Abnormal Psychology & Comorbidity

First and foremost let me give you due disclosure; I am new to psychology and plan on entering graduate studies in psychology soon, and I only hold my bachelor’s degree right now. After taking an a few psychology courses and most notably an abnormal psychology course I would like to discuss a topic that keeps entering my mind.

The topic is about how we look at and perceive abnormal psychology as a whole. The DSM-IV-TR is laid out in such a fashion that if one can examine a person’s daily interactions/thoughts/etc they can match these symptoms to a list of corresponding and known disabilities. For example if one has a fear of wide open spaces, and they meet the correct criteria they will most likely be diagnosed with agoraphobia which is translated to “a fear of the market place.” I noticed that within the realm of abnormal psychology each of these afflictions are highly comorbid (2 or more existing diagnosis’s). IE, schizophrenia is often, and almost always comorbid with drug dependence. I begin to question if these comorbidities are by chance or wonder if they hint to us that there is a “deeper level” we should be looking at in order to diagnose mental illness.

Again, admittedly not well versed in this topic, and writing this short article after only reading a beginners abnormal psychology textbook as well as taking the companion course, I often got the notion that the way we look at mental health is incorrect. I can better illustrate my ideas with pictures. If you think of a person as a tree for a moment, imagine that their abnormalities are roots. It seems to me that the DSM treats these abnormalities like a plant that has a very noncomplex root system. Like a weed with a few dangling stringy roots. Within the DSM, if we can find the one, or perhaps two, or three roots, and “take care” of them than we may have fixed the problem. In the picture below the red marks are representative of where the intervention takes place, where the person is diagnosed.

simple

On the second mark in from the left one can see where the DSM would normally define comorbidity. Is this the type of structure that our mental disorders take? Or could it be more highly complex like the roots of a real tree that spawn and sprawl off into the distance. Do we need to work at “jumping up a level” somehow when treating mental health? This is a big question, and you may posit; you can only diagnose what you can see or observe, this is true to some extent, but along with the rapidly growing neurosciences I believe that coupling the behavioral side with the physiological side will be paramount in “finding” this higher level that we can’t treat at present time.

Below is my proposed system of how mental disorders would actually look like if one could “see” them somehow.

complicated

The first blue line represents a diagnosis and treatment, the second one does as well but it is comorbid with another affliction. But look up the same root and you will eventually see a red line higher up. If we can treat at this level we are severing 6 different mental health disorders/problems. Some of these roots may be looked at as environmental and social factors as well.

The basic synopsis here is that I think abnormal psychology and the diagnosis and treatment thereof is looked at way too simplistic in the current DSM. I think that we need to look at in a much more complex comorbid-enviornmental-social outlook. We need to look for a higher level of treatment.

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