Psychology Essay

2017/8/2 PSY101 - Module 13.2

https://www .riolearn.or g/content/psy/psy101/PSY101_INTER_0000_v8/lessons/module13-02.shtml 1/4

M o d u le 1 3 .2 : D ia g n o s in g a n d C la s s if y in g P s y c h o lo g ic a l D is o r d e r s

A ﬁrst step in the study of psychological disorders is carefully and system atically discerning signiﬁcant signs and sym ptom s. H ow do m ental

health professionals ascertain w hether or not a person's inner states and behaviors truly represent a psychological disorder? Arriving at a

proper diagnosis— that is, appropriately identifying and labeling a set of deﬁned sym ptom s— is absolutely crucial. This process enables

professionals to use a com m on language w ith others in the ﬁeld and aids in com m unication about the disorder w ith the patient, colleagues and

the public. A proper diagnosis is an essential elem ent to guide proper and successful treatm ent. For these reasons, classiﬁcation system s that

organize psychological disorders system atically are necessary.

T h e D ia g n o s tic a n d S ta tis tic a l M a n u a l o f M e n ta l D is o rd e rs (D S M )

Although a num ber of classiﬁcation system s have been developed over tim e, the one that is used by m ost m ental health professionals in the

U nited States is the D iagnostic and Statistical M anual of M ental D isorders (D SM -5), published by the Am erican Psychiatric Association (2013).

(N ote that the Am erican Psychiatric Association differs from the Am erican Psychological Association; both are abbreviated APA.) The ﬁrst edition

of the D SM , published in 1952, classiﬁed psychological disorders according to a form at developed by the U .S. Arm y during W orld W ar II. In the

years since, the D SM has undergone num erous revisions and editions. The m ost recent edition, published in 2013, is the D SM -5.

The D SM -5 includes m any categories of disorders (e.g., anxiety disorders, depressive disorders, and dissociative disorders). Each disorder is

described in detail, including an overview of the disorder (diagnostic features), speciﬁc sym ptom s required for diagnosis (diagnostic criteria),

prevalence inform ation (w hat percent of the population is thought to be aﬄ icted w ith the disorder), and risk factors associated w ith the

disorder.

The D SM -5 also provides inform ation about com orbidity; the co-occurrence of tw o disorders. For exam ple, the D SM -5 m entions that 41% of

people w ith obsessive-com pulsive disorder (O CD ) also m eet the diagnostic criteria for m ajor depressive disorder (Figure 13.3). D rug use is

highly com orbid w ith other m ental illnesses; 6 out of 10 people w ho have a substance use disorder also suffer from another form of m ental

illness.

The D SM has changed considerably in the half-century since it w as originally published. The ﬁrst tw o editions of the D SM , for exam ple, listed

hom osexuality as a disorder; how ever, in 1973, the APA voted to rem ove it from the m anual. Additionally, beginning w ith the D SM -III in 1980,

m ental disorders have been described in m uch greater detail, and the num ber of diagnosable conditions has grow n steadily, as has the size of

the m anual itself. D SM -I included 106 diagnoses and w as 130 total pages, w hereas D SM -III included m ore than 2 tim es as m any diagnoses (265)

and w as nearly seven tim es its size (886 total pages). Although the D SM -5 is longer than the D SM -IV, the volum e includes only 237 disorders, a

Print This Page 2017/8/2 PSY101 - Module 13.2

https://www .riolearn.or g/content/psy/psy101/PSY101_INTER_0000_v8/lessons/module13-02.shtml 2/4

Figure 13.3 Obsessive-com pulsive disorder and m ajor depressive disorder

frequently occur in the sam e person.

decrease from the 297 disorders that w ere listed in the D SM -IV. The latest

edition, D SM -5, includes revisions in the organization and nam ing of

categories and in the diagnostic criteria for various disorders, w hile

em phasizing careful consideration of the im portance of gender and cultural

difference in the expression of various sym ptom s.

Som e believe that establishing new diagnoses m ight over-pathologize the

hum an condition by turning com m on hum an problem s into m ental illnesses.

Indeed, the ﬁnding that nearly half of all Am ericans w ill m eet the criteria for

a D SM disorder at som e point in their life likely fuels m uch of this

skepticism . The D SM -5 is also criticized on the grounds that its diagnostic

criteria have been loosened, thereby threatening to "turn our current

diagnostic inﬂation into diagnostic hyperinﬂation" (Frances, 2012, para. 22).

For exam ple, D SM -IV speciﬁed that the sym ptom s of m ajor depressive

disorder m ust not be attributable to norm al bereavem ent (loss of a loved

one). The D SM -5, how ever, has rem oved this bereavem ent exclusion,

essentially m eaning that grief and sadness after a loved one's death can

constitute m ajor depressive disorder.

This lesson is based on the D SM paradigm . It should be noted, how ever, that

w hile the D SM is the classiﬁcation system of choice am ong U .S. m ental health professionals, it is not w idely used outside of the U nited States.

O ther regions and countries of the w orld have developed alternative classiﬁcation and diagnostic system s, such as the International Statistical

Classiﬁcation of D iseases and Related H ealth Problem s (ICD ) used in Europe and the Chinese Classiﬁcation and D iagnostic Criteria of M ental

D isorders used in China. O ne of the reasons for this is the criticism that the D SM carries a cultural bias tow ard w hite Am ericans and

understates the scientiﬁc im portance of social-psychological variables.

T h e C o m p a s s io n a te V ie w o f P s y c h o lo g ic a l D is o rd e rs

As these disorders are outlined, please bear tw o things in m ind. First, rem em ber that psychological disorders represent extrem es of inner

experience and behavior. If, w hile reading about these disorders, you feel that these descriptions begin to personally characterize you, do not

w orry— this m om ent of enlightenm ent probably m eans nothing m ore than that you are norm al. Each of us experiences episodes of sadness,

anxiety, and preoccupation w ith certain thoughts— tim es w hen w e do not quite feel ourselves. These episodes should not be considered

problem atic unless the accom panying thoughts and behaviors becom e extrem e and have a disruptive effect on one's life.

Second, understand that people w ith psychological disorders are far m ore than just em bodim ents of their disorders. W e do not use term s such

as schizophrenics, depressives, or phobics because they are labels that objectify people w ho suffer from these conditions, thus prom oting

biased and disparaging assum ptions about them . It is im portant to rem em ber that a psychological disorder is not w hat a person is; it is 2017/8/2 PSY101 - Module 13.2

https://www .riolearn.or g/content/psy/psy101/PSY101_INTER_0000_v8/lessons/module13-02.shtml 3/4

som ething that a person has— through no fault of his or her ow n. As is the case w ith cancer or diabetes, those w ith psychological disorders

suffer debilitating, often painful conditions that are not of their ow n choosing. These individuals deserve to be view ed and treated w ith

com passion, understanding, and dignity.

C h e ck Yo u r K n o w le d g e

True or False?

U se the questions below to test yourself! Read each of the statem ents carefully and decide if they are true or false.

1. A diagnosis is appropriately identifying and labeling a set of deﬁned sym ptom s. blockquote>

a. True

b. False

2. The D iagnostic and Statistical M anual of M ental D isorders (D SM -5) is published by the W orld H ealth O rganization and is

used for clinical purposes as w ell as to exam ine the general health of populations and to m onitor the prevalence of

diseases and other health problem s internationally. blockquote>

a. True

b. False

3. Com orbidity is the co-occurrence of tw o disorders. blockquote>

a. True

b. False

M odule 13.1 M odule 13.3 2017/8/2 PSY101 - Module 13.2

https://www .riolearn.or g/content/psy/psy101/PSY101_INTER_0000_v8/lessons/module13-02.shtml 4/4