DSM

Question 1

Classifying Psychological Disorders. DIFFERENCE between idiographic and nomothetic

Answer 1

• Idiographic Framework: This approach focuses on the uniqueness of mental illness in each individual. It suggests that psychological disorders manifest differently in everyone, emphasizing the singular experience of each person.
  
  • Nomothetic Framework: This method is based on predefined categories, using established classifications of disorders. It compares individual cases to previously described psychological conditions. The DSM-V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) operates under a nomothetic framework, classifying disorders based on common patterns seen across multiple cases.

Question 2

Key Thoughts on Psychopathology and Individual Differences

Answer 2

• A central question in modern clinical psychology is whether psychopathology (mental disorders) represents an individual difference (ID).
  
  • Personality and IQ are clear examples of individual differences, as they vary quantitatively between people. These can be measured across individuals because they exist along a continuum.
  • Physical conditions like broken legs and heart attacks are qualitative differences, not individual differences, because they represent distinct categories rather than measurable variations across a continuum.
  • There is debate about whether psychopathologies can be considered individual differences. It may be that specific behaviors in mental disorders represent individual differences, but the overall disorders themselves might not be classified as such because they could involve more distinct, qualitative aspects.

Question 3

Dimensional View of Psychopathology

Answer 3

In recent years, there has been a shift toward viewing psychopathology through a dimensional lens. This perspective suggests that mental illnesses represent quantitative deviations from normal behavior rather than categorical distinctions. This means that mental disorders may not be entirely different from normal functioning but could be seen as extensions or degrees of certain behaviors or emotions, differing by intensity rather than type.

This dimensional view was part of discussions leading up to the DSM-V, reflecting an increasing acknowledgment that many psychological conditions exist on a spectrum rather than as distinct categories.

Question 4

Personality Disorders in DSM-V

Answer 4

• Traditionally, personality disorders have been classified categorically, grouping them into three clusters:
  
  • Cluster A: Antisocial
  • Cluster B: Schizotypal, Schizoid, Paranoid
  • Cluster C: Avoidant, Obsessive-Compulsive, Dependent, Passive-Aggressive
    These clusters have represented qualitative differences in personality traits.

Question 5

Shift with DSM-v

Answer 5

With the DSM-V, there was an almost fundamental shift in the classification of personality disorders toward a dimensional model:

*	Instead of classifying personality disorders as distinct categories, the focus began shifting toward scales or dimensions of traits.
*	The new approach proposed fewer personality disorder types and measured individuals on a range of personality traits.
*	For instance, rather than diagnosing someone with paranoid personality disorder, clinicians might evaluate traits like high intimacy avoidance, which reflects a more quantitative rather than qualitative approach to diagnosis.

This proposed change in DSM-V reflects a broader trend toward understanding personality disorders on a continuum of traits, aligning with the dimensional view of psychopathology.

Question 6

Categories vs. Dimensions

Answer 6

1. Categories:
   
   • A categorical approach classifies psychological disorders or traits into distinct groups. Each group represents a specific diagnosis, and individuals either fit into the group or they don’t. This is an all-or-nothing system.
   • For example, in a categorical model, someone either has depression (they meet the criteria for major depressive disorder) or they don’t. There is no middle ground.
   • This is the traditional model used in systems like the DSM-IV and largely still in the DSM-V, where disorders are defined by clear diagnostic criteria.
     2. Dimensions:
   • A dimensional approach views psychological traits or disorders as existing on a continuum. Rather than having distinct categories, this model assumes there are varying degrees of traits or symptoms.
   • In a dimensional model, instead of saying someone either has or doesn’t have a disorder, the focus is on how much of a particular trait or behavior they exhibit. For example, everyone may experience some level of anxiety, but it can vary in intensity and frequency, with clinical anxiety being at the extreme end of this spectrum.
   • This approach suggests that mental health conditions are not entirely separate from normal behavior but are quantitative deviations from it.

Question 7

Categorical framework vs framework approach

Answer 7

• Categorical Framework (Traditional Model):
  
  • The DSM (especially DSM-IV and earlier) has traditionally used a categorical approach. A person either meets the diagnostic criteria for a disorder or they do not.
  • Personality disorders, for instance, were traditionally classified in categories (e.g., someone is diagnosed with paranoid personality disorder if they meet a certain number of criteria).
  • Dimensional Framework (Emerging Model):
  • In recent years, there has been a growing shift toward a dimensional approach, particularly for some disorders like personality disorders.
  • For example, DSM-V considered changing personality disorders from categorical diagnoses to dimensional scales. Instead of saying someone has or does not have a specific personality disorder, the new approach would look at how much of a trait they have (e.g., how much intimacy avoidance or impulsivity they exhibit). This would allow for a more nuanced understanding of the disorder, seeing it as a spectrum rather than a fixed category.
  • This dimensional view aligns with the idea that many mental disorders are quantitative variations from normal behavior rather than distinct, separate conditions.

Question 8

Relevance to the Discussion on Psychopathology:

Answer 8

1. Idiographic vs. Nomothetic:
   
   • The nomothetic approach, which the DSM-V follows, aligns more with a categorical system, creating fixed diagnostic groups.
   • However, the dimensional view of psychopathology challenges this by suggesting that mental health issues may not be separate categories but variations along a continuum.
     2. Psychopathology as an Individual Difference (ID):
   • The question of whether psychopathology is an individual difference (ID) is tied to this debate.
   • Personality traits and IQ are clearly dimensional constructs, varying in degree between individuals.
   • If mental disorders are viewed dimensionally, they could be considered individual differences, just like personality or intelligence, varying in severity rather than being separate categories.