Psychology Chapter 13 – Psychological Disorders: Defining Mental Illness (Pages 420–427)

Field dedicated to the scientific study of mental disorders, covering theory, empirical research, diagnostic practice, and treatment methodology.
Integrates multiple disciplines: biology, neuroscience, sociology, anthropology, philosophy, and clinical practice.
Distinction from general psychology:
- Abnormal psychology focuses on patterns that deviate from statistical, cultural, or functional norms.
- Psychopathology zeroes in on the origin (\etiology) and progression of these disorders.
Significance:
- Provides the conceptual and research foundation for clinical intervention.
- Bridges lab findings (e.g., neurotransmitter studies) with real‐world therapy.

Working definition (per transcript): "Health conditions involving changes in emotion, thinking, or behavior (or any combination) that are associated with distress and/or functional impairment in social, work, or family life."
Two‐part diagnostic threshold:
- Atypicality / Unusual behavior.
- Maladaptiveness – the behavior must cause distress or impair functioning.
Illustrative scenario:
- A person who enjoys being alone (unusual) vs. a person whose social withdrawal prevents employment (maladaptive). Only the latter is clinically relevant.
Ethical angle: Clinicians must balance respect for individual difference with the need to intervene when suffering or impairment is clear.

Approx. 21 % of U.S. adults experienced a diagnosable mental illness in 2020.
- Expressed mathematically: 21\% = \frac{21}{100} = 0.21 of the adult population.
Practical impact: underscores the public‐health scale of mental health care and the need for systemic resources.

Multidimensional framework positing that no single factor fully explains mental illness.
Components & examples (referenced Figure 13.1):
- Biological: genetics, brain chemistry, hormonal influences, physical illness.
- Psychological: cognitive patterns, emotional regulation, personality traits.
- Social: family dynamics, peer relationships, socioeconomic status.
- Cultural: societal norms, stigma, culturally bound syndromes, religious beliefs.
Integrative takeaway: Treatment plans often combine medication (biological), psychotherapy (psychological), family or group interventions (social), and culturally sensitive practices (cultural).
Hypothetical composite case:
- Genetic predisposition + negative self‐talk + workplace bullying + cultural shame → higher depression risk.

Definition: Concurrent diagnosis of two or more psychological disorders in the same individual.
Clinical importance:
- Complicates treatment (e.g., substance use disorder + major depressive disorder).
- Suggests overlapping causal mechanisms (shared genes, environmental stressors).
Research implication: Encourages transdiagnostic approaches rather than isolated “silo” treatments.

Clinicians use structured criteria to determine if behavior qualifies as a disorder.
Criteria capture:
- Symptom count & duration (e.g., minimum 2 weeks of depressed mood).
- Rule‐outs: medical conditions, substance effects, cultural consistency.
Functional assessment: How much the symptoms impair daily living.
Ethical responsibility: Prevent both false positives (over‐pathologizing) and false negatives (missing genuine distress).

Primary classification tool in the United States.
Historical timeline:
- First edition 1952.
- Revised five times, most recent DSM-5 (2013).
Rationale for revisions:
- New scientific evidence (e.g., brain‐imaging, genetic findings).
- Shifts in cultural understanding (e.g., removal of homosexuality as a disorder).
Structure of a DSM entry:
- Diagnostic criteria.
- Associated features.
- Prevalence data.
- Development & course.
- Risk & prognostic factors.
- Differential diagnosis.
Practical upside: Common language among clinicians, researchers, insurers, and patients.

Categorical rigidity: Disorders are listed as discrete boxes rather than spectrums.
Western bias: Cultural syndromes outside the West may be underrepresented or mischaracterized.
Risk of medicalizing normal variation ("diagnostic inflation").
Ongoing debate: Move toward dimensional models (severity scales) vs. current categorical approach.

In many systems, a formal DSM diagnosis is required for insurance reimbursement of therapy.
Double‐edged sword:
- Facilitates access to affordable treatment.
- May incentivize premature labeling or stigmatization.
Ethical consideration: Clinicians must diagnose accurately—not merely to satisfy payers.

DSM encourages evaluating:
- Primary disorder(s).
- Relevant medical conditions (e.g., thyroid disease mimicking depression).
- Psychological & cultural factors (e.g., grief rituals, minority stress).
- Overall functioning—historically via Global Assessment of Functioning (GAF), now often WHODAS.
Holistic goal: Craft a person‐centered treatment plan that respects biological realities, psychological needs, social supports, and cultural identity.