Classifying Psychological Disorders
DSM-5 TR defines a mental disorder as a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. A syndrome, on the other hand, is simply a group of symptoms that usually occur together and are often attributed to a disorder. To understand, identify and treat a disorder, it is imperative to have a well-organized classification of disorders.
Why Do We Need Classification of Psychological Disorders?
Given the basic comorbid nature of psychological disorders, it becomes even more important to classify disorders to identify which disorders exist in an individual and how to treat them. Beyond the basic need for prognosis, diagnosis, and treatment, classification also plays an important role in research and academic communication of psychological disorders. Knowing the significance of the classification of psychological disorders, many academicians, as well as institutions, have tried to classify disorders over a period of time. The two of these classification systems that are most popular today are DSM classification by APA (the latest version of which is DSM-V TR) and ICD classification by WHO (the latest version of which is ICD 10). Before understanding some of the most common classifications that are necessary for understanding psychological disorders, it is imperative to know various models that have been used as a tool to understand psychological disorders. These are discussed in the next section.
Models of Psychological Disorder
Models of psychological disorders are different understandings of abnormality and its causes, symptoms, and treatment. Some of the most popular models are as follows:
- Biological model: This model characterizes psychological disorders as originating from biological causes, usually issues with the brain, and encourages pharmacological treatment for disorders.
- Psychodynamic model: This model originated from the psychodynamic theory of Freud and views imbalance in internal psychological forces of id, ego, and superego as a cause of psychological disorders. Further, it suggests psychodynamic-therapeutic methods of dream analysis, free association, transference, etc., as a means of treatment.
- Behavioral Model: This model considers maladaptive learned behavior as a cause of disorders and suggests behavioral manipulations through behavioral therapies to bring adaptive behavioral change.
- Cognitive Model: This model characterizes maladaptive cognition as a major cause of the psychological disorder and therefore focuses on replacing and modifying these maladaptive cognitions as a way of treatment.
- Humanistic Existential Model: The main concepts of this model are self-actualization, individual responsibility, self-determination, and individual choice, among others. It suggests abnormality as a result of maladaptiveness in these concepts of humanism and existentialism and, therefore, focuses on resolving them through focusing on the individual's ability to resolve them with therapists' assistance.
- Socio-cultural model: This model emphasizes the role of cultural and social underpinnings in causing a psychological disorder; thus, its treatment is also oriented towards cultural and social dimensions.
- Eclectic approach: This approach is the most recent and accepted one and considers all other approaches while creating a holistic understanding treatment of psychological disorders.
While these models may result in the classification of psychological disorders of their own, one of the most common and significant classifications that one should be acquainted with before understanding any other complex classification is based on symptoms and causes, i.e., psychosis and neurosis.
Psychosis vs. Neurosis
The most basic classification of psychological disorders includes the differentiation of psychosis and neurosis. This difference between the two can be conceptualized as follows:
|Mild functional disorders that cause a sense of distress
or deficit in functioning.||Severe mental illness impacts a person's thoughts,
perceptions, and reality.|
|Contact with reality may only be partially lost.||Loss of contact with reality.|
|No effect on personality, hardly any effect on
language, and low self-harm tendencies.||It affects personality and language; self-harm
tendencies are higher.|
|Causal factors could be biological, socio-cultural,
psychological, pedagogical, and economic.||Causal factors could be biochemical, genetic, and
|Treatment involves psychological and pharmacological
approaches, along with support from society.||Treatment involves antipsychotic medicines,
psychological therapies, and social support.|
|Example: Depression, Somatoform disorder,
Obsessive-compulsive disorder, Panic attack, etc.||Example: Schizophrenia, Dissociative identity
disorder, delusional disorder, etc.|
Classifying Disorders Based on Their Similarity
DSM and ICD often use 'similarity of symptoms and causes as a basis of classification. Such a classification may include the following heads:
- Anxiety disorders: The characteristic symptom of anxiety disorder is anxiety itself. Though anxiety is normal, when it becomes maladaptive, starts affecting normal functioning. If it persists longer, it can result in a disorder. Various symptoms of anxiety are heightened heart rate, sweating, restlessness, aches, worry, etc. Some anxiety disorders are generalized anxiety disorder, social anxiety disorder, panic attack, phobia, and separation anxiety disorder.
- Mood disorders: These disorders are characterized by abnormally distorted or inconsistent emotional states that result in maladaptive functioning. Symptoms of a mood disorder may include heightened or low mood, abnormally fast mood swings, and persistence of a negative or positive mood for a longer time period. Some mood disorders are major depression, bipolar disorder, dysthymia, Hypomania, etc.
- Personality disorders: These can be understood as maladaptive patterns of thinking, feeling, and behaving that may deviate from the context (i.e., culture), causes significant distress and is likely not to have any underlying organic or substance use cause. Some of its subtypes are borderline personality disorder, narcissistic personality disorder, paranoid personality, schizoid personality, antisocial personality, dependent personality, etc.
- Eating and substance use disorders: These are related to maladaptive and unhealthy eating patterns that cause distress and dysfunction within an individual. These may either be related to eating styles that are maladaptive or eating substances that are not healthy. Some examples of these disorders are anorexia nervosa, bulimia nervosa, binge eating, and substance abuse disorder.
- Somatoform disorders: These disorders have physical symptoms that lack organic causes like pain without an injury or experiencing a phantom limb. Some examples of these disorders could be conversion disorder, hypochondriasis, pain disorder, and undifferentiated somatoform disorder.
- Neuro-developmental disorders: As per DSM-5, neuro-developmental disorders are "early-onset deficits of variable severity in personal, social, academic, or occupational functioning." These disorders are usually seen early in life, and their causes can be traced back to gene, fetal and neonatal stages. Some examples of these disorders are autism spectrum disorder, learning disability, pervasive developmental disorder, ADHD, and conduct disorder.
- Neurocognitive disorders: These disorders have organic causes and thus are caused either by an injury or malfunction in the nervous system. These result in different kinds of normal physical and psychological dysfunction resulting in distress and dysfunction. Some examples could be prosopagnosia, Alzheimer's, epilepsy, vascular dementia, Parkinson's disease, etc.
- Psychotic disorders: The main symptom of these disorders is psychosis. They are characterized by hallucinations, delusions, disordered thinking and speech, loss of contact with reality, or the formation of a new parallel reality. Some common examples of these disorders are schizophrenia, dissociative identity disorder, delusional disorder, shared psychotic disorder, etc.
Classifying psychological disorders has always been a taxing job, given the interrelatedness of causes and similarity of symptoms that syndromes have. Classifications are usually based on similarities in causes and symptoms of the disorders and sometimes even on the treatment pedagogies used. Nevertheless, the necessity of classification is an undeniable necessity for the field of psychology to prosper in the clinical field and to resolve client issues.