cons of DSM-5
- Can mislead us into:
o Forgetting that tis is only one way of classifying
psychopathology
o No alternative to classifying
o Overlooking it’s a work in progress, product of human minds
o Placement of disorders in categories shifts
o Consideration of a “disorder” changes
New disorders emerge
Ex. Disruptive mood regulation (kids)
Old disorders no longer exist
Homosexuality
o It is a categorical system
Based off medical model
Implies sharp division
Between “normal” and abnormal”
o Example: high functioning psychopath,
would meet many psychopathic symptoms
except for getting in trouble by law
Between disorders
o Example: body dysmorphia and OCD. Both
repetitive thoughts and behavior
Categorical diagnostic system
- Meet 5/9 criteria? Yes- diagnosis No
Dimension approach
- ID primary dimensions of human personality and psychological
functioning
o These apply to whole population
o Building block of human experience
o Extraversion
o Negative affectivity
o Impulsivity
o Perfectionism
o Neuroticism (emotional instability)
o Hostility
- Locate the individuals scores on the dimensions
o Only extremes, or some combinations, may be pathological
DSM-5 structure
- no longer multi-axial
o Previous DSM thought of disorders as either long term or
short-term
- Mental disorders
o Symptom syndrome (“state” disorders)
“Short term”
o Personality dysfunction (“trait” disorders)
- Relevant medical conditions
o Some medical conditions have similar symptoms to mental
conditions
- Other conditions that can be focus of clinical attention
o E.g. psychosocial/environmental factors
- Optional: disability rating
o WHO disability assessment schedule
Caveats
- Dangers of looking at symptoms in isolation
o Overestimate amount of mental illness... “pathologizing”
Ex. Medical student syndrome, applying everything to
ourselves
Everyone has elements of disorders
o Overlook continuity with all human experience
o Overlook social causes and personal context
