PSYC10004 Lecture Notes - Lecture 29: Mental Disorder, Social Anxiety Disorder, Dsm-5
14 Jun 2018
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PSYC10004 - MIND, BRAIN & BEHAVIOUR 2 Lecture 29 - Wednesday 5 October 2016
LECTURE 29
DIAGNOSES & CLASSIFICATION IN
CLINICAL PSYCHOLOGY
STUDYING MENTAL DISORDERS
•Involves;
•Definition: What do we mean by mental disorder?
•Classification: How do we distinguish between different mental disorders?
•Explanation: How do we understand mental disorder?
•Treatment: How do we treat mental disorder?
GOALS OF A CLASSIFICATION SYSTEM
•Communication: among clinicians,between science and practice
•Clinical: facilitate identification, treatment, and prevention of mental disorders
•Research: test treatment efficacy and understand etiology
•Education: teach psychopathology
•Information Management: measure and pay for care
WHAT IS A MENTAL DISORDER?
•The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (the DSM-5) is
used as the current authoritative listing of mental disorders. It broadly defines mental disorder as:
“clinically significant disturbance in an individual’s cognition, emotion regulation or
behaviour...usually associated with significant distress or disability in social, occupational or other
important activities” (DSM-5)
WHAT IS NOT A MENTAL DISORDER?
•According to the DSM 5: “an expectable or culturally approved response to a common stressor
or loss, such as the death of a love one, is not a mental disorder.”
OTHER WAYS TO DEFINE ABNORMAL
•Statistical Deviance
•Biological Dysfunction
•Distress, disability or disadvantage
•Maladaptive behaviour
•Norm or value violation
•Harmful Dysfunction
OPTION 1: STATISTICAL DEVIANCE
•Considers only those conditions that are rare or uncommon (e.g. schizophrenia)
•Criticisms;
•Not all abnormal conditions are rare or uncommon
•Eg. Suicide is leading cause of death for young people. Also, anxiety (~14%) and
depression (~20%) (high prevalence).
•Does that mean it is normal?
•Not all rare or uncommon conditions are abnormal
•Eg. High intelligence is uncommon
•Does that mean it is abnormal?
OPTION 2: BIOLOGICAL DYSFUNCTION
•The biological dysfunction option proposes that a person has a mental disorder when a mental
mechanism is not performing the natural function it was designed to perform.
•Criticisms;
•For many mechanisms there is a wide range of adaptive functioning across people and
situations (fear response).
PSYC10004 - MIND, BRAIN & BEHAVIOUR 2 Lecture 29 - Wednesday 5 October 2016
•Many things that we want to call a disorder might actually be adaptive reactions.
OPTION 3: DISTRESS, DISABILITY OR DISADVANTAGE
•The distress, disability or disadvantage option considers conditions if your behavior causes you
distress or disability that is not expected
•Criticisms;
•Lots of conditions cause distress or disability, but are not considered disorders
•Eg. Poverty or discrimination
•What about conditions that do not cause distress?
•Eg. Drug abuse, mania
OPTION 4: MENTAL DISORDER AS MALADAPTIVE BEHAVIOUR
•The mental disorder as maladaptive behaviour option proposes that a person has a mental
disorder if they engage in behaviour that prevents them from meeting the demands of life.
•Criticisms;
•There may be situations that people should not have to adapt to.
•This approach emphasizes “fitting in” as being ultimately important.
OPTION 5: MENTAL DISORDER AS NORM OR VALUE VIOLATION
•The mental disorder as norm or value violation proposes that a person has a mental disorder if
they have experiences and exhibit behaviours that are inconsistent with the norms and values of
society.
•Examples:
•Behaviour that is harmful to oneself or others
•Poor reality contact
•Inappropriate emotional reactions
•Erratic behaviour
•Criticisms;
•What if violation is the result of external circumstances
•Such a criteria can seem too arbitrary and open to abuse
•Consider the history of homosexuality (classified as a mental
disorder in DSM II and earlier).
OPTION 6: WAKEFIELD’S HARMFUL DYSFUNCTION ANALYSIS
OF MENTAL DISORDER
•Wakefield’s harmful dysfunction analysis of mental disorder says that
mental disorder must have two properties.
•“Harmful” refers to the fact that the features causes significant harm to a
person under present cultural circumstances.
•This involves a value judgement.
•The condition must also result from the inability of some internal mental
mechanism to perform its natural function
•Natural function is defined by the task for which the mechanism was
designed by evolution.
•Example: Spider Phobia.
•Harmful:
•Results in distress and avoidance of bathroom and shower even
when it would be advantageous
•Dysfunction:
•This fear is meant to protect against harm, but when abnormal, could affect social and
occupational function
Document Summary
Goals of a classification system: communication: among clinicians,between science and practice, clinical: facilitate identification, treatment, and prevention of mental disorders, research: test treatment efficacy and understand etiology, education: teach psychopathology, information management: measure and pay for care. What is a mental disorder: the fifth edition of the diagnostic and statistical manual of mental disorders (the dsm-5) is used as the current authoritative listing of mental disorders. Clinically significant disturbance in an individual"s cognition, emotion regulation or behaviourusually associated with significant distress or disability in social, occupational or other important activities (dsm-5) What is not a mental disorder: according to the dsm 5: an expectable or culturally approved response to a common stressor or loss, such as the death of a love one, is not a mental disorder. Other ways to define abnormal: statistical deviance, biological dysfunction, distress, disability or disadvantage, maladaptive behaviour, norm or value violation, harmful dysfunction.
