5.3 Explaining and Classifying Psychological Disorders

Learning Objectives and Core Vocabulary

• Major Criteria for Defining Disorders: The study of psychological disorders begins by identifying three main criteria: dysfunction, distress, and deviance.
• Sociocultural Influence: Culture and society play a fundamental role in shaping the collective understanding of what constitutes mental illness.
• Classification Systems: Mental disorders are diagnosed using standardized systems including the Diagnostic and Statistical Manual of Mental Disorders ($DSM$) and the International Classification of Diseases ($ICD$).
• Evaluation of Diagnosis: The process of diagnosis involves evaluating pros and cons, specifically addressing topics of stigma, bias, and access to care.
• Psychological Perspectives: Understanding mental disorders requires comparing various psychological perspectives to explain etiology (causes).
• The Eclectic Approach: Utilizing a mix of multiple theoretical approaches is considered helpful for both diagnosis and treatment planning.
• Comprehensive Models of Causality: Models such as the biopsychosocial model and the diathesis-stress model illustrate that disorders arise from a combination of biological, psychological, and social factors.
• Key Vocabulary Terms:
      * Psychological disorder
      * Dysfunction
      * Distress
      * Deviance
      * Maladaptive
      * Stigma
      * American Psychiatric Association ($APA$)
      * Diagnostic and Statistical Manual of Mental Disorders ($DSM$)
      * World Health Organization ($WHO$)
      * International Classification of Diseases ($ICD$)
      * Psychological perspectives
      * Behavioral
      * Psychodynamic
      * Humanistic
      * Cognitive
      * Evolutionary
      * Sociocultural
      * Biological
      * Eclectic approach
      * Biopsychosocial model
      * Diathesis-stress model

Defining Psychological Disorders

• Basic Definition: A psychological disorder is characterized as an unusual pattern of thinking, feeling, or behaving.
• The Concept of Maladaptive Behavior: Actions or responses are considered maladaptive if they:
      * Hinder an individual's ability to adjust to specific situations.
      * Hinder the ability to cope with life challenges.
      * Prevent the maintenance of healthy relationships.
      * Lead to overall negative consequences.

Identification and Diagnosis of Disorders

• The Three Pillars of Identification:
      * Level of DYSFUNCTION: This measures the degree to which the patterns of behavior or thought impact the individual's ability to conduct daily life.
      * Perception of Personal DISTRESS: This refers to the level of personal discomfort or internal suffering experienced by the individual.
      * DEVIATION: This measures how much the behavior or thinking differs from established social norms.
• Variables in Diagnosis: To formally diagnose a disorder, clinicians examine:
      * Symptoms: Evaluation based on both severity and duration.
      * Functional Impact: Looking at the overall impact on well-being and daily functioning.
      * Contextual Factors: Considering the individual's cultural background and personal context.
• The Impact of Diagnostic Labels:
      * Benefits: Labels can provide a framework for treatment and understanding.
      * Risks (Stigma): Diagnosis can lead to stigma, which is defined as a negative attitude toward an individual or group based on a perceived characteristic that society considers a deficiency.

Standardized Classification Manuals

• $DSM-5$ (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition):
      * Published by the American Psychological Association ($APA$).
      * Commonly referred to as the ‘Bible’ of psychiatric diagnosis.
      * Regularly updated with new diagnostic criteria.
      * Modified to be aligned with the $ICD$.
• $ICD-11$ (International Classification of Diseases, $11$th Revision):
      * Published by the World Health Organization ($WHO$).
      * The primary system used to classify disorders outside of the United States.

Theoretical Perspectives on Etiology

• Etiology Defined: The study of the causes or origins of psychological disorders.
• The Eclectic Approach: Most mental health professionals do not adhere to a single theory but utilize a combination of various approaches to provide comprehensive care.
• Specific Theoretical Perspectives:
      * Behavioral: Posits that disorders are learned through the principles of classical and operant conditioning.
      * Psychodynamic: Suggests that disorders stem from childhood trauma and unresolved unconscious thoughts.
      * Humanistic: Views illness as a result of low self-esteem, a poor self-concept, and the inability of an individual to be their authentic self.
      * Cognitive: Argues that disorders result from illogical, irrational, and maladaptive thought processes.
      * Evolutionary: Suggests that conditions develop from ineffective reactions to challenges; it posits that certain traits were once beneficial to the survival of ancestors but have become problematic in a modern context.
      * Sociocultural: Emphasizes the significant role of society, social groups, and cultural environments in determining what is considered abnormal behavior.
      * Biological: A medical approach that identifies genetic factors and brain chemistry as the primary causes of disorders.

Integrated Models of Mental Health

• The Biopsychosocial Model: This is an integrated model that combines three distinct areas to allow for a thorough approach to explaining, diagnosing, and treating disorders:
      * Biological Factors: Includes physiology, medications, neurochemistry, and genetics.
      * Psychological Factors: Includes emotions, attitudes, learning, beliefs, and stress management techniques.
      * Social Factors: Includes family dynamics, peer relationships, culture, and socioeconomics.
• The Diathesis-Stress Model: This model explains how disorders develop through the interaction of vulnerabilities and environment:
      * Diathesis: A biological or genetic vulnerability.
      * Stress: Environmental stressors that act upon the individual.
      * Interaction: Some individuals are more likely to develop disorders than others based on the balance of these two factors.
      * Risk Factors: Stressful experiences that serve to trigger psychological issues.
      * Protective Factors: Proactive steps or environmental conditions that decrease the likelihood that a disorder will occur.