Diagnose or Not to Diagnose

¶ … Diagnose or Not to Diagnose

Differentiate among the various types of mental illness described in case examples

People suffering with mental illness experience limitations in their cognitive and behavior skills along with emotional and behavioral disorders. These disorders limit their ability to learn new skills. Some of the common conditions that are considered as mental illnesses are "Anxiety Disorder, Mood Disorders, Psychotic Disorders, Eating Disorders, Impulse control and addiction disorders, Personality disorders, Adjustment disorder, Dissociative disorder, Factitious disorder, Sexual and gender disorder, Somatoform disorder, Tic disorder, Depression and Suicide ideation. Some other problems that may be faced by mental illnesses are post-traumatic stress disorder, dementia, and high rates of urinary incontinence, immobility in elderly people, aggression, withdrawal or antisocial behavior, inappropriate behaviors, socio-pathic characteristics, suicidal or runaway behaviors and pica." (Chan, Colin, 2002).

A wide range of treatments for people suffering with the aforementioned and similar problems are available that include "in-patient treatment models, acute in-patient treatment model, family involvement in residential treatment" (Baker, Blacher, & Pfeiffer, 1993), 'community-based models' (Davidson, Cain, Sloane-Reeves, Giesow, Quijano, Van Heyningen & Sholam, 1995) or an 'inter-agency collaborative approach' (Chan, Colin, 2002).

Articulate the controversies in abnormal psychology (which is abnormal behavior / mood disorders)

The major controversy of abnormal psychology is the fact that there is no established definition of the construct of mental disorder. It is very hard to distinguish a mental disorder or abnormal behavior in general. "For example, the normality of a depressive response to the loss of a loved one might not be a matter of its rationality, commonality, understandability, or even symptom severity. If the reaction is maladaptive and it is not within adequate control of the person, then perhaps it should be classified as a mental disorder." (Widiger; Sankis, 2001) Many a time even seemingly very normal behavior in cases of bereavement may indicate "irrational cognitive schema or a neuro-chemical dysregulation." (Widiger; Sankis, 2001)

As per a research study conducted by Regier et al. It has been suggested that "in the current U.S. climate of determining the medical necessity for care in managed health care plans, it is doubtful that 28% or 29% of the population would be judged to need mental health treatment in a year. Hence additional impairment and other criteria should be developed." (Regier et al., 1998) Yet, government, insurance companies and medical authorities fail to provide adequate funds for research and treatment of mental disorders and this is a significant social and clinical problem. On the other hand, many specialists also mention that there has been a lot of over-diagnosis for mental illnesses which is not required. Some claims that the expansion of diagnosis researches over mental illnesses is more political than scientific. (Rogler 1997)

Indicate whether you would prefer your therapist to diagnose and classify your problem before engaging in therapy with you or to forego the diagnostic process to begin therapy with you, without any diagnostic impressions

Diagnostic process can prove to be very important in any case of physical illness. Without proper diagnostic process, it would be very difficult for doctors to provide right sort of prescriptions. Many a times, the symptoms of an illness may not be so clear and hence the importance of proper diagnostic increases especially when one can attain perfect diagnostic results in physical illness cases. Yet in mental illness case, one may feel uneasy to trust with the results and consequences of diagnostic or dual diagnostic tests. The issue of scientific diagnosis in case of mental illness is too much controversial. Many a times, it becomes evident that so much stress on the issue of mental illness is just because of political motives and government or corporate controlled research institutes keep over-lamenting these issues with political motives to control individual liberty and thinking or behavioral process. (Widiger; Sankis, 2001)

One should also realize that every individual has a right to follow his personal traits, his behavior. If government or corporate controlled research institutes, doctors, psychologists and authorities will indulge in declaring what is normal and what abnormal is, then the right of individual liberty will definitely be reduced to an issue of mental illness. Furthermore, it is very difficult to accept the validity of many of these diagnostic processes. The most important issue is how to define normal and the abnormal. There is no natural line of difference. Some behavioral actions that are being considered as normal right now may prove to be abysmal and abnormal after some researches. (Widiger; Sankis, 2001)

One cannot put up his personal attitude and behavior to be checked and assessed by someone else and if someone has a particularly unique or different behavior in certain circumstances, then he or she has a right to enjoy that behavior unless it is not becoming a problem for him/herself. Also, his or her personal behavior may not cause exploitation of individual rights of others too. Thus, if I feel that I am suffering with a particular emotional or mental behavior that is causing problem to me and I am willing to change it, I won't consider that a diagnosis is necessary. If I want to get rid of a particular mental or emotional behavior in my personality, it is my right to take proper therapy -- regular or alternative like meditation, yoga etc. To get rid of that particular behavior.

Talk about the pros and cons of each from your personal perspective and defend your preference

A person looking for others including therapists, advice about the issues related with his or her personal behavior accepts that he is not the right person to check his own individual behavior. There is nothing wrong in it. He simply has a right to choose others to decide for himself. It is very difficult to suggest the pros or cons of letting other to assess and decide your behavior. Mencken mentioned in his book 'Notes on Democracy', mentioned that: "Men differ inside their heads as they differ outside. There are men who are naturally intelligent and can learn, and there are men who are naturally stupid and cannot." (Mencken, 2008)

There can be some positive effects of psychological diagnosis too, certain diagnosis may help in the healing process. The proper labeling and categorizing of different so-called psychopathological disorders let people to seek proper treatment and aid. With the advancement of variety of drugs, a psychologist may help them in better ways. Yet, most of the times, such psychological diagnosis themselves start pushing the client in a depressive zone. He starts feeling that he is ill, abnormal, unaccepted, that his personal behavior is wrong and unsocial. It certainly is a kind of exploitation of individual by the society and the state -- government or rulers who control the medical authorities. Furthermore, it is very difficult to believe the intentions behind these psychological diagnoses. (Widiger; Sankis, 2001)

The state governments throughout the world also support the system to control the individual by keeping the medical facilities in the governmental hands. Seldom people try to get rid of the government supported medical authorities such as FDA. Some of these authorities and the supported doctors may work for the benefits of the patients, but mostly these government supported doctors and authorities works for protecting the medical profession. (The Economist, 1995)

On the basis of aforementioned rational, I will suggest that although one has a right to opt for psychological diagnosis for his behavior, I won't have opted for one. If I am feeling some problem with any of my behavioral activity and I want to get rid of it, I don't need to ask others whether it is a right decision. Also, I cannot allow others to tell me that any of my personal traits is abnormal and I should change. Even an effort to establish the definition of what is normal or what abnormal is direct attack on individual liberty, a definite and ill-framed governmental endeavor to control the citizens and rule over their mentality.

Articulate the controversies in abnormal psychology (abnormal behavior / mood disorders)

Although the question has already been answered, it needs a little more discussion. If a person or a child is considered as a person suffering from mental illness, and he is forced to have a diagnosis to put him in a certain category, it will create a negative shift in his mentality. Once you put a person in a pre-defined group, he will start associating himself with that group, without trying to explore his own potential. Such consequences can be found in the cases of children that have been categorized as patient of ADD or ADHD. Often such students enjoy their illness as an excuse of their bad performance or bad behavior. They start enjoying silliness and inability. The situation becomes extremely negative when such children start thinking that they simply cannot pay attention, they cannot learn anything, the parents starts demanding sympathy for their children and teachers starts providing them. Nobody in such situation tries to provide a way for such children to learn and to try to stand on their own.

Discuss the criteria used to define abnormality (abnormal behavior / mood disorders)

There are no established criteria to define what is abnormal. On the other hand, every individual trait can be said as abnormal on some social plane. (Oracle think quest, 2010) Some of the preferred ideas to define abnormality are as given below:

Statistical Norms Deviation: Certain population facts such as height, weight and intelligence are measured and recorded. Most of people come in the middle range of intelligence. Those who fail in general terms and falls below the so-called intelligence scale are termed as abnormal. But then, the people with extra intelligence also become abnormal. Furthermore, intelligence is a subjective issue. (Oracle think quest, 2010)

Social Norms Deviation: People going again social norms and trying to make their idiosyncratic identity are also termed as abnormal. Galileo was abnormal and he was brutally punished for his abnormality, he suggested that earth revolves round the sun which was abnormal as per biblical standards. (Oracle think quest, 2010)

Behavior Maladaptiveness: This is a better criterion to consider what is normal and what is abnormal. The criterion involves the issue of how the behavior affects the well-being of the individual and/or social group. Yet, the issue is in case, an individual's particular behavior starts exploiting the freedom of others, it should be termed illegal or criminal rather than abnormal illness. Mentioning such criminal activities as some mental illness means that the authorities and government are failing to protect the individual liberty of citizens and trying to protect the criminals by terming them mentally sick and offering them treatment and clemency. (Oracle think quest, 2010)

Personal Forms of Distress: This is by far the best criterion to define abnormal behavior. This criterion involves a study of personal problems. "The individual's subjective feelings and personal distresses are considered as abnormal." (Oracle think quest, 2010) "Most people diagnosed as 'mentally ill' feel miserable, anxious, depressed and may suffer from insomnia." (Oracle think quest, 2010) Yet the issue is, if a person is actually suffering such problems, then he simply doesn't need to go through the wastage of psychopathological diagnosis. He should be free to search proper treatment; the treatment can be clinical or alternative like meditation, natural relief and stress reduction processes, ayurveda, yoga, exercises etc. (Oracle think quest, 2010)

Summarize legal and ethical issues related to abnormal psychology (abnormal behavior / mood disorders)

All the legal and ethical issues related with abnormal psychology relates to the issue of individual liberty and the state's actions against individual liberty.

Evaluate classification system of abnormal behavior / mood disorders

The abnormal behavior patterns are classified according to the previously discussed abnormal criteria. The DSM system was introduced in 1952. The abnormal behavior are classified as mental disorders involving mental/emotional distress, significantly impaired functioning, or behavior that places people at risk for personal suffering, pain, disability, or death such as repeated usage of harmful drugs, suicidal attempts, etc. (Nevid; Rathus; Greene, 2005)

Discuss which classifications (in abnormal behavior / mood disorders) would be the most difficult to be diagnosed and why?

The DSM system is the most difficult to be assessed and used to diagnosis abnormal behavior. A diagnosis can be termed as useful only if it demonstrates validity and reliability. DSM system can be considered as reliable and valid only if different evaluators using the system are likely to arrive at the same diagnoses when they evaluate the same cases. The system may be considered valid if diagnostic judgments correspond with observed behavior. For example, people diagnosed with social phobia should show abnormal levels of anxiety in social situations. (Nevid; Rathus; Greene, 2005)