Diagnostic classification and controversy in abnormal psychology treatment

¶ … 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.

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)

Another form of validity is predictive validity, or ability to predict the course the disorder is likely to follow or its response to treatment. There are some evidences that support the reliability of DSM system in many categories including some anxiety and mood disorders and alcohol and drug dependence disorders. Yet questions about validity persist for some diagnostic classes, such as Axis II personality disorders, as well as Axis V, Global Assessment of Functioning. One can say that the functioning of DSM classification remains highly controversial and it needs a lot of research, debates and arguments. (Nevid; Rathus; Greene, 2005)

Furthermore, the DSM system is not very concerned with cultural and ethnic diversity. Some behaviors that may be considered as normal in America can be termed as abnormal in India and vice versa. One of the major advantages of DSM system is its designation of specific diagnostic criteria. The DSM permits the clinician to readily match a client's complaints and associated features with specific standards to see which diagnosis best fits the case. This allows therapists to properly prescribe medicines that may provide positive effects. (Nevid; Rathus; Greene, 2005)

Illustrate treatments of psychological disorders (abnormal behavior / mood disorders)

Major treatments available for "abnormal behavior are drug therapy which is psychopharmacology that includes anxiolytics, antidepressants, tricylics, selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, mood stabilizers and antipsychotic agents. Other treatments are 'Electroconvulsive Therapy -- ECT' and 'Light Therapy'." (Sparks notes, 2009) Apart from that, alternative therapies like stress reduction methods, meditation etc. are also popular.

Assess treatments of psychological disorders (abnormal behavior / mood disorders)

Psychopharmacology may prove to be effective; it may cause dangerous side effects too. Often people become addictive to the medical treatments and the effectiveness of medicines starts declining. ECT, and light therapy along with mental relief and stress reduction exercises, meditation etc. are better ways for treatment as per my views.

Demonstrate the ability to evaluate and incorporate emerging relevant technologies applicable to the field of abnormal psychology (abnormal behavior / mood disorders)

As a result of highly expensive researches going on in the field of abnormal behavior under the pressure of political and corporate groups, (Widiger; Sankis, 2001) some of very amazing technologies are emerging in the market. It is really difficult to assess and evaluate the ability of these technologies in the field of abnormal psychology unless a proper definition of abnormal behavior is established.

Analyze and evaluate information critically and effectively (abnormal behavior / mood disorders)

Abnormal behavior or mood disorder is very confusing issue that includes a lot of conspiring information. (Widiger; Sankis, 2001)

Demonstrate ethical behavior in regard to information and information technology (abnormal behavior / mood disorders)

Ethically, governments and authorities should let the individuals decide for what treatment they want to get help against which of their personal behavior. Trying to establish a definition of abnormal behavior will tend a complete brainwash of citizens. IT should explore more about the ways in which the governmental authorities may try to control and restrict individual thinking process.