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Complex Relationship Between Mental and Physical Health

 

There is a stigmatizing attitude among society over mental health or psychological disorders.  When individuals fail to conform to the expected societal norm, he or she may be perceived as “insane, mad, lunatic, kooky (Nolen-Hoeksema, 12/2013), etc. causing them to not seek treatment for their self-diagnosed, abnormal behaviors, feelings, or thoughts.  On a personal level, I believe diagnosis is a double-edged sword because one does not want to deal with the stigma associated with mental illness in combination with the persistent symptoms.  I also believe, at times, the individual may be in denial because they have grown or dealt with the illness for so long, it is normal for them and altering a perceived normality could scare the individual.  Another issue with diagnosis is the potential for mis-diagnosis due to the overlap of symptoms into several disorders.  Additionally, people may feel anxiety towards therapy or medication due to cultural values and beliefs.  If an individual seeks help and receives a diagnosis, others may perceive them differently and begin to alter their treatment and reactions toward the individual in either a positive or negative manner, both of which could hinder treatment.

Three approaches to developing a diagnostic scheme include categorical, dimensional, and prototypical approaches.  The categorical approach, as found in the DSM, classifies symptoms biologically and medically into categories with one set of causative factors that do not overlap, creating a single category that each individual in the category should meet (Kreuger, Watson, & Barlow, 2005).  Due to only having to suffice a single subset of criteria for an individual to identify under a single category creates heterogeneity among the disorder and treatment (Kreuger, Watson, & Barlow, 2005).  Thus creating difficulties in treatment as no two people may identify mutually.  I believe the categorical approach would maintain stigma as the disorder is a generalization of a major category rather than a specific detriment.

The dimensional approach classifies disordered thought, affect, and behavior as multiple dimensions (Kreuger, Watson, & Barlow, 2005).  The dimensional approach measures the degree to which behaviors persist indicating variances of symptoms versus normative behavior reducing the possibility of comorbid disorders (Hudziak, Achenbach, Althoff, & Spine, 2007).  However, inconsistencies cause a void in the use of the yes or no treatment and diagnosis process and testing may have higher costs than traditional categorical diagnostic measures.  I think the dimensional approach may increase stigma as the degree of the behavior is scrutinized leaving the individual open for judgment on how “bad” off they appear.

The prototypical approach conceptualizes psychopathology into categories within the DSM (Kreuger, Watson, & Barlow, 2005).  This approach allows for a high heterogeneity within categories as individuals must only meet a certain number of symptoms to fall within a category and therefore, may qualify under more than one as several disorders share similar symptoms (Kreuger, Watson, & Barlow, 2005).  Prototypical approach opens the door for mis-diagnosis and co-existing disorders rather than a single unified diagnosis as the symptoms may be versatile among categories.  Treatment could turn into an unnecessary trial and error basis.   I think the prototypical approach may increase stigma as the diagnosis seems to be open to more error than the other approaches.  This allows for the individual to feel as if they may be untreatable.

References:

Hudziak, J. J., Achenbach, T. M., Althoff, R. R., & Spine, D.  S. (2007).  A dimensional approach to developmental psychopathology.  International Journal of Methods in Psychiatric Research 16(S1):  S16-S23.  http://doi.org/10.1002/mpr.217

Krueger, R. F., Watson, D., & Barlow, D. H. (2005). Introduction to the Special Section: Toward a Dimensionally Based Taxonomy of Psychopathology.  Journal of Abnormal Psychology114(4), 491–493. http://doi.org/10.1037/0021-843X.114.4.491

Nolen-Hoeksema, Susan.  (12/2013).  Abnormal Psychology, 6th Edition. [VitalSource Bookshelf Online].  Retrieved from https://digitalbookshelf.argosy.edu/#/books/1259316335/

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