6.15.2016

Classification of Mental Disorders: Assessing Jim

My wife reading in bed. And it wasn't because ...
My wife reading in bed. And it wasn't because she was trying to get to sleep. (Photo credit: Wikipedia)
By Elizabeth Hall
Introduction
In the field of psychopathology, clinicians and researchers have specific criteria utilized to determine if a person actually has a mental disorder as held by Butcher, Hooley & Mineka (2010).  Generally psychologists refer to six primary elements of behavioral standards to determine the nature and extent of the behavior.  The American Psychological Association publishes a manual for clinicians and researchers that relate to the six elements of behavior and to the Diagnostic and Statistical Manual IV (DSM-IV) for qualifications of a diagnosis of specific disorders.  In this article we will discuss the case of Jim to determine if his behavior warrants a diagnosis, or if he might just be a little bit odd, along with the pros and cons of having classification systems to diagnose and assess mental illness.    
Six Elements of Abnormal Behavior
According to Butcher, Hooley, and Mineka (2010) the six primary elements of behavior used to establish abnormal behavior and mental illness consist of, suffering, maladaptiveness, deviancy, violating what people think of as standard behaviors, irrationality along with unpredictable behavior, and social discomfort.  Having one of these elements present does not in itself constitute a disorder but having several of them does indicate that there presents the likeliness of mental illness.  These standards come from social judgments and what society deems acceptable, so the qualifications change with changing societal values. The DSM-IV outlines specific criteria for diagnosis of psychological illness in their definition of mental disorders that must be met to establish a diagnosis (Butcher, Hooley, and Mineka, 2010). 
These include four factors for consideration, including substantial behavioral patterns considered psychologically abnormal, definite deficiencies causing duress to the client, ensuring that the reaction does not surface due to normal reactions to particular stressors such as loss due to a death, and must show clear dysfunctional behaviors, thought processes and actions.  All of these factors must be present for qualification of mental disorders (Butcher, Hooley, & Mineka, 2010).
Assessment of Jim
Jim, often described as a loner is a 48 year old male who does not have any interest in any kind of relationships with either family members or people he knows.  He spends his free time reading, and on the computer, and really does not care what anyone else thinks of him, although he realizes that he is different from them.  Others notice regularly that Jim often misses social indications and cues, and tends to give his opinion with extremely heartless honesty.  He prefers to live “under the radar” and with the exception of working does not have any interest in social interaction whatsoever. He has managed to keep the same job for fifteen years, always pays his bills on time, and would be considered reliable. 
In relation to the six factors that clinicians consider when assessing abnormal behavior, Jim only really falls into one of these factors, social discomfort as he does make others uncomfortable with his reactions and lack of social behavior skills.  Jim does not feel bothered by his lack of social interaction so he is not suffering, and maladaptive behavior does not apply because these issues do not appear to affect his sense of well-being.  Deviancy does not apply here because being a loner seems to be a personal choice for Jim and neither does violating societal rules because being a loner is neither a crime nor would it fall into societal rules people deem necessary.  If Jim was irrational and unpredictable he would not kept the same job for fifteen years because these behaviors would have had consequences. 
The DSM-IV criteria would also suggest that Jim is just different, as he is not under duress by these issues, he does not have significant dysfunctional behaviors because with the exception of social interaction and missing some social cues, his behavior could register as normal.  There is no indication of abnormal thought, and idea patterns, and does not seem irrational or unpredictable.  It would appear that Jim just does not like or find any satisfaction from other people.  By these standards Jim does not qualify for a diagnosis of a mental disorder. 
Pros and Cons of Classification Systems
The classification system used to classify mental diseases has proven itself a useful tool for those in the field, as we attempt to understand the complex world of mental illness.  The system provides standards of normal and deviant behavior for comparison, allowing for standardized testing, diagnostics, and treatments of specific disorders.  This allows the psychologist to identify the problem areas that people with the disorder display routinely.  It is not without pitfalls, however because there are limitations due to the individualization of the human being.  Not all symptoms, reactions, and treatments, manifest for everyone, and comorbidity can complicate this issue even further (Butcher, Hooley, & Mineka, 2010).
Conclusion
By assessing Jim’s behaviors with the six elements of abnormal behaviors, and the DSM-IV criterion for mental illness we determined that he does not have a mental disorder.  He does not have enough factors in his history or present to indicate that there is any significant hindrance of daily activities.  The classification system utilized by the American Psychological Association does provide important tools for diagnosis, and research applications, however limitations of design leaves room for error based on the judgment of the assessing clinician.  Another thing to consider is that because these standards rely on societal norms, the classification system requires frequent updates, as society becomes more tolerant of people and their differences. 

  




References:
Butcher, J.N., Hooley, J. M., & Mineka, S., (2010).  Abnormal Psychology. 14th Ed, Ch. 1-4, pp. 2-138.  Allyn & Bacon.  Pearson Education Inc.


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