The Diagnosis of Mental Disorders - Essay Example

?Medical Model in the Diagnosis of Mental Disorder School Introduction Before we go into studying the medical model in the diagnosis of a mental disorder, it is important to understand what a psychological disorder is and what are the different models of abnormal behaviour or psychological disorder? According to the APA, if the behaviour of an individual causes significant distress or dysfunction in one’s daily activities then it is classified as a psychological disorder, and it may be due to a biological cause, due to a mental process or from a learned behaviour. This abnormal response or behaviour may not be a normal response to an external event, nor is an intentional reaction. The abnormal behaviour on the other hand is deviant away from normal, is distressing and is a maladaptive pattern. The abnormal behaviour may be a concern to self or others and would differ from normative behaviour (Kovera 2012). There are three models for accounting abnormal behaviour including the medical model, the psychological model and the socio-cultural model. The medical model accounts for physical disease being the cause for abnormal thoughts, feelings, behaviours, etc, and this may be due to a genetic cause, abnormal structure and function of the brain or due to imbalances in hormones and neurotransmitters. The focus is on the illness rather than on health, with an intention of diagnosing the condition based on the symptoms and causes, and providing a treatment to alleviate the symptoms. The psychological model places the onus on past life and current experiences as being the cause for mental illness and these may include war, abuse, social rejection, illnesses, or failures in life. The socio-cultural model takes into consideration the social and the cultural causes for the development of psychological disorders and includes cultural stressors. There may be certain culture-bound syndromes; for example, eating disorders are common in young girls in the West, and Koro, which is seen in young Asian men who fear to venture out of their homes. It has been noted that the prevalence of certain mental disorders may follow certain trends across certain cultures, due to which the socio-cultural model was being developed (Kovera 2012). One of the models that have been well-accepted is the medical model, as it is an evidence-based method that incorporates aspects of biology and science. However, even though the medical-module is well-established, perspective from other models including psychological and socio-cultural need to be taken into consideration (Serendip 2006). Body According to the medical model, psychological disorders are handled in the same manner as can any other physical disease that produces physical symptoms. In the medical model, symptoms are considered to be outer manifestations of inner organic disorder. A symptom-complex or a syndrome is a group of symptoms that can be noticed from a particular cause or disease-pattern and have an appropriate treatment (Leod 2008). The symptoms that occur together are classified as a syndrome, and they form the diagnostic elements of psychiatry. One difference between the medical model when used for psychological disorders and for physical disorder is that in psychiatry, a syndrome may not be associated from a single underlying cause, and often the symptoms that may be present in one disorder, may also be present in another. For example, depression may be symptoms of almost any psychiatric disorder, whereas chest pain is usually a symptom of either a cardiac or lung disorder (Serendip 2006). Medical model considers that any abnormal behaviour would be a disease. In the medical model, a cause could result in the development of a disease, and the disease would result in production of symptoms. The symptoms that develop may be alleviated by giving a drug or using a certain treatment method. However, if the treatment given is to reduce the symptom, the treatment may or may not reduce the disease, and at the same time, the treatment itself (for example a drug) would be having certain undesired effects, side-effects, risks, etc (Whittenhall 2007). Freud adopted the medical model to understand psychological disorders. He grouped certain behaviours such as hallucinations or certain fear responses together under the symptom-complexes, though n general he found it difficult to make a diagnosis and identify the disorder. In the year 1897, Kraft-Ebing found that Treponema pallidum, a spirochete was responsible for the development of psychological symptoms and behavioural changes in syphilis. This gave scientists greater faith in using the medical model for the psychiatric diseases. However, when the medical model is being used for abnormal behaviour there are a few advantages and disadvantages. These were brought into the light by Sigmund Freud, during the early part of the 20th century (Beck 2001). Firstly, the medical model considered a medical illness like any other disorder and hence people suffering from abnormal behaviour were considered ill and were given an understanding and respect like any other person who fell ill with a physical disorder. This helped to remove the theory that people suffering from mental disorders were possessed by the demon. This was the single greater achievement of the medical model, during the early days of the Modern Age. Secondly, since like any other physical illness, there was strong belief that a cure and treatment existed, efforts were made and research studies were conducted to treat and cure mental illnesses. This created the all new science of psychiatry and psychology, wherein new treatments in the form of drug therapy and psychotherapy began to be employed. Thirdly, though there were several questions being raised, Sigmund Freud’s explanation of neurotic behaviour was considered a valid theory. He basically suggested that neurotic behaviour developed from unpleasant childhood experiences that were often suppressed by the conscious mind. During the development of neurotic behaviour, there was a regression to an earlier stage of life. Fourthly, using the theory, the social environment that results in abnormal behaviour is better understood. However, Sigmund Freud concentrated to a greater extent on the social environment of children and ignored adults (Beck 2001). However, applying the medical model to abnormal behaviour may also have certain disadvantages that need to be tackled. Firstly, using the term ‘mentally ill’ in psychology created a lot of stigma as people suffering from the disorder felt that they may not be given a good chance. Secondly, when the term ill is being used, it means that the individual is passive and has to be cured. Greater emphasis is placed on curing and treatment for ill patients, and hence if the psychological prognosis was poor, it would be very difficult for the patient. Thirdly, there are several concepts mentioned by Freud which are very difficult to study scientifically and include ego strength, underlying conflict and libido. Some of these concepts may be difficult to measure and some may be very difficult to identify if present or absent. They may pose additional difficulties as the medical model gives importance to diagnosis. Fourthly, even though Freud’s theory was accepted, there was a controversy regarding symptom substitution that needs to be taken into consideration. According to symptom substitution, when a symptom is removed without removing the underlying cause, the symptom would be substituted with another symptom, which is usually seen in physical disorder. However, it has been not much seen in mental disorder, which goes on to jeopardize the validity of the medial model (Thomas 2007). The DSM-IV-TR is a system of classifying the mental disorders and provides criteria for the process of differential diagnosis as applied to mental disorders. It promoted the bio-psychosocial model and had 5 diagnostic axises to classify mental disorders. The method of classifying a disorder in the DSM classifying is based on symptoms and would not give importance to the underlying nature or cause of the disorder. Using the symptom-based approach which is also a feature of the Medical model system, has permitted diseases to be grouped. It does not give any importance to the cause or origin of the disorder, and patients with similar symptoms would be treated in a similar fashion without importance to the cause. Besides, it has been found that since diseases are classified based on their symptoms, often discrimination and social stigma would be evident just from the main symptom that may be present in the condition. By using the symptom-approach for classifying the disorders, there are endless ways of getting additional medical conditions and this may create complexities. However, the process of differential diagnosis is very easy as based on the presence or absence of a disorder; it can either be deleted or added. Due to greater emphasis on symptoms and complexities in classifying the disorder based on nature or cause, often disorders are treated by using drugs and hence, a false notion is being generated amongst the population. Lastly, the DSM-IV-TR does not take into consideration those behaviours that may not be abnormal but may be considered as extremes of the normal range. Though all these considerations point out at the difficult of the DSM-IV-TR, they have made life of the practitioners much easier at identifying, diagnosing and treating psychological disorders (Mind Disorder 2012). Conclusion Though the medical model is complete and helps to classify and diagnose the psychiatric disorder based on symptoms and signs, they do not given importance to the cause, as the root idea of treating any medical problem is to cure the condition rather than alleviate the symptoms. The DSM criteria strongly support the Medical Model. It is important that the medical model takes concepts from other models into consideration as the same has been validated in the past. Though the medical model has helped to remove any supernatural model that was considered, but there are limitations to the extent that it can be applied. Broader prospective needs to be taken into consideration by using the other models including the socio-cultural and psychological models. The current Medical model needs to be expanded taking the psychological and socio-cultural factors into consideration. Bibliography Beck, H. P. 2001. Medical Model of Abnormal Behavior. [online], Available: http://www1.appstate.edu/~beckhp/genthemedicalmodel.htm Kovera, M. 2012. Models of Mental Illness and Anxiety Disorders. [online], Available: http://web.jjay.cuny.edu/~mkovera/anxiety.htm McLeod, S. 2008. The Medical Model. [online], Available: http://www.simplypsychology.org/medical-model.html Mind Disorder 2012. DSM. [online], Available: http://www.minddisorders.com/Del-Fi/Diagnostic-and-Statistical-Manual-of-Mental-Disorders.html#b Serendip. 2007. Models of Mental Health: A Critique and Prospectus. [online], Available: http://serendip.brynmawr.edu/sci_cult/mentalhealth/models/mentalhealthmodels2.html#allev Serendip. 2007. Models of Mental Health: A Critique and Prospectus. [online], Available: http://serendip.brynmawr.edu/sci_cult/mentalhealth/models/ Thomas, P. 2007. ‘Explanatory Models for Mental Illness.’ Pak J Neurosol Sci. vol. 2, no. 3, pp. 176-181. http://www.mentalhealth.freeuk.com/pjns.pdf Whittenhall, J. 2012. The Medical Model of Mental Illness: Ethical and Practical Implications for Diagnosis. The International Honor Society in Psychology, [online], Available: http://www.psichi.org/pubs/articles/article_598.aspx Read More