Critical Review: Approaches to Understanding and Classifying Mental Disorder
The Diagnostic and Statistical Manual (DSM-5) of mental disorders is not a valid tool for classifying psychiatric disorders with respect to the scale’s etiology. There is a contentious issue on the possibility of finding a predominant cause of mental disorders due to the existence of many theories. The etiological factors suggest that mental disorders are impacted by various factors, such as neurons and neighborhoods. However, there is no definite level of analysis that has shown causa dominance over the other. This paper discusses DSM concerning various thresholds that give comprehensive results that can ascertain substantial influence on the tool’s success.
The essay explains the need to revise DSM-5 concerning the classification and diagnostic system. As per Clark et al. (2017), DSM-5 is a tool that involves the incorporation of psycho-pathological, epidemiological, and cultural developments that can be useful to give definite results. However, the specificity of DSM procedural diagnosis has barred progress in searching for underlying metrics. Additionally, the paper supports the authors’ opinion about the tool in that the clinical realities were not covered fully by the patients after gaining experience with the physicians. Thus, due to notable changes in DSM-5, many evidence-based developments were discovered and probed developers to improve the process of the diagnostic system.
Critical Review of DSM Tool by Using Relevant Literature and Evidence-Based Concepts
The use of the DSM-5 as a tool for classifying psychiatric disorders has caused etiological issues. To begin, Clark et al. (2017) argue that the considerations introduced later after the initial structure of the tool had risked the prognostic factors, gender, and the environment. The authors have given a logical elaboration about the impact on disorder severity that can be used to show traumatic events. For example, the inability of a person to perform funerary rites after a certain massacre may be different across cultural subsets. That means that the tool may have a discrepancy in the results that a scientist may bring along the presentation (Clark et al., 2017). Thus, the structural design of DSM-5 limits the probability of getting tallying results, lowering utility in terms of patient diagnosis.
From the level of expertise concerning the biological and environmental factors, it becomes difficult to undertake necessary indications that regard the root cause of a given disease. Unlike the International Classification of Diseases (ICD-11), which aims to develop comprehensive literary information about various mental developments, DSM-5 has not been including a concrete theoretical model that can be used to show the interconnection between the thresholds. Therefore, due to the above factor, there is a need to revise the DSM-5 to accurately determine the causal effects of mental disorders in clinical approaches.
Many other researchers have criticized the tool for its diagnostic criteria. For example, Deacon (2013) argues that expanding the procedural discovery of causes of mental disorders may lead to a high number of ‘mentally ill’ persons and make the behavior seem normal. In this case, there might be millions of people who will be exposed to clinical interventions that cause more harm than recovery. There is another criticism by Johnstone (2017). DSM-5 is not favorable for psychiatric discoveries due to the decreasing manner it has on thresholds that exist for given criteria. For example, personality disorders have been affected by a radical overhaul that shows the tool’s concept has sudden and unexpected aspects hence, chances of framing different views when it comes to the prescriptive requirements for people with specific disorders. It is important to mention that during DSM criteria, disorders may be assumed to be personal in that they give the wrong perception about a patient. ICD is different from DSM in that it provides guidance and diagnostic criteria. At the same time, DSM 5 shows operational criteria but with systems that cannot detect independence of variation, and that is where the clinical discrepancy comes to be noticed.
There is uncertainty about the diagnosis threshold during the use of the DSM 5 tool. According to Timimi (2014), the limitations of the diagnostic system are revealed during the assessment of the frequency, duration, and intensity of the matter in contention. When utilizing a DSM scale, the severity of some mental diseases, such as schizophrenia, shows fewer symptoms. Still, the extent of a disorder is not included in the diagnostic criteria, which means it is impossible to get a clinically significant result due to the lack of thresholds useful in diagnosis. Therefore, it is factual to say that the use of the DSM-5 tool has rigidity as a result of categories that show the inconsistency of clinical realities (Timimi, 2014). The limited efficacy of the DSM-5 tool can be manifested when diagnosing unidimensional symptom-related mental disorders such as trichotillomania. During the use of the scale, the particular threshold required may not show changes due to the conceptualization of phenomena that interfere with research or the clinical metrics applicable.
Other scholars have an opposing opinion concerning the effectiveness of using the DSM tool for mental disorder classification. For example, Gambrill (2013) says, “The diagnostic and statistical manual of mental disorders as a major form of dehumanization in the modern world.” There is a need to explore those remarks by critiquing the point he raises concerning the criteria followed. More reliability is evident in DSM than in an ICD in terms of the measures taken about the description of disorders using the tool (Gambrill, 2013). For example, in attention-deficit hyperactivity disorder (ADHD), the patterns of developed behaviors can show numerous settings, enabling a researcher to note uncertainty regarding the processes. In this case, the argument favors DSM-5 due to the accuracy of the diagnosis. Gambrill (2013) insinuates that for the reason that there are advanced operational criteria applied. In the DSM-5 tool, a resourceful amount of effort is used to classify disorders in terms of etiology and multiple dimensions of behaviors, particularly those that affect personal behaviors.
It is important to ascertain whether the counterarguments raised are relevant to the assessment of this tool. During the application of DSM-5, occurrence, concentration, and duration measures are useful to ascertain the outcomes. When severity evaluating instruments limit the particular diagnosis, a DSM-based workgroup develops one hence, showing the efficacy (Gary, 2018). In other words, DSM-5 has advanced what was developed initially in terms of the theoretical stance and utility of diagnosing patients in a clinical background. Despite all these notable rationales, this paper argues that the DSM-5 tool needs an operational criterion that can increase its validity and hence, remain reliable. This knowledge can be supported by Timmi’s (2014) analysis, where he says that the use of DSM-5 created clinically significant distress due to inherent pathological findings realized. This paper holds the idea that the DSM-5 scale has threshold issues in assessing the functionality of severity measures for intermingling elements obtainable during diagnosis. Thus, using the DSM-5 practice requires advanced organization of tasks rather than criteria that may be limited to a given disorder.
The other etiological limit in the use of DSM-5 is its influence on the pharmaceutical industry. Di Cerbo (2021) critiques that the DSM scale that measures psychological disorders to classify them medicalizes the patterns of human traits. As a result, moods that may not be a key consideration of notable disorders are defined and included. Due to the conflict of interest between the DSM-5 crew and the pharmacological companies, there is a probability of having an affiliation with the healthcare business when diagnosing various mental disorders. Moreover, the reduction of diagnostic thresholds for multiple disease groupings leads to inaccuracy hence, inappropriate clinical dissemination to vulnerable groups. The scale’s major classification does not show qualitative research on the final concurrence that leads to the definition of diseases. For instance, disruptive mood dysregulation disorder (DMDD) has been accommodated by DSM-5 as severe temper realizations that may develop with time and show more than three times a week (Clark et al., 2017). Concerning such characterization, there is no clarity in application to persons seeking clinical help for mental disorders in the current world.
Based on DSM’s approach, various scientists believe that the scale is not a methodological conspiracy but rather a wide-ranging modification in the determination of the classification of disorders. Contrary to the notion that the scale medicalizes patterns of human behavior, Clark et al. (2017) argue that the DSM-5 adds to diagnostic groups useful for individuals seeking clinical intervention on psychological matters. When using this method, there is an exclusive focus on criteria that uses biological equations of the mind that help understands the deviations of a patient’s psychiatry cues. In this case, many researchers hypothesize that DSM test-retest ability reflects the impact of the diagnosis on medical decision-making, and there is evidence that substantially differentiates the tool from ICD and others. This paper retains the idea that using the DSM-5 tool has the potential for misdiagnoses or overdiagnoses (Timimi, 2014). The reason is that, from what is depicted in many literary sources supporting this argument, people are labeled to have a given behavior after personality traits do not tally with the ideal being measured. Hence, etiological labels provided during the measurements used in the process may be stigmatizing.
This critical review significantly advances my registered nurses’ standards for practice (RNSFP). Through the exploration of literature, I can understand a patient due to common language in clinical delivery about various psychological disorders. The reason is that DSM-5 and other scales comprise descriptions and operational criteria that can effectively diagnose mental issues that affect human beings in their daily lives (Gambrill, 2013). Most importantly, I can differentiate between personal traits and behaviors caused by mental problems. That helps me recognize the significant course of action needed during a consultative session with a patient. Furthermore, I can distinguish, manage, and curl cause problems that can lead to mental ailments, improving my capability to deliver effective care to individuals in a clinical facility.
Summary
DSM-5 is a scale that includes updated criteria for the diagnosis of major mental disorders. However, the efficiency in diagnosing the same is limited as a result of given etiological issues that bar thresholds required for fostering clinical success. There are studies that argue that the scale is far better than ICD because of the accuracy and reliability approaches. However, this paper contends that the DSM-5 scale does not result in clinically significant outcomes in all assessments. To support the opinion, it is true to say that discrepancies such as inherent pathological presentation, the medicalization of behaviors as ailments, and difficulty in organizing tasks contribute to the ineffectiveness of the tool.
References
Clark, L., Cuthbert, B., Lewis-Fernández, R., Narrow, W., & Reed, G. (2017). Three approaches to understanding and classifying mental disorders: ICD-11, DSM-5, and the National Institute of Mental Health’s research domain criteria (RDoC). Psychological Science in the Public Interest, 18(2), 72-145. Web.
Deacon, B. (2013). The biomedical model of mental disorder: A critical analysis of its validity, utility, and effects on psychotherapy research. Clinical Psychology Review, 33(7), 846-861. Web.
Di Cerbo, A. (2021). Letter to the editor: Convergences and divergences in the ICD-11 vs. DSM5 classification of mood disorders. Turkish Journal of Psychiatry, 34(2), 293-295. Web.
Gambrill, E. (2013). The diagnostic and statistical manual of mental disorders as a major form of dehumanization in the modern world. Research on Social Work Practice, 24(1), 13-36. Web.
Gary, H. (2018). A diagnosis of “borderline personality disorder” Who am I? Who could I have been? Who can I become? Psychosis, 10(1), 70-75. Web.
Johnstone, L. (2017). Psychological formulation as an alternative to psychiatric diagnosis. Journal of Humanistic Psychology, 58(1), 30-46. Web.
Timimi, S. (2014). No more psychiatric labels: Why formal psychiatric diagnostic systems should be abolished. International Journal of Clinical and Health Psychology, 14(3), 208-215. Web.