Mental Disorder Explained
What is a Mental Disorder?
Whilst ideal health may be considered to be the optimal integrated functioning of many different aspects of the self - physical, mental, social, emotional and spiritual - mental illness is more than the mere diagnosis of a disorder. Mental disorders invariably include an array of symptoms which are often obvious but sometimes quite subtle.
There is no clear distinction between mental and physical disorders. We know that disorders which are predominantly mental in presentation often have a physical dimension, and physical conditions are not isolated from mental components. Even the DSM acknowledges that there is no particular definition of mental disorders which can be useful in all scenarios because there is no particular boundary between mental and physical. Therefore sometimes one definition is more apt than another.
Also, like mental disorder definitions, the definitions of all physical conditions include at least some abstract terminology and again one type of definition may be more suitable in a different situation to others. Mental disorders can be defined through a medical model or through cultural values.
Some of the different ways to define mental disorders include the following:
Deviation from Statistical Norms
If a person's behaviour falls outside the normal range i.e. when it is represented on a normal curve it falls at either extreme, then it is considered a disorder. The problem with this approach is that it does not distinguish between either extreme. Taking intelligence as an example, it would mark those with extremely low IQs as being abnormal, along with those with extremely high IQs. Therefore, positive deviations are not separated from negative ones. Also, not all negative deviations should be considered a disorder. For instance, someone could be antisocial because they are eccentric rather than they have an antisocial personality disorder or some other mental health issue.
Disorder as Dysfunction
Dysfunction is another common way of describing mental disorders. This is where a mental faculty or mechanism is not functioning as it should. Different authors have suggested different ways that dysfunction may be explained. For example, Rosenhan and Seligman (1989) suggested that abnormality was indicated when it was involved in the following:
- Vividness and unconventionality
- Loss of control
- Observer discomfort
- Violation of moral and ideal standards
They argued that the more of these features that are in evidence, the more likely it is that the person’s behaviour would be considered abnormal. However, this approach has also been criticised for relying heavily on subjective assessments and because it does not sufficiently differentiate abnormal behaviour from unconventional, non-conformist or eccentric behaviour. Also, for many mental mechanisms there is a wide range of functioning which could be useful in different situations. For instance, fear is a useful response when threatened but it could be considered maladaptive if it becomes generalised. It follows that we might refer to something as a disorder when it could in fact be an adaptive reaction.
Other definitions focus on whether a psychological condition or behaviour causes and individual distress, whether it is maladaptive or whether it violates social norms. Exceptions can again be found for each of these definitions. Given the difficulties associated with these definitions, the DSM veers towards a broader definition concerning a syndrome:
Mental disorders are a significant cluster of symptoms, behavioural or psychological, which cause the person distress, disability or increased risk of suffering. Distress can be a painful symptom and disability is impairment to at least one area of normal functioning. Suffering can relate to loss of freedom, pain, disability or even death. Furthermore, the syndromal pattern of behaviour should not be a normal cultural response to a particular event like the loss of a loved one. Conflicts between and individual and society and deviant behaviour are not considered to be mental disorders unless these behaviours are considered to be part of dysfunction in the person. The DSM also emphasises that the mental disorder is what is being classified and not the person. So, rather than refer to someone as a schizophrenic it is more appropriate to refer to them as a person with schizophrenia or an individual with schizophrenia.
Influences of Culture
No matter how mental disorder is perceived, culture plays a critical role. If you prefer a biomedical approach to understanding and defining mental disorders then culture may be seen as influencing how disorders affect members of particular cultures. From a culture-based perspective, some disorders may not be regarded as disorders within those particular cultures. In some non-Western cultures spirituality is not segregated from psychology and so mental disorders may be viewed more as a disturbance in spirituality. Often there is a greater sense of community and so relationships are more collective. Rather than consider problems as individualistic they may be more likely to consider them to be due to a breakdown on interpersonal relationships.
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