Psychological diagnosis? Yes or no?
Since the beginning of psychology as a science responsible for the study of the mind and human behavior, numerous investigations have been carried out to determine the origins, consequences and perpetuating factors of the vast majority of psychological disorders.
But... Does this initiative have to name psychological phenomena some drawback?
- Related article: "The differences between syndrome, disorder and disease"
The investigation of mental disorders
The American Psychiatric Association (APA) and the World Health Organization (WHO) are two of the organizations that have invested the most time and effort in trying to understand in greater depth and provide clarification about how mental disorders work , what are the symptoms associated with each of them, how to detect them (how many symptoms must be present in order to establish an accurate diagnosis and for how long), etc. This information is reflected in their corresponding diagnostic manuals: the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and the International Classification of Diseases (ICD-10).
The APA and other institutions such as the National Institute for Health and Care Excellente (NICE) have also been in charge since the 90s to verify which treatments are the most effective for each type of disorder, trying to establish empirical validations of different ways of carrying out out a therapeutic process.
Specifically, division 12 of the APA, created in 1993 a working group on the promotion and dissemination of psychological treatments based on the findings of their research, leading to the development of treatment guides with a theoretical-practical basis adapted to the characteristics of each disorder.
On the other hand, NICE's action includes the provision of information, education and guidance, the promotion of prevention and the proposal of ways to proceed in primary care and specialized services.
- You may be interested: "No, mental disorders are not adjectives"
Different perspectives from which to investigate
The main difference we can find between one organism and another is how the APA focuses on the investigation of "classic" or "pure" disorders, while the NICE addresses issues that do not necessarily meet a clinical diagnosis, but rather Launches strategies to improve mental health in general (pregnancies, adherence to treatment, suspicion of abuse in childhood, welfare in the elderly, etc.).
In the case of the APA, "Purism" is a factor that usually limits the clinical performance because it is rare for a disorder to appear in its purest and most easily recognizable form, but criteria for other disorders (comorbidity) are usually met or variations of greater complexity are presented.
Therefore, in psychology to this day we have a wide range of research not only on the different types of disorders that we can find, but on which are the most appropriate ways of approaching them (to date).
Is the psychological diagnosis useful?
Usually, the procedure when you are going to perform some kind of psychological treatment is begin with an evaluation phase . In this phase, the interview known as the clinic provides us with a large amount of information about the situation of the patient in question.
Depending on the current of therapy from which each psychologist works, the interviews can have a more open or more structured format, but they will always have the objective of knowing in greater depth the functioning and environment of the person in front .
The evaluation phase can allow us to establish a diagnosis if there is a disorder, since some of the difficulties that arise in consultation (known as Z codes) are not included in the diagnostic manuals because they are considered critical situations / changes in the life cycle more than mental disorders (cases of separation, marital dissatisfaction, difficulties in managing the behavior of the children, duels, etc.).
In the case of a disorder, in the evaluation phase (in which, in addition to interviews, standardized questionnaires can be used) we will have been able to clarify the symptomatology, the course and the evolution of the patient's condition , as well as giving a name to the experience that is living.
This diagnosis, based on the aforementioned, allows us in a very useful way to know with what difficulty we are relating and to establish the most appropriate treatment mode for each person, so that we address the problem in the most effective and efficient way possible.
Should we always offer a diagnosis?
As health professionals we must take into account that each person is completely different from any other , and that what we would transmit to one patient may be harmful to another.
The diagnosis helps the professionals to understand and clarify the situation that is before us, as well as to design and plan our way of acting to solve it. However, we must be very careful when establishing diagnoses, since there are several dangers:
The label can be converted indirectly into a definition of the person
That is, we no longer talk about "X has schizophrenia", but we can incur "X is schizophrenic".
Diagnosis can lead to victimization of the patient
Whether prudently or not, establish a diagnosis can lead to the person being absorbed by his label : "I can not do X because I am agoraphobic".
The little detailed diagnosis can lead to a state of confusion in the patient
If sufficient information is not provided and the patient does not understand what is really happening to them, it is very likely that they "fill in" the gaps of information with data that can be extracted from less reliable sources than a health professional, generating negative and unrealistic expectations about your mental state .
The diagnostic label can generate feelings of guilt
"Something I've done to deserve this."
conclusion
Bearing this in mind, it goes without saying that for psychologists it is extremely complicated not to establish a mental diagnosis of the situation that is presented to us, since the diagnostic labels they facilitate the understanding of information in our mental schemes .
But, despite this, if the patient does not directly request a diagnosis for some reason, it is likely that they do not need to know what name the experience is going through, and simply seek to resolve it.
On the other hand, if we find a great insistence on "labeling" what is happening, it is important to first clarify whether the request has a solid basis in the person or can be influenced and pushed by other means with which it is related (social links, data on the internet, etc.).
