Psychology of
Dysfunctional
Behavior
David Valdez
The Myth of Mental Illness
Does the concept of mental illness even make sense?
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Thomas Szasz (1960) claimed it does not. For him (and subsequent writers,
eg: Sarbin & Mancuso, 1980; Scheff, 1966), mental illness is a myth. There is
no such thing.
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The things that psychotherapists treat people for are not illnesses, but simply
individual traits or behaviors that society deems unacceptable-- immoral,
deviant, etc.
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Szasz believes labeling such people as ill harms them - they come to accept
the label, and they are treated accordingly. We are telling people that they must
act in ways seen as normal by the psychiatric profession, rather that attacking
the social factors that don't allow these people to use their own unique abilities,
traits, etc.
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Goffman: stigma
Defining a Disorder
What do I call it?
• Abnormal Psych. Vs. Dysfunctional Psych Vs. Mental Disorder
Criteria
• Deviation from statistical norms; the word abnormal means 'away from
the norm'
• Deviation from social norms; every culture has certain standards for
acceptable behavior
• Maladaptiveness of behavior; this third criteria is how the behavior
affects the well-being of the individual and/or social group.
• Personal distress; the fourth criteria considers abnormality in terms of
the individual's subjective feelings, personal distress, rather than his
behavior.
Diagnosis of Mental Illness
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The World Health Organization’s International Classification of
Diseases (ICD) is the official classification for mortality and
morbidity statistics for all signatories to the U.N. Used in US by
the Health Care Financing Administration.
The DSM IV-TR, the classificatory systems used in the US,
assumes mental disorders fall into a number of distinct categories
such as anxiety, psychosis, mood disturbance, and cognitive
deficits. These categories are broad, heterogeneous, and
somewhat overlapping.
The DSM organizes mental disorders into 16 major diagnostic classes. For each
disorder within a diagnostic class, the DSM enumerates specific criteria for
making the diagnosis. DSM-IV also lists diagnostic “subtypes” for some
disorders. A subtype is a subgroup within a diagnosis that confers greater
specificity. The DSM is descriptive in its listing of symptoms and does not take a
position about underlying causation.
Disorders usually first diagnosed in infancy, childhood, or
adolescence
Delerium, dementia, and amnestic and other cognitive disorders
Mental disorders due to a general medical condition
Substance-related disorders
Schizophrenia and other psychotic disorders
Mood disorders
Anxiety disorders
Somatoform disorders
Factitious disorders
Dissociative disorders
Sexual and gender identity disorders
Eating disorders
Sleep disorders
Impulse-control disorders
Adjustment disorders
Personality disorders
The DSM-IV TR
It examines the disorder by considering
five axes:
• clinical syndromes
• personality disorders
• general medical conditions
• psychosocial and environmental
problems
• global functioning.
Assumptions of the Medical Model
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Assumption of "illness" as distinct
category
Assumption of perfectibility in
humans (some ideal state of health)
Assumption of all people as aspiring
to same "ideal"
Assumption of "patient" as object
Search for efficient "quick fix"
therapies (Cure vs. Treatment)
Neglects important issues of
personal responsibility & cultural
influences
Limitations of the Medical Model
• The medical model: abnormal behavior reflects a disease
• Some critics claim the DSM is a way to enforce societies norms
• Social stigma associated with being labeled mentally ill (Goffman)
• We know of no exclusive organic basis for many of these disorders
• A DX suggests that people can not control their behavior
• Diagnoses are not always based on consistently reliable research.
• Diagnosis rests on clinician judgment about whether clients’
symptom patterns and impairments of functioning meet diagnostic
criteria.
Limitations cont’d.
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Cultural differences in emotional expression and social
behavior can be misinterpreted as “impaired” if clinicians are
not sensitive to the cultural context and meaning of
exhibited symptoms.
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Some everyday problems are considered disorders
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System may be biased against women & minorities. Some
critics point to a bias in diagnosing mental disorders in
children, older persons, and racial and ethnic minority
groups.
Strengths of the Medical Model
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Helps us research the causes of disorders
Allows professionals to communicate
Allows for appropriate treatments
Diagnosis is essential in all areas of health for shaping
treatment and supportive care, establishing a
prognosis, and preventing related disability
• Diagnosis serves as shorthand to enhance
reimbursement and surveillance in order to track the
regional trends/prevalence.
Jeopardizing Patient Rights
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Institutionalized clients have their privacy marginalized by the invasion
of clinicians and interested family members.
At what point does sincere care become an intrusion? At what point are
patient civil rights to privacy and confidentiality compromised for the
sake of psychiatric care?
HIPAA Privacy Act
Webquest activity
References
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Myers, D. (2004). Psychology. Worth Publishers. Holland, MI.
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Glassman, W. Approaches to Psychology. Open University Press.
Berkshire, England.
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Travis, C. (2001). Psychology in Perspective. Prentice-Hall. Upper
Saddle River, NJ.