diff --git a/18-Interview-DSM.Rmd b/18-Interview-DSM.Rmd index d99a3837f..a5fd330ad 100644 --- a/18-Interview-DSM.Rmd +++ b/18-Interview-DSM.Rmd @@ -205,13 +205,16 @@ However, there are also key concerns with the DSM and ICD.\index{Diagnostic and One potential concern with the DSM and ICD is stigmatization.\index{Diagnostic and Statistical Manual of Mental Disorders}\index{International Classification of Diseases}\index{Diagnostic and Statistical Manual of Mental Disorders!concerns}\index{stigmatization} The goal of the DSM/ICD is not to label people.\index{Diagnostic and Statistical Manual of Mental Disorders}\index{International Classification of Diseases}\index{Diagnostic and Statistical Manual of Mental Disorders!concerns} Labeling people can be an unfortunate consequence, however, and it can be stigmatizing because mental disorders often carry a stigma.\index{Diagnostic and Statistical Manual of Mental Disorders}\index{International Classification of Diseases}\index{Diagnostic and Statistical Manual of Mental Disorders!concerns}\index{stigmatization} -A second concern is that we may be pathologizing normality.\index{Diagnostic and Statistical Manual of Mental Disorders}\index{International Classification of Diseases}\index{Diagnostic and Statistical Manual of Mental Disorders!concerns} +A second concern is that providing a label to a client may lead the client to see their difficulties as stable and unchangeable; they may mistakenly interpret the label as something that they "have" (rather than as description of what they "do"), a misconception which is clarified later in this section.\index{Diagnostic and Statistical Manual of Mental Disorders}\index{International Classification of Diseases}\index{Diagnostic and Statistical Manual of Mental Disorders!concerns} +For instance, @Ahuvia2024 found that college students who self-labeled themselves as having depression had less perceived control over depression and experienced more catastrophizing, even after controlling for depression symptom severity.\index{Diagnostic and Statistical Manual of Mental Disorders}\index{International Classification of Diseases}\index{Diagnostic and Statistical Manual of Mental Disorders!concerns} +Another concern of the DSM and ICD that they may be pathologizing normality.\index{Diagnostic and Statistical Manual of Mental Disorders}\index{International Classification of Diseases}\index{Diagnostic and Statistical Manual of Mental Disorders!concerns} Mental disorders are not infrequent.\index{Diagnostic and Statistical Manual of Mental Disorders}\index{International Classification of Diseases}\index{Diagnostic and Statistical Manual of Mental Disorders!concerns} Estimates of lifetime prevalence of mental disorders are around 75% [@Schaefer2017].\index{Diagnostic and Statistical Manual of Mental Disorders}\index{International Classification of Diseases}\index{Diagnostic and Statistical Manual of Mental Disorders!concerns} That is, three out of four people will experience a mental disorder at some point in their life.\index{Diagnostic and Statistical Manual of Mental Disorders}\index{International Classification of Diseases}\index{Diagnostic and Statistical Manual of Mental Disorders!concerns} Thus, abnormality as defined by the DSM and ICD are *normal*.\index{Diagnostic and Statistical Manual of Mental Disorders}\index{International Classification of Diseases}\index{Diagnostic and Statistical Manual of Mental Disorders!concerns} Another concern with the DSM and ICD is that they medicalize and pathologize problems in living as mental illnesses, and they obscure the role of environmental factors such as poverty [@Gambrill2014].\index{Diagnostic and Statistical Manual of Mental Disorders}\index{International Classification of Diseases}\index{Diagnostic and Statistical Manual of Mental Disorders!concerns} -Moreover, diagnoses specified in the DSM and ICD ignore causes and etiology—they do not provide explanations for behavior [@Fried2022]. +Moreover, diagnoses specified in the DSM and ICD ignore causes and etiology—they do not provide explanations for behavior [@Fried2022].\index{Diagnostic and Statistical Manual of Mental Disorders}\index{International Classification of Diseases}\index{Diagnostic and Statistical Manual of Mental Disorders!concerns} +It [would thus be incorrect (and tautological) to say that someone engages in a particular behavior because they have ADHD](https://www.psychologytoday.com/us/blog/psychologically-minded/201907/a-psychiatric-diagnosis-is-not-a-disease) (or insert whatever diagnosis; archived at https://perma.cc/5972-PUQD).\index{Diagnostic and Statistical Manual of Mental Disorders}\index{International Classification of Diseases}\index{Diagnostic and Statistical Manual of Mental Disorders!concerns} Ideally, a diagnostic system should have [validity](#validity) and [utility](#treatmentUtility).\index{diagnostic system!validity}\index{validity!utility}\index{diagnostic system!utility} For instance, the diagnoses in a diagnostic system should have [construct validity](#constructValidity).\index{diagnostic system!validity}\index{validity!construct}\index{validity!diagnostic}