Understanding What Abnormal Psychology Actually Is

Psychology, at its core, looks at the human mind and what it does. The mind is a tangled thing, so the discipline studying it inherits that difficulty. One branch within the larger field goes by the name abnormal psychology. The label points to what it covers: thoughts and behaviors that drift away from what we treat as normal. In practice that usually means mental disorders, the kind that bend how a person thinks and acts. Researchers investigate these patterns, while counselors and psychiatrists handle the actual treatment of the conditions that follow. For reference, clinicians lean on the Diagnostic and Statistical Manual, the DSM, published by the American Psychiatric Association. At present it stands at its fourth edition, DSM-IV.

When a clinician wants to say whether a patient is mentally ill, the DSM-IV is the tool that shapes that call. Assessment runs across five separate axes. Axis I captures clinical syndromes such as schizophrenia or generalized anxiety disorder, and this is the central diagnosis. Axis II covers developmental and personality disorders that have shaped the patient's life in a broad, lasting way; mental retardation and antisocial personality disorder fit here. Axis III records physical medical conditions, diabetes or HIV among them, that could sharpen the symptoms of the disorder. Axis IV notes the psychosocial and environmental pressures in play, things like abuse or a divorce. Axis V applies the Global Assessment of Functioning, scoring how well the patient is managing on a scale from 0 to 100, with 0 marking the most severe impairment.

The manual does not escape criticism, and people have questioned whether it holds up. Critics keep a running list of its weak points. Before DSM-III, for instance, homosexuality carried the label of mental illness, and today transsexualism appears as Gender Identity Disorder. A separate concern sits in the way the DSM sorts things into categories. The dividing lines between one disorder and another are sometimes thin, and real patients rarely slot into the criteria as cleanly as the book assumes. Take major depressive disorder: the diagnosis calls for a major depressive episode lasting two full weeks. Someone whose episode ran a single day short would fall outside the definition, yet calling that person free of depression seems obviously wrong.

Nobody seriously argues that mental illness is a fiction, so the field itself is on solid ground. Pinning down exactly what abnormal psychology is, though, remains a problem the discipline has not fully solved. It keeps moving, turning up fresh ways of spotting and treating mental illness as the years pass. DSM-V is expected at some point down the line, and after it a DSM-VI, or maybe a manual of a completely different shape.