Chapter 1 Overview/Summary
Encountering instances of abnormal behavior is a common experience for all of us. This is not
surprising given the high prevalence of many forms of mental disorder. A precise definition of
abnormality is still elusive. Even though we lack consensus on the precise definition of
abnormality, there are clear elements of abnormality: suffering, maladaptiveness, deviancy,
violations of society’s standards, causing discomfort in others, and irrationality or
unpredictability. These elements allow for the adoption of a prototype model of abnormality.
Although this model is helpful, we have the additional problem of changing values and
expectations in society at large.
Despite these difficulties, psychologists continue to classify mental disorders for several reasons:
classification systems provide a nomenclature that allows us to structure information in a more
helpful way, research on etiological factors, treatment decisions, social and political
implications, and insurance reimbursement. There are also many disadvantages to classifying
mental disorders: loss of information, stigma, stereotyping, and labeling.
The DSM-IV definition is atheoretical, focusing on a clinically significant behavioral or
psychological syndrome or pattern that is associated with distress or disability (impairment in
one or more areas of functioning), and not simply a predictable or culturally sanctioned response
to a particular event. Mental disorders, then, are the product of ‘dysfunctions’ within the
individual. As might be expected, there are many criticisms of this definition. For example, what
is meant by the term “clinically significant,” who determines what is culturally sanctioned, and
how much impairment is necessary for a diagnosis to be made? Wakefield has proposed a
definition that describes a mental disorder as a “harmful dysfunction.” His approach focuses on
social values in defining abnormality as well as an evolutionary model to determine what is
functional, creating potential new difficulties. This current text utilizes the prototype model
adopted by the DSM classification system.
Culture shapes the presentation of clinical disorders in some cases. There are also certain
disorders, such as
that appear to be highly culture specific. DSM opts for a
categorical classification system similar to that used in medicine. Disorders are regarded as
discrete clinical entities, although not all clinical disorders are best considered in this way. Even
though it is not without problems, the DSM provides us with a working set of criteria that help
clinicians and researchers to identify and study specific and important problems that affect
people’s lives. Although it is far from a “finished product,” knowledge of the DSM is essential to
a serious study of the field.