By Catherine A. Sanderson, Amherst College
People with a psychological disorder show a more definite pattern of behaviors, thoughts, or emotions that are considered pathological, which means diseased or disordered. Pathology is based on one or more of three reasons: deviance, dysfunction, or distress.
Pathological Reasons
The term deviance refers to behaviors, thoughts, or emotions that deviate from a society or culture’s norms, values, and laws. For instance, adults who are sexually attracted to children are diagnosed as having a psychological disorder known as pedophilia.
Next, the term dysfunction refers to behaviors, thoughts, or emotions that interfere with daily functioning. Someone who has a major depressive disorder or clinical depression is unable to participate really in any way in their regular life.
They may have trouble focusing on work, spending time with friends, or even taking care of themselves—showering, eating, sleeping, etc.
Finally, the term distress refers to experiencing negative feelings, such as anxiety, loneliness, or confusion.
Someone who has a social anxiety disorder has a tremendous fear of being judged by others and therefore feels terrified at the thought of interacting with people at parties, at school, at a work event, and so on.
This distress can lead to severe disruptions in their personal and professional lives: they won’t attend parties or family events with their spouse, they are unwilling to make presentations at work, and so on.
Challenges in Identifying Disorders
There is an inherent challenge in determining whether someone has a psychological disorder because people don’t fall neatly into categories—people with a disorder, and people without. Instead, many people fall on some type of a continuum with mental health on one end and mental illness on the other.
For example, the rate of ADHD diagnosis was significantly higher among children born close to the cutoff dates for initial school entry than among their older peers. This finding from 2018 suggests that younger children, who may have more difficulty paying attention, simply due to their age, may be more likely to have this age-related lag labeled a disorder.
Dichotomy in Eating Disorders
Here’s a classic example of the challenge of determining when certain thoughts and behaviors meet the diagnostic criteria for a psychological disorder. Many people in Western cultures, especially girls and women, have some symptoms of disordered eating. They may focus intently on what they weigh, the shape and size of their bodies, and the fat, and calories in the food they eat. They may skip or restrict certain food groups completely (no carbs) or adopt weird eating rituals (going on a cleanse).
But these habits are frankly pretty common among many people, and none of these on its own meets the diagnostic criteria of an eating disorder, such as anorexia nervosa or bulimia nervosa.
This article comes directly from content in the video series Introduction to Psychology. Watch it now, on Wondrium.
Criteria Specified by the American Psychiatric Association
Apart from the criteria and challenges common to all disorders, there is a specific diagnosis based on more specific criteria.
In the United States, there is a manual created by the American Psychiatric Association called the Diagnostic and Statistical Manual of Mental Disorders (DSM). First issued in 1952, this manual received major revisions in 1968, 1980, 1994, and 2013.
The Diagnostic and Statistical Manual of Mental Disorders (DSM)
The DSM from 2013 describes symptoms for around 400 different psychological disorders, which are grouped into 22 different categories. These are sometimes classified even more broadly, into five groups:
- Neurodevelopmental: describing brain disorders that begin at birth or from early in life
- Neurocognitive disorders: affect the brain later in life, including traumatic brain injury and Alzheimer’s
- Internalizing disorders: such as anxiety or depression
- Externalizing disorders: like the manic phase of bipolar
- A miscellaneous group of other disorders: including those involving sleep, eating, and addiction
The DSM also describes other aspects of each disorder, including the typical age at which symptoms start occurring, which gender is more affected, how common treatment approaches and how effective they are.
Discrepancy between Symptoms and Having a Disorder
There is a discrepancy between showing symptoms of disordered eating and actually having an eating disorder. To get a clinical diagnosis of anorexia nervosa, a person must show three distinct symptoms:
- A deficient body weight, meaning below what is expected for their age and height
- An intense fear of gaining weight or behavior that makes it very difficult to gain weight, such as eating very small amounts of food or exercising for several hours a day
- A disturbance in how they see their body’s shape or size, such as a lack of recognition of their low weight.
All of these symptoms must exist together for a person to reach the diagnostic criteria for anorexia. So, a person who is very thin but recognizes they are thin and tries to gain weight doesn’t have anorexia. Neither does a person who is afraid of becoming fat and counting calories, but who isn’t actually very thin.
So even though there are pathological factors, behavioral patterns, and specified criteria associated with psychological disorders, they are not exempted from disagreement and disparity.
Common Questions about Psychological Disorders and their Pathological Reasons
Psychological disorders show a definite pattern of behaviors, thoughts, or emotions that are considered pathological, which means diseased or disordered. Pathological reasons are based on one or more of three: deviance, dysfunction, or distress.
There is an inherent challenge in determining whether someone has a psychological disorder because people don’t fall neatly into categories—people with a disorder, and people without. Instead, many people fall on some type of a continuum with mental health on one end and mental illness on the other.
The DSM is a manual on psychological disorders created by the American Psychiatric Association. First issued in 1952, this manual received major revisions in 1968, 1980, 1994, and 2013.
