Different Psychological Paradigms

• Axis III is the medical conditions the patient has.

• Axis IV is the environmental and psychosocial factors that might be contributory.

• Axis V is the global assessment of functioning.

The DSM-5 was published in 2013. There were extensive revisions and broader diagnostic definitions in many cases. Subtypes of schizophrenia no longer existed in this manual as well as the subtypes of autism spectrum disorder.

Over time, many of the different changes in the DSM have been made in order to have a manual that was reliable enough that two different psychologists would make the same diagnosis if given the same patient and his or set of symptoms. The problem is that, even with improvements, this kind of reliability does not exist to the extent that it should be. The DSM also focuses on symptoms while avoiding issues like a person’s genetics or other testing that might be just as important as the different symptoms.

Overall, the biggest issue was related to reliability, which is actually quite low when comparing the diagnosis given by different clinicians examining the same patient. Other issues less commonly argued are that the DSM causes the overdiagnosis of mental disorders and that the division between two diagnoses is somewhat arbitrary. The degree of impairment is also not addressed in every diagnosis and there may also be a cultural bias based on European and American thought processes and approaches.

DIFFERENT PSYCHOLOGICAL PARADIGMS

There are different possible approaches to how to describe human thoughts and behavior. There are perspectives that address the biological issues related to mental illness, while others have a more psychosocial approach. As you have learned, there have been different accepted paradigms over the course of history that have attempted to explain psychological disorders. Nowadays, there are different perspectives or paradigms used to talk about mental illness. Let’s look at what these are:

The psychodynamic perspective started with Sigmund Freud and emphasizes the subconscious or unconscious in mental illnesses. It also looks at early childhood experiences and relationships a person has with others. Those who use this perspective

often apply psychanalysis and use the three mind concepts of id, ego, and superego. In this case, the id is a person’s subconscious desires, while the ego is their rational self that deals with everyday issues. The superego develops last and is focused on internal morality.

The behavioral perspective or behaviorism looks not at internal states but on what can be observed by watching the patient. John B Watson and others studied and developed this perspective. It is not as commonly a part of psychological thought now but is concerned with ways to reinforce learned behaviors. It is still used in certain mental health settings to modify unwanted behaviors in the person.

The cognitive perspective has been more prominent since the 1960s and looks at thought processes and issues related to problem-solving, decision-making, language, and memory. Jean Piaget and Albert Bandura both studied and formulated this perspective, which helps patients through managing how information is processed and utilized.

The biological perspective looks at how physiology plays a role in psychological disorders. It is sometimes called biopsychology and looks at things like neurotransmitter problems as causative of mental disorders. Genetics is also related to some mental illnesses and this is part of the biological perspective as well as how the immune system, brain injury, and the endocrine system play into mental illnesses. The newer imaging tests like the PET scan and the functional MRI scan reveal a lot about which areas of the brain are more or less prominent in certain mental disorders.

The cross-cultural perspective is relatively recent and studies the cultural differences in what represents normal behavior and what is a disease state. It turns out that one’s culture strongly influences their thoughts and behaviors. There are two spectra of culture types that control a person’s thoughts about themselves and others. Individualistic cultures emphasize the individual, while collectivistic cultures look at the interplay between the person and those they live and work with.

The evolutionary perspective attempts to explain the ways in which evolution has influenced our responses to the environment. It looks at natural selection to explain some of the differences between male and female thoughts and behaviors. The