Are mental disorders over-diagnosed?

This week the British Psychological Association released an article regarding the Diagnostic and Statistical Manual for Mental Disorders.  DSM-5 will now include disorders such as addiction to the internet, to gambling or have an eccentric personality as medical problems.  They will include shyness in children and depression after losing a loved one as mental disorders too.  Personally I find this shocking.  Being eccentric does not make you mental, it makes you different to the rest of the crowd which is positive.  Isn’t shyness in children and feeling depressed after a loss natural?  I believe that shyness is the opposite of confident and too much confidence is never good so why categorize shyness as a disorder?

In Van der Molens’ (1990) book he defines shyness.  There is no certain definition but behaviourist views  shy people as people who have “failed to acquire the social skills necessary for developing relations with others.”  Sociologists on the other hand views shyness as a “matter of social programming.”  Even though Van der Molen believes that they fail social skills I believe that shyness within childhood is natural as children try to adapt to new situations and people.  Not being shy can also be dangerous.  Shyness can be a defence mechanism to defend children from uncertain situations such as talking to strangers as well as giving you some time to sense any risks.

Gleitman, Gross and Reisberg (2011) defines the DSM as “the manual that provides specific guidance on how to diagnose each of the nearly 200 psychological disorders.”  It is made in the US but is being used my clinicians and researchers across the world.

Many people have disagreed with this announcement such as Peter Kinderman, a member of the BPS.  He said that “Many people who are shy, bereaved, eccentric, or have unconventional romantic lives will suddenly find themselves labelled as ‘mentally ill’. This isn’t valid, isn’t true, isn’t humane. And it won’t help decide what help a person needs.”  Do you agree with this?

Another examples of recent disorders are Oppositional Defiant Disorder used for disobedient children and Paraphilic Coercive Disorder used for serial rapists and sex abusers.  I disagree with labelling these kind of people as it will lead to no prosecution.

Kagan, Reznick and Snidman (1998) researched on 2 year old children which were restraint or spontaneous in unfamiliar situations.  When 7 years of age most the restraint children were quiet and avoidance while the spontaneous children were talkative and interactive.  Shyness in childhood leads to social avoidance in adulthood.  Cheek and Buss (1981) researched into the correlation between shyness and sociability.  When the participants self-reported they didn’t believe that their shyness led to low sociability.  Further experiments proved that shyness did not mean that their were unsociable even though they talked less and gazed more.

In my opinion, most mental disorders are over-diagnosed.  In 1840 there was only one category for mental disorders.  In the DSM’s last revision there were 347. (DSM, 2000)  Even though shyness in childhood can effect your adult life, it is not always negative and therefore I don’t believe that shyness or many other features in personalities should be classified as disorders.

 

Cheek, J.M. & Buss, A.H. (1981). Shyness and sociability. Journal of Personality and Social Psychology, 42(2), 330-339.

Diagnostic and statistical manual of mental disorder: DSM-IV-TR (4^th ed.). (2000). USA: American Psychiatric Association.

Gleitman, H., Gross, J. & Reisberg, D. (2011). Psychology. UK: W.W.Norton & Company.

Kagan, J., Reznick, J.S. & Snidman, N. (1998). Biological bases of childhood shyness. Science, 240, 167-171.

Van der Molen, H.T. (1990). Shyness and embarrassment. UK: Cambridge University Press.

A yw hi’n bosibl atal cyflyrau meddwl rhag datblygu yn gyfan gwbl?

Wrth ystyried y cwestiwn hwn ar yr olwg gyntaf, credaf ei bod hi’n anodd neu’n amhosibl atal salwch meddwl rhag datblygu.  Roeddwn i’n credu hyn gan fod nifer o ymchwilwyr megis Kety (1983) yn credu bod cyflyrau meddyliol yn etifeddu o fewn teuluoedd.  Er hynny byddai’n rhaid i’r unigolyn fod wedi dioddef trawma seicolegol neu straen amgylcheddol er mwyn datblygu’r anhwylder.  Y rheswm yr oeddwn i yn credu ei bod yn anodd atal salwch meddwl yw am ei bod hi’n anodd rheoli cyflyrau genetig. (Sachdev, 2011)  Ydych chi’n credu ei bod hi’n bosibl atal cyflyrau meddyliol rhag datblygu?

Wedi darllen erthyglau ymhellach am y testun, rwy’n tueddu i anghytuno efo’r hyn oeddwn i yn ei gredu cyn hyn.  Ar y we fe ddarganfyddais lawer o wefannau a chanllawiau ar sut i atal y cyflyrau.  Un o’r gwefannau gorau oedd www.preventmentalillness.org oedd yn wefan wedi cael ei greu ar gyfer pobl ifanc er mwyn adnabod symptomau.  Hefyd mae’r World Health Organistation wedi cyhoeddi crynodeb am ‘Prevention of Mental Disorderes – Effective Interventions and Policy Options’.  Cyhoeddodd Domitrovich a Greenberg (2009) erthygl sy’n cynnwys 34 rhaglen wahanol er mwyn atal salwch meddwl yn cynnwys lleihau symptomau seicopathi a ffactorau risg ac mae pob rhaglen wedi arddangos canlyniadau positif.  Mae hyn yn cadarnhau ei bod hi’n bosibl atal cyflyrau.

Yn ôl Pan (2010), sydd wedi ymchwilio’n ddwfn i’r maes hwn, mae ymchwil diweddar yn dangos bod ychwanegiadau olew pysgod yn lleihau risg o ddatblygu seicosis a sgitsoffrenia ymysg pobl ifanc, yn ogystal ag atal iselder a cham-drin cyffuriau.   Yn bersonol, rwy’n credu bod hyn ychydig yn rhy uchelgeisiol ac nad yw’n cyfleu realiti ond ar y llaw arall mae’r ychwanegiadau hyn yn gryf mewn asidau omega-3 sy’n cael effaith cadarnhaol ar y corff cyfan yn ôl Simopoulus (1991) ac felly yn debygol o gael effaith cadarnhaol ar y meddwl hefyd.  Profodd Assisi et al (2006) hefyd bod yr ychwanegiadau hyn yn lleihau risg o Alzheimer’s, Sgitsoffrenia, iselder a gorfywiogrwydd.

Er hynny credaf nad yw’n hi’n bosibl atal salwch meddwl yn gyfan gwbl ond ei bod hi’n bosibl gwella’r salwch rhag datblygu ymhellach drwy ymyrraeth, newid ffordd o fyw, therapi a meddyginiaethau.

Assasi, A. (2006). Fish oil and mental health: the role of n-3 long-chain polyunsaturated fatty acids in cognitive development and neurological disorders. International Clinical Psychopharmacology, 21(6), 319-336.

Domitrovichg, C.E. & Greenberg, M.T. (2000). The Study of Implementation: Current Findings From Effective Programs that Prevent Mental Disorders in School-Aged Children. Journal of Educational and Psychological Consulation, 11(2), 193-221

Kety, S.S. (1983). Mental illness in the biological and adoptive relatives of schizophrenic adoptees : Findings relevant to genetic and environmental factors in etiology. The American Journal of Psychiatry, 140(6), 720-727.

Pan, C. (2010). GP’s view: Mental illness. Body + Soul

Simopoulos, A.P. (1991). Omega-3 fatty acids in health and disease and in growth and development. American Journal of Clinical Nutrition, 54, 438-463.