Mental Health Disorders and the DSM Overview

Overview of Mental Health Disorders

• The course previously known as "abnormal psychology" is now referred to as "psychiatric disorders."
• All individuals in the class may qualify for at least one mental health disorder, challenging the label of "abnormal."

Defining a Disorder

• Disorder Characteristics:

  • Distress: Does the behavior cause distress to the individual or their loved ones?
  • Dysfunction: Is the individual able to function normally in day-to-day life?
  • Deviance: Is the behavior culturally deviant or socially unacceptable?

• Examples:

  • Alcoholism may not seem distressful for the user, but it affects family and friends.
  • Age can play a role in what is considered deviant behavior (e.g., running naked in a library could be normal in certain cultures or contexts).

Diagnostic and Statistical Manual of Mental Disorders (DSM)

• The DSM outlines recognized mental disorders and their criteria for diagnosis, changing over time based on cultural shifts.
  • First Edition (1952): Listed 102 disorders.
  • Changes in Subsequent Editions:
  • DSM II (1968): Included controversial views such as classifying homosexuality as a disorder.
  • DSM III (1980): Introduced a multi-axial assessment system, which has since been discarded.
  • DSM V (2013): Contained about 300 disorders but was criticized for consolidating autism spectrum disorders and changing substance use disorder definitions.

Multi-Axial Assessment (Historical Context)

• Axis I: Clinical disorders (e.g., depression, anxiety).
• Axis II: Personality disorders and mental retardation (permanent conditions).
• Axis III: Physical health problems potentially impacting mental health.
• Axis IV: Psychosocial and environmental problems.
• Axis V: Global Assessment of Functioning (GAF), scored 1-100 to assess overall functioning (no longer utilized in DSM V).

Cultural Variations in Disorder Definitions

• Disorders viewed differently based on cultural contexts; e.g., eating disorders common in the U.S. but rare in underdeveloped countries due to availability of food.
• Specific cultural syndromes (e.g., coro and DHAT in India) illustrate how behaviors viewed as problematic in one culture may not apply to others.

Historical Perspectives and Reforms

• Nellie Bly's Expose (1887): Highlighted the inhumane conditions in mental asylums, advocating for widespread reform.
• David Rosenhan's Study (1973): Revealed difficulties in diagnosing mental health conditions and questioned the methodology surrounding mental health diagnoses.
  • Fake patients admitted to psychiatric hospitals and struggled to be released, demonstrating systemic issues.

Importance of Diagnosis in Mental Health

• Diagnostic labels can provide clarity but also risk stigmatization and mischaracterization of individuals based on cultural or social norms.
• The variability of diagnoses and their implications for treatment and insurance coverage highlight the complexities involved in mental health care.

Summary Points for Exam Preparation

• Key Questions to Reflect On:
  • What constitutes a mental health disorder?
  • How do distress, dysfunction, and deviance interplay in diagnoses?
  • What are the implications of evolving definitions of mental disorders?
• Rosenhan's Experiments: Demonstrated the inadequacies in psychiatric diagnostics, raising questions about our understanding and classification of mental health issues.